Has anyone else heard anything about The Cures Act. I do know I am not really big on my standalone billing software company trying to push their EMR on me. Certainly, the data transfer would be easier but still. While a patient portal is a good idea, it is soon going to be mandatory.
This means that those who do not have a full practice management program, i.e. use Medisoft (if that is still a think) or Medware, you have to switch. And, something like mandatory patient portals, etc.
Bert I also got one of those letters. It came FedEx to make it look really special. I have always believed that electronic medical records would eventually strangle the practice of medicine, and here we are. I now have approximately five months left to practice medicine before I retire, and I'm unlikely to respond favorably to one of these blatant attempts to extort. Noted also that Greenway appears to have increased the price of "support" by 30% without actually doing anything to improve the product.
We have used MEDWARE successfully since about 1996, and I am sure it is not in compliance with rules that keep changing, especially since it's basically a DOS program with some early Windows overlays.
I am inclined to ignore all of this including the Amazing Charts database upgrade which I'm afraid to try based on some of the responses in this forum. Some of the more inflammatory language in the regulatory language from HIPAA suggest that we could be hit with $50,000 penalties or even jail time.
When I was a young and carefree country doctor in 1975 I thought the world around me was crazy. It seems only to have become worse--the only saving grace is that so far nobody has started a nuclear war
I started a thread back in December about Pt Portal. The reason I started it was because of the Cares Act and the fact that we have to have a pt portal. I thought it was just Medicare requiring the portal but not sure. I still have not implemented the portal for pts.
Interesting I think I have only had a couple of pt's ask about it. I also have pts tell me the hospital has a portal but " I can't figure out how to use it". The easiest and most used seems to be from the local labs. Pt's can get results and we can discuss even if the lab was ordered by someone else in town.
I do not use Medware. We use AC and Harris Caretracker is our billing software.
Is Harris.... integrated with AC? Was it Cares (which would make sense) or CURES act. We hate it when we get messages wondering why the creatinine in a two-year-old was low at 0.35.
Harris is not 100% integrated with AC but my in office biller says it is much easier than when we were using Kareo for our billing.
Caretracker has a PM portion where the staff will schedule pts and then this comes over to AC but if you schedule in AC it does not go into Caretracker. When a chart is signed off in AC the billing codes automatically go to Caretracker. She also checks my codes in the computer against a paper check in sheet that I jot down notes on. So we don't miss things like in office tests I forget to code.
She also says that insurance information, when corrected in Caretracker does not cross to AC the same. If she deletes an insurance in Caretracker then it is not deleted in AC, she has to go into AC to delete. If she adds an insurance in Caretracker then it also adds it to AC.
We also have issues with names being different and in Caretracker than in AC. If there is the slightest thing off in Caretracker or for some reason a name changes in Caretracker then a new chart in AC is automatically made. I have had to merge several charts together due to this problem.
Sounds fun. I would just ask her to read the pdf document attached. Out of spite, I wouldn't want to purchase Intergy from Medware just because it is their standalone program. Everything works fine and now, of course, the government has to screw it up.
If a patient has a portal and can look up their own labs, there should be a caveat stating that they should purchase a Harriett-Lane for lab results for children and Google all others. I know that some offices tend more than others to have patients come in to go over labwork, but that seems like a good idea when patients call in wondering about a creatinine of 0.30. Or send them to Google.
I am also inclined to skip the Medware BS unless it becomes mandatory and then I would likely switch to an online EMR that includes everything. It's always interesting because when an online EMR has its different pricing part of it is PM (offset by the ridiculously new support cost of dropping Medware) and free reminder texts, which we pay $75 per month. If you divide the payment for the support I NEVER use for the simple program Medware and add it to the $75.00, your discount practically makes the new EMR cost nearly nothing.
I know once when I was a bit disenchanted with AC, I was looking at SEVERAL EMRs. I mean at least 10 seriously over at least a month. Intergy certainly wasn't in that mix. It's not like, "Oh, cool, Intergy was my number two choice.
We used Medware for billing and scheduling and AC for just the overall clinical things but not scheduling or PM. Everyone who came to work here in the beginning was very familiar with Medware and scheduling.
The CURES act says that we have to be able to "promptly" share patients medical information with them upon request. AC has a portal. We use Updox (same portal though I am not sure exactly how those of you without Updox integrate with the portal). If a patient requests their results, the CURES act says we must promptly provide it to them electronically. When a patient makes such a request, we send it to them in the portal.
Right. CURES act doesn't say open chart is required. It says we must respond to record request promptly and in the format the patient wants. If the patient wants it through a portal, we have to provide it that way. I believe there are exceptions for "within reason" or something like that. And the promptly means - some organizations would hold medical records request for X days as a policy - that's not allowed.
Serene Office Manager General Pediatrics Houston, Texas
We will fax them to another office. We will send a CD to another office. We can print paper for a patient if they really want it that way. Typically we put it on CD or flash drive. They are entitled to a COPY of their records. But, we ain't gonna send them through a portal that we don't have just because they demand it that way.
Sometimes we will send records via regular email if the patient is an inactive patient (so portal will not work) or an adult patient who just needs the meningococcal vaccine record for college. I get them to sign a form that basically says it's ok for us to send an email w/o that password protection and warns of possible breaches, etc.
Last edited by serene; 07/01/202211:19 AM.
Serene Office Manager General Pediatrics Houston, Texas
Cures Act is much bigger than just patients asking for their information. The ONC has defined a new data format how clinical information is to be shared. The goal is to have one single universal format so we all speak the same language. I'll outline a typical use case you could experience ..If you think about it you'll see there are many holes that ONC has not considered as part of the equation and what I list is only the tip of the iceburg.
-Patient subscribes to a mobile application (i.e BlueButton) which offers the ability to access all of their medical information (Portal data) across multiple providers so they don't have to log into 3 different portals.
- Patient calls your practice and asks you to send their information to BlueButton. This is real time, all the time, for every service you enter for this patient.
- The Practice will access a new data sharing application provided within the EHR and registers patient for data sharing with BlueButton.
- This new application will provide the patients credentials (username and password) they need to enter in BlueButton so BB can pull their data down the the BB servers
- All clinical data, and all future services, for this patient will be sent to a central data sharing server we host that manages requests from Bluebutton and all the other 3rd parties. . They do not retrieve data from your server. We will send the data from your server to our Master Data sharing server that manages all these requests from 3rd parties.
- Patient also calls their other providers and requests the same access for BB
- BlueButton retrieves patient data from our shared server, and also retrieves the data from the patients' other EHR practices, and presents it to the patient in aggregate..
Just think about this for a moment...There are so many unknowns at this point. The one thing that is certain is we must have this completed, certified by the ONC and installed at all practices who participate in MIPS by the end of this year. Now, no one may ever call your practice and ask for this. Or maybe they start calling next year. Can you say you don't want to play? There's no clear cut answer on that either. Is it information blocking since you can provide the patient with their information in a variety of other forms. There's no clear cut answer on that either..But what I describe above is the objective for CURES..the end game is to provide the patient with complete clinical data access to "an application of their choosing" and create a robust competitive marketplace that will foster the development of new applications
Of course there is a cost to the practice for this which is unknown at this point in time. We'll have more information available as we get closer to release later this year.
Thank you! This was the answer I was looking for, i.e. The Cures Act is going to make for a lot more time and money to providers. Your answer begs the question. Is this just for those who do MIPS?
Agreed...let's assume it does become popular ...you could have hundreds of patients all calling asking for you to make their data accessible to possibly many dozens+ of different apps they find on the market. Your front desk has to manage this. And office staff has to manage the phone calls from the patients when they don't see data they expect on this new app. They'll probably call the app Blue Button support first but they'll refer the patient to the physician's office.
Now you take calls today from patients with questions about their patient portal but this will be more complicated....the office will not have familiarity with these apps...
Personally, i don't see this being a big issue for years, if it ever even takes off at all. But we have to build it nonetheless....
This is all so disheartening to me. Nowhere in any of this discussion is the fact that insurance companies and the government limit what we can charge, and that limiting charges supposedly builds in overhead costs. Overhead costs -- at least in Medicare -- include things like rent and heat and lights, but also bandages, dressing material, office help, and IT costs. The "overhead" formulas were determined before any of us had computers, and there has never been (at least not to me) ant adjustment for the cost of EHR's. Increasing costs can not be passed on to the payers, and as a result, our only surivial tactic is to see more patients per day -- degrading the quality of care.
I do not believe that ANYONE can make the claim that EHR's have increased eiher the quality or availability of medical care, or reduced its cost.
In the beginning, AC was a very cost effective way to explore and develop EHR's, and the early versions were promising. As they got loaded down with more bells and whlstles, and became tools of the administrative class, not the medical professional class, they became sluggish, burdensom and expensive. There is no way that AC can compete with the monster corporate EHR's like EPIC, and so the destruction of independent practice willl be complete.
I am sad to be leaving all my patients and going out to pasture -- but at the same time, it will be a great relief.
People always talk about paperwork and there was a time that paperwork sucked but seemed part of the job. Now it is just overwhelming. Personally, I don't give a f...k about HIPAA and I just try to do what little I can to keep my data safe.
I love patient portals so that patient can call me and ask me why the creatinine is 0.25 in a one-year-old. I just tell them it would be helpful that knowing their child better than I can they come up with a differential based on the labs. You can see them before me, you can call me and waste my time (yes I would call them in good time when it is convenient to read them and ask my staff to call), so go ahead an interpret them.
The only thing I don't understand is when some will say "see another patient." We just don't have that luxury. We rarely turn them away and more rarely not have a space to see another patient, so I can't make an another patient to see. Trust me, I wish I could so I don't have to be forced to have my MAs apply varnish to the teeth at every well child on every kid. We aren't dentists. And, they don't pay dentists enough to see these kids. But, of the 25 things we are supposed to strive for, the varnish is a must and if you don't do it, you lose $3500 a month.
Was at the bar last night and struck up a conversation with a nice woman. What do I do? I push paper all day. No, I told her. What do you do? I am a customer service manager for Athena Health. That made it an interesting conversation.
I guess there are practices that use Athena Health, but every time I have looked into it (they often have booths at medical meetings) they are extremely cagey about how much it costs. But what I can estimate is that it is very expensive and I don't see how any primary care practice (that followed the rules anyway) could afford it.
Yeah, the reason all of the bigger companies who charge by subscription seem to be affordable is it allows us to not pay for support to Medware and not pay for reminder texts. That always brings the subscription down by over $150 dollars. And, she was pretty cute so I would have service right here in town, lol. I still like Charm EMR and you can't beat the lifelong trial.
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