Query: Windows 10 and E-prescribing
I just upgraded to a new workstation with a Windows 10 operating system. Although my EMR is functional on the Windows 10 OS, the e-prescribing function does not work. When I called my vendor for support, they informed me that because CMS does not recognize Windows 10 to be a compliant OS for quality measures, the vendor cannot make the software changes to make the e-prescribe work with windows 10. Is this accurate? Is anyone using Windows 10 and e-prescribing? If yes, what EMR are you using?
Farshid Nejad, DPM, Beverly Hills, CA
Query: EMR and New Patient Input
My office still has the patients filling out new patient paperwork, and then my medical assistants enter the information for EVERY new patient. Obviously this is a substantial burden on them and is a lot of time they could be using to do other front and back office tasks. Our EMR provider, Medisoft, has an electronic version of new patient paperwork where the patient can enter their own information on a tablet and the staff double checks it.
My staff isn't convinced it's the way to go, mostly because we have so many geriatric patients who may not be 'computer savvy'. I would like to know what success or failures other providers have had with this, and what mistakes to avoid.
Daniel Jones, DPM, Casper, WY
Query: Practice Fusion and Dragon
Being semi-retired, I am looking at some basic EMR companies to eliminate paper charts and general shuffling of paper common to an "old fashioned" charting system. My biggest need is to be able to dictate a chart along with the use of macros for common podiatric procedures. Does Practice Fusion allow for some degree of integration of voice dictation using Dragon or other types of voice recognition programs with their system? If so, what are some of the dictation software programs being used with Practice Fusion?
Jack Ressler, DPM, Delray Beach, FL
Query: Is Second EMR Back-up Required
My EMR company is offering a "cloud" with a built-in disaster recovery plan (back-up) necessary for HIPAA compliance. Their back-up uses another third-party (Microsoft) to implement this plan.
Question: To ensure HIPAA compliance, do I need a separate, independent company to do a "second" back-up in the event my EMR company closes their doors?
Joe Boylan, DPM, Ridgefield, NJ
Query: EHR Registry Exemption
Since Stage II MU for 2016 requires that podiatrists report through a specialty registry for treatment of flatfoot (adult and congenital) and for plantar fasciitis, then is it true that you can be "exempt" for this measure if your vendor is not able to download this electronic information to this specialty registry?
Here is what I received from my EHR software vendor today on this exact issue regarding the exemption: "Since your vendor is unable to create the type of file we need to import for our registry, you will be able to claim the alternate exemption for the specialty registry measure for meaningful use. Here is the information:" Can someone provide clarity on this issue?
Joseph Borreggine, DPM, Charleston, IL
Query: Recommendations for Cloud-based EMR/PMI Vendor
We are trying select a cloud-based EMR/PMI vendor to replace the patchwork of older systems we have now. What advice do PM News readers have for us to narrow down the long list of possible vendors?
Susan Wexler, DPM, Malden, MA
Query: EHR and Drug Interactions
I am using an EHR that I really like. It shows up drug interactions as mild, moderate, or severe. It also tells what said interactions "could" be. But here is the problem: when I enter meds that the patient is taking into the EHR, and when it shows a possible drug interaction, whom do I call or what do I do next? This now seems to happen every day. The few times I called the pharmacies, they seemed to be appreciative, but I wonder why their software did not find the problem. Worse though, when I call the PCP, neurologist, etc, they are particularly unappreciative, even rude e.g. "thanks for the heads up," and hangup. What do I do going forward: keep on banging the drum or against my Hippocratic proclivity, be quiet?
A. James Fisher, DPM, Eureka, CA
Query: 2017 Medicare Hardship Exemption
I am looking into applying for exemption from the 2017 Medicare EHR penalty. Can someone tell me which box to check in the form of "Provider application for hardship exception 2017 Medicare EHR Incentive Program Payment Adjustment"? CMS supposedly allows EP to apply under the "Extreme and uncontrollable Circumstances."
There are four choices in the category:
2.2.a Diasater (nature disaster in which the EHR system was damaged/destroyed).
2.2.b Practice or hospital closure
2.2.c Bankruptcy or debt restructuring
2.2.d EHR certification/Vendor issues
Catherine Wu, DPM, Revere, MA
QUERIES (EMR) - PART 1
Query: Meaningful Use and Direct Messaging
Not all EHRs use the Updox Network for direct messaging. Are there any exceptions to meeting meaningful use stage 2 direct messaging standard regarding direct messaging?
Daniel Chaskin, DPM, Ridgewood, NY
QUERIES (EMR) - PART 2
Query: EMR Recommendations
We are a podiatric office located in the Central Pennsylvania area and are looking for a new EMR program. We are currently using Office Ally and are experiencing too many issues to continue using it at this time. We would appreciaiate any suggestions.
Queries: Meaningful Use Penalties
RecentIy, I received a letter from CMS letting me know that as an eligible professional, I did not demonstrate meaningful use for reporting period for 2014 or 2015. They were very nice to let me know I will get slammed another 2% on top of PQRS and electronic Rxs from 2012. Then they let me know that if I don't continue to meet meaningful use for future years, I'll get slammed even more. Soon, I will be writing out checks to CMS when a Medicare patient walks into my office.
For those of us who were smart enough to never get involved with EMR, are they getting all of the same penalties? Do the non-users get more or less penalties? If I were to let CMS know that I no longer want to be an eligible professional for meaningful use, do the penalties stop? We tried to talk with CMS the other day to get some answers and after 3 hours on hold, we somehow got disconnected.
Brian Zale, DPM, Sugar Land, TX
Query: Password Security for EHR
I have recently switched to a new EHR system. It requires me to enter the company's website into my browser and log in using a user name and password. From a security standpoint, it feels like something is missing. Shouldn't there be more to accessing tens of thousands of patient records than entering a user name and password?
Editor's Comment: PM News does not provide legal advice. Your query underscores the importance of having a complicated username and password. These days, many data critical sites require at least one capital letter, one number, and one symbol. An additional security feature is a Captcha generator to ensure that robots are not trying to enter the site via brute force.
It is also important to change your password frequently. Many security experts recommend that this be done at least once every 90 days.
Query: Help Simplifying Registering New Patients
From: Ken Meisler, DPM
I'm wondering if anyone has suggestions for solving an issue we have in our office about entering new patient information into our EMR program.
Our office sees many new patients a day. We tried to get patients to download the new patient information sheet from our website, fill it out and fax the information a day or two before the visit so all of the information could be entered in the computer before they arrived. Many patients preferred to fill the form out when they...
Editor's note: Dr. Meisler's extended-length note can be read here.
Query: Greenway PrimeSUITE for EHR
My hospital is using Greenway PrimeSUITE for EHR. I find this system cumbersome to create templates. There are podiatry templates that I can import, but they are incomplete and not intuitive. I was wondering if anyone has used this system and if there are any help/tutorials that I could use.
Denis J. Lamontagne, DPM, St. Johnsbury, VT
Query: Registry for Meaningful Use
I am having some difficulties with this and I think others are too. How do I start to document and for which registries do we need to report on and then upload?
Stu Kitton, DPM, NY, NY
Query: Changing EMR Software
I am considering changing my EMR software from Traknet 3.0 to Meditouch and would like feedback from other podiatrists. What experience have podiatrists had regarding the ease of use for yourselves and your staff.
Olga Luepschen, DPM, Sebring, FL
Query: OneTouch EMR
I would like to hear others' experiences with using OneTouch EMR for practice management.
David J Haile, DPM, Sebastian, FL
Query: Office Ally’s Practice Mate
I am looking at Office Ally’s Practice Mate product for billing only. To anyone who has it, how was the process of importing patient data and CPT codes? It does not appear to have a CPT library built in. Did you actually have to add your own with CPT descriptions and pricing details? What else should I be warned of, or what positives should I be aware of? How simple is the patient billing and EOB posting process?
David L. Kahan, DPM, Sacramento, CA
Query: Dragon Dictation and Traknet 3.0
I had been using Dragon dictation successfully in TRAKnet 2. Now that I am working in TRAKnet 3.0, Dragon is no longer working well at all. I have spoken with Nuance, the makers of Dragon, and have been told that they have no Dragon versions (including Dragon Medical) that work in TRAKnet 3. Nuance did suggest use of the "dictation box" but that's not a very practical solution for the long-term. I am wondering what others are doing who are facing this same problem. Are there other dictation software programs that work in TRAKnet 3.0?
Howard Bonenberger, DPM, Nashua, NH
Query: Collecting Data for MU
Everyone is waiting for the final ruling and the MU website is down. If I have not yet attested for stage II in 2015, should I hold off on collecting data for a 90-day period in 2015. This assumes that we will have an extension possibly into 2016 to collect data and to attest.
Joe Boylan, DPM , Ridgefield, NJ
Query: MU Website Down
I am wondering if you are getting any posts or have heard anything from Dr. Brody in the recent past about the MU website not being available to attest to 2015 MU. We have tried repeatedly for the past 4-5 wks to attest to stage II MU but the government website doesn’t seem to be open for business.
Mark Tuccio, DPM, Jamestown, NY
Response: CMS published a NPRN (Notice of Proposed Rulemaking) which proposes some sweeping changes to Meaningful use for THIS YEAR. Due to these pending changes, the web site for attestation is not currently available. Once the changes are finalized, the web site will be updated and you will be able to attest for Meaningful Use for 2015. They do not expect the attestation site to be available prior to the end of 2015.
Michael Brody, DPM, Commack, NY
Query: Kareo EHR
I'm considering using Kareo EHR and electronic claims submission. Anyone with experience good or bad, please respond.
John Moglia, DPM, Berkeley Heights, NJ
Query: MediTouch EHR/Billing System
What experiences have others had using HealthFusion's MediTouch EHR/Billing system? I have been using PracticeFusion with Advanced MD. My staff and I are finding their new system more cumbersome and much slower. Their live support is hard/slow to obtain (except online), and their answers about being completely ready for ICD-10 or with crossovers, come October 1, have been much less than forthcoming or specific.
Jerry S. Silverman DPM MBA, Houston, TX
Query: Recommendation for EHR System
We have started up a solo practice in Wailuku and are suffering from buying an EMR that does not work well. Does anyone have any recommendations for EMR systems?
Steven King, DPM, Wailuku, HI
Query: PQRS Registry
Can anyone recommend a podiatry-friendly registry? Although we were successful with the one we used last year, they were not easy to work with.
Michael Helms, DPM, Indianapolis, IN