Chest compressions during chiropractic spinal manipulation result in little or no risk of chest injury, according to new research. The study, published in the May 13 online edition of the Journal of Manipulative and Physiological Therapeutics, measured and examined the force of chest compressions ranging from typical to extremely rigorous and found all to be well under the threshold for injury.

Courtesy of John Conniff

Providers won’t have to convert all your medical records and make them available on the web by 2012. Not only is such a task technically impossible right now but the no such legal requirement exists. While many public and private organizations are working to develop and implement an electronic medical records system accessible by all who treat a particular patient, the work is far from done. Many different organizations are developing and testing various systems. Beware of grapevines – many “growers” of these vines have something to sell.

Second, without going into great detail into all of the aspects of these efforts, here is an excerpt from the December report put out through the White House describing the beginnings of the efforts directed by law:

In 2009, the HITECH Act (part of the American Recovery and Reinvestment Act, or ARRA) authorized expenditures on the order of $20 billion (with estimates in the range $9 billion to $27 billion) over five years to promote the adoption and use of [electronic health records] “EHR” technologies that would be connected through a national health information network. The legislation sets forth a plan for the “meaningful use” of health IT to improve the quality of care and enable changes in delivery systems essential to healthcare reform.

The HITECH Act attempts to create incentives for all hospitals and eligible providers, not just those associated with large systems, to adopt and use electronic information. A centerpiece of the Act is to put in place strong financial incentives for hospitals and physicians to adopt and meaningfully use electronic health records. Physicians who adopt electronic records by 2014 can qualify for Medicare bonus payments of up to $44,000. Beginning in 2016, physicians who have not adopted electronic records will be penalized in the form of reduced Medicare reimbursements. Similarly, Medicaid providers can receive up to $63,750 over the five years. These payments and penalties depend on the provider meeting the requirements for meaningful use.

The definition of meaningful use under HITECH involves both ONC and CMS, but CMS is the principal rule-making body since payment will be linked to the reporting of meaningful use measures. The statute leaves CMS broad discretion, requiring only that the definition include e-prescribing, the ability to exchange information with other healthcare providers to improve care, and the reporting of clinical quality measures to CMS. With input from several Federal advisory committees, CMS has proposed to phase in meaningful use criteria in three stages. Stage 1 criteria, to take effect in 2011, focus on electronically capturing health information in a coded format, implementing decision support, sharing information with patients, testing the ability to exchange information, and initiating the reporting of clinical quality measures to CMS. Stage 2 criteria, to take effect in 2013, would require more robust exchange of information and other high value uses of EHRs. Stage 3 criteria, to take effect in 2015, would require physicians to demonstrate the use of EHR technology in ways that improve the outcomes of care. The broad goal is to gradually acclimate providers to workflow changes and practice improvement opportunities that, ideally, will accompany the adoption of technology.

Finally, many different insurance companies are experimenting with various electronic billing and medical record systems. However, these private requirements are a far cry from universal, legally mandated, internet based patient records.

We will communicate new legal mandates to your association when and if they appear. For those who wish to access a more credible source of information on EHR activities, this link will help – White House Report

 Best regards,

John

Tel. (253) 759-7767 Fax. (253) 761-5328

Conniff Website

Practitioner contracts are not assignable and typically, expressly require that all contracted services must be performed by the credentialed practitioner.   Here is a sample non-assignment clause from a practitioner agreement:

 Assignment. This Agreement, being intended to secure the services of Practitioner, may not be assigned, delegated, or otherwise transferred by Practitioner. For the purposes of continuity of care, Network will consider every reasonable request for an application from a practitioner who practices in the office of an existing Practitioner or has purchased the practice of an existing Practitioner. The applicant will be subject to Network’s Credentialing and Network criteria at the time of the application.  

Note that the contract does not promise to accept a practitioner who purchases a practice but rather to “consider every reasonable request.” Some contracts don’t even promise this much consideration.