Guest post by Eric McDonald, founder and CEO, DocuTap.
Expediency, exceptional service and a reasonable price. It’s the ideal for American consumers, particularly in healthcare. Because of that demand, patients were the drivers behind the adoption of the urgent care industry.
It started in the late 1970s and early ‘80s. Family practices started taking walk-in patients. While it wasn’t branded as such, that was the inception of urgent care. Since then, the urgent care industry has morphed into what it is today – a walk-in facility with extended hour service for adults and children with acute illnesses and injuries. But, that definition doesn’t do urgent cares justice. Urgent cares are setting the tone for what healthcare consumers want. They want unscheduled appointments, they want stellar service, they want a location that’s easy to find with accessible parking, they want distinguishable amenities, and they want the cost to be lower and more transparent.
There are approximately 9,000 urgent care centers in operation, according to the Urgent Care Association of America. The UCAOA’s 2012 Urgent Care Benchmarking Study concludes that urgent care centers see three million visits per week, totaling more than 160 million visits annually. The urgent care industry is one of the fastest-growing industries in the country. With roughly two clinics opening every day, it’s expected there will be 15,000 urgent care centers by 2019.
With the boom in the urgent care space, some in the healthcare industry are concerned about the flow of patient information. Considering urgent care visits are typically one-offs, some patient information isn’t getting back to the primary care providers and health systems as it should. However, the healthcare industry is making strides to combat this through technology, interfaces, federal initiatives, and health systems partnering with urgent cares.
Guest Column by Val Van’t Hul, Meaningful Use Project Manager, DocuTAP.
Providers at urgent care centers around the country are preparing to attest for either Stage 1 or Stage 2 meaningful use this year, and knowing the differences in reporting periods can make a huge difference in the process. Reporting periods vary depending on which stage an eligible professional (EP) is in, and whether a provider is attesting through the Medicaid or Medicare EHR incentive program.
To further explain this process, here are the reporting periods for 2014 indicated by the Centers for Medicare & Medicaid Services (CMS):
An EP must select any 90-day reporting period that falls within the 2014 calendar year. Since Medicaid is state government-based, urgent care centers are tasked with researching any particular rules and regulations that pertain to their location, as these vary from state to state.
An EP participating in the first year of meaningful use (Stage 1, year 1) must select any 90-day reporting period. However, to avoid the 2015 payment adjustment the EP must begin the reporting period by July 1 and submit attestation data by October 1, 2014. This grace period is designed to help clinics that are still working out best practices and processes for attestation.
Medicare – An EP who is beyond their first year of Meaningful Use (Stage 1, year 2 or beyond) must select a three-month reporting period that is fixed to the quarter of the calendar year (i.e. July to September or October to December). There is not one quarter that is better than others for reporting, but clinics should keep in mind that there should be ample time to implement any changes in clinical workflow prior to the start of the reporting period. If an EHR vendor is properly certified for Meaningful Use and the urgent care client can begin the process, they may choose a later reporting period to allow time to properly order their workflow.
Meaningful Use Tracking & Reporting
Urgent care centers should monitor clinical workflow progress often to benchmark the eligible professional’s progress in working toward achieving Meaningful Use objectives. It is wise to run meaningful use reports from the EHR software, as well as conduct a provider analysis every few weeks to find out where and how adjustments need to be made in the progression toward these objectives. If EPs are falling below a preferred threshold in any area, this benchmarking provides ample time to get up-to-speed on clinic initiatives.
In addition to implementing tracking measures, it is necessary to understand the importance of delineating between “yes or no” and numerator/denominator reports. While the former are fairly self-explanatory (i.e. as with drug interaction checks), clinics should take careful documentation measures to prove compliance, including taking regular screenshots of what is happening in a clinic’s EHR software system during the reporting period. For example, when pop-ups of patient medicinal allergies occur, a screenshot of this notification, along with a date/time stamp, should be taken and a copy kept on file for up to six years, as this is the standard amount of time for which CMS may audit the eligible professionals.
Guest post by Darin VanderWell, Director of Product, DocuTAP.
Rumors about the next phase of the Centers for Medicare and Medicaid Services (CMS) EHR Incentive Program has prompted concern among healthcare providers. To truly understand meaningful use Stage 3 and its impact, it is important to differentiate between the rumors and the truth.
The final rule for meaningful use Stage 3 has yet to be published, so discussion on its effects are based on available drafts. Even those drafts are in question since the December 2013 announcement that Stage 3 would be delayed until 2017. One reason cited was to allow more time to research the impacts of Stage 2 before finalizing Stage 3. The delay will be particularly important for that research, since compared to Stage 1, 2011 Edition, there are so few Stage 2 vendors certified currently.
As for what is expected, the attention turns from data capture and access (Stage 1) and information exchange (Stage 2) to improved outcomes in Stage 3. One expected goal is to simplify and reduce the reporting requirements on those attesting. Some of that change can be achieved by consolidating the program’s current objectives, which I expect hospitals and providers will welcome, provided it truly reduces the reporting burden and does not coincide with other, new objectives and reporting requirements.
Stage 3’s goal of improving outcomes will be incredibly interesting – through November 2013, CMS had disbursed nearly $18 billion in incentive payments. Until now, the program’s success has been judged by the number of participants adopting certified EHRs. At some point during Stage 3 (or thereafter), we will know whether those payments have truly improved outcomes.