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EPtalk by Dr. Jayne 9/10/15

September 10, 2015 Dr. Jayne No Comments

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I was pleased to see that Vermont finally legalized electronic prescribing of controlled substances, making the process now legal in all 50 states. According to Surescripts, only 2 percent of physicians are electronically prescribing controlled substances. Early on, even if it was legal in your state, it was still a challenge due to lack of pharmacy participation. Now nearly 80 percent of pharmacies can accept controlled substance prescriptions and I’m guessing that the cumbersome workflows involved are contributing to the low numbers.

The two-factor authentication options offered by my primary vendor include a key fob token or a soft token installed on a cell phone. We have a strict “no cell phones” policy (even for physicians) so that option is out and my partners weren’t too wild about having to carry a token. We dispense most of our controlled substances in-house, so our practice hasn’t adopted yet. Since we dispense, we’re not afraid of being able to meet the controlled substances requirements, but I have several friends who are nervous about the auditing and reporting requirements.

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This week, CMS is urging practice to contact their software vendors, clearinghouses, and billing services to “ask about testing and training opportunities.” We’re three weeks out and I think it’s a little late in the game if practices are just starting this process. I continue to be amazed by the number of practices that are way behind on their preparations. A solo physician contacted me today, finally realizing that we’re not going to get a reprieve. He forwarded a 26-page “checklist” of to-do items from his software vendor. It was more like a novella than a checklist and had cross-references to more than a dozen other documents, each with other check lists.

Although the document was overwhelming, I can’t fault the vendor too much because their checklist outlined a timeline that was to have begun six months ago. Had the work been done on the vendor’s suggested timeline, the steps would have been relatively small and manageable by any practice. Trying to tackle it at the last minute though is like standing at the bottom of a cliff and hoping a flying elephant can help you get to the top. I’m going to do some ICD-10 coding training for him, but had to refer him out for the technical pieces. I haven’t adjusted my fee schedule for the last-minute rush, but I bet clients will be paying a premium for technical services as we get closer to the deadline.

CMS also released webcasts for Dental, Lab, Pharmacy, and Radiology clinical concepts. In addition to new documentation requirements, the presentations cover physician perspective. I’m sure the physician perspectives they present are pretty far from what many of my colleagues are thinking, which ranges from, “Why did I go into medicine again?” to, “I should have gone to a cash-only practice when I could.”

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Last week, Mr. H mentioned a study that looked at episodes of “Grey’s Anatomy” and “House” and how on-screen patients fared with CPR. They survived at twice the rate of real patients. Thanks to Netflix and some quality time on the treadmill, I’m finally caught up on “Grey’s” and was happy to see Dr. Miranda Bailey discuss her end-of-life preferences with her husband even if he didn’t agree.

HIMSS recently sent me a “Connected Health” survey that asked about my organization’s plans to expand technologies in the next year. Most of the organizations I’m working with are delaying any strategic planning sessions until after the Meaningful Use final rule is released. Between the uncertainty of the requirements and the strain of ICD-10 and related upgrades, everyone just seems to be running out of gas.

A reader made my day with this piece in The Onion: “Health Experts Recommend Standing Up at Desk, Leaving Office, Never Coming Back.” I’ve definitely had days when I feel like taking their advice to use my lunch break “to walk until nothing looks familiar any more.” I sent back an email of thanks and was rewarded with this gem from Gomer Blog detailing an EHR upgrade gone wrong.

Have you ever had a week when you feel like you’re going to have to send your IT team to a safe house? Email me.

Email Dr. Jayne.

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