IO Practiceware: Official Blog

Need a Reason to Invest in EHR? How about 6!

2011-09-08T10:32:00.005-04:00

Yes, electronic health records (EHR) systems are an expensive investment. But do their returns amount to an offer you can't refuse?

Here are the top six ways EHR will pay for itself in cost savings and increased quality, according to your colleagues, (and they don't even mention government incentives.):

Payroll Savings
- EHR isn't necessarily about reducing staff, it's also about freeing up existing staff to do more meaningful, practice-building work instead of filing and looking for charts or resubmitting paperwork multiple times...
Improved Quality Control
- “EHR encourages and supports precise documentation and thinking throughout the case that improves the quality of care and reduces legal exposure” Dr. Castleberry says...
Real Estate Savings
- Paper files need space, and as a practice grows, these files require more space...
Enhanced Disaster Prevention
- When paper files are destroyed, they are gone for good...
Easy Referral and Consult Letters
- In the past, a referral letter required setting time aside to write or dictate the letter, then tasking a staff person with typing and formatting it, sending it to the patient or doctor, confirming it was received and resending it if it wasn't....
Effective Marketing
- By using patient demographic information along with medical information an EHR can create reports to help decide on certain marketing methods....

The Incentive is Real: $75M Distributed in First Round of Meaningful Use

2011-06-10T11:25:00.004-04:00

CMS announced that more than 300 health care providers have received a total of $75 million in Medicare incentive payments for demonstrating meaningful use of electronic health records, HealthLeaders Media reports (Tocknell, HealthLeaders Media, 5/27).

CMS estimates more than 42,600 eligible physicians and hospitals have registered for the Medicare and Medicaid incentive programs, and roughly 485,000 could be eligible to participate, according to AHA News (AHA News, 5/26).

A list of health care providers who received Medicare meaningful use payments is available on a CMS website (Modern Healthcare, 5/27). The amounts of the specific payments were not revealed.

COME VISIT US @ TOA/TEXMED May 13-14, 2011

2011-05-04T13:23:00.005-04:00

Click on the image above to find out more.
See you in Houston!

ASCRS 2011: What a Great Meeting!

2011-04-01T10:04:00.008-04:00

What a great meeting in San Diego, thanks to everyone who stopped by our booth and to all our friends @ASCRS. See you next year in Chicago!

But if you can't wait that long we still have a few more stops this year, next one is in Texas. Learn more.

See more pics from this years ASCRS Symposium and Congress in San Diego: http://on.fb.me/dXnJ7b

Are you eligible? Study: Many Physicians Eligible for Incentives but Lack EHR

2011-03-14T11:56:00.002-04:00

"Many physicians are eligible for federal incentive payments for the meaningful use of electronic health records but lack a basic EHR system, according to a study published in the journal Health Affairs, Healthcare IT News reports.

Overall, researchers found that nearly 83% of office-based physicians are eligible for either the Medicare or Medicaid incentive program."

IO CEO Highlighted in Newest Edition of "Ophthalmology Managament"

2011-02-04T11:15:00.016-05:00

Our own CEO, Gregory Leopold, speaks about the importance of EMR/EHR certification and buying the system that's right for you in the newest edition of the "Ophthalmology Management" magazine.

-Mr. Leopold urges ophthalmologists to get involved with choosing an EHR for their practice. “You can have someone else screen for you, but at the end of the day, you should buy the EMR that feels right to you.” The most important predictor of a successful implementation, he contends, is physician commitment and comfort with their EHR choice.-

Read the full article titled "At the EHR Starting Line" by René Luthe, Senior Associate Editor of "Ophthalmology Management.

“If the system costs you time in the exam room, it will cost you much more than what you ‘saved’ when you bought it." - Gregory Leopold http://bit.ly/ieHEJC

Happy Holidays from IO Practiceware

2010-12-22T09:35:00.012-05:00

Happy Holidays

Wishing you and your families a wonderful holiday season
and a prosperous New Year.

Sincerely,

The IO Practiceware Team

CCHIT Update: What is "Meaningful Use" and "How Useful is CCHIT certification"?

2010-02-05T10:44:00.009-05:00

So, we've been getting a lot of questions regarding CCHIT and our role in helping our clients when it comes to qualifying for and receiving the incentive payments.

The answer is "Yes", we will be applying for certification on February 12th (the day the window opens) for certification under the ARRA rules issued on December 30, 2009. CCHIT has said that that is the first day they will be accepting applications. We do not know how fast they will process them. However, we expect to be certified in the next 6 months. Any previous certifications are no longer valid, as far as, the incentive plan is concerned. So, every vendor has to get this certification.
We will also help our clients in anyway we can. Although, it is not entirely clear how much help you'll need. Take a look at the articles below. They answer, in great detail, what meaningful use will mean for doctors and address the issue of CCHIT certification as a useful tool for choosing the right EMR.

Updates on Meaningful Use

Should CCHIT Influence Your EMR Selection

Hope you find these resources helpful!

- KH

January Newsletter: Buying the right EMR

2010-01-18T14:14:00.003-05:00

In case you did not get the email version, here is the January newsletter in full. Hopefully, it will help you in avoiding some of the common pitfalls we've seen when people are choosing an EMR.

I'm the first one to admit I'm easily lured in by clever marketing and fancy labels when I'm shopping for food, shampoo, ... ok, everything! BUT, you have to know when to be more fastidious and read the labels. This is one of those times. Focus on whats most important and all the rest will fall into place.

- KH

BUYING THE RIGHT EMR

Several recent surveys (most notably by KLAS) have noted a drop in customer satisfaction with the EMR software purchased. While those surveys don’t offer opinions about why there is increasing dissatisfaction among EMR users, I have a theory. I believe that new buyers are not selecting the best system for their practices. Instead, they are being distracted from the most important criteria. Here are some points to consider when you are deciding what EMR to buy:

1. Buying an EMR is not like buying a car.
EMR software is still a work in progress. All the cars on the market today will get you where you’re going. All cars have pretty much the same set of controls. If you know how to drive a car, you can expect to be able to succeed in driving any car you buy. They do come with different features. They come in different colors. There are varying degrees of comfort and service, but no matter which one you choose, you will not find yourself with a car that you can’t drive or that will double your commuting time.

At some point in the future, perhaps the same may be true of EMRs. However, it’s not true now. Eventually, most EMRs will probably be well made. Today, the quality and focus of EMRs varies greatly. There is no standard for usability. There is no standard for applicability to your practice. There is no standard for even basic functionality.

2. CCHIT certification is not a standard for usability or applicability to your needs.
IO Practiceware supports CCHIT certification. Along with pretty much all of our competitors, we expect to achieve CCHIT 2011 ARRA certification in early 2010. We believe that CCHIT certification is a good first step in developing standards for EMRs – and it’s required for the $44,000 per doctor incentive payments that you’ll receive beginning next year.
However, CCHIT certification does not address usability. An EMR can get CCHIT certified and be absolutely useless in your practice. It can be much worse than useless – lengthening your exam room encounters and jeopardizing your reimbursements.
The most important criteria when purchasing an EMR should be usability. Examine each EMR thinking about whether you can use it in your exam rooms. My advice is to look at nothing else – at least not until you’re satisfied that you’ve found the best EMR for you – in the exam room. Everything else is secondary.

3. Don’t even think about an EMR that does not have successful implementations in practices like your own.
After you think you’ve found the EMR that offers you the best chance of being able to use it in your exam room, then make sure that the company that makes it has at least some successful implementations in practices like yours. The more the better. I don’t mean to stifle innovation. New companies and new products can sometimes be much better than the more established incumbents. But, my advice is to let someone else be the first practice to use a new system. In fact, you really don’t want to be customer 1-20. Resist all offers to be a “Beta Site”. The risk is almost always too great.

4. Buy an ophthalmology specific EMR.
With one possible exception (NextGen) you’ve got to be nuts to buy an EMR that does not specialize in ophthalmology. It’s tough enough for ophthalmology specific EMRs to satisfy your needs. With a non-ophthalmology specific product, you’re lowering your odds for success to unacceptable levels. Just don’t do it. No matter why you think this might be a good idea, “Just Say No”.

5. Other considerations …… Price, Practice size, Longevity.
It’s reasonable to consider these criteria – but by far the most important criteria are usability and a successful track record. If you still have a choice after considering those, then you might take a look at these other, way less important, criteria.
Since the cost of all the successful EMRs is pretty much the same, it’s hard to use this criterion. There may be occasional bargains to be had, but remember that the most important cost is your time in implementing your new EMR. Buying an inferior system because it’s a few thousand (or even a few tens of thousands) of dollars less is really the dumbest thing you can do. If your new EMR costs you a minute more for each exam, you’ll soon find that the bargain price was no bargain at all.
To consider matching your practice’s size to your vendor’s size is not as dumb as buying the wrong EMR because it’s cheaper. Smaller vendors may have difficulty meeting the needs of larger customers. Larger vendors might not “care” about their smaller customers. However, this should be your least important factor in the decision making process. Buy the EMR that works in your exam room. All successful EMR companies will grow much larger in the next few years.

To that point, worrying about your vendor going out of business is not completely illogical, but it is for the most part irrelevant if you’ve paid attention to the other criteria mentioned above. If you buy the best EMR you can find, that company will prosper and be one of the survivors.

In summary, just in case you’re still wondering what I think is the most important criteria for choosing an EMR for your practice …… Buy the EMR you believe works best in your exam rooms. Don’t get hung up on any other issues. All other issues are way less important in the end.

All of us at IO Practiceware wish you and yours a prosperous and happy New Year.

Regards,

Gregory Leopold
CEO IO Practiceware

CSEP 2010

2010-01-02T11:25:00.000-05:00

For all of you Connecticut Ophthalmology doctors and staff:

IO Practiceware will be attending the January 8th 2010
Connecticut Society of Eye Physicians:
Annual Educational Program & Vendor Expo

We will have a booth set up for you to see the IO EMR up close and personal.
If you will be attending the show it would be a great opportunity to see how IO's touchscreen interface works and interact with it firsthand.

So stop by our booth and we'll be happy to give you a demo!

How do I post my comments?

2009-11-18T14:50:00.001-05:00

Many of you have asked, so here is the direct link to CCHIT's public comments forum. In order to submit, you first have to register a username and password.

CCHIT public comments forum begins Monday

2009-11-14T11:53:00.001-05:00

Remember that one time I decided to be really obnoxious and chastise the physician constituency for not speaking up about the ongoing EMR Certification process? Well, I stand by my obnoxiousness! Because now you actually have a forum to make yourself heard. Observe, the latest from the Certification Commission's newsletter:

"The first 30-day public comment period of the 2011 development cycle will open Nov. 16 – Dec. 15, 2009. Comment will be accepted for the first round of criteria for additional electronic health record (EHR) Comprehensive certifications not included in the Commission’s Oct. 7 launch of CCHIT Certified® Comprehensive and Preliminary ARRA certification programs.

These expanded areas include Clinical Research and Dermatology criteria (optional add-ons to the current Ambulatory EHR certification) and Behavioral Health EHR criteria - both standalone and as an optional add-on to the current Ambulatory EHR certification. Comment will only be taken through the Commission’s Web site."

Feel free also to share comments below, or email me with questions. Up next: stay tuned for a summary of the latest on certification guidelines.

--FR

Live Blogging from AAO 2009!

2009-10-27T14:48:00.000-04:00

Or, We've Been So Busy We Haven't Had Time for Blogging!
Or, The Bottom Line Is: Everybody Loves EMR!

Dear Poor, Neglected, Though Ever-Constant, Blog Readers,

So much to say, so little time, as I write this now while sitting at booth 2964 at AAO 2009. That's right, live blogging! (Although, admittedly, because of limited internet access, I won't be able to publish this post until I go upstairs... But let's pretend it's totally live.)

Live blogging -- which is to say, the instantaneous transmission of information -- is perhaps emblematic of what we at IO Practiceware perceive to be a new era of doctors and their staff embracing technology! Which is to say: it looks like the ophthalmology community is finally (dare I say it?) embracing EMR!!!

Quite the revelation, I know. And, sure, maybe it's slightly premature. But I'm going to roll with it. It's like when you really, really, really like a boy and right after he kisses you you blurt out that you want to marry him and have his babies, only to find that it was way too premature, and way too effusive, and, uh, on second thought, he doesn't really feel the same way, and, uh, let's be friends.

But let's put aside my relationship issues. Let's instead talk more about this new climate of EMR warm and fuzzies. That's right: warm and fuzzies. We at IO Practiceware have been so pleased by the positive feedback we've been getting from the health care community, and especially those of you who have been following our product for a while, and especially especially those of you who have decided to take the plunge and implement our software.

Indeed, we have always suspected that the slow-turning gears of EMR acceptance would finally come full circle, but it's quite amazing to encounter affirmative feedback firsthand.

Why is this the case, you ask? Good question. We suspect that, most generally, EMR has become less scary. More specifically, with the newly-released CCHIT guidelines, the whole concept of certification has become more or less demystified (...much more on this topic in the next post...). What's more-- the practice landscape is now replete with success stories. EMR is no longer associated with failure, no longer the harbinger of doom. Instead, it is the gateway to the future! It is truth! It is beauty! It is freedom!

Bohemian maxims aside, AAO 2009 has been awesome. Thank you to all the folks (current customers included!) who have helped keep our spirits high. And, to those of you who want to join the party, be sure to check out our company website. Click here to contact us. We would be happy to set up a demonstration for you.

More to come soon!

It's good to be back.

--FR

Coming Attractions: AAO Joint Meeting, Oct 24-27

2009-08-28T12:20:00.000-04:00

(A sneak peek of what's coming up after the New York Retina Congress)

American Academy of Ophthalmology, Oct. 24-27, 2009
San Francisco | The Moscone Convention Center
IO PRACTICEWARE EXHIBITING AT BOOTH 2964

Click here for a complete list of exhibitor "virtual booths." IO Practiceware's is listed under the letter "I" -- or you can scroll through to page number 10 (we are the first listing at the top).

CCHIT Town Call's anticipated gist: "HURRY UP."

2009-08-25T15:55:00.000-04:00

Hate to say, "I told you so," but CCHIT's latest take on the long road to EMR adoption goes a little something like:

HURRY UP.

Their latest statement, released earlier today, urges health care providers not to wait until Spring of 2010 to begin adoption, because this will most likely prevent them from establishing meaningful use by the 2011 deadline. Press release excerpted below:

“We are concerned that providers could not achieve meaningful EHR use in 2011 if they wait until Spring 2010 – the expected date of HHS final approval of requirements – to begin adopting this technology,” said Mark Leavitt, M.D., Ph.D., Commission chair. “CCHIT has analyzed the recommendations of the Federal HIT Advisory Committees and is preparing to offer new paths to certification beginning this October. We invite vendors and developers to join us on a Town Call as we finalize the details of this process.”

CCHIT's Town Call, the latest in a series of group web conference whose intention is to incorporate the thoughts and concerns of doctors, practice administrators, as well as EMR vendors, will be hosted on September 3 at 1PM EST. Complete information on how to join the discussion listed below.

DATE: 9/3/2009
TIME: 1:00pm EST / 12:00pm CDT
WEB CONFERENCING: Information on how to link up online available here.

AUDIO: To use computer audio, you need speakers and microphone, or a headset.

To use telephone conferencing:
US/Canada Dial-in #: (866) 900-5706
Conference ID: 27236682

IO Practiceware to Exhibit at ASRS's Retina Congress 2009, New York City

2009-08-25T14:15:00.000-04:00

Hello, dear, friendly, and inexusably neglected, Blog readers!

Let it be here writ that IO Practiceware, paragon of EMR vendor-ship and goodwill toward ophthalomology, will be exhibiting at the upcoming ASRS Retina Congress of New York.

Will you be in attendance? Here are all the details you need to know:

The American Society of Retina Specialists (ASRS) Presents
RETINA CONGRESS 2009
September 30 - October 4, 2009
Sheraton New York Hotel and Towers
IO PRACTICEWARE EXHIBITING AT BOOTH 230

Booth number 230, is, for your information, a corner booth! And corner booths are reserved only for the most illustrious and popular individuals. It's like how Jack Nicholson always sits in one of the front rows at the Academy Awards. (Here is a complete ASRS booth floorplan.)

If you are not already signed up to attend the meeting, registration has unfortunately been closed to newcomers. But there's always next year or, if you'll be in San Francisco in October, AAO 2009.

Smartphone Survey Results

2009-08-03T11:07:00.000-04:00

From Softwareadvice.com:

Last week, Software Advice set out to answer the question: Which smartphone will own the healthcare market?

Doctors, nurses, students and many others in the healthcare industry responded to our survey.

You can find those results here.

Reductive Positivity Amidst the Mire of Uncertainty

2009-07-26T16:10:00.000-04:00

Dearest Readers,

Sure, sure, sure, we're all like, "What's going to happen with EMR?" "What if I don't get my incentive payment?" "Why won't Craig call me back?"*

(*This concern may, in fact, apply only to me.)

Friends, I have the answer: We must accentuate the positive. Because my last post was a real downer. And because things could always be worse. You could, for example, be Amy Winehouse. And -- what's more -- there have been some truly encouraging developments in the past few months with respect to EMR certification:

1) CCHIT is working around the clock alongside ARRA to define meaningful use for EMR vendors. Sure, it's still half-baked, but we can nevertheless smell its cake battery goodness emanating from the kitchen into the living room as we watch cartoons with our baby brother and fight over the remote control. And, sooner or later, Mom's gonna call us in for dessert. And by "Mom" I mean CCHIT/ARRA, and by "dessert" I mean we'll know for sure what the heck "meaningful use" means. And then lots of $$$ for you and your practice via the stimulus package's incentive payment plan.

2) Who am I really to push you to make a decision before you're ready, but: when you think about it, there is actually no reason to fret about the impending certification criteria. As I wrote in this article, EMR vendor compliance is an absolute, unconditional, take-no-prisoners, definite MUST. As in, vendor survival will depend solely on this compliance. As in, no need to delay. As in, what are you waiting for? As in, I won't hold it against you if you continue to wait, but there are some extremely important reasons why you shouldn't, like this one, for example.

3) IO Practiceware continues to be awesome. If you're not part of an ophthalmology practice, I'm sorry IO can't offer you our ophthalmology-specific software -- but if you are, you can smile broadly and pat yourself on the back for choosing the field in which the best EMR vendor in the universe has chosen to specialize. And then you can buy our software. (Why are we the best EMR vendor in the universe? Here are a few reasons why.)

So there it is folks, as promised. Reductive positivity. Because, in the words of the atomic particle: "I was pretty bummed yesterday when I lost my electron -- but you know what? Now I'm more positive."

--FR

Not Enough EMR to Go Around?

2009-07-20T18:24:00.001-04:00

Did you not have your dose of Cold Hard Truth this morning? Well, here's a pill or two:

There is an impending capacity overload for EMR vendors. IO Practiceware and, from what we've heard, our competitors have been working around the clock to accomodate the ever-growing surge of interest from practices planning to adopt EMR systems.

And while we will continue to provide the best possible service for every practice that's been queued up for a 2009 implementation, there's no freaking way we'll be able to support this level of interest if it grows at a more steeply exponential rate. Which means we'll have to cap off the volume of our customer base, and increase in the number of implementations per quarter at a much more steady, deliberate, and slow-moving pace. Which means some potential customers will, sadly, lose out.

The EMR industry as a whole -- and IO Practiceware in particular -- is having difficulty imagining how the EMR industry can satisfy the coming demands. Delivery times are lengthening, not only for IO, but for others in the industry. And the unfortunate reality for buyers is that practices that persist in twiddling their thumbs will ultimately lose out. Because, quite frankly, there won't be enough EMR to go around!

Think Christmas, Tickle-Me-Elmo, Ferbie. Same idea. Except, like, way, way more important.

If you're a prospective buyer, identify what's holding you back, and then demand that your questions be answered. IO Practiceware understands the Buyer's Dilemma with respect to CCHIT, but we've made our response pretty clear. (Article here.)

So: no pressure. Actually-- yeah, pressure.

Survey on Smartphones from SoftwareAdvice.com

2009-07-19T11:49:00.000-04:00

Do you use a Smartphone? You might want to post your two cents via this survey from SoftwareAdvice.com that closes Tues. July 28 @ 5PM. From the accompanying article:

The smartphone industry is on fire. iPhone, Blackberry, Palm Pre and Google are all in the hunt for dominance. We want to know one thing: Which phone will become the device of choice for healthcare providers?

Briefly: "Meaningful Use" Response from CCHIT

2009-07-02T14:48:00.000-04:00

After the ONC (Office of the National Coordinator) published its Meaningful Use guidelines and objectives (available here, with annotation), CCHIT responded with a cover letter assessing the value and anticipated shortcomings of those guidelines.

IO Blog commentary coming soon...

EMR: The Buyer's Dilemma

2009-07-01T15:51:00.000-04:00

Catch-22. Cart-before-the-horse. Chickens-before-they-hatch.

Pick an idiom. It seems from your email messages that any of the above encapsulates the conundrum of buying an EMR system before it has been certified. And we at IO Practiceware feel your pain. But we'd also like to put you at ease. But not in a sleazy way, involving low lighting or Barry Manilow music. Because, c'mon, Barry Manilow makes you uncomfortable, and you know it.

You may have many reasons to delay your EMR decision until next year or beyond, but concerns about CCHIT certification should not be one of them. IO Practiceware -- and all other EMR vendors -- have no choice but to follow the ARRA rules. It's true that certain consultants and other industry figures say that practices must wait until vendors get certified -- but this presumes that there's a high level of uncertainty and/or ambiguity surrounding the process and guidelines for certification. But there simply is not. Companies can either choose to take the necessary steps or choose not to.

For everyone's sake, we choose: certification.

And, it's like, um, obvious. Not only are we being compliant for our customers' sake, but getting certified is an unconditional must if we -- or any company -- hope to remain on the market as a viable EMR vendor.

IO Practiceware will be certified as an EMR-C ("Comprehensive"), as opposed to -M ("Module"), by CCHIT for the 2011-2012 period -- which is the soonest possible period for all vendors. (There is no freestanding 2009-2010 certification. In fact, all currently CCHIT certified vendors must be re-certified for the new period.) Testing will begin in September 2009, and we are gearing up for this process by developing all the necessary enhancements for our software. (Here is an article that breaks down the timeline in greater detail.)

So, believe it or not, you can start to breathe easy. In a world of relative uncertainty and inexplicability -- where haircuts like this achieve national celebrity -- CCHIT certification should be a comfort, not a source of angst. Given the recent revisions to its criteria, CCHIT has become a means by which EMR can achieve high functionality, uniformity, and interconnectivity. Vendors like IO Practiceware, committed to the success of customers and the EMR industry, will do what it takes, get certified, and work to improve American health care.

--FR

More on CCHIT from ModernHealthcare.com

2009-07-01T15:11:00.000-04:00

Article on exploring the effects of the new meaningful-use criteria.

The Latest from CCHIT: "New Paths to Certification" (Recap)

2009-06-16T14:34:00.000-04:00

If you didn't have time to take part in today's Town Call with CCHIT (or, if you did, and would like a pared-down recapitulation), here is a list of major points worth knowing:

There are now three paths to certification, and three different certification types therein:

1) EHR-C - which stands for EHR Comprehensive
2) EHR-M - which stands for EHR Module
3) EHR-S - which stands for EHR Site

All three constitute certification, but differ in their requirements.

Comprehensive - "Rigorous certification of comprehensive EHR systems that significantly exceed minimum Federal standards requirements." Needs to meet all of the Meaningful Use Objectives.

Module - "Flexible certification of Federal standards compliance for EHR, HIE, eRx, PHR, Registry and other EHR-related technologies." Needs to meet one or more of the Meaningful Use Objectives. Applies to many specialty-specific EMRs.

Site - "Simplified, low cost certification of EHR technologies in use at a specific site." Applies to "any physician office, clinic, hospital, other facility or network that has self-developed or assembled an EHR from various sources and wishes to apply to ARRA incentives."

Process of Applying for ARRA Incentive Payments

Certification by CCHIT allots various certification "codes" to the EHR vendor -- which apply specifically, and exclusively, to that vendor, and vary depending on the corresponding status (EHR-C versus -M versus -S have different codes) . These are then conveyed to the health care provider upon usage.
Health care provider submits these codes in their ARRA incentive payment application.
Health care provider must also submit additional "measure data" required for ARRA's own definition "meaningful use" (separate from CCHIT criteria).

Other Info / Points of Clarification

Providers do not apply to CCHIT for the incentive payment; they apply to HHS. The means by which this will be done is still unclear, and has not yet been stipulated. Will it be a contractor? An online site? Via regional extension centers? What we do know is it will be through some government-named body that will 1) accept CCHIT codes and provider application; 2) assess, reject or accept quality measure data; 3) send or withhold the incentive check.
EHR-M status can be awarded to groups of vendors. If certification is awarded to a group of vendors, they collectively must cover all (as opposed to one, or a few) Meaningful Use Objectives.
Certification awarded in two year increments.
Certification no longer "locked" into a software's parent version; all upgrades that maintain the previously approved Meaningful Use Objectives maintain those corresponding approval codes.
A provider's site can be certified as EHR-S, even if the EHR software has not been approved as EHR-C or EHR-M. If a site uses an EHR-C or EHR-M, then it is certified as an EHR-S. The converse, however, is not true: EHR-S does not confer -M or -C certification status onto the software in use.
CCHIT testing will begin in September of 2009. There will be no freestanding certification for 2009-2010. All testing will be geared toward the ARRA requirements for the upcoming 2011-2012 period. In other words, there will be no maintenance of any old CCHIT certification. (Click here for more on ARRA timing.)

If you have additional questions, you can email dwilson@cchit.org, me, or you can submit your comment below.

Complete CCHIT Presentation slide show available here.

CCHIT Hosts "Town Call" Web Conference June 16 & 17

2009-06-15T12:51:00.000-04:00

Tired of seeming complacent? Well, here's a chance to make yourself heard:

CCHIT to Propose New Paths to Certification

CCHIT has announced two Town Call web conferences on June 16 and 17 to gather stakeholder input on new paths to certification of electronic health record (EHR) technologies, with the goal of supporting more rapid, widespread adoption and meaningful use under the American Recovery and Reinvestment Act of 2009 (ARRA).

To join the calls:

Tuesday, Jun 16, 2009 1 PM EDT / 10 AM PDT
“New Paths to Certification: Dialog with the Open Source Community”
Dial-In Number: (866) 900-5706
Conference ID: 15249954

Wednesday, Jun 17, 2009 11 AM EDT / 8 AM PDT
“New Paths to Certification”
Dial-In Number: (866) 900-5706
Conference ID: 15316708

For more information, see CCHIT Town Calls.

Be sure to tune in!

"Meaningful use" criteria slated for June 16

2009-06-02T22:42:00.000-04:00

Briefly: much buzzed-about meaningful use criteria will supposedly be released by the federal government on June 16. These criteria will apply to ambulatory and in-patient EMRs.

Jury out on specifics of stimulus in New York

2009-06-01T22:47:00.000-04:00

Because my company is based in New York I've gotten a lot of queries about how the national total of $19,000,000 allotted toward health care technology will be available to the state of New York. The best answer I can give is: check out the New York State Senate's page, which includes a helpful breakdown of national funding versus New York funding, arranged by application and area of impact.

But next to "Health Information Technology" for New York? A looming and conspicuous: "TBD."

So, stay tuned and check back. I'll convey the details as soon as I know them.

--FR

Practice Management Blog! (And you thought you'd seen it all)

2009-05-21T16:47:00.000-04:00

Because we niche Bloggers need to stick together, let me plug a little gem of a weblog that my colleague came across recently while listlessly browsing the internet. It's called Manage My Practice, and, in the words of editor Mary Pat Whaley, it "provide[s] healthcare executives and medical practice managers [with] a place to find resources and information."

Mary isn't joking around, and, as a Board Certified Healthcare manager and a Fellow in the American College of Medical Practice Executives, she certainly knows her stuff.

We at IO Practiceware are tech-y types, so we're particularly stoked about the "Technology Answers" section. But the whole site is a wealth of information. With topics that span from "Innovation" to "Reimbursement," Manage My Practice tips you off on the latest in several corners of healthcare, from Medicare to swine flu to Twitter.

Way to go, Mary; keep up the good work!

--FR

Patients say, "EMR is A-OK"

2009-05-19T17:27:00.000-04:00

Check out this recent article from ScienceDaily, which recounts Beth Israel Deaconess Medical Center's qualitative poll of patients about their opinions on EMR use. The basic gist is that patients are willing to sacrifice some standards of privacy in exchange for better, streamlined communication with their medical care professionals.

CCHIT: Docs, What Matters to You?

2009-05-12T14:17:00.000-04:00

Few credible articles begin with sweeping generalizations, but here I go (again): Doctors are acting as mere bystanders while regulatory groups -- for whom physician's needs are not paramount -- decide the future of electronic medical records. And the world. (How's that for sweeping?)

But, seriously, here's what's been going on: Docs receive pronouncements from the government, or other organizations like CCHIT, that will not only determine the fate of health care IT, but which will radically influence their day-to-day lives as medical practitioners. In the meantime, there's a lot of fretting, twitching, Googling, and conjecturing about what is to come. It's an insidious kind of self-disenfranchisement: doctors proactively (and rightfully) strain to listen to the cacophony of voices that have something to say about EMR, but are then reluctant to disagree with what they're hearing. And most of the time these voices do not address or accommodate the specific needs of ophthalmologists -- the ones who will actually have to come in contact with the new technology.

Docs, it's time to take matters into your own hands!

Okay, so I work for an EMR company. If you're a doc, there are probably some trust issues here. But, in all seriousness, it's become apparent to my colleagues and me that, without fail, the issues that concern doctors about electronic health records do not align with the issues prioritized by the higher ups.

And why should they? Apples and oranges, folks. Doctors want an EMR that will work for them: something that is fast, usable and will not compromise their work flow or productivity. In turn, EMR vendors are working to develop products that will respond, specifically, to these challenges.

The government, on the other hand, presumes the blanket success of the EMR industry to be a foregone conclusion. As such, health care higher-ups have preemptively -- and prematurely -- devoted their efforts to the regulation and proliferation of the industry.

But -- what industry? C'mon.

Consider CCHIT-certification. Nearly all stipulated criteria thus far have revolved around issues external to individual practices -- issues like auditing or interconnectivity. There's nothing inherently bad about tackling these issues, but it's a total cart-before-the-horse scenario. The timeline has been curiously inverted, such that less-pressing issues garner precedence over other measures that would ensure usability.

Take, for instance, the requirement that EMRs support DICOM images. Fine. It's something that, if uniformly adopted, would foster standardization and, eventually, interconnectivity. The problem is: almost no (or at least, very few) ophthlamic machines create DICOM images. There's no so-called "community network" to move these images around in. So why, then, make this a pressing issue for 2009?

The need for more doctor involvement in the regulation of EMR is clear. How can you get the ball rolling? Write to ASCRS. Write to AAO. It's at least a start. Make sure that your interests are being met. Create pressure so that the issues that matter in the exam room (speed, interoperability with practice management systems, etc.) are prioritized.

EMR is still in its infancy. In order to serve doctors and to succeed as an industry, we should be most concerned with enhancing and streamlining actual usage. Of course, IO Practiceware believes deeply in the importance of interconnectivity with other practices -- but it should be Stage 2, as opposed to Stage 1, of the CCHIT certification process.

Stage 1: Let's make it happen.

--FR

Email the author

EMR is the Horseless Carriage of the New Millenium

2009-05-02T19:04:00.000-04:00

Dear Blog Readers,

I am stuck on a train. The engine has stopped working. In times of crisis and/or intense boredom my thoughts naturally turn to electronic medical records. I dedicate the following unfounded and under-researched article to all the EMR-skeptics out there (you know who you are).

Presenting,

E.M.R. is the Horseless Carriage of the New Millenium, or
GOOD IDEAS PEOPLE* THOUGHT WERE BAD
UNTIL THEY REALIZED THAT THEY WERE GOOD
*In some instances, "people" may, in fact, mean only me.

Horseless carriages or, as we now call them, cars. Yes, hopefully you saw this coming from the title.
The American Revolution. I think of IO Practiceware as the rebel army and myself as General George Washington. The British correlative is, um, paper charts.
Rihanna's mullet-esque haircut. I was destroyed by it at first, but now I see its many merits.
Bikini waxes. Like EMR because momentary burning sensation precedes lasting silky smoothness.
Telling my sister Santa doesn't exist.
Shuffleboard. I have no evidentiary basis for saying this, but if you've seen the sport played I'm sure you'd agree that early on someone must have been skeptical about its potential for widespread appeal. But how wrong they were.
Indigo-colored nail polish. I have received many compliments and I don't believe them to be disingenuous.
The internet. Right?
Baby carrots.

And to round things out, here are a few
BAD IDEAS PEOPLE* THOUGHT WERE GOOD
UNTIL THEY REALIZED THAT THEY WERE BAD
*Same rules apply.

Clear-colored Coke.
Younger men.
This article.

Sincerely,
FR

Nuts and Bolts of an IO Implementation

2009-05-01T15:47:00.000-04:00

Three Weeks, Three Links

2009-04-29T18:03:00.000-04:00

Dear Faithful Blog Reader,

I have been neglecting you for the past three weeks, and for this I am deeply sorry. As an act of contrition, I offer you one EMR-related link for each week of my remission:

1) You've probably heard this one already, but in case you haven't: Obama promised to create an interconnected EMR system for veterans. Hooray! Read more...

2) Only 1 in 4 doctors knows about the $44,000 (per doc) incentive payment awarded to those practices that adopt electronic medical records. If you're the 1 in 4 who's still in the dark, read this.

3) Is there a future for Mac in electronic health record development? Read this post from the Software Advice blog, which describes the potential success of a not-yet-developed-but-so-called "iTablet" -- a portable, touchscreen-based device (hmm...sound familiar?) that could have widespread applicability in Health Care IT. [Oh, look! My own horn; let me toot it: in espousing the benefits and usability of the hypothetical iTablet's touchscreen, Software Advice's article more or less reiterates my own arguments in favor of IO Practiceware's touchscreen-based system. Booyah!]

Paper Medical Records "Blowing in the Wind"

2009-04-08T12:17:00.001-04:00

Those of you who have nightmares about the Big Brother dystopia that will be wrought on our planet when electronic medical records make significant headway should check out this article from Richmond, VA's WTVR.com, which describes how yesterday morning a large pile of paper charts were "blowing around" a Babies R Us parking lot.

In conclusion: paper is cool for things like funny hats, not patient charts.

Days 2 & 3: Joyous, Excruciating ASCRS Conference Continues

2009-04-07T10:21:00.000-04:00

How can I possibly impart to you the perplexing reality that is working a vendor Booth at the San Francisco ASCRS show?

I will now quote Britney Spears, in rapid succession, without explanation or qualification:

1. "I have always wanted to travel across seas, like, to Canada and stuff."

2. "If I had a bad show and I know it, don't tell me I had a good show. I hate that. I guess because I'm 17, people think I don't see stuff like that.”

3. "I think it's stupid when you see guys with big necklaces. I think that's the biggest turn off in the world. Who do they think they are?"

4. "I'm rich - freaking RICH."

--FR

IO Travel Journal: Tales from the ASCRS Ghetto

2009-04-05T10:40:00.000-04:00

Greetings, faithful Blog readers! I write to you now from my comfortable and quintessentially flamboyant San Francisco hotel room, while wearing giraffe-print bath robe, in anticipation of Day 2 of the ASCRS conference.

Yesterday was alternately joyous and excruciating - joyous because I had the pleasure of meeting many of you and excruciating because I was in four-inch pumps. I failed to take adequate notes on the goings on of the show, but I will be sure to do so today and will report back with due diligence. Yesterday, the play-by-play went something like:

8:50 AM Walked to Moscone Center in heels. Ouch.
9:10 AM Began setting up our Booth.
9:55 AM Befriended some nearby ASCRS compatriots. Stole their candy.
10:55 AM Dear God, these heels.
12:01PM SHOW OPENS! Flood of visitors to Booth 3032! Like bees to honey! Like sharks to blood! Like me to the restroom when it was time to get picked for sports teams in seventh grade!
...Yada yada yada yada lots of interest, holy cow, I don't think I've said the acronym "EMR" more times in a row and with such high-pitched inflection....
4:55PM Why were high heels invented?
6:00PM Celebratory dinner of paella and tapas with the IO Team. Sangria. Lots of Sangria.

Hope to see you all today. More Blogging to come...

--FR

(Picture: "Felicia Gives ASCRS the Thumbs Up")

News Article: A Patient's Perspective

2009-04-02T11:51:00.001-04:00

Take a look at this recent article from The Huffington Post about electronic medical record use -- written from a patient's perspective.

Author Elizabeth Rigley says she's mostly impressed with her doctor's system (she doesn't name the vendor), but also has some concerns. Among them:

"The patient does a lot of the typing" [during check-in]
"Sick patients typing on the same keyboard = germs"
"I hadn't considered that it can take a really long time for a doctor, who rarely typed before as a part of this job, to type in the facts you are telling him. For someone who types quickly, this can be a little excruciating to witness."

Do you see a trend? Using a keyboard for information input is, in a word, problematic.

But this is hardly an unavoidable consequence of EMR. On the contrary, IO Practiceware can actually help you gain speed in the exam room. How?

Two words: Touch Screen!

To learn more, check out this article, this FAQ, or visit our company website.

Opinion: EMR not a cure-all, but an enabler

2009-04-02T09:05:00.000-04:00

In a recent US News and World Report blog article by Avery Comarow, the author writes that

...about one fourth of more than 175,000 medication errors registered in 2006 "involved some aspect of computer technology as at least one cause of the error." Mislabeled bar codes, confusing screen displays, and physicians overriding warnings on the screen about a drug were among the examples cited. Bad health IT, or bad use of it, can kill as effectively as low-quality care of any kind.

Hm. This seems like a false attribution to me. "Computer technology" (a vague phrase, indeed) is cited as being "one" component that led to various errors - but Mr. Comarow does not stipulate how or under what circumstances.

To this I say, briefly: Physicians who choose to override computerized pharmaceutical warnings are not doing so because they are hampered by the supposed impediments of EMR, but are rather persisting in what seems to be a lack of vigilance and responsibility on the part of that individual provider. EMR will continue to manifest these oversights, but one cannot attribute those kinds of errors - which are perhaps more prevalent, though less documented, with the use of paper charts - to Health IT.

Electronic health records is not a cure-all - to say this short changes the arguments in favor of EMR. EMR can, and will, enable health care providers to achieve the utmost in interoperable, fluid, and unified care - but only if those providers share a common commitment to its success.

Emeril says, "Visit IO Practiceware at Booth 3032!"

2009-03-23T14:16:00.000-04:00

IO Practiceware will exhibit its software at Booth 3032 (see above) at the American Society of Cataract and Refractive Surgery's 2009 Congress and Symposium this coming April 3-8 in San Francisco, CA.

We'll be demonstrating many of our new features, including:
1) New e-prescribing software - in partnership with SureScripts, our software delivers to your practice Medicare's 2% incentive. (Read more...) 2) New PQRI software - providing you with better automation for reporting PQRI measures. 3) New image management software - enabling you to view multiple images on your electronic chart, between visits, and across several diagnostic tests and images -- which essentially means better comparative capabilities. 4) New financial management and scheduling software. Based on customer feedback, we have revamped these key features to provide you with a clearer economy of information, more accessible references for faster payment posting, and clearer streams of display.

Finding booths at ASCRS can be tricky, so write down our number! 3032! 3032. Yes: 3032.

As a mnemonic: envision Emeril Lagasse violently yelling, "Booth 3032!" while throwing spices into a steaming cauldron.

Interest in EMR Explodes!

2009-03-23T12:43:00.000-04:00

That's right, you heard me! EMR and health care IT use has more than doubled in five years, a new American College of Physician Executives survey says. According to a core group of 10,000 ACPE members, use of electronic medical records has skyrocketed from 33.1% to 64.5%, and only 5.9% of participants said they were not preparing for future implementation.

For those who had not yet adopted EMR or were reluctant to begin planning, "cost" was cited as the primary concern. Indeed, physicians and their practice teams can become overwhelmed if they consider EMR systems as being revenue-negative.

In response, IO Practiceware hopes you will read this recent post on EMR cost vs. EMR value.

And then we hope you will join us in the EMR revolution!

(Source: ModernHealthcare.com's "Doc use of IT up; money still key issue")

Is Wal-Mart off the Wall(-Mart)? Thoughts on EMR Cost

2009-03-17T15:33:00.000-04:00

For the Record: AAO on CCHIT

2009-03-06T12:41:00.000-05:00

For those interested, here is the American Academy of Ophthalmology's official stance on CCHIT with respect to eye care:

The 2007 Ambulatory EHR Criteria represent basic requirements that the Commission and its workgroups believe are appropriate for many common ambulatory care settings. CCHIT acknowledges that these criteria may not be suitable for settings such as behavioral health, emergency departments, or specialty practices and our current certification makes no representation for these. Purchasers should not interpret a lack of CCHIT Certification as being of significance for specialties and domains not yet addressed by CCHIT Criteria.

Currently, there is no eye care specialty CCHIT certification. The current process for testing is not designed for eye care only EHR vendors, and they cannot participate in the process. A lack of current CCHIT certification does not have significance for eye care specialty needs. Current CCHIT certification means that the system satisfies basic ambulatory care needs. Practices need to look at different systems and how they best meet your needs in delivering eye care services.

From Flora Lum, M.D.
Quality of Care and Knowledge Base Development, AAO

Get with the Times, NYTimes: A Letter from Our CEO

2009-03-02T14:24:00.000-05:00

In response to the New York Times' Article "How to Make Electronic Medical Records A Reality":

While it is undeniable that the adoption of electronic medical records (EMR) is hard, the solution selected by the City of New York to endorse one product and spend a great deal of resources on that one product only makes the problem worse. There are many reasons why adoption is difficult, but the most important one is value creation for the practice. Regulatory uncertainty adds to the confusion and uncertainty about adopting EMR.

If all EMRs unquestionably created value for a practice, all other problems would not matter very much. The truth is that many EMRs on the market today slow down doctors in the examination room and either add to or are neutral as to the administrative burden of the practice. In addition, a general-purpose EMR is not the best solution for most medical specialties. Better EMRs that do indeed create clinical and administrative efficiencies are slowly gaining acceptance -- as experience validates the value they create in the medical practice and word gets around. The worst possible thing governments can do at this point is to adopt a "One Size Fits All" mentality, select a single EMR product to cover all medical specialties and to make it the "official choice." This will stifle innovation and slow the process of value creation that competition fosters. This is a good time to let “a thousand flowers bloom."

Government can help the adoption of EMR by dealing with the regulatory environment. Government programs, agencies, and quasi-governmental agencies such as the Certification Commission for Healthcare Information Technology (CCHIT), the primary association certifying EMRs, need be to sensitive to the need to create value in practices as they regulate EMR. An example of poor priorities is to set future public benefits before present need of value creation. Currently, CCHIT certification requires that EMRs communicate with (mostly non-existent) central data repositories, but not that they support practitioner workflow in the exam room by efficient recording of data or help practices with patient communication or insurance billing. If medical practices do not get value from EMRs, they will not implement them and any value that improved communications can offer will not be realized. Government regulation and policy should not eliminate innovators from the EMR field by well-meant but overly burdensome requirements; they should foster value creation by supporting many solutions for the varied and complex needs of the different specialties in the medical world.

While value creation for practices must come first, the regulatory environment must be clear as well. Practices are reluctant to purchase EMRs from companies that may not meet regulatory rules. Therefore, a clear regulatory path is essential to promote EMR adoption. Congress and/or Medicare needs to enact national standards for EMR that clearly state what regulations will be implemented and when.

Government programs designed to help practices implement EMRs are doomed to fail if the EMRs don’t create value for practices.

Sincerely,

Gregory Leopold

Got comments? Post them below!

How Much Will IO Cost You? A Letter from our CEO

2009-02-25T16:40:00.000-05:00

Dear Friends of IO Practiceware:

In this otherwise challenging economic time, one bright spot for physicians is the new economic stimulus bill. The bill instructs Medicare to pay physicians who use electronic medical records (EMR) a total of $47,000 each (over a five year period). This means that your purchase of our software is now nearly or completely free. The cost of an outright purchase will be returned to you over five years. If you lease the software, you'll have no out of pocket expense at all.

To receive an estimate tailored to your practice, please email us with the following information:

Approximate number of patient encounters each month
Number of offices with significant patient volume
Do you dispense glasses? if so, at how many locations?
Which diagnostic test equipment do you use (imaging, lensometers, OCTs, etc.)

The bottom line is: IO's software increases your revenues 2-5% and lowers your costs 5-20% -- even without additional incentives. With the new incentive, it's pretty much an economic no brainer.

Our implementation calendar is filling up, but we can always make room for your practice.

If you'd like to start working with us to improve your bottom line, give us a call or send us an email.

Regards,

Gregory

Health Care IT: The Latest from the Obama Team

2009-02-16T13:19:00.000-05:00

By now you've probably caught wind of Obama's advocacy of health care IT -- exciting news for doctors and EMR vendors alike. According to President Obama, our shared goal of improved efficiency, connectivity, and cost-effectiveness is achievable through widespread EMR adoption.

Most recently, Congress has approved of allocating $19 billion toward health care IT -- specifically, transforming paper charts into their electronic form -- as part of a greater $100 billion push for better, more widespread health care coverage. (Read more...)

Moreover, Congress has declared that physicians who use electronic medical records are eligible for up to $44,000 in incentive payments, which will be delivered over a four or five-year period as of 2011. Early birds who begin using EMR by December 31, 2010 or 2011 are eligible for an $18,000 first-year payment, followed by $12,000, $8,000, $4,000 and $2,000 in subsequent years. If practices begin use by December 31, 2012, payments in years 2-5 are the same, but their first-year payment is reduced to $15,000. The reception of this EMR incentive, however, will preclude physicians from collecting additional money for e-prescribing. As for penalties, those who do not adopt HIT incur a 1 percent penalty in their Medicare fee schedule payments in 2015, 2 percent in 2016, 3 percent in 2017, and 3 percent every year beyond that.

Now, ladies and gentlemen, we continue to speculate on how exactly, in practical terms, the Obama team will aid in the implementation of this plan for digitized health records. Indeed, IO Practiceware believes in the value of some form of standardization for EMRs -- to enable and promote practice interconnectivity -- but is wary of the roadblocks posed by CCHIT's limited definition of a "certified" EMR system.

In the meantime, we applaude the Obama administration for encouraging EMR adoption through monetary incentive, enabling the emergence and implementation of specialty-specific EMRs like IO Practiceware.

What do you think? Contact Obama's team or write to your state's senator.

In the meantime, you can check out some related articles: Obama's Big Idea: Digital Health Records, from CNN.com or our previous Blog post on Obama.

IO Practiceware to Exhibit at ASCRS 2009

2009-02-16T12:01:00.000-05:00

IO Practiceware will exhibit its software at the American Society of Cataract and Refractive Surgery's 2009 Congress and Symposium this coming April 3-8 in San Francisco, CA. Come visit our booth (number 3032), where we'll be showing off our software, answering questions, and performing live demos. And elaborate tap dances.* We will also be dressed like the Osmonds.*

(*Subject to change.)

Moreover, we'll be demonstrating many of our new features, which include:

New e-prescribing software - in partnership with SureScripts, our software delivers to your practice Medicare's 2% incentive. Read more...
New PQRI software - providing you with better automation for reporting PQRI measures.
New image management software - enabling you to view multiple images on your electronic chart, between visits, and across several diagnostic tests and images -- which essentially means better comparative capabilities.
New financial management and scheduling software. Based on customer feedback, we have revamped these key features to provide you with a clearer economy of information, more accessible references for faster payment posting, and clearer streams of display.

Again, IO Practiceware's station will be located at Booth 3032. Finding booths at ASCRS can be tricky, so for an easy mnemonic, just remember:

Booth = (F - 4) x 58, if F = the square root of 3166.924.

Or just write down "3032."

Hope to see you there!

Frequenty Asked Questions

2009-02-14T15:27:00.000-05:00

Everything You Always Wanted to Know About IO Practiceware*
*But Were Afraid to Ask

Q: Is IO Practiceware an internet-based system or does it utilize a server on the practice site?

Q: Your big-button touch screen design is fast, but does it limit functionality?

Q: Why are there no dropdowns?

Q: Why doesn't IO use templates like other EMRs?

Q: In the event of an extremely anomalous patient or finding, does the doctor have the option of typing in notes?

Q: Will IO Practiceware let me e-prescribe and collect Medicare's incentive in the coming year?

Q: Does IO Practiceware supply its own practice management system?

Q: Should I buy IO Practiceware's practice management system or interface with my existing PMS?

Q: Does IO Practiceware use an external system to manage its images, or is this included in the system?

Q: Are there additional fees for updates, upgrades, customer service, hardware and network, or is this included in the pricing?

Q: I would like to get a price quote from IO Practiceware - what information should I send to you about my practice?

Q: If a doctor wants to order a medical work-up, how does he/she print out the specific tests to avoid actually writing it out by hand?

Q: Do you have a sample CD of your software that I can play around with before I purchase your product?

Q: Why do you need to "supervise" my playing with your software?

Q: How much does IO Practiceware cost?

Q: How do I submit an FAQ?

Click here any link above to see its corresponding answer.

Spotlight on IO Practiceware in Ophthalmology Management

2009-02-10T12:30:00.000-05:00

Ophthalmology Management, a monthly magazine distributed both online and in print, has featured IO Practiceware in its February Technology and Technique section. The article zooms in on New Jersey-based ophthalmologist Ron Sachs as he recounts his experience transitioning to IO's electronic medical records and practice management systems.

Dr. Sachs offers some general info on IO's improvement of his practice's workflow, noting specifically the benefits of IO Practiceware's billing system (included in the software), his practice's ease of transition, and, most importantly, the fact that IO Practiceware was tailor-made for ophthalmologists -- and only ophthalmologists.

The article also quotes Charles Reing, M.D., one of the doctors who helped design IO Practiceware. He believes confidently that IO's software offers 95-98% of what eye care physicians and their staff are looking for in an EMR system.

Which is to say: we're not perfect -- but we're pretty darn close.

Click here to read the full article in Ophthalmology Management.

Related links: Dr. Reing's article in the Review of Ophthalmology about choosing IO Practiceware (2006).

EMR-phobia: Winding and Unapologetic Musings About How Everyone Is So Freaking Scared of EMR

2009-02-10T00:26:00.000-05:00

You may have asked yourself: who exactly writes IO Practiceware's Blog? Is it an actual person, or a hapless team of subhumans who must submit to the deranged and senseless dictates of one omnipotent, EMR-obsessed ruler?

Does/do this/these person/people really think he/she/they is/are funny?

All valid questions, but ones that must remain unanswered. (That is, er, unless you email me yourself. Minor loophole.) And in order to kindle this fire of ambiguity (?), I'm going to relay to you an anecdote from my night out tonight...

While wearing an outfit that can best be described as hipster-meets-mariachi-band (think black skinny jeans and sequined vest), I attended a musical theater cabaret show at Don't Tell Mama in midtown Manhattan. One of my good friends from elementary school (who, incidentally, proposed to me in the third grade) was entertaining on stage. 55 minutes of musical-theater-song-stylings short, it was a rollicking good time.

THE POINT IS. Afterwards when I said hello to my friend's parents -- whom I hadn't seen in years -- I told the dad (who, you should know, is a doctor) that I was in the EMR business.

Here's where it gets freaky-tastic, folks. That's right: freaky-tastic. No sooner had the fated acronym "E-M-R" left my lips than had Dr. Dad broken into a cold, EMR-induced sweat and begun to make a bee-line for the Christmas light-cabled doorway.

"Dr. Dad, wait!" I yelled. He stopped and spun around to face me. "What's EMR ever done to you?!" I cried, in tears. We held intense, unflinching eye contact for about fourteen minutes. Finally, Dr. Dad agreed to sit down and talk it out.

Here's where the drama dies down a bit; what ensued was a basic, run of the mill back and forth about the pros and cons of electronic medical records. (Which is to say, I schooled him! OH BAM!)

But I will not get into the minutia. I write this self-described "Winding and Unapologetic" "article" not to parse apart the common arguments for and against EMR, but rather to convey to you the harrowing knee-jerk reaction of a doctor who is EMR-phobic, and to reflect on the experience.

I do not blame the man for being so staunchly opposed to EMRs; they have a bad rep, and for good reason! Dozens of EMR systems have slowed doctors in the exam room and caused them to lose precious time and money. Furthermore, docs are worried that a new health care IT era means the ultimate ascendancy of a Big Brother-esque figure, whereby all people's health records will be instantly accessible to all kinds of crazies.

In response, I could say:

Read this.

Or this.

Or this.

And, unrelatedly, take a look at this.

But I won't. Instead, I say: Friends, Romans, countrymen! Like all things unknown, EMR systems are scary! But, please, know: you are not alone! IO Practiceware would like to help you! We believe in collaboration, and disclosure, and a freeflow of information that enables, as opposed to compromises, our customers and their practices.

So: when you feel yourself breaking into a cold sweat and making a metaphorical bolt for the metaphorical exit, take a deep breath and don't shut the door on EMR just yet.

Give us a call. At the very least, we'll have a seat and talk it out.

Squeaky wheels seek CCHIT oil

2009-01-27T18:52:00.000-05:00

CCHIT's timeline for EMR certification excludes ophthalmology-specific EMRs like IO Practiceware until the year 2011. While we in the Eye Care community have an overwhelming urge to go Chuck Norris on CCHIT, we're going to first try peaceful resistance.

If you believe in the value of specialty-specific EMRs, make your voice heard! Post comments below.

To start the dialogue, here is a letter from Gregory Leopold, CEO of IO Practiceware:

Some of the most innovative EMRs are specialty-specific. This is certainly true in ophthalmology. While it may be self-serving to say so, it is true that non-specialty specific EMR have generally failed to supply ophthalmology practices with the tools they need to record their exams properly and cost effectively. The American Academy of Ophthalmology has been working with a group of ophthalmology-specific EMR companies to develop scripts for CCHIT certification for ophthalmology-specific EMR vendors. The work on these scripts has been completed and they could be used immediately to certify ophthalmology specific EMR companies.

While we appreciate CCHIT’s willingness to work with us in this area, the timeline for completion of the CCHIT certification process for eye care – which is currently set for 2011 – is unacceptable. Other EMR vendors in the AAO sponsored group share my concern and disquietude.

It is crucial that the timeline be moved to 2009 – or that some sort of arrangements are made for ophthalmology-specific EMR companies to receive some sort of “in progress” certification that allows us to participate in a marketplace that increasingly shuts out non-CCHIT certified products.

Either let us in now or tell the world that it’s OK for us to be “in the process”. It would be a great disservice to the cause of EMR if CCHIT were to drive some of the most innovative EMR companies out of business because it could not certify them promptly.

If our respectful protestations don't get CCHIT's attention, we may have to resort to Article B: a diatribe of semi-vulgar, though pun-obscured expletives entitled, "Cut the *BULLCCHIT*" (stay tuned).

Touch Pad Technology, or, Our Superiority Complex

2009-01-19T15:37:00.001-05:00

Let's be honest: at IO Practiceware, we think we're pretty awesome. Why?

Three words: Touch Screen Interface.

"Touch Screen" = self-explanatory. "Interface" = our software's ability to communicate between chart displays and information tables, creating a system of truly integrated data entry, retrieval, revision and review.

But what make's IO Practiceware's Touch Screen Interface better than other companies'? Why the self-described "superiority complex?"

Well, apart from the fact that all our employees are ridiculously and inexplicably attractive, our software was designed as touch screen software -- which is to say, to support touch screen data entry. Other companies that "use" touch screens usually do not offer software that is properly designed for this form of input. Which means that it doesn't make much of a difference whether or not you use your finger, a mouse, a pencil, a herring bone - it's all just as slow (even slower!) than paper charts.

So how does IO Practiceware remain a shining beacon of truth and beauty?

IOInfo: How To Clean Your Touch Screen

2009-01-16T14:44:00.001-05:00

Let's face it: all that touching can make you feel...dirty.

So get cleaning!

Any standard glass cleaner can be used to clean the IO Touch Screen, but be sure to avoid products containing ammonia.

Always spray the glass cleaner on the cloth or towel first and then clean the Touch Screen. Glass cleaner sprayed directly on the monitor could possibly leak inside a non-sealed unit and cause damage.

Dirt and fingerprints do not affect the operation of a properly sealed AccuTouch or IntelliTouch touch display.

Which means if you clean your IO Touch Screen effectively, you'll never have to wash your hands or trim your nails again! Your patients may object, but your Touch Screen won't.

IOInfo: Calibrating Elo Touchscreens

2009-01-16T12:00:00.000-05:00

Over time, your Elo touchscreen may require calibration. Often this becomes apparent when the mouse or pointing icon does not appear in the location where you touched the screen -- which often becomes apparent when your doctors or techs shout expletives from the exam room.

To protect the innocence of young children in the waiting room, all you need to do is calibrate your touch screen!

How?

Yes We Can: Under Obama, Bright Future for Health Care, EMR

2009-01-11T15:13:00.000-05:00

We all knew President-Elect Barack Obama looked great in his skivvies, but some were skeptical about his proposed health care plan. To what extent, we still wonder, will Obama advocate for better health technology? How much money will he allocate toward facilitating widespread adoption of EMR systems?

On Thursday afternoon the Harbinger of Hope proposed a preliminary outline for a $100 billion package for healthcare, and at the top of this agenda is a plan to bestow new incentives onto practices that use electronic medical records. It seems he has great faith in the future success, and necessity, of EMR. Says Obama:

To improve the quality of our health care while lowering its cost, we will make the immediate investments necessary to ensure that, within five years, all of America's medical records are computerized. This will cut waste, eliminate red tape and reduce the need to repeat expensive medical tests.

IO Practiceware Goes Paperless in 2009

2008-12-31T16:28:00.000-05:00

E-Prescribing: IO Delivers Incentives to Your Practice

2008-12-29T15:24:00.000-05:00

Click here for full article.

In the coming year, many ophthalmology practices will switch to e-prescribing in order to reap its numerous benefits: CMS is offering a 2% incentive payment of a practice’s total Medicare reimbursement -- in addition to the 2% PQRI incentive. Using IO’s new e-prescribing EMR software release is simple and increases productivity in the practice. This will mean:

No more work prescribing drugs than is currently required
No more paper Rxs to print, retrieve, and hand to patients
No more printer jams
Greatly reduced need to order and pay for special Rx paper
Better tracking of medications

PQRI from A to Z: An Ophthalmologist's Guide

2008-12-22T11:00:00.000-05:00

In 2009 the Physician Quality Reporting Initiative (more affectionately known as PQRI) will increase their number of measures to 153 (also the total number of touchdowns NFL quarterback Roger Staubach threw during his career... coincidence?!) and we suspect you'd like to know what this will mean for your ophthalmology practice.

Where to start? You've probably consulted the harrowingly long-winded CMS website and found numerous PDFs that describe each measure and the accompanying procedure for reporting.

But because weeding through this information is about as pleasant as getting a root canal in the Lincoln Tunnel while driving at rush hour wearing a hair sui t and talking on the phone with your mother-in-law, IO Practiceware has done the dirty work for you (because we like pain!) and compiled a summary of all PQRI info that relates to ophthalmology and your practice.

To view the summary, click here or the above link.

Need more? See also our articles on Auto-Coding and E-Prescribing.

Still need more? Leave a comment!

--IO

Help Us Revise Our Website

2008-12-19T10:44:00.000-05:00

IO Practiceware's Company Website is undergoing a number of changes.

We're trying to determine how exhaustively one can (or should) represent an EMR or PMS system via the World Wide Web. We're like moody adolescents: we go back and forth between wanting to tell you everything and wanting to be as concise as possible, and wanting you to mind your own business, Mom! and then wanting to paint our nails and talk on the phone and go to the prom and [insert adolescent cliché].

Because, seriously -- trying to get you to like our multi-faceted and expansive EMR and PMS system just by looking at our website is like trying to get you to marry this guy named Neville based on his Facebook profile.

We'd like your input! You there. Yes, you. We're wondering:

What information is most crucial to you when you're looking online for an EMR or practice management system? What purpose should that company's website serve for you -- should it be a preliminary introduction, a "preview" of the software, or a comprehensive representation of the software?

Leave us a comment, send us an email, or give us a call (212) 844-0105.

Yours in Truth,

IO Practiceware

Troubleshooting: Stop the "Anti-Virus" Virus

2008-12-16T15:37:00.000-05:00

Hey everybody,

Many of you have been asking questions about a recent "anti-virus" virus that infiltrates your system by pretending to be anti-virus software. Once you install the "software," it infects your system so you then have to buy more and more virus-disguised-as-software to eradicate it. Pretty tricky, right? Like eating ice cream cake to lose weight! Or shaving your head to grow out your hair! Or asking Tom Cruise for advice!

But, behold: here is an article from PC World that explains how to remove the virus from your computer. Bam. It's time we out-virused the anti-virus virus.

Yours as ever,

P.S. If you found this article helpful, have any questions, or know of any more info, leave us a post in our comments section!

News Article: EMR a 'no brainer'

2008-12-03T12:37:00.000-05:00

Dear Faithful Blog Readers,

FierceHealthcareIT, which publishes weekly articles relating to the health care industry, has just posted something worth checking out: it's an op-ed by Anne Zieger about how EMR is awesome. If you think we're biased (and we're not! Okay, maybe we are), just take it from Anne. She'll give you an informed account of how EMR will fatten the proverbial hen that is your practice, salvage the future of health care, and save the world as we know it.

Ever yours,
IO

Act II: "E-M-Are You Serious?"

2008-11-27T23:30:00.000-05:00

(a continuation of Nov. 25's post "Is EMR really that scary?")

Doctor: So, IO-- while I like what I'm hearing, I'm skeptical. The sad fact is, doctors have been using paper charts since the beginning of time--

IO: --well, since the beginning of doctors, and paper...

Doctor: -- right -- and, you have to understand, I've heard horror stories from friends who invested in an EMR system that not only slowed them down and failed to increase revenue, but actually made them lose money. How do I know IO Practiceware won't do that?

Is EMR really that scary?

2008-11-25T14:29:00.000-05:00

No need to be scared. Breathe. Three little words: "Electronic Medical Records." That wasn't so bad, was it? We know -- you're scared of EMR. And who could blame you? Humans have always been scared of the unknown. I, myself, refused to try spinach until I was in college (dining halls have the uncanny ability to oblige culinary exploration).

We're guessing that if you aren't already using EMR, the idea of ditching your paper records seems about as appealing to you as regrouting your bathroom or going on a date with this guy.

And we feel your pain. To you, EMR is unknown. And the unknown can be scary.

That's why the team at IO Practiceware is here to assuage your fears. We proudly present:

"Everything You've Always Wanted To Know About EMR*
*But Were Afraid To Ask"
(A Three Act Play)

Act I - "The Stubborn Ophthalmologist"

IO: I suspect from your cherry red complexion and the fact that your fists are clenched that you're frustrated.

Doctor: Hmmmph.

IO: You're worried that the government is going to force you into buying EMR?

Doctor: Hmmmph.

IO: You're frustrated that your three year-old daughter can use the internet faster than you can?

Doctor: ...I'm just...not good with computers. I'm afraid EMR will slow me down in the exam room! How will I keep my practice on schedule and on task?

IO: Look, Doc, here's the thing: IO Practiceware designed its EMR with ophthalmologists like you in mind. Our touch-screen interface requires no fancy typing, no complex commands or codes. Not only is the touch pad easy to use, but it's way faster than writing, typing, or using a mouse.

Doctor: But won't it take me forever to learn how to use it?

IO: Au contraire, mon ami! Our staff works with you on-site for two weeks to teach you everything there is to know about using our EMR. Think of it as a kind of EMR boot camp, except you don't have to shave your head.

Doctor: Okay, okay. I'm intrigued. Can you tell me more?

(Stay tuned for Act II - "E-M-Are You Serious?")

What is IO Practiceware?

2008-11-25T13:36:00.001-05:00

As software designed exclusively for ophthalmologists, IO revolutionizes the way your practice works. With a unique touch-screen interface, accurate auto-coding, electronic medical records, image and practice management systems, a two-week on-site training program, and 24/7 personal care from our staff, it’s no wonder our product has 100% success.

At a Glance: EMR Background Info

2008-11-25T02:05:00.000-05:00

"Why is everyone so obsessed with EMR?!" you shout at your computer screen. "I take pride in my doctorly chicken scratch!" You hurl your microwaveable lunch at a potted plant and start convulsing. Then stillness, before you whisper:

"What is the meaning of life?"

Indeed, it's understandable if thoughts of EMR induce inexplicable bouts of existentialism -- days where you wake up wondering why, oh WHY you must burden yourself with thoughts of electronics and software and other such technical nonsense. Why, oh WHY!

There's no quick fix for these symptoms. But, for starters, take a peek at this article, which will give you a basic overview of ophthalmology EMRs, their checkered past, their illustrious future.

Hugs and kisses,

Welcome!

2008-10-25T13:55:00.000-04:00

Welcome to IO Practiceware's official blog, where you'll find news, updates, articles, and case studies relating to our EMR and practice management software. We also post links and articles that involve or relate to the greater ophthalmology community. Questions or comments? Email our webmaster.

Touch Pad Technology, or, Our Superiority Complex

2008-10-18T16:14:00.000-04:00

Let's be honest: at IO Practiceware, we think we're pretty awesome. Why?

Three words: Touch Screen Interface.

But what make's IO Practiceware's Touch Screen Interface better than other companies'? Why the self-described "superiority complex?"

So how does IO Practiceware remain a shining beacon of truth and beauty?

Our large data entry buttons function quite differently from a mouse pad, keyboard or stylus -- and are significantly faster. Having to scroll through dropdown menus or type information is frequently what slows doctors down when using EMRs. Our system, however, doesn't ask you to do this; it guides you screen to screen, with data entry a mere, single click away.

Moreover, the draw function in our charts allows you to record your visual observations electronically, at which point these observations are interpreted and translated for you, which removes the need for redundant data entry and greatly reduces time spent in the exam room.

To summarize:

We're awesome.
Why?
Because we look like the cast of Baywatch.
Also because of our Touch Screen Interface.
Unlike other companies, our software was designed for touch screen data entry.
Our big button design means super lightning speed in the exam room.
In Irkukstian Dialect, IO Practiceware means "World Peace."

Need more info? Check out our "Learn More" page.

YES WE CAN: Under Obama, Bright Future for Health Care, EMR

2008-10-11T15:10:00.000-04:00

To improve the quality of our health care while lowering its cost, we will make the immediate investments necessary to ensure that, within five years, all of America's medical records are computerized. This will cut waste, eliminate red tape and reduce the need to repeat expensive medical tests.

Consistent with IO Practiceware's outlook, Obama envisions a future of highly interconnected practices and medical treatment centers, benefitting patients, doctors, and medical staff with a new grade of efficiency and cost-effectiveness; to the Obama administration, the adoption of EMR should, and will, reflect the new era of technological savvy within the communal, and global, network of health care. As Chris Frates from Politico.com writes in "Health care could nab $100B payday":

The streamlining effort is aimed at improving quality and saving money and could include digitizing patients’ medical records and pushing doctors to use e-prescribing.

Some of those funds would be funneled as incentive payments directly to doctors and hospitals that participate in Medicare, which provides health care to the nation’s seniors. The idea is similar to the payments used to coax doctors to make the upgrade from prescription pads to e-prescribing.   A critical component...is getting medical practitioners access to the Web, which would reduce paperwork, allow them to communicate more efficiently with each other, and track the care and history of patients even as they change doctors.   

Officials would also like to fund a coordinator who would help set national health IT standards to govern the emerging system. Uniform standards are key to creating a system under which a doctor in New York can access the medical records of a tourist from Oklahoma.

Whoa! A President-Elect who champions EMR! Who would have thought Barack Obama could electrify audiences -- and medical records?! (Bad joke.) Who knew he could deliver so much change -- to your pocket! (Worse joke.)

In all seriousness, what does this potential "$100B payday" mean for you and your practice? Our friends over at the Health Care blog have expressed concerns in the past over the efficacy -- or more precisely, practicality -- of Obama's plan. Like many persons in the medical community, their qualms manifest a strong mistrust of paperless practices, with a particularly cynical outlook on electronic medical records in general.

In the midst of this skepticism, the Team at IO maintains: "Yes We Can." But what about you? What concerns do you have about widespread use of EMR?

Please submit comments below, and check out our upcoming post on EMR adoption ("Crossing Ts and Dotting Eyes: EMR, Point by Point").

From the archives: A testimonial

2008-10-06T02:30:00.000-04:00

Don't just take it from us, read here about one practice's successful implementation of IO Practiceware.

(Of course, in the two years that have past since its publication, IO has made significant changes and improvements; still, this article might give you some useful perspective.)

"E-M-Are You Serious?"

2008-10-01T23:35:00.000-04:00

(a continuation of Nov. 25's post "Is EMR really that scary?")

Doctor: So, IO-- while I like what I'm hearing, I'm skeptical. The sad fact is, doctors have been using paper charts since the beginning of time--

IO: -- well, since the beginning of doctors, and paper...

Doctor: -- right -- and, you have to understand, I've heard horror stories from friends who invested in an EMR system that not only slowed them down and failed to increase revenue, but actually made them lose money. How do I know IO Practiceware won't do that?

IO: Okay, a few things. Of all the systems we've installed since we opened as a company, 100% of our EMRs have benefited the doctors and their practices. Which is to say, to this day, all of our clients use their EMR successfully.

Doctor: E-M-Are You Serious?

IO: Oh yeah.

Doctor: How? Explain.

IO: Where to start? To be honest, most people looking into purchasing EMR don't always know what to look for. Because of this, the touch screen might not at first seem all that crucial to the success of your EMR. But we assure you -- it is. It's just faster. Period.

Doctor: Don't a lot of other companies' EMRs use touch screens as well?

IO: Some do, yes...but beware of impostors! With these other companies' touch screens, the on-screen maneuvering with your finger functions exactly like a mouse, so it isn't any faster. Sometimes it's actually slower.

Doctor: Tricky distinction. How is IO's touch screen different?

IO: Well, our software was programmed specifically to support the touch-screen interface, so when using our EMR, you never have to simulate the act of writing, typing, or using a stylus with drop down screens; this wouldn't speed things up much. Instead, we thought long and hard about the best way to group together observations, diagnoses, and recommendations, such that we lead you from screen to screen, from button to button, anticipating your next move, assisting you in grouping together observations. These systematic and logical groupings, combined with the inherent fastness of using a touch screen to push buttons, helps you to positively fly through your patient's exam.

Doctor: How have you catered your software so specifically to the needs of ophthalmologists?

IO: Well, unlike a lot of other companies that sell EMRs, IO Practiceware was designed exclusively for ophthalmologists. To that end, we've researched extensively the best way to organize our charts so they make the most sense for you -- logical groupings by symptom, possible treatments -- you name it.

Doctor: And do I also have the option of customizing according to my own preferences and methodologies?

IO: You betcha!

Doctor: Whoa, you just sounded like Sarah Palin.

IO: Sorry.

Doctor: So what about imaging?

IO: That's one of the coolest parts! In addition to having all x-rays, printouts, and patient-related images right there at your fingertips, our EMRs have a draw function that not only lets you record your visual observations, but which will interpret your markings on the spot, supplying you with possible diagnoses even before you have to look them up.

Doctor: Wow.

IO: Yep. The whole process is so quick, you might even have time to kill -- which means you'll have to make small talk, maybe ask your patient about his golf swing, or tell some eye-related jokes, or do that trick where your pen disappears.

Doctor: I love that trick.

IO: I know, me too.

Doctor: Okay, now I'm really interested. Tell me more!

(stay tuned for Act III: "Crossing T's and Dotting Eyes")

IO Practiceware Goes Paperless in 2009

2008-10-01T16:20:00.000-04:00

In order to provide our customers with the best possible service, IO Practiceware has reinvigorated its commitment to cutting costs and creating an eco-friendly business model by eliminating its use of paper. Mailings, invoices, release memos, and other important informational will be conveyed electronically over email.

While worldwide paper consumption was on the rise throughout the 1980s and ‘90s, in recent years there has been a net decrease of 9 percent in developed countries. The paperless model now pervades a variety of businesses and continues to find new applications – from online banking to electronic boarding passes to (of course) electronic medical records.

A paperless business – like a paperless ophthalmology practice – improves workflow by eradicating wasteful habits, like the unnecessary printing out of correspondences, memos, faxes and other miscellany that cost money, time and efficiency. We at IO Practiceware believe that operating entirely electronically reflects and typifies the goal of our electronic medical records and practice management software, which is to streamline and optimize your practice’s functionality, creating tremendous value that will increase greatly over time.

IO is in the process of collecting official email addresses from its current customers. (If you are a customer who has not yet replied to our e-memo, please be sure to forward or confirm your official email address(es) to fricci@iopracticeware.com.)

IO will continue its efforts to create a cost-effective and green workplace and will keep you abreast of its ongoing developments. We look forward to reporting back on how this change benefits us – and you – in 2009.

(For more on the benefits of our paperless EMR and PMS software, click here.)

E-Prescribing: IO Delivers Incentives to Your Practice

2008-10-01T15:08:00.000-04:00

In the coming year, many ophthalmology practices will switch to e-prescribing in order to reap its numerous benefits. CMS is offering a 2% incentive payment of a practice’s total Medicare reimbursement -- in addition to the 2% PQRI incentive. Using IO Practiceware’s new e-prescribing EMR software release is simple and increases productivity in the practice. This will mean:

No more work prescribing drugs than is currently required
No more paper Rxs to print, retrieve, and hand to patients
No more printer jams
Greatly reduced need to order and pay for special Rx paper
Better tracking of medications

IO Practiceware is working in partnership with SureScripts, the largest and best e-prescribing partner; together, the two companies will provide your practice with these services:

Secure electronic transmission of prescription information.
Electronic refills. When patients request a refill from their pharmacy, practices receive the request electronically and are able to approve the request with the click of a button.
Formulary and eligibility information will be instantly available.
Drug cautions and interactions will be shown.
In time, complete patient medication histories will be downloadable – saving tech time.

In order for a physician to qualify for the 2% Medicare incentive, he or she will need to prescribe electronically and report on at least 50% of qualified cases throughout the calendar year. This does not mean that practices must begin reporting on January 1, 2009. The 50% is gauged by the total number of patients seen throughout the year. Thus, you should not worry if your practice does not begin e-prescribing or reporting until the spring; you will still be able to qualify for the incentive payment.  In order to e-prescribe and report, practices must:

Sign up with IO for this service. The cost of installation is one month’s maintenance. The cost of use is a surcharge of 10% on your Monthly Fee.
Register. IO will do this for you.
Receive training. Before you begin using e-prescribing, we will provide your practice with a training session regarding how the process works.
Use the IO software to e-prescribe. The IO clinical software has been modified so that your front desk can record which pharmacy each patient wants their prescriptions sent to. Otherwise, there are no changes in the way you write Rxs.
Report. Medicare is informed that you are e-prescribing by including a “zero dollar” service code on each claim for which you report an office visit code.

There are three codes that will be used and IO will automatically put these codes on the claims for you. The codes are:

G8443 – All prescriptions for this visit were sent electronically through a qualified e-prescribing system.
G8445 – You have a qualified e-prescribing system but no drugs were prescribed during this visit.
G8446 - Some or all drugs prescribed during this visit were printed or were phoned in because of one of the following reasons:
Required by law (Schedule II-V drugs or other state law)
Patient request
Qualified e-prescribing system temporarily unavailable

In short: E-prescribing will soon be available to IO customers, and those who use IO to e-prescribe will find the new incentive translates to a significant increase in revenue.  If you have questions, please feel free to contact us.

Ophthalmic PQRI Measures

2008-09-22T11:32:00.000-04:00

IO Practiceware sifted through the 2009 PQRI measures and compiled a list of those that relate to ophthalmology practices that use EMR. Below is a breakdown of measure number, measure description, reporting procedure, diagnosis codes (to combine with office visit code), reporting code, and modifiers on those reporting codes.

By implementing IO Practiceware's EMR software, your practice automatically satisfies measures 124 and 130.

12 - POAG

Optic Nerve Evaluation
365.01, 365.10, 365.11, 365.12, 365.15
2027F
1P, 3P

14 - AMD

Dilated Macular Examination
362.50, 362.51, 362.52
2019F
1P, 2P, 3P

18 - Diabetic Retinopathy

Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy
362.01, 362.02, 362.03, 362.04, 362.05, 362.06
1P, 2P, 3P

19 - Diabetic Retinopathy

Communication with the Physician Managing Ongoing Diabetes Care
362.01, 362.02, 362.03, 362.04, 362.05, 362.06
5010F and G8397, or G8398
2P, 3P, 8P

117 - Diabetes Mellitus

Dilated Eye Exam in Diabetic Patient
250.00, 250.01, 250.02, 250.03, 250.10, 250.11, 250.12, 250.13, 250.20, 250.21, 250.22, 250.23, 250.30, 250.31, 250.32, 250.33, 250.40, 250.41, 250.42, 250.43, 250.50, 250.51, 250.52, 250.53, 250.60, 250.61, 250.62, 250.63, 250.70, 250.71, 250.72, 250.73, 250.80, 250.81, 250.82, 250.83, 250.90, 250.91, 250.92, 250.93, 357.2, 362.01, 362.02, 362.03, 362.04, 362.05, 362.06, 362.07, 366.41, 648.00, 648.01, 648.02, 648.03, 648.04
2022F or 2024F or 2026F or 3072F
8P

124 - HIT

Adoption/Use of EMR
All patient encounters
G8447, G8448
No modifiers

130

Documentation and Verification of Current Medications in Medical Record
All encounters with patients 18 years or older
G8427, G8430, G8507, G8428, G8429
No modifiers.

139 - Cataracts

Comprehensive Preoperative Assessment for Cataract Surgery with IOL Placement
Encounters with patients 18 years or older
0014F
8P

140 - AMD

Counseling on Antioxidant Supplement
362.50, 362.51, 365.52
4177F
3P, 8P

141 - POAG

Reduction of IOP by 15% OR Documentation of a Plan of Care
365.10, 365.11, 365.12, 365.15
3284F, 0517F and 3285F, 0517F with 3P and 3285F, 0517F with 8P and 3285F
3P, 8P

E-Prescribing: Better Than Chocolate

2008-09-21T11:37:00.000-04:00

IOInfo: Calibrating Elo Touchscreens

2008-09-16T15:11:00.000-04:00

To protect the innocence of young children in the waiting room, all you need to do is calibrate your touch screen!

How? Follow these steps:

1. Get to the Alignment screen.

2. If an Elo icon is available in the tool tray at the lower right side of the desktop, click it, then click Align. Otherwise, go to the Windows Control Panel, double-click Elo Touchscreen and click the Align button on the General tab.

(If no Elo icon, click the "Switch to Classic View" button on the left.)

3. Touch and release the upper left target; the target should jump to the lower right.

4. Touch and release the lower right target; the target should jump to the upper right.

5. Touch and release the upper right target; the target should jump to the lower right.

6. Touch and release the green check mark; the check screen should disappear.

7. The cursor should now jump to the point of touch.

8. If the Elo Control Panel is open, close it and the Windows Control Panel.

For more info, visit Elo's Support Page.

Nuts and Bolts of an IO Implementation

2008-05-01T16:06:00.000-04:00

Besides its staff being inexplicably and distractingly attractive, one thing that sets IO Practiceware apart from other electronic health record companies is its commitment to customer service.

Yeah, sure, you've heard the phrase "customer service" more times than you've heard mention of swine flu, or Susan Boyle, or whether Susan Boyle has swine flu, in the past few weeks. But here at IO Practiceware, when we say "customer service," we mean it!

One prime example of just how extensively IO Practiceware's blood, sweat, and streaming river of tears go into supporting its customers is the infamous IO Implementation -- or, as I like to call it, OPERATION: WE DON'T SLEEP, SO YOU CAN.

I participated in my inaugural on-site implementation one week ago at a three-doctor retinal practice in Central Florida and realized that many of you would probably be curious to know what the heck goes on. I have therefore decided to record my experiences in a way that's significantly more illuminating than, say, my ASCRS 2009 Diary, which was purely an exercise in indulgence and irrelevance.

So: if you'd like a play-by-play of what its like transitioning to IO's EMR system, read on!

IO IMPLEMENTATION

Preparation: IO Practiceware sends one of its employees down to your practice a week and a half prior to initial training in order to set up and configure your network. This means, basically, IO connects all of your new hardware, makes sure the server and internet connection are functioning. In addition, IO takes all the patient demographics that have been stored in your previous practice management system and converts them into IO's practice management system (though not the clinical portion).

Step One: IO Training. We take a full day to teach the practice management / scheduling portion of the software and two days to teach the clinical. Another half day or so is devoted to the billing portion. We set up a cluster of computers in your practice's waiting room area (or wherever there's room) so that the office staff can learn everything together. (See picture at top.) All of IO's staff, which usually numbers between three and four people, is on hand during these classes to answer any questions that may arise.

Meanwhile, Step Two: Members of the practice note problems or concerns they have, and also begin a log of software preferences -- for example, a working list of "Favorites" (where available in the software) are customized to suit the needs of the specific practice. A good portion of the dialogue about these customizable features occurs during training.

Step Three: IO takes a peek at your pre-existing practice management / scheduling system and converts all upcoming appointments so that you can receive patients, old and new, into the new system as they arrive for their appointments.

Step Four: GO LIVE! This is where things get...hairy, so to speak. But into the fray we venture together, fearless and ready to fight! The most difficult part of "going live" with IO Practiceware's software is the initial workflow disruption. IO Practiceware recommends that practices see somewhere between five to seven patients electronically on the first day. Often, these are patients who are new to the practice -- the reasoning being, it's easier to begin using the clinical software on patients for whom you don't have to cross reference old, paper charts.

There's often a good deal of miscommunication on the first, even second, days of going live. Common questions and points of confusion depend on the practice, but they most often have to do with general anxiety about mistakenly performing redundant tasks -- or, in the effort to eliminate redundancy, neglecting to perform those tasks.

It also takes a day or so for an office staff to get used to the flow of how our practice management system relates to our clinical software -- namely: a patient cannot be seen in the exam room if he or she has not been checked in properly and, conversely, a patient cannot be checked out if his or her clinical chart has not been "closed" in the exam room.

Meanwhile, Step Five: IO looks at your practice's outgoing letter templates and converts them into IO Practiceware; these letters are henceforth generated from the IO exam software.

Meanwhile, Step Six: All patients, old or new, get their picture taken and have their IDs and insurance cards re-scanned into the new system.

Step Seven: IO Practiceware stays at your practice for two weeks after your first "go-live" day. Each day, three or so more patients are seen electronically. The onus of picking and choosing which patients to see electronically becomes transferred from the IO Staff (who have, initially, been the Taskmasters of making sure the practice continue to challenge themselves with the clinical software) to the ophthalmology practice's staff.

Meanwhile, Step Eight: The on-site IO staff keeps a dynamic log of glitches, challenges, and suggestions that present themselves after the first go-live day. We stay late after the last patient is seen to do "clean-up" and to continue to customize the software as best we can.

Step Nine: How to deal with old patient charts? It's really the practice's preference. Many times old billing information is converted so that old procedures and visits are automatically incorporated into the patient's electronic chart. Oftentimes, the office staff will need to take some time to scan old images or chart notes such that they become digital, and accessible through IO's EMR.

Step Ten: Typically, by the time IO Practiceware leaves the transitioning practice, all patients are being seen electronically.

And that, my friends, is a basic play-by-play of an IO Implementation. It is quite an endeavor, and is quite time consuming for the IO Staff. But we feel incredibly strongly that it's most important to get your practice up and running properly, even on the first day, so that you have a working, useful product that will support and enhance your practice.

Any questions? Did I leave something out? Post your comments below.

--FR

Is Wal-Mart off the Wall(-Mart)? Thoughts on EMR Cost

2008-03-17T16:22:00.000-04:00

Wal-Mart, beloved and reviled omnivendor, plans to sell "affordable" EMR software to smaller practices that are loath to invest in "higher costing" systems. Hardware, software, installation, maintenance and product training will be available through Sam's Club for a price that, apparently, undercuts competition by 50%.

Well, I don't know whether I should clap my hands together like a jolly newborn or claw at my own skin while listening to this song.

Because, on the one hand: Nothing could be a clearer harbinger of widespread EMR use and adoption than to see Wal-Mart jump on the proverbial EMR-bandwagon. And that's nice.

But, on the other hand: What?!?!?!

If practices reluctant to adopt EMR are willing to invest in systems simply because they're cheap, we suspect these practices are laboring under some major misconceptions about the value and function of EMR.

Thus, we would like to offer our two cents regarding EMR cost versus EMR value. (Since our specialty is ophthalmology, we will speak about our experiences in that particular field -- though we believe you can apply our points more broadly to other specialties.)

When considering the switch to EMR, a practice should calculate the value of the EMR system. We believe value can be assessed by the following three questions:

1. Will the EMR compromise workflow and slow me down? If an EMR slows you down in the exam room, you can't afford it - no matter what it costs. Unfortunately, many EMRs, particularly general purpose EMRs, do just this, and claim it to be a necessary drawback of all EMRs. This is not the case! Specialty-specific EMRs, like IO Practiceware, are generally better at addressing the needs of each practice - and so can actually enhance and improve workflow. We can't speak for all specialty-specific EMRs, but we know, for a fact, that ours is fast.

2. How much time will my staff and I have to spend customizing the software? Most vendors require that you create or modify templates. They claim that these templates are an important part of customizing process. We believe, however, that asking doctors to create templates for their most common findings is simply an admission that the EMR company (because it wasn't designed exclusively for a specialty, like ophthalmology) doesn't understand enough about that specialty to create software that allows physicians to enter their findings. While templates might seem like a plus, they actually ask you to make decisions about EMR that you are unequipped to make - not because you don't know your field, but because you are unequipped to design software. No offense, or anything. But, yeah -- I can't run a 3 minute mile, and you can't design software! Deal with your limitations!

3. How much help will I get transitioning over to EMR? Implementing an EMR is a big change for your practice. We have learned from experience that you can use some help during the first weeks after installation - particularly with respect to solving the inevitable workflow problems that arise as you move to any new system. If your EMR package doesn't come with this kind of customer service and attention, then it is likely you have invested in a product you won't be able to use properly.

Now that we've laid it down, it's time for us to toot our own horn: We believe that IO creates more value than its competitors because it's much faster in the exam room, it can be easily integrated and customized to suit your ophthalmology practice's workflow, and its package comes with training and support that ensures success.

We know that many of you fret about EMR cost. Many vendors, like Wal-Mart, charge “a la carte” – a certain number per physician, per office, for data conversion, equipment interfaces, training, on-site support, and other add-ons. But IO prefers inclusive pricing – including in the initial estimate all the things a particular practice will need. (For more info on our pricing, click here.) And while different vendors use different formulae to calculate price, the truth is: all the serious EMR players in ophthalmology end up with about the same result. And if not, well... just ask yourself the three aforementioned questions and determine the true value of your (ostensibly) "cheap" purchase.

IO Practiceware offers you a complete system. We sometimes joke that our competitors sell an EMR "kit." But we deliver a finished product - without sacrificing any potential for customization.

IO Practiceware is revenue positive from the start -- with no sunk costs, not even in the first year. This should be a major consideration in your quest to find an EMR that's right for you.

Questions? Comments? Leave us a note below or send us an email.

(Cited: FierceHealth IT's article on Wal-Mart's EMR Marketing.)

IO Practiceware: Frequently Asked Questions

2008-03-05T14:50:00.000-05:00

Everything You Always Wanted to Know About IO Practiceware*
*But Were Afraid to Ask

Or, Frequently Asked Questions

Q: Is IO Practiceware an internet-based system or does it utilize a server on the practice site?

Q: Your big-button touch screen design is fast, but does it limit functionality?

Q: Why are there no dropdowns?

Q: Why doesn't IO use templates like other EMRs?

Q: In the event of an extremely anomalous patient or finding, does the doctor have the option of typing in notes?

Q: Will IO Practiceware let me e-prescribe and collect Medicare's incentive in the coming year?

Q: Does IO Practiceware supply its own practice management system?

Q: Should I buy IO Practiceware's practice management system or interface with my existing PMS?

Q: Does IO Practiceware use an external system to manage its images, or is this included in the system?

Q: Are there additional fees for updates, upgrades, customer service, hardware and network, or is this included in the pricing?

Q: I would like to get a price quote from IO Practiceware - what information should I send to you about my practice?

Q: If a doctor wants to order a medical work-up, how does he/she print out the specific tests to avoid actually writing it out by hand?

Q: Do you have a sample CD of your software that I can play around with before I purchase your product?

Q: Why do you need to "supervise" my playing with your software?

Q: How much does IO Practiceware cost?

Q: How do I submit an FAQ?

Q: Is IO Practiceware an internet-based system or does it utilize a server on the practice site?

A: IO's software can run with or without a local server. In offices where patients are seen more than one day a week, IO recommends the use of a local server in order to achieve the maximum speed possible - particularly in the exam room - because using a local server optimizes some of our software's features (i.e. scanning, image management and interfacing with test equipment). If a practice prefers remote connection via the internet to either a server hosted at the main practice office or at IO's office, we recommend this only for locations where patients are seen less than one day a week or where patient volume is very light. Back to FAQs

Q: Your big-button touch screen design is fast, but does it limit functionality?

A: The IO screens are designed to present you with the all information you need to perform the task at hand. Each screen presents only the portion of the patient's record that is required for analysis and a method for entering your findings, impressions or billing information. IO believes that displaying all information on a single screen slows you down because it's harder to see the information you're looking for. Back to FAQs

Q: Why are there no dropdowns?

There are no dropdown menus because they slow doctors down. Our big-button design offers the fastest possible interface -- a tried and true method of fast data input. (Ever been to a fast food restaurant? Orders are entered via touch screen.)

Perhaps it's helpful to think of IO's touch screen as a series of rooms, and each button as a doorway. When a doctor sees a new patient, he or she walks through a series of doorways, systematically and consistently arranged, and "maps" the patient's specific diagnoses and treatment plans. Each room has a theme or principle of arrangement that can be customized by the doctor, depending on what he or she frequently records, prescribes, or notes (see next question).

If it's hard to conceptualize through our description how exactly IO Practiceware's software works, we strongly encourage you schedule an online demo. It's the best way to understand firsthand just how fast IO's data entry is. Back to FAQs

Q: Why doesn't IO use templates like other EMRs?

A: Asking doctors to create templates for their most common findings is an admission that the EMR company (because it wasn't designed exclusively for ophthalmology) doesn't understand enough about the specialty to create software that allows physicians to enter their findings. IO presents findings to doctors that are related to ophthalmic conditions and easily facilitates entry via a graphical interface (i.e. just touch the finding and touch the corresponding part of the eye). Of course, if the physician is interested in customizing IO's software to suit his or her needs, it is possible to adjust many of the IO screens and fine tune them to individual doctor's clinical and linguistic preferences. The key difference is: we don't ask you to perform the impossible task of inventing your own software, because, inevitably, you'll spend more time later trying to fix it. Back to FAQs

Q: In the event of an extremely anomalous patient or finding, does the doctor have the option of typing in notes?

A: Yes. All systems come with a keyboard and mouse. While our touch screen design discourages the use of typing (because typing is much slower), doctors may use the keyboard (or dictate) if the need arises -- but it's IO's job to make sure that rarely happens. And, believe us, our buttons cover pretty much everything -- including Marcus Gunn jaw-winking...and its reverse! Back to FAQs

Q: Will IO Practiceware let me e-prescribe and collect Medicare's incentive in the coming year?

A: Yes. We are currently in the process of becoming fully certified with our partner, SureScripts-RxHub, at which point we will offer the service of e-prescribing to all practices that use IO's EMR system. Back to FAQs

Q: Does IO Practiceware supply its own practice management system?

A: Yes. IO Practiceware's software includes its own practice management system. We can, however, (in most cases) interface with your practice's existing PMS (see next question). Click here for more information on IO Practiceware's integrated PMS. Back to FAQs

Q: Should I buy IO Practiceware's practice management system or interface with my existing PMS?

IO's system can interface with your existing PMS if the software is capable of interfacing with an HL-7 system -- which is, in short, a software standard by which transactions and information exchanges can exist between pieces of software (i.e. name, phone, address, etc.). We have found, however, that operating with two separate systems leads to more costs than benefits, primarily because after you install our EMR system you will have to pay two monthly fees (one to IO Practiceware for upkeep, service, and continuing development, and one to your PMS provider). In the end, however, it is entirely up to your practice to decide the best way to proceed. Back to FAQs

Q: Does IO Practiceware use an external system to manage its images, or is this included in the system?

A: IO Practiceware's software includes its own system of image management that is fully integrated with your practice's test equipment. We can, however, interface with your practice's existing image management software if this is a preferable. Click here for more information on IO Practiceware's image management system. Back to FAQs

Q: Are there additional fees for updates, upgrades, customer service, hardware and network?

A: No. Your monthly fee includes all enhancements and upgrades. Back to FAQs

Q: I would like to get a price quote from IO Practiceware - what information should I send to you about my practice?

A: To estimate the cost of installing our IO software in your practice, we need to know the following:

Approximate number of patient encounters in an average week
Number of full time / full time equivalent doctors your practice has (MDs, DOs, and ODs)
Number of practice locations
Do you dispense glasses? If so, at how many locations?

Email us for a customized estimate. Back to FAQs

Q: If a doctor wants to order a medical work-up, how does he/she print out the specific tests to avoid writing it by hand?

A: Our software allows you to print a test order with a single click. Simultaneously, the software notes the command on the patient's chart and posts a note in the "alert" section of our "highlights" screen. This means that our disposition sequence ensures 1) that the patient's work-up is accurate, 2) that the patient's chart records the request for this work-up, 3) that some sort of follow-up will occur, whether that's a notification to say the test has been done or to remind the doctor/practice that the test is still outstanding. Through easy notation in an area called "clinical follow-up" the chart maps the test results and monitors non-compliance. Back to FAQs

Q: Do you have a sample CD of your software that I can play around with before I purchase your product?

A: IO welcomes you to use our software yourself, but, rather than hand you our EMR on a CD, we ask you to engage in what we call "supervised play." Supervised play means you set the pace and the exploratory path, but we get to tag along and help you if you get stuck. Supervised play is done remotely from the comfort of your home or office and an IO Practiceware staff member watches and concurrently answers your questions over the phone. Back to FAQs

Q: Why do you need to "supervise" my playing with your software?

A: Imagine you'd like to do something else unfamiliar -- like, fly a fighter Jet or bake an apple soufflé -- would you go at it alone, or would you seek the guidance of someone who knew the ropes? Without them, how would you know which buttons to push? How much powdered sugar to sprinkle? Of course, our EMR is much easier to master than fighter jets or soufflés, but the point is: during supervised play, our goal is to act as a resource for you as you experience our software for the first time. You would do a disservice to yourself if you randomly clicked around screens that had no meaning to you and led you to decide, because of misinformation, that IO Practiceware's EMR was simply a pain in the neck. So give supervised play a shot; you'll be glad you did. Back to FAQs

Q: How much does IO Practiceware cost?

A: There is great diversity among ophthalmology practices that use our software, so it's impossible for us to publish a cost estimate that accurately applies to every practice in the community. We are happy, however, to give you a customized estimate based on these criteria. Back to FAQs

Q: How do I submit an FAQ?

A: Post your question in the "Comments" section below, or request a call back from our IO Team. Back to FAQs