Automated coding software and other information technology can help in the detection, prevention and prosecution of healthcare fraud, according to reports by the research arm of the American Health Information Management Association. The reports were released last month at AHIMA's annual meeting in San Diego. The HHS-funded project on fraud and IT resulted in 10 principles for fraud-proofing a national health information network. Those principles include greater collaboration between payers and providers and use of statistics- and rules-based coding systems. "A large net reduction in healthcare fraud-related spending is within reach. But only if it is explicitly targeted in the (national network's) design and execution," says Arnold Milstein, M.D., co-chairman of the committee that led the study. Milstein is medical director at the Pacific Business Group on Health in San Francisco. The healthcare industry loses $51 billion to $170 billion to fraud annually, according to estimates.
Practices capture Davies awards
Private practices in Alabama, Georgia and Texas were recognized for their excellence in the use and implementation of health information technology by the Chicago-based Healthcare Information and Management Systems Society. Winning the HIMSS' Nicholas E. Davies Award for ambulatory care were: Wayne Obstetrics and Gynecology, a solo practice based in Jesup, Ga., with 6,000 patient visits annually; Southeast Texas Medical Associates, which in 10 years has grown from five providers in one location in Beaumont to a three-clinic, 24-physician operation with a staff of 260; and Sports Medicine & Orthopedics Specialists, a four-physician practice in Birmingham, Ala. All three practices use fully integrated electronic medical records. The awards are named after the late Nicholas Davies, M.D., who was serving as chairman-elect of the American College of Physicians when he died in a plane crash in April 1991. The awards were
created in 1995, with a category for organizations; the public health and ambulatory-care categories were added in 2003. The awards are designed to promote the use of EMR systems by showing examples of excellence, recognizing and providing visibility to high-impact systems, and the sharing of implementation strategies.
Public favors online record access
Nearly three out of four Americans favor the development of electronic patient records that would allow health information to be shared via the Internet with authorized individuals quickly, privately and securely, according to a survey of 800 adults conducted for the Markle Foundation. But 79% of respondents say that their records should be carefully guarded and the information contained within released only with their permission. The survey also found that 81% of respondents want the ability to review their medical information and 91% want a high level of checks and balances in order to keep prying eyes away. The study also showed that 80% of Americans believe that using electronic medical records would boost healthcare quality.
GE expands IT presence
GE Healthcare announced an agreement to acquire IDX, Burlington, Vt., in a deal valued at approximately $1.2 billion. The deal is expected to close in early 2006, subject to regulatory approval. The combination of IDX and GE Healthcare will create one of the most comprehensive packages of clinical, imaging and administrative information systems under a single company, officials say. Under terms of the deal, IDX shareholders will receive $44 per share. Officials say IDX shareholders owning about 20% of the company's shares have agreed to vote in favor of the deal.
Cerner to test doc EMR market
Cerner Corp. is pilot-testing a remote-hosted electronic medical-records system it intends to offer physicians for a monthly fee without the upfront cost of software site licenses, its top executive says. Upfront costs related to software licenses constitute a significant portion of EMR ownership costs and are commonly cited by physicians in solo and small-group practices as the key barrier to EMR adoption. Cerner primarily sells IT systems to hospitals. Neal Patterson, the company's chairman and chief executive officer, says Cerner plans to offer a low-cost EMR directly to physicians through an application service provider model, in which the software and data are stored on Cerner central computers and made accessible to physician offices via data transmission lines. Everything -- the cost of the software, support and connectivity -- will be bundled together in one monthly bill. Pricing has not been set yet, but initially could be in the range of $300 per month for an EMR only, and $500 per month for both the EMR and practicemanagement system.
Brailer joins NQF board
The National Quality Forum added two prominent board members -- David Brailer, M.D., HHS' national coordinator for health information technology, and Jonathan Perlin, M.D., undersecretary for health at the Veterans Affairs Department. The NQF also has endorsed several voluntary consensus standards related to heart attack and heart failure mortality, public reporting of ambulatory-care quality and internal quality-improvement programs for outpatient diabetes care.