APMA News - June 2012 - (Page 31)

IT Consultant By James R. Christina, DPM Looking Beyond Incentive Payments Anyone who received the first incentive payment from Medicare for meaningful use of an Electronic Health Record (EHR) will probably tell you that the $18,000 incentive, while nice, did not come close to covering all the costs of implementing the EHR—both actual costs as well as lost productivity, staff time, and general angst within the office. Even if a practitioner achieves the maximum reimbursement of $44,000 over five years, this amount only helps to offset the costs of implementing an EHR program. The goals of the EHR program as enunciated by the Office of the National Coordinator (ONC) on Health Information Technology (HIT) and Medicare are: to improve quality, safety, and efficiency and reduce health disparities; to engage patients and families in their health care; to improve care coordination; to improve population and public health; and to maintain privacy and security. gest that not taking the patient’s height, weight, and blood pressure in your office during a visit is an opportunity missed. Obviously, your medical judgment will determine how frequently you update this information, but that initial entry into the patient’s EHR presents many opportunities. Some examples: The patient may balk and question why recording vital signs is necessary, giving you an opportunity to educate the patient that while you are providing care for the foot and ankle, it is important to be aware of his or her overall health because it may be important to the care you provide for his or her lower extremity conditions. Medications you prescribe potentially could affect the patient’s blood pressure, exercise, or rehabilitation programs. If the patient’s blood pressure is elevated significantly, you have the opportunity to interact with his or her primary care physician, potentially leading to a relationship with a new referral source at the least, and helping to prevent catastrophic events for the patient at the most. If the patient has an elevated BMI, you have the opportunity to discuss the possibility of developing diabetes and the devastating effect the disease can have on the lower extremities. There is the opportunity to discuss an exercise program for weight reduction or refer the patient to his or her primary care physician or a nutritionist—again, multiple opportunities to build your referral base and do what is best in caring for the patient. • • • • • • • These lofty goals are worth pursuing both in terms of improvements in the overall health of the population and reducing health-care costs. However, current EHRs have not made communication with patients and other health-care providers through Health Information Exchanges a reality. Despite the drawbacks of the current meaningful use requirements, they present opportunities for podiatrists to enhance our contributions to patients’ overall health care and position ourselves as valuable members of the health-care team. Let us examine one of those opportunities in greater detail. One of the core requirements of Stage 1 of meaningful use is to “record and chart changes in vital signs.” The technical requirement breaks down to: “[F]or more than 50 percent of all unique patients ages two and over seen by the eligible provider (EP) have height, weight, and blood pressure recorded as structured data.” Further explanation of the measure reveals that “height, weight, and blood pressure can get into the patient’s record by a number of ways. Some examples include entry by the EP, entry by someone on the EP’s staff, transfer of information electronically or otherwise from another provider or entered directly by the patient through a portal or other means.” In other words, you or members of your staff do not have to take the height, weight, and blood pressure yourself. Also, the height, weight, and blood pressure do not have to be updated at each subsequent visit. The EP can make the determination about whether to update these vital signs more often than once per reporting period based on the patient’s individual circumstances. I would sug- These are just a few examples of opportunities that something as simple as taking the patient’s height, weight, and blood pressure may present. One of the interesting findings in the Thomson Reuters study published in the Journal of the American Podiatric Medical Association was that for patients with diabetes who developed a foot ulceration, just one visit to a podiatrist in the year preceding the ulceration resulted in decreased hospitalizations. The interesting part of this finding was that hospitalizations decreased for all causes, not just those related to foot ulcerations, suggesting that podiatric physicians make an important contribution to overall health. All indicators are that preventive care will play a large role in health care in the future, and podiatric physicians can establish themselves as key members of the health-care team in the prevention effort. We just have to be able to recognize opportunities and not see them as encumbrances. n Contact Dr. Christina at jrchristina@apma.org. APMA News June 2012 31

Table of Contents for the Digital Edition of APMA News - June 2012

APMA News - June 2012
President’s Message
Contents
APMA Introduces REdRC
Legislative Scrapbook
APMA By the Decade
Profiles in Progress
2011 Podiatric Practice Survey
Reimbursement
Federal Advocacy Forum
List of Cosponsors to the Equity and Access for Podiatric Physicians Under Medicaid Act
APMAPAC Chair Report
IT Consultant
Website Wisdom
Technofile
Small Business 101
CPME Update
Pediatric Medical Assistans' Education Program
Annual Scientific Meeting Preliminary Program
Annual Scientific Meeting Sponsors
Annual Scientific Meeting Registration Form
APMA All Stars
In Short
Worthy of Note
Affiliates Corner
List of Affiliated Organizations
Insurance Advisor
New Members
Death Notices
APMAPAC Update
Development Update
Call for Third-party Comments
Classified Advertising
Dates to Remember
Advertising Index
Your APMA

APMA News - June 2012