Advicemedical

Electronic Medical Records Are There Reasons for Low Implementation?

Electronic medical records promise to make the future of healthcare brighter for patients and medical providers, yet across the board, its estimated only 10 to 15 percent of doctors even use them. If the promises of EMRs are so grand, why dont more healthcare professionals take advantage? While there are many reasons doctors have slowly adopted EMR technology, the top three are cost, data security and lack of uniform standards. This article will discuss these top objections to EMR implementation.

EMR Costs

Implementing an electronic medical record system can entail a significant upfront cost, especially if converting to a paperless medical office the first time. Its not surprising then the segment of doctors most resistant to electronic medical records are those with the smallest amount of income. Large practices, hospitals and insurance companies are adopting EMRs at twice the rate of small doctors since they realize the financial benefits and have the resources for fast implementation.

While there is a cost to EMR implementation, the financial benefits alone provide a strong return on investment even to the smallest practices. An article posted in the April, 2003 American Journal of Medicine examined the return on investment of EMRs for small practices and concluded the gains in productivity and decrease in denied or lost claims could gain an average practice 86,400 in a five year span. With an initial investment of 6,600 the return on investment is phenomenal! While larger healthcare providers need to spend larger sums for software, there are many EMRs and medical practice management programs available for small practices that fit into the 6600 cited by the study and even allow for computer and printer purchases.

EMR Security

Securing patient medical records is another big reason doctors are slow to convert to paperless medical offices. Many EMRs currently available utilize clientserver technologymeaning that software is permanently installed on a server located in the doctors office and accessed through the network. This type of software clearly places the responsibility of backups and patient records security on the medical office. Web-based EMRs shift that responsibility away from the doctor and onto the software company who
are better equipped to secure electronic patient records. Though vigilant hackers can break into just about any system, web-based EMRs reduce that risk significantly.

EMR Standardization

Perhaps the biggest complication to widespread use of electronic medical records is the lack of standardization. One of the catalysts to the creation of EMRs is the Health Insurance Portability and Accountability Act of 1996. Commonly known as HIPAA, this law promulgated the creation of electronic patient records, but failed to implement standards for them. To be fair, technology has changed quite a bit since 1996 and Congress doesnt own a crystal ball. Even Yahoos website looked quite a bit different ten years ago.

There is no real explanation why the components of modern electronic medical records havent been standardized. In fact, the name hasnt even been settled on!

Electronic medical records have many AKAs including:

PMRI – Patient Medical Record Information – US
ICRS Integrated Care Record Services – UK
CMR Computerized Medical Record US, International
CPR Computer-based Patient Record – US, International
PCR Patient-carried Patient Record – Germany
PHR Personal Health Record – International
EMR Electronic Medical Record – US
DMR Digital Medical Record – Asia
EPR Electronic Patient Record
EHR Electronic Health Record
LHII Local Health Information Infrastructure – US
CCR Continuity of Care Record

With a substantial upfront cost, both of money and training, the fear of having to change EMR systems due to government regulation is certainly reasonable.

EMR Implementation Summary

Doctors may soon have little choice but to implement computerized medical billing and patient record systems. HIPAAs scope recently expanded to health care providers with less than 5 million in revenue. Insurance companies and other payers are increasingly requiring electronic filing. Even patients recognize the value of electronic medical records with a 2005 survey stating patients strongly believed widespread use of EMRs would decrease wait time, paperwork and reduce visit costs. Lets hope small practice
physicians take note.

References:
http:www.acgroup.orgimages2005_ACG_Mid-Year_White_Paper_-_EMR_Marketplace.pdf
http:square.umin.ac.jpDMIESemiy200420040913_2.pdf
http:www.healthcareitnews.comstory.cms?id=3355

Medical Review Companies Role in Your Insurance Claims – Your Health, Your Coverage, Your Guarantee

A medical review company supplies more than a second opinion. The unbiased nature of a medical review company is critical not only to the bottom pound, but to the final result. Too often, patients think they are just numbers in a file or bits of information in a computer program. The maligned image of an insurance companys automatic denial of claims without really understanding the patients need contributes consumer dissatisfaction and frustration.

What Does It Have to Do With You?

Patients are people and when they need healthcare, they dont want to read the fine print or a medical dictionary, they just want their claims covered. Most often, its unlikely they would realize that their insurance claim went through an Insurance Review Organizations medical insurance review process. In fact, they probably just fill out the forms, hand a receptionist their insurance card and sign on the necessary release forms.

One of the most common complaints about needing healthcare is the cost followed closely by the complications of paperwork generated through authorization forms, claim forms and more. An insurance review organization is an intermediary company that insurance companies may outsource their claims to in order to determine with medical and insurance coverage accuracy the validity of a claim filed by someone insured by their company.

Your Health Matters

Insurance companies who deny a claim are often portrayed as heartless or more interested in the bottom pound than they are about showing compassion. This perception is only augmented when an insurance company rejects a claim for anecdotal evidence. When a claim goes through a medical review companys insurance review process it will not be rejected or denied based on anecdotal evidence.

For example, a patient suffers from shoulder, back and neck pain as well as bra strap grooving and eczema. Her medical history indicates years of chiropractic treatment as well as advice for non-steroidal anti-inflammatory drugs (i.e. Tylenol, Advil) and worn specialized support bras to support a 34DD frame and all of it to no success. Excessively large breasts can cause many of the symptoms the womans medical history indicated.

The doctor recommended a breast reduction procedure to alleviate the problem and the symptoms.

Your Coverage Matters

When the claim is submitted to the insurance company, the policy may not cover elective cosmetic procedures. Many policies do not. Claim managers lacking medical expertise will often compare a procedure request against a list of approved procedures. If cosmetic procedures are not covered, it is likely the claim will be denied. The patient is left either choosing to pay for the procedure out of pocket or continuing to suffer.

If the claim is submitted to a third party intermediary such as a medical review company, the answer will be different. The medical review company has access to a large number of medical specialist and insurance experts. The medical specialists will review the patients medical history and the doctors recommendations. When her file is reviewed, the third-party specialist will take into account the history of shoulder, neck and back pain. They will note the visits to a chiropractor and other pertinent symptoms.

If the medical specialist agrees with the patients physician that she is suffering from Macromastia (excessively large breasts), then he or she will understand that the cosmetic surgery of breast reduction provides the patient with the best option for the patients relief.

Confidence Matters

The review process may be transparent to patients whose insurance company uses a medical review company; but the effect is profound. Their coverage premiums will likely be lower. Their medical needs will be addressed. They will not see their healthcare costs rise due to the underwriting of unnecessary procedures. When it comes right down to it, a medical review company gives patients confidence that both their medical and insurance needs will be met. They wont have to suffer misery unnecessarily nor face collections over mounting debt.

If you want to get a good deal on your medical insurance, there are a couple of things you should consider doing. Some of them are optional and some of them are absolutely vital and cannot be passed by.

The first is to shop around. You really cannot get a good deal on medical insurance unless you are prepared to shop around and search the market. Finding out what is available on the market really is the only way you can know if any particular offer is good or not and whether or not you should accept it. By getting to know what kind of offers are out there, you will know what you should be expecting to pay for what kind of benefits and are far less likely to get ripped off by making an uninformed decision on which medical insurance to buy.

You should also consider speaking to an insurance broker. These will be able to advise you on the plans offered by a wide range of insurers and let you know what kind of offers are available. Therefore, they can save you a lot of the legwork of shopping around since they have access to an array of insurance companies. They will also have access to preferential rates and deals since they can bargain with companies and use their knowledge of the industry to get good deals. They can then pass these savings on to you in some form or another.

However, even if you are going through a broker, you cannot forgo shopping around and informing yourself properly of what is on the market. This is because you will not be sure if the offer the broker is giving you is any better than that of other brokers or even of prices you can find your self.

Shopping online is another good idea. The Internet gives you access to virtually all the insurers in the market. They are right there at your fingertips and can often give you instant quotes right there on the website. This means that you can do a lot of shopping around and get a good idea of what is on the market just be going on line and visiting their websites.

Medical insurance is a very important purchase for you and your family. It can determine the level of health care and service you will have access to in the case of an accident or serious illness and also represents a significant cost to you when you pay your premiums. Therefore you should always shop the market and make sure you are getting as good a deal as possible before you commit to any one policy.