Making the User Friendly EHR Even Friendlier

An Electronic Health Records System is only as user-friendly as its customers think it is and year after year Amazing Charts scores in the top tier rankings of user-friendly EHR applications.

Right out of the box, Amazing Charts is intuitive and easy to use and addresses one of the most frequently complained about pain points for many physicians – the “death by 1,000 clicks” syndrome some providers experience. Amazing Charts keeps your chart in front of you – no need to go several screens deep, as in some other EHR’s, to find what you are looking for.

In addition to being user-friendly for anyone using mouse and keyboard, Amazing Charts is also speech recognition friendly, and therefore takes ease of use to another level, saving physicians even more time.

Amazing Charts EHR works beautifully for those physicians who wish to continue using a traditional and familiar dictation style of documenting the patient encounter via speech recognition. With the addition of NoteSwift, dictating medicines, allergies, and prescriptions can be done effortlessly in the Amazing Charts Patient Encounter window.

There are no commands to learn. Simply say what part of the patient note you want and begin to speak the narrative. NoteSwift easily handles structured data as well, no drop-down menus or lists to click through – NoteSwift does the lookup for you. You can even call up your favorite templates if you wish.

Take a look at the NoteSwift video .

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Whether you use NoteSwift, or mouse and keyboard, or a combination, Amazing Charts allows you to work the way you want to work. And that is very friendly.

Social Media for Your Practice: Not the Bitter Pill You Imagined

At Pri-Med Southwest a few weeks ago, I had the opportunity to talk with clinicians, practice owners, and practice managers about social media tools like Facebook and Twitter.

While using social media comes naturally to me, I saw that many people are intimidated by it, and haven’t been shown how valuable these tools can be for a small healthcare practice with limited marketing resources.

As owners/managers of small healthcare practices, you have neither the time nor resources to run traditional marketing campaigns like other businesses do, which makes social media that much more valuable for you.

ACUG South 2013

Hello from the ACUG at Pri-Med South in sunny Fort Lauderdale! I’m thrilled to be attending my first Amazing Charts Users Group (ACUG) meeting since joining the company as Director of Product Strategy!

There are about 60 users here today learning about Amazing Charts and sharing their thoughts about the product.

We started the day with a keynote address from Dr. Jon Bertman, who discussed the evolution of Amazing Charts and the exciting opportunities we have today as part of the Pri-Med family.  Next, the group heard our product plans, as mentioned in my recent User Board post, for solidifying our Practice Management (PM) strategy and other initiatives we are pursuing this year.

The morning session was full of “ooohhs” and “aaaahs” as folks got a look at our newest product version, 6.5. We got great feedback on the re-designed letter writer, the new formulary tools and our new check-in / check-out screen that makes updating patient demographics and collecting co-pays even easier.

Users spent time in our product lab getting one on one tips and tricks from our product and technical support specialists. They also attended sessions covering Meaningful Use and  learned more about the hundreds of interfaces available today  for labs, radiology and medical devices.

The staff did a fabulous job planning this event, but the ‘special sauce’ came directly from the attendees – users that took time from their busy schedules to come and engage with us and each other.

The Amazing Charts  user community is awesome! They share their tips and troubles freely  and they tell us what it is we need to do to make the product more efficient and effective for their practice and their patients.

I am leaving completely energized and with a long list of ideas and requests and I look  forward to working with our engineering team to make these ideas a reality. I learned so much today and look forward to the next ACUG meeting ( and the next one, and the next one….)

I hope to see you at a user meeting, or a Pri-Med event soon.

Practice Hero of the Month: Dr. Michael Garver

In the remote villages of the Transkei region of South Africa, medical services are rare and even common medications can be non-existent. Lack of sanitary water means that parasites and skin infections, such as scabies, are widespread among children. Orphans of parents who died from HIV have practically no access to basic healthcare.

These are the reasons why Michael Garver, MD, has made three “medical mission” trips to Africa. Dr. Garver, a pediatrician practicing independently in Great Falls, Montana, brings Amazing Charts EHR to Africa to record demographics and treatments for follow-up visits. He even uses Amazing Charts to track the growth of children from visit to visit.

“We needed an ‘off-the-shelf’ EHR that could be loaded onto a ruggedized laptop computer and run without any Internet connection,” explains Dr. Gerver. “Amazing Charts is the perfect solution and it does everything we need.”

Dr. Garver and his team of medical and non-medical volunteers treat up to 70 children each day in orphanages and small villages. “Amazing Charts is efficient at documentation, which allows us to see a lot of kids in a single day,” says Dr. Garver. “We plan to use the data collected to show our financial supporters the value of their donations.

Another mission is planned for October 2017, but Dr. Garver is unable to attend. He seeks a family physician or pediatrician who can go in his place. Please email [email protected] to learn more.

 

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How to Verify and Restore Your Amazing Charts Data Backup

Verification can still be done unassisted, but new security measures mean you may need our help to restore a data backup

At the last meeting of the Amazing Charts Clinician Advisory Board, we were reminded that many clients don’t know about or understand how data backups are: (1) verified for completeness; and (2) restored to a new server in case of an emergency.

New Security Measures Impact Restore

The board’s primary concern is that users are unaware of new security measures in version 9.2, specifically the security credentialing process for new servers being provisioned to run Amazing Charts for the very first time.

Security credentialing impacts the process of restoring a data backup on new servers, not computers that have already run Amazing Charts V9.2 or higher. Our Technical Support team performs this service as part of your Guardian Angel Support.

Let’s divide the Amazing Charts community into three distinct groups and see how each one is affected by this change.

Amazing Charts in the Cloud

The 500+ practices that use Amazing Charts in the Cloud (ACitC) are completely unaffected by this change.  Their data is securely backed-up at redundant offsite facilities nightly.  It is always ready to be restored at a moment’s notice.  We sincerely urge all clients to consider moving to the Cloud for this reason and a myriad of other benefits. A current promotion lets you save 25% for the first year.

On Premise Servers with Amazing Backup

The 1400+ practices that subscribe to Amazing Backup enjoy a fully automated service specifically designed for our EHR data set, including imported items.  Files are stored at a data center with 24/7/365 on-site security, backup power generators, and disaster recovery. Connectivity is via secure encrypted 256-bit SSL.

Daily reports provide practices with the status of their Amazing Backup. These emails alert them of any errors in creating the backup file, so the practice can rest assured that their data is complete and restorable. If the practice doesn’t see two messages daily, they know to contact us immediately.

One major caveat: practices using Amazing Backup must notify us if they make significant changes to their main server as we might need to reinstall Amazing Backup. These changes include upgrading from pre-9.2 versions; reinstalling Amazing Charts to a new directory; or migrating to a new computer.

With no need for additional verification, these practices can focus how to restore their data in an emergency. As mentioned above, restoring backups to a production machine that was previously hosting Amazing Charts V9.2 and higher can be done by the practice without the need to contact technical support.

If restoring to a new computer which was not previously hosting Amazing Charts, the end user will need to contact technical support.  We will credential the new computer and then assist you with the restoration of data.

On Premise Servers Not Using Amazing Backup

Amazing Charts includes a Local Backup utility that runs manually or automatically per user settings.  The utility creates *.bak (back-up) files, then compresses the files into a *.zip folder, and finally encodes the package into an *.enc file.

The local backup utility provides an option to check encryption and zip files for integrity. This will notify the user of any backup errors present in the backup file itself. The utility finishes by saving the encrypted file and deleting all other files.

Restoration of files is the same as with Amazing Backup.  You do not need our assistance if using a server that has run Amazing Charts V9.2 or higher.  Backups can be safely and easily restored by the end user using the Backup Restore utility. New servers must be provisioned by our technical support group.

CMS Proposes Quality Payment Program Updates to Increase Flexibility and Reduce Burdens

Today, CMS released a proposed rule outlining how the Quality Payment Program (which MIPS falls under) would operate in 2018 and it’s a clear win for physicians who have had to scuttle from one federal program to the next over the last 7 years.

The proposed rule eases requirements on physicians in a number of areas: CMS is proposing that in 2018, clinicians can continue to use the same software they used in 2017, withdrawing an earlier requirement that would have required physicians to upgrade by Jan 1. They’re also proposing exempting more physicians from having to participate in MIPS by increasing the amount of Medicare Part B charges and patients that would make a clinicians eligible. While CMS is proposing an increase in the 2018 performance threshold (aka the number of points you’d need to earn in order to avoid a negative payment adjustment), the proposed rule offers immense relief to clinicians, especially those who work in small practices – like many of our users.

Amazing Charts offers tools and resources to support obesity management

In the February blog “Documenting a diagnosis of obesity increases the likelihood of clinical management,” Amazing Charts provided tools to help manage your patient panel.  We recognize there are barriers to managing obesity and have more resources available to help overcome these obstacles.

Amazing Charts recognizes that interventions easily implemented in your workflow may reduce barriers to care.  We suggest the following steps to help efficiency:

The Clinical Decision Support system within Amazing Charts helps raise awareness of excess weight based on BMI. Sharing the evidence based recommendation with your patient can help start a discussion.

Obesity counseling in primary care is positively associated with self-reported behavior change in patients with obesity.  Implementing the “5 A’s“, an evidence based intervention, facilitates weight management and promotes physician-patient communication.[i]  The “5 A’s” was modified from a smoking cessation tool and is available in the Obesity section of the ACRC as well as within the AACE Obesity Resource Toolkit.  This document can be modified and incorporated into a template to reflect your practice. Templates can be accessed from almost every text box in Amazing Charts by right-clicking your mouse. View Amazing Charts Contents >Getting Started >User templates to see instructions for customizing templates.

Creating templates with pre-populated text helps with efficiency.  You can document in a complete, accurate, and consistent manner, modifying text where appropriate to capture patient specific nuances.  While you are creating a template for the “5 A’s” you may find it valuable to create a template to document follow-up plans. Arranging follow-up is important so that the support of the physician recommendations can continue.[ii]  For instance Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan CMS69v5 requires a follow-up plan be documented.

Self-management is a critical component for weight management. Collaborative goal setting can incorporate practices and materials the patient needs to implement at home to be effective.  Providing literature, checklists and a food diary is easy with Amazing Charts. Visit the ACRC and download material to save to your Amazing Chart “Practice Documents” or print handouts from the ACRC each time you visit.

At Amazing Charts, we are always looking for ways to help you gain efficiencies while using our EHR.  We hope you find this information useful.

Documenting a diagnosis of obesity increases the likelihood of clinical management

Documenting a diagnosis of obesity increases the likelihood of clinical management

You can’t treat what you don’t diagnose! Documenting a diagnosis of obesity increases the likelihood of clinical management*. A recent assessment of patients with a BMI greater than or equal to 30 found obesity is both underdiagnosed and often not coded within Amazing Charts. We have tools to help you easily screen your patients for obesity, which may increase the likelihood of capturing the diagnosis.

Amazing Charts EHR prompts the user to screen for obesity in several ways.

  • Once a user documents the height and weight in the vital signs bar, the BMI is automatically calculated. If the BMI is normal, the box remains green; if the BMI is elevated, the color is changed to yellow; and if the BMI is greater than or equal to 30, the box is highlighted in red.
  • Clinical Decision Support rules remind the user to evaluate patients for obesity yearly, according to USPSTF guidelines.
    • Charts with a documented BMI greater than or equal to 25 will automatically trigger a specific guideline based on the presence or absence of adiposity related complications. If no complications are documented, the guideline recommends assessing for these conditions.
      • Metabolic syndrome • Prediabetes • Type 2 diabetes • Dyslipidemia • Hypertension • Cardiovascular disease • Nonalcoholic fatty liver disease • Polycystic ovary syndrome • Female infertility • Male hypogonadism • Obstructive sleep apnea • Asthma/reactive airway disease • Osteoarthritis • Urinary stress incontinence • Gastroesophageal reflux disease • Depression

Amazing Charts EHR has tools available for management of your patient panel or population as well. Using the Reports tool, you can search under “Population Health” to identify and compare cohorts of patients, as well as a population of patients that remain undiagnosed.

Identification, documentation, and education are important steps to effectively manage obesity and its related complications. You may also want to provide important patient education material to your patients, which can be accessed through clicking on the “info button” within the chart, or going to the Patient Education Tab within the Amazing Charts Resource Center (ACRC).

We hope you find these new tools and resources valuable additions to help you improve patient outcomes.

How to prepare for MIPS in 2017

Many providers using Amazing Charts are wondering what should they do to prepare for MIPS in 2017. First, rest easy with the knowledge that your EHR is already prepared for MIPS.

Amazing Charts has been 2014 certified since 2014, which means you can use it today for all MIPS reporting in 2017. You’ll report slightly different advancing care information measures than a provider using a 2015 certified EHR, but that’s the only difference.

We recommend clinicians upgrade to the newly released Version 9.3, which includes a multitude of new features we think you’ll enjoy.

Our 2015 certified version of Amazing Charts, Version 10, is expected in late Q4 2017. You must be on a 2015 certified version in 2018.

The real challenge is deciding what path you want to follow: (1) Test, (2) Partial, or (3) Full. The path you follow determines the number of points you can get and, ultimately, the payment adjustment you’ll earn.

For Quality, you can wait for Amazing Charts Version 10, which will allow for calculation of quality measures, or you can consider using a Qualified Clinical Data Registry (QCDR) or other registry to calculate measures if you want to earn the most points possible in 2017; Clinicians should research what QCDR/registry their professional organization suggests they use.

You will not be able to use the Meaningful Use Wizard in 2017 for tracking quality measures; you also aren’t able to attest to your quality measures numbers on the CMS website like you did in Meaningful Use. Instead, you’ll need to submit your information via claims, a QCDR, or a registry.

For Advancing Care Information, clinicians should familiarize themselves with the “new” measures for MIPS. Hint: They’re all old MU measures, but easier. There’s no more required thresholds to “pass” a measure.

Be sure you know how many measures you have to report on. If you’re doing the “Test” path with Amazing Charts 2014 edition software, you have to report on the four base measures over any time period and you only have to get one in the numerator, and attest “yes” to the security risk audit.

Meanwhile, if you’re doing the “Partial” or “Full” path, you need to report on all four base measures, and track your performance on the performance measures; performance measures earn you more points the higher the percentages you get. CMS will be creating an attestation website for you to submit data, but you can also submit data via a registry or QCDR if they offer it.

For Improvement Activities, review the improvement activities on the QPP website to see how to best use Amazing Charts to accomplish one of them. You’ll earn extra points for using an EHR to complete an improvement activity. But even if you don’t use Amazing Charts to complete the activity, you’ll still get credit for it, just no bonus points.

Don’t forget, if you’re a Patient Centered Medical Home (PCMH), you get credit for the Improvement Activities category automatically; if you’re a small practice, you also get a break in terms of the number of activities you have to attest to. CMS will be creating an attestation website for you to submit data, but you can also submit data via a registry or QCDR if they offer it.

How to Collect Thousands of Dollars Monthly for What You Already Do

Chronic Care Management lets you bill for non-face-to-face care services

What if you could earn hundreds or even thousands of Medicare dollars each month by billing for care management services your practice already performs today? Sounds too good to be true, right?

It’s all too true for some practices, thanks to a program called Chronic Care Management (CCM). The new CPT code 99490 allows you to submit monthly claims for non-face-to-face services provided to Medicare beneficiaries who have multiple chronic conditions. In 2015, the average reimbursement was $42.60 per patient, adjusted based on geography.

Examples of non-face-to-face services include phone calls and email with patient; time spent coordinating care (by phone or other electronic communication) with other clinicians, facilities, community resources, and caregivers; and time spent on prescription management and medication reconciliation.

In essence, CCM allows your office to become a care coordination hub for ongoing care between visits, generating additional practice revenue for functions already being performed by your team today. We recently profiled one practice collecting $60,000 annually in CCM billings, which the office manager describes as “found money” for the physicians.

How CCM works

Amazing Charts has partnered with Caremerge, a leading care coordination network, to help you deliver the services required for CCM with minimal practice disruption.

The first step is figuring out which patients qualify for CCM. They must be Medicare beneficiaries with multiple (two or more), significant chronic, continuous, or episodic health conditions that are expected to last at least 12 months. Common examples are COPD, diabetes, and hypertension.

You can use the reporting function in your Amazing Charts EHR to search for and create a list of patients who meet the criteria; on average, 80% of Medicare patients will qualify. This is your pool of eligible participants.

To get patients enrolled, use the EHR to send a postal letter or email informing patients of the program and asking them to discuss it during their next visit. Caremerge provides talking points for providers, and verbal consent is noted in Amazing Charts EHR.

The next step is to create a comprehensive care plan for each enrolled patient using Caremerge templates, which is automatically imported into Amazing Charts and attached to the patient’s chart. The Caremerge network provides the care team with 24/7 access to the electronic plan via web browser.

Finally, you or your staff captures care coordination notes with just three clicks using Caremerge’s digital time tracking. A report tells which patients have reached the 20-minute threshold. Submit CCM billing under CPT code 99490 using Amazing Charts EHR just like normal.

That’s it!

How much can you earn? Let’s say you signed up just 200 patients and billed $42 per month for all of them. Your practice’s additional income would be approximately $108,800 per year!

New rules make CCM even better in 2017 

Medicare is effectively “doubling down” on its investment in CCM, which can keep people healthier and out of hospitals, while rewarding medical providers who perform this valuable work with new revenue.  Here’s a highlight of the changes:

A 3.7% increase in the CPT 99490 payment rate for 2017, to an average of $46.87

A new code, CPT 99487, that addresses the needs of more complex patients. Complex CCM requires 60 minutes of non-face-to-face services per month, with an average payment of $92.66

A new code, CPT GPPP7, that pays you for care plan development, including assessment during a face-to-face service. The projected payment rate for GPPP7 is $63.68.

A reduction in the administrative burden of CCM, most notably removing the requirement for a written consent for patient enrollment, and removing the initiating visit requirement for patients who have been seen within the past year by the practice.

CCM will qualify as a “practice improvement” under the Merit-based Incentive Payment System (MIPS), one of the new MACRA Quality Payment Programs.

Two ways to get started

For do-it-yourselfers and practices with sufficient manpower, we offer Caremerge Provider. You launch and maintain the CCM program. An easy-to-use online platform lets you input all data, run reports, and upload care plans to Amazing Charts. This option requires your staff to make required patient updates.

For those who don’t have the time or resources to manage this program themselves, we offer Caremerge Provider Premium. A telehealth staff (licensed RNs, certified MAs, and Pharmacists) will support your CCM requirements in collaboration with your staff, using remote access to Amazing Charts. This turnkey service provides care plan development, time tracking, and patient education. Although costlier that Caremerge Provider, this option requires no additional staff time.