20 Questions to Ask Your EHR Vendor

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Whether your practice is shopping around for an EHR or waiting for upgrades, it’s good to know what you’re in for, technology- and time-wise. That’s why we asked our readers, practice consultants, IT experts, and members of our Physicians Practice Group on LinkedIn to submit their thoughts for the most crucial questions you should be asking your vendor. Here are our favorites:

1. Do you have an implementation team that will make an assessment of the readiness of your practice and staff?

2. Do you have a user group that meets annually and that has a listserv for sharing information online?

3. Do you have a dashboard report to track phone message turnaround time by nurses and providers?

4. How often do you update your software; what updates are you planning for your next two releases?

5. Have your clients been more successful with a "big bang" implementation approach or a phase-in approach?

6. What happens when your office is hit by a disaster; are the records safe?

7. How many providers in our specialty use this system? Can you refer our practice to at least three who have set up this current version to see how it went?

8. Which systems failed implementation or were replaced within 24 months of implementation?

9. How many clients can demonstrate they have achieved their ROI?
10. Can we load our insurance contracts and see apples-to-apples performance comparisons?

11. Do you carry cyber and privacy liability insurance coverage?

12. Will an EHR migration absorb all of the patient demographics through a reverse migration from the billing data?

13. How often are coding updates incorporated (if the vendor provides this component)?

14. Do you, the vendor, have a complete inventory of drug, allergy, food interactions and their respective alerts incorporated into the system and again, how often is the database updated?

15. What is the pricing structure, by practitioner? By location? Are there different prices for varying types of practitioners?

16. Is the specific system version you are proposing: the same system that won the awards you tout; the same one that’s CCHIT/ONC certified; and the same one that is certified as interoperable with our regional health information exchange or health information organization?

17. You say your system is template-driven and completely customizable. For my specific specialty, how much time do I need to devote to populate and customize the templates to become functional in my practice?

18. What reporting capabilities are natively embedded in your system? Is it a separate module? How easy is it to generate my own custom reports?

19. To achieve meaningful use qualification, do you have dashboards and other tools to allow me to evaluate how our providers are doing in the specific areas needed to qualify for ARRA/HITECH funds?

20. Do you have a money-back guarantee for Stage 2 and Stage 3 of meaningful use qualification?



CMS SEEKS PROVIDERS TO TEST BUNDLED PAYMENTS

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August 23, 2011 - Mary Mosquera



Healthcare providers will be able to apply to participate in one or more of the initial four models to test the use of bundled payments and their incentives for improving patient care and their outcomes, according to the Centers for Medicare and Medicaid Services.

 

The effort is designed to encourage physicians, nurses and specialists to coordinate care across settings and offer incentives to clinicians and hospitals that do so. In the process, Medicare will save money, CMS said in an Aug. 23 announcement. 

Health IT tools, such as electronic health records (EHRs) and standards for information exchange, are critical components to enable the coordination of care and reporting quality measures that are part of the bundled payments effort. Those health IT tools are also a foundation for meaningful use of EHRs.

The Bundled Payments for Care Improvement Initiative, launched by CMS’ Innovation Center, will align payments for the medical services delivered to treat a condition, termed an episode of care, such as heart bypass or hip replacement. Currently, Medicare separately pays hospitals, physicians and other clinicians who provide care for beneficiaries for their services.

The Innovation Center, which was created by the Affordable Care Act, is searching for and testing better ways to provide and pay for health care to a growing population of Medicare and Medicaid beneficiaries.

Under the bundled payments effort, CMS will combine care for a package of services that patients receive to treat a specific medical condition during a single hospital stay and/or recovery from that stay, known as an episode of care.

By bundling payment across providers for multiple services, providers will have a greater incentive to coordinate and assure continuity of care across settings, which can reduce unnecessary duplication of services, reduce preventable medical errors, help patients heal without harm, and lower costs.

Under the request for applications released in the Federal Register, CMS outlined four broad approaches to bundled payments. Providers will have flexibility to determine which episodes of care and which services will be bundled together to make it easier for providers of different sizes and readiness to participate in this effort, CMS said.

Hospitals and physicians have called for a flexible approach to patient care improvement, said Dr. Donald Berwick, CMS administrator. 

“All around the country, many of the leading health care institutions have already implemented these kinds of projects and seen positive results,” he said in the announcement.

The Bundled Payments initiative is based on research and previous demonstration projects that suggest this approach has tremendous potential. For example, a Medicare heart bypass surgery bundled payment demonstration saved the program $42.3 million, or about 10 percent of expected costs, and saved patients $7.9 million in co-insurance payments while improving care and lowering hospital mortality.

From a patient perspective, bundled payments make sense, Berwick said. “You want your doctors to collaborate more closely with your physical therapist, your pharmacist and your family caregivers. But that sort of common sense practice is hard to achieve without a payment system that supports coordination over fragmentation and fosters the kinds of relationships we expect our health care providers to have,” he said.