Archive for December, 2010

HealthLeadersMedia’s Top 5 Physician Challenges in 2011

December 31, 2010 Leave a comment

HealthLeadersMedia has identified the “Top 5 Physician Challenges in 2011.”

The author of the article, Joe Cantlupe, describes these challenges as “carry-overs, issues that unfolded in 2010, and will continue to be important for physicians in 2011, whether physicians are changing their practices or cutting back on their hours. These are certainly hot-button  issues …”

The five challenges are listed below (linked to some additional explanatory material), but read the entire article for the complete discussion.

1.  “Doc Fix

2.  Electronic Health Records

3.  Impact of Primary Care Shortages

4.  Accountable Care Organizations

5.  The American Board of Internal Medicine


December 31, 2010 Leave a comment

Yesterday, CMS announced its enhancement of its Physician Directory tool, which now will includes new information about physicians and other healthcare workers.  The Physician Directory website is now called “Physician Compare.” 

The new website, which was required by the Affordable Care Act of 2010, contains information about physicians enrolled in the Medicare program (M.D.s, D.O.s, O.D.s, D.P.M.s, and D.C.s).  The site also contains information about other types of health professionals who routinely care for Medicare beneficiaries, such as nurse practitioners, clinical psychologists, registered dietitians, physical therapists, physician assistants, and occupational therapists.

The goal of the new website is to provide more provider-specific information for Medicare beneficiaries and other consumers.  Presently, the information on the site includes contact and address information for offices, the professional’s medical specialty, where the professional completed his or her degree as well as residency or other clinical training, whether the professional speaks a foreign language, and the professional’s gender.

Later in 2011, CMS plans a second phase of the “Physician Compare” website which will indicate whether professionals choose to participate in a voluntary effort with CMS to prescribe medicines electronically. 

More important, in future years, CMS will expand the “Physician Compare” website to include information about the quality of care Medicare beneficiaries receive from the healthcare professionals profiled on the website. This will include information on quality of care and patient experience.  The Affordable Care Act requires CMS to develop a plan to implement this expansion by 2013.

“Meaningful Use” Checklist for EHR from

December 30, 2010 Leave a comment

The website,, has published a helpful checklist for “meaningful use” in EHR.   The checklist is reprinted below, but the website provides some useful CMS links.

Meaningful Use Checklist

In order to access federal incentive dollars through your EHR, you must prove “meaningful use,” the goal of which is to improve care and outcomes for your patients.

As defined by CMS, to achieve meaningful use you must first meet 15 core objectives plus 5 additional objectives from the menu below:

15 Core Objectives (You must meet all 15)

1. Computerized provider order entry (CPOE)
2. Drug-drug and drug-allergy interaction checks
3. Maintain an up-to-date problem list of current and active diagnoses
4. E-Prescribing (eRx) (CMS does not currently have e-prescribing guidelines available; check their EHR Web site for updates.)
5. Maintain active medication list
6. Maintain active medication allergy list
7. Record demographics
8. Record and chart changes in vital signs
9. Record smoking status for patients 13 years or older
10. Report ambulatory clinical quality measures to CMS/States
11. Implement one clinical decision support rule
12. Provide patients with an electronic copy of their health information, upon request
13. Provide clinical summaries for patients for each office visit
14. Capability to exchange key clinical information among providers of care and patient-authorized entities electronically
15. Protect electronic health information

10 Additional Objectives (You must choose 5)

1. Drug-formulary checks
2. Incorporate clinical lab test results as structured data
3. Generate lists of patients by specific conditions
4. Send reminders to patients per patient preference for preventive/follow up care
5. Provide patients with timely electronic access to their health information
6. Use certified EHR technology to identify patient-specific education resources and provide to patient, if appropriate
7. Medication reconciliation
8. Summary of care record for each transition of care/referrals
9. Capability to submit electronic data to immunization registries/systems (At least 1 public health objective must be selected)
10. Capability to provide electronic syndromic surveillance data to public health agencies (At least 1 public health objective must be selected)

Clinical Quality Measures (You must choose 6)

CMS also requires that you also meet 6 clinical quality measures –

One-Half of the clinical quality measures must be either the CMS core quality measures:

(NQF Measure Number & PQRI Implementation Number / Clinical Quality Measure Title)
* NQF 0013 /Hypertension: Blood Pressure Measurement
* NQF 0028 / Preventive Care and Screening Measure Pair:  a) Tobacco Use Assessment; b) Tobacco Cessation Intervention]
* NQF 0421, PQRI 128 / Adult Weight Screening and Follow-up

Or the CMS alternate core measures

(NQF Measure Number & PQRI Implementation Number / Clinical Quality Measure Title)
* NQF 0024 / Weight Assessment and Counseling for Children and Adolescents
* NQF0041 / PQRI 110
* Preventive Care and Screening:  Influenza Immunization for Patients 50 Years Old or Older / NQF 0038

You choose 3 more quality measures from a menu of 38 measures.

For more information on clinical quality measures, go to the following link.  In total, to achieve meaningful use, you will need to meet 26 requirements: 18 mandatory objectives and measures and another 8 of your choosing. 

You can get more information directly from CMS.

OIG’s “Roadmap for New Physicians”

December 10, 2010 Leave a comment

The Office of the Inspector General of the Department of Health and Human Services recently published on its website, “A Roadmap for New Physicians — Avoiding Medicare and Medicaid Fraud and Abuse.”  This publication was the result of a survey done by the OIG to learn what types of instruction medical students, residents, and fellows receive on Medicare and Medicaid fraud, waste, and abuse.  Both the Roadmap and the survey, along with the enhanced fraud and abuse and compliance provisions of the Healthcare Reform Act, clearly demonstrate the importance of these issues to the government.   It is too late to try to fix a long ignored compliance problem at a physician’s office when the men and women with badges and guns are at the door.

Categories: Physician Practices
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