medical billing transcription supplier information

Whether it's purchasing a new information system or upgrading existing technology, weighing an investment in information technology (IT) can be particularly challenging. Factors contributing to the pressure-filled situation are numerous.

The magnitude of IT operating and capital budgets. IT operating expenses may consume 2 to 3 percent of the total operating budget, and IT capital may claim 15 to 30 percent of all capital. As a result, an investment in IT easily can mean the difference between a negative or positive operating margin. Also important is the potential impact on competing interests and strategic planning. An IT capital expenditure of 15 to 30 percent reduces the amount of funding available for opportunities such as biomedical equipment, which could be used for new revenue, and buildings, which support the growth of clinical services.

The projected growth in IT budgets. Provider organizations may permit overall operating budgets to increase at a rate close to the medical inflation rate. However, expenditures on IT often experience growth rates of an additional 2 to 5 percent. At some point, an organization will note that the IT budget growth rate may single-handedly lead to insolvency

Demand often seems insatiable. Worthwhile proposals go unfunded every year. And infrastructure replacement and upgrades can seem never ending. It's not uncommon to hear leadership say: "I thought we upgraded our network two years ago. Are you back already?"

It is difficult to evaluate IT budget requests. IT's diverse applications can make the examination process challenging. For example, it can be difficult to compare a proposal that is directed to improve service with other proposals designed to improve care quality, increase revenue, or achieve some level of regulatory compliance.

Reputations for failure are difficult to outlive. Leadership may return blank stares when asked, "List three instances over the past five years where IT investments have resulted in clear and unarguable returns to the organization." However, the conversation may be difficult to stop when asked, "List three major IT investment disappointments that have occurred over the past five years."

Despite these numerous obstacles, some techniques can help aid the process of assessing IT value. Finding the most useful approach typically begins with understanding that value from IT investment decisions is real and diverse.

Where's the Value?

Value occurs when IT implementations catalyze or contribute to tangible improvements in organizational performance, such as reductions in medical errors, reductions in costs, improvements in service, and increases in revenue. Practical examples of IT applications producing value are numerous.

At Boston-based Partners HealthCare System, an analysis of the costs and benefits of the computerized medical record shows that financial benefits can range from $9,000 to $19,000 per physician FTE per year. This revenue can be captured through reduction in transcription costs and record-retrieval costs, improved conformance to ordering from approved formularies in cases where risk is shared, and improved billing accuracy

At Brigham and Women's Hospital, a member of the Partners system, inpatient provider order entry has led to a 55 percent reduction in serious medication errors. The technology employed highlights possible drug allergies, drug-drug interactions, and drug-laboratory result problems at the time of medication order entry.

At a health center of Massachusetts General Hospital, also a member of the Partners system, implementation of a picture archival and communication system (PACS) has reduced time spent for interpreting radiology images from 72 hours to one hour. Introduction of the technology also has reduced the cost of an examination by 30 percent and reduced the time that image-intense specialists, such as neurosurgeons, spend trying to locate films.

These and similar experiences at other organizations clearly demonstrate that opportunities for value creation through IT implementation are real and diverse.

How Do You Find Value?

The diversity of value means that the analyses of proposed IT investments must use diverse techniques. The investment-analysis technique of calculating return on investment (ROI) comes to mind first, and in many cases it is effective. For example, managers can calculate an ROI if a set of investments, including an IT component, is intended to reduce clerical staff.

However, there are times when calculating ROI is clearly not appropriate, particularly in relation to strategic initiatives. For example, consider determining the ROI of electronic mail or word processing. Such an analysis would not fully capture the benefits of the technology What's more, the technology's full impact would most likely not be understood until years after the investment. When it comes to strategic uses of IT, ROI analysis done at the time of weighing an investment frequently becomes wrong and is highly speculative at the very least.

Legislative proposals affecting the workplace often take top billing on Capitol Hill, but this year human resource issues will take a back seat to the faltering economy and possible war with Iraq.

While President Bush's State of the Union address Jan. 28 prominently featured his economic stimulus proposals and the need to disarm Iraq, he briefly sketched out his domestic policy agenda and placed health care and Medicare reform high on his priorities. And while many employers agree that the steeply rising cost of providing health care benefits is a major concern, the 108th Congress probably won't be making any major reforms to the health care system this year.

"The more things change, the more they remain the same," says Deron Zeppelin, PHR, director of governmental affairs for the Society for Human Resource Management (SHRM). "Even though the Republicans hold both houses of Congress and the presidency, the dynamics have pretty much stayed the same."

Bush indicated that the administration's proposals for containing health care costs would focus on setting caps for punitive and compensatory damages in medical malpractice lawsuits and on reforming legislation governing malpractice insurance. The GOP-controlled Congress will be following the president's lead, but Zeppelin says, "Medical malpractice reform has been on the plate before and is just one piece of the puzzle for containing health costs. Reform of the care system is such a complex and contentious issue that we probably won't see any radical changes or fixes coming from this Congress."

The reason, Zeppelin says, is that the Republicans' small majority in the Senate (51 GOP, 48 Democrats, 1 independent) means Bush and the Republican leadership cannot enact some legislative proposals without significant compromises.

Neil Reichenberg, executive director of the International Personnel Management Association, an association of government HR professionals, agrees that the administration's proposals for substantial changes such as Medicare reform will face stiff opposition.

"Bush's proposal that senior citizens join an HMO [health maintenance organization] in order to receive prescription benefits through Medicare will be a really tough sell and won't go much of anywhere," Reichenberg says.

The administration did back away from its stance on the HMO proposal after negative public reaction. Two days after the State of the Union address, presidential Press Secretary Ari Fleischer said several proposals were on the table for Medicare prescription benefits, and that seniors should be able to choose a medical plan that best fits their needs.

"I think the real message from Fleischer's comment is that the administration wants to find common ground and create proposals that have bipartisan support and have a strong chance of passing through Congress," says James Klein, president of the American Benefits Council.

Klein predicts Congress will pass a Medicare reform measure this year, but agrees with Zeppelin that the possibility of any far-reaching health care reform being enacted this year is remote.

"Congress has seemed content to debate these issues but then do nothing about them because, frankly, it's easier than the protracted political fights it will take to make these very tough and complicated decisions," Klein says. "While I think we will see some changes made, Congress likes to make these changes in small increments, and we won't be seeing any real sweeping or radical changes for issues like health care and pension reform."

Training and the Economy

Another key piece of workplace legislation that will be facing Congress this year will be the reauthorization of the Workforce Investment Act of 1998, which was designed to help consolidate federal employment and training programs and require states and localities to develop a single "one-stop center" system to better serve job seekers and employers. The law is up for renewal for the 2004 fiscal year, so Congress will be making decisions that should have some far-reaching effects on workforce development issues, according to Cynthia Pantazis, director of legislative affairs for the American Society for Training and Development (ASTD).

"The decisions they make will definitely hinge on the economy," she says. "If the economy is still sputtering along six months from now, then Congress will definitely change focus from looking at ways to Support employer-provided workforce development and training to creating more job opportunities for the unemployed through training programs."

Fixing the faltering economy is probably the biggest challenge facing Bush and the Congress. And Bush's economic stimulus package is drawing harsh criticism from organized labor. Officials with the AFL-CIO claim Bush's economic stimulus package is overly generous to the wealthy and provides no real support for working Americans. The labor federation has pledged to lobby For several counterproposals to Bush's stimulus package, such as increasing the minimum wage and further extending emergency unemployment benefits.

Study objectives: The clinical outcomes and health-care costs of a cohort of 413 patients with COPD are reported.

Design: This study was a retrospective pharmacoeconomic analysis.

Setting: University teaching hospital and affiliated clinics.

Patients: COPD patients with an [FEV.sub.1] [is less than] 65% of predicted and an [FEV.sub.1]/FVC ratio [is less than] 70% were eligible to be included in this analysis.

Interventions: Health-care resource utilization and costs were identified through chart review and were stratified according to the severity of COPD using the American Thoracic Society stages I, II, and III. The pharmacoeconomic analysis was a cost-of-illness evaluation that included the acquisition costs of initially prescribed pulmonary drugs, acquisition cost of pulmonary drugs added during the follow-up period, oxygen therapy, laboratory and diagnostic test costs, clinic visit costs, and emergency department and hospital costs.

Results: Total treatment cost was highly correlated with disease severity, with stage I COPD having the lowest cost ($1,681 per patient per year), stage III COPD having the highest cost ($10,812 per patient per year), and stage II COPD having a cost intermediate to stage I and stage III ($5,037 per patient per year). With the exception of add-on drug acquisition cost, all cost variables were the highest in stage III COPD, the lowest in stage I COPD, and intermediate in stage II COPD. Hospitalization was the most important cost variable for all three stages of COPD severity. When stratified by both disease severity and initial bronchodilator drug selection, ipratropium alone in stage I COPD patients and the combination of ipratropium plus a [Beta]-agonist (with or without steroid therapy) in stage II and stage III COPD patients had the lowest total costs. Reasons for the lower total cost of the ipratropium and ipratropium plus [Beta]-agonist treatment groups included lower add-on drug costs, fewer diagnostic and laboratory tests, and a lower utilization rate for clinic visits, emergency department visits, and hospitalizations.

Conclusions: Our study demonstrates a strong correlation between disease severity and total treatment cost in COPD. In addition, the type of bronchodilator therapy impacts total cost in COPD. In stage I COPD, ipratropium alone had the lowest total cost, while in stage II and stage III COPD, a combination of ipratropium plus a [Beta]-agonist had the lowest total cost. These data support the concept that adherence to published treatment guidelines will result in lower health-care costs due to COPD.

The new Medicare home health prospective payment system pays fixed, predetermined rates for services provided during episodes of home health care. This article details the construction and principal components of the new payment system and shows how episode payment rates and other amounts that Medicare now pays for home health care are calculated. Suggestions are made for steps that home health agencies can take to respond most effectively to the new system's operational requirements and align themselves with the plan's financial incentives.

On October 1, 2000, Medicare began paying providers of home health care at fixed, predetermined rates for services and supplies bundled into 60-day episodes of home health care. The episode payment rates vary, depending on the patient's clinical, functional, and services utilization characteristics. The new approach is expected to redistribute Medicare payments among home health agencies, extend the cost savings introduced by the home health interim payment system UPS), improve the coordination of services, and reduce the number of unnecessary home health visits.

Before October 1997, Medicare paid home health agencies at a rate reflecting either their reasonable costs or their per-visit cost limit applied in the aggregate, whichever was lower. Reasonable costs were based on the Medicare payment principles effective at the time. A home health agency's per-visit aggregate cost limit was established by multiplying a predetermined cost per visit by discipline (eg, skilled nursing, physical therapy) by the corresponding number of Medicare visits and summing the results.

The lower-rate test gave home health agencies financial incentives to continue furnishing care as long as a visit's marginal revenue exceeded its marginal cost, regardless of whether the benefits to patients were perceptible. Further, the absence of coinsurance on home health services (except for durable medical equipment) allowed Medicare beneficiaries unrestrained use of these services without financial penalty These inflationary underpinnings help to explain why Medicare payments for home health care soared about 800 percent between 1987 and 1997, while the number of users doubled and the number of visits per user tripled.

With the introduction of the IPS, a third component to the lower-rate test came into play: the beneficiary aggregate cost limit. This limit was obtained by multiplying a predetermined per-beneficiary payment amount by the unduplicated number of Medicare patients treated during the year. Like the visit cost limit, the beneficiary cost limit was applied in the aggregate. Beginning October 1, 1998, most home health agencies with a beneficiary cost limit below the national median limit were allowed to retain one-third of the difference. Overall, the beneficiary cost limit capped both the reimbursable cost per visit and the reimbursable average number of visits.

The IPS exerted further financial pressure on home health agencies by reducing the aggregate cost limit, Beginning October 1, 1997, the limit for all home health agencies was set at 105 percent of median costs in 1994, updated for inflation, for freestanding home health agencies. The previous ceiling had been 112 percent of the mean costs for freestanding home health agencies.

The IPS also introduced consolidated billing for covered home health services furnished to Medicare patients, regardless of whether the services or supplies were provided directly by the agency or under arrangements with outside entities. This requirement prevents home health agencies from shifting services encompassed by the beneficiary limit to outside suppliers that could bill Medicare separately Consolidated billing also minimizes instances of inadvertent duplicate billing for the same services.

THE NEW PPS SYSTEM

The new home health PPS replaces the cost-related IPS without a transition period, blended rates, or phasing into prospective payment based on the cost-reporting year. The new system pays prospective rates for services provided during 60-day episodes of care (see Exhibit 1). Episodes of care for Medicare patients began with the first billable visit after September 30, 2000, including patients with an open plan of care on that date.

The payment rates vary depending on the home health resource groups (HHRGs) to which Medicare patients are assigned. Reduced or additional amounts are paid when certain conditions exist. All payments are subject to medical review adjustments reflecting beneficiary eligibility decisions, medical-necessity determinations, and HHRG assignments.

Covered services. Episode-of-care payment rates apply to covered home health services that Medicare pays on a cost-related basis as of August 5, 1997. This includes:

* The six home health disciplines: home health aide services, medical social services, occupational therapy physical therapy, skilled nursing care, and speech language pathology; and

* Routine and nonroutine medical supplies provided under a plan of care, including nonroutine medical supplies that are unrelated to the plan of care but are covered as a Medicare home health service.

Pocket CPT Coding Guide and Reference With Revolutionary New MyCPT

Customization Gives Billing Specialists, Medical Support Staff,

Hospital Administrators, Auditors, and Consultants Anywhere,

Anytime Access to Complete AMA CPT Coding Information

Using Any Palm OS Handheld Computer

Palmtop Publishing, the leading business provider of engaging, Palm OS(TM) professional references and business event guides, today introduced MyCPT and the Pocket CPT 2000 Coding Guide and Reference -- medical coding tools for smooth and accurate billing that are compatible with the entire family of Palm OS handheld computers.

The new MyCPT and Pocket CPT Coding Guide and Reference arm medical and billing professionals with instant, always in hand access to critical AMA CPT procedure codes and modifiers along with full descriptions, coding guidelines by discipline, and E&M guidelines for fast, accurate and easy coding.

The Pocket CPT Coding Guide and Reference allow medical professionals to view critical CPT coding information for over 7,500 CPT codes on any Palm OS device. For convenient access to a specialized, more focused set of specific codes, the innovative MyCPT capability lets medical professionals create one or more customized sets of MyCPT codes to use as "HotLists", addressing the specific needs of specialized practices, clients, procedures, and clinics. Pocket CPT and MyCPT are highly organized and completely searchable, enabling auditors and billing professionals to quickly find a CPT code or it's detailed description by discipline, word or phrase search, or number. CPT 2001 updates will be made available this Fall when CPT 2001 is released from the American Medical Association.

"This combination of easy to install Palm software coupled with the powerful customization capabilities of MyCPT, provides instant access to a complete set of CPT data, and, at the same time, offers quick access to more focused and customized sets of specific codes for the unique needs of specialty practices and consultants," said Trina Clickner, founder of Palmtop Publishing. "This literally lets medical professionals segment and carry just the data they need and also puts any piece of CPT coding and procedure data, including guidelines and Level I and II code modifiers and descriptions, just a tap or two away."

The Pocket CPT Coding Guide and Reference and MyCPT are easy to use, completely searchable, and lightening-fast. Installation is easy from any Windows(R) PC, Apple(R) Macintosh(R) (Nasdaq:APPL), minicomputer or mainframe. Powered by OnTap(R) Technology, Pocket CPT runs on every make and model of Palm OS handheld computer and is available for $149 by calling Palmtop Publishing directly at 206/923-0901 . A special Pocket CPT introductory offer runs through September 2000 and includes a brand new hardcopy, print edition of the traditional AMA CPT 2001 Standard Edition reference and a $20 savings on the Pocket CPT 2001 edition upgrade, both available this Fall.

SAN DIEGO -- Wilkes Regional Medical Center of North Wilkesboro, N.C., has awarded a $1 million contract to DR Systems for an enterprise-wide implementation of the company's Dominator(TM) PACS. E[acute accent]Wilkes Regional has a McKesson hospital information system but opted to install DR Systems' "best of breed" PACS. The hospital currently performs approximately 60,000 radiology exams per year. The center plans to add a new outpatient center by 2007.

E[acute accent]The hospital's new PACS system will feature:

E[acute accent]--A unified system that includes web distribution of images, report and audio summary, printing, faxing, document imaging, 3-D, billing capture and archive

E[acute accent]--Common user-friendly interface at all the PACS workstations

E[acute accent]--Referring doctors' ability to clinically review automatically downloaded images and reports at their home or office

E[acute accent]--Instant access to 'in progress' study images and audio summaries by ER or OR doctors

E[acute accent]--Patented automated hanging protocols for radiologists and output preferences for referring physicians

E[acute accent]DR Systems was rated the #1 PACS vendor by MD Buyline in its July 2005 Intelligence Report; ranked #2 by KLAS in their 2004 Top 20 Year End Best in KLAS Community Clinical and Ancillary Solutions Report; and ranked #3 in their 2004 Top 20 Year End Best in KLAS Acute Care Report.

E[acute accent]About Wilkes Regional Medical Center

E[acute accent]Wilkes Regional Medical Center is a JCAHO accredited hospital owned by the town of North Wilkesboro and governed by the Hospital Operating Corporation, a volunteer team of community leaders. The hospital is licensed for 130 beds, including a 10-bed skilled nursing unit. For more information, access www.wilkesregional.org/nodes/1.aspx.

E[acute accent]About DR Systems, Inc.

E[acute accent]DR Systems, Inc. is the leading independent provider of scalable, film-free medical systems and paperless information systems for diagnostic imaging centers and hospitals. Since 1993, the company has helped more than 250 hospitals and imaging centers improve the management of patient information, eliminate film costs and increase workflow speed, all while providing better clinical quality and patient care. DR Systems' unified RIS/PACS integrates numerous tools to improve financial performance and productivity, including: client-server distribution and Web-based distribution; patented, automated hanging protocols for radiologists; and the report format preferences of individual referring physicians.

Nightingale Informatix Corporation (TSX VENTURE:NGH) today announced it has signed a multi-year agreement with Mount Sinai Hospital's Temmy Latner Centre for Palliative Care (TLCPC) to provide physicians with wireless computer technology that will allow them to access the records of patients being treated in their homes.

The community based TLCPC physicians and other clinical professionals visit the homes of more than 2,500 patients and families each year - as many as 600 to 700 patients at any given time - to provide palliative care.

Palliative care is the combination of active and compassionate therapies aimed at reducing the symptoms and suffering of individuals and families facing a life-threatening illness. It strives to meet physical, psychological, social, and spiritual needs while remaining sensitive to personal, cultural, and religious values, beliefs, and practices. In addition, the Centre is actively involved in furthering palliative care services at a local, provincial, and national level.

The agreement will provide wireless computer technology that allows healthcare professionals visiting patients in their homes to access up-to-date, complete patient records.

"Having complete patient profiles at our fingertips, and at the patient bedside, will significantly enhance our ability to provide seamless, high quality care," said Dr. Russell Goldman, Assistant Director of the Temmy Latner Centre for Palliative Care.

Dr. Goldman said the technology provides many benefits that can be passed on to the patient in a timely way.

"Having the most recent patient information available right at the bedside will also mean that a physician who is making a house call as part of our after-hours service will know things like what medications the patient is on, even if a change has been made earlier that day, and they won't need to trouble family members by asking them to repeat their story."

The agreement between Nightingale and the Temmy Latner Centre will encompass the Centre's 18 physicians, the Max and Beatrice Wolfe Children's Centre team, and all TLCPC administrative staff.

"This agreement is further validation of Nightingale's technologies and track record in its ability to build great healthcare platform that focuses on our clients' needs to improve the quality of patient care," says Sam Chebib, President and CEO of Nightingale. "This is reflective of Nightingale's overall commitment to set the standard not just for practice management automation, but our 'patient centric' model for healthcare record management. We're pleased to be partnering with the Temmy Latner Centre and to be a part of the very important work they do."

This agreement is the latest announcement with Mount Sinai Hospital and includes Nightingale's latest Hybrid Version of its applications, which will derive all the benefits of web-based application as well as enable physicians to use the myNightingale application outside of the clinic setting, where no internet connection is available.

About Nightingale

Nightingale's internet-based Electronic Health Record (EHR) and Practice Management solutions are designed to help physicians, clinics, hospitals and other healthcare organizations manage their practices, as well as their patient records, through a secure internet browser. Nightingale's Practice Management and EMR solutions offer multi-location, enterprise-wide management and reporting capabilities. Nightingale's suite of products offer Canadian and United States physicians leading-edge functionality for patient scheduling, resource scheduling, billing, claims processing, work flow tools, clinical documentation, laboratory interfaces, document management and patient portals, and other real-time patient services. OpenX Technologies and VisionMD are wholly-owned subsidiaries of Nightingale. Nightingale services customers in every province in Canada. Visit www.nightingale.md for more information about Nightingale.

About Temmy Latner Centre for Palliative Care

The Temmy Latner Centre for Palliative Care at Mount Sinai Hospital, is a community-based program that provides palliative care to more than 2,500 individuals and families each year. Palliative care is the combination of active and compassionate therapies aimed at reducing the symptoms and suffering of individuals and families facing a life-threatening illness. It strives to meet physical, psychological, social, and spiritual needs while remaining sensitive to personal, cultural, and religious values, beliefs, and practices. In addition, the Centre is actively involved in furthering palliative care services at a local, provincial, and national level. Visit http://www.tlcpc.org for more information about TLCPC.

Except for historical information contained herein, this news release contains forward-looking statements that involve risks and uncertainties. Actual results may differ materially. Factors that might cause a difference include, but are not limited to, market acceptance of principal products, the impact of competitive products and technologies, the possibility of products infringing patents and other intellectual property of fourth parties, and costs of product development. Nightingale Venquest will not update these forward-looking statements to reflect events or circumstances after the date hereof. More detailed information about potential factors that could affect financial results is included in the documents filed from time to time with the Canadian securities regulatory authorities by Nightingale.

3M today announced that customers of Siemens Medical Solutions' Soarian health information solution will have access to the latest medical necessity intelligence through a strategic alliance with 3M Health Information Systems Division, a leading provider of advanced coding and compliance software and content. Siemens will embed 3M Medical Necessity Dictionaries in Soarian, enabling customers to detect coding and compliance issues during scheduling and registration, and to verify post-service claim compliance.

"Maintaining Medicare compliance continues to be a significant administrative and financial challenge for hospitals," said Brenna Quinn, vice president, Healthcare IT Division, Siemens Medical Solutions. "Through this agreement, we are combining the workflow-engineered strength of Soarian with 3M's comprehensive medical necessity content to provide our Soarian customers with a premier solution for their Medicare compliance challenges."

With access to 3M Medical Necessity Dictionaries within Soarian, Siemens customers will be able to validate medical necessity before service delivery by identifying charges that are not covered by Medicare. Correcting these issues prior to service delivery reduces payment rejections and denials, helps ensure compliance, and ultimately improves reimbursement for hospitals.

"3M has a long history of providing medical necessity intelligence for a wide range of health care applications - from scheduling, registration and billing, all the way to CPOE," said Nancy Larson, division vice president, 3M Health Information Systems Division. "The Siemens initiative will enable a wide range of users to leverage our content in innovative ways through Soarian's integrated workflow."

3M currently maintains coding and compliance content covering all 50 states and encompassing more than 96 million data elements. 3M Medical Necessity Dictionaries contain comprehensive tables of thousands of CPT/HCPCS procedure codes, as well as supporting ICD-9 diagnostic codes and modifiers. Standard content also includes Local Medical Review Policies (LMRPs), which are updated monthly, as well as National Coverage Decisions (NCDs), and Local Coverage Decisions (LCDs).

Soarian is Siemens' new generation, workflow-engineered health information solution that integrates clinical, financial, diagnostic and administrative processes to support patient-centered care. The solution is distinguished by three innovative characteristics: it is workflow-engineered to synchronize processes across the health enterprise; its smart user interface is designed to accommodate tasks based on the roles of individual users; and its embedded analytics that empower users to proactively monitor and measure an enterprise's performance, and then act on those conclusions.

The 3M Medical Necessity Dictionaries and 3M Medical Necessity Online were originally developed and marketed by Info-X Inc., a provider of Web-based coding compliance tools for hospitals and physician groups. 3M Health Information Systems announced the acquisition of Info-X on Aug. 2, 2004.

Omni Medical Holdings, Inc. (OTCBB:ONMH), a national provider of turn key back office solutions for medical practitioners and facilities, announced today that it is has engaged Westminster Securities Corporation as its financial advisor.

Omni CEO Arthur Lyons said, "We believe Westminster's involvement will add a new dimension to our corporate growth and long term success, especially with regard to corporate development, capital structure, acquisitions, and strategic partnerships."

About Omni Medical Holdings Inc.

Omni Medical Holdings, Inc. and its' subsidiaries provide a complete line of integrated back-office products for physicians and hospitals, including GE Centricity and Misys practice management and electronic medical records solutions, web based decision support reporting tools, data warehousing, disease management benchmarking, as well as medical billing and medical transcription services. Our ASP hosted products are designed to maximize practice performance by identifying ancillary revenue enhancement and cost savings opportunities, while eliminating the upfront costs and ongoing expense of owning, upgrading, staffing and maintaining multiple in-house operations and reporting systems.

About Westminster Securities Corporation:

Westminster Securities Corporation is a full service brokerage firm operating in five principal areas: Investment Banking, Research, Retail & Institutional Account Management, Execution Services, and Clearing and Operations. Founded in 1971, Westminster is a member of the New York Stock Exchange, National Association of Securities Dealers, and the Securities Investor Protection Corporation. Westminster is headquartered at 100 Wall Street, New York with branch offices in Atlanta, Cyprus, Miami, Shanghai, St. Louis, and Toronto.

FORWARD LOOKING STATEMENT:

Certain statements contained herein may constitute forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, 21E of the Exchange Act of 1934 and/or the Private Securities Litigation Reform Act of 1995. Such statements include, without limitation, statements regarding business plans, future regulatory environment and approval and the Company's ability to comply with the rules and policies of independent regulatory agencies. Although the Company believes the statements contained herein to be accurate as of the date they were made, it can give no assurance that such expectations will prove to be correct. The Company undertakes no obligation to update these forward-looking statements.

The New York Institute of Technology School of Allied Health and Life Sciences has been renamed the School of Health Professions, Behavioral and Life Sciences.

The new name represents a more contemporary view of the health professions, said Dr. Barbara Ross-Lee, NYIT's vice president for health science and medical affairs. It further supports the concept of the health care team where every member's expertise is valued through the unique perspective that they bring to the comprehensive and holistic care of patients.

The moniker was approved in a NYIT faculty vote and by NYIT President Edward Guiliano.

Courses for the school, which has more than 900 students studying for undergraduate and graduate degrees in everything from nursing to nutrition, are offered through NYIT's Manhattan, Old Westbury and Central Islip campuses.

They include classes in nursing, occupational therapy, psychology, physical therapy, physician assistant studies, nutrition science, behavioral sciences, biology, biomedical engineering, biomedical engineering technology, chemistry, clinical nutrition, criminal justice and life sciences.

Fonar drums up interest at radiology expo

MRI equipment maker Fonar Corp. took its show on the road last week, attracting a flurry of interest as it set up a Stand-Up MRI at the annual meeting and exhibit held by the Radiological Society of North American in Chicago.

The company, which said it hoped the interest would translate into sales, invited visitors to take a ride by sitting, standing or lying down in the device that Fonar is billing as a more effective and comfortable alternative to the traditional MRI.

Fonar also let people watch a video on a 42-inch flat screen TV that comes with the unit.

The Melville-based company is touting its device as a breakthrough in medical imaging, since it allows scans to be done while patients are in the positions where they experience pain or symptoms.

Conventional MRIs scan people lying down, which Fonar said lacks the flexibility to measure results that its Stand-Up MRI affords.

The Nov. 30-Dec. 4 meeting, which attracts about 60,000 radiologists, physicians and other medical professionals, is considered among the world's foremost showcases for medical imaging technology.

Judging from the unusually high volume of visitors we had at the exhibit, it's clear that the medical community is beginning to understand and appreciate the tremendous importance of upright imaging, Fonar CEO Dr. Raymond Damadian said.

Fonar has sold 59 Stand-UP MRI devices, but Damadian said he's hopeful that interest at the show will translate into sales for the firm the following year.

The traffic we enjoyed at the show is important to Fonar, Damadian said, because this level of end-of-year interest promises vigorous sales activity in 2004.

Radiologists Dr. J. Randy Jinkins of Downstate Medical Center in New York and Professor Francis W. Smith of the University of Aberdeen in Scotland gave presentations at the show on the benefits of using Fonar's flexible version of the MRI.

Southampton bows out of after-hours clinic

Southampton Hospital is ending its role as manager of the Pantigo Primary Care Center, an after-hours clinic in East Hampton, and turning over management to the doctor who has been at the clinic since it opened a little more than a year ago.

The hospital said the clinic's hours, services and location will remain the same once Dr. George Dempsey begins to run the clinic in January. Dempsey already served as the sole physician.

The Pantigo clinic, open weekdays from 4 p.m. to 8 p.m. and 8 a.m. to 6 p.m. on Saturday, is located in Suite F of the East Hampton Healthcare Center.

The center was established with a grant from the New York State Department of Health and support from the East Hampton Healthcare Foundation to provide after-hours medical care.

The service is now well enough established to thrive on its own, said Southampton Hospital CEO Annette B. Leahy.

She said that the clinic receives about 300 visits from patients each month.

Southampton Hospital, Leahy added, will continue to provide laboratory, X-ray and mammography services at the East Hampton Healthcare Center, which also houses 11 medical practices and a pharmacy.

LOS ALTOS, Calif. & MINNEAPOLIS -- ScImage, a leading enterprise PACS and information management company, based in Los Altos, California, and ProVation Medical, developer of procedure documentation and coding software, announced today that they have entered into a co-marketing agreement. The Minneapolis-based software provider will offer ScImage's PicomEnterprise(R) to its current and future Cardiology customers; in turn, ScImage will offer ProVation MD Software for Cardiology documentation and coding compliance to its customers.

ScImage's PicomEnterprise solution is a single database, single archive imaging solution for multiple departments that can capture both DICOM images and non-DICOM objects for any subspecialty in the healthcare enterprise. In addition to being an enterprise-wide, web-based solution, PicomEnterprise has department-specific analysis and workflow tools.

ProVation MD software eliminates dictation and transcription, allowing clinicians to create and finalize procedure notes in minutes - complete with the appropriate ICD/CPT/ CCI Edit codes for proper reimbursement, compliance and faster payment. The software's unique DocuDiagram feature provides a graphical method for documenting cardiac function and findings data that automatically generates the medical content and coding of the note.

"The strength of PicomEnterprise and ProVation MD integrated together is a powerful combination," stated ScImage Founder and CEO, Sai P. Raya, Ph.D. "We're looking forward to a very successful relationship."

"ProVation is committed to forming strategic partnerships with companies whose products complement our systems and offer additional value to our Cardiology customers, and we are pleased to enter into this co-marketing agreement with ScImage," said Mark Wagner, chief executive officer, ProVation Medical. "Together, ProVation and ScImage offer a multi-departmental PACS with streamlined, efficient procedure documentation and coding."

About ProVation Medical, Inc.

ProVation Medical, Inc. (Minneapolis, MN), a leading healthcare software and services company, provides solutions that significantly enhance revenue and decrease costs per medical procedure. Hospitals and Ambulatory Surgery Centers that use ProVation Medical software (1) improve their coding accuracy resulting in a 5-25 percent improvement in reimbursement for their medical procedures, (2) eliminate transcription costs, and (3) consolidate and simplify all the major financial, clinical and administrative tasks that accompany each procedure.

ProVation MD/RN software replaces inefficient dictation/transcription processes, producing complete, billing-ready, image- and diagram-enhanced documentation for multi-specialty clinical procedures. Through an innovative "Anticipatory Interface(R)", the software links deep medical content designed by ProVation's in-house 12-member physician and coding staff to compliant CPT/ICD/CCI-edit reimbursement codes, producing a comprehensive operative note. The result is coder-ready documentation delivering compliance, proper reimbursement, and shortened days in Accounts Receivable with an ROI ranging from 25-200% and payback within 12-20 months.

TOPIC. The research, planning, implementation, and evaluation of school-based mental health clinics located throughout a large metropolitan city, which were established in a joint project by four local mental health centers.

PURPOSE. To explain the evolution of the idea of providing school-based mental health to a large, inner-city population, including the delineation of team roles and responsibilities.

SOURCES. Nursing, medical, social work, and educational literature. Notes detailing the formation of InteCare, the school-based mental health clinic system.

CONCLUSIONS. Providing mental health services in inner-city schools improves access and removes barriers to treatment for this population. Working collegially with school personnel and families significantly improves the academic function of the children, the functioning of the families, and the relationships between parents and schools.

Search terms: Collaborative project, inner-city psychiatric population, school-based mental health centers

Studies show that the majority of inner-city children could benefit from mental health services, yet fewer than one third of those children needing mental health services receives adequate treatment (U.S. Department of Health and Human Services, 1999). School-based programs "not only minimize the stigma of seeking care, but also avoid financial, transportation, and other barriers, as well as long waiting lists and long intake procedures" (Lamberg, 1998, p. 5).

Violence in the schools is both a traumatic event for students and staff and a reflection of the poverty, violence, and unmet mental health needs of the community. Children who frequently experience violence and crime in their communities and schools accurately feel that adults do not protect them. They often become depressed and anxious, and may suffer from post-traumatic stress disorder. They may begin carrying weapons to school to protect themselves from perceived threats.

The U.S. Department of Education (USDE, 2001) reports that for 1999,2.5 million 12- to 18-year-olds were victims of crimes at school. Of these crimes, 186,000 were serious violent crimes such as rape, sexual assault, robbery, and aggravated assault. During this period, 1.7 million teachers were victims of nonfatal crimes in schools, of which 635,000 were violent crimes such as rape, sexual assault, robbery, or aggravated or simple assault (Kostinsky, Bixler, & Kettle, 2001). Unfortunately, statistics for elementary school violence is not available. Seven percent of high school students admitted to carrying a weapon at school (USDE).

School systems are becoming more aware of the link between violence and unmet mental health needs of their students and families. The Indianapolis Public School System identified increased mental health services as one of the top five goals in its system's 5-year long-range plan. In response to this, the four local mental health centers collaborated in a joint project to establish school-based mental health centers in many of the public schools. An effort was made to eliminate as many barriers to service as possible. After 4 years of operation, there are now school-based mental health centers in 54 of the district's 76 schools. This article addresses details in the research, planning, implementation, and evaluation of this program. Practical matters such as funding, billing, establishing relationships, team roles, and challenges encountered are discussed, and a strength-based model is presented. And, finally, we share what we have learned throughout this process, as well as the difficulties encountered in obtaining outcome data.

How We Got Started

Building a Coalition

InteCare was created as a nonprofit corporation formed through an affiliation among the four Indianapolis mental health centers: Adult and Child, Behavior Corp, Gallahue, and Midtown. Program development focused on a collaborative effort among the four InteCare providers and the Indianapolis Public School System (IPS). InteCare's mission is to manage a comprehensive, integrated, nonprofit behavioral healthcare system that is customer driven, demonstrates high quality, is community based, and assures the provision of services to individuals and their families regardless of their source of payment or resources for payment. Many of the specifics of the collaboration are contained in agreements, signed annually, between the mental health centers and the school system. The schools agree to provide space, furniture, and a telephone. The providers agree to provide staff and all supplies needed to deliver mental health services. Medical records are maintained and remain the property of the InteCare provider. Confidentiality is maintained, and communication to school personnel is with appropriate consent from the parent(s) or guardian.

Establishing Funding

The school-based clinics arose out of a shared vision by the clinical leaders of the child/adolescent teams of the four local mental health centers. Each of the respective managers felt strongly that providing mental health services to our inner-city children was the right thing to do, and committed to providing services. No grant money was available, thus program development became, in many ways, a leap of faith for all parties involved. Fortunately, the IPS system, through research and work in the Bridges to Success Program, had established the need for mental health services and was eager to contract for services.

MINNEAPOLIS -- ProVation(R) Medical, Inc. today announced that it has formed the ProVation Nursing Council, a highly esteemed multi-specialty group of Hospital and Ambulatory Surgery Center (ASC) professionals dedicated to advancing clinical care and nursing informatics. The Nursing Council will provide input to enhance ProVation MD(R), ProVation(R) RN and ProVation(TM) MultiCare procedure documentation software, and will address the technological, regulatory and care-related issues that most affect today's nursing professionals.

ProVation(R) MD software for multi-specialty procedure documentation and coding compliance replaces the current dictation/transcription approach and streamlines the coding and billing process. Driven by deep medical content, ProVation MD allows clinicians to quickly and completely document medical procedures and apply the appropriate CPT and ICD codes, as well as CCI edits. ProVation RN software for nursing documentation provides complete nursing notes configurable to the unique reporting needs of each medical facility.

ProVation(TM) MultiCare software delivers multispecialty perioperative documentation, streamlining workflow by intelligently reusing data at various points while automatically retrieving data from multiple IT systems. The software is slated for release to the ASC market at the end of this year.

"ProVation Medical is privileged to have such an esteemed group of professionals on our Nursing Council," said Mark Wagner, Chief Executive Officer, ProVation Medical, Inc. "Their range of expertise encompasses the entire continuum of care and provides us with the kind of broad-based experience that is crucial to our offering. They have put our products to the test and continue to guide us as we progress."

"Sharing best practices in nursing informatics allows us to better harness technology to improve documentation, efficiency and patient care," said Stephanie Diem, RN, Clinical Director of Philadelphia's Washington Endoscopy Center. "I know firsthand the positive impact that ProVation's software has on procedure documentation and coding, and I am excited to serve as a member of the company's Nursing Council."

About ProVation Medical, Inc.

ProVation Medical, Inc. (Minneapolis, MN), a leading healthcare software and services company, provides solutions that significantly enhance revenue and decrease costs per medical procedure. Hospitals and Ambulatory Surgery Centers that use ProVation Medical software (1) improve their coding accuracy resulting in a 5-25 percent improvement in reimbursement for their medical procedures, (2) eliminate transcription costs, and (3) consolidate and simplify all the major financial, clinical and administrative tasks that accompany each procedure.

ProVation MD/RN software replaces inefficient dictation/transcription processes, producing complete, billing-ready, image- and diagram-enhanced documentation for multi-specialty clinical procedures. Through an innovative "Anticipatory Interface(R)", the software links deep medical content designed by ProVation's in-house 12-member physician and coding staff to compliant CPT/ICD/CCI-edit reimbursement codes, producing a comprehensive operative note. The result is coder-ready documentation delivering compliance, proper reimbursement, and shortened days in Accounts Receivable with an ROI ranging from 25-200% and payback within 12-20 months.

"Are all patients in clinical trials identified as such at registration?"

"After a sponsored study, what is done with any residual funds?"

"Do we know when physicians are using non-Medicare-approved devices?"

"Do we know who discloses protected health information and to whom?"

Compliance questions such as these may be lurking around any corner. And these questions are not just for the compliance officer; most are directly related to the financial well-being of the organization.

Today nine out of 10 U.S. healthcare providers have an organized corporate compliance program that is an integral part of daily operations. (a) Its purpose is to ensure that the organization is aware of and follows all the applicable laws and regulations, from antitrust to zoning. In an industry as heavily regulated as ours, compliance can be an awesome responsibility.

The compliance department deals with such issues as discharge disposition, consolidated billing of skilled nursing facilities, allegations of violations of human resources policy, audits of inpatient billing, supervision of residents in teaching programs, distribution of advance beneficiary notices for Medicare patients, billing for investigational devices, privacy and security concerns under HIPAA, and myriad other questions. To do this, the compliance officer calls on people throughout the organization for their input and assistance in improving polices and processes.

Some of a compliance officer's most important allies are in the finance department: the CFO and those who report to him or her, particularly the persons responsible for the patient-billing process. Experience has shown that compliance audits often uncover missed revenue opportunities that, when corrected, can improve the facility's bottom line. For example, one compliance audit discovered that due to an error in the facility's charge description master (CDM), the charge for pacemakers did not appear on the final bill. In one year alone, correction of this error resulted in more than $i million of additional revenue. Of course, compliance efforts sometimes disclose instances of erroneous billing that require refunds to the payer; however, the consensus in the industry is that hospitals and physicians underbill more often than they overbill.

Aside from monitoring the accuracy of bills, what major issues should readers be concerned with in this age of increased compliance awareness? Following are some of the issues that keep this compliance officer awake at night.

Clinical Research Compliance

Clinical research is a multibillion-dollar industry. The federal government spends about $3o billion on biomedical research, and the pharmaceutical industry spends more than that on research and development of new drugs. More than 16,000 clinical trials are conducted each year, involving millions of patients. Many finance and compliance issues can arise in clinical research, and financial managers need to be aware of what they are. Here are some questions to ask.

"After a sponsored study; what is done with residual funds (funds that are left over after all costs of the study have been paid)?" The answer may depend on the contract with the study's sponsor, but residual funds generally can be used for further research or for a mission-related purpose. They cannot inure to the principal investigator's benefit. Not managed properly, residual funds can cause compliance issues such as unrelated business income tax, private inurement, and conflict of interest.

"Why are there residuals in the first place?" The existence of residual funds may indicate that services were not billed to the research account at all, were billed but were not paid, or were billed inappropriately to another payer.

"Does the budget cover the full cost of performing the trial?" Many organizations consider the amount the sponsor is willing to pay for each patient and then back into a budget. This approach often does not cover administrative costs, staff time, overhead, and other legitimate costs to the organization. Once a budget that estimates all the institution's costs has been prepared, a committee in the facility should review the trial solely from a financial perspective. If a shortfall will occur, the committee can decide whether to renegotiate with the sponsor or take the loss because of the benefit to science, the organization's reputation, or other factors. If the funding is excessive, management needs to address the compliance issues mentioned earlier.

"Are all patients in clinical trials identified as such at registration?" The answer is usually "no" because not all patients in trials know at the time of registration that they will be enrolled. Even those who do know are not always properly identified as such. Identifying research patients is important to ensure that the proper account is charged for the trial-related services. Treatments that would be given to patients whether or not they are enrolled in the trial (that is, services that are considered "standard of care") must be billed to the patient's insurance, not the sponsor's account. (Note: According to Medicare's national coverage decisions, in a "qualified" trial, Medicare will pay for standard therapies that would have been provided in the absence of the trial. These procedures must be separated from those that are trial-related and must be billed separately. As a result, clinical personnel who enter charges need to be educated about the billing distinction, often a difficult proposition.)

FAYETTEVILLE--North Medical PC announced the opening of The Women's Place at Northeast Medical Center recently, billing it as "the area's first totally comprehensive women's wellness center." (Another such center, Choices, has since opened at Medical Center West.)

The Women's Place offers healthcare services to women and girls of all ages. The multi-specialty practice allows them access to a family physician, internist, gynecologist, and preventive medicine in one location. The 10,000-sq.-ft. center, developed by Susan Merola McConn, M.D. and A. John Merola, M.D., is located on the first floor of the Northeast Medical Center.

The practice's director, Merola-McConn, says The Women's Place is "solidly focused on providing access to quality care for a woman's body, mind, and spirit." She explains that today's lifestyles dictate the need to provide women access to healthcare that is convenient and encompasses the needs of the total woman.

"Women require primary and gynecological care," adds Merola-McConn, "but are equally troubled by other health concerns such as cardiac stress, incontinence, menopause management, and osteoporosis, to name just a few."

To meet these needs, The Women's Place offers such diagnostic exams as Pap smears, mammography, bone-density analysis, general X-ray, cardiac-stress testing, flexible sigmoidoscopy, minor surgical procedures, as well as routine physicals and preventive care. Services are provided for birth control, exercise prescriptions, hearing tests, hormone problems, infertility, immunizations, laparoscopy, pre-menstrual syndrome, smoking cessation, ultrasound, hyperlipidemia management, and other women's health needs.

In addition, patients of The Women's Place have access to care 24 hours a day, every day of the year, through Northeast Medical Urgent Care, which is located in the same building. "And as part of North Medical PC," says Merola-McConn, "medical records can be accessed by the attending urgent-care physician through the practice's shared, state-of-the-art medical-records system," which enables vital access to the patient's medical history during an urgent situation.

Source Medical Solutions, a leading provider of outpatient information management solutions, today announced that year-to-date sales of its ambulatory surgery center (ASC) information management system have topped 184. The new orders bring Source Medical's national ASC customer base to over 1,700 ASCs, further extending the company's market leadership position.

Source Medical's ASC information management systems are specifically designed for the unique needs of the highly specialized ambulatory surgery marketplace. The company's suite of ASC solutions includes a comprehensive ASC application, an integrated practice management and electronic health records (EHR) system and a specialized surgical hospital information management system. Its solutions enable ASCs to automate and improve administrative and clinical processes enterprise-wide, from scheduling, registration, clinical documentation and inventory management, to billing, collections and revenue cycle management.

"We're pleased that ASCs continue to choose Source Medical's applications to help manage their overall enterprise. We strive to continually enhance our products and services to meet the changing needs of the ASC marketplace. The number of signings year-to-date illustrates the market's acceptance and continuing preference for our solutions," said Ralph Riccardi, Source Medical executive vice president and chief operating officer.

About Source Medical Solutions

Source Medical provides outpatient information solutions and services for ambulatory surgery centers, rehabilitation clinics and diagnostic imaging centers nationwide. With a 20-year track record and more than 3,300 satisfied customers, Source Medical is the trusted source for innovative applications, in-depth industry expertise and unsurpassed customer service. The company's unique, end-to-end systems improve operational efficiency and cash flow while enabling healthcare facilities to deliver a higher standard of patient care.

Omni Medical Holdings, Inc. (OTCBB:ONMH), a national provider of turn key back office solutions for medical practitioners and facilities, announced today that it is has executed a 1 for 4 reverse split effective November 4, 2005. Omni also announced a relocation of its corporate headquarters from Rapid City, SD to Colorado Springs, CO.

Omni CEO Arthur Lyons said, "We believe this reverse split is in the overall best interest of the company, as we seek to add shareholder value. Due to this reverse split, Omni has determined that it will abandon the Preliminary 14C Information Statement respecting an increase in our authorized shares. Additionally, the move to Colorado now puts us in closer proximity to our DataFuzion subsidiary and other members of our management team."

About Omni Medical Holdings Inc.

Omni Medical Holdings, Inc. and its' subsidiaries provide a complete line of integrated back-office products for physicians and hospitals, including GE Centricity and Misys practice management and electronic medical records solutions, web based decision support reporting tools, data warehousing, disease management benchmarking, as well as medical billing and medical transcription services. Our ASP hosted products are designed to maximize practice performance by identifying ancillary revenue enhancement and cost savings opportunities, while eliminating the upfront costs and ongoing expense of owning, upgrading, staffing and maintaining multiple in-house operations and reporting systems.

Certain statements contained herein may constitute forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, 21E of the Exchange Act of 1934 and/or the Private Securities Litigation Reform Act of 1995. Such statements include, without limitation, statements regarding business plans, future regulatory environment and approval and the Company's ability to comply with the rules and policies of independent regulatory agencies. Although the Company believes the statements contained herein to be accurate as of the date they were made, it can give no assurance that such expectations will prove to be correct. The Company undertakes no obligation to update these forward-looking statements.

Marratech(R), a leading global developer of Web collaboration solutions, has announced that the Nova Medical Group (NMG) has selected its Marratech Manager Web collaboration application to help its doctors improve communications and connections with its patients even while working from home and to save valuable time for staff to develop their skills.

"We have multiple locations to tend and Marratech Manager allows me to connect with people at any of them without the delay associated with driving time," said Grace L Keenan, M.D., medical director and owner of Nova Medical Group. "It has also allowed me to be at home more, which is important for maintaining a good work/family balance. The system is definitely becoming a part of how we work here at NMG on a daily basis."

The Group, which has offices in Ashburn, VA; Leesburg, VA; and Warrenton, VA, employs 175 people. In addition to allowing for remote communications, Marratech's solution has streamlined employee training. The medical practice records its meetings to allow anyone who has missed a session to review a video of what transpired in the meeting. The system also allows the medical group to provide training and instruction on compliance, coding, documentation and more to employees.

The medical practice began using Marratech Manager when it was invited to be part of a pilot program sponsored by the Telework Consortium. The consortium wanted to explore the potential uses of the virtual office, with virtual meeting rooms, and Web-based collaboration tools in medical applications.

"Marratech Manager can streamline the way things are done in a medical office and allow doctors to focus more on their patients as well as provide the flexibility to do a certain amount of consultation from home in order to maintain that healthy balance," said Lars Persson, CEO of Marratech. "We are encouraged by the ways that the Nova Medical Group is using Marratech Manager, as well as by the innovative uses that the group envisions."

In its initial rollout of Marratech Manager, the Nova Medical Group has trained team leaders and managers on the system. Marratech Manager provides all of the necessary tools to create a Web-based conference, including high-quality voice communications, live video, messaging, application sharing and an interactive whiteboard. The state-of-the-art video conferencing capabilities that Marratech Manager offers requires only the use of simple client software, as well as a Web cam and headset, on the users Windows, Macintosh or Linux system. Meeting attendees can see and speak to each other, and share documents and applications interactively in order to exchange ideas and work together. The software provides a secure connection over the Internet via any broadband connection.

However, as Nova employees get more familiar with using the system, the medical group anticipates many other potential applications. For example, as the practice grows and with office space at a premium, Keenan anticipates that some staff responsible for billing and bookkeeping might be able to work at home. "We have used up a lot of our space in this facility, so working at home would be the next best option for our operation," said Keenan.

The doctor also envisions an executive wellness program which would bring busy executives into the office for a comprehensive medical exam over two days, but would give them the option of having the results reviewed over the Web collaboration system. "There's definitely a role for this type of solution in clinical care, but we haven't implemented it just yet," said Keenan, adding that elderly and infirm individuals might benefit from a consultation over the system to gauge whether an office visit is truly necessary and should be scheduled.