Group Practice Innovators: Investing in Success Tuesday, Sep 27 2011

Group Practice Innovators: Investing in Success.

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Latest New Orleans City Business article by Jennifer Larino Tuesday, Aug 16 2011

Medical professionals question cost, pace of electronic medical records

POSTED: 12:08 PM Tuesday, August 9, 2011

BY: Jennifer Larino, Staff Writer

TAGS: electronic medial records, Jenny Smith, Louisiana Health Care Quality Forum, Madelaine Feldman, Medicaid, medical records, Medicare, Nadine Robin, Ochsner Health System, Practice Fusion Inc., Robert Rowley, Scharmaine Baker

 

On a recent weekday morning, Scharmaine Baker sat in her vehicle and pulled up the day’s schedule for her mobile health care practice on her iPad.

 

Baker, a nurse practitioner with her own practice, spends her days weaving throughNew Orleansneighborhoods and visiting the homes of her elderly and homebound patients.

 

She carries the traditional stethoscope and blood pressure cuff. But she said it’s the iPad at her side and free, web-based electronic health record software that keeps her practice going, allowing her to draft visit notes, record blood pressure and pull up lab results from anywhere.

 

Baker used to track each patient on paper and then transcribe those notes to her computer before her 100-patient practice washed away after Hurricane Katrina. She bought her first electronic health record system in 2006 as her client base swelled to 500.

 

“It was crazy then. I was seeing five and six people at a time in a home,” Baker said.

 

Today, Baker is an enthusiastic early adopter of electronic health records as many private practitioners are still wading through the costs and mandates surrounding them.

 

In 2009, Congress set up standards and incentives to help providers achieve nationwide electronic medical record access by 2014. In four years, the federal government will start cutting Medicare reimbursements for physicians who have not implemented an electronic record system and features such as e-prescriptions.

 

Louisianais using $10.5 million in federal money to build a statewide medical records network to connect physicians and hospitals.

 

While the technology to link the two worlds stands at the ready, actually doing so will mean clearing cost and cultural hurdles.

 

The Louisiana Health Care Quality Forum will staff a resource center for physicians transitioning to e-records and oversee implementation of a network this fall.

 

Program manager Jenny Smith said the goal is to allow patients and physicians to access and store data, such as allergy information, prescription medications and lab work, on a central network and outside servers. The first phase will be live at select hospitals and physician facilities inLafayetteandShreveportby November.

 

“We’re taking a hybrid approach largely for hurricane preparedness reasons,” Smith said.

 

Smith said many doctors and hospitals aren’t ready to be linked into the network.

 

Though hospitals and clinics, such as Ochsner Health System, are moving to implement e-record systems this year, private physicians are still trying to figure things out.

 

Dr. Madelaine Feldman, a practitioner at a three-person private rheumatology group onNapoleon Avenue, said cost and complex federal mandates are barriers. The Uptown practice has spent $78,000 on its electronic health records system since 2008. Feldman said it has eased the prescription process and reduced paperwork.

 

“But it’s been over three years and we’re still finding things that we had no idea we had the capability to use,” Feldman said. “The learning curve on this is very shallow.”

 

To qualify for federal incentives, physicians have to follow standards. That includes using approved systems to write notes and electronic prescriptions, maintain electronic medication lists and electronically exchange information.

 

Feldman said the standards are complex and she knows several area physicians considering taking less money from Medicare rather than adhering to the standards. Her fear is replacing patient-doctor relationships with a mechanical system.

 

“Until we stick a brain into these computers that can think the way I think, you’re going to lose the art of medicine,” Feldman said.

 

Nadine Robin, program manager for the Health Care Forum’sLouisianaHealthInformationTechnologyResourceCenter, said Medicare and Medicaid incentives are tipping the cost and fear factors. Incentives can be as high as $63,750 paid over six years.

 

“People are realizing that these payments are real and that this is coming. It’s not something that’s going to go away while we go to sleep tonight,” Robin said.

 

The larger obstacle, she said, is changing habits. Robin noted the software is worthless without skilled physicians using it.

 

“That’s like assuming that if I gave you a copy of QuickBooks software, you could be an accountant,” Robin said.

 

For now, the initial use hurdle is simply getting the technology into the hands of practitioners. The next step will be linking dozens of software types to a larger network and deciding who pays for it.

 

Baker, the nurse practitioner, uses Practice Fusion, a free, advertising-supported software. Robert Rowley, chief medical officer at theSan Franciscofirm that created the software, said the technology is there to link to e-health networks, but connecting to isolated systems is cost prohibitive for his company.

 

“We can’t really be building interfaces for 1,600 different health information exchanges,” Rowley said, adding that he is skeptical private doctors using free software will pay to connect to an exchange.

 

Baker is thrilled by the idea of an e-health network. Still, cost is an issue for her practice. She has gone through three software programs in five years, paying as much as $1,500 per month before finding her current one.

 

Feldman, the rheumatologist, is also interested to see what changes the statewide network and widespread electronic health records will bring. But she’s reserved about the pace of the process.

 

“I wonder if 50 years from now people will look back and see these things called charts and view them the way we see drawings on cave walls now,” Feldman said, laughing. “Maybe that’s the way it will be. But for now, sometimes it’s fun being a caveman.”

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Housecall Residency Future Dates Thursday, Apr 22 2010

Housecall Residency: Future Course Dates Procedure

Due to the huge demand for this popular Housecall course,  we at Advanced Clinical Consultants (ACC) will now allow all learners to pick their own dates for the course. Please see the following process for independently selecting your Housecall Residency dates.

Thanks again for supporting the ONLY Housecall Residency in the nation for Nurse Practitioners!

1. Select 3 top dates that YOU want to attend the course (Friday-Saturday combination). You decide what works for you and I will accommodate you.
2. Email these dates to me at scharlaw01@yahoo.com
3. I will verify that those dates are available.
4. Once your dates are verified and said available by me (via email confirmation), as soon as possible, send your $100 and the Registration Form to 3715 Prytania Street, Suite 220, New Orleans, La. 70115. Make check payable to Advanced Clinical Consultants. This holds your spot.
5. The remaining $1000 is due 1 week before the course begins.
6. On the first day of class (Friday) meet at 3715 Prytania Street, Suite 220, New Orleans, La. 70115 at 8:30 am.
7. On the second day of class (Saturday) meet at 3715 Prytania Street, Suite 220, New Orleans, La. 70115 at 9:00 am.

Additional notes: Lunch is included on both days and please bring your lab jackets.

Hope this helps.

See you in N’awlins!!!!

Dr. Scharmaine

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Housecall Residency Hotel Information Sunday, Jan 3 2010

The following Hotel Information will be added to the website later this week:

This is a partial list of nearby hotels.

The Prytania Park Hotel
1525 Prytania Street
NOLA
504-524-0427

Courtyard by Marriott Convention Center
300 Julia Street
NOLA
504-598-9898

Best Western St. Charles Avenue
3636 St. Charles Avenue
NOLA
504-899-8888

Hampton Inn St. Charles Avenue
3626 St. Charles Avenue
NOLA
504-899-9990

Also, if anybody has a “burning” question…before you attend the course, it would be helpful if you would please email it to me ahead of time. Therefore, I will make sure it is answered during the course.
See Ya Soon.

~Dr. Schar

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Housecall Residency Program Course Dates Sunday, Dec 20 2009

Outside a trailer, New Orleans 09'

Housecall Residency Program Information

The two-day format will be as follows: Beginning in 2010, the course will be offered on a Friday and Saturday of each month. In January & March, we will have two courses. On the Friday course dates, it will be a classroom day and on the Saturday course dates, it will be an actual Housecall day. Each day will be 8 hours which will give you the 16 hour credits from AANP.

Due to the nature of the Housecall, I can only accommodate two NP’s at a time. This will bring the total to three people entering a person’s home. Most of the patients surveyed for the Housecall program said that three is the maximum amount of visitors at any time from Home Health that they would be able to comfortably accommodate in their home.

Course Dates:

January

Fri. Jan. 22, 2010 & Sat. Jan. 23, 2010
Fri. Jan. 29, 2010 & Sat. Jan. 30, 2010

February

Fri. Feb. 26, 2010 & Sat. Feb. 27, 2010

March

Fri. March 19, 2010 & March 20, 2010
Fri. March 26, 2010 & March 27, 2010

I sure hope this helps. Please email me for questions. I look forward to sharing in this exciting healthcare delivery experience!

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Housecalls Residency Update Sunday, Nov 29 2009

Hello Everyone:

First, I would like to thank all of you who have inquired about the Housecall Residency Program. We at Advanced Clinical Consultants are thrilled that our Housecall Residency Program is your choice for learning how to provide Primary Care in the home. I am writing to give you an update on the program and when classes are set to begin.

There has been an extreme interest in the Housecall Residency Program. Therefore, I am in the process of shifting patient loads and NP student loads to accommodate the many prospective NP participants. With the patients’ welfare in view, this shifting is paramount because we don’t want to bring an “army” of clinicians into someone’s home.

Therefore, we only plan to have 2 NP’s at a time in the course. The program’s format is: 1 day of Housecalls (Day 1) and 1 day of classroom learning (Day 2). I thank you for your patience as we want everyone to experience a very unique clinical residency. Hence, the program will not begin until January of 2010. The schedule as well as the Registration Form will be posted on our website www.advancedclinicalconsultants.com in December of this year.

Second, I would like to commend everyone for seeking to serve those who would otherwise not receive healthcare without a Housecall. I wish you and your family blessings this holiday season.

Respectfully,

Dr. Scharmaine Lawson-Baker, FNP-BC
Advanced Clinical Consultants, LLC. President/CEO
3715 Prytania Street, Suite 220
New Orleans, Louisiana 70115
Phone: 504-894-8307

http://www.advancedclinicalconsultants.com

http://www.geriatricinitiatives.org

“Keep in mind that the true measure of an individual is how he treats a person who can do him absolutely no good.”
Ann Landers
1918- , American columnist and author.

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Housecall Residency Program obtains approval from AANP (American Academy of Nurse Practitioners) Tuesday, Oct 13 2009

Advanced Clinical Consultants just received word of the approval of our Housecall Residency Program. This is exciting news! The 2 day intensive course will offer NP’s a detailed look at Housecalls, how to get a program started, necessary forms, what to put in the Housecall bag, technology “must-haves”, and other general business pearls from ADVANCE magazine’s 2008 Entrepreneur of the Year winner, Dr. Scharmaine Lawson-Baker. See the letter from AANP below. More of the program’s curriculum, pricing, and other particulars will be posted on the web. This is the FIRST Housecall Residency approved by AANP in the nation!

AANP Letter:

Dr Scharmaine Lawson-Baker
Advanced Clinical Consultants
3715 Prytania St, Ste 230
New Orleans, LA 70115

Dear M Lawson-Baker,

The continuing education program titled House Call Residency Program sponsored by Advanced Clinical Consultants (initial program date September 2009) is approved for continuing education by the American Academy of Nurse Practitioners. You sessions are approved as submitted. The appropriate wording for this is:

“This program is approved for 16 contact hour(s) of continuing education by the American Academy of Nurse Practitioners. Program ID 0908276.”

In addition, the following statement should accompany all AANP-approved activities: “This program was planned in accordance with AANP CE Standards and Policies and AANP Commercial Support Standards.”

ID number 0908276 has been assigned to this application. Please refer to this number when you send the required reports (the list of participants who receive continuing education credit for this program, the evaluation summary, etc.) and any other contacts pertaining to this application. This program has been approved for 2 years (through August 31, 2011), provided no changes are made. Attendance sheets and evaluation summaries are due in this office one month after the program’s initial presentation. If the program is enduring or repeated, reports are due again at one year and at program’s end, unless other arrangements have been authorized.

Thank you,

Stormy Causey
CE Coordinator

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Another Battle Won. Monday, Oct 5 2009

In October of 2008, I decided that I wanted to become a Community Care provider (La. Medicaid’s version of an HMO). I was told to apply because this area (New Orleans) was still considered a “provider shortage area” since Hurricane KATRINA and that “free-standing” Nurse Practitioner clinic’s would have no problem getting credentialed. So, I immediately filled out the paperwork and waited for a response while I ventured off to fight other battles. Alas, December 2008 arrived and I still have not heard a word from my “new” Provider Relations department. I pick up the phone and give them a call. I am now told that, “after reviewing your application Ms./Dr. Lawson-Baker, New Orleans is no longer a shortage area. We are only allowing physicians and/or NP’s if it is deemed a ‘provider shortage’ area.” “Oh”, is my response as my face becomes as flushed as a Louisiana Creole Tomato. Ms./Dr. Lawson-Baker, you are welcome to appeal, the attendant says… At this point, I am still speechless as I say, “Don’t worry, I will tell all my Medicaid Community Care patients to find another provider.” I hang up the phone.
Three months pass, and we are now in April of 2009. I muster the strength to appeal and discover that the program is now “under new management”. This could be good, I say to myself. Real good. Hence, I begin a renewed fervor round of calls and letters to the “new management team” to figure out the hierarchy and decide who to pester, in a pleasant, but consistent manner. I am given a name and I place my first call to the leader of the team in June of 2009. I am told that I should re-submit my application and “really explain” just what my practice entails. “No problem”, I say.
After a few application “do-overs” and phone calls (of course), on October, 1st, 2009, Advanced Clinical Consultants became the first NP-owned Community Care Clinic in the City of New Orleans. We were told that 1,000 patients may be assigned to our roster. We saw our first patient today and already have 9 patients “assigned” to the clinic. I still have my Armour on…HUMANA is still in view. I got to get that directory insanity fixed now. Stay Tuned…

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Memphis Speaks Wednesday, Aug 5 2009

I took a chance and stepped out against my usual speaking engagements to deliver a scientific talk on Constipation and Irritable Bowel Syndrome in the elderly.  It involved overnight travel to the University of Memphis.  Overall the talk went well.  Of course before I actually spoke on my required speech, I had to give the usual “KATRINA” update.  It is as if KATRINA was yesterday in some parts of the 9th Ward, New Orleans East, and St. Bernard parishes is what I said, as various audience members showed shock and surprise on their faces.  Well, it’s sad, but true.

Anyway, the subject of constipation is where we must continue.  Hence, after the speech, many were interested and focused on filling out the post-test for their 1 hr CE.  Therefore, no questions regarding chronic constipation were asked or solicited.  This was a comfort.  I found the staff and waiters at the University of Memphis Holiday Inn to be surprisingly helpful and genuine.  The hotel was nice too.  I was not sure of what to expect, but when I saw that room service was available, I knew my 2 night stay would be “right up my alley”.  I honestly did not know that Holiday Inn’s had room service?

Will I speak on behalf of a pharmaceutical company again?  I think so.  The only real issue for me was I expected more support with some of the slide content which is customary from most pharm companies…just not this one. Oh well, I guess you can’t have it all.  My overall regret was not getting out to Interstate BBQ or Neely’s BBQ!

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Alaska Day 1, Monday Tuesday, Jun 23 2009

We left NOLA at 0500.  We did not arrive in Anchorage until 1400 (1700 in NOLA).  We check into our hotel that has Taxidermy on a magnificent display in several glass cases (bears, moose, reindeer [Prancer, Vixon], and a wolverine –like from X-Men).  The weather is a misty 60 degrees.  Our hotel room is clean, but a bit rustic complete with a moose lamp and Native-American art on the wall.  After a quick shower, we’re off to dinner with a few other couples and locals in a private dining room at a local restaurant.

WoW.

First of all, I have never had beer-battered Halibut. Yummy. I try theMacadamia encrusted Alaskan Salmon filet with asparagus and Jasmine rice.  Yummy.  I passed on the fried Calamari, reindeer (Prancer) sausage, and Buffalo links.  Second, I met someone who said he was an Eskimo.  Well, me being me, I asked him if Igloos existed.  Yes, at one time they did, he says, but explained that he nor any members of his tribe live in one.  We continue eating and talking until 2300 (0200 in NOLA).  I was exhausted and could not believe it was still daylight outside.   Yes, I did not see the sun, but it was light outside and the temperature had dropped to a windy 40 degrees.  We get back to the hotel and are surprised that everybody is still awake (restaurant/bar still open), discover that we have been up 24 hours because it is now 0200 (0500 in NOLA), and lovingly appreciate another city that never sleeps.

Welcome

Big White Bear Greeting

Alaska Day 2, Tuesday to follow

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