APMA News - February 2013 - (Page 38)
By James R. Christina, DPM
Doing Your EHR Homework
For many practitioners, the decision regarding electronic
health records (EHR) is really a two-fold process. The first
question is whether to proceed with an EHR in your practice.
The second is how to select the EHR that is right for you.
The decision to adopt EHR is based on a multitude of factors. For those who want to take advantage of CMS incentives,
purchasing a certified EHR and meeting the requirements for
meaningful use for the first time in 2013 will mean that you
have the potential to receive up to $39,000 in incentive payments over a four-year period. (Those who began in 2011 or
2012 have the potential to earn up to $44,000 over five years.)
Some will feel the pressure to adopt an EHR and use it in
a meaningful way to avoid the CMS payment reductions that
start in 2015. The penalty will start as either a 1-percent or
2-percent reduction (depending on whether you were also a
successful e-prescriber). Failing to meet the meaningful use
requirements will mean that the penalties will max out at a
5-percent reduction in Medicare payments.
At this point, all requirements related to EHRs and meaningful use relate to the CMS program, not commercial insurance. It is unknown if other insurance carriers will begin to
require EHR use. Another consideration may be how much
longer a podiatrist will continue to practice and if having an
EHR makes his or her practice easier to sell. Other issues to
be considered include current Medicare patient volume (i.e.,
how much the penalties will affect your income); whether an
EHR will be necessary to remain competitive and transmit
medical information to referring physicians; and how it will
affect your entire practice—your charting method, your office staff, and your patient ﬂow.
If you decide to proceed with a certified EHR and attempt
to recoup some incentive payments from CMS, then you face
the second decision: selecting an EHR for your practice. You
can start with the basic considerations. The first may be
cloud-based versus server-based.
Cloud-based EHR involves a website you log in to and
then begin the EHR process. It requires an Internet connection, but less capital investment—you do not need to purchase hardware, such as a server, and your EHR vendor backs
up and stores the information. It also means you need to have
some mechanism to access your patient information if you end
your relationship with your vendor. Being cloud-based also
means that you must be confident in the security measures
employed by the vendor to protect your patient information.
Your contract with the vendor should spell out these two issues: your access to stored patient information and security.
A server-based system requires that you purchase a server,
and the software from the vendor will be installed on the
38 APMA News February 2013
server in your office. This approach can mean more upfront
costs, and storage and security are squarely your responsibility. You must take the proper precautions (just as you do
now) to make sure you protect patient information properly.
Many podiatrists like the idea of having all their patient information stored on their own servers, but remember that you
must back up the data regularly to make sure it is protected
in case of disasters such as ﬂoods or fires. Some server-based
programs may offer cloud-based data back-up.
With a cloud-based system, updates to the software may
be easier, as they are done in the background and are ready
when you log in. On a server-based system, updates must be
loaded onto your system. Be sure to examine both options
and make the choice that you are most comfortable with and
that fits your budget.
Another basic consideration is the type of EHR vendor to
choose. A large vendor provides service for many different
types of providers. A smaller vendor may be more podiatryspecific. This choice may be inﬂuenced by the vendor that
your hospital uses, or a vendor commonly used by many providers in your community. Podiatry-specific vendors may be
more in tune with your charting needs, offering templates for
common problems, while large vendors may require more
work on your part to develop your own templates—but be
aware you will probably have to customize templates to meet
the specifics of your charting preferences no matter which type
of vendor you select.
The final important consideration in selecting an EHR is
that CMS meaningful use requirements dictate that all vendors must meet Office of the National Coordinator (ONC)
2014 certification requirements. Even a vendor that is currently ONC-certified will need to go through the process of
getting 2014 ONC certification to meet CMS requirements for
2014 and beyond. If you are purchasing an EHR in 2013, be
sure your contract includes language that addresses the need
for ONC 2014 certification and whether it will mean increased costs to you. Many of these requirements are related
to Stage 2 of meaningful use; however, whether you are attesting in Stage 1 or Stage 2 in 2014 and beyond, you must be
using an ONC 2014 certified EHR.
The EHR choice is difficult, personal, and complex, so be
sure to do your homework before making this important
Contact Dr. Christina at firstname.lastname@example.org.
Table of Contents for the Digital Edition of APMA News - February 2013
APMA News - February 2013
Table of Contents
Keeping Boots on the Ground: Podiatric Physicians in the Military
Catch Comedian Tom Cotter at The National Opening Session
Annual Meeting Sponsors
State Advocacy in Focus: Sowing Grassroots Advocacy
APMA Staff Celebrates 100th Anniversary with Time Capsule
Social Media 101: Strategies for Today’s Podiatrist
2012 Podiatric Practice Survey: Year of Graduation from Podiatric Medical College by Practice Arrangement Type
Federal Advocacy Forum
APMAPAC Chair Report
Small Business 101
Seeking Award Nominations
Call for Abstracts
Worthy of Note
Call for Abstracts
List of Affi liated Organizations
Classifi ed Advertising
Dates to Remember
2013 Annual Scientific Meeting Preliminary Program
APMA News - February 2013