On September 27, 2011, I wrote a blog entitled “Free EHR Software — Be Careful, a Real Catch- 22”. In that blog I discussed that the Internet advertising model had migrated to the EHR space and that there are several companies that will provide EHR services “for free”, in return for being allowed to advertise to you — the physician. I discussed the moral dilemma related to using an advertising based model. What we didn’t know at that time was that Congress could be legislating new laws that will make it very hard for a physician to choose those free EHRs without breaking the HIPAA law.
Earlier this month the U.S. Department of Health & Human services released the new HIPAA megarule that imposes new limitations on marketing. The new rule requires providers to obtain patient authorizations “for all treatment and healthcare operations communications where the covered entity receives financial remuneration for making the communications for a third party whose product or service is being marketed.” According to Fierce EHR “the authorization can’t be buried in the provider’s notice of privacy practices, and it must inform the patient that the physician is receiving a financial benefit for sharing the third party’s information with the patient.”
The goal of banner or pop-up ads is to promote the advertiser’s products to physicians with the expectation that they will prescribe, endorse or sell those products to patients. This is important because the targeted buyer is not the doctor; instead it is the patient. We believe this type of marketing is what the new HIPAA rule is addressing. If the physician sees the ad and then promotes the drug, product or service in the ad without patient authorization then there is a violation of HIPAA. Per the rule, the financial benefit can be direct or indirect. Since the ads are assisting in the sponsorship of the free EHR then the physician incurs a financial benefit.
In our last blog on this topic we explained the Catch-22 of free EHRs and this new law just reinforces the no-win dilemma, “heads I win, tails you lose”. If you recommend the product or service you may be breaking the HIPAA law, if you don’t then the advertisers won’t continue sponsorship and your EHR vendor will no longer be able to offer the software for free. The funny thing is that viewing advertising is like the old trick your friends used to play; they would say, “Don’t think of Pink Elephants” and of course that’s all you could think of once the impression was verbalized. Those ads are like Pink Elephants – subliminally impacting physician decisions, it will be hard for doctors to deny they were influenced.
What we said in our last blog still holds true.
In the exam room the doctor’s attention should be focused exclusively on the patient. Frankly, I don’t want to seek medical advice from a physician that is distracted from my care by anything or anyone, especially when I am one-on-one with my doctor in the exam room.
The big question: How do I move advertisements that are blocking the screen? Well…
There is no free lunch. “Free” EHRs are not free; in fact, they are expensive. They require a costly ethical and now a legal compromise, is that risk really worth a couple of hundred bucks a month?
My role as a blogger has never been to pick a political side. Rest assured my subsequent analysis of the recent letter sent to Kathleen Sebelius (Secretary of Health and Human Services) by influential Congressmen (Republican leaders Dave Camp and Wally Herger, chair of the Ways and Means Committee and its health subcommittee, respectively, and Fred Upton and Joe Pitts, chair of the Energy and Commerce Committee and its health subcommittee, respectively) is based solely on fact checking and not politics.
I believe that if there is to be a battle to change the course of the Meaningful Use program the initiative will need to be based on solid facts, not flat-out inaccuracies. This attempt to reverse course on EHR adoption is so amateurish that I can’t help but believe that there is ZERO chance that it will succeed. Continue reading…
In a recent blog post titled, Beyond Meaningful Use/Stimulus — EHR is a Revenue Enhancer — Time to think BIG!, we featured our new virtual office visit feature. The response to the blog post has been remarkable. Physicians were interested in learning more about how virtual visits work with Medicare patients. As a service to our providers, I have attached a letter from Medicare that clarifies their position regarding charging patients “on a cash basis” for this service.
The bottom line:
- Medicare pays for “telemedicine” only in certain cases when the provider is a “distant site practitioner” (see our prior blog)
- For providers who don’t meet the “distant site practitioner” standard, the service is a “non-covered service” and charging “on a cash basis” is within the provider’s right
- An Advance Beneficiary Notice (ABN) is not required, but the provider may issue a voluntary ABN to the beneficiary indicating that the service is non-covered by Medicare
Using video-based virtual office visits make taking care of home bound seniors easier — Who says doctors don’t make house calls anymore? With MediTouch EHR a virtual house call is just a click away! Continue reading…
We will be authoring a couple of blog posts on how MediTouch EHR® can enhance revenue for your practice. Most EHR/EMR vendors publicize Meaningful Use as the sole revenue enhancement methodology related to adopting an EMR/EHR. It takes a special kind of EHR/EMR vendor to create software that goes beyond the typical tactics with regard to increasing your practices revenue line. Again, we are not speaking about ways that EHRs save money — they do, but that is not the emphasis of our next couple of blog posts, the focus is the top line.
Telemedicine, e-Visits, Virtual Office Visits — You pick the title… We have the solution
If you have read some of my previous blog posts you may have guessed that I just can’t get EHR related issues off of my mind. At a party or a barbeque I can’t help but do market research regarding how my friends and family feel about new ideas that our team is considering, regarding EHR and patient portal software. One question I like to ask people is:
“Would you pay around 2-3 times your co-pay to get medical care for certain non-emergency health issues and NOT have to visit the doctor’s office?”
I always get a yes.
So, per my very small sample size, our team concluded that if we could find a way to integrate an electronic visit or virtual office visit within the MediTouch® system, then our doctors would be able to provide a service that is in great and growing demand. And, of course we have found that method!
Regarding terminology, we will use the term virtual office visit rather than e-visit or telemedicine, because we think it best describes the services that can be provided via MediTouch EHR and the YourHealthFile® Patient Portal.Continue reading…
Today, August 23, 2012, the Centers for Medicare and Medicaid Service (CMS) released the Final Rule for Meaningful Use Stage 2. With regard to timing most of the Stage 2 Rule is what we expected and planned upon, such as the delay of Stage 2 until 2014. However, there was one element of the final rule that pleasantly surprised even us, and should do the same for our MediTouch users. Continue reading…