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07/29/2013
RESPONSES / COMMENTS (EMR)
RE: Security Risk Analysis Cost (Mark Aldrich, DPM)
From: Michael L. Brody, DPM
Your security risk analysis involves much more than vulnerability and penetration testing. A proper security risk analysis looks at physical, administrative, and technical measures to protect your data. Penetration testing is only looking at one aspect of technical vulnerabilities.
Under the HIPAA regulations, you must do everything that is reasonable to protect your data. The question becomes "What is the risk of a hacker penetrating your network to obtain data?" If you look at the ONC 'wall of shame' that list large HIPAA breaches, you will see that most are due to human error or devices being physically stolen or lost. A very small percentage of breaches are due to an electronic break-in.
Therefore, the take away from this is that it is reasonable to determine that the probability of a cyber attack resulting in a breach is low, and you are better served spending that same money on physical and administrative measures. You can close a lot more gaps that are of higher risk in that manner and that is what a risk analysis is all about - determining what risks have a high likelihood of being exploited and closing those potential gaps in your security.
I do not recommend spending the money on this test until you have addressed the issues that have historically been shown to result in large breaches.
Michael L. Brody, DPM, Commack, NY, mbrody@tldsystems.com
Other messages in this thread:
09/09/2013
RESPONSES / COMMENTS (EMR)
RE: Genius Solutions Billing Software
From: Carla-Ruth Poma
I have been a long-time user of Genius Solutions. As a billing service located in Michigan, I believe that their reputation here is among the best of the best. They have a great product and their service and support is terrific and very reasonably priced. I use Availity as my clearinghouse for Palmetto claims and NGS DME claims, which is free. Currently, I have no out-of-state clients, but would use Availity if I did. I have used Genius for non-Michigan based clients and it performed beautifully. It is my understanding that they have passed ICD-10 testing requirements.
Disclosure: I have no financial interest in Genius Solutions or Availity.
Carla-Ruth Poma, South Lyon, MI, Mmbsinc@aol.com
09/06/2013
RESPONSES / COMMENTS (EMR)
RE: McKesson EHR Software and Outsourced Billing? (Carl Solomon, DPM)
From: Joseph A. Megara, III, DPM
Although I do not have experience with McKesson's EHR product, I am currently using TRAKnet EHR software as well as the TRAKnet RCM billing service. I have used MediSoft and MediNotes in the past which have integrated EHR and billing. For several years prior, I also used billing software that did not have EHR integrated (Wisdom by Cerner) as well as 3 other independent billing companies.
Since I changed to combining the two TRAKnet services, my life has become easier. I really like the fact that the services are run by podiatrists. It seems like they understand the pitfalls we face more than other companies. Integrating the RCM services makes my billing much easier because everything is encompassed in one "system". They’ve also provided me with answers to any questions I’ve had regarding coding and reimbursement.
For me, customer service is key, and both TRAKnet services have been excellent with that. They have also reviewed my code utilization and have made suggestions that have optimized my revenue stream. Right now, my charting is easier, billing turn-around is generally out within 24-48 hours, my cash flow has increased, and my aggravation has decreased. Overall, I wish I had done this years ago.
Joseph A. Megara, III, DPM, Thorofare, NJ, footcaremegara@comcast.net
09/05/2013
RESPONSES / COMMENTS (EMR)
RE: McKesson EHR Software and Outsourced Billing (Carl Solomon, DPM)
From: Pat Straub
We have been using McKesson’s Practice Partner EHR with their in-house billing software package successfully and happily since 2010. Our practice, along with another local podiatry practice, diligently looked at all of the products being offered at the time. We both felt the McKesson Corporation with its longevity in the medical field would be in it as a partner to our practices for the long haul. Although we do not utilize their outsourced billing product, I can tell you that McKesson has been stellar in supporting their products and making sure we are provided with the tools and education needed in this ever-changing world of electronic medical records and billing.
There are a lot of good EHR systems out there and deciding which product to go with can be a hard decision. By doing your homework like you are, you will be able to decide confidently on the system that will best fit your practice. Both our practices are so thankful we chose McKesson’s Practice Partner product; by doing so we rest easy knowing they are going to get us where we need to be, when we need to be there.
Pat Straub, Office Mgr., Allan Rothschild, DPM, Dunedin, FL, awrdpm@aol.com
07/30/2013
RESPONSES / COMMENTS (EMR)
RE: Security Risk Analysis Cost (Michael Brody, DPM)
From: Mark J. Tuccio, DPM
Dr. Brody is spot on with his assessment. I posted many months ago that attestation to Meaningful Use was a huge trap with regard to meeting core measure 15. It seems that the chicken has come to roost for many who were unlucky enough to be selected for a Meaningful Use audit.
For those who are now concerned with this measure, Practice Fusion has a “Privacy and Security Toolkit” that will help with the documentation needed for conducting an EHR security and risk analysis. The government website also contains...
Editor's note: Dr. Tuccio's extended-length letter can be read here.
02/27/2013
RESPONSES / COMMENTS (EMR)
RE: Reasonably Priced EMR with Good Tech Support (Mary Carlson, DPM)
From: Michael Tongue, DPM, Elliot Udell, DPM
Try Realmed by Intuitive Solutions. You should be able to find them on the Internet. They are Chicago-based. The price is roughly $7,000.
Michael Tongue, DPM, West River, MD, m.tongue@att.net
I have been using Practice Fusion for over a year. They have by far the best tech support that I have ever encountered in any computer software I have ever used. If you have a problem with anything related to your work, you click on a help button and a live person comes online almost immediately and helps solve your problem. What is mind-boggling is that the program is actually free, and you can be up and running with it within five minutes from the time you register for it.
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com
02/02/2013
RESPONSES / COMMENTS (EMR) - PART 1
RE: Primatrix Approved by Medicare for Chronic Wounds
From: Paul Kesselman, DPM
For a change, some positive news out of Medicare and just announced on the NGS Website. National Government Services the Medicare Administrative Contractor for MAC 13 (NY and CT) has announced a policy article addition to the LCD covering skin substitutes (biologic products). Effective immediately, Primatrix is now covered for many chronic wounds treated by podiatrists. These include: diabetic foot ulcers, decubitus (pressure) ulcers, and venous ulcers. I am hopeful that it will be the first of many more products which require no special storage requirements (e.g., long shelf life at room temperature), and which podiatrists and other wound care specialists can add to their tool box.
One should check their LCD and policy articles for further information regarding frequency, diagnosis codes, and other important parameters.
Paul Kesselman, DPM, Woodside, NY, drkesselmandpm1@hotmail.com
12/13/2012
RESPONSES / COMMENTS (EMR) - PART 1B
RE: Stage 2 Meaningful Use (Bill Lockner, DPM)
From: Mark K. Johnson, DPM
There may be more shifting sands as well between Stages 2 and 3 of Meaningful Use. The delay of Stage 2 to 2014 was announced months ago, however, staying in Stage 1 in 2013 may be "better" for two reasons. First, the incentive payments are "front loaded" to the early years of attestation. Second, CMS plans a 90-day interval for Stage 2 attestations in 2014 ONLY, rather than 12 months.
Regarding the purchase expenses of EMR, we are transitioning to the very cost-effective (i.e. free) EMR Practice Fusion in January 2013, and will gladly navigate its somewhat scaled-down but certified architecture.
Mark K. Johnson, DPM, West Plains, MO, DDR004@centurytel.net
12/08/2012
RESPONSES / COMMENTS (EMR)
RE: Warning to EMR Users
From: Allen Jacobs, DPM
Recently, at the Kilo Diabetes meeting, healthcare attourney John Irwin reviewed meaningful use laws relative to EMR. There was a stern warning issued by him relative to cloning of records which must be considered by PM News readers.
From my experience in reviewing medical records, it is clear that doctors have fallen into the habit of ritualistically using the same note for visit after visit, and on patient after patient. The same vascular exam, neurologic exam, etc.
Cloning refers to...
Editor's note: Dr. Jacob's extended-length letter can be read here.
11/22/2012
RESPONSES / COMMENTS (EMR) - PART 1B
RE: EMR Auditing (James Breedlove, DPM)
From: Robert Kornfeld, DPM
Dr. Breedlove only discusses the "tip of the iceberg". Medicare's implementation of EMR was NOT designed to create better communication systems between doctors' offices and hospitals. It was designed to have easy access to patient records for the purpose of auditing and recouping money. Here you see that the government will be taking back stimulus money by making it very difficult to "comply". Not surprising. They will also be auditing all of your patient care records and there is going to be an enormous recoupment of Medicare reimbursement at your expense. Is this surprising? I think not. We have a government that simply can't pay its bills. Even if you dot all the i's and cross all the t's, they will find guideline violations. If this isn't BIG BROTHER, I don't know what is. But Dr. Breedlove beware. You will not be able to "go back to paper." Your claims will not be processed. You have willingly walked into the lion's den.
The moral of this story is...when you give away your power and freedom (cooperate with imposed regulations) to any governmental beauracracy, you will either become a slave (participating doctor) or an inmate. Free enterprise medicine has every right to exist. This is a democracy. You choose or you lose.
Robert Kornfeld, DPM, Manhasset, NY, Holfoot153@aol.com
11/22/2012
RESPONSES / COMMENTS (EMR) - PART 1A
RE: EMR Auditing (James Breedlove, DPM)
From: David E. Gurvis, DPM
I have done a basic security self-audit. I am "secure" by any standards that a "normal" person would consider. That is my way of saying if you wanted to get into my computer system, there is no way in hell anyone but the best of hackers would be able to. I seriously doubt I would pass some CMS bureaucrats' idea of security. Actually, I doubt the bureaucrat office could pass it either.
The Government giveth, and the government taketh.
David E. Gurvis, DPM, Avon, IN deg1@comcast.net
03/20/2012
RESPONSES / COMMENTS (EMR)
RE: All Scripts vs. Practice Fusion EMR (Howard Shapiro, DPM)
From: Brandon Macy, DPM
I’ve used Allscripts MyWay online for the past 8-9 months. There are some things I like and other features I wish were better. As it is a general medical program (although one reseller has podiatry-specific content that I’m not certain is necessary), there is some customization involved on your part. But shortcuts are easy to do, once you learn the logic of their program. The help buttons are actually pretty good too.
Brandon Macy, DPM, Clark, NJ, bmacydpm@comcast.net
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