Minimum requirements for EMR government

ecbates wrote on Wednesday, December 14, 2011:

……reimbursement.

Will installing (out-of-box) and configuring OpenEMR on a HIPPA compliant hosted server satisfy the initial requirements for reimbursements?  If NOT, what HAS to be installed and configured to meet the criteria for 2011, 2012, 2013, 2014, 2015 and beyond?

If anyone can provide a link, it would greatly appreciated.  I have been told that the criteria for reimbursement is billing (ability) and eprescribing in an EMR.

My potential clients want to start using a comprehensive EMR system for demographics, scheduling and ramp-up to eprescribe and billing later.

Thanks,
Ellis

yehster wrote on Wednesday, December 14, 2011:

The short answer is no.  Simply installing OpenEMR is far from sufficient to receive the meaningful use.
Official information on the program is available here.
http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__meaningful_use_-_providers/2998

If you want to read about one provider’s efforts to get the incentive using OpenEMR refer to this thread.
https://sourceforge.net/projects/openemr/forums/forum/202504/topic/4745124

-Kevin Yeh
kevin.y@integralemr.com

yehster wrote on Wednesday, December 14, 2011:

Here is a check list for what you need to do to receive the incentive payments for stage 1.
http://www.hitecla.org/sites/default/files/HITEC-LA%20Stage%201%20MU%20Checklist_2011%200613.pdf

ecbates wrote on Wednesday, December 14, 2011:

Thanks for the quick response.

bradymiller wrote on Wednesday, December 14, 2011:

Hi,
Also check out the FAQ section in the online User Manual that points you to places that also go over these issues:
http://www.open-emr.org/wiki/index.php/OpenEMR_4.1_Users_Guide#Frequently_Asked_Questions_.28FAQ.29
-brady

ecbates wrote on Wednesday, December 14, 2011:

Thanks again.  Is it possible to meet “meaningful use” w/o having to customize OpenEMR?  I’m fine recommending 3rd party products (I know, not free) until OpenEMR fulfills functionality natively.

-ellis

tmccormi wrote on Wednesday, December 14, 2011:

Meeting meaningful use is the whole point of certification. So, yes, it is possible, OpenEMR is certifiied, we could not be certified unless we could be used to meet meaningful use critieria.
Tony
www.mi-squared.com / @tonymi2
oemr.org / @OEMR_org

ecbates wrote on Thursday, December 15, 2011:

I apologize for my simplistic questions.  I understand that OpenEMR is ONC Complete Ambulatory EHR certified.  If OpenEMR is populated with patient data, and meets milestones outlined in the above link (checklist); while employing help from 3rd party vendors (e-prescribe); doctors can start the process for medicare/medicaid reimbursements to meet meaningful use….right?

juggernautsei wrote on Thursday, December 15, 2011:

Theorectily yes,

We would have to get some of the doctors on the board to answer for sure. I have a doctor that getting ready to “atest” to the use of OpenEMR to meet the meaningful use criteria. I did hear the office manager tell the doctor that they have to have been using the program for at least a quarter before they can apply for incentive monies.
I will ask a couple of the billing people that I know about this question and post what I find out.

Sherwin
openmedpractice.com

yehster wrote on Thursday, December 15, 2011:

Sherwin,
I’m curious what that doctor is using for ePrescribing/drug-drug interaction checking. I also wonder which five of the optional items they found easiest to accomplish.

Thanks,
-Kevin

cverk wrote on Friday, December 16, 2011:

I can put in my two cents as a provider. The health care reform law created funds for state agencies (CFMC here ) to help small primary care offices achieve meaningful use objectives.  If that is available to you, contact them and use it. They have been actually quite helpful for me. I performed various core requirements through them such as security analysis and information exchange, and they have kept independent confirmation of my achieving the requirements. It appears I will make it to attest to stage one for Oct-Dec of this year using openemr 4.1 with allscripts free version. I will attest using 1,3,6,7,and 8 on the optional list. I also qualify for #9 because I am on a waiting list for the state, and I could get an exemption for #10 because it is not yet available here in Colorado. As I have written, the AMC calculation for #6 doesn’t work for me, but it can be counted by other means such as the sql query I noted. So that will be 2011.  For 2012 , or 2013 if you don’t get started until 2012, you just have to make the same criteria, but for the whole year instead of just 3 months.  I think for years after that, the stage 2 requirements aren’t even finalized yet, so who knows. I imagine you will need to work on the other currently optional areas.  #2 lab results requires currently a paid service as outlined. I contacted the big labs here (quest and labcorp) and pretty much got blown off as not being involved in a big enough project with enough money involved to be of any real interest to them. Discouraging, but that seems to be reality.  #4 patient reminders has a slow query problem for larger databases and seems to be best handled if you set up your own e-mail server to the web, which gets me to #5 the patient portal which puts you directly exposed to the internet and all its security considerations. So for now, I am documenting that you can make stage 1 meaningful use requirements with openemr and allscripts on an office based server behind firewalls without the exposure of web servers,portals,lab interfaces etc.  This will likely not make stage 2 requirements, so work on security, cloud servers, portal arrangements etc are areas I have previously brought up for discussion. The IT people at the state level here were actually pretty impressed with openemr, and felt it was a much better system that many of the very expensive commercial systems that they had helped other providers work with. Pretty clearly, the first set of attestations for openemr will be the end of this year, so it would be interesting to hear from any other offices that make it successfully.

cverk wrote on Thursday, January 05, 2012:

As followup to this, I performed and passed Medicare 2011 meaningful use attestation today with openemr 4.1 and allscripts free addition using Yehster’s  greasemonkey script with no outside paid services or support. I did however have help from the local state agency as part of health care reform supporting primary care offices, which is paid for by the federal government as part of the healthcare finance reform legislation.  I have also successfully converted to 5010 billing and had successful free electronic claims through OfficeAlly to all my major payers without incident. I hope I have done my small part in helping others as well, and I hope to be proof that this project is now on par with any of the commercial options available out there.
   Obviously, there is still a lot of things to work on, ICD-10, somewhat glitchy billing module, portal security issues, slow database scripts for AMC etc., but I just wanted to point out what an incredible job has been done by all of the people who have worked on this.

yehster wrote on Thursday, January 05, 2012:

Cverk,
Congratulations are in order.  Out of curiosity, how long prior to your meaningful use quest have you been using OpenEMR?

cverk wrote on Thursday, January 05, 2012:

I transferred practice management/billing to openemr September 2010 after database conversion from an old dos version of medisoft that I had used since 1992.  In January 2011 I started dictating chart notes into openemr using dragon voice dictation. In May 2011 I started electronic prescribing with allscripts mostly for complex patient refills to mail order programs.  On Oct 1 , 2011 I made the full jump to all of the meaningful use criteria except lab and portals. I am now importing all outside information using fax to e-mail and scanning into paperport.  I have made an electronic signature to add to pdf’s in paperport. I have added no paper to charts since October, and after several years of scanning all inactive charts to PDF, we are now ready to start scanning active patient charts.

tonderin wrote on Thursday, January 05, 2012:

Cverk,
Very well done, Congratulations! Could you outline your steps in greater detail please and post it here, so people could follow in your footsteps?    It may be a little time consuming, but please do it for this forum community as detailed as possible.  I am sure everyone would like to know how you mastered it.   Could you also give your reasoning as to why you have used allscripts over newcrop and OfficeAlly over Availity? 
Big Thanks in Advance!

cverk wrote on Saturday, January 07, 2012:

I pretty much followed this list and tested with the state agency.

http://sourceforge.net/projects/openemr/forums/forum/202504/topic/4745124

bradymiller wrote on Saturday, January 07, 2012:

Hi,

This sounds like a great story for the Success story page on the wiki:
http://open-emr.org/wiki/index.php/Success_Stories
(this page is part of a strategy to market OpenEMR described here: http://open-emr.org/wiki/index.php/Open_source_openemr )

-brady

verbus wrote on Saturday, January 07, 2012:

Hi,

We have some success stories we would like to post. How do we do this?

Verbus@emrtsolutions.com

bradymiller wrote on Saturday, January 07, 2012:

Hi,
Migrated the Success Story wiki page topic to this thread. Please move that discussion there:
http://sourceforge.net/projects/openemr/forums/forum/202506/topic/4933021
-brady