Electronic Medical Records

Transcription

1 IN THIS ISSUE Electronic Medical Records... 1 Volume Fifteen Issue Two May 2012 Electronic Medical Records About the ViewsLetter... 1 Did You Know... 2 Tattoos - Not Just For Artistic Expression... 3 Trend Tidbits... 3 Your Questions... 4 Technical Corner... 5 Computerized medical records continue to be a hotly debated issue among health care providers, insurance carriers and industry stakeholders. Some studies show that these electronic medical records (EMRs) reduce administrative costs and improve the quality of care. Others indicate the potential savings and quality improvements are overstated. For example, a recent Health Affairs article suggested that office-based physicians with access to electronic imaging tend to order more follow-up images than physicians without electronic access. Many health care providers have been slow to adopt EMRs, which are often standalone and accessible only by the hospital or doctor providing care. The technology is readily available, but the cost is usually the drawback. It is expensive to convert to an electronic-based system. Not only is the technology itself expensive, but there is also a cost associated with the time it takes to enter all the paper records and to train the staff. EMRs can streamline record keeping and improve efficiency in a number of ways: Less time spent pulling charts: Once a practice converts to electronic medical records, paper charts are no longer necessary. Office staff can use any electronic workstation to access patient charts. In fact, some physicians use ipads for portable access to records. In addition, they can enter patient information electronically. They no longer have to pull files, enter data manually and then refile the charts. Fewer opportunities to lose data: With paper files, chances for human error are abundant, even in the best managed environment. Paper notes and records can be misplaced or lost. About the ViewsLetter We welcome you to the second quarterly issue in Volume Fifteen of the McGraw Wentworth ViewsLetter. It is our mission to be the leader in the employee group benefits brokerage and consulting industry to mid-sized organizations. We have established the ViewsLetter as an integral part of our commitment to keep Continued on page 2 you informed of benefit trends, legislative and marketplace developments that may affect your group benefit programs. We welcome your comments and suggestions regarding the ViewsLetter. You can pass your comments directly to your McGraw Wentworth Account Director or Account Manager, or you can reach us at

2 Electronic Medical Records, cont. Patient records can easily be misfiled. Record-keeping errors can be extremely difficult to find and correct. Universal chart access: EMRs can be accessed simultaneously at multiple points in the office. For example, a physician can view the file for a visit and enter progress notes. At the same time, a nurse can update immunizations, while the front desk enters the patient s next scheduled visit. Improved external and internal communication: EMRs reduce administration time. They allow administrative personnel to multitask more effectively, without having to pull files for each situation. Sharing files with other medical professionals becomes much easier as well. EMRs can also improve the quality of care in several ways: Better quality documentation: Electronic records improve the quality of patient charts. They reduce handwriting errors and inconsistent documentation. Many records can be updated with physician progress notes. Built-in protocols and reminders: EMRs can give health care providers important information at the point of treatment. Many software programs offer diagnosis-specific templates to remind providers about recommended treatment protocols. Improved medication management: Medication compliance is an important part of quality care, especially for chronic conditions. The EMR can show drug-to-drug and drug-to-allergy interaction, indicate medication list updates, and even check against medical plans formularies. As one of the primary payers for medical care, the federal government is very interested in encouraging physicians to use EMRs. It stands to gain from the resulting improved administration and quality of care. For this reason, the government provides financial incentives to help physicians convert to electronic medical record systems. The Health Information Technology for Economic and Clinical Health (HITECH) Act offers Medicare and Medicaid incentive payments to eligible health care professionals and hospitals when they adopt certain electronic technology. DID YOU KNOW? Of cases seen in the emergency room, 84% are not actual medical emergencies. Urgent care centers are able to treat many of these conditions at a much lower cost for both patients and employers. The average insured patient s out-of-pocket cost was $45 for an urgent care visit and $180 for an emergency room visit. The urgent care center was 75% less expensive than the emergency room. The average employer cost was $100 for an urgent care visit and $750 for an emergency room visit. The urgent care center was 87% less expensive than the emergency room. The average cost for anyone without insurance was $185 for an urgent care visit and $922 for an emergency room visit. The urgent care center was 80% less expensive than the emergency room. Source: 2012 IFEBP Benefits Magazine, data from Concentra, a division of Humana These incentives have staggered effective dates. Initially, incentives were provided simply to encourage providers to use EMRs. In 2014 and beyond, the Centers for Medicare and Medicaid Services (CMS) will require providers to meet a meaningful use standard to receive incentive payments. This standard will require providers to establish online access to health information for patients and electronic information exchange among providers. CMS reports that the EMR incentives have been highly effective. Between 2009 and 2011, the number of hospitals using EMRs more than doubled, from 16% to 35%. Eighty-five percent of hospitals reported that they intend to adopt EMRs by 2015 to qualify for incentive payments. Some insurance carriers are also offering primary care physicians incentives to convert to electronic medical record systems. These are typically included with the incentives for becoming a patient-centered medical home. Continued on page 3 2

3 Electronic Medical Records, cont. The government has invested billions of dollars to convert health care providers from paper-based record systems to EMRs. It may take some time to see a return on this investment, but it will affect the cost and quality of care. Converting to stand-alone electronic medical records is just the first step in automating medical records. Visionaries hope that the technology will continue to evolve. They anticipate a day when all provider records are in a central database, resulting in a tremendous impact on our health care system. Fragmented care would no longer be such a significant cost drain. A specialist, or even a new primary care doctor, could instantly access a patient s treatment history, so tests would not need to be repeated. Quality of care would also be better. Imagine how emergency treatment could be improved if the emergency room physician had realtime access to a patient s medical records. The investment in an electronicbased medical record system should pay off in the long run, especially when providers have universal access to patients electronic medical records. MW TREND TIDBITS Tattoos Not Just For Artistic Expression Tattoos are becoming common in today s society. Most tattoos are purely artistic expressions or fashion statements. However, a growing number of Americans are getting inked for medical reasons. Some people are using tattoos to inform first responders about critical medical conditions. Emergency personnel need to be aware of chronic conditions, such as diabetes, or serious medication allergies. Medical alert bracelets or necklaces often communicate this information. But these alerts are useful only when a patient remembers to wear them. Patients occasionally forget to wear them, or lose their medical alert accessories. Tattoos are a permanent physical record imprinted on the patient. $ PPO plans are projected to increase by 9.9% in 2012, down from 11.2% in $ Point of Service plans are projected to increase by 9.9% in 2012, down from 11.0% in While the American Medical Association (AMA) does not officially mention medical tattoos, some physicians are lobbying the AMA to establish guidelines. Currently, tattoos may include a medical symbol and information about a medical condition. Physician advocates of the tattoo hope that AMA guidelines will establish a specific area of the body for these tattoos. Emergency responders could then quickly check that area for any medical alerts. It would also help to recommend a common medical alert symbol. Creating common graphics will make it easier for first responders to identify medical information. Medical alert tattoos have no legal standing in most states. For example, a person may have No CPR tattooed on his or her chest to communicate end-of-life wishes. That tattoo would have no legal standing. On the other hand, a signed DNR (do not resuscitate) request is a legally binding contract medical professionals must accept. Medical tattoos are not widely used and are certainly not for everyone. Many medical professionals feel that medical alert jewelry is still the better option for communicating medical information. These bracelets can provide a more complete snapshot of a patient s condition because they often come with round the clock customer service. Medical providers can contact the service provider directly to ask for more details or to notify the family. While tattoos are not conventional among older generations, they are much more common in younger people. In fact, younger people may prefer having a tattoo to wearing a medical alert bracelet or necklace. $ HMO plans are projected to increase by 9.9% in 2012, down from 11.0% in $ HDHPs associated with consumer driven health plans are projected to increase by 9.9@ in 2012, down from 11.1% in Source: 2012 National Health Care Trend Survey, Buck Consultants Continued on page 4 3

4 Tattoos - Not Just For Artistic Expression, cont. Medical professionals are split on the value and importance of medical tattoos. Some physicians see the medical tattoo as a valuable tool for patients to communicate serious medical conditions or allergies. It is a permanent record that may prevent medical complications and even death. Other physicians do not see tattoos as a valid method for communicating critical medical information. Medical tattoos will certainly become more effective if the AMA issues some guidelines on placement, symbols and included information. While medical tattoos are not considered legal directives, they will certainly impact first responders during the first critical moments of emergency care. MW Until electronic medical records can provide universal access to health information, medical tattoos will remain an option. Some patients feel medical tattoos relieve the pressure to remember to always wear medical alert jewelry. YOUR QUESTIONS Q. My organization will have to report the value of employer-sponsored medical coverage on employees W-2s next year. I am creating a process to track the reportable value for Our company offers a fully insured, high deductible health plan. We allocate $750 annually to an HRA to help employees with deductible expenses, and allow year-end balances to roll over to a maximum account balance of $2,000. Does the HRA have to be included in the reportable value? If so, how should I determine the amount to report? A. The IRS allows some flexibility regarding HRAs and the W-2 reporting requirements. Employers can choose to include or exclude the HRA in the reportable value. The only stipulation is that you must include or exclude it consistently across your population. In your case, you could calculate the reportable value on the insured rates for your high deductible health plan. If you choose to include the HRA in the reportable value, use the amount your plan charges for COBRA, less the 2%. Your COBRA rate should have two components, the insured premium and the fully insured equivalent rate for your HRA. Since not all employees use the $750 allocated to the HRA during the year, the plan would need to develop an equivalent rate based on anticipated use. 4

5 Technical CornerTeam Many businesses use social media as a part of their marketing strategy. These businesses typically develop a social media policy to specify the type of information they will share with the public. Organizations have Facebook pages, LinkedIn accounts and Twitter accounts. They may designate an employee or several employees to manage the company s social media activity. Twitter users create a name, or handle, to tweet. An organization s name will often be part of that handle. Does your social media policy cover ownership of your Twitter handle? If the employee who tweets for your organization leaves, will your social media strategy be affected? Ownership of Twitter Accounts The U.S. District Court in Northern California is set to hear a case involving ownership of a Twitter handle. In this case, an employee used the company name in his Twitter handle. Part of his responsibilities included tweeting for the company. He terminated his employment and continued to tweet under his handle. The company then claimed that it owned the Twitter account and any of the followers associated with the account. The employee claims that Twitter actually owns the account and the followers are human beings. They are therefore not property and can t be owned. It will be interesting to see how this case turns out. Most companies embrace social media as part of their marketing strategy. It would be prudent to decide who owns your corporate marketing Twitter accounts. MW Copyright McGraw Wentworth, Inc. Our publications are written and produced by McGraw Wentworth staff and are intended to inform our clients and friends on general information relating to employee benefit plans and related topics. They are based on general information at the time they are prepared. They should not be relied upon to provide either legal or tax advice. Before making a decision on whether or not to implement or participate in implementing any welfare, pension benefit, or other program, employers and others must consult with their benefits, tax and/or legal advisor for advice that is appropriate to their specific circumstances. This information cannot be used by any taxpayer to avoid tax penalties West Big Beaver Road, Suite 200 Troy, MI Telephone: Fax: McGraw Wentworth, Inc. 250 Monroe Ave. NW, Suite 400 Grand Rapids, MI Telephone: Fax: