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Friday, February 6, 2015

Transition of Care documents: Easing the burden

In a recent HITECH Answers post, Meaningful Use expert Jim Tate draws attention to the major stumbling block presented by “Transition of Care” (TOC) requirements.

In Stage 2 of Meaningful Use, TOCs became a core requirement. Meeting the measure requires that an eligible hospital/CAH or eligible professional “who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care” produce a summary care document for each transition or referral.

To that end, EHs (Core Measure #12) and EPs (Core Measure #15)  each have three measure thresholds which they must meet:
  • Summary of care record for > 50 percent of transitions and referrals.
  • Summary of care record for > 10 percent of transitions and referrals by one of two methods
  • Choose one of two criteria: (1) Conduct at a least one successful electronic exchange of TOC; or (2) Conducts at least one successful test with the CMS designated test EHR during reporting period

As Tate writes, EHs in particular see meeting these measures as the major obstacle in achieving Meaningful Use.

Transition of Care, while challenging to incorporate into existing workflows, need not be the "real killer" in MU2. For a Hospital on 2014 Certified Software, sending a TOC CCDA to another physician should be as easy as a few clicks.

Ideally, EMR Systems can capitalize on the ease of the
DIRECT standard, making the movement of TOC documents between physicians to be as fluid as e-mail.  Partnering with an Accredited HISP such as MaxMD makes DIRECT practical for most any workflow.

MaxMD’s SendAnywhere offers functionality similar to that of a web mail portal:
  • TOCs – and other confidential health information – can be sent any email address on the web
  • Direct mdEmail users can communicate securely beyond their network
  • Recipients who may not be “Direct-enabled” can still view/download TOC documents
ConnectEHR allows Direct Send to run in the background and broker exchanges of critical healthcare information. So there’s no need for trepidation about navigating the waters outside your EMR.


Wednesday, January 21, 2015

What We Learned at FHIR Connect-a-thon 8

Coding away at the FHIR Connect-a-thon

Dynamic Health IT was on the scene at FHIR Connectathon 8 in San Antonio. Over two days of furious coding and interfacing, we gained new insight into FHIR’s potential to transform the management and exchange of health information. The event’s overflow crowd was proof of the health IT world’s growing enthusiasm about the standard.

The Connectathon explored three themes/tracks:
  • basic patient management
  • patient access to data
  • “experimental” implementations
On the first day, attendees developed and tested code, while the second day was reserved for more formal testing and a show-and-tell session from developers. In contrast to “hackathons” and other coding meet-ups, participants were not in direct competition, but rather there to support each other in the experimentation process and share development tricks.

The event hosted a diverse set of participants – hospital systems, insurers, researchers, developers large and small.  There was also diversity in FHIR implementations. Most users are currently approaching FHIR as an interface, but some are looking to FHIR as the “source of truth” for the data they handle.

The latter – a more ambitious implementation – involves using FHIR as a hub for retrieving patient information. For example, FHIR was being used by one Connectathon participant to broker information between OpenEMR and providers. A FHIR server becomes the switching station for exchanging information between facilities.  A primary care office submits data to the FHIR server on OpenEMR. The  patient arrives at another facility, which then connects to same FHIR server for continuity.

EHR vendors such as Epic have opened up new pathways to integration through  support for FHIR. Epic has outlined its plan for open exchange of data through open.epic (http://open.epic.com). McKesson also shared with the group their work in building complex medication regimens through FHIR.

Applications are not confined to conventional patient care. One of the virtues of FHIR is that it is extensible and can be applied to a potentially limitless range of possible data. For instance, Vanderbilt University is using it in genome research, adding genetic sequence resources to FHIR and querying a large number of patients.

While healthy competition fuels our industry, when it comes to something as ambitious as the push for true interoperability, we’re in this together.

Monday, January 12, 2015

Ozlem Kurt celebrates five years with Dynamic Health IT!

Dynamic Health IT would like to congratulate Ozlem on making five years with the company on December 23rd!

Ozlem has been a true asset to our company since she joined us. In those five years, she has contributed skill, time, ideas, energy, and loyalty. We’ve noticed and appreciated all these contributions on our behalf!






We love having Ozlem on our team.  She has a phenomenal work ethic and can tackle pretty much any technical problem.  As if that weren’t enough, she also has a great personality and positive outlook!  Congrats to Ozlem on her 5 year anniversary (time flies!)
-- Jeff Robbins

Ozlem, this has been a truly wonderful 5 years, working alongside you, and getting to know you as a co-worker and as a friend. Your programming skills and work ethic are tremendous, and your other talents, such as the ability to explain and teach, are so appreciated.  As a person, I've never met anyone in my life, who is more honest, sincere and kind.  I consider myself so lucky that you joined our team here.
-- Connie Zimmermann

Ozlem you are an incredible coworker and friend. I have learned so much from you over the years and look forward to many more years of brainstorming, problem solving and creative development that is a must in this Dynamic Health IT World. 
-- Raychelle Fernandez

Congratulations on your 5 years with DHIT! Ozlem has an amazing ability to focus on the task at hand and solve any problem that arises. She is a great colleague and I look forward to working on many more projects with her and sharing office adventures.
-- Maria Ruiz

It’s a pleasure working with Ozlem. While her enthusiasm is infectious she brings loads of knowledge, dedication and loyalty to DHIT.  Ozlem is a main catalyst to our team! Congrats!
-- Beth Lanier

Ozlem's ability to solve problems in the face of difficult situations is always a welcome relief. As an added bonus her friendly nature and positive attitude makes her a joy to work with. We are so lucky to have Ozlem on our team.
-- Matthew Dugal

Ozlem’s experience and enthusiasm have made her a pleasure to work with.  She has genuinely helped me several times over in understanding our problem domain and our approach to solving it.  Whether brainstorming or getting into technical details of a particular solution, Ozlem has been an incredibly valuable resource and an indispensable member of this team.
-- Nathan Pennington

Ozlem is a very kind- hearted person, she always has a smile on her face and such a hard worker!
-- Erica Shepherd

It's not hard for me to think of positive things to say about Ozlem. Ozlem is a good teacher. She patiently listens to beginner-level questions and can explain technically complex concepts.  I can always count on Ozlem to have the answers. She knows our products and clients inside and out.  She maintains an upbeat and easy-going attitude, with a friendly word when it’s most needed.  And... She’s the biggest Pelicans fan I know!!
-- Josh Shreve

Congrats on five years Ozlem!  It is a pleasure working with you!!
-- Amanda Mitternight


Thanks again Ozlem for your hard work and dedication to Dynamic Health IT!

Friday, January 2, 2015

Podcasting at the Gulf Coast HIMSS Conference

The Gulf Coast HIMSS Chapters 2014 Conference took place December 4-5 here in New Orleans. Health IT professionals and thought leaders from the three Gulf Coast states (Louisiana, Mississippi, Alabama) flocked to the Astor Crowne Plaza Hotel and packed a lot into those two days.

Dynamic Health IT was proud to be a conference sponsor – and it certainly didn’t hurt that it all took place just down Canal Street from our offices.

During the conference, DHIT President Jeff Robbins sat down to record a podcast episode with Intrepid Healthcare. You can listen to the episode here. Jeff spoke with hosts Joe Lavelle and Todd Scnick about a range of topics:
  •  Jeff’s 30-year experience in healthcare IT and Dynamic Health IT’s origins in HL7 interface support and Cloverleaf integration
  • How DHIT found HL7 Connect by Kestral, its ease of use and DHIT’s emergence as the software’s exclusive North American provider
  • Branching out into Meaningful Use (MU) certification and software development by helping vendors become certified under MU Stage 1 and Stage 2
  • Working with a diverse portfolio of clients
  • Pulling off aggressive implementation timelines, including deploying DHIT’s patient portal in less than a week
  • Outlook for the future of health IT and interoperability, including the promise of the Fast Health Integration Resources (FHIR) project
  •  Developing a flexible, streamlined patient portal and working toward the ideal of a globally-accessible record
Jeff had a great time chatting with Joe and Todd at GC3. Stay tuned for more media from Dynamic Health IT.

Friday, June 27, 2014

Maria Ruiz celebrates five years with Dynamic Health IT!

Dynamic Health IT would like to congratulate Maria on making five years with the company on June 29th!

Maria has been a true asset to our company since she joined us. In those five years, she has contributed skill, time, ideas, energy, and loyalty. We’ve noticed and appreciated all these contributions on our behalf!






Congrats on your 5 years of service with DHIT!  You’ve grown a lot during your time here and accomplished a lot.  Master of invoicing and ICD Pointer Table uploads are two that come to mind.  Also, I appreciate your new skills with web development!  I’m excited that you are finishing your Computer Science degree and look forward to you continuing your career development with DHIT. 
-- Jeff Robbins

I remember a brilliant young math genius, who simply needed a part time job while finishing college.  Fast forward five years, and  we have not only a graduate, but now a budding programmer working on a second degree and so knowledgeable now about healthcare IT!  I've enjoyed spending these years with you and not only watching your development, but also benefiting from your hard work.  I can't wait to have you on the team programming VBScripts for HL7Connect projects!!  I've very excited about that.
 -- Connie Zimmermann

What a journey! You have come a long way. I am looking forward to seeing you continue to soak in the knowledge and grow with DHIT! It's been amazing to see your palette of talents develop, from office administration to graphic and web design, ICD-9/10 and trademarking.  Next on the horizon... programming!
-- Raychelle Fernandez

It is a pleasure to work with Maria. She is a great asset to DHIT. Happy 5 years! 
-- Ozlem Kurt

Maria – It has been great working with you over the past three years!  You are a fantastic resource to DHIT and a wonderful roomie!  :)
-- Renee Martin 

No challenge is too great for this young crusader! Maria’s quiet but unrelenting work ethic is to be commended. I know working through school and a full time job will pay off for both you and DHIT! You’ve been an inspirational teacher to me and I enjoy working with you. Congratulations on 5 years of flourishing and best wishes for many more!
-- Beth Lanier

Maria’s resourceful problem solving abilities and diligence mixed with a pleasant personality make her an ideal employee and coworker. I am impressed and eager to watch her abilities grow over time.
-- Matthew Dugal

Maria is an awesome member of the DHIT team and it is such a pleasure to work with her. I learned many things from her and hope to keep learning from her in the future. Congratulations on making 5 years Maria!!!
-- Katelyn Borden

Thank you Maria for always driving me around when I didn't have a car and thanks for helping me at the office!
-- Luke Robbins


Thanks again Maria for your hard work and dedication to Dynamic Health IT!

Tuesday, June 17, 2014

.NET/SQL Healthcare Software Developer (New Orleans)


 
Small, fast-growing dynamic local healthcare information technology company is looking for a New Orleans area individual with software development and programming expertise. Must be customer service oriented self-starter.

Required skills/experience:
- Database experience, including MS SQL Server. Ability to write Stored Procedures.
- Experience with web development and ASPX
- Knowledge/experience with software implementation/programming, including VB and/or .NET

Other desirable skills/experience:
- Experience with hospital/Healthcare application software
- Familiarity with XML
- Expertise with HL7
- Project management skills
- Experience with healthcare applications/workflow

Must be available to work here in the office. Excellent compensation. Flexible hours, good benefits, casual friendly work environment. Great location on street car line in uptown New Orleans
==> Excellent compensation + Benefits
==> Will pay $ for referrals!!!

Thursday, June 12, 2014

Would a hardship exemption save you?


Are you doing everything you can to avoid the upcoming Medicare payment adjustment for the 2015 reporting year?
Payment adjustments for the Medicare EHR Incentive Program will begin on January 1, 2015 for eligible professionals.
All you need to do is complete the hardship exception application and supporting documentation that proves demonstrating meaningful use would be a significant hardship for you.
Applications for the 2015 payment adjustments are due July 1, 2014 for eligible professionals. If approved, the exception is valid for one year.
This applies to you if you are a Medicare provider who was unable to successfully demonstrate meaningful use for 2013.
CMS has posted hardship exception applications on the EHR website for:




You can also avoid payment adjustments by successfully demonstrating meaningful use prior to the payment adjustment.
Dynamic Health IT has solutions for Stage 2 MU & ONC Certification headaches.
 
 

 

Thursday, April 24, 2014

EP Meaningful Use Payment Adjustments and Hardship Exception

As the reporting period start date deadlines are drawing near for Eligible Professionals (EP), and vendors are still working to get their EHR's certified and rolled out to their customers, a big question on everyone's mind is 'what happens if I can't attest in 2014?'. Eligible Professionals must begin their 90-day reporting period by October 1, 2014 in order to attest in 2014. So what options do EP's have if they can't meet these deadlines?

First, let's look at who Payment Adjustments affect and when these adjustments begin. The adjustments will affect Medicare EP's as well as EP's that bill Medicare and can participate in either the Medicare or Medicaid EHR Incentive Programs. The only individuals who are not affected are Medicaid EP's who can only participate in the Medicaid EHR Incentive Program and do not bill Medicare. If you are eligible for both the Medicare and Medicaid programs, you must demonstrate meaningful use in order to avoid the payment adjustment - receiving a payment for adopt/implement/upgrade (AIU) under the Medicaid EHR program does not make you exempt from payment adjustments.

Adjustments will be applied at the beginning of the 2015 calendar year for EP's (January 1, 2015). For EP's, the Adjustment starts at 1% and increases by 1% for every year that an EP is not meaningful user with a maximum adjustment of 5%. EP's must continue to demonstrate meaningful use every year to avoid payment adjustments in subsequent years.

So, how does CMS determine who the 2015 adjustments apply to? In order to avoid the adjustments, EP's must demonstrate MU prior to 2015 calendar year. This means they have either attested to MU successfully in the 2013 reporting year or the 2014 reporting year.

What if your vendor does not deliver software to you in time to attest in 2014? In this case you can apply for a Hardship Exception based on the reason of '2014 Vendor Issues'.

If you are an EP planning to attest for the first time in 2014 (new participant) and your vendor will not meet the deadline for you to attest in 2014, you can apply for a hardship exception for the 2015 payment adjustment.  You must attest by October 1, 2014 to receive incentives and avoid 2015 penalties. If you cannot attest by October 1, 2014, EP's should apply for the hardship to avoid 2015 penalties.  To apply, use the eligible professional hardship exception form for 2015. These forms must be submitted to CMS by July 1, 2014.

EP Hardship Exception Form

If you are an EP who attested to MU in the 2013 reporting year, you will not be subjected to the 2015 payment adjustment. But if your vendor is not able to deliver a 2014 certified solution before the attestation deadline, you can apply for a hardship exception for the 2016 payment adjustment. To apply, use the eligible professional hardship exception for 2016 which will be available after July 1, 2014. These forms must be submitted to CMS by July 1, 2015.



Contact Dynamic Health IT if you have questions about Meaningful Use or if you need assistance with your 2014 Edition Certification at 504-309-9103.

EH Meaningful Use Payment Adjustments and Hardship Exception


As the reporting period start date deadlines are drawing near for Eligible Hospitals (EH), and vendors are still working to get their EHR's certified and rolled out to their customers, a big question on everyone's minds is 'what happens if I can't attest in 2014?'. Eligible Hospitals must start their 90-day reporting period by July 1, 2014 in order to attest in 2014, so what options do EH's have if they can't meet this deadline?

First, let's look at who Payment Adjustments affect and when these adjustments begin. The adjustments will affect Medicare EH's as well as EH's that bill Medicare and can participate in either the Medicare or Medicaid EHR Incentive Programs. If you are eligible for both the Medicare and Medicaid programs, you must demonstrate meaningful use in order to avoid the payment adjustment - receiving a payment for adopt/implement/upgrade (AIU) under the Medicaid EHR program does not make you exempt from payment adjustments.

Adjustments will be applied at the beginning of the 2015 fiscal year for EH's (October 1, 2014). Hospital adjustments are based on the Inpatient Prospective Payment System (IPPS) - to read more about EH adjustments, visit the EH and CAH Hardship Exception Tipsheet. EH's must continue to demonstrate meaningful use every year to avoid payment adjustments in subsequent years.

So, how does CMS determine who the 2015 adjustments apply to? In order to avoid the adjustments, EH's must demonstrate MU prior to the 2015 fiscal year. This means they have either attested to MU successfully in the 2013 reporting year or the 2014 reporting year.

What if your vendor does not deliver software to you in time to attest in 2014? In this case you can apply for a Hardship Exception based on the reason of '2014 Vendor Issues'.

If you are an EH who planned to attest for the first time in 2014 (new participant) and your vendor will not meet the deadline for you to attest in 2014, the deadline to file for hardship exception to avoid the 2015 payment adjustment has passed. These forms had to be submitted to CMS by April 1, 2014.

If you are an EH who attested to MU in the 2013 reporting year, you will not be subjected to the 2015 payment adjustment. But if your vendor is not able to deliver a 2014 certified solution before the attestation deadline, you can apply for a hardship exception for the 2016 payment adjustment. To apply, use the eligible hospital hardship exception for 2016. These forms must be submitted to CMS by April 1, 2015.




Contact Dynamic Health IT if you have questions about Meaningful Use or if you need assistance with your 2014 Edition Certification at 504-309-9103.

Wednesday, March 26, 2014

Meeting the Percentages

 


50% and 5% are thresholds for the Meaningful Use Stage 2 (2014 Edition) View, Download & Transmit requirement (VDT) – one of the toughest Stage 2 requirements for both vendors & providers.

Post-encounter, a minimum of 50% of patients must have on-line access to key clinical data and 5% must actually view, download or transmit this data.

The vendor certification requirement is:   § 170.314(e)(1) : View, Download and Transmit to 3rd Party

 
CCDA documents must be loaded to the patient portal and available for the patient to:
  • View Human Readable format
  • Download in XML format
  • Transmit via Direct Protocol
The Required Code sets for CCDA: 
 Smoking Status, Procedures, Problems and Care plan - SNOMED-CT
 Medications and Medication Allergies - RxNorm
 Laboratory Tests and Values/Results – LOINC
 
CCDA (Consolidated Clinical Document Architecture) XML format with Common MU Data Set

 
A certified EHR must provide patients (and their authorized representatives) with online VDT.  Specifically, this requires:

  • Support for Direct Protocol, including HISP (Health Information Services Provider)
  • Online Patient Portal with “authorized representative” capabilities
  • Portal must meet WCAG (Web Content Accessibility Guidelines)