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What Is the Difference between a Patient Portal and a PHR?

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Posted by Amanda Guerrero on January 31, 2013 at 11:21 am

What is PHR? What is patient portal?There are a lot of buzzwords being thrown around in hospitals, physician practices and medical facilities across the United States, and it can be easy for patients to get confused about which terms matter and what they mean. With federal programs incentivizing healthcare providers for engaging patients in their health, two terms that caregivers are using a lot lately are “personal health record” and “patient portal” – both extremely relevant to patients and crucial for getting them involved in decisions about their health. But what does each one mean?

Personal Health Record (PHR)

A PHR is an electronic record of an individual’s health information that can draw information from various sources. This can include data obtained by the patient (weight, height, current medications, emergency contact information and family medical history), as well as data obtained from providers (diagnoses, immunizations and lab results).

In stark contrast to an electronic health record (EHR), which contains data entered and controlled by a healthcare provider, many PHRs are managed primarily by the patient. The patient can share the data with a physician if they choose to, but they are not required to. This type of PHR is referred to as “standalone.”

The other type of personal health record, which is slowly becoming more common, connects to a healthcare organization’s EHR system so that both the patient and their provider can access and update data contained within the record, resulting in a more accurate and comprehensive medical record.

Patient Portal

An online patient portal is a tool that connects to a healthcare organization’s electronic health record software. It allows patients to view certain portions of their medical record, similar to a PHR. However, unlike a PHR, patients cannot always make changes to their record. Instead, they can view data such as clinical summaries and test results and benefit from features such as:

  • Secure electronic messaging
  • Appointment scheduling
  • Prescription refill request
  • Online bill pay

Though patient portals appear to be more comprehensive resources than patient-maintained PHRs, a major downside is that they do not contain data from all of a patient’s physicians. In fact, each healthcare group will have their own portal with data pulled from that organization’s own EHR.

Do your providers use a patient portal or EHR-connected PHR? Do you maintain your own personal health record? Which method do you prefer?

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How Big Of A Problem Is Medical Debt In Arizona?

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Posted by Amanda Guerrero on October 3, 2012 at 10:49 am

Arizona state flagHealthcare debt collection is a serious problem throughout the country, and Arizona residents are not exempt from the financial hardships brought about by medical debt. In fact, a study by University of Arizona researchers found that residents of the Grand Canyon State owed more than $2.4 billion in medical bills in 2008. What’s more, one in four surveyed adults were either paying healthcare-related debts or had had problems paying a medical bill in the last year.

Who is most affected by medical debt?

Although medical debt seems to affect Arizona residents in different age groups and economic classes, middle-aged Arizonans with low to moderate incomes have the highest rate of debt. Following is a breakdown by age group of adults who were paying off medical bills at the time of the survey:

•    Ages 18-29: 26 percent
•    Ages 30-39: 34 percent
•    Ages 40-49: 32 percent
•    Ages 50-64: 24 percent

Families with children are also greatly affected, especially those headed by couples or single females. In fact, these households are 60 percent more likely to have medical debt than those headed by a single male or those without children.

How does Arizona compare to the rest of the country?

Arizonans are, on the whole, better off when it comes to medical debt than the average American. A national survey of healthcare debt collection found that 65 percent of Americans with medical bills had problems paying for other necessities. In Arizona, however, only 39 percent of adults with medical debt reported being unable to pay for basic necessities.

What can healthcare organizations do to collect on unpaid debts?

Partnering with a medical collection agency whose employees are well-trained in collecting from patients is one way that healthcare professionals can increase collections. For example, instead of overwhelming patients by demanding full payment, medical collection agencies often work with patients to set up manageable payment plans. This not only brings in money for the healthcare facility, but it helps patients pay down their debts.

Source: arizonahealthsurvey.org

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What Are the Differences Between Obamacare and Romneycare?

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Posted by Amanda Guerrero on September 12, 2012 at 3:00 pm

Capitol domeFrom EHR law to health insurance reform, big changes are happening in healthcare and not everyone is in agreement about the direction those changes are taking. More recently, the Affordable Care Act (ACA), which President Obama signed into law in 2010, has been topic of conversation, as people try to discern the differences between the so-called Obamacare law and a similar healthcare plan Mitt Romney signed into law in Massachusetts four years earlier.

In an article posted on this blog last month by Health News Watch, some of the main parts of the ACA were broken down and explained more simply. Here, I’ll talk about some of the ways the two health plans differ – which, as it turns out, is only slightly.

Is there a penalty for not buying insurance? Both plans have penalties in place for those who choose not to purchase insurance. Under Obamacare, the yearly minimum would be just under $700. Meanwhile, the yearly minimum for Romneycare is approximately $1,200.

Are employers penalized for not providing insurance? The ACA penalizes companies with more than 50 employees, while the Massachusetts plan does so for companies with more than 11 employees. The actually penalty per employee would be $2,000 and $295, respectively.

Do insurance companies have to cover pre-existing conditions? Both plans require coverage of pre-existing illnesses; however, the Massachusetts plan allows insurers to limit coverage of certain conditions to six months.

Until what age can children stay on their parents’ insurance plan? Both Romneycare and Obamacare allow children to remain covered by their parents’ insurance until the age of 26. The difference with Romneycare is that if a child has filed taxes on their own (not as a dependent) for at least two years, even if they are under 26, they must purchase their own insurance plan.

How are the plans funded? Romneycare is funded in large part by the federal government, which made it possible for the state not to raise taxes for residents. Obamacare, on the other hand, is a federal program, and funding for the health plan must come from new taxes. This includes a tax on tanning salons, some medical devices, and certain premium health plans.

The different changes being implemented in the healthcare industry can be confusing. With the help of healthcare professionals and EHR law experts, patients can learn more about those changes, including how they are affecting care delivery, access to medical treatment, and cost of care.

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How Do Patients Benefit From e-Prescribing?

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Posted by Melissa Le Furge on March 11, 2012 at 5:53 pm

e-Prescribing, or eRx, is the new method doctors use to submit your prescriptions to payers and pharmacies.  Now streamlined into a click of one button, electronic prescription submission replaced a procedure that once required a ream of copy paper and a perpetually busy fax line is   Proven to reduce dosage and interpretation errors, e-Prescribing is now required for all certified EMR software that your doctor implements.

As a patient, you may not be aware how e-Prescribing benefits you, but it indeed does.  From saving your life to saving time in line at the pharmacy, your doctor’s use of electronic prescriptions increases the quality of care you receive.

Safety First – The number one benefit patients receive from e-Prescribing is the protection from fatal dosage errors.  Electronic prescription writing eliminates errors made in dosage calculations and prevents the names of medications from being misread by the pharmacy from doctors’ notoriously sloppy handwriting.  Integrated with an EMR, you doctor can check for drug possible adverse reactions from allergies and other medications.

Your Past Meets Your Present – e-Prescribing lists all your medications from the past and present for your doctor to access.  Doctors can utilize the informed clinical decision support of EMR based on comparing your medication list with your past treatment notes to devise a new or continued course of treatment.

Saves Time – Prescriptions get filled quicker through e-Prescribing.  After your doctor checks for interactions and allergies, they submit the prescription to the payer to check eligibility of coverage and then submit it to the pharmacy.  Without having to sit through dial-through menus or wait to speak to a pharmacist, e-Prescribing shaves minutes to hours off of the prescription process, meaning you get your medication faster.

Better Health! – Patients whose doctors use electronic prescribing are more likely to take their medications than those who do not have an eRx system.  Did you know that a whopping 20% of paper prescriptions go unfilled?  Patients either lose the paper script or don’t take it to the pharmacy because it’s too much of a hassle.  e-Prescribing eliminates the patient from the submission process; all they have to do is pick it up.  By correctly following the doctor’s recommended course of treatment, you can play an active role in improving the quality of care you receive and the overall quality of your health.

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Can EMRs Reduce Human Error?

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Posted by Amanda Rahi on February 21, 2012 at 10:52 am

Human error in medicine in intolerable and completely unacceptable, according to Alexandra Godfrey, MS, PA-C, contributor to the journal of the American Academy of Physician Assistants (AAPA)., a peer-reviewed clinical journal.

Godfrey explains that while all medical professionals do everything possible to avoid errors, we should recognize that human error is unavoidable. In fact, there are many factors that can lead to error that are very common in the healthcare environment, such as constant interruption, shift work, disrupted sleep patterns, unique situations, volatile situations, diagnostic uncertainty, and cognitive overload.

EMR software and systems are designed to make the many routine and mindless tasks taken care of by a computer, instead of the human brain that could be better used in other areas. Electronic medical records in the emergency healthcare environment can significantly help medical staff take their focus off small tasks so that they can give more attention to the medical emergencies. For example, physicians can request serial NMTS instantly and begin diagnoses order sets for serious conditions that need to be handled immediately.

An emergency room is a very difficult and intense environment that demands assiduous and painstakingly close attention to detail and rapid and immediate responses. There are certain things that are better left to computer, such as patient health record organization and filing, and diagnostic orders. Electronic medical record systems can facilitate and streamline processes and leave medical staff more available to focus on the patient care. 

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What Is an EMR ROI Calculator?

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Posted by Melissa Le Furge on January 31, 2012 at 11:00 am

EMR ROI CalculatorImplementing an EMR software solution is a serious investment for your practice. With all investments comes a certain level of risk. What if take the risk by putting all your money (and faith) into a certain EMR and it does nothing for your practice? You’re back to square one and thousands of dollars in the hole. Running a cost-benefit analysis study before the purchase tells you whether or not a particular EMR is a worthy investment. An EMR ROI calculator, designed specifically with hospitals and practices in mind, gives doctors and practice managers an idea how much a software solution will either save them (or cost them) per month.

Before using the EMR ROI calculator, ask the vendor the following questions about the product: How much does the EMR cost? How much hardware is required to run the EMR? What is the cost of maintenance? What is the average cost of training the staff? Once you have this information, the calculator will ask for the following information regarding your practice:
Paper Materials – Number per day and cost per unit
• New patient charts
• Superbills
• Faxes
Cost of Medical Record Space
• Size of room
• Monthly rent paid per square foot
Monthly Employee Cost – Minutes spent per action
• Patient Chart Pulls
• Patient Chart Filing
• Chart Transfer to Other Locations
Physician Time – Minutes spent per action
• Record dictation

After entering the data, the EMR ROI calculator generates an immediate estimate. Depending on the work flow of your practice and the particular EMR in mind, the calculation determines whether or not the implementation will result in savings or loss in the following areas:
• Staff Time – The more records converted to electronic means less chart pulling staffing expenses.
• Paper Supplies – Fewer paper charts mean less printing, telephone faxing and less need to purchase paper.
• Additional Patients Seen – An efficient workflow allows the practice to treat more patients in a day that previously possible.
• Financial Savings/Cost Benefit of EMR – This is the number that will really sum it up for you. Are you gaining or losing? If your numbers end up positive, then perhaps this is the right EMR for your practice. If they come out negative, then maybe it’s best to continue shopping around for an EMR that will help your practice attain its long-term financial goals.

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What Is Healthcare IT Certification?

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Posted by Melissa Le Furge on January 17, 2012 at 8:00 pm

Healthcare IT CertificationA term that became very relevant in the past year that you’ll start hearing more frequently is healthcare IT certification. What is it exactly and why are we hearing this particular phrase more? Healthcare IT certification involves the inspection and approval of EHR and EMR technology for meaningful use based on the criteria set by the Office of the National Coordinator (ONC) of Health and Human Services.

The certification of EHR technology is overseen by the Certification Commission for Health Information Technology (CCHIT). This independent non-profit organization promotes the advancement of the adoption of health information technology. The commission assists physicians and practices with the transition to electronic medical record systems, as well as ensuring the interoperability of healthcare IT products between facilities. EHR and EMR software receives approval certification by ONC-Authorized Testing and Certification Bodies (ATCB), in six locations throughout the U.S.

We’re hearing more about healthcare IT certification now because of the commencement of Stage 1 meaningful use attestation in April, 2011. It’s relevant because an EHR software solution needs to be certified by ONC-ATCB in order to thoroughly demonstrate the meaningful use of electronic data for attestation. By certifying the technology, it proves the EHR’s ability to meet the core objectives of meaningful use.

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What Is An Electronic Medical Billing Service?

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Posted by Melissa Le Furge on January 10, 2012 at 9:29 pm

Electronic Medical Billing ServiceWith the changes in the medical billing playing field, physicians run the risk of losing revenue over the erroneous coding of superbills.  Physicians are to comply with the ANSI 5010 claims submission standards by January 1st, 2012.  The ICD-9 code changes to ICD-10 in October, 2013 as well; so understandably, mastering the change is a big challenge for office staff.  By employing an electronic medical billing service, physicians increase their revenue as well as avoid billing errors made by the adjustment to changes in coding; a billing service provides a software solution and support to generate charge slips, track denied claims and schedule collection follow-ups.

One in five Americans currently has trouble paying their medical bills, says a recent survey posted on the Kaiser Health News blog.  Coding errors easily made by staff cost both the practice and the patients dearly.  An electronic medical billing service automatically generates charge slips according to the services the physician has entered.  The expert support staff turns the charge slip into a claim and “scrubs” it for coding errors before electronically submitting it to insurance companies, Medicare and Medicaid.  Check that your billing service is ANSI 5010 and ICD-10 compatible to avoid claim rejections this year.  Fewer claims rejections mean fewer out-of-pocket payments from patients.

Despite the scrubbing for coding errors, claim rejection still occurs.  Perhaps the patient’s insurance provider altered their coverage or isn’t enough to cover the entire service.  When this happens, your electronic medical billing service re-submits the claim to the secondary insurance company and sometimes to the primary insurance again.  Sometimes claim approval isn’t possible after many attempts, or if the patient doesn’t have insurance at all, the billing service will electronically generate statements to be mailed to the patient.  The specially-trained billing support team makes routine follow up calls for missing or delinquent payments from both the insurers and patients, striving to protect physicians from any loss of revenue that could easily be collected on with a little diligence and patience.

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Q: What Is EMR? A: Patient Empowering Tool

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Posted by Melissa Le Furge on January 9, 2012 at 10:04 pm

What Is EMRMost patients are aware of HIPAA and the serious repercussions health care providers face if their privacy is breached.  Electronic medical records (EMR) perhaps not so much.  When I tell people what I do for a living, they cock their head, scrunch their nose and ask, “EMR? What is EMR?”  Simple: An EMR is a computerized system of collecting and storing clinical health information and patient medical records.  Sharing the data collected is also a very important function of an EMR, meaning an improved continuity of care between physicians and a way to keep patients informed of their own health.

Sharing data with other doctors is understandable, but would allowing patients to look at their own medical records be such a good idea?  Wouldn’t be they be confused by scientific medical terms?  Would they go into the denial about the state of their health?  They would not, according to research study posted in a recent New York Times Article.  90 percent of patients surveyed thought viewing their own medical records would actually empower them to take better care of themselves.   The most of the doctors surveyed were ambivalent about showing patients their medical records.  The optimistic doctors see the open door, that which is EMR, to get patients interested in their own health.  “That’s the great challenge in medicine: getting patients to be more active in their own care,” said Dr. Tom Delbanco, professor of medicine at Harvard Medical School.  “What we’re doing is opening the black box and letting you look inside.”

Did sharing the information from the EMRs frighten patients in the research study?  Article survey says no.  Patients found the information useful and were able to review what they might have forgotten at the doctor’s office.  “It never upset me, except the first time I read about my bones,” said survivor or two forms of blood cancer, Paul Grabowski.  “I heard about it from my doctor, but it’s different when you read it in black and white.”  The sharing of EMRs with patients also encourages patients to take their medications, manage their weight and make follow up treatment appointments.

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Urgent Care EMRs: Are They Necessary?

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Posted by Melissa Le Furge on January 3, 2012 at 9:23 pm

The urgent care clinic is not a place where patients want to find themselves on a regular basis.  They might only see that doctor once in their lifetime, unlike their primary care physician whom they see regularly.  So if an urgent care doctor doesn’t see the same patients on a regular basis, does an urgent care clinic really need an EMR?  Urgent care EMR assists with the fluid movement of patient encounters and directs patients toward continuing follow-up treatment after their urgent care visit.

Urgent care clinics have been in existence since the 1970s, but have become increasingly popular within the past few years.  The driving force behind their newfound success is the lengthy wait time in hospital emergency rooms for non-life-threatening emergencies.  Despite being made for minor emergencies, some patients set up permanent residence in urgent care because they feel they can’t wait for an appointment with their primary care doctor.  The dilemma in that situation is the lack of communication between urgent care and primary care physicians.  Urgent care EMR electronically faxes the encounter information to the patient’s primary care physician.  To eliminate the probability of repeat visits, the EMR software either composes a referral letter to get the patient started with primary care or alerts the existing doctor of the patient’s visit and to schedule a follow up appointment.

Even though urgent care physicians don’t have regular patients, it doesn’t mean they won’t benefit from EMR technology.  Exam templates are laid out for emergency situations, as opposed to routine physicals.  They include data entry for work accidents and workers’ compensation reports.  The template for urgent care EMR software is designed with fluidity in a fast-paced environment in mind.  Content such as bubble sheet intake forms and rapid-loading chart templates allow doctors and office staff to accurately enter patient encounter data quickly, without interfering with the time spent with patients.

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