News from the AOA's Blog

From kindergarten to college, teachers commonly issue homework assignments to help students review their lessons and test their understanding of the materials covered in class.

However, when it comes to the implementation of electronic health records (EHRs), optometrists and their office personnel will probably want to do some homework before attending programs such as the AOA Health Information Technology and Telemedicine Committee’s (AOA-HITTC) “Enhancing Patient Care through the Implementation of Electronic Health Records” (EHRs) continuing education course, instructors say.  

There are a number of relatively simple but important steps that optometrists and staff in virtually any practice can immediately take to develop a basic familiarity with health information technology (HIT) and determine the basic facts they will need to assess how EHRs will impact their practice, instructors told course attendees.

Practitioners will then be much better prepared to ask specific questions about the use of EHRs as well as to try out and compare various EHR systems for applicability in the practice.

Course instructors suggest the following:

• Study the HITECH incentives – Become familiar with the U.S. Department of Health & Human Services’ plans for the Nationwide Health Information Network, the department’s basic criteria for the “meaningful use” of EHRs, and the federal Health Information Technology for Economic and Clinical Health (HITECH) Act incentives that will be offered through the Medicare and Medicaid programs for meeting that EHR utilization criteria. Basic information on all three can be found on the AOA Web site’s Electronic Health Records page (www.aoa.org/EHR). More detailed information can be found on the AOA Web site’s Health Information Technology page (www.aoa.org/HIT).
• Assess Medicare and Medicaid participation – Medicare EHR incentives will be based on total annual Medicare payments. The Medicaid incentive program will be open only to practitioners who serve primarily Medicaid (or, in some cases, other low income) patients.  Practitioners should therefore determine the total amount of revenues they receive from Medicare each year and the total percentage of their patients covered by Medicaid. Most office software systems can produce a report with this information. So can office practice bookkeepers, accountants, or billing firms.
• Ensure current Medicare enrollment records in PECOS – Newly announced federal regulations will require physicians to have current enrollment records in Medicare’s Provider Enrollment, Chain and Ownership System (PECOS) by July 6, 2010 (see related article). Health care practitioners can determine if they have an enrollment record in PECOS by calling their designated Medicare carrier or A/B MAC, or by going on-line to access Medicare’s special PECOS Web site (https://pecos.cms.hhs.gov/pecos/login.doc). 
• Report PQRI measures – EHR systems are intended in part to facilitate the quality measure reporting programs that will be increasingly emphasized in the coming years by Medicare and other public and private health plans. Participating in the Medicare Physician Quality Reporting Initiative (PQRI) will provide a practice with experience in reporting health care quality measures in addition to the potential for Medicare bonuses. Simply begin reporting PQRI quality measures on claims. Practices need not formally register for the program. And this year, PQRI will have a special half-year reporting period beginning in July. See the AOA Web site’s PQRI page (www.aoa.org/PQRI) for details.
• e-Prescribe – Electronic pharmaceutical prescribing is among the HHS’s proposed EHR utilization criteria. By starting to e-prescribe now, practitioners can not only gain experience, they can still qualify for a 2 percent Medicare e-prescribing bonus this year. Practitioners can visit www.GetRxConnected.com/Optometric for a free E-Prescribing Readiness Assessment. Free stand-alone eRx software is available to every doctor free of charge by accessing the National E-Prescribing Safety Initiative (NEPSI) Web site (www.nationalerx.com).
• Know your access options – Health information exchanges (HIE) – databases through which EHRs will be transferred – are now being developed in every state. A new NHIN Direct option is being developed for any practitioners are still without access to an HIE when the HITECH incentive program begins next year. Information on HIEs will appear in a coming issue of Optometry: Journal of the American Optometric Association and will be posted to the AOA Web site EHR page.  Practitioners should identify the HIE that will serve their area and begin obtaining information on start-up date, access charges and other specifics. 
• Assess practice software – Practitioners who already have office software systems should contact their software providers as soon as possible to determine if the software can be updated to meet HHS meaningful use criteria. They should also determine when updates will be available and any costs that may be involved. Practitioners who do not have practice software system, or learn their present systems may not be upgradable, should begin shopping for a fully functional EHR system in their office.

Above all, AOA members should stay current on the latest in EHR-related developments.

The HHS’ meaningful use criteria is expected to be finalized in the coming weeks.

Articles on EHRs appear in each issue of AOA News and Optometry. Information is regularly posted to the AOA EHR Web site at www.aoa.org/ehr.  Questions may be e-mailed any time to ehr@aoa.org.

Scheduled for presentation at a total of 31 state optometric association meeting over the next year-and-a-half, the course offers three-hours of COPE approved continuing optometric education on EHR functions, the use of those functions in patient care, federal EHR utilization standards, strategies for the assessing and implementation of EHRs systems in practice and, following most of the scheduled course presentations, on-site demonstrations by leading EHR vendors to allow practitioners the opportunity to try out systems.

The AOA Enhancing Patient Care through the Implementation of EHRs course was developed as part of the AOA Electronic Health Records Preparedness Program for Optometry and is supported by grants from Compulink Business Systems, EMRlogic Systems, Inc., Eyefinity/Officemate, First Insight, Marco, Practice Director, QuikEyes, RevolutionEHR, and Topcon.