Guest guest Posted November 5, 2010 Report Share Posted November 5, 2010 Hi Becky, The simple answer is that private practice PT does not have implement EMR because PT's were excluded from the legislation (which provides grant money to pay for upgrading to EMR). For those that are included in the legislation like hospitals and physician practices, money started being available, if the legislation's requirements were met, starting in fiscal year 2011 (which started Oct 1). For these organizations, bonus money for implementing EMR will change to penalties by 2015 if EMR is not implemented (or simply if you qualify to upgrade to EMR and you haven't done so by 2015 then you will be reimbursed less (by Medicare)). While the APTA continues to try and get PT's included, the fact is that private practice PT's are in a bind. While we don't have to implement EMR, it may be necessary to upgrade anyway to be able to communicate and integrate with providers and hospitals. Right now it is cost prohibitive to upgrade without grants from the Federal government, so hence the Catch 22. For more information check out the APTA website: apta.org/healthIT. The information is members-only so you would have to have a member access it. Another brief update was published in the " Today in PT " magazine October 4th edition (can be accessed online). Tom Howell, P.T., M.P.T. Howell Physical Therapy Eagle, ID thowell@... This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email. _____ From: PTManager [mailto:PTManager ] On Behalf Of Becky Sewell Sent: Friday, November 05, 2010 8:38 AM To: PTManager Subject: EMR I know this topic has probably been discussed before but one of my clinic owners was asking me this week about the rules on implementing an EMR program. She stated that she knows she has until 2012 to implement an electronic medical records program at her clinic but did not know what that needed to entail. I was thinking that private practices were not required to implement EMRs but I have been wrong before. Can someone give me a run down on the rules for EMR implementation in a private practice setting or point me to a good resource for me to read up on it? Thanks for your help in advance! Becky A. Sewell, MRC, CRC Rehab Net of AR/ArPTA P.O. Box 202 Conway, AR 72033 ph/fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 5, 2010 Report Share Posted November 5, 2010 Thanks Tom, That is what I thought but I could not find anything to back me up. I will let my clinic owner know. Becky A. Sewell, MRC, CRC Rehab Net of AR/ArPTA P.O. Box 202 Conway, AR 72033 ph/fax _____ From: PTManager [mailto:PTManager ] On Behalf Of M. Howell, PT, MPT Sent: Friday, November 05, 2010 1:58 PM To: PTManager Subject: RE: EMR Hi Becky, The simple answer is that private practice PT does not have implement EMR because PT's were excluded from the legislation (which provides grant money to pay for upgrading to EMR). For those that are included in the legislation like hospitals and physician practices, money started being available, if the legislation's requirements were met, starting in fiscal year 2011 (which started Oct 1). For these organizations, bonus money for implementing EMR will change to penalties by 2015 if EMR is not implemented (or simply if you qualify to upgrade to EMR and you haven't done so by 2015 then you will be reimbursed less (by Medicare)). While the APTA continues to try and get PT's included, the fact is that private practice PT's are in a bind. While we don't have to implement EMR, it may be necessary to upgrade anyway to be able to communicate and integrate with providers and hospitals. Right now it is cost prohibitive to upgrade without grants from the Federal government, so hence the Catch 22. For more information check out the APTA website: apta.org/healthIT. The information is members-only so you would have to have a member access it. Another brief update was published in the " Today in PT " magazine October 4th edition (can be accessed online). Tom Howell, P.T., M.P.T. Howell Physical Therapy Eagle, ID thowell@... <mailto:thowell%40fiberpipe.net> This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email. _____ From: PTManager <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On Behalf Of Becky Sewell Sent: Friday, November 05, 2010 8:38 AM To: PTManager <mailto:PTManager%40yahoogroups.com> Subject: EMR I know this topic has probably been discussed before but one of my clinic owners was asking me this week about the rules on implementing an EMR program. She stated that she knows she has until 2012 to implement an electronic medical records program at her clinic but did not know what that needed to entail. I was thinking that private practices were not required to implement EMRs but I have been wrong before. Can someone give me a run down on the rules for EMR implementation in a private practice setting or point me to a good resource for me to read up on it? Thanks for your help in advance! Becky A. Sewell, MRC, CRC Rehab Net of AR/ArPTA P.O. Box 202 Conway, AR 72033 ph/fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2010 Report Share Posted November 8, 2010 There is much misunderstanding and oversimplified interpretation of new government rules concerning EMRs. First and foremost, while the feds appear to be offering a financial windfall to hospitals and physicians who go along, by our internal analysis, the money doesn't even come close to covering the costs. (This is based on a five-year analysis that includes pesky necessities such as hardware and software upgrades, maintenance contracts, increased staffing for 24/7 systems-i.e. those things that are easy to forget when a new system is implemented.) Also, we should all keep in mind that the gun being held to hospitals' and physicians' heads is a threatened reimbursement reduction scheduled for 2017 for those that don't go along. (I am unaware of any related planned reductions to private practices who do not convert to electronic documentation systems.) On top of that, many of these rules are tied to Obama's vastly unpopular healthcare reforms, which may soon be partially or fully dismantled (this AFTER many organizations have invested significant sums into compliance). For hospital therapy services, it's particularly difficult because rehab service EMRs are not included in the criteria to demonstrate " meaningful use " (the phrase Uncle Sam uses to adjudicate whether money can be paid to those attempt to comply). Nevertheless, rehab EMRs will become necessary anyway, to bring hospital internal systems into alignment and to allow communication between divisions. In other words, forced investment without even the thrown bone of capital cost remuneration. Last and most important, this is yet another example of government designing, building, and ruling the private sector. Most evidently it is occurring in hospital and physician offices, but behind the front lines government rules are remaking software vendor businesses as well. Watch the flurries of mergers and takeovers as vendors scramble to divert their resources to meeting government rules, and watch software businesses that were targeting other service lines fall behind and die off. All because of decisions made by central controllers overruling the natural supply/demand activities of private business and individuals. Dave Milano, PT, Rehabilitation Director Laurel Health System ________________________________ From: PTManager [mailto:PTManager ] On Behalf Of M. Howell, PT, MPT Sent: Friday, November 05, 2010 2:58 PM To: PTManager Subject: RE: EMR Hi Becky, The simple answer is that private practice PT does not have implement EMR because PT's were excluded from the legislation (which provides grant money to pay for upgrading to EMR). For those that are included in the legislation like hospitals and physician practices, money started being available, if the legislation's requirements were met, starting in fiscal year 2011 (which started Oct 1). For these organizations, bonus money for implementing EMR will change to penalties by 2015 if EMR is not implemented (or simply if you qualify to upgrade to EMR and you haven't done so by 2015 then you will be reimbursed less (by Medicare)). While the APTA continues to try and get PT's included, the fact is that private practice PT's are in a bind. While we don't have to implement EMR, it may be necessary to upgrade anyway to be able to communicate and integrate with providers and hospitals. Right now it is cost prohibitive to upgrade without grants from the Federal government, so hence the Catch 22. For more information check out the APTA website: apta.org/healthIT. The information is members-only so you would have to have a member access it. Another brief update was published in the " Today in PT " magazine October 4th edition (can be accessed online). Tom Howell, P.T., M.P.T. Howell Physical Therapy Eagle, ID thowell@...<mailto:thowell%40fiberpipe.net> This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email. _____ From: PTManager <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com>] On Behalf Of Becky Sewell Sent: Friday, November 05, 2010 8:38 AM To: PTManager <mailto:PTManager%40yahoogroups.com> Subject: EMR I know this topic has probably been discussed before but one of my clinic owners was asking me this week about the rules on implementing an EMR program. She stated that she knows she has until 2012 to implement an electronic medical records program at her clinic but did not know what that needed to entail. I was thinking that private practices were not required to implement EMRs but I have been wrong before. Can someone give me a run down on the rules for EMR implementation in a private practice setting or point me to a good resource for me to read up on it? Thanks for your help in advance! Becky A. Sewell, MRC, CRC Rehab Net of AR/ArPTA P.O. Box 202 Conway, AR 72033 ph/fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2010 Report Share Posted November 8, 2010 Hi Dave, A couple of questions for you: Do you agree or disagree that an integrated EMR system would save the healthcare system a tremendous amount of money and reduce medical errors? How would you propose it be implemented? Tom Howell, P.T., M.P.T. Howell Physical Therapy Eagle, ID thowell@... This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email. _____ From: PTManager [mailto:PTManager ] On Behalf Of Milano, Dave Sent: Monday, November 08, 2010 8:04 AM To: PTManager Subject: RE: EMR There is much misunderstanding and oversimplified interpretation of new government rules concerning EMRs. First and foremost, while the feds appear to be offering a financial windfall to hospitals and physicians who go along, by our internal analysis, the money doesn't even come close to covering the costs. (This is based on a five-year analysis that includes pesky necessities such as hardware and software upgrades, maintenance contracts, increased staffing for 24/7 systems-i.e. those things that are easy to forget when a new system is implemented.) Also, we should all keep in mind that the gun being held to hospitals' and physicians' heads is a threatened reimbursement reduction scheduled for 2017 for those that don't go along. (I am unaware of any related planned reductions to private practices who do not convert to electronic documentation systems.) On top of that, many of these rules are tied to Obama's vastly unpopular healthcare reforms, which may soon be partially or fully dismantled (this AFTER many organizations have invested significant sums into compliance). For hospital therapy services, it's particularly difficult because rehab service EMRs are not included in the criteria to demonstrate " meaningful use " (the phrase Uncle Sam uses to adjudicate whether money can be paid to those attempt to comply). Nevertheless, rehab EMRs will become necessary anyway, to bring hospital internal systems into alignment and to allow communication between divisions. In other words, forced investment without even the thrown bone of capital cost remuneration. Last and most important, this is yet another example of government designing, building, and ruling the private sector. Most evidently it is occurring in hospital and physician offices, but behind the front lines government rules are remaking software vendor businesses as well. Watch the flurries of mergers and takeovers as vendors scramble to divert their resources to meeting government rules, and watch software businesses that were targeting other service lines fall behind and die off. All because of decisions made by central controllers overruling the natural supply/demand activities of private business and individuals. Dave Milano, PT, Rehabilitation Director Laurel Health System ________________________________ From: PTManager <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On Behalf Of M. Howell, PT, MPT Sent: Friday, November 05, 2010 2:58 PM To: PTManager <mailto:PTManager%40yahoogroups.com> Subject: RE: EMR Hi Becky, The simple answer is that private practice PT does not have implement EMR because PT's were excluded from the legislation (which provides grant money to pay for upgrading to EMR). For those that are included in the legislation like hospitals and physician practices, money started being available, if the legislation's requirements were met, starting in fiscal year 2011 (which started Oct 1). For these organizations, bonus money for implementing EMR will change to penalties by 2015 if EMR is not implemented (or simply if you qualify to upgrade to EMR and you haven't done so by 2015 then you will be reimbursed less (by Medicare)). While the APTA continues to try and get PT's included, the fact is that private practice PT's are in a bind. While we don't have to implement EMR, it may be necessary to upgrade anyway to be able to communicate and integrate with providers and hospitals. Right now it is cost prohibitive to upgrade without grants from the Federal government, so hence the Catch 22. For more information check out the APTA website: apta.org/healthIT. The information is members-only so you would have to have a member access it. Another brief update was published in the " Today in PT " magazine October 4th edition (can be accessed online). Tom Howell, P.T., M.P.T. Howell Physical Therapy Eagle, ID thowell@... <mailto:thowell%40fiberpipe.net> <mailto:thowell%40fiberpipe.net> This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email. _____ From: PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com>] On Behalf Of Becky Sewell Sent: Friday, November 05, 2010 8:38 AM To: PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> Subject: EMR I know this topic has probably been discussed before but one of my clinic owners was asking me this week about the rules on implementing an EMR program. She stated that she knows she has until 2012 to implement an electronic medical records program at her clinic but did not know what that needed to entail. I was thinking that private practices were not required to implement EMRs but I have been wrong before. Can someone give me a run down on the rules for EMR implementation in a private practice setting or point me to a good resource for me to read up on it? Thanks for your help in advance! Becky A. Sewell, MRC, CRC Rehab Net of AR/ArPTA P.O. Box 202 Conway, AR 72033 ph/fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 9, 2010 Report Share Posted November 9, 2010 I advocated for an EMR in our CCRC corporation, which falls outside of the criteria for an early implementation award... but the benefits to implementing an EMR reach far beyond a monetary award... Yes, these systems are costly and the transition from paper to a digital system is tough... But from a therapy standpoint alone, we will jettison to a new level of efficiency and accuracy in recording what we do. We will eliminate redundant input of information for daily documentation, PPS data and charge logs, as well as associated inevitable transcription errors. Computer charge input from paper charge sheets will be gone (currently one of the major tasks for our secretary). We will have ready access to medical record information and more real-time data as we move toward a greater amount of point of service documentation. " Flags " will cue staff to provide all needed information to meet basic standards and Medicare/3rd party payer requirements. Plus we will have the benefit of easily accessible reports to assist in strategies and decision making processes. If we were eligible for a monetary award, it would be a bonus- but please look beyond the bonus to see the real benefits of an electronic system... Melinda Nygren Pierce, PT, MS Director of Rehabilitation Presbyterian Homes 3200 Grant Street ton, IL 60201 phone: fax: " Working to encourage older adults to experience fullness of life in community with dignity, joy and the maximum level of independence their health will allow. " ail Disclosure Statement This email and any attachments are intended solely for the addressee(s) named. It may contain confidential and privileged information that should remain confidential. If you are not the intended recipient of this message, or if it has been addressed to you in error, please immediately alert the sender by reply email and then delete this message and any attachments from your system. If you are not the intended recipient, do not deliver, distribute or copy this message and/or any attachments; and, do not disclose or take any action upon or rely on any information in the communication. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 9, 2010 Report Share Posted November 9, 2010 Tom, The great medical science debunker, Dr. Ioannidis, has for years been patiently pointing out that often it is not the answers we discover that are wrong, but the questions we ask. (Here's a lay-article link that will introduce you to Dr. Ioannidis if you are not familiar with him and his work: http://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-medical\ -science/8269/1/) Along those lines, regarding electronic medical documentation systems, asking whether or not more technology will save the healthcare system money merely directs us away from the salient question, which is whether there should even be a " system " of healthcare delivery at all. Similarly one might wonder if government-issued gasmasks would be an effective antidote to air pollution, or nutritional supplements a fix for low-nutrient foods, or air-conditioning a solution to global warming. We should be asking much higher-level, fundamental questions, like how on earth did we allow system-makers to push their way between patients and providers, ultimately between human beings and their right to self-determination? Are we to be happy that distant third parties with no personal interest in any individual's needs or desires are directing our healthcare (and whose only real interest is in financial management)? Look at what that sort of thinking has gotten us. We have virtually canonized a record-breakingly expensive, poorly titrated, densely controlled system that has spawned medical care insurance monopolies, pharmaceutical monopolies, and allopathic medicine monopolies, not to mention system-sized waste, fraud, and theft. And to boot, we are still demonstrably unhealthy. So our next great idea is to make the system more efficient. Not for me. Diddling with these systems to make them " better " simply helps cement them into place. Dave Milano, PT, Rehabilitation Director Laurel Health System ________________________________ From: PTManager [mailto:PTManager ] On Behalf Of M. Howell, PT, MPT Sent: Monday, November 08, 2010 7:57 PM To: PTManager Subject: RE: EMR Hi Dave, A couple of questions for you: Do you agree or disagree that an integrated EMR system would save the healthcare system a tremendous amount of money and reduce medical errors? How would you propose it be implemented? Tom Howell, P.T., M.P.T. Howell Physical Therapy Eagle, ID thowell@...<mailto:thowell%40fiberpipe.net> This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email. _____ From: PTManager <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com>] On Behalf Of Milano, Dave Sent: Monday, November 08, 2010 8:04 AM To: PTManager <mailto:PTManager%40yahoogroups.com> Subject: RE: EMR There is much misunderstanding and oversimplified interpretation of new government rules concerning EMRs. First and foremost, while the feds appear to be offering a financial windfall to hospitals and physicians who go along, by our internal analysis, the money doesn't even come close to covering the costs. (This is based on a five-year analysis that includes pesky necessities such as hardware and software upgrades, maintenance contracts, increased staffing for 24/7 systems-i.e. those things that are easy to forget when a new system is implemented.) Also, we should all keep in mind that the gun being held to hospitals' and physicians' heads is a threatened reimbursement reduction scheduled for 2017 for those that don't go along. (I am unaware of any related planned reductions to private practices who do not convert to electronic documentation systems.) On top of that, many of these rules are tied to Obama's vastly unpopular healthcare reforms, which may soon be partially or fully dismantled (this AFTER many organizations have invested significant sums into compliance). For hospital therapy services, it's particularly difficult because rehab service EMRs are not included in the criteria to demonstrate " meaningful use " (the phrase Uncle Sam uses to adjudicate whether money can be paid to those attempt to comply). Nevertheless, rehab EMRs will become necessary anyway, to bring hospital internal systems into alignment and to allow communication between divisions. In other words, forced investment without even the thrown bone of capital cost remuneration. Last and most important, this is yet another example of government designing, building, and ruling the private sector. Most evidently it is occurring in hospital and physician offices, but behind the front lines government rules are remaking software vendor businesses as well. Watch the flurries of mergers and takeovers as vendors scramble to divert their resources to meeting government rules, and watch software businesses that were targeting other service lines fall behind and die off. All because of decisions made by central controllers overruling the natural supply/demand activities of private business and individuals. Dave Milano, PT, Rehabilitation Director Laurel Health System ________________________________ From: PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> ] On Behalf Of M. Howell, PT, MPT Sent: Friday, November 05, 2010 2:58 PM To: PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> Subject: RE: EMR Hi Becky, The simple answer is that private practice PT does not have implement EMR because PT's were excluded from the legislation (which provides grant money to pay for upgrading to EMR). For those that are included in the legislation like hospitals and physician practices, money started being available, if the legislation's requirements were met, starting in fiscal year 2011 (which started Oct 1). For these organizations, bonus money for implementing EMR will change to penalties by 2015 if EMR is not implemented (or simply if you qualify to upgrade to EMR and you haven't done so by 2015 then you will be reimbursed less (by Medicare)). While the APTA continues to try and get PT's included, the fact is that private practice PT's are in a bind. While we don't have to implement EMR, it may be necessary to upgrade anyway to be able to communicate and integrate with providers and hospitals. Right now it is cost prohibitive to upgrade without grants from the Federal government, so hence the Catch 22. For more information check out the APTA website: apta.org/healthIT. The information is members-only so you would have to have a member access it. Another brief update was published in the " Today in PT " magazine October 4th edition (can be accessed online). Tom Howell, P.T., M.P.T. Howell Physical Therapy Eagle, ID thowell@...<mailto:thowell%40fiberpipe.net> <mailto:thowell%40fiberpipe.net> <mailto:thowell%40fiberpipe.net> This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email. _____ From: PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com>] On Behalf Of Becky Sewell Sent: Friday, November 05, 2010 8:38 AM To: PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> Subject: EMR I know this topic has probably been discussed before but one of my clinic owners was asking me this week about the rules on implementing an EMR program. She stated that she knows she has until 2012 to implement an electronic medical records program at her clinic but did not know what that needed to entail. I was thinking that private practices were not required to implement EMRs but I have been wrong before. Can someone give me a run down on the rules for EMR implementation in a private practice setting or point me to a good resource for me to read up on it? Thanks for your help in advance! Becky A. Sewell, MRC, CRC Rehab Net of AR/ArPTA P.O. Box 202 Conway, AR 72033 ph/fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 11, 2010 Report Share Posted November 11, 2010 Hi everyone, For a balanced perspective, let the record show that the only reason government got into healthcare was because the private sector messed it up through greed and fraud. And as history also shows, when the government has to step in, things don't get better. Now comes an attempt to do something tangible that a majority agree on, ie institute efficiency through coordinated computer systems for medical information. It is long overdue and will help the patients we serve tremendously no matter what the naysayers say (who cannot offer alternative solutions as well). Not one opinion on this that I have read during the healthcare reform debate disagreed on how important this transition is. The choice is to let those that messed the system up in the first place have the control again. I say " go ahead " . Let the system crash (and it will under those circumstances). I am no fan of bailouts but the healthcare system will be too important and necessary to let crumble and the only one there to rescue it will be the government. And at that point it will create universal government-run health care which very few really want. I certainly don't want universal care and think the partnership of the government and the private sector is the way to go. Whether you like healthcare reform or not, the bill is amendable. Let the opponents have their day and try and repeal it. The millions that are being helped by the bill already as well as those that stand to be helped in the future will not be silent and will fight just as hard as those that want to repeal it! I think the better course would be to continue to work on it and improve it. And that extends to the EMR provisions because they are among the most important tasks that lie ahead. Look no matter what I say there will always be an opposing viewpoint but just know that there is a strong opposing viewpoint to the post and opinion below. Tom Howell, P.T., M.P.T. Howell Physical Therapy Eagle, ID thowell@... This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email. _____ From: PTManager [mailto:PTManager ] On Behalf Of Milano, Dave Sent: Tuesday, November 09, 2010 9:42 AM To: PTManager Subject: RE: EMR Tom, The great medical science debunker, Dr. Ioannidis, has for years been patiently pointing out that often it is not the answers we discover that are wrong, but the questions we ask. (Here's a lay-article link that will introduce you to Dr. Ioannidis if you are not familiar with him and his work: http://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-med ical-science/8269/1/) Along those lines, regarding electronic medical documentation systems, asking whether or not more technology will save the healthcare system money merely directs us away from the salient question, which is whether there should even be a " system " of healthcare delivery at all. Similarly one might wonder if government-issued gasmasks would be an effective antidote to air pollution, or nutritional supplements a fix for low-nutrient foods, or air-conditioning a solution to global warming. We should be asking much higher-level, fundamental questions, like how on earth did we allow system-makers to push their way between patients and providers, ultimately between human beings and their right to self-determination? Are we to be happy that distant third parties with no personal interest in any individual's needs or desires are directing our healthcare (and whose only real interest is in financial management)? Look at what that sort of thinking has gotten us. We have virtually canonized a record-breakingly expensive, poorly titrated, densely controlled system that has spawned medical care insurance monopolies, pharmaceutical monopolies, and allopathic medicine monopolies, not to mention system-sized waste, fraud, and theft. And to boot, we are still demonstrably unhealthy. So our next great idea is to make the system more efficient. Not for me. Diddling with these systems to make them " better " simply helps cement them into place. Dave Milano, PT, Rehabilitation Director Laurel Health System ________________________________ From: PTManager <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On Behalf Of M. Howell, PT, MPT Sent: Monday, November 08, 2010 7:57 PM To: PTManager <mailto:PTManager%40yahoogroups.com> Subject: RE: EMR Hi Dave, A couple of questions for you: Do you agree or disagree that an integrated EMR system would save the healthcare system a tremendous amount of money and reduce medical errors? How would you propose it be implemented? Tom Howell, P.T., M.P.T. Howell Physical Therapy Eagle, ID thowell@... <mailto:thowell%40fiberpipe.net> <mailto:thowell%40fiberpipe.net> This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email. _____ From: PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com>] On Behalf Of Milano, Dave Sent: Monday, November 08, 2010 8:04 AM To: PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> Subject: RE: EMR There is much misunderstanding and oversimplified interpretation of new government rules concerning EMRs. First and foremost, while the feds appear to be offering a financial windfall to hospitals and physicians who go along, by our internal analysis, the money doesn't even come close to covering the costs. (This is based on a five-year analysis that includes pesky necessities such as hardware and software upgrades, maintenance contracts, increased staffing for 24/7 systems-i.e. those things that are easy to forget when a new system is implemented.) Also, we should all keep in mind that the gun being held to hospitals' and physicians' heads is a threatened reimbursement reduction scheduled for 2017 for those that don't go along. (I am unaware of any related planned reductions to private practices who do not convert to electronic documentation systems.) On top of that, many of these rules are tied to Obama's vastly unpopular healthcare reforms, which may soon be partially or fully dismantled (this AFTER many organizations have invested significant sums into compliance). For hospital therapy services, it's particularly difficult because rehab service EMRs are not included in the criteria to demonstrate " meaningful use " (the phrase Uncle Sam uses to adjudicate whether money can be paid to those attempt to comply). Nevertheless, rehab EMRs will become necessary anyway, to bring hospital internal systems into alignment and to allow communication between divisions. In other words, forced investment without even the thrown bone of capital cost remuneration. Last and most important, this is yet another example of government designing, building, and ruling the private sector. Most evidently it is occurring in hospital and physician offices, but behind the front lines government rules are remaking software vendor businesses as well. Watch the flurries of mergers and takeovers as vendors scramble to divert their resources to meeting government rules, and watch software businesses that were targeting other service lines fall behind and die off. All because of decisions made by central controllers overruling the natural supply/demand activities of private business and individuals. Dave Milano, PT, Rehabilitation Director Laurel Health System ________________________________ From: PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> ] On Behalf Of M. Howell, PT, MPT Sent: Friday, November 05, 2010 2:58 PM To: PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> Subject: RE: EMR Hi Becky, The simple answer is that private practice PT does not have implement EMR because PT's were excluded from the legislation (which provides grant money to pay for upgrading to EMR). For those that are included in the legislation like hospitals and physician practices, money started being available, if the legislation's requirements were met, starting in fiscal year 2011 (which started Oct 1). For these organizations, bonus money for implementing EMR will change to penalties by 2015 if EMR is not implemented (or simply if you qualify to upgrade to EMR and you haven't done so by 2015 then you will be reimbursed less (by Medicare)). While the APTA continues to try and get PT's included, the fact is that private practice PT's are in a bind. While we don't have to implement EMR, it may be necessary to upgrade anyway to be able to communicate and integrate with providers and hospitals. Right now it is cost prohibitive to upgrade without grants from the Federal government, so hence the Catch 22. For more information check out the APTA website: apta.org/healthIT. The information is members-only so you would have to have a member access it. Another brief update was published in the " Today in PT " magazine October 4th edition (can be accessed online). Tom Howell, P.T., M.P.T. Howell Physical Therapy Eagle, ID thowell@... <mailto:thowell%40fiberpipe.net> <mailto:thowell%40fiberpipe.net> <mailto:thowell%40fiberpipe.net> <mailto:thowell%40fiberpipe.net> This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email. _____ From: PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com>] On Behalf Of Becky Sewell Sent: Friday, November 05, 2010 8:38 AM To: PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> Subject: EMR I know this topic has probably been discussed before but one of my clinic owners was asking me this week about the rules on implementing an EMR program. She stated that she knows she has until 2012 to implement an electronic medical records program at her clinic but did not know what that needed to entail. I was thinking that private practices were not required to implement EMRs but I have been wrong before. Can someone give me a run down on the rules for EMR implementation in a private practice setting or point me to a good resource for me to read up on it? Thanks for your help in advance! Becky A. Sewell, MRC, CRC Rehab Net of AR/ArPTA P.O. Box 202 Conway, AR 72033 ph/fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 11, 2010 Report Share Posted November 11, 2010 Tom, While I find your opinions are generally well thought out, balanced, and reasonable, I also find that I side with Dave Milano here. His outside-the-box thoughts are a welcome breath of fresh air on this subject. Here is a well know and powerful healthcare lobbyist (who, by the way, made $1.6 million last year on your back and mine). http://en.wikipedia.org/wiki/_Ignagni Note this quote from the article: " As described by Ignagni, " The report makes clear that several major provisions in the current legislative proposal will cause healthcare costs to increase far faster and higher than they would under the current system " . " Read it again. It says that healthcare costs will increase FAR FASTER AND HIGHER than they would under the current system. Now could you please tell me how " millions are being helped by the bill already " because I don't see it. What I do see is that our country and its economic competitiveness is being strangled by legislation, regulation, and litigation and " little by little, more and more is being controlled by fewer and fewer " . Personally, I've never cared much for being manipulated and quite frankly, they're playing us like a fiddle, both as professionals and as citizens. I, for one, don't plan on becoming a serf in what is ultimately evolving into a neo-feudalistic system. It's time we as a profession and as Americans, take the red pill, wake up, and act accordingly. , PT, OCS Marquette, MI EMR I know this topic has probably been discussed before but one of my clinic owners was asking me this week about the rules on implementing an EMR program. She stated that she knows she has until 2012 to implement an electronic medical records program at her clinic but did not know what that needed to entail. I was thinking that private practices were not required to implement EMRs but I have been wrong before. Can someone give me a run down on the rules for EMR implementation in a private practice setting or point me to a good resource for me to read up on it? Thanks for your help in advance! Becky A. Sewell, MRC, CRC Rehab Net of AR/ArPTA P.O. Box 202 Conway, AR 72033 ph/fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 11, 2010 Report Share Posted November 11, 2010 Hi , All I can say is that I'm sure that all of the young Americans up to age 26 who would have lost healthcare but can stay on their parents policy, all those that would have reached lifetime maximums, all those that can now get an insurance policy even though they have pre-existing conditions and all the small businesses that can now offer healthcare due to significant tax credits are just a start. By the way the last poll I saw the split was dead even for those for the healthcare bill and those against and the numbers skew even more for those that like at least parts of it. All I am saying is that reform will work better than repeal. And no I have no illusions that the bill is weighted heavily in favor of insurances, hospitals and corporate entities so it will still be incumbent upon us to use our grassroots voice to push for change. I do think strongly, however, that an overhaul of the use of computer systems to integrate care and improve communication is long overdue and will save a tremendous amount of money. People's memories are short and they forget that during Bill Clinton's presidency a major effort was made to computerize the government bureaucracy and was partially responsible for his administration being able to control cost (and, oh yeah, eliminate the deficit). I think healthcare will gain the same cost savings with transitioning to EMR. Tom Howell, P.T., M.P.T. Howell Physical Therapy Eagle, ID thowell@... This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email. _____ From: PTManager [mailto:PTManager ] On Behalf Of Sent: Thursday, November 11, 2010 6:23 PM To: PTManager Subject: Re: EMR Tom, While I find your opinions are generally well thought out, balanced, and reasonable, I also find that I side with Dave Milano here. His outside-the-box thoughts are a welcome breath of fresh air on this subject. Here is a well know and powerful healthcare lobbyist (who, by the way, made $1.6 million last year on your back and mine). http://en.wikipedia.org/wiki/_Ignagni Note this quote from the article: " As described by Ignagni, " The report makes clear that several major provisions in the current legislative proposal will cause healthcare costs to increase far faster and higher than they would under the current system " . " Read it again. It says that healthcare costs will increase FAR FASTER AND HIGHER than they would under the current system. Now could you please tell me how " millions are being helped by the bill already " because I don't see it. What I do see is that our country and its economic competitiveness is being strangled by legislation, regulation, and litigation and " little by little, more and more is being controlled by fewer and fewer " . Personally, I've never cared much for being manipulated and quite frankly, they're playing us like a fiddle, both as professionals and as citizens. I, for one, don't plan on becoming a serf in what is ultimately evolving into a neo-feudalistic system. It's time we as a profession and as Americans, take the red pill, wake up, and act accordingly. , PT, OCS Marquette, MI EMR I know this topic has probably been discussed before but one of my clinic owners was asking me this week about the rules on implementing an EMR program. She stated that she knows she has until 2012 to implement an electronic medical records program at her clinic but did not know what that needed to entail. I was thinking that private practices were not required to implement EMRs but I have been wrong before. Can someone give me a run down on the rules for EMR implementation in a private practice setting or point me to a good resource for me to read up on it? Thanks for your help in advance! Becky A. Sewell, MRC, CRC Rehab Net of AR/ArPTA P.O. Box 202 Conway, AR 72033 ph/fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 11, 2010 Report Share Posted November 11, 2010 Hi , All I can say is that I'm sure that all of the young Americans up to age 26 who would have lost healthcare but can stay on their parents policy, all those that would have reached lifetime maximums, all those that can now get an insurance policy even though they have pre-existing conditions and all the small businesses that can now offer healthcare due to significant tax credits are just a start. By the way the last poll I saw the split was dead even for those for the healthcare bill and those against and the numbers skew even more for those that like at least parts of it. All I am saying is that reform will work better than repeal. And no I have no illusions that the bill is weighted heavily in favor of insurances, hospitals and corporate entities so it will still be incumbent upon us to use our grassroots voice to push for change. I do think strongly, however, that an overhaul of the use of computer systems to integrate care and improve communication is long overdue and will save a tremendous amount of money. People's memories are short and they forget that during Bill Clinton's presidency a major effort was made to computerize the government bureaucracy and was partially responsible for his administration being able to control cost (and, oh yeah, eliminate the deficit). I think healthcare will gain the same cost savings with transitioning to EMR. Tom Howell, P.T., M.P.T. Howell Physical Therapy Eagle, ID thowell@... This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email. _____ From: PTManager [mailto:PTManager ] On Behalf Of Sent: Thursday, November 11, 2010 6:23 PM To: PTManager Subject: Re: EMR Tom, While I find your opinions are generally well thought out, balanced, and reasonable, I also find that I side with Dave Milano here. His outside-the-box thoughts are a welcome breath of fresh air on this subject. Here is a well know and powerful healthcare lobbyist (who, by the way, made $1.6 million last year on your back and mine). http://en.wikipedia.org/wiki/_Ignagni Note this quote from the article: " As described by Ignagni, " The report makes clear that several major provisions in the current legislative proposal will cause healthcare costs to increase far faster and higher than they would under the current system " . " Read it again. It says that healthcare costs will increase FAR FASTER AND HIGHER than they would under the current system. Now could you please tell me how " millions are being helped by the bill already " because I don't see it. What I do see is that our country and its economic competitiveness is being strangled by legislation, regulation, and litigation and " little by little, more and more is being controlled by fewer and fewer " . Personally, I've never cared much for being manipulated and quite frankly, they're playing us like a fiddle, both as professionals and as citizens. I, for one, don't plan on becoming a serf in what is ultimately evolving into a neo-feudalistic system. It's time we as a profession and as Americans, take the red pill, wake up, and act accordingly. , PT, OCS Marquette, MI EMR I know this topic has probably been discussed before but one of my clinic owners was asking me this week about the rules on implementing an EMR program. She stated that she knows she has until 2012 to implement an electronic medical records program at her clinic but did not know what that needed to entail. I was thinking that private practices were not required to implement EMRs but I have been wrong before. Can someone give me a run down on the rules for EMR implementation in a private practice setting or point me to a good resource for me to read up on it? Thanks for your help in advance! Becky A. Sewell, MRC, CRC Rehab Net of AR/ArPTA P.O. Box 202 Conway, AR 72033 ph/fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 12, 2010 Report Share Posted November 12, 2010 I am always captivated by the lively discussions and the differing perspectives. Personally, I will think it is pretty cool when one day, communication between providers is easy and readily available. Utopia, but probably won't happen... but wouldn't it be cool if all providers could know easily what each other was doing? Wouldn't it be cool if patients didn't have to provide redundant information? How many times have you heard, " I was just at the doctors and had to go through all this... " as you hand the patient your paperwork? How cool would it be for you to have access to reports and past history information? If systems could speak to each other, that would be pretty darn sweet. Probably the closest we'll ever get might be the online electronic health records that patients can use. And yes, electronic medical records have saved lives and reduced errors. I think some hospital systems have somehow implemented scanners and bar codes to be used on patients and medications. I think the electronic medical records have also helped with identifying drug seekers. Pharmacists can much more easily read electronic prescriptions. There are some good reasons for technology. If we sign a contract with a payer, we made a choice. If we don't like their rules and regulations, why sign a contract? If we sign a contract... wouldn't it be great to have a tool at our fingertips to use to help reduce the occurrences of time intensive denials? What if the tool was interactive with us? What if the tool had the capability to indicate that the patient in front of us is like a certain group of patients we treated in the past and was able to indicate the outcomes with those patients? What after indicating the plan of care for a particular patient, the tool had the capability to highlight some evidence based options that weren't easily apparent in your plan? What if the tool could predict outcomes? What if we finally can have a tool that can help us readily know our outcomes? Physical therapy business owners can easily know the " health " of their business, but sadly, the physical therapy business owners have no idea the " health " of the overall performance of staff. Nobody is screaming for this type of information or systems to help us perform better. What about the value we bring to health care? Is it possible that having the right documentation system with it having the capability to pull data and query data to help us analyze our services could very well assist in establishing comparative effectiveness of our services over other options for certain conditions? The future looks so bright in this area... and is something that I look forward to seeing evolve. I certainly hope as a whole, we can definitively know what it is we want the electronic medical record to do for us... demand that it will do it... and then use it as a tool to better our performance, our service to patients and our profession. Selena Horner, PT ton, MI > > Hi everyone, > > > > For a balanced perspective, let the record show that the only reason > government got into healthcare was because the private sector messed it up > through greed and fraud. And as history also shows, when the government has > to step in, things don't get better. > > > > Now comes an attempt to do something tangible that a majority agree on, ie > institute efficiency through coordinated computer systems for medical > information. It is long overdue and will help the patients we serve > tremendously no matter what the naysayers say (who cannot offer alternative > solutions as well). Not one opinion on this that I have read during the > healthcare reform debate disagreed on how important this transition is. > > > > The choice is to let those that messed the system up in the first place have > the control again. I say " go ahead " . Let the system crash (and it will > under those circumstances). I am no fan of bailouts but the healthcare > system will be too important and necessary to let crumble and the only one > there to rescue it will be the government. And at that point it will create > universal government-run health care which very few really want. I > certainly don't want universal care and think the partnership of the > government and the private sector is the way to go. > > > > Whether you like healthcare reform or not, the bill is amendable. Let the > opponents have their day and try and repeal it. The millions that are being > helped by the bill already as well as those that stand to be helped in the > future will not be silent and will fight just as hard as those that want to > repeal it! I think the better course would be to continue to work on it and > improve it. And that extends to the EMR provisions because they are among > the most important tasks that lie ahead. > > > > Look no matter what I say there will always be an opposing viewpoint but > just know that there is a strong opposing viewpoint to the post and opinion > below. > > > > Tom Howell, P.T., M.P.T. > > Howell Physical Therapy > > Eagle, ID > > thowell@... > > > > > > This email and any files transmitted with it may contain PRIVILEGED or > CONFIDENTIAL information and may be read or used only by the intended > recipient. If you are not the intended recipient of the email or any of its > attachments, please be advised that you have received this email in error > and that any use, dissemination, distribution, forwarding, printing or > copying of this email or any attached files is strictly prohibited. If you > have received this email in error, please immediately purge it and all > attachments and notify the sender by reply email. > > > > > > _____ > > From: PTManager [mailto:PTManager ] On Behalf > Of Milano, Dave > Sent: Tuesday, November 09, 2010 9:42 AM > To: PTManager > Subject: RE: EMR > > > > > > Tom, > > The great medical science debunker, Dr. Ioannidis, has for years been > patiently pointing out that often it is not the answers we discover that are > wrong, but the questions we ask. > > (Here's a lay-article link that will introduce you to Dr. Ioannidis if you > are not familiar with him and his work: > http://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-med > ical-science/8269/1/) > > Along those lines, regarding electronic medical documentation systems, > asking whether or not more technology will save the healthcare system money > merely directs us away from the salient question, which is whether there > should even be a " system " of healthcare delivery at all. Similarly one might > wonder if government-issued gasmasks would be an effective antidote to air > pollution, or nutritional supplements a fix for low-nutrient foods, or > air-conditioning a solution to global warming. > > We should be asking much higher-level, fundamental questions, like how on > earth did we allow system-makers to push their way between patients and > providers, ultimately between human beings and their right to > self-determination? Are we to be happy that distant third parties with no > personal interest in any individual's needs or desires are directing our > healthcare (and whose only real interest is in financial management)? Look > at what that sort of thinking has gotten us. We have virtually canonized a > record-breakingly expensive, poorly titrated, densely controlled system that > has spawned medical care insurance monopolies, pharmaceutical monopolies, > and allopathic medicine monopolies, not to mention system-sized waste, > fraud, and theft. And to boot, we are still demonstrably unhealthy. > > So our next great idea is to make the system more efficient. Not for me. > Diddling with these systems to make them " better " simply helps cement them > into place. > > Dave Milano, PT, Rehabilitation Director > Laurel Health System > > ________________________________ > From: PTManager <mailto:PTManager%40yahoogroups.com> > [mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On > Behalf Of M. Howell, PT, MPT > Sent: Monday, November 08, 2010 7:57 PM > To: PTManager <mailto:PTManager%40yahoogroups.com> > Subject: RE: EMR > > Hi Dave, > > A couple of questions for you: > > Do you agree or disagree that an integrated EMR system would save the > healthcare system a tremendous amount of money and reduce medical errors? > > How would you propose it be implemented? > > Tom Howell, P.T., M.P.T. > > Howell Physical Therapy > > Eagle, ID > > thowell@... <mailto:thowell%40fiberpipe.net> > <mailto:thowell%40fiberpipe.net> > > This email and any files transmitted with it may contain PRIVILEGED or > CONFIDENTIAL information and may be read or used only by the intended > recipient. If you are not the intended recipient of the email or any of its > attachments, please be advised that you have received this email in error > and that any use, dissemination, distribution, forwarding, printing or > copying of this email or any attached files is strictly prohibited. If you > have received this email in error, please immediately purge it and all > attachments and notify the sender by reply email. > > _____ > > From: PTManager <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> [mailto:PTManager > <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com>] > On Behalf > Of Milano, Dave > Sent: Monday, November 08, 2010 8:04 AM > To: PTManager <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> > Subject: RE: EMR > > There is much misunderstanding and oversimplified interpretation of new > government rules concerning EMRs. > > First and foremost, while the feds appear to be offering a financial > windfall to hospitals and physicians who go along, by our internal analysis, > the money doesn't even come close to covering the costs. (This is based on a > five-year analysis that includes pesky necessities such as hardware and > software upgrades, maintenance contracts, increased staffing for 24/7 > systems-i.e. those things that are easy to forget when a new system is > implemented.) Also, we should all keep in mind that the gun being held to > hospitals' and physicians' heads is a threatened reimbursement reduction > scheduled for 2017 for those that don't go along. (I am unaware of any > related planned reductions to private practices who do not convert to > electronic documentation systems.) On top of that, many of these rules are > tied to Obama's vastly unpopular healthcare reforms, which may soon be > partially or fully dismantled (this AFTER many organizations have invested > significant sums into compliance). > > For hospital therapy services, it's particularly difficult because rehab > service EMRs are not included in the criteria to demonstrate " meaningful > use " (the phrase Uncle Sam uses to adjudicate whether money can be paid to > those attempt to comply). Nevertheless, rehab EMRs will become necessary > anyway, to bring hospital internal systems into alignment and to allow > communication between divisions. In other words, forced investment without > even the thrown bone of capital cost remuneration. > > Last and most important, this is yet another example of government > designing, building, and ruling the private sector. Most evidently it is > occurring in hospital and physician offices, but behind the front lines > government rules are remaking software vendor businesses as well. Watch the > flurries of mergers and takeovers as vendors scramble to divert their > resources to meeting government rules, and watch software businesses that > were targeting other service lines fall behind and die off. All because of > decisions made by central controllers overruling the natural supply/demand > activities of private business and individuals. > > Dave Milano, PT, Rehabilitation Director > Laurel Health System > > ________________________________ > From: PTManager <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> > [mailto:PTManager <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> ] > On > Behalf Of M. Howell, PT, MPT > Sent: Friday, November 05, 2010 2:58 PM > To: PTManager <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> > Subject: RE: EMR > > Hi Becky, > > The simple answer is that private practice PT does not have implement EMR > because PT's were excluded from the legislation (which provides grant money > to pay for upgrading to EMR). For those that are included in the > legislation like hospitals and physician practices, money started being > available, if the legislation's requirements were met, starting in fiscal > year 2011 (which started Oct 1). For these organizations, bonus money for > implementing EMR will change to penalties by 2015 if EMR is not implemented > (or simply if you qualify to upgrade to EMR and you haven't done so by 2015 > then you will be reimbursed less (by Medicare)). > > While the APTA continues to try and get PT's included, the fact is that > private practice PT's are in a bind. While we don't have to implement EMR, > it may be necessary to upgrade anyway to be able to communicate and > integrate with providers and hospitals. Right now it is cost prohibitive to > upgrade without grants from the Federal government, so hence the Catch 22. > > For more information check out the APTA website: apta.org/healthIT. The > information is members-only so you would have to have a member access it. > Another brief update was published in the " Today in PT " magazine October 4th > edition (can be accessed online). > > Tom Howell, P.T., M.P.T. > > Howell Physical Therapy > > Eagle, ID > > thowell@... <mailto:thowell%40fiberpipe.net> > <mailto:thowell%40fiberpipe.net> <mailto:thowell%40fiberpipe.net> > <mailto:thowell%40fiberpipe.net> > > This email and any files transmitted with it may contain PRIVILEGED or > CONFIDENTIAL information and may be read or used only by the intended > recipient. If you are not the intended recipient of the email or any of its > attachments, please be advised that you have received this email in error > and that any use, dissemination, distribution, forwarding, printing or > copying of this email or any attached files is strictly prohibited. If you > have received this email in error, please immediately purge it and all > attachments and notify the sender by reply email. > > _____ > > From: PTManager <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> [mailto:PTManager > <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com>] > On Behalf > Of Becky Sewell > Sent: Friday, November 05, 2010 8:38 AM > To: PTManager <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> > Subject: EMR > > I know this topic has probably been discussed before but one of my clinic > owners was asking me this week about the rules on implementing an EMR > program. She stated that she knows she has until 2012 to implement an > electronic medical records program at her clinic but did not know what that > needed to entail. I was thinking that private practices were not required > to implement EMRs but I have been wrong before. Can someone give me a run > down on the rules for EMR implementation in a private practice setting or > point me to a good resource for me to read up on it? > > Thanks for your help in advance! > > Becky A. Sewell, MRC, CRC > > Rehab Net of AR/ArPTA > > P.O. Box 202 > > Conway, AR 72033 > > begin_of_the_skype_highlighting end_of_the_skype_\ highlighting ph/fax > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 12, 2010 Report Share Posted November 12, 2010 I am always captivated by the lively discussions and the differing perspectives. Personally, I will think it is pretty cool when one day, communication between providers is easy and readily available. Utopia, but probably won't happen... but wouldn't it be cool if all providers could know easily what each other was doing? Wouldn't it be cool if patients didn't have to provide redundant information? How many times have you heard, " I was just at the doctors and had to go through all this... " as you hand the patient your paperwork? How cool would it be for you to have access to reports and past history information? If systems could speak to each other, that would be pretty darn sweet. Probably the closest we'll ever get might be the online electronic health records that patients can use. And yes, electronic medical records have saved lives and reduced errors. I think some hospital systems have somehow implemented scanners and bar codes to be used on patients and medications. I think the electronic medical records have also helped with identifying drug seekers. Pharmacists can much more easily read electronic prescriptions. There are some good reasons for technology. If we sign a contract with a payer, we made a choice. If we don't like their rules and regulations, why sign a contract? If we sign a contract... wouldn't it be great to have a tool at our fingertips to use to help reduce the occurrences of time intensive denials? What if the tool was interactive with us? What if the tool had the capability to indicate that the patient in front of us is like a certain group of patients we treated in the past and was able to indicate the outcomes with those patients? What after indicating the plan of care for a particular patient, the tool had the capability to highlight some evidence based options that weren't easily apparent in your plan? What if the tool could predict outcomes? What if we finally can have a tool that can help us readily know our outcomes? Physical therapy business owners can easily know the " health " of their business, but sadly, the physical therapy business owners have no idea the " health " of the overall performance of staff. Nobody is screaming for this type of information or systems to help us perform better. What about the value we bring to health care? Is it possible that having the right documentation system with it having the capability to pull data and query data to help us analyze our services could very well assist in establishing comparative effectiveness of our services over other options for certain conditions? The future looks so bright in this area... and is something that I look forward to seeing evolve. I certainly hope as a whole, we can definitively know what it is we want the electronic medical record to do for us... demand that it will do it... and then use it as a tool to better our performance, our service to patients and our profession. Selena Horner, PT ton, MI > > Hi everyone, > > > > For a balanced perspective, let the record show that the only reason > government got into healthcare was because the private sector messed it up > through greed and fraud. And as history also shows, when the government has > to step in, things don't get better. > > > > Now comes an attempt to do something tangible that a majority agree on, ie > institute efficiency through coordinated computer systems for medical > information. It is long overdue and will help the patients we serve > tremendously no matter what the naysayers say (who cannot offer alternative > solutions as well). Not one opinion on this that I have read during the > healthcare reform debate disagreed on how important this transition is. > > > > The choice is to let those that messed the system up in the first place have > the control again. I say " go ahead " . Let the system crash (and it will > under those circumstances). I am no fan of bailouts but the healthcare > system will be too important and necessary to let crumble and the only one > there to rescue it will be the government. And at that point it will create > universal government-run health care which very few really want. I > certainly don't want universal care and think the partnership of the > government and the private sector is the way to go. > > > > Whether you like healthcare reform or not, the bill is amendable. Let the > opponents have their day and try and repeal it. The millions that are being > helped by the bill already as well as those that stand to be helped in the > future will not be silent and will fight just as hard as those that want to > repeal it! I think the better course would be to continue to work on it and > improve it. And that extends to the EMR provisions because they are among > the most important tasks that lie ahead. > > > > Look no matter what I say there will always be an opposing viewpoint but > just know that there is a strong opposing viewpoint to the post and opinion > below. > > > > Tom Howell, P.T., M.P.T. > > Howell Physical Therapy > > Eagle, ID > > thowell@... > > > > > > This email and any files transmitted with it may contain PRIVILEGED or > CONFIDENTIAL information and may be read or used only by the intended > recipient. If you are not the intended recipient of the email or any of its > attachments, please be advised that you have received this email in error > and that any use, dissemination, distribution, forwarding, printing or > copying of this email or any attached files is strictly prohibited. If you > have received this email in error, please immediately purge it and all > attachments and notify the sender by reply email. > > > > > > _____ > > From: PTManager [mailto:PTManager ] On Behalf > Of Milano, Dave > Sent: Tuesday, November 09, 2010 9:42 AM > To: PTManager > Subject: RE: EMR > > > > > > Tom, > > The great medical science debunker, Dr. Ioannidis, has for years been > patiently pointing out that often it is not the answers we discover that are > wrong, but the questions we ask. > > (Here's a lay-article link that will introduce you to Dr. Ioannidis if you > are not familiar with him and his work: > http://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-med > ical-science/8269/1/) > > Along those lines, regarding electronic medical documentation systems, > asking whether or not more technology will save the healthcare system money > merely directs us away from the salient question, which is whether there > should even be a " system " of healthcare delivery at all. Similarly one might > wonder if government-issued gasmasks would be an effective antidote to air > pollution, or nutritional supplements a fix for low-nutrient foods, or > air-conditioning a solution to global warming. > > We should be asking much higher-level, fundamental questions, like how on > earth did we allow system-makers to push their way between patients and > providers, ultimately between human beings and their right to > self-determination? Are we to be happy that distant third parties with no > personal interest in any individual's needs or desires are directing our > healthcare (and whose only real interest is in financial management)? Look > at what that sort of thinking has gotten us. We have virtually canonized a > record-breakingly expensive, poorly titrated, densely controlled system that > has spawned medical care insurance monopolies, pharmaceutical monopolies, > and allopathic medicine monopolies, not to mention system-sized waste, > fraud, and theft. And to boot, we are still demonstrably unhealthy. > > So our next great idea is to make the system more efficient. Not for me. > Diddling with these systems to make them " better " simply helps cement them > into place. > > Dave Milano, PT, Rehabilitation Director > Laurel Health System > > ________________________________ > From: PTManager <mailto:PTManager%40yahoogroups.com> > [mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On > Behalf Of M. Howell, PT, MPT > Sent: Monday, November 08, 2010 7:57 PM > To: PTManager <mailto:PTManager%40yahoogroups.com> > Subject: RE: EMR > > Hi Dave, > > A couple of questions for you: > > Do you agree or disagree that an integrated EMR system would save the > healthcare system a tremendous amount of money and reduce medical errors? > > How would you propose it be implemented? > > Tom Howell, P.T., M.P.T. > > Howell Physical Therapy > > Eagle, ID > > thowell@... <mailto:thowell%40fiberpipe.net> > <mailto:thowell%40fiberpipe.net> > > This email and any files transmitted with it may contain PRIVILEGED or > CONFIDENTIAL information and may be read or used only by the intended > recipient. If you are not the intended recipient of the email or any of its > attachments, please be advised that you have received this email in error > and that any use, dissemination, distribution, forwarding, printing or > copying of this email or any attached files is strictly prohibited. If you > have received this email in error, please immediately purge it and all > attachments and notify the sender by reply email. > > _____ > > From: PTManager <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> [mailto:PTManager > <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com>] > On Behalf > Of Milano, Dave > Sent: Monday, November 08, 2010 8:04 AM > To: PTManager <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> > Subject: RE: EMR > > There is much misunderstanding and oversimplified interpretation of new > government rules concerning EMRs. > > First and foremost, while the feds appear to be offering a financial > windfall to hospitals and physicians who go along, by our internal analysis, > the money doesn't even come close to covering the costs. (This is based on a > five-year analysis that includes pesky necessities such as hardware and > software upgrades, maintenance contracts, increased staffing for 24/7 > systems-i.e. those things that are easy to forget when a new system is > implemented.) Also, we should all keep in mind that the gun being held to > hospitals' and physicians' heads is a threatened reimbursement reduction > scheduled for 2017 for those that don't go along. (I am unaware of any > related planned reductions to private practices who do not convert to > electronic documentation systems.) On top of that, many of these rules are > tied to Obama's vastly unpopular healthcare reforms, which may soon be > partially or fully dismantled (this AFTER many organizations have invested > significant sums into compliance). > > For hospital therapy services, it's particularly difficult because rehab > service EMRs are not included in the criteria to demonstrate " meaningful > use " (the phrase Uncle Sam uses to adjudicate whether money can be paid to > those attempt to comply). Nevertheless, rehab EMRs will become necessary > anyway, to bring hospital internal systems into alignment and to allow > communication between divisions. In other words, forced investment without > even the thrown bone of capital cost remuneration. > > Last and most important, this is yet another example of government > designing, building, and ruling the private sector. Most evidently it is > occurring in hospital and physician offices, but behind the front lines > government rules are remaking software vendor businesses as well. Watch the > flurries of mergers and takeovers as vendors scramble to divert their > resources to meeting government rules, and watch software businesses that > were targeting other service lines fall behind and die off. All because of > decisions made by central controllers overruling the natural supply/demand > activities of private business and individuals. > > Dave Milano, PT, Rehabilitation Director > Laurel Health System > > ________________________________ > From: PTManager <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> > [mailto:PTManager <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> ] > On > Behalf Of M. Howell, PT, MPT > Sent: Friday, November 05, 2010 2:58 PM > To: PTManager <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> > Subject: RE: EMR > > Hi Becky, > > The simple answer is that private practice PT does not have implement EMR > because PT's were excluded from the legislation (which provides grant money > to pay for upgrading to EMR). For those that are included in the > legislation like hospitals and physician practices, money started being > available, if the legislation's requirements were met, starting in fiscal > year 2011 (which started Oct 1). For these organizations, bonus money for > implementing EMR will change to penalties by 2015 if EMR is not implemented > (or simply if you qualify to upgrade to EMR and you haven't done so by 2015 > then you will be reimbursed less (by Medicare)). > > While the APTA continues to try and get PT's included, the fact is that > private practice PT's are in a bind. While we don't have to implement EMR, > it may be necessary to upgrade anyway to be able to communicate and > integrate with providers and hospitals. Right now it is cost prohibitive to > upgrade without grants from the Federal government, so hence the Catch 22. > > For more information check out the APTA website: apta.org/healthIT. The > information is members-only so you would have to have a member access it. > Another brief update was published in the " Today in PT " magazine October 4th > edition (can be accessed online). > > Tom Howell, P.T., M.P.T. > > Howell Physical Therapy > > Eagle, ID > > thowell@... <mailto:thowell%40fiberpipe.net> > <mailto:thowell%40fiberpipe.net> <mailto:thowell%40fiberpipe.net> > <mailto:thowell%40fiberpipe.net> > > This email and any files transmitted with it may contain PRIVILEGED or > CONFIDENTIAL information and may be read or used only by the intended > recipient. If you are not the intended recipient of the email or any of its > attachments, please be advised that you have received this email in error > and that any use, dissemination, distribution, forwarding, printing or > copying of this email or any attached files is strictly prohibited. If you > have received this email in error, please immediately purge it and all > attachments and notify the sender by reply email. > > _____ > > From: PTManager <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> [mailto:PTManager > <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com>] > On Behalf > Of Becky Sewell > Sent: Friday, November 05, 2010 8:38 AM > To: PTManager <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> > <mailto:PTManager%40yahoogroups.com> > Subject: EMR > > I know this topic has probably been discussed before but one of my clinic > owners was asking me this week about the rules on implementing an EMR > program. She stated that she knows she has until 2012 to implement an > electronic medical records program at her clinic but did not know what that > needed to entail. I was thinking that private practices were not required > to implement EMRs but I have been wrong before. Can someone give me a run > down on the rules for EMR implementation in a private practice setting or > point me to a good resource for me to read up on it? > > Thanks for your help in advance! > > Becky A. Sewell, MRC, CRC > > Rehab Net of AR/ArPTA > > P.O. Box 202 > > Conway, AR 72033 > > begin_of_the_skype_highlighting end_of_the_skype_\ highlighting ph/fax > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 12, 2010 Report Share Posted November 12, 2010 Tom, The issue of healthcare reform was, as you know, debated at length here many moons ago so I won't revisit that subject in detail. Nevertheless, while the benefits of the so-called healthcare reform [which I prefer to call sickness management reshuffling since it does little to address the fundamental flaws of our healthcare system] that you list below are certainly positive, the primary point is that this legislation was proposed ostensibly to reduce costs for the average American. It will not. It will raise them. Ask yourself if, in a country with a true inflation rate approximately 3 times that of the heavily massaged government figures (as cited by of Shadow Government statistics, a highly respected Dartmouth trained economist), a true unemployment rate of over 22.5%, close to 43 million people on food stamps, record foreclosure rates, record underwater mortgage rates, record low interest rates on bank accounts, etc., you think the increase in premium costs for your average individual (and especially for your average small businessman) with his diminished asset base will be beneficial or detrimental to his financial well being or even his solvency? I think it will be highly detrimental and accelerate the downward economic spiral. In so far as polls being any indication of correct decision making, surely you realize that the plurality opinion on any issue of signifance generally bears little relationship to the wisdom of that opinion. Also, what is your evidence that reform will work better than repeal? While you correctly recognize that this bill is weighed heavily in favor of the monied business interests, can you really be naive enough to think that grassroots voices will actually create substantive change once these business interests have their foot in the door? The historical precedents for this type of occurrence are virtually non-existent. While the benefits of EMR are obvious, perhaps the dangers are not. Both you and your patients will be increasingly micro-managed through use of these systems. You will have less and less independence in decision making, less and less control over patient care, less and less income, and more and more paperwork. Central control will increasingly be used to influence and direct the behavior of the citizenry. Again, can you cite me historical precedent for a political system which becomes increasingly benevolent as it gains increased control? The opposite has virtually always been true. As for the myth of Clinton eliminating the deficit, it's just that, a myth. http://www.craigsteiner.us/articles/16 I don't mean to be harsh Tom because I respect your opinions but my studies don't allow me to view events from the same naive perspective I once had and which I think most physical therapists have. Over the past decade, I've seen the trends in the physical therapy profession and realized I no longer wanted to tie my future entirely to the vagaries of healthcare. I read literally hundreds of books and tens of thousands of articles to learn more about investing so that I could become financially independent and practice physical therapy simply because I wanted to, not because I had to. Those studies started a journey into finance, economics, politics, history, geopolitics, trader and crowd psychology, etc. because all of those subjects are interrelated and influence one's success in the investment arena. I learned things I wish I never learned but that knowledge put me in a position to see the reality of what is occurring and to act accordingly to protect myself and my family. The words of Damon Vrabel succinctly express what I found (the following being a quote except for slight editing). " The truth has never been clearer. We're living in a voracious empire based on people ownership, i.e. subjugating humans to increasing debt servitude to Wall Street and the global banking establishment. This debt system has morphed economics from a study in human progress to an engine of human enslavement. Spirituality( " sense of meaning " ) and psychology have been crushed as a result. Any sense of a meaningful life has almost been vanquished as the corporate system that serves Wall Street has replaced truth with fake media PR and replaced our communities with a narcissistic hierarchy. The good news is that this system is on its last leg. It will end. However, we are not prepared to weather the storm and our communities are not equipped to ensure a better system emerges. Our instincts have been trying to tell us this for a long time, but it has felt safer to go along with the fake PR of the corporate/political system pumped through the media. It's time to have the courage to face the truth. Then we must rebuild our communities with an economic system informed by healthy spirituality and psychology rather than one specifically designed to crush them. " Thanks but I'll pass on the blue pill. , PT, OCS Marquette, MI EMR I know this topic has probably been discussed before but one of my clinic owners was asking me this week about the rules on implementing an EMR program. She stated that she knows she has until 2012 to implement an electronic medical records program at her clinic but did not know what that needed to entail. I was thinking that private practices were not required to implement EMRs but I have been wrong before. Can someone give me a run down on the rules for EMR implementation in a private practice setting or point me to a good resource for me to read up on it? Thanks for your help in advance! Becky A. Sewell, MRC, CRC Rehab Net of AR/ArPTA P.O. Box 202 Conway, AR 72033 ph/fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 12, 2010 Report Share Posted November 12, 2010 Tom, The issue of healthcare reform was, as you know, debated at length here many moons ago so I won't revisit that subject in detail. Nevertheless, while the benefits of the so-called healthcare reform [which I prefer to call sickness management reshuffling since it does little to address the fundamental flaws of our healthcare system] that you list below are certainly positive, the primary point is that this legislation was proposed ostensibly to reduce costs for the average American. It will not. It will raise them. Ask yourself if, in a country with a true inflation rate approximately 3 times that of the heavily massaged government figures (as cited by of Shadow Government statistics, a highly respected Dartmouth trained economist), a true unemployment rate of over 22.5%, close to 43 million people on food stamps, record foreclosure rates, record underwater mortgage rates, record low interest rates on bank accounts, etc., you think the increase in premium costs for your average individual (and especially for your average small businessman) with his diminished asset base will be beneficial or detrimental to his financial well being or even his solvency? I think it will be highly detrimental and accelerate the downward economic spiral. In so far as polls being any indication of correct decision making, surely you realize that the plurality opinion on any issue of signifance generally bears little relationship to the wisdom of that opinion. Also, what is your evidence that reform will work better than repeal? While you correctly recognize that this bill is weighed heavily in favor of the monied business interests, can you really be naive enough to think that grassroots voices will actually create substantive change once these business interests have their foot in the door? The historical precedents for this type of occurrence are virtually non-existent. While the benefits of EMR are obvious, perhaps the dangers are not. Both you and your patients will be increasingly micro-managed through use of these systems. You will have less and less independence in decision making, less and less control over patient care, less and less income, and more and more paperwork. Central control will increasingly be used to influence and direct the behavior of the citizenry. Again, can you cite me historical precedent for a political system which becomes increasingly benevolent as it gains increased control? The opposite has virtually always been true. As for the myth of Clinton eliminating the deficit, it's just that, a myth. http://www.craigsteiner.us/articles/16 I don't mean to be harsh Tom because I respect your opinions but my studies don't allow me to view events from the same naive perspective I once had and which I think most physical therapists have. Over the past decade, I've seen the trends in the physical therapy profession and realized I no longer wanted to tie my future entirely to the vagaries of healthcare. I read literally hundreds of books and tens of thousands of articles to learn more about investing so that I could become financially independent and practice physical therapy simply because I wanted to, not because I had to. Those studies started a journey into finance, economics, politics, history, geopolitics, trader and crowd psychology, etc. because all of those subjects are interrelated and influence one's success in the investment arena. I learned things I wish I never learned but that knowledge put me in a position to see the reality of what is occurring and to act accordingly to protect myself and my family. The words of Damon Vrabel succinctly express what I found (the following being a quote except for slight editing). " The truth has never been clearer. We're living in a voracious empire based on people ownership, i.e. subjugating humans to increasing debt servitude to Wall Street and the global banking establishment. This debt system has morphed economics from a study in human progress to an engine of human enslavement. Spirituality( " sense of meaning " ) and psychology have been crushed as a result. Any sense of a meaningful life has almost been vanquished as the corporate system that serves Wall Street has replaced truth with fake media PR and replaced our communities with a narcissistic hierarchy. The good news is that this system is on its last leg. It will end. However, we are not prepared to weather the storm and our communities are not equipped to ensure a better system emerges. Our instincts have been trying to tell us this for a long time, but it has felt safer to go along with the fake PR of the corporate/political system pumped through the media. It's time to have the courage to face the truth. Then we must rebuild our communities with an economic system informed by healthy spirituality and psychology rather than one specifically designed to crush them. " Thanks but I'll pass on the blue pill. , PT, OCS Marquette, MI EMR I know this topic has probably been discussed before but one of my clinic owners was asking me this week about the rules on implementing an EMR program. She stated that she knows she has until 2012 to implement an electronic medical records program at her clinic but did not know what that needed to entail. I was thinking that private practices were not required to implement EMRs but I have been wrong before. Can someone give me a run down on the rules for EMR implementation in a private practice setting or point me to a good resource for me to read up on it? Thanks for your help in advance! Becky A. Sewell, MRC, CRC Rehab Net of AR/ArPTA P.O. Box 202 Conway, AR 72033 ph/fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 15, 2010 Report Share Posted November 15, 2010 Hi everyone, It has taken me a few days to respond as it is hard to respond after reading a post and saying “What the ***k?” but that’s what I did after reading the response to my post from Mr. . I know it is my responsibility because I put a target on my back by posting on the listserve but man, I literally was speechless (at first and not for very long!). Listen, I have always firmly understood that we have differing and strong opinions and I apologize to the list for opening the can of worms on political discourse, but what brings us together is the firm desire and belief in what we do in our professions. We do a noble thing day in and day out, hopefully within the crazy regulations we are given, and we keep coming up with ways to continue battling for the patients/clients we serve. Now we have the prospect of the widespread upgrade of computer systems including EMR and plenty of real world research by health care providers already supporting it (my family doctor’s group has been using it for the last two years so I understand on a personal level how it will help and be a good thing). It is clear from all that I have read and seen and from the 30 plus years that I have been in healthcare (the last 20 ½ as a PT) that this system-wide change will save lives, will improve the delivery of healthcare and will save money. I appreciate the posts by Selena and Tim who very wisely spoke to the many benefits of this upgrade. There is nothing that can be said to change my opinion that this computer upgrade will be an exciting and needed change and one that will give us additional tools to continue the daily fight to meet the needs of the patients/clients we serve. At the end of the day it is always about the patients/clients that we serve and finding ways within the system we work under, new and innovative ways, to continue to meet that daily goal. I appreciate having this listserve, that is a computer creation BTW, that allows the exchange of positive ideas on how we can continue to keep up that daily fight to do what is best for our patients/clients. Tom Howell, P.T., M.P.T. Howell Physical Therapy Eagle, ID thowell@... This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 7, 2011 Report Share Posted January 7, 2011 Newsflash: " California Can't Block Staggering Health Insurance Rate Hikes " . http://abcnews.go.com/US/blue-shield-california-announces-massive-rate-hikes-med\ ical/story?id=12555419 Hmmm ... does this have a ring of familiarity? Read below. , PT, OCS Marquette, MI EMR I know this topic has probably been discussed before but one of my clinic owners was asking me this week about the rules on implementing an EMR program. She stated that she knows she has until 2012 to implement an electronic medical records program at her clinic but did not know what that needed to entail. I was thinking that private practices were not required to implement EMRs but I have been wrong before. Can someone give me a run down on the rules for EMR implementation in a private practice setting or point me to a good resource for me to read up on it? Thanks for your help in advance! Becky A. Sewell, MRC, CRC Rehab Net of AR/ArPTA P.O. Box 202 Conway, AR 72033 ph/fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 22, 2011 Report Share Posted June 22, 2011 As a follow up to this question I am at a SNF with an OP attached. Is there a definite date when e-doc will be required? Thank you in advance for your assistance. Pamela J. Harbert, LPTA Director of Therapy Services Henry County Health and Rehab Abbeville, AL " Excellence is not a skill. It is an attitude. " From: PTManager [mailto:PTManager ] On Behalf Of Mike Moreau Sent: Wednesday, June 22, 2011 6:44 AM To: PTManager Cc: Subject: EMR Is there any requirement that PPPT has to convert to EMR (by a certain date)? Thanks, Mike Outpatient, NC Quote Link to comment Share on other sites More sharing options...
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