Guest post by Lea Chatham, content marketing manager, Kareo.
In the recent Physicians Practice Technology Survey, sponsored by Kareo, there are two trends that bode well. First, the majority of practices surveyed were independent, and second, there were more positives about EHRs than negatives. It looks like things are finally heading in the right direction.
Ongoing EHR Concerns Linger
That isn’t to say that practices don’t continue to have concerns, however. Nearly 20 percent of those surveyed still don’t have an EHR. The barriers? Implementation, interoperability and cost. And implementation of EHRs is cited as the top technology challenge for practices.
“The transition to an EHR can be hard, especially when practices choose the wrong system the first time and have to go through the process twice,” explains Laurie Morgan, senior partner at Capko and Morgan, a practice management consulting firm. “So it is really important to make the right choice. What we have seen is that the practices that have been on a good system for while do see the value and the workflow benefits. It just takes some time.”
On the flip side though, 57 percent are happy with their choice of vendor, which may mean that we will start to see a slowdown in EHR switching, giving providers a chance to focus on patient care and building their practices. In addition, more than 40 percent say they have seen a return on investment, and even more cite an improvement in efficiency.
For those who are unhappy with their EHR, this is a clear sign that better technology is out there. It is a matter of making sure to choose the right one and implement it correctly. “There are several steps practices can take to make sure they get the right EHR at the right price,” says Tom Giannulli, MD, MS, chief medical information officer at Kareo. “These days most of the affordable cloud-based EHRs will have the basic features so it often comes down to a few special needs and the implementation and training. To help improve satisfaction with the EHR it is really important to take advantage of all training and support and invest the time to get familiar with the system.”
Every day, physicians send and receive clinical information to and from patients, nurses, care managers, pharmacy technicians, specialty clinics and other physicians. These communications occur through a wide range of modes—including smart phones, pagers, CPOE, emails, texts and even messaging features within electronic medical records. Patient health information (PHI) is constantly exchanged through these messages, and to avoid a HIPAA violation, which can cost millions of dollars plus a hit to reputation, practices must make sure proper security features are in place.
Especially for physicians in smaller practices who are already strapped for time and resources, a HIPAA violation could leave their practice in a precarious situation. In fact, according to a recent study by the Ponemon Institute, the average cost of HIPPA breaches from 2010 through 2012 was $2.4 million per organization. To meet evolving guidelines around the quality of care, increase efficiency and potentially avoid financial penalties in the years to come, physicians must address communications security holistically.
The final HIPAA ruling requires physicians look at their entire risk management process, and not just specific technologies, which is why “HIPAA-compliant” text messaging isn’t yet possible. While texts are commonly sent between two individuals via their mobile phones, the “communication universe” into which a text enters is actually much bigger. This universe also includes creating electronic PHI (ePHI) and sending messages—in text and voice modalities—from mobile carrier web sites, paging applications, call centers, answering services and hospital switchboards.
The law stipulates that a covered entity – i.e. a physician, medical group practice, hospital or health system – must perform a formal risk assessment; develop and implement and effective risk management strategy based upon the findings in that risk assessment; implement the strategy using sound policies and procedures; and monitor its risk on an ongoing basis. These regulations apply to physicians creating, transmitting and receiving PHI in any electronic form.
While there is no “one-size-fits-all” approach, medical practices can take the following steps to improve the security of their communications:
Chris Fox, CEO of Avantas, discusses how he and his firm help physicians improve their operational performance; healthcare staffing; the need for addressing operational efficiencies across a health system without following some traditional approaches — like layoffs; and market trends that continue to perplex, yet offer opportunity for growth and development.
Avantas started as a group within Alegent Creighton Health more than a decade ago with the goal of optimizing its workforce across the health system. Its efforts were so successful that it became a separate company and began offering its expertise to the entire industry.
In 2007 Avantas developed a healthcare scheduling software, Smart Square, as no other solution on the market offered the flexibility and customization necessary to fully automate our strategies and provide a transparent view of staffing, scheduling, and productivity at the enterprise level.
Avantas executives provide thought leadership in healthcare labor management.
What keeps your passion for this mission, and the organization, alive? Tell me more about what excites you about your work and why you love what you do?
Very simply, if we are successful as a company it is because we have helped our clients – healthcare providers – improve their operational, clinical, and financial performance. Stronger healthcare providers means more services, more community outreach, basically, better, more affordable healthcare for everyone. It’s pretty easy to be passionate about that.
What draws you to healthcare? Did you seek out the sector when you began your career?
I’ve worked in software development and innovation for more than 15 years within a number of industries. It’s a funny story, but I actually got involved in healthcare because of a chance seat assignment on an airplane almost 10 years ago. I was seated next to Lorane Kinney, Avantas’ co-founder. We got to talking about Avantas and what she was trying to build there. Hearing Lorane’s passion for the company and the need to automate a new approach to labor optimization in healthcare was very inspiring. I knew I wanted to be a part of it, and I knew I could play a big role in bringing Lorane’s vision to fruition. Avantas has a compelling story and big aspirations. As Avantas’ CEO, I, like Lorane, seek out individuals who are passionate about the vision we have for the industry and want to be part of that change.
Tell me more about the evolution of Avantas, from where you started to where you’ve come today? Where are you headed and why?
Avantas started as a group within what is today Alegent Creighton Health more than a decade ago with the goal of leveraging economies of scale and standardizing its labor proactively across its then five Omaha hospitals. Our purpose was to develop and implement strategies that would leverage the system’s care staff, both proactively and in the moment to cost effectively adjust to the natural rise and fall in patient volume. Our efforts were so successful we became a separate company in 2001 and began offering our workforce management expertise to the entire industry via consulting. In 2006 Avantas conducted an RFP to find a scheduling solution we could use within our client base to automate the labor strategies we had developed. After we were unable to identify an appropriate solution we developed our own healthcare-specific enterprise scheduling solution, Smart Square. Now Smart Square is being utilized in more than 200 facilities across the country. Our strategies and technology solutions are packaged in a comprehensive methodology called HELM, which stands for healthcare enterprise labor management. HELM takes a step-by-step approach at restructuring an organization’s labor management strategy by first right-sizing its staffing sources, standardizing policies, and implementing best practices. Next we automate those policies with Smart Square. We also work with our clients to develop centralized methods of managing staffing resources as well as helping them build out the necessary layers of contingency staff, enabling them to cost effectively adjust to constantly changing patient demand. We help our clients implement these strategies across their systems: inpatient, ancillary and outpatient areas, like medical group practice sites.
No one will argue that there are not benefits to EHRs (electronic health records). They eliminate paper, enable providers to track data efficiently over a period of time, create a clearinghouse of patient health information in one place, just to name a few. Some argue EHRs improve the overall quality of patient care and business management. However, with so many EHRs on the market, hospitals and doctors’ offices face the daunting task of selecting the right system. Like the general population, most healthcare professionals’ exposure to technology has been limited to that of a consumer, making the selection of the right EHR system a process out of their comfort zone. Then getting trained on how to efficiently use the system while maintaining a high level of patient care comes into play. This has proven to be frustrating, ineffective and possibly dangerous in extreme cases when information is incorrect and/or cannot be accessed. This situation has put healthcare providers in a challenging position, to say the least.
Since 2009 when the federal government rolled out the $30 billion American Recovery and Reinvestment Act as an incentive program for the healthcare industry to go digital with its records, the landscape has changed. One of the first things that happened was the huge influx of technology vendors who decided to make their foray into the healthcare space. Unfortunately, most of these companies did not understand how the industry operated, no pun intended. In fact, the average vendor just launched its first product to the industry in the last year so that does not provide a lot of industry longevity/credibility. Many vendors were focused on getting the peace of $30 billion pie at the cost of their client not getting what the system they needed. Established technology vendors, who shifted their focus on solving the industry’s problems, were outnumbered by the new players who entered the market chasing government grants. The availability of these grants actually created an EHR technology bubble in very short period of time. To make matter worse, well-intended government rules only focused on the end users’ ability to implement technology correctly instead of the technology producers.
With the overwhelming amount of information out there about EHR technology and the providers, healthcare professionals must do thorough due diligence to find the best system that fits their needs. This will take both a time and resource commitment. Let’s look using a metaphor that most people understand or at least have had some experience with, dating. The same principles used in dating can apply when selecting the right EHR technology. Here are four simple rules that can help any healthcare provider make a good business decision when looking for an EHR solution.
MobileSmith is an online app development platform, enabling hospitals and health organizations to create custom, native apps, across iPhone, Android and iPad devices, without any coding required.
Elevator Pitch
We have a platform that allows a marketing department with no development experience to create custom, native mobile apps. With us, any hospital can enhance their patient engagement strategy, without coding, and without the cost of hiring developers.
Founders Story
The earliest foundations of the company that would become MobileSmith, were laid in 1993. Back then, the company, known as SmartOnline, sold software to assist small businesses. SmartOnline became one of the early pioneers of the SaaS (Software as a Service) model that we use today. The company worked to adapt to the constantly changing technology. In 2010, the company hired Bob Dieterle as senior VP and general manager. He advocated and orchestrated a complete overhaul of the company services, and focused the company, instead, on the budding industry of mobile applications. The company wanted to deliver organizations a means to quickly create and manage apps to connect to their consumers, without having to rely heavily on an IT department. Working to that end, the MobileSmith online platform was developed, and in July 2013, the overhaul was complete, as the company rebranded itself as MobileSmith Inc. and has since focused entirely on delivering quality and cost-effective mobile apps to organizations.
Market Opportunity and Strategy
There are several app development platforms out there, such as Appcelerator or Kony. These platforms still require a programmer or developer to write code for the apps. Our platform requires no coding whatsoever. A designer or marketer can easily come to us and use our platform to design, prototype, build and deploy an app. While we have clients from a variety of fields, healthcare providers have found our platform particularly useful. With healthcare IT departments swamped with EHR implementation and marketing desperately trying to enhance patient engagement options, our platform has been able to fill their needs without placing any further burden on their IT, and avoiding the higher labor cost of developers. As only 35 percent of healthcare providers offer mobile apps, according to the HIMSS Analytics Survey, there is a clear need in the healthcare industry for our platform, and several organizations have found us to be an excellent means of enhancing their patient engagement via mobile apps.
Healthcare IT Leaders, an award-winning consulting and staff augmentation firm that connects hospitals and health systems with top healthcare IT talent, announces its picks for the Best Healthcare IT Blogs of 2014. The winning blogs were chosen for their timely content, insightful writing and subject matter expertise on topics important to the HIT industry.
Electronic Health Reporter was among one of 15 sites nominated, and selected, for the honor of best healthcare IT blogs of 2014.
“It’s exciting to see the healthcare IT industry unfold from so many perspectives,” said Alex Gramling, chief marketing officer for Healthcare IT Leaders. “The blogging of CIOs, physicians, consultants, tech journalists, industry experts and lawmakers, whether they’re behind the scenes or right there in the action, helps inform, educate and entertain all of us.”
Site nominations came from social media followers and readers of the Healthcare IT Leaders blog.
Healthcare IT Leaders matches skilled IT talent to contract and full-time HIT consulting jobs. Through its blog, the company provides content, infographics, and news updates as well as insights from its chief medical officer, Dr. Frank Speidel. In 2013, Healthcare IT Leaders was named by Staffing Industry Analysts as one of the Best Staffing Firms to Work For in the US.
Here’s the complete list of sites selected as this year’s best:
Guest post by Ken Perez, vice president of healthcare policy,Omnicell.
In the wake of mixed initial results for the Pioneer ACO Model and Medicare Shared Savings Program (MSSP), this is the year for the Centers for Medicare & Medicaid Services (CMS) to take the feedback it has received and revamp its ACO programs.
The proposed rule for the 2015 Physician Fee Schedule (PFS), a 609-page document released on June 19, 2014, interestingly included the first installment of modifications to the ACO programs. The proposed rule devoted 52 pages to changes to the quality measures for the MSSP. Throughout the document, CMS emphasized its intent to align the numerous physician quality reporting programs, such as the Medicare EHR Incentive Program for Eligible Professionals and the MSSP, as much as possible, to reduce the administrative burden on the eligible professionals and group practices participating in these programs.
The final rule for the MSSP, issued in November 2011, presented 33 quality measures against which ACOs would be measured. These quality measures also apply to Pioneer ACOs. The measures pertain to four domains: patient/care giver experience, care coordination/patient safety, preventive health, and at-risk populations.
The proposed rule recommends the addition of the following 12 new measures:
You’re passionate about helping people. It’s why you got into this field and what drives you to do your best. But it’s very likely that your day-to-day life is filled with paperwork and admin tasks instead of spending time doing the clinical work that you love.
As a side effect of your success, you’ll find yourself consumed by the quotidian responsibilities as an administrator, including:
Invoice preparation and billing
Managing timely and accurate payments from school systems, insurance companies, private and governmental payer sources
Completing applications for insurance companies in order to become an “in-network” provider
Managing ever changing staff schedules
Managing issues related to human resource (e.g., hiring, payroll, progressive discipline and employee rights issues)
Managing public relations
And more
Should I Stay or Should I Go?
The more successful your practice becomes, the more these tasks eat up your days. You’re pushed away from the reason you entered the field – and you come to a point where you need to make a decision.
All successful small business owners have been at this point of realization. They are suddenly faced with a “stay or leave” decision about the business. If they decide to stay, an infusion of additional capital and resources is necessary to build or maintain the quality business they envisioned at the start. A decision to leave will mean a significant shift in their perceived autonomy and sense of success.
It’s a difficult decision to make, but it’s essential. Staying in this state for too long can have a negative impact on your professional life, relationships with friends and family, personal health and overall quality of life.
If you don’t have the capital and resources to add, you need an exit strategy for the situation you’re in. But your exit strategy doesn’t always mean selling or closing the business.
Why Not Choose Option 3?
Opting for a merger relationship with a larger entity can help a practice expand without putting additional pressure on your individual practice’s time or resources. There are multiple benefits to a merger decision that can help you do the work you’re passionate about and reduce the administrative load.
You gain access to an infrastructure for clinical excellence.
As a clinician and business owner, you encounter complicated circumstances that need to be managed expeditiously and responsibly. You need a “clinical home” to handle the circumstances involved in managing treatment resistant behavior disorders, complex behavioral presentations (e.g., a child with an anxiety disorder) and sensitive family situations (e.g., families impacted by psychiatric problems, separation, divorce, substance abuse and domestic violence).
