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18 EW SHOW DAILY Monday, April 22, 2013 ASCRS Symposia EMR session addresses questions and concerns for practice transitions By Ellen Stodola EyeWorld Staff Writer ASCRS dIrector of government relations Nancey K. McCann speaks during the government relations symposium. F eatured in a session on transitioning to EMR were Jessica E. Chan, MD, New York, ASCRS director of government relations Nancey McCann, Fairfax, Va., Joshua Young, MD, New York, Jack Vinson, Springfield, Ill., and Tina Pinke, COE, COT, Shelton, Conn. The session discussed the growing push toward EMR, or an electronic medical record, and it also discussed specific details for practices and some concerns physicians might face when considering this option. Dr. Chan said that there has recently been a growing push toward computerized medical records. "Practices will have to meet meaningful use criteria within the next few years or face penalties," she said. However, she also said that there is a fear that EMRs will turn physicians' attention away from patient interaction and more toward the computer. Ms. McCann clarified some of the details of EMR and meaningful use. "I think there's been a lot of misunderstanding about EMR and meaningful use," she said. Despite many people believing that this is tied to President Obama and Obamacare, it is separate legislation, and the initiative was actually started with the Bush administration. "In 2009, however, the American Recovery and Reinvestment Act authorized CMS to provide financial incentive for physicians who are "meaningful users" of certified electronic health record technology," Ms. McCann said. There THING!S BIG RE here A will be penalties for those who do not use this by 2015, and she said at this point, the plan is bipartisan. To avoid penalties starting in 2015, which are –1%, she said eligible providers need to attest no later than October 1, 2014, and also must begin their 90-day EHR reporting period no later than July 1, 2014. In addition, Ms. McCann said penalties will go up each year a provider is not showing meaningful use. Going forward, the bar will be raised, and some of the things to continue to consider include patient and family engagement, patient safety, care coordination and efficient use of healthcare resources. Most of the measures continue to be primary care focused and not specialty specific, Ms. McCann said. Dr. Young discussed the importance of choosing what models you will use when you choose to integrate your practice to EMR. Things to choose include scanners, shredders, and software. He explained some of the processes of scanning paper records and making sure to take note of which records have been transferred from paper to electronic storage. He also suggested that if a practice should decide to transfer to integrated billing, it should not do this as the same time as integrating charts because this will just provide even more stress and confusion. Dr. Young discussed the differences and pros and cons of choosing either a cloud or client server record system. He said a cloud system offers certain advantages, namely that it's especially easy to integrate a satellite office. In addition, it would enable easy access to charts from other locations, like home or vacation. When it comes to choosing between a cloud based and a client server, however, you need to consider both data security and data liability. With the cloud, Dr. Young said data security and data liability are primarily shifted to the vendor. Implementation tends to be simple with a cloud system, and hardware requirements are much lower, Dr. Young said. However, he said that bandwidth requirements are expensive. On the other hand, Dr. Young said with a client server the bandwidth requirements are lower than with the cloud. However, he said the reliability for a client server is only as good as the server, and the hardware requirements are a challenge. Mr. Vinson spoke specifically about what his practice considered when it came time to choose an EMR system. He said that it was not a question of if, but it was rather a question of when. Considering the cost was a really big factor, he said. Another thing to consider is whether the system should be ophthalmic specific or provide more of a multi-specialty option. Mr. Vinson said in the case of his practice, an ophthalmic or eye specific system was desirable. He also said to consider template development flexibility after implementation. He said that his practice "wanted the flexibility to modify those templates and even add some of our own into that over time." Finally, he added that it's important to consider whether or not an on-site IT specialist is needed. EW Editors' note: Ms. Pinke provides EMR consulting services. The other panelists have no related financial interests. 02! OTH #11 RS BO t At ASC Find Ou JOGP!FZFNBHJOBUJPOTDPNttXXXFZFNBHJOBUJPOTDPN 8BTIJOHUPO"WFOVF 4VJUF #BMUJNPSF .%