The Future of Healthcare Depends on Partnerships

This tweet from Estrella Jaramillo (See her @HelloBwom app) quoting the incomparable Rasu Shrestha (@RasuShrestha) really stuck with me when I read it. I agree 100% with the concept that partnerships will determine the destiny of most healthcare organizations. It’s very clear that one organization is not going to be able to do everything they have to do in healthcare.

What scares me about this idea is that many healthcare organizations aren’t embracing it. Many healthcare organization and even their partner health IT companies don’t embrace the idea of partnerships. Instead, they think they can build everything themselves. They sincerely believe that a single source system is the best thing for the future of healthcare.

This type of arrogant attitude is going to leave these organizations behind. In the short term, a single source system is better. However, once the community starts innovating and integrating, these single source systems start to fall behind and fall behind quickly.

I’m reminded of a popular African proverb (at least I think that’s the source) that Dr. Nick shared on Facebook recently “If you want to go fast, go alone. If you want to go further, go together.” Too many in healthcare are playing the short game. That’s going to eventually catch up to them.

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Cerner Tops List Of Hospital Vendors For Medicare EHR Incentive Program

Research from the ONC concludes that Cerner systems are in use by the most hospitals using certified technology to participate in the Medicare EHR Incentive Program. It’s interesting to note that this list includes players that rarely appear on overall lists of top hospital EHR vendors, though admittedly, there’s no one way to measure market dominance that produces consistent results every time.

According to ONC statistics, there were 175 vendors supplying certified health IT to 4,474 nonfederal acute-care hospitals participating in the Medicare EHR Incentive Program. Ninety-five percent of these vendors have 2014 certified technology.

The report notes that six of these vendors (Cerner, Meditech, Epic, Evident, Medhost and McKesson) provide 2014 certified technology 92% of hospitals using the technology. When you throw in athenahealth, Prognosis and QuadraMed, bringing the list to 10 vendors, you’ve got a group that supplies 2014 technology to 98% of eligible hospitals.

According to the data, the vendors at the top fall in as follows. Cerner tops the list of total hospitals using its certified health IT, with 1,029 hospitals;  Meditech was next with 953 hospitals; Epic came in third with 869 hospitals; CPSI’s Evident (formerly Healthland) was fourth with 637 hospitals; McKesson fifth with 462 hospitals; and Medhost sixth with 359 hospitals.

As is usually the case with any attempt to look at market share, the data comes with its own quirks. For example, when looking at ONC’s data as of July 2016 on ambulatory healthcare providers choice of certified technology, Epic was way ahead of the pack with 83,674 users. Allscripts came in at a distant second with 33,123 users. Cerner came in sixth with 15,100 ambulatory users. In other words, vendors one might class as “enterprise” focused are doing well among clinicians. (See more data along these lines in a Medscape survey I summarized previously.)

Then consider data from HIMSS Analytics, which concludes that Epic has 40% of the hospital health IT market, followed by Cerner at a distant second with 13%, Allscripts at 10%, Meditech at 7% and eClinicalWorks at 5% and NextGen with 4%. Why the big difference in numbers? It seems that HIMSS Analytics includes the size of the hospital in its calculations versus the ONC data above which talks about the number of hospitals.

No doubt the buying patterns vary when you look at the number of beds a hospital has. For example, according to research done last year by peer60, CPSI and eClinicalWorks held the biggest share of the market among facilities with less than 100 beds, MEDITECH, McKesson and Siemens dominated the mid-sized hospital categories, and as the number of beds rises from 250 to 1000+ plus, Cerner and Epic emerge as the top players.

The truth is, market share numbers are interesting, and not just to the vendors who hope to emerge on top. Everyone loves a good horse race, after all. But it’s good to take these numbers with a large dose of context, or they mean very little.

Posted in Hospital EHR, Hospital EHR Company, Hospital EHR Vendor, Hospital Electronic Health Record, Hospital Electronic Medical Record, Hospital EMR, Hospital EMR Company, Hospital EMR Vendor, Hospital Healthcare IT, Mid-Size Hospitals | Tagged , , , , , , , , , , | Comments Off on Cerner Tops List Of Hospital Vendors For Medicare EHR Incentive Program

Find Out if 2016 Exclusions and Alternate Exclusions Apply to You

National Health IT Week is September 26-30, 2016. CMS is sharing guidance throughout the week to help providers and industry members participate successfully in ongoing CMS health IT initiatives. Stay tuned all week for the latest news and updates from CMS.

To participate successfully in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs in 2016, providers must meet the thresholds of all required objectives and measures, or qualify for an exclusion and/or alternate exclusion. Providers who meet the qualifications for an exclusion and/or alternate exclusion will not need to report on that specific objective or measure.

Exclusions

Exclusions exempt you from having to meet specific objectives. If you meet the qualifications for an exclusion, then you will not have to report on that objective and will avoid a payment adjustment in future years.

  • Exclusions are not based on specialty.
  • Specialists must evaluate whether or not they meet the exclusion criteria for each objective.
  • There is no blanket exclusion for any type of eligible professional (EP).

Alternate Exclusions

The final rule released in October 2015 – which outlined requirements for the EHR Incentive Programs in 2015-2017 (Modified Stage 2) and Stage 3 in 2018 and beyond— included additional exclusions known as “alternate exclusions” for certain objectives and measures in 2015 and 2016.

These alternate exclusions are intended to assist providers in the early stages of meaningful use by:

  • Allowing providers to use a lower threshold for certain measures, or to exclude certain measures for which there is no Stage 1 equivalent;
  • Accommodating changes required for the transition to the Modified Stage 2 objectives and measures, especially potential changes to the implementation of certified EHR technology.

In 2016, alternate exclusions are available for the following objectives:

A. Computerized Provider Order Entry

  • Measure 2: Laboratory Orders
  • Measure 3: Radiology Orders

B. Electronic prescribing (Eligible hospitals only)

C. Public Health Reporting

  • Measure 2: Syndromic Surveillance Reporting (EPs)
  • Measure 3: Specialized Registry Reporting (EPs, and Eligible hospitals and CAHs)

Many of the alternate exclusions that were available in 2015 are not applicable in 2016.

Note: Providers may opt to use the alternate exclusions, but they are not required to use them. The registration and attestation system will automatically identify providers who are eligible for alternate exclusions.

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Mana Health Launches ManaCreate™ to Enable Agile and Efficient Commercialization of Healthcare IT Innovations

First Platform Targeted to Health System Innovation Groups to Spur Faster, More Cost Effective Innovation

NEW YORK, NY, September 27, 2016 — Mana Health, a leading technology provider for healthcare data access solutions, announced today the availability of ManaCreate, a technology and support solution designed to enable faster and more cost effective commercialization of healthcare innovation. Targeted to innovation and IT groups within health systems and hospitals, ManaCreate supports the process for testing and integration of new applications to support a more agile innovation process.

“A cardiologist envisions treating patients faster with the right data points and providing targeted content. She is certain that with this experience she can improve outcomes.  With ManaCreate™ and an efficient development team, she can expedite the design process, integrate all the right data, and move into deployment mode faster for the betterment of healthcare,” explained Chris Bradley, co-founder, Mana Health.

Bringing any new healthcare IT system to market generally requires the same basic process of developing a first phase of a workable product, conducting testing, going to live deployment – in a HIPAA Compliant environment, and ultimately creating a minimal viable product (MVP). This can not only be time consuming but costly, with the typical new integration can be $200,000 to upwards of $500,000.

ManaCreate successfully removes the barriers of data flow by instantly providing a test environment that is pre-loaded with test patients, with a well-documented API and developer support, and the ability to switch to live data at any time using the production level ManaCloud™ platform. Specific features of the ManaCreate service include the following:

  • Thousands of test patients’ worth of clinical data
  • Ability to import additional custom records from your facility
  • Developer-friendly API, support, and documentation portal
  • Seamless path to EHR integration and live deployment
  • HIPAA-compliant data management

“As developers ourselves, it’s a passion for us to help reduce the barriers to innovation in healthcare. We created a health IT sandbox that enables anyone – from innovation teams at health systems and pharma companies to healthcare accelerators – to test new digital health services without the heavy lifting of creating deep integrations at the outset,” said Bradley. “To allow innovation to flourish in healthcare, more flexible systems are needed for the ‘test and learn’ process, along with more robust data output, and this is exactly what ManaCreate™ provides,” said Bradley.

ManaCreate becomes the third pillar of data access solutions from Mana Health, which also include ManaCloud and ManaPortal patient portal.  The ManaCloud architecture is the foundation of ManaCreate, and Mana Portal, an award winning untethered meaningful use patient portal.

ManaCreate is commercially available and being sold throughout the U.S. For more information, visit www.manahealth.com/ManaCreate.

About Mana Health
Mana Health is a technology solutions company that enables streamlined data access in healthcare. Based in New York City, our solutions are deployed to major healthcare clients reaching hundreds of hospitals and millions of patients. Our passionate team has over 100 combined years of experience deploying software technology into large-scale enterprises in the healthcare, telecom, and government verticals. We are a member of the CommonWell Health Alliance and proud to be featured in publications such as HIT consultant, Health Data Management, Information Week, and more. To learn more about Mana Health, visit www.manahealth.com.

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InstaMed Announces $50 Million Investment From Carrick Capital Partners

Capital to Drive the Growth of the InstaMed Network

PHILADELPHIA, PA and NEWPORT BEACH, CA (September 26, 2016)– InstaMed, healthcare’s most trusted payments network, today announced a $50 million investment from Carrick Capital Partners, an investment firm jointly based in Newport Beach and San Francisco, CA that focuses on technology-enabled businesses including SaaS, BPO and Transaction Processing.

The investment will be used to drive the growth of the InstaMed Network, accelerate go-to-market strategy and drive further innovation in healthcare payments technology. InstaMed’s solutions enable providers and payers to manage all of their healthcare payments on a single platform, integrated into any healthcare IT system. As consumer healthcare payment responsibility continues to soar, InstaMed’s innovative solutions offer ways for providers and payers to address the demands of consumerism while maintaining the highest levels of security and compliance.

“We are very excited to be working with InstaMed President and CEO Bill Marvin and his team, who are revolutionizing healthcare payments by simplifying the experience for providers, payers and consumers,” said Jim Madden, Co-Founder and Managing Director of Carrick Capital Partners. “We identified InstaMed as part of our thematic sourcing efforts in healthcare technology and recognized the value of their unique single-technology platform, network effect business model and relentless focus on security and compliance,” he added.

Madden will join the InstaMed board of directors, and Chris Wenner, a Vice President at Carrick Capital Partners, will become an observer to the board of directors.

“We are thrilled to partner with Carrick Capital Partners and benefit from their deep experience in the healthcare marketplace,” said Bill Marvin, Co-Founder, President and CEO of InstaMed. “Carrick’s investment and experience will help drive the growth of the InstaMed Network and enhance the healthcare payment experience for providers, payers and consumers.”

Cowen and Company served as InstaMed’s sole financial advisor.

About InstaMed
InstaMed is healthcare’s most trusted payments network, connecting providers, payers and consumers on one platform. The InstaMed Network connects over two-thirds of the market and processes tens of billions of dollars in healthcare payments annually. InstaMed reduces the risks, costs and complexities of working with multiple payment vendors by delivering one platform for all forms of payment in healthcare, designed and developed on one code base and supported by one onshore team of experts in healthcare payments. InstaMed enables providers to collect more money from patients and payers while reducing the cost and time to collect. InstaMed allows payers to cut settlement and disbursement costs with electronic payments and facilitate consumerism for their members. Visit InstaMed on the web at www.instamed.com.
About Carrick Capital Partners
Headquartered in San Francisco and Newport Beach, Carrick Capital Partners is a growth-oriented investment firm that utilizes ABV (Approach to Building Value) to operationally scale fast-growing, technology-enabled businesses. Carrick adds value by taking a concentrated approach and dedicating significant resources post-investment. Leveraging decades of experience, Carrick helps scale great companies that deliver excellent returns for investors, stimulating economic growth and positively impacting the industry landscape. Working directly with CEOs and entrepreneurs, Carrick fulfills a vital need for investment capital and growth expertise.

 

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Nurses Have Love-Hate Relationship With EMRs

Data collected by a nursing degree program suggests that nurses have a love-hate relationship with EMRs, one which acknowledges many flaws but also suggests some degree of satisfaction.

The data, which was gathered by Adventist University of Health Sciences RN to BSN Online Program, offers a window into how nurses feel about hospital EMRs. And much of what they feel doesn’t reflect well on hospital EMRs.

For example, the graphic notes that in 2014, 92% of nurses were dissatisfied with EMR they had to use. Eighty-four percent said the EMR disrupted workflow and productivity, and 85% complained of “continually flawed” EMR systems. In other words, not only did they see their EMRs as flawed, they saw it as broken.

And these weren’t just vague expressions of discomfort. Ninety percent of nurses surveyed by the study said that EMR is negatively impacting interactions between nurses and patients, a fairly concerning claim. What’s more, 94% said that EMRs had failed to improve communication between nurses and doctors.

On top of everything else, a large percentage (88%) blamed high-ranking hospital administrators staff for selecting cheap systems. Isn’t it great to hear that EMR rollouts are alienating nurses as well as doctors? Just lovely.

On the other hand, surprisingly, 71% of nurses told a different study that they would not consider going back to paper-based medical records. Also, in other research, 72% agreed that EMRs help to improve patient safety and avoid medication errors, and 73% felt that EMR’s were enabling collaboration with other clinicians inside their organizations.

Looking at this collection of data, a few things stand out:

  • Generally speaking, nurses seem more comfortable with EMRs than physicians, more of whom seem to feel that EMR systems create obstacles to providing good care. But they’re frustrated nonetheless.
  • Too many nurses seem concerned that their EMR is glitchy technically. This should worry hospital administrators, because even if this perception is false, it’s a real problem if nurses believe that they can’t provide adequate care using the system.
  • Given that more than two-thirds of nurses responding to one study wouldn’t go back to paper, clearly some hospitals are doing things right (or at least paper was even worse than EHR).

Of course, nurses don’t develop ideas about EMRs in a vacuum. Hospitals can do a great deal to help nurses become comfortable with their new or upgraded EMR, such as enlisting the support of the chief nursing officer in any rollouts that take place and appointing nurses as EMR champions along with physicians. Not to mention ensuring appropriate training even after go-live.

Also, hospitals can do much to set appropriate expectations for EMR use. For example, I’d wager that few hospital IT leaders see EMRs as a particularly apt tool for supporting collaboration (though they might hope that it becomes so in the future). Being clear to nurses as to what they can realistically expect to do with an EMR — and what future features might be — makes it more likely that they’ll appreciate what the system can actually do. Like anybody else, if a nurse knows what they’re getting into with an EMR system, they are more likely to be on board.

Posted in Hospital EHR, Hospital Electronic Health Record, Hospital Electronic Medical Record, Hospital EMR, Hospital Healthcare IT | Tagged , , , | Comments Off on Nurses Have Love-Hate Relationship With EMRs

Getting the Team in an EHR State of Mind

Recently I had the opportunity to do something different, fun, and unexpected – I opened a team meeting with a music video.

I am currently leading an EHR implementation. Each month, I hold a meeting of the nearly 80 hospital staff members who are part of the project. The meetings combine sharing information about the project with each other, team building activities, and teaching them about change management, process improvement, and team dynamics techniques. I am always looking for a way to make each meeting interesting and memorable.

This month I wanted to initiate a good dialog in the meeting about a topic I wanted to address head-on: Why do Physicians Hate EHRs? And what are we, as a team, going to do about it to make our physicians love their EHR?

It reminded me of a great video crated by a physician right here in Las Vegas, ZDoggMD, whose videos I found through Healthcarescene.com. Viewing it again, it was indeed the perfect way to set the stage for this discussion. Fun, entertaining and such an accurate representation of how physicians feel about these applications.

The video itself got the team excited, motivated, and laughing – and led to one of the most engaging, productive, and thought-provoking conversations we have had on the project.

For the project leaders out there – I would recommend trying this type of technique with your teams.

For any physician or anyone else who has used an EHR and has not seen this music video, enjoy and share if it represents your point of view about EHR applications:

If you’d like to receive future posts by Brian in your inbox, you can subscribe to future Healthcare Optimization Scene posts here. Be sure to also read the archive of previous Healthcare Optimization Scene posts.

Posted in Healthcare CIO, Hospital CIO, Hospital EHR, Hospital Electronic Health Record, Hospital Electronic Medical Record, Hospital EMR, Hospital Healthcare IT | Tagged , , | Comments Off on Getting the Team in an EHR State of Mind

Growth of the Wearables Market Dominated by Healthcare

wearable-market-growth

This chart illustrates an incredible explosion in the wearables market and illustrates how it’s likely to continue to grow for years to come. The big takeaway for me is how healthcare totally dominates these graphs. The two biggest growth markets for wearable are “Healthcare” and “Sports/Activity Trackers.” Many would argue that Sports/Activity trackers should be included in healthcare. That’s amazing.

The only other wearable that gets reasonably close is the smart watches, but even those could be argued as healthcare devices as well. Sure, they do a lot more, but they all have some sort of health component to them as well.

I’m going to point to these graphs from now on when I talk about the impact of wearables on healthcare. Although, I guess I could also say that the wearables market is largely healthcare. I’m excited by this continued growth and I still think we’re just getting started on what will be possible. Watch out for wearables major impact on healthcare. I think it’s inevitable.

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Clinical System Replacement & Decommissioning: Migrate or Archive? – Tackling EHR & EMR Transition Series

clinical-system-complexity
(See Full Healthcare Data Archival Infographic)

A Maturing Healthcare IT Landscape
If 2010 was the year of EMR implementations and optimization driven by initiatives like Meaningful Use, the ARRA, and Obamacare, then 2015 might be known as the year that clinical application retirement became a prevalent topic for many mature healthcare organizations.

Application retirement is nothing new. Large organizations both inside and outside of healthcare have had application retirement strategies in place (typically doled out by expensive consulting companies with fancy matrices, methodologies, and graphs in tow) for a decade or more. Anytime an organization outlives a large IT system (or, in many cases, that system’s vendor), retirement becomes a pressing need. In the case of healthcare, the two largest driving factors forcing clinical application retirement are the consolidation of organizations into large integrated care delivery networks, and replacement of existing electronic healthcare record systems due to poor usability or inadequate functionality.

Migration and Archival – Not Migration Versus Archival
One question that often comes up early on in the process of clinical application retirement is whether it’s necessary at all if the data in these systems is also being migrated into a new EMR. Conversely, the question of whether the cost of a migration is worth it if the archival solution being considered supports some sort of continuity of care solution like seamless single sign on from the new EMR. In most cases, it turns out that the ideal approach is migration and archival.

Just Migrate?
The process of EMR data migration almost always results in some fairly fundamental alteration of the legacy EMR data. The data models used by different EMRs are typically quite different, and it’s not a matter of export/import. Instead, it’s a true ETL process – extract, transform, load.

The shape of the data is changed. Sometimes data types undergo conversions, such as a number to a string, which if done poorly can result in loss of precision. Data sets, such as order codes, result codes, diagnosis categories, note types, and various other types of dictionaries are mapped from the values in the legacy EMR to the values used by the new EMR. Fields that have no apparent corollary in the new EMR are often just dropped entirely. It’s frequently not possible to know for sure what the data actually looked like in the legacy system once this process is complete and the legacy system is actually retired.
legacy-ehr-archive
Not only that, but from a clinical perspective, it’s probably not useful to take 15 years of legacy data and load that directly into your new EMR. Most organizations opt for something more likely to be relevant, while still remaining safe; perhaps 3 to 5 years of data. While the state and federal requirements for archival are clear on how long you need to preserve data (from 6 years to forever, depending on a variety of factors), they aren’t nice enough to say that the data you need to preserve is limited to what’s usually currently clinically relevant. In other words, that 10-year-old test result is still, technically, part of the legal medical record.
legal-medical-record-and-continuity-of-care
Some EMR vendors will even outright limit the mechanisms for data import to something like a CCD (clinical continuity document) import, which inherently limits the scope and quantity of available data that can be preserved.

Just Archive?
Ok. You give up. Obviously a migration isn’t going to cover us, and if the archive has everything we need legally and clinically, let’s skip that time consuming and expensive migration and just archive. Well, you can do that, but just archiving means that your organization is abandoning millions of dollars of hard won documentation and all the automation and analytics that goes with that.

An EMR is a lot more than a place to store clinical documentation. Virtually all modern EMRs have substantial functionality surrounding clinical decision support, health maintenance planning, and quality reporting. They also often are crucial source of data for analytics suites that are the pillars of population health management. In short, not migrating this data means you should have just stuck with paper charts until your latest and greatest EMR was available.

It’s certainly possible to bring over data in a manual, piece meal fashion as patients are seen or based on some other reasonably predicable event whose workflow can be augmented. This will, eventually, patch up the gaps in data that not performing a migration results in. If your organization is willing to suffer the significant, but probably short to medium term repercussions of temporarily losing this data in your EMR and related operational data repositories, then migration might not be necessary.

Not All Archives Are Created Equal
Inside the world of data archival, there are nearly as many different types of archives as there are vendors. Many of the existing archival solutions that have gained popularity with large healthcare organizations are ones that are also frequently utilized by other sectors and often claim to be able to “archive anything”. This can be very appealing, as an organization going through a merger will often retire dozens or even hundreds of systems, some clinical, but most only tangentially related to the delivery of care. HR systems, general ledger financial systems, inventory management, time tracking, and CRMs are just a few of the systems that might also be slated for the chopping block. The idea of retiring all of these into a single logical archiving is very appealing, but this approach can be a dangerous one. The needs of healthcare are not necessarily the same as the needs of other sectors.

Some factors that make healthcare different include:

  • The highly complex data models used by electronic healthcare record systems.
  • The common need for specialized user interfaces to properly visualize the data.
  • The continuing need for clinicians to seamlessly access the archived data with minimal workflow interruption.
  • The incredible variety of source systems that are in need of archival.
  • The lack of data format standards to make it easy to determine what needs to be archived.
  • The need for HIPPA and HITECH compliance (think encryption and auditing).
  • The massive size of the data to be archived, the need to constantly add new sources of data to an existing archive as the organization expands.
  • The frequent need to rapidly produce specific subsets of archived data during an eDiscovery proceeding or other legal compliance scenarios.

Summary:

  • There must be a clear distinction made between “migrated” or “converted” data and archived data, as the drivers and considerations for each are different. Retiring a legacy application and housing the data in an archival solution has markedly different requirements than migrating data from an existing clinical application to another.
  • Retiring legacy systems typically do not necessitate changing the “shape” of the data to fit a particular model. A data archival solution facilitates legacy system retirement, providing a storage solution for clinical data archival in compliance with state and federal regulations for protected health information (PHI).
  • With EMR migration, data typically needs to be mapped and translated to facilitate proper import into the target system. This is critical for the clinical impact and workflow integration required to support a discrete clinical data migration.

Download the full archival whitepaper to evaluate available EMR data migration & EMR data archival options and processes critical to EMR replacement and legacy system decommissioning.

About Robert Downey
Robert is Vice President, Product Development, at Galen Healthcare Solutions. He has nearly 10 years of healthcare IT experience and over 20 years in Software Engineering. Robert is responsible for design and development of Galen’s products and supporting technology, including the VitalCenter Online Archival solution. He is an expert in healthcare IT and software development, as well as cloud based solutions delivery. Connect with Robert on LinkedIn.

About Galen Healthcare Solutions
Galen Healthcare Solutions is an award-winning, #1 in KLAS healthcare IT technical & professional services and solutions company providing high-skilled, cross-platform expertise and proud sponsor of the Tackling EHR & EMR Transition Series. For over a decade, Galen has partnered with more than 300 specialty practices, hospitals, health information exchanges, health systems and integrated delivery networks to provide high-quality, expert level IT consulting services including strategy, optimization, data migration, project management, and interoperability. Galen also delivers a suite of fully integrated products that enhance, automate, and simplify the access and use of clinical patient data within those systems to improve cost-efficiency and quality outcomes. For more information, visit www.galenhealthcare.com. Connect with us on Twitter, Facebook and LinkedIn.

Posted in Health Information Governance, Healthcare CIO, Healthcare ERP, Hospital EHR, Hospital Electronic Health Record, Hospital Electronic Medical Record, Hospital EMR | Tagged , , , , , , , , | Comments Off on Clinical System Replacement & Decommissioning: Migrate or Archive? – Tackling EHR & EMR Transition Series

Meaningful Use Has Done Its Job

While Meaningful Use has been challenging at times, the vast majority of hospitals seem to have stayed on top of things. In its new report on the IPPS negative payment adjustments for fiscal 2017, CMS said that 98% of eligible hospitals and critical access hospitals managed to avoid Medicare payment dialbacks for next year, because they successfully attested to stage 1 or stage 2 Meaningful Use compliance, according to EHR Intelligence.

CMS began making Medicare payment adjustments on October 1, 2014 for eligible hospitals, of which there are more than 4,800 in the United States. The current adjustment will fall into place on October 1, 2016, as a reduction in the percentage increase to the Inpatient Perspective Payment System.

The negative payment adjustments to the IPPS now stand at 75%, up from 25% for the 2013 reporting period. Eligible hospitals had a chance to apply for hardship exceptions to the payment adjustments, though if they haven’t done so already it’s too late, as the window for seeking those exceptions for 2017 closed in April of this year. But as noted, few hospitals will be affected.

At this point, it’s worth taking time to stop and admire how this took place. Even when you consider that the feds handed lot a lot of money in incentives, this has all happened relatively quickly as IT investments go. Everyone likes to talk about how successful the banking industry was at rolling out interoperability with ATMs, but I doubt the backroom negotiations went any faster than the cascade of Meaningful Use attestations. In other words, Meaningful Use did its job.

After all, very few programs achieve close to 100% compliance under any circumstances. Even if providers face large government fines, no initiative is going to get 100% of the industry on board. So bringing 98% of eligible hospitals on board within a few scant years is an impressive achievement, particularly considering the healthcare industry’s record of foot dragging when it comes to new technologies.

Of course, the industry has clearly gone well beyond the need for Meaningful Use’s rather mechanical reporting requirements, valuable though they may have been as a training ground. So if we assume that Meaningful Use isn’t that, well, meaningful anymore, what’s next?

The answer is….drumroll…quality. Most hospitals will be focusing on the larger and more complex quality measurement demands imposed by the next generation of incentive payments proposed by CMS.

As many readers know, the Medicare Meaningful Use program for ambulatory is being rolled into the Merit-Based Incentive Payment System (MIPS), along with the Physician Quality Reporting System and Value-Based Modifier programs. beginning with the 2017 performance year.

Meaningful Use now has a new name in ambulatory care, Advancing Care Information, and strong performance on this measure can contribute up to 25% of the MIPS score a provider receives – or in other words, smart health IT deployment still counts. But that’s dwarfed by the 50% of the score contributed by strong quality performance.

This shift away from IT-specific performance measures is necessary and valuable. But as federal authorities lay out their new incentive programs, it’s worth giving good ol’ Meaningful Use a send-off. A job needed to be done, and however unsubtly, MU did it. We’ll see how quickly the MIPS program rolls over to replace MU in hospitals.

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