Meaningful Use Stage 2—New Core Objectives

Now that the Stage 2 meaningful use standards are available, health care providers should start planning to implement attestation requirements.  Providers cannot begin to attest until 2014.  However, providers should consider two factors that indicate the need to plan.  First, the requirements for both stages of attestation are now more rigorous than before, and providers will no longer be able to count exclusions toward their non-core objectives.  Second, the number of core objectives that providers must meet has significantly increased.

In particular, providers should plan to meet one of two new Stage 2 core objectives.  Eligible physicians must use secure electronic messaging to communicate with patients on relevant health information.  Eligible hospitals and critical access hospitals must use automatic medication tracking from order to administration using assistive technologies and an electronic medication administration record.  Providers should also keep in mind that many of the objectives that carry over from Stage 1 to Stage 2 have significantly higher thresholds.  To meet these thresholds, providers should consider the use of external audits and implementation planning to meet Stage 2 requirements in 2014.

© 2012 Parsonage Vandenack Williams LLC

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Effective Use of QR Codes in Medical Practice

Quick response (“QR”) codes may be an effective way for physicians to market themselves to potential and existing clients.  QR codes are barcode-like images that can store up to fourteen different types of data, including web links and phone numbers.  These images may be placed on nearly anything from advertisements to business cards, and will deliver data encoded in the image to the user’s smartphone when scanned.  Marketing experts suggest that physicians avoid merely using QR codes to provide a link to the practice’s homepage.  Physicians should instead use them in creative ways to provide unique and special content.  Some potential uses include:

  1. Educate patients—prove links to information like health tips, recent medical advances, and other online resources.
  2. Promote services—provide links to information regarding specialty services, seasonal reminders, etc.
  3. Introduce physicians—may be used to link potential patients to website bios, introductory videos, etc.
  4. Invite patients to special events
  5. Make appointments online—can place on appointment reminder cards that provide a link to your online appointment system.
  6. Link to patient testimonials on social media websites

Remember, however, to make sure that your website and other content linked to QR codes is mobile-ready, otherwise users will be unable to use the QR code effectively.

© 2012 Parsonage Vandenack Williams LLC

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Reminder to Physicians: Meaningful Use Checks are Arriving

On May 19, the Centers for Medicare and Medicaid Services (“CMS”) mailed the first checks for the Medicare incentive program to physicians who had attested that they had achieved meaningful use of their electronic health records (EHRs).

EHR incentive payments are also available to eligible professionals from state Medicaid programs.  However, the Medicaid program has different incentive requirements.

The actual arrival of checks from Medicare should encourage more doctors to acquire EHRs and demonstrate meaningful use. The checks show that meaningful use and successful EHR implementation is certainly achievable.

Given EHR is going to be the standard of practice and physicians will eventually need to implement EHR systems, there is no better time than the present to get started.

We do not have our EHR incentive program outline on the PVWLaw website because we were only providing to clients.  I could do the same thing we did with some of the health care bill articles and state “PVWLaw has prepared a comprehensive outline on the EHR incentive programs called “EHR Incentive Program Outline”.  If you would like to receive a copy of the outline, please email the following information to and we will reply promptly including a pdf attachment of the document requested:

1.    Name of the document requested

2.    Your name

3.    Name of your company

4.    Your title

5.    City and State where your company primarily does business

Please note, requesting a document will add you to our email list. This means you will receive certain emails that we believe may be of interest to our clients and friends. To unsubscribe and stop receiving emails from us, please send an email to from the email address where you receive our emails.

© 2011 Parsonage Vandenack Williams LLC

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Physicians: Exercise Caution When Using Social Media

When a physician accesses social media – whether it be LinkedIn, Facebook, Twitter or another social media site – it is very important to be honest, respect privacy, and uphold the reputation of the medical profession.  It is also important to seriously consider separating one’s professional use of social media from one’s personal use.

Physicians must be aware of what is being posted online and how it is presented, given the ever-increasing use of social networking and blogs.  Physician employers should also be aware of what their employees are posting online, both professionally and personally.  Many employers in the health care field have established social media policies to govern the use of social media both during and after work hours.  

Additionally, physicians need to take into account the use of online rating sites and search engines by patients.  How can these sites affect a physician and his or her practice?  Physicians should work to understand, manage and proactively review their online identity and personal brand.

A smart strategy for physicians is to consider all postings – whether professional or personal – as public.  Examine privacy settings closely.

Finally, in the event that a physician communicates directly with patients electronically, it is crucial to do so via secure messaging, have a physician-patient communications policy in place, and comply with the rules of such policy.

Source: Rajecki, Ron. “Be Careful When Using Social Media.” Medical Economics. 12 May 2011.

© 2011 Parsonage Vandenack Williams LLC

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On April 7, 2009 CMS announced that, as a result of the incentive provisions for physicians to encourage the adoption of health information technology in the American Recovery and Reinvestment Act of 2009 (“ARRA”), CMS will change its plans for implementing the electronic health records (“HER”) Demonstration.  CMS will continue implementation of Phase I of the EHR Demonstration program on schedule.  CMS will continue working with Phase I community partners and practices, including local kick off meetings for more than 400 selected practices in May, 2009. The demonstration will begin as planned on June 1, 2009 and continue through May 21, 2014. However, CMS has decided to discontinue Phase II of the EHR demonstration, which originally was planned to begin operations in mid-2010.  



The EHR demonstration initiative aims to reward delivery of high-quality care supported by the adoption and use of electronic health records in physician practices. This initiative expands upon the foundation created by the Medicare Care Management Performance (“MCMP”) Demonstration. The goal of the demonstration is to foster the implementation and adoption of EHRs and health information technology (“HIT”) more broadly as effective vehicles to improve the quality of care provided and to transform the way medicine is practiced and delivered. 


As part of the EHR demonstration, all participating primary care physician practices will be required to have a Certification Commission for Healthcare Information Technology (“CCHIT”)-certified EHR by the end of the second year. (CCHIT is the recognized certification authority for EHRs and their networks.)  Physician practices must, as part of the demonstration, utilize the EHR to perform specific minimum core functionalities that can positively impact patient care processes, (e.g., clinical documentation, ordering of lab tests, recording lab tests, and recording of prescriptions).  The core incentive payment is based on performance on the quality measures, with an enhanced bonus based on the degree of HIT functionality used to manage care. 


On June 10, 2008 CMS announced its selection of 12 community partners in defined sites to help CMS implement the EHR demonstration. The approved community partners in each site represent diverse groups of organizations including varied HIT stakeholder collaborations, medical societies, primary care professional organizations and health departments. Phase I includes the following 4 sites: Louisiana, Southwest Pennsylvania, South Dakota (and some counties in bordering states), and Maryland and the District of Columbia. Recruitment of physician practices in the four Phase I sites was initiated on September 2, 2008, and the enrollment period closed on November 26, 2008. Over 800 eligible applications were received from interested practices in the four Phase I sites. 



© 2009 Parsonage Vandenack Williams LLC

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New Behavioral Health “Network of Care” Web Site Launched by Department of Health and Human Services

The Nebraska Department of Health and Human Services (“DHHS”) has launched a new, easy-to-use Web site offering a comprehensive, Internet-based community resource for people with mental illness, their caregivers and service providers. The Network of Care Web for Behavioral Health Web site can be accessed at



“The Network of Care site is a big step forward in helping people find services and connect and share their stories,” said Scot Adams, director of the Division of Behavioral Health. “This one-stop information tool lets you access vital information about treatment resources and diagnoses, insurance, and advocacy and find other pertinent behavioral health Web sites. Consumers can also choose to communicate directly with others and to organize and store personal health records.”



Benefits of this Network of Care Web site include:


  • Helping people find the right services at the right time. Click anywhere on the Nebraska map on the home page to get a comprehensive Service Directory of providers, organized by Behavioral Health Region.
  • Giving consumers the option to use the secure Personal Health Record section to organize and store medical and healthcare-related information.
  • Having communication tools such as message boards and community calendars to help people connect with each other or share information.
  • Facilitating providers who want to share challenges and ideas or use the private message boards. Providers can even build their own free Web sites.
  • Accessing the easy-to-search libraries; information about specific behavioral health disorders, pending legislation and advocacy; and daily news articles and the latest research about mental health and substance abuse issues from around the world.
  • Having a site that is fully ADA-compliant and that offers a text-only version.



© 2009 Parsonage Vandenack Williams LLC

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Physician Communications Via Email

If a physician (or physician’s office) is going to email patients, due consideration should be given to HIPAA implications as well as medical malpractice issues. Whenever drafting an email, consider what the email could look like posted as evidence in a courtroom. Adopt a policy concerning email communications and stick with the policy.

Consider the following:

Encrypt email for secured communications.

Save emails to your medical record. You do not want to be in a position ever where a patient can produce an email from you but you don’t have a copy of it.

Include a confidentiality notice on all email.

Include the minimum necessary information in an email.

Never write emails when you are tired or angry. Save your email as a draft. Review once more before sending.

Do not copy others on emails to patients unless it is to your office administrator who is responsible for diligently saving the email.

Do not use email as a replacement for office visits.

Require patients to agree to the use of email for communications. Provide the patient a policy specifying what email can be used for.

 © 2008 Parsonage Vandenack Williams LLC  

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