Are you electronically prescribing in your practice?

As a clinician, I have used more than 5 Electronic Medical Record (EMR) systems in my career. I have experienced a full on practice implementation as well as a transition from one system to another, all while continuing to service patients and provide direct care. Maintaining patient flow, ensuring accurate and documentation and arranging care coordination is a challenge when you are navigating software that is not always intuitive.

Tip #1 – When implementing an EMR it is absolutely critical to get all members of the team involved. Redesigning processes like prescription refills, lab requisitions and x-ray requests are distinctly different within a software framework as opposed to a paper order. Coordination of smooth messaging from one provider to a nurse or from a front desk staffer to a provider must be well orchestrated and efficient.

Tip #2 – While the EMR transition is occurring, engaging temporary help can be a revenue saving benefit. Practices cite decreases in patient flow and therefore decreased overall revenue as a primary deterrent to EMR implementation. When faced with fixed overhead costs, fear of lost revenue (from decreased patient volume) during transition is a reality.

Tip #3 – One of the deadly sins of EMR implementation is failure to fully participate in training. This occurs for many reasons but is also an expenditure for the practice when purchasing an EMR system. Often practices will have providers with differing levels of “emr literacy” and as the providers are the key revenue drivers, adequate training is key.

As your practice deals with issues like attestation for meaningful use revenue in 2012, consider these tactics to make your transition easier on your team as well as your practice revenue stream.

Lisa P. Shock, MHS, PA-C, is a seasoned PA who has used EMRs since her student days at the Duke PA program in the late 90s. She enjoys part time clinical primary care practice and is the President and CEO of Utilization Solutions in Healthcare – a specialty consultant company for physician practices and hospitals, offering a wide range of services to help implement and improve upon the utilization of PAs in the health care system

She is familiar with the SuiteMed system offered by MICA and loves the ease of navigation as well as its easy customization options. Contact her with questions at lisa@pushpa.biz

Lisa Shock was a guest blogger for MICA in January 2012, the above post was written for their newsletter. To view the entire newsletter as sent out to subscribers click here.

Are you located in a HPSA (Health Professions Shortage Area)?

Do you contact your legislators when there is significant legislation affecting your profession?

Does Medicaid Credential PAs in your state?

President/CEO Utilization Solutions in Healthcare, Inc.

CompHealth Consultant

National PA Week is approaching – October 6-12, 2011.  Some of you may know that the original PA Day was Oct 6 – and that coincided with Dr. Eugene Stead’s birthday.  Dr. Stead, as our founding father, was a local legend at Duke Medical Center and those of us fortunate to have known him remember his great stories and his amazing vision for our profession.

A recent article in HealthLeaders Media comments on the Physician Assistant workforce experiencing a 100% increase in the last 10 years.   I am often fond of saying that PAs are like type O blood – we can practice in every specialty and in every medical practice setting.  It is not surprising that practices and health care systems are utilizing us more to deliver high quality, cost effective medical care.

One of the largest trends I have seen over my career is the change in demographics.  According to the AAPA, female PAs outnumber male PAs by nearly 20,000 and this is evidenced in the student applicant pool as well.  Factors including lifestyle, flexibility, and family planning have all contributed to this shift.

My prediction is that our profession will continue with another 100% doubling in the next 10 years.  Health reform initiatives will increase the number of patients that need care.  The only way the US healthcare system can absorb the huge changes we have been talking about is through more efficient utilization of all resources – and when it comes to the actual delivery of care by providers it will have to be through more efficient teams. The growth in the number and size of PA training programs has been substantial, with more than 5,300 graduates projected in 2010, and although the number of PAs in clinical practice could reach 110,000 by 2015, this remains less than one PA for every five medical and surgical specialists.

In my 12 years of practice, I remain young compared to some of my colleagues, but feel old when I am training my students and I am not as technologically savvy or as connected on Facebook.  In order for us to sustain our growth, we need to continue to mentor those who come after us and remember our commitment to high quality patient care.

Reference: http://www.healthleadersmedia.com/page-1/PHY-270712/US-Physician-Assistant-Workforce-Doubles-in-10-Years

Lisa P. Shock, MHS, PA-C, CompHealth consultant, is a seasoned PA who is a proud alumna of the Duke PA Program. She enjoys part time clinical primary care practice and is the President and CEO of Utilization Solutions in Healthcare – a specialty consultant company for physician practices and hospitals, offering a wide range of services to help implement and improve upon the utilization of PAs in the health care system. Contact her at lisa@pushpa.biz

President/CEO Utilization Solutions in Healthcare, Inc.

CompHealth Consultant

As a clinician, I have used more than 5 Electronic Medical Record (EMR) systems in my career.  I have experienced a full on practice implementation as well as a transition from one system to another, all while continuing to service patients and provide direct care.  Maintaining patient flow, documentation and care coordination is a challenge when you are navigating software that is not always intuitive.

A recent FierceEMR article discusses the worst EMR implementation sins and as I was reviewing this, I thought of my colleagues at CompHealth.  When implementing an EMR it is absolutely critical to get all members of the team involved.  Redesigning  processes like prescription refills, lab requisitions and x-ray requests are distinctly different within a software framework as opposed to a paper order.  Coordination of smooth messaging from one provider to a nurse or from a front desk staffer to a provider must be well orchestrated and efficient.

While the EMR transition is occurring, engaging temporary help can be a revenue saving benefit.  Practices cite decreases in patient flow and therefore decreased overall revenue as a primary deterrent to EMR implementation.  When faced with fixed overhead costs, fear of lost revenue (from decreased patient volume) during transition is a reality.

One of the deadly sins quoted by FierceEMR is failure to participate in training.  This occurs for many reasons but is also an expenditure for the practice when purchasing an EMR system.  Locums-tenens providers have the unique advantage of traveling to several practice locations within a calendar year.  This exposure to different settings and specialties makes them uniquely qualified to help with EMR transitions.  CompHealth staffers and recruiters can tailor provider placement to the clinical demand as well as the practice environment, and utilizing a locums provider who is already familiar with a particular EMR software can be invaluable to maintain patient volume, while also assisting in some of the ancillary curbside training that we all experience in our clinical careers.

Reference:: http://www.fierceemr.com/story/worst-emr-implementation-sins-lack-communication-shortsightedness/2011-09-08

Lisa P. Shock, MHS, PA-C, CompHealth consultant, is a seasoned PA who has used EMRs since her student days at the Duke PA program in the late 90s. She enjoys part time clinical primary care practice and is the President and CEO of Utilization Solutions in Healthcare – a specialty consultant company for physician practices and hospitals, offering a wide range of services to help implement and improve upon the utilization of PAs in the health care system. Contact her at lisa@pushpa.biz

Health reform is a hot topic and how Physician Assistants (PAs) will be included is of great interest. As the debate continues regarding health care delivery and cost effectiveness, there are many changes also pending on the documentation side of the clinical record. There are a multitude of terms in the media right now – ARRA, MU, EHR, ONC.

They may appear confusing and are often misunderstood and misrepresented. Check out my article in the December 2010 issue of PA Professional, a publication of the American Academy of Physician Assistants (AAPA), which explains the overview of Meaningful Use (MU) and who is eligible to receive incentive payments.

http://paprofessional.cadmus.com//index.aspx?issue=01-dec-2010 Page 36.

In 2009, the American Recovery and Reinvestment Act (ARRA) was passed.

A portion of this legislation set aside financial incentives for medical practices to adopt electronic health records (EHR) that meet specific requirements. The HITECH Act – Health Information Technology for Economic and Clinical Health Act has a primary purpose to encourage the adoption of EHR/EMR by providing billions of dollars in financial incentives. As a result, many medical practices are feeling pressured to embrace EHRs in an effort to receive some of the financial incentives.

In order to meet the financial requirements and receive the incentives, you must use the EHR in a meaningful way – i.e., meet the criteria for Meaningful Use (MU). The Office of the National Coordinator for Health Information Technology (ONC) issues the rules identifying the standards and certification criteria for EHR technology to be certified. If you are not using a system that is certified, you will not receive incentive payments.

You must also be an eligible provider, or EP, recognized by the government, in order to receive incentive funds. Under the current legislation, a Medicaid Eligible Provider is a physician, dentist, nurse practitioner, certified nurse midwife, or physician assistant practicing predominantly in a Federally Qualified Health Center or Rural Health Clinic (FQHC/RHC) that is directed by a physician assistant. Therefore the only PAs that qualify for incentive payments are those practicing in a federally qualified health clinic, collecting Medicaid incentive payments.

Currently, there is a great deal of debate regarding Medicaid qualifying incentive payments. AAPA is encouraging all members to contact their congressional representatives to urge them to amend the Health Information Technology for Economic and Clinical Health

(HITECH) Act to extend the Electronic Health Record (EHR) Medicaid incentive payment to all physician assistants whose patient volume includes at least 30% Medicaid recipients.

By placing a restriction on which populations of working PAs can receive incentive payments, patient access to care and exposure to EHR practices may be limited. Such regulations also disincentivize and potentially limit the hiring and placement of PAs in underserved areas.

PAs do qualify as authorized health care professionals under the federal e-prescribing and Physician Quality Reporting Initiative programs, and should therefore be included in the Medicaid Incentive Program. The exclusion of PAs as professionals that deliver primary care health services may possibly undermine EHR adoption efforts and negate the original intentions of meaningful use.

Lisa P. Shock, MHS, PA-C is the President/CEO of Utilization Solutions in Healthcare, Inc., a consulting firm specializing in teaching physicians how to get paid for the services that they provide and how to utilize PAs to their fullest potential. Please visit her website at www.pushpa.biz or contact her directly at:

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