Q: We were told that programs are better and “cutting edge” when they’re “DOT NET” and that any program that doesn’t use .NET is antiquated. What does this mean? Is it true? Should I care?

A: Actually, every version of Windows – including Vista & Windows 7, along with Microsoft Office, Adobe Acrobat & Photoshop, Intuit Quicken and QuickBooks, are written in… drum roll please… C++. No “.NET” anywhere to be seen. Even .NET itself is written in C++ and C#. In fact, worldwide, whether you’re using a cell phone, a PDA, a Mac (.NET doesn’t run on Macs), or a Windows machine, most of the commercial software you interact with is written in C++.

.NET is great for rapid development. Performance however, is another matter. Rather than get technical, I’ll simply send you back to the above paragraph.

If .NET is the wave of the future… why don’t all the market leading companies mentioned above use it for their apps? It’s been out for years now. Maybe Microsoft can’t afford to rewrite its own technologies? Oops. They developed .NET.

You don’t need to have degrees in Computer Science like I do to recognize when someone is telling a whopper. By the way, you can Google all the above information for yourself. It’s not a secret.

From a technical standpoint, .NET programmers are working with a “wrapper” that makes programming easier, but adds an additional layer of computer code… for everything. Their gain (easier to write) is your loss (performance hits).

The real question is should you care?

Probably not. However, when peak performance is a requirement, go back to paragraph 1. And by the way, if you hit the sales people over the head with this information and they start talking about SQL… Microsoft’s SQL engine is written in C++ too. At this point, I’m sure that comes as quite a surprise.

Q: How can I tell if a company is truly HIPAA compliant? Sometimes it’s hard to tell what to believe…

A: Ask questions.

First, HIPAA compliant electronic billing means the company can generate ANSI 837 billing files and read ANSI 835 remittance files. Many companies are unable to generate 837 files directly. Instead, they send what’s commonly known as “print capture” files to a third party who converts them.

Is this bad? No. However, it’s likely that fees will be involved. More important, it tells you that your vendor doesn’t have the capability to handle one of the most important aspects of HIPAA internally. That’s potentially scary.

You must be able to generate a report detailing who accessed a patient’s file, what they may have viewed, whether changes were made, information was printed, etc. The ability to directly import 835 files and apply payments isn’t just important for HIPAA. It’s important for secondary billing. If you bill electronically, you need information from the 835 files to bill secondary carriers.

Q: All through 2009, experts at seminars I attended told me that I needed to run and buy CCHIT certified EMR software. Then, software vendors said I would get back $44,000 from the government to cover my costs. Is this true? And how do I know if someone is an expert?

A: On December 31, 2009, DHHS finally released the 556 page document describing a proposed rule for the EHR incentive program.

As I explained to any of you who were listening in 2009, it’s not that simple. Much of the information you were provided in 2009 was at best misinformed.

© 2010 Mike Norworth

About the Author

With degrees in Biology & Chemistry, graduate degrees in Computer Science and over 25 years of experience in health care, Mike is the chief architect of ECLIPSE® Practice Management Software. He also has extensive experience with audits & computer forensics investigations at the local, state, and federal level. Finally, he has advised health care providers, equipment manufacturers, corporations and management consultants for over two decades with regard to business practices, operations and technical issues.