Physicians News » Medicine & Technology

Practical Implications of Telemedicine Credentialing

Physicians News — Mon, 30 Jan 2012 20:03:46 +0000

By Lucia Francesca Bruno, J.D., LL.M., M.B.A. For the past century, information technology has reinvented the familiar and revolutionized the art of medicine. As health care professionals struggle to keep pace with an ever-changing and consolidating industry, traditional forms of health care have succumbed to modern technology and fiscal constraints. No longer are patients and providers afforded the luxury of being in the same place at the same time. Recent developments in patient-service delivery systems have transformed the doctor/patient relationship; paving the way for advances in telemedicine and the credentialing and privileging of telemedicine practitioners. Inside Look into Telemedicine The Centers for Medicare and Medicaid (“CMS”) defines telemedicine as “the provision of clinical services to patients from a distance via electronic communications.”[1] Although telemedicine is not considered a medical specialty, products and services unique to this practice of medicine often require a costly investment in information technology and the delivery of clinical care by health care providers. Telemedicine seeks to improve a patient’s health by permitting two-way, interactive, communication between the patient and the physician, at a distant-site, for purposes of assessment, diagnosis, and intervention. Examples of telemedicine include, but are not limited, to the following: videoconferencing; transmission of still images, and remote monitoring of vital signs. A Past Marred by Obstacles Historically, smaller hospitals and Critical Access Hospitals (“CAHs”) desiring to take advantage of this cost-effective form of clinical care were hampered by duplicative and burdensome Conditions of Participation (“CoPs”) and redundant regulations. In particular, the credentialing process of obtaining and reviewing practitioner data such as licensure, training, certifications, insurance, and National Practitioner Data Bank queries created a financial burden many hospitals simply could not afford. Furthermore, many lacked the clinical expertise within their medical staff to evaluate and grant privileges to physicians providing telemedicine services. In a notorious policy brief issued by the National Rural Health Association (“NRHA”) in 2010, providers maintained that “the current telehealth credentialing process was more than an annoyance; it was a deterrent for providers and hospitals, and a barrier to expanding health care access.”[2] NRHA urged CMS to “adopt a policy that allowed telemedicine providers to receive deemed status (as having met Medicare/Medicaid certification requirements) and permit health care facilities receiving telehealth services to perform credentialing by proxy (delegated credentialing).”[3] NRHA surmised that “if a provider was already credentialed at a Medicare-participating facility, that credential would be sufficient to provide telemedicine services at another facility; while, the privileging process would remain the responsibility of the originating health care facility.”[4] A Future Swayed by Reason Acknowledging the need for transformational change, on May 5, 2011, CMS introduced the final rule which superseded prior Joint Commission privileging recommendations, and considerably streamlined the credentialing and privileging process for physicians providing telemedicine services. [5] The final rule, effective July 5, 2011, made Federal requirements more flexible and encouraged innovative approaches to the delivery of patient-services; thereby, allowing patients to receive medically necessary interventions in a timelier manner.[6] In addition to taking a more lenient approach to CoPs, CMS expanded the platform of telemedicine by defining key terms and requiring a written agreement between the "patient-site" and the "distant-site." The written agreement, subject to disclosure to CMS, must include specific elements and evidence the telemedicine practitioner’s privileges at the “distant-site.” Key Terms Defined by CMS “Telemedicine” is defined as “the provision of clinical services to hospital or CAH patients by practitioners from a distance via electronic communications, either simultaneously or non-simultaneously.”[7] “Simultaneous” telemedicine services are performed in real-time, similar to the actions of an on-site practitioner when called in by an attending physician to see a patient, e.g., teleICU services. [8] “Non-simultaneous” services are clinical services provided to the patient upon a formal request from the patient’s attending physician or practitioner; such services may involve after-the-fact interpretation of diagnostic tests and do not necessarily require the telemedicine practitioner to directly assess the patient in real-time, e.g., teleradiology services.[9] “Distant-site” the location at which the physician or other licensed practitioner delivering the service is located at the time the service is provided via telecommunications. A “distant-site” is either a Medicare-participating hospital or telemedicine entity (non-Medicare participating hospital) that provides contracted telemedicine services in a manner that enables the hospital or CAH using telemedicine services to meet all applicable CoPs; particularly, those related to the credentialing and privileging of telemedicine practitioners. [10] Written Agreement Required: Distant-Site Hospital When the distant-site is a Medicare-certified hospital, the final rule requires that the hospital or CAH have a written agreement that expressly states that it is the responsibility of the distant-site hospital to meet the credentialing requirements of 42 C.F.R. 482.12(a)(1)-(a)(7) for hospitals or 42 C.F.R. 485.616(c)(i)-(c)(vii) for CAHs. In addition, the written agreement must contain the following: (i) the distant-site hospital is a Medicare-participating hospital; (ii) the distant-site practitioner is privileged at the distant-site hospital as evidenced by a current list of the practitioner’s privileges provided by the distant-site hospital; (iii) the practitioner holds a license issued and/or recognized by the state in which the hospital or CAH whose patients receive telemedicine services is located; and (iv) the hospital that credentials and privileges the distant-site practitioner disclose the practitioner’s performance information, e.g., adverse events, complaints, and internal reviews. Written Agreement Required: Distant-Site Telemedicine Entity To rely on the credentialing and privileging decisions by a distant-site telemedicine entity, the distant-site must affirm, in writing, that the telemedicine entity is a contactor of services to the hospital and furnishes contracted services in a manner that permits the hospital to comply with all applicable CoPs, 42 C.F.R. 482.12(a)(1)-(a)(7) for hospitals or 42 C.F.R. 485.616(c)(i)-(c)(vii) for CAHs. In addition, the written agreement must contain the following: (i) the distant site’s credentialing and privileging process at least meet the standards in 42 C.F.R. 482.12(a)(1)-(a)(7) and 42 C.F.R. 482.22(a)(1)-(a)(2) when the originating-site is a hospital or 42 C.F.R. 485.616(c)(1)(i)-(c)(1)(vii) when the originating-site is a CAH; (ii) the distant-site practitioner has the experience and expertise as represented by the distant-site telemedicine entity; (iii) the practitioner holds a license issued and/or recognized by the state in which the hospital or CAH is located; and (iv) the hospital or CAH has evidence of an internal review of the distant-site practitioner’s performance of privileges to be exercised at the hospital or CAH; conversely, the hospital or CAH must send the distant-site entity performance information for use in the entity’s periodic appraisal of the distant-site practitioner. Effect on State Licensure Despite the sweeping reform brought about by the final rule, CMS cautioned that all state-based physician licensure requirements will remain unchanged. Recognizing the fact that “licensure laws and regulations have traditionally been, and continue to be, the provenance of individual States, the final rule does not pre-empt State authority.”[11] Although states remain split on the issue of telemedicine, many states espouse that their existing laws adequately reflect their position on the licensure of telemedicine practitioners. Other states, however, affirm that a full and unrestricted license is necessary to practice telemedicine, and have reinforced that stance in law or policy.[12] In an effort to address growing concerns amongst medical professionals, the American Medical Association (“AMA”) reaffirmed its policy to support state-based licensure for physicians and oppose national licensure approaches to telemedicine. In its annual assessment of physician licensure, the AMA declared that “telemedicine in particular has crystallized the tension between the states’ role in protecting patients from incompetent physicians and protecting in-state physicians from out-of-state competition, and the desirability of ensuring patients’ access to the highest quality medical advice and treatment possible, wherever located.” [13] Despite tension between the states’ power to regulate health care professionals and the prohibition against restraint on interstate commerce, the practice of telemedicine has yet to be addressed by the courts. Only time will tell if the final rule is sufficient to spur litigation in this cutting-edge practice of medicine. Informed Consent Considerations Despite comments to CMS encouraging patient informed consent be obtained before the use of telemedicine services by a hospital or CAH, CMS affirmed that under the final rule “there is no difference between distant-site practitioners and in-house or on-site practitioners with respect to informed consent.”[14] CMS reiterated that “as long as the telemedicine practitioner is performing his or her duties within the privileges granted by the hospital or CAH, in accordance to a policy that requires informed consent, then consent must be obtained regardless of whether treatment is furnished by telemedicine or not.”[15] For providers, this insightful decision alleviated one more instance of costly red tape. Medical Staff Bylaws and Standard Operating Procedures In order to ensure full compliance and avoid unnecessary complications, providers are encouraged to amend medical staff bylaws and revise policies and procedures related to credentialing and privileging. In particular, medical staff bylaws should contain current definitions relevant to telemedicine and an accurate description of the information-sharing process. Medical staff bylaws should also reflect administrative changes to the provider’s Credentials Committee and Medical Executive Committee, especially as it pertains to clinical services provided by telemedicine. Furthermore, medical staff policies and procedures should be amended to account for changes in clinical protocols, insurance coverage, billing and reimbursement, and HIPAA compliance. As a precautionary measure, any medical staff policies that require the “physical presence” of a physician should be reevaluated to account for the delivery of patient services by electronic communications. Finally, under the final rule, hospitals and CAHs that take advantage of privileging by proxy must disclose privileged peer review information to the distant-site. Therefore, it is advisable that hospitals and CAHs carefully assess state-specific peer review guidelines and include language in the written agreement that ensures ongoing protection of peer review information. Conclusion There is no doubt that sweeping changes in the credentialing and privileging process has paved the way for greater advances in telemedicine services. Dale Alverson, M.D., past president of the American Telemedicine Association surmised that “the final rule will truly help patients receive the care they need, no matter where they live or where their doctor is located.”[16] By eliminating the overly burdensome credentialing and privileging rules in Medicare, Dr. Alverson concluded that “CMS has shown growing support of telemedicine.” [17] Despite the obvious benefits to patients, the long-term ramifications of the final rule on providers are yet, unknown. Hospitals and CAHs using telemedicine services of distant-site practitioners are, therefore, encouraged to implement adequate policies and procedures to protect their interests and those of their patients. ### Lucia Francesca Bruno, J.D., LL.M., M.B.A., is Principal Shareholder of Physicians’ Legal Group, LLC (www.physicianslegalgroup.com). She can be reached at Lbruno@physicianslegalgroup.com.

[1] Medicare and Medicaid Programs: Changes Affecting Hospitals and Critical Access Hospital Conditions of Participation: Telemedicine Credentialing and Privileging, 76 Fed. Reg. 25, 551 (May 5, 2011).

[2] Lewis, Pam, Mandy Bell, BA, Deanna Larson, RN, BSN, and Jay Weems, MBA: “Telehealth Provider Credentialing” National Rural Health Association Policy Brief (2010): 1-4.

[3] Lewis, Bell, Larson, Weems, Telehealth Provider Credentialing, 1.

[4] Id. at 1

[5] Medicare and Medicaid Programs: Changes Affecting Hospitals and Critical Access Hospital Conditions of Participation: Telemedicine Credentialing and Privileging, 76 Fed. Reg. 25,550, 25,551 (May 5, 2011).

[6] 76 Fed. Reg. 25,551.

[7] Id. at 551.

[8] Id.

[9] Id.

[10] Section 1834(m)(4)(A) of the Social Security Act

[11] 76 Fed. Reg. 25,557.

[12] Office for the Advancement of Telemedicine, “Telemedicine Licensure Report” (2003).

[13] American Medical Association, “Physician Licensure: An Update of Trends” American Medical Association, 2012. Web. 15 January 2012 http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/young-physicians-section/advocacy-resources/physician-licensure-an-update-trends.page.

[14] 76 Fed. Reg. 25,555.

[15] Id. at 255.

[16] http://learntelehealth.org/blog/post/final-ruling-on-credentialing-privileging-of-telehealth-providers/

[17] Id.

Should Docs Use Email to Talk to Patients?

Physicians News — Mon, 23 Jan 2012 16:28:57 +0000

[caption id="attachment_3626" align="alignleft" width="255" caption="."][/caption] The Wall Street Journal today features a discussion about whether docs should use email to communicate with patients. There are many issues to consider including privacy, liability, exchange of accurate information, ability to "read" the patient, etc. WSJ featured two opposing views on the matter. The full article can be read here. Dr. Joseph Kvedar -- founder and director of the Center for Connected Health in Boston, which promotes the use of information technology to improve health care -- is a proponent of email: "Sure, privacy is a problem with email. But it's a problem with any communications system. Phone conversations can be overheard, patients' paper files can be misplaced or left exposed to the view of people who shouldn't see them, and so on. Emails can also end up in the wrong hands or be read by the wrong eyes. "But such fears are overblown. Privacy can be protected to a great degree by encryption of email messages, or by the use of secure messaging applications that are often a feature of a patient portal or the electronic medical-records systems offered by physicians and hospitals....What's more, I believe that patients understand the risks of email communication, and are willing to bear those risks in exchange for the more timely, useful and personal care that email can help bring about." "In my own experience, making myself available via email gives my patients a sense of direct access to me. It sends a message that I care and that I'm available to answer questions in a timely manner. It builds a bond between us that has tangible benefits for my patients' health....Email can also help doctors retain patients." Dr. Sam Bierstock -- founder and president of Champions in Healthcare, a health-care IT consulting group in Delray Beach, Fla. -- took the opposing view: "In short, email can be useful for certain very basic patient-doctor communications, such as appointment scheduling, prescription refills and questions about drug dosages. But it is no way to practice medicine." "Providing care includes an ability to interpret body language, facial expressions and other silent forms of communication that allow doctors to assess patient reactions to information about their health (apprehension, fear, anxiety) and the accuracy of their responses to questions. Online communications eliminate the ability to interpret these important signals." What are your thoughts?

Attract Patients & Keep Them (Healthy) with Social Media

Physicians News — Fri, 23 Dec 2011 15:18:46 +0000

By Katie Matlack Over on the Software Advice blog, we discussed ways doctors can use social media for a variety of purposes. A recent study reported over half of all doctors use social media because of the benefit it can add for marketing and business development purposes. Beyond this marketing utility, however, some research has shown that getting information from a doctor after an in-person consultation can make patients more likely to take medicine properly and follow their physician’s instructions.

If you’re ready to get social--social networking, that is--you should prioritize knowing your audience and its habits first, before you ever log in to Facebook or LinkedIn. This involves knowing whether or not they even use social media, first of all. Then, you should figure out what they would like to learn about from you. An easy way to find this out might be to leave a quick paper survey in the waiting room for patients to fill out. Once you know that your patients are on social networks and know what kind of information they’d like, you should identify what kind of content will appeal to them:

Think about your audience. For example, if you’re a pediatrician, preteen patients will probably appreciate links to YouTube videos where Justin Bieber talks on the importance of an active lifestyle. But if you’re a physician serving largely college-aged patients, sharing the Bieber video would paint you as out-of-touch.

The next step is to create a schedule and publish regularly. Start out with a Facebook business page that links to your practice website. Then make the move up to LinkedIn, and create a strong profile that accurately reflects your experience, before you reach out to your current and former colleagues. After you’re publishing one to two times each week and feel comfortable at this rate, you can round out your social media presence with a Twitter account. If you approach social media with the intention of creating a two-sided conversation, and you know what kind of information your patients like to hear, you’ll be in good shape.

To read the rest of the article, you can check out the entire post on the Software Advice Blog.

###

Katie Matlack is the Medical Market Analyst for Software Advice, a company that helps people make choices on electronic medical records software and health information technology.

Going mobile: How EHRs and mobile technology are shaping one physician’s practice

Physicians News — Fri, 28 Oct 2011 13:38:51 +0000

By Dr. Michael West Two classes of physicians are slowly forming, those who use electronic medical records and digital mobile technology and those who stick with paper charts. You might call these the digital haves and the digital have-nots. No one among my friends and colleagues has yet pooh-pooh'd the idea of mobile tech, but I admit that the mobile tech crowd is still fairly small in the world of electronic healthcare. The bottom line is that most doctors are still on paper charts. In my case, though, my EMR and mobile technology are essential both to my work and my goal of having the highest efficiency possible in my practice. In an effort to share how that works, I thought I'd take the readers on a field trip into my life and my year-and-a-half old private medical practice in Washington, DC. In my office and on the road, I use Practice Fusion, a SaaS-based electronic health record. Practice Fusion has over 100,000 users and currently provides electronic medical records for more than 10 million patients. The nice thing about any SaaS-based record is that doctors can log in just about anywhere with an internet connection. One example of how this works for me came in mid-July, when I was at the New Jersey shore for a 5-day getaway. Unfortunately, there was a poor signal in the beach house for my personal MiFi 2200 device from Virgin Mobile. However, on the road home, the wireless signal was stronger and I was able to login to my EHR system, retrieve messages, review labs, and return patient phone calls. Thank goodness someone else was driving! Another example of my love affair with mobile health technology: I found myself lying in bed surfing the Net one night when my iPhone rang. It was my after-hours answering service calling to let me know that my patient, a young man with diabetes had run out of his insulin and needed help immediately. In a flash, I called him back, and with my wireless MacBook Air sitting on my chest, I opened up a new tab in my Safari browser and logged into Practice Fusion. After opening his file, reading his medication list and verifying that the patient was still using the same pharmacy to which I had previously e-prescribed his medications, I sent in insulin refills with a few clicks. It took me about three minutes in total, without even getting out of bed. Easy. So, am I suggesting that this approach would work for everybody, in every situation? Not necessarily. As with any technology, mobile EMR use has limits. For example, I'll admit that although doctors can reportedly access Practice Fusion using a Logmein app to run on the iPad, it's apparently not the same as using PF via a native iPad app. (To be fair, I've not tried this and don't know the basis for the concern.) Generally speaking, though, being a mobile-friendly physician isn't very tricky. In fact, I would say that this should not be any more of a hassle that upgrading to the next cell phone every few years. Sure, things might get more complicated if you use multiple mobile devices, but so far it's been manageable for me. I recommend that any physician who’s uncertain give mobile technology a try. After all, if you're going to use an EHR, you've already made a commitment to digital patient management. At that point, going mobile is just a no-brainer. ### Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009. He blogs regularly at The Happy EMR Doctor and can be reached by email at doctorwestindc@gmail.com.

iPad EMR Apps: A Guide to Electronic Medical Records

Physicians News — Mon, 12 Sep 2011 14:21:40 +0000

By Houston Neal Although unexpected by some, it appears the iPad is not only leading the tablet charge, but in computing, in general. One of the first mass-produced modern tablet computers, Apple’s iPad boasts great design and durability, a long battery life, and a iOS developer platform that’s helping the tablet lead the way into the next generation of computer technology. Physicians and medical professionals have been some of the earliest adopters and strongest supporters of the iPad, and many electronic medical record (EMR) vendors are responding to the increased demand by producing solutions that are iPad-compatible. Medical software vendors are approaching iPad solutions in various ways, but the development efforts can be summarized into these three options: (1) Native iPad EMRs. These solutions have been developed specifically for the iPad and its iOS operating system. They take full advantage of the operating system and iPad user interface. The downside is that they are limited in terms of availability - so you only have a few robust choices if you want a native iPad EMR. Many of these iPad apps are really great software applications. One solution, Dr. Chrono, allows physicians to easily pull up previous history charts and electronically send prescriptions to pharmacies. Nimble, another native iPad EMR, includes a module that allows physicians to display medical images and actually mark on them via the touchscreen interface - an intuitive and useful application that is the type of design that we’ll most likely see in other, future touchscreen-compatible EMRs. These applications are new, meaning they lack many of the complex feature sets that on-premise or web-based EMR solutions offer. It will take some time for these systems to develop the full functionality of the more traditional systems. They most certainly will, but they simply don’t have all that the other systems can offer today. [caption id="attachment_2166" align="alignleft" width="150" caption="."][/caption] (2) Remote access EMRs. Many software vendors are porting their native EMR solutions to the iPad by the means of remote access utilities, such as Citrix. The benefit is that most systems can be ported to the iPad using this technology. The drawback, however, is that this approach is simply creating a “window” via the iPad to access these on-premise EMRs. Physicians invested in the iPad because of its operating system and design, which is lost in these remote access ports. Because remote access EMRs require some IT resources to host the system, this isn’t the best solution for physicians that are looking to eliminate server or hosting responsibilities. (3) Web-based EMRs. These EMRs are some of the most popular solutions for doctors seeking HITECH Act incentive funds. In addition, there are a large amount of solutions from software vendors offered in a web-based, software-as-as-service model. With many solutions to pick from, physicians can select the system that best fits their budgeting and practice needs. Web-based EMRs run through the physician’s web browser, and many solutions are optimized for Apple’s Safari. That’s perfect for the iPad, as Safari is the native iPad Internet browser. These systems do have their drawbacks when used on the iPad, though. The performance of web-based EMRs on the iPad will largely depend on your Internet connection - so an excellent WiFi network is essential. In addition, since these systems were created with a keyboard and mouse in mind, tablet use many be hindered at times, especially when manual key entry is required. So what are physicians’ options? Today, most vendors offer some sort of remote access option for their EHR solutions. Look for many of these to offer more iPad-centric solutions as the platform gains more and more physician and industry support. For more information on the iPad EMR options check out: iPad EMR Apps | A Guide to Electronic Medical Records. In the guide, we took a look at the top ten EMR solutions (in terms of market share), and put together a list of their iPad EMR offerings. Allscripts (Allscripts Remote). Through Allscript’s propietary web services technology (UAI), the Appscripts EMR can be accessed via the iPad. eClinicalWorks (iClickDoc). The eClinicalWorks reseller easeMD offers a remote access application. Eclipsys (Sunrise Mobile MD). Sunrise Mobile MD allows remote access to the Sunrise hospital EHR. Note: Eclipsys is now a part of Allscripts. Epic (Canto). Little is known about the Epic iPad app. The system has three stars and 13 reviews in iTunes. GE Centricity. GE just launched their native iPad application. The app is a free download for all of GE’s web-based EMR clients. Greenway Medical (PrimeMobile). The system provides remote access to Greenway’s PrimeSUITE EHR. The native application is available to Greenway customers, and offers a 30-day trial of the software. NextGen (NextGen Mobile). NextGen’s mobile EHR software works on all Apple devices, Blackberries, and some Android systems. Practice Fusion. Physicians can log into Practice Fusion on the iPad via the third-party app, LogMeIn. Sage Intergy. The Intergy EHR solution can be accessed via remote access applications. SOAPware. Physicians can use third-party applications such as Jaadu or LogMeIn applications to access SOAPware. ### Houston Neal is Director of Marketing for Software Advice.

mHealth: Docs, Patients Jump on Mobile Bandwagon

Physicians News — Thu, 19 May 2011 00:05:08 +0000

By Howard Larkin Got kidney stones? There's an app for that—and for just about every other clinical and administrative function. As mobile applications reshape health care, hospitals will be pressed to keep up. "The No. 1 thing that patients can do to reduce their risk of kidney stones is to drink more fluid. But people don't drink as much as they think they do, so how do you keep track?" asks William Johnston III, M.D., a urologist practicing at NorthShore University HealthSystem in Chicago's northern suburbs. Johnston's answer is a mobile app he developed for the iPhone. Since going live on the Apple Store in June 2010, the free program has been downloaded more than 2,500 times. Every time a patient drinks a soda or coffee or a glass of water, he opens the app, taps a picture of the beverage and enters the amount. The application automatically tracks the quantity and displays it as a percentage of the daily target—typically set at 75 ounces. It also charts fluid intake over the last week and month. It even can e-mail the information right to a physician. "Patients are mobile, so this makes it easier to keep accurate records and get them to the physician," Johnston says. Currently, clinic staff must transfer data manually from the app to NorthShore's sophisticated electronic medical record, but Johnston is working on systems that will enable mobile apps to populate patient health records directly . But does the app really help patients drink more—or reduce kidney stones? "Our observation in clinic is it definitely does," Johnston says. "When they start using it, most patients find they are not anywhere close to the goal. If you look at it in the afternoon and you are at 25 percent, it makes you want to drink some water. I use it myself." He is planning a clinical trial to measure the impact of the app on patient behavior and outcomes. He's also developing an app to help patients with enlarged prostates monitor urine flow. Other apps will provide prostate surgery patients with day-by-day perioperative and discharge instructions—complete with checklists, warning signs, and automated medication and follow-up appointment reminders. "If the patient is at the mall and they see blood in their urine after prostate surgery, the information they need is right in their pocket. If they need help, they can call or message right away. It really opens up a new frontier for patient care, patient safety and access to doctors," Johnston says. 17,000 Apps—and Counting As of November, there were more than 17,000 medical applications available for download from major app stores for the Apple iPhone and iPad, and for smart phones and mobile computers using the Android, Microsoft Mobile, Blackberry, Palm and Symbian operating systems, says Ralf-Gordon Jahns, head of research at research2guidance.com, a Munich, Germany-based IT consultancy specializing in mobile technologies. And that's just the consumer end of the market, which is dominated by mobile phone operators and specialized health care firms. Countless mobile apps exist or are being developed by traditional health care providers, device manufacturers, pharmaceutical manufacturers and researchers around the world. They range from dedicated devices linked to glucometers and blood pressure cuffs that have been around for more than a decade to new applications that take advantage of the accelerometer and GPS capabilities of the latest smart phones to detect and automatically report patient falls and even elopements of patients with dementia. Bluetooth-enabled scales and other detectors that will automate home monitoring of a wide range of clinical conditions also are hitting the market. Applications for monitoring patients and accessing electronic records inside the hospital using smart phones and tablets also are proliferating. Indeed, many major electronic medical-record suppliers now are developing interfaces that can run as native applications on mobile devices. "Our Haiku application for physicians and nurses allows users to look up any patient in the system and review the chart, notes, labs, X-ray results, medications. Everything that is in the chart can be viewed on the iPhone," says Sam Butler, M.D., a pulmonary and critical care specialist who is now a clinical informatics team member for Epic. The iPhone app also supports clinical scheduling and dictation, and e-prescribing is in the works. An iPad version also is being developed. Epic, as well as other EMR suppliers, also makes personal health records available to patients over the Internet. But more significant than the sheer volume of apps is the growing public acceptance of the technology and the increasing ability to integrate capabilities, which heretofore largely have been siloed in phones or dedicated devices, into the mainstream workflow of providers, Jahns says. He points out that many remote applications have been around for years, but haven't gotten past the trial stage because of provider concerns about privacy and a lack of a standardized way to engage patients. But with the broad acceptance of smart phone apps, he believes the tipping point is at hand. "In the next three to five years, we see the likelihood that doctors and patients both will realize they have smart phones, and there will be discussions like 'I see an app for my condition. Is there a chance to include it in my treatment plan so I don't have to come in all the time?'" Jahns says. Insurance arrangements that reward use of efficiency-creating technology, either directly or through arrangements such as global payment for episodes of care, will cement the deal. He projects that by 2015, 500 million of an estimated 1.4 billion smart phone users worldwide will use an mHealth app—and millions of U.S. baby boomers will be at the forefront. Jahns also believes that health care providers, as well as pharmaceutical manufacturers, will supplant mobile phone companies as the primary distributors of mHealth apps, with diabetes management leading the way. Until now, charges per download and data transmission charges have paid for mHealth apps, but increasingly the funding will come from providers who can leverage the technology to improve efficiency, and pharmaceutical companies that can use it as a promotional and advertising vehicle, he believes. "Patient demand is driving it," Jahns says. The iPad Effect And so will physician demand, says William Phillips, vice president and chief information officer of University Health System in San Antonio, a 500-bed county-owned facility that conducts more than 550,000 outpatient visits annually. The main reason is the iPad. Nineteen million of them were sold in a mere nine months after they were introduced. That caught the e-media punditry off guard, and their popularity among physicians startled hospitals and EMR developers. "We anticipated that mobile apps were coming, but we weren't quite prepared for the iPad," Phillips says. "They [physicians] are buying their own and asking, 'Can you connect this with the hospital network?' The portability, intuitive interface and 10-hour-plus battery life made it an instant hit with clinicians. The quality of radiology images is actually better on the iPad than on some of the hardwired clinical workstations." Doctors like the device because it allows them to keep tabs on more patients without being physically present—a big plus in these days of shrinking reimbursement. For example, anesthesiologists at Emory University developed an iPad app that allows them to monitor patients before and after surgery, increasing their efficiency as well as improving patient safety. Responding to physician demand, University Health System developed a Citrix interface, which is a commercial program that not only allows remote access to PCs and other computers, but also allows physicians to use their iPads to use the system's Allscripts EMR. Traffic over the hospital's Wi-Fi network has increased by about one-third since the Citrix app went online, Phillips says. Like many emerging eHealth apps, integration with commercially available mobile devices appeared decisive. Allscripts is developing a native iPad interface, and Phillips expects it to be available by year's end. But the advantages to even the Citrix interface, which may be slower than a native application and restrict access to some EMR functions, are so compelling that he already has begun implementing it in some nursing units. "We wanted to wait for the native app, but we couldn't." Phillips notes that the cost of the iPad is about one-third of a similarly capable laptop. Essentially, it is set up as a dumb terminal accessing the main EMR database. All data processing takes place on the secure computer system, which communicates wirelessly with mobile devices using appropriate encryption and other data safety features. The battery life and convenience of recharging the device is a huge advance over the typical computer on wheels, or COW, which requires not only a laptop computer, but also an expensive cart and mobile battery to ensure it can make it through an 8- to 12-hour nursing shift. "The cost of a COW is up to six times [that of] an iPad," Phillips says Of course, it's also a lot easier for nurses to tuck an iPad or similar device under their arm than to push an unwieldy COW from room to room, all the time worrying about when it will need to be recharged—in a location that does not violate Joint Commission standards for keeping hallways clear. That's no small advantage for nurses who often are being asked to care for more and more patients. Moreoever, iPads eliminate the fight for COWs that can take place at the beginning of shifts. While the durability of iPad battery life is an open question, so far it is even longer than the 10 hours advertised, Phillips says. In its new inpatient facility, University HealthSystem is incorporating not only iPad docking stations in patient rooms, but also a much more robust mobile wireless network, including antennae in stairwells and lobbies, to support an anticipated geometric increase in clinical mobile use within the hospital. Moving Target But while the expansion of mobile health apps seems inevitable, the precise technology that will be needed is an open question. For example, the latest Wi-Fi protocol—802.11n—allows communication over 5 GHz transmitters as well as the earlier 2.4 GHz bands, and may interfere with 2.4 GHz 802.11a-g transmissions from existing devices. The upcoming 802.11ac standard may jam existing 2.4 GHz signals altogether. This could require hospitals to install new antennae to keep up with changing standards, as well as higher-capacity wireless routers to keep up with growing bandwidth demands. "Ten years ago, who knew that 802.11n at 5.2 GHz would be in place today?" says Scott W. Johnson, vice president of communications planning for engineering firm SSR Inc. in Nashville. "If you installed 2.4 GHz antennae, you may be ripping it out today. The industry has not been very good at future-proofing technology." Cellular substations inside the hospital also may need to be installed to accommodate physicians who want access over the GSM network used by AT&T as well as Verizon's UDMA , both of which now support the iPhone, the most popular smart phone in the United States. And potential interference with existing hospital telemetry equipment, RF devices as well as medical devices such as pacemakers, must be addressed. More profound is the impact mobile devices will have on provider workflow—and even the balance of inpatient versus outpatient facilities health systems require. "Transformation care for us means extraordinary care for every patient, compassionate service, coordinated care and exceptional clinical outcomes," says Curt Kwak, CIO for western Washington State for Providence Health & Services in Washington and Montana. "We believe adoption of mobility technologies will enable us to get there, but mobile technologies are not the only factor in becoming a transformation force." To help determine the strategic role of mobile apps and infrastructure—and the level of investment required to support them—the system regularly addresses the issue in information systems staff meetings and with clinicians. The system has developed a plan for working with mobile application developers to support its transition to incorporating them into its delivery system, Kwak says. And while the migration to standard commercial devices opens up the market by making mobile apps available to both physicians and patients, it also presents substantial security risks, Phillips notes. Maintaining control over how smart phones and tablets connect to the health system network will be critical, as will constant upgrades to ensure data security. Given the level of infrastructure investment that may be required—and the uncertainty of future needs—SSR's Johnson recommends that hospital leaders assess where they and their competitors are in the market, and decide how much they need to spend to remain competitive. In building or renovating facilities, he also advocates a flexible design strategy. It may be wise to invest in wiring or conduits that can support greater bandwidth, and to position mobile antennae stations in places where they can be reached easily for upgrades without disrupting patient care. "You never know what technology to anticipate," Johnson says. "The iPad was in development before the iPhone, but they elected to go with the iPhone first. Now that the iPad is here, all the developers are in a reactive mode. The need for CIOs to put connectivity and security in place to accommodate the iPad is one thing we didn't see coming. It's a challenge, but it's the way technology advances." ### Howard Larkin is a contributing editor to H&HN. Reprinted from Hospitals & Health Networks, by permission, April 2011, Copyright 2011, by Health Forum, Inc.

AMA Introduces Its First-Ever Physician App; Launches App Challenge

Physicians News — Tue, 29 Mar 2011 12:22:47 +0000

[caption id="attachment_3987" align="alignleft" width="200" caption="An image from the AMA's new CPT app."][/caption] The American Medical Association (AMA) today introduced its first-ever app designed specifically for physicians that allows them to quickly find CPT (Current Procedural Terminology) billing codes. The app is now available for free through the iTunes store. It also launched the 2011 AMA App Challenge to find the next great medical app idea. "The AMA's new CPT quick reference app helps physicians determine the appropriate E/M code for billing quickly, easily and accurately," said AMA Board Secretary Steven J. Stack, M.D. "To find the next great medical app idea we are going right to the source by inviting physicians, residents and medical students to participate in the first-ever AMA App Challenge." Open to all U.S. physicians, residents and medical students, the 2011 AMA App Challenge calls on those on the front lines of medicine to submit their unique app idea for a chance to have the AMA bring it to life. Participants can submit their app ideas easily through an online form beginning today. Submissions will be accepted through June 30th, 2011. Two winners will be selected, one from the resident/fellow or medical student category and one from the physician category. The winners will each receive ,500 in cash and prizes, plus a trip for two to New Orleans for the grand unveiling of their winning idea at the AMA’s meeting in November. Developed by the AMA for physicians, the CPT evaluation and management quick reference app is an on-the-go reference guide that helps physicians determine the appropriate CPT code to use for billing. Compatible with Apple iPhone, iPod Touch and the iPad, the app features both decision-tree logic and quick search options, allowing physicians to digitally track CPT codes and email them anywhere. Physicians can also save their most frequently used codes by location or type of service to allow for even more ease of use. "Quick access to accurate information physicians use daily was the goal behind creating the CPT app," said Dr. Stack. "We are eager to discover which other medical apps physicians, residents and medical students would find useful through their App Challenge idea submissions, and we are thrilled to be able to bring two of the best ideas to the physician community."

FDA Approves First Diagnostic Radiology App for iPhone/iPad

Physicians News — Tue, 08 Feb 2011 15:44:13 +0000

A new mobile radiology app cleared yesterday by the FDA will allow physicians to view medical images on the iPhone and iPad. The app -- Mobile MIM -- is the first cleared by the FDA for viewing images and making medical diagnoses based on computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine technology, such as positron emission tomography (PET). It is not intended to replace full workstations and is indicated for use only when there is no access to a workstation. “This important mobile technology provides physicians with the ability to immediately view images and make diagnoses without having to be back at the workstation or wait for film,” said William Maisel, M.D., M.P.H., chief scientist and deputy director for science in the FDA’s Center for Devices and Radiological Health. Radiology images taken in the hospital or physician’s office are compressed for secure network transfer then sent to the appropriate portable wireless device via Mobile MIM, which allows the physician to measure distance on the image and image intensity values and display measurement lines, annotations and regions of interest. In its evaluation, the FDA reviewed performance test results on various portable devices. These tests measured luminance, image quality (resolution), and noise in accordance with international standards and guidelines. The FDA also reviewed results from demonstration studies with qualified radiologists under different lighting conditions. All participants agreed that the device was sufficient for diagnostic image interpretation under the recommended lighting conditions. The Mobile MIM app includes sufficient labeling and safety features to mitigate the risk of poor image display due to improper screen luminance or lighting conditions. The device includes an interactive contrast test in which a small part of the screen is a slightly different shade than the rest of the screen. If the physician can identify and tap this portion of the screen, then the lighting conditions are not interfering with the physician’s ability to discern subtle differences in contrast. In addition, a safety guide is included within the application. The Mobile MIM app is available through Apple's App Store.

Physician Demand for iPad EMRs is Growing. Are Vendors Ready?

Physicians News — Tue, 01 Feb 2011 14:59:50 +0000

By Austin Merritt Chief Operating Officer, Software Advice The answer to that question is a surprisingly resounding “No!” The medical software industry is far from supporting the iPad on a meaningful scale. Buyers would think that vendors eager to grow market share would quickly adopt new, flashy technologies, but software vendors are surprisingly slow to react. Electronic health records vendors need to get on board or face the prospect of losing market share to faster-moving competitors. There is no doubt that buyer demand for the iPad is surging. A recent Software Advice survey found that nearly 35% of healthcare providers were “very likely” to purchase a tablet PC in the next year. Don’t forget that the iPad enjoys 87% market share of the tablet PC market. That’s a lot of potential customers looking for iPad EHRs.??However, there are very few vendors well-positioned to benefit from this trend. In fact, only two EHR systems currently on the market were built from the ground up for the iPad: Nimble – Released by ClearPractice in October, 2010. Dr. Chrono – Founded in 2009 with their first release in 2010. Aside from these two companies, only a handful of other vendors (most notably AllScripts and Quest) have released iPad apps to supplement existing EHR systems. I should note there are other systems on the market that are accessible from the iPad’s web browser, but they are not native iPad apps. (Some readers might be wondering about MacPractice. Their SaaS system does run on the iPad via a VCN interface, but it’s not a native iPad app either.) So where are the 300+ other EHR software companies? They have iPad apps “in the works,” but not ready yet. This really comes as no surprise. The medical software industry is notoriously slow to adopt new technologies. Have you ever seen your doctor’s office running a system that looks like it is from the 80s? We hear from these practices every day. Plenty of software vendors are still selling outdated, DOS-based systems with Windows interfaces (we will withhold names to protect the innocent). As a result of this slow movement, we expect a number of newer software companies to quickly gain popularity and seize market share from vendors who are slow to move. Interestingly, a number of garage-based startups are already poised for growth: medical iPhone and iPad app developers. There are currently well over 10,000 medical apps available in the App Store. These apps range from basic ICD-9 lookup tools to more advanced apps to track patient SOAP notes. While many of these small developers won’t have the resources to scale and develop sophisticated EHRs, some just might have the ability (and the guts). These potential movers include some of the more popular medical apps. Here are our top candidates: Lightweight EHRs iMediNotes – iMediNotes lets physicians create and track basic SOAP notes. It offers very limited templates. Mediforms EMR – The free version of this EMR was released in early 2010 and is geared towards gynecologists. The paid version will be coming in 2011 and will be more full-featured, including templates for other specialties. SurgiChart – Released just last week, SurgiChart allows surgeons to track and share their patient case summaries. It currently does not allow the ability to create or edit them. Scutsheet – Scutsheet provides basic functionality for creating, editing, and tracking patient progress notes and lab test results. Other Medical Apps MediMobile – MediMobile is primarily a charge capture application. It also offers the ability to track patient information and PQRI requirements. It also integrates with existing billing systems. This core functionality provides a lot of the core EMR functionality and could pave the way towards a more complete EMR system. Epocrates – One of the most popular medical apps on the App Store, Epocrates is a mobile drug information resource for physicians. It doesn’t offer ability to track patient records, but tracking drug interactions is a key component of EMRs. If they were able to build a mobile EMR, they’d be able to capture market share quickly through their large user base. Medscape – While this app is comparable to Epocrates as a drug reference tool, the vendor WebMD is a likely iPad EMR candidate. Despite the WebMD/Emdeon split in 2006, WebMD could realize synergies with their past medical billing systems and leverage a large network of users. ### Austin Merritt is Chief Operating Officer for Software Advice. Click here to read more from Austin and learn more about Software Advice.

Converting to Electronic Health Records (EHRs) with the NJ-HITECH Regional Extension Center

Physicians News — Mon, 30 Jan 2012 20:03:46 +0000

[2] Lewis, Pam, Mandy Bell, BA, Deanna Larson, RN, BSN, and Jay Weems, MBA: “Telehealth Provider Credentialing” National Rural Health Association Policy Brief (2010): 1-4.

[3] Lewis, Bell, Larson, Weems, Telehealth Provider Credentialing, 1.

[4] Id. at 1

[6] 76 Fed. Reg. 25,551.

[7] Id. at 551.

[8] Id.

[9] Id.

[10] Section 1834(m)(4)(A) of the Social Security Act

[11] 76 Fed. Reg. 25,557.

[12] Office for the Advancement of Telemedicine, “Telemedicine Licensure Report” (2003).

[14] 76 Fed. Reg. 25,555.

[15] Id. at 255.

[16] http://learntelehealth.org/blog/post/final-ruling-on-credentialing-privileging-of-telehealth-providers/

[17] Id.

Should Docs Use Email to Talk to Patients?

Physicians News — Mon, 23 Jan 2012 16:28:57 +0000

Attract Patients & Keep Them (Healthy) with Social Media

Physicians News — Fri, 23 Dec 2011 15:18:46 +0000

To read the rest of the article, you can check out the entire post on the Software Advice Blog.

###

Katie Matlack is the Medical Market Analyst for Software Advice, a company that helps people make choices on electronic medical records software and health information technology.

Going mobile: How EHRs and mobile technology are shaping one physician’s practice

Physicians News — Fri, 28 Oct 2011 13:38:51 +0000

iPad EMR Apps: A Guide to Electronic Medical Records

Physicians News — Mon, 12 Sep 2011 14:21:40 +0000

mHealth: Docs, Patients Jump on Mobile Bandwagon

Physicians News — Thu, 19 May 2011 00:05:08 +0000

AMA Introduces Its First-Ever Physician App; Launches App Challenge

Physicians News — Tue, 29 Mar 2011 12:22:47 +0000

FDA Approves First Diagnostic Radiology App for iPhone/iPad

Physicians News — Tue, 08 Feb 2011 15:44:13 +0000

Physician Demand for iPad EMRs is Growing. Are Vendors Ready?

Physicians News — Tue, 01 Feb 2011 14:59:50 +0000

Converting to Electronic Health Records (EHRs) with the NJ-HITECH Regional Extension Center

Physicians News — Mon, 30 Jan 2012 20:03:46 +0000

[2] Lewis, Pam, Mandy Bell, BA, Deanna Larson, RN, BSN, and Jay Weems, MBA: “Telehealth Provider Credentialing” National Rural Health Association Policy Brief (2010): 1-4.

[3] Lewis, Bell, Larson, Weems, Telehealth Provider Credentialing, 1.

[4] Id. at 1

[6] 76 Fed. Reg. 25,551.

[7] Id. at 551.

[8] Id.

[9] Id.

[10] Section 1834(m)(4)(A) of the Social Security Act

[11] 76 Fed. Reg. 25,557.

[12] Office for the Advancement of Telemedicine, “Telemedicine Licensure Report” (2003).

[14] 76 Fed. Reg. 25,555.

[15] Id. at 255.

[16] http://learntelehealth.org/blog/post/final-ruling-on-credentialing-privileging-of-telehealth-providers/

[17] Id.

Physicians News » Medicine & Technology

Physicians News — Mon, 30 Jan 2012 20:03:46 +0000

[2] Lewis, Pam, Mandy Bell, BA, Deanna Larson, RN, BSN, and Jay Weems, MBA: “Telehealth Provider Credentialing” National Rural Health Association Policy Brief (2010): 1-4.

[3] Lewis, Bell, Larson, Weems, Telehealth Provider Credentialing, 1.

[4] Id. at 1

[6] 76 Fed. Reg. 25,551.

[7] Id. at 551.

[8] Id.

[9] Id.

[10] Section 1834(m)(4)(A) of the Social Security Act

[11] 76 Fed. Reg. 25,557.

[12] Office for the Advancement of Telemedicine, “Telemedicine Licensure Report” (2003).

[14] 76 Fed. Reg. 25,555.

[15] Id. at 255.

[16] http://learntelehealth.org/blog/post/final-ruling-on-credentialing-privileging-of-telehealth-providers/

[17] Id.

Should Docs Use Email to Talk to Patients?

Physicians News — Mon, 23 Jan 2012 16:28:57 +0000

Attract Patients & Keep Them (Healthy) with Social Media

Physicians News — Fri, 23 Dec 2011 15:18:46 +0000

To read the rest of the article, you can check out the entire post on the Software Advice Blog.

###

Katie Matlack is the Medical Market Analyst for Software Advice, a company that helps people make choices on electronic medical records software and health information technology.

Going mobile: How EHRs and mobile technology are shaping one physician’s practice

Physicians News — Fri, 28 Oct 2011 13:38:51 +0000

iPad EMR Apps: A Guide to Electronic Medical Records

Physicians News — Mon, 12 Sep 2011 14:21:40 +0000

mHealth: Docs, Patients Jump on Mobile Bandwagon

Physicians News — Thu, 19 May 2011 00:05:08 +0000

AMA Introduces Its First-Ever Physician App; Launches App Challenge

Physicians News — Tue, 29 Mar 2011 12:22:47 +0000

FDA Approves First Diagnostic Radiology App for iPhone/iPad

Physicians News — Tue, 08 Feb 2011 15:44:13 +0000

Physician Demand for iPad EMRs is Growing. Are Vendors Ready?

Physicians News — Tue, 01 Feb 2011 14:59:50 +0000

Converting to Electronic Health Records (EHRs) with the NJ-HITECH Regional Extension Center

Physicians News — Mon, 23 Jan 2012 16:28:57 +0000

Physicians News » Medicine & Technology

Physicians News — Mon, 30 Jan 2012 20:03:46 +0000

[2] Lewis, Pam, Mandy Bell, BA, Deanna Larson, RN, BSN, and Jay Weems, MBA: “Telehealth Provider Credentialing” National Rural Health Association Policy Brief (2010): 1-4.

[3] Lewis, Bell, Larson, Weems, Telehealth Provider Credentialing, 1.

[4] Id. at 1

[6] 76 Fed. Reg. 25,551.

[7] Id. at 551.

[8] Id.

[9] Id.

[10] Section 1834(m)(4)(A) of the Social Security Act

[11] 76 Fed. Reg. 25,557.

[12] Office for the Advancement of Telemedicine, “Telemedicine Licensure Report” (2003).

[14] 76 Fed. Reg. 25,555.

[15] Id. at 255.

[16] http://learntelehealth.org/blog/post/final-ruling-on-credentialing-privileging-of-telehealth-providers/

[17] Id.

Should Docs Use Email to Talk to Patients?

Physicians News — Mon, 23 Jan 2012 16:28:57 +0000

Attract Patients & Keep Them (Healthy) with Social Media

Physicians News — Fri, 23 Dec 2011 15:18:46 +0000

To read the rest of the article, you can check out the entire post on the Software Advice Blog.

###

Katie Matlack is the Medical Market Analyst for Software Advice, a company that helps people make choices on electronic medical records software and health information technology.

Going mobile: How EHRs and mobile technology are shaping one physician’s practice

Physicians News — Fri, 28 Oct 2011 13:38:51 +0000

iPad EMR Apps: A Guide to Electronic Medical Records

Physicians News — Mon, 12 Sep 2011 14:21:40 +0000

mHealth: Docs, Patients Jump on Mobile Bandwagon

Physicians News — Thu, 19 May 2011 00:05:08 +0000

AMA Introduces Its First-Ever Physician App; Launches App Challenge

Physicians News — Tue, 29 Mar 2011 12:22:47 +0000

FDA Approves First Diagnostic Radiology App for iPhone/iPad

Physicians News — Tue, 08 Feb 2011 15:44:13 +0000

Physician Demand for iPad EMRs is Growing. Are Vendors Ready?

Physicians News — Tue, 01 Feb 2011 14:59:50 +0000

Converting to Electronic Health Records (EHRs) with the NJ-HITECH Regional Extension Center

Physicians News — Fri, 23 Dec 2011 15:18:46 +0000

To read the rest of the article, you can check out the entire post on the Software Advice Blog.

###

Katie Matlack is the Medical Market Analyst for Software Advice, a company that helps people make choices on electronic medical records software and health information technology.

Physicians News » Medicine & Technology

Physicians News — Mon, 30 Jan 2012 20:03:46 +0000

[2] Lewis, Pam, Mandy Bell, BA, Deanna Larson, RN, BSN, and Jay Weems, MBA: “Telehealth Provider Credentialing” National Rural Health Association Policy Brief (2010): 1-4.

[3] Lewis, Bell, Larson, Weems, Telehealth Provider Credentialing, 1.

[4] Id. at 1

[6] 76 Fed. Reg. 25,551.

[7] Id. at 551.

[8] Id.

[9] Id.

[10] Section 1834(m)(4)(A) of the Social Security Act

[11] 76 Fed. Reg. 25,557.

[12] Office for the Advancement of Telemedicine, “Telemedicine Licensure Report” (2003).

[14] 76 Fed. Reg. 25,555.

[15] Id. at 255.

[16] http://learntelehealth.org/blog/post/final-ruling-on-credentialing-privileging-of-telehealth-providers/

[17] Id.

Should Docs Use Email to Talk to Patients?

Physicians News — Mon, 23 Jan 2012 16:28:57 +0000

Attract Patients & Keep Them (Healthy) with Social Media

Physicians News — Fri, 23 Dec 2011 15:18:46 +0000

To read the rest of the article, you can check out the entire post on the Software Advice Blog.

###

Katie Matlack is the Medical Market Analyst for Software Advice, a company that helps people make choices on electronic medical records software and health information technology.

Going mobile: How EHRs and mobile technology are shaping one physician’s practice

Physicians News — Fri, 28 Oct 2011 13:38:51 +0000

iPad EMR Apps: A Guide to Electronic Medical Records

Physicians News — Mon, 12 Sep 2011 14:21:40 +0000

mHealth: Docs, Patients Jump on Mobile Bandwagon

Physicians News — Thu, 19 May 2011 00:05:08 +0000

AMA Introduces Its First-Ever Physician App; Launches App Challenge

Physicians News — Tue, 29 Mar 2011 12:22:47 +0000

FDA Approves First Diagnostic Radiology App for iPhone/iPad

Physicians News — Tue, 08 Feb 2011 15:44:13 +0000

Physician Demand for iPad EMRs is Growing. Are Vendors Ready?

Physicians News — Tue, 01 Feb 2011 14:59:50 +0000

Converting to Electronic Health Records (EHRs) with the NJ-HITECH Regional Extension Center

Physicians News — Fri, 28 Oct 2011 13:38:51 +0000

Physicians News » Medicine & Technology

Physicians News — Mon, 30 Jan 2012 20:03:46 +0000

[2] Lewis, Pam, Mandy Bell, BA, Deanna Larson, RN, BSN, and Jay Weems, MBA: “Telehealth Provider Credentialing” National Rural Health Association Policy Brief (2010): 1-4.

[3] Lewis, Bell, Larson, Weems, Telehealth Provider Credentialing, 1.

[4] Id. at 1

[6] 76 Fed. Reg. 25,551.

[7] Id. at 551.

[8] Id.

[9] Id.

[10] Section 1834(m)(4)(A) of the Social Security Act

[11] 76 Fed. Reg. 25,557.

[12] Office for the Advancement of Telemedicine, “Telemedicine Licensure Report” (2003).

[14] 76 Fed. Reg. 25,555.

[15] Id. at 255.

[16] http://learntelehealth.org/blog/post/final-ruling-on-credentialing-privileging-of-telehealth-providers/

[17] Id.

Should Docs Use Email to Talk to Patients?

Physicians News — Mon, 23 Jan 2012 16:28:57 +0000

Attract Patients & Keep Them (Healthy) with Social Media

Physicians News — Fri, 23 Dec 2011 15:18:46 +0000

To read the rest of the article, you can check out the entire post on the Software Advice Blog.

###

Katie Matlack is the Medical Market Analyst for Software Advice, a company that helps people make choices on electronic medical records software and health information technology.

Going mobile: How EHRs and mobile technology are shaping one physician’s practice

Physicians News — Fri, 28 Oct 2011 13:38:51 +0000

iPad EMR Apps: A Guide to Electronic Medical Records

Physicians News — Mon, 12 Sep 2011 14:21:40 +0000

mHealth: Docs, Patients Jump on Mobile Bandwagon

Physicians News — Thu, 19 May 2011 00:05:08 +0000

AMA Introduces Its First-Ever Physician App; Launches App Challenge

Physicians News — Tue, 29 Mar 2011 12:22:47 +0000

FDA Approves First Diagnostic Radiology App for iPhone/iPad

Physicians News — Tue, 08 Feb 2011 15:44:13 +0000

Physician Demand for iPad EMRs is Growing. Are Vendors Ready?

Physicians News — Tue, 01 Feb 2011 14:59:50 +0000

Converting to Electronic Health Records (EHRs) with the NJ-HITECH Regional Extension Center

Physicians News — Mon, 12 Sep 2011 14:21:40 +0000

Physicians News » Medicine & Technology

Physicians News — Mon, 30 Jan 2012 20:03:46 +0000

[2] Lewis, Pam, Mandy Bell, BA, Deanna Larson, RN, BSN, and Jay Weems, MBA: “Telehealth Provider Credentialing” National Rural Health Association Policy Brief (2010): 1-4.

[3] Lewis, Bell, Larson, Weems, Telehealth Provider Credentialing, 1.

[4] Id. at 1

[6] 76 Fed. Reg. 25,551.

[7] Id. at 551.

[8] Id.

[9] Id.

[10] Section 1834(m)(4)(A) of the Social Security Act

[11] 76 Fed. Reg. 25,557.

[12] Office for the Advancement of Telemedicine, “Telemedicine Licensure Report” (2003).

[14] 76 Fed. Reg. 25,555.

[15] Id. at 255.

[16] http://learntelehealth.org/blog/post/final-ruling-on-credentialing-privileging-of-telehealth-providers/

[17] Id.

Should Docs Use Email to Talk to Patients?

Physicians News — Mon, 23 Jan 2012 16:28:57 +0000

Attract Patients & Keep Them (Healthy) with Social Media

Physicians News — Fri, 23 Dec 2011 15:18:46 +0000

To read the rest of the article, you can check out the entire post on the Software Advice Blog.

###

Katie Matlack is the Medical Market Analyst for Software Advice, a company that helps people make choices on electronic medical records software and health information technology.