Business of Medicine

Face Time: Ask the right questions when meeting with EMR vendors

In my last column (ENT Today, August 2011), I explained some of the broader issues regarding electronic medical records/electronic health records (EMR/EHR) selection, centered around the understanding that an EMR is a record that is more practice centered while an EHR is a health record intended to follow the patient through multiple providers. This article is directed toward practices with a large degree of autonomy in selecting their products; therefore, we will be discussing EMRs. If you’re part of a multidisciplinary practice or a university, you likely had little to no input regarding the EHR chosen. This is because larger numbers like primary care drive EHR selection. Don’t stop reading, however; assessment of disease-specific pathways is still applicable for the EHR you have.

Payment Shifts: Expect reimbursement structure changes ahead, policy experts say

Although the new U.S. health care law does not specifically alter the current fee-for-service payment structure, changes to how physicians and hospitals will be reimbursed for services are under construction. These changes are reflected by the growing focus on the development and implementation of quality improvement and physician and institutional performance measures on which reimbursement will increasingly be made, panelists said here on Sept. 11 at the 2011 American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) Annual Meeting.

A Blessing and a Curse: Health care reform comes at a steep price

There is a Chinese proverb that is both a blessing and a curse. The blessing is, “May you live in interesting times,” and the curse is, “May you live in interesting times.” All of us would like things to stabilize into a constant, comfortable and predictable environment for us to live our lives, raise our families and care for our patients. We are entering the most complex and challenging period that medicine has experienced since the 1960s when Medicare was introduced. From now on, everything we have come to know and are comfortable with in our professional lives will change.

Rent the Right Way: Medical offices require unique leases

As tenants of medical office spaces, physicians often create special leasing issues. Medical tenants use hazardous materials, generate biomedical waste, demand confidentiality of patient records and require compliance with occupational safety standards—all unique aspects of the medical profession. Yet, often, physicians will sign “form” medical office lease agreements provided by the landlord without the benefit of legal counsel. Typically, the landlord provides a standard fill-in-the-blank lease form with the tenant’s name and the general business terms (including the term of lease, rental rate and commencement date). Tenants may gloss over the legal boilerplate provisions included in the lease agreement, assuming that these terms are standard to all leases and are not subject to negotiation.

Chaos Control: Plan ahead to ensure your practice survives a disaster

Ten years have passed since the U.S. was attacked on September 11, 2001 and six since Hurricane Katrina slammed into the Gulf Coast. And, while disasters of that magnitude are rare, hundreds of smaller-scale disasters occur every year, including tornadoes, blizzards, fires, earthquakes, airline crashes and chemical spills.

The Lost Art of Medicine: Patient care is paramount in practice

The science of medicine continues to expand rapidly, and this is obviously good for humanity. The art of medicine, on the other hand, has been largely forgotten. This skill is the basis of the time-honored physician-patient relationship and is an important aspect of good patient care. So why have so many physicians forgotten this basic skill? Why would a caring physician disregard any expertise that would benefit his patient?

Update Your Practice: Follow these tips to select the right EMR for your group

I have been working with electronic medical records (EMR) for many years, having first become interested in 1996, when I was looking for a tool to collect data for pediatric sinusitis. As we designed a product to collect this data, our scope expanded into developing a subspecialty-specific EMR. I have since learned a great deal about developing and codifying information and am currently participating in my third and largest implementation of an EMR at Boys Town National Research Hospital in Omaha, Neb. In this column, I would like to discuss what to look for in an EMR and give some initial thoughts on implementation.