Guest post by Ken Perez, vice president of healthcare policy, Omnicell.
Years ago, I worked in a business unit of a large technology company that was involved in mergers, acquisitions and partnerships. In the course of our work, even when some proposed deals would fall through and some partnerships would not come together, the strategic intent of the company remained clear to us. It was like a beacon that we kept pursuing no matter what.
With healthcare-related legislation, all too often we can lose sight of the strategic intent of CMS. We immerse ourselves in the debate over details, but often fail to step back and reflect on the “end game” that one can hang their hat on. What is CMS signaling to healthcare providers?
Currently, there is bipartisan and bicameral support for permanent repeal of the unpopular, annually overridden sustainable growth rate (SGR) provision, a formulaic approach intended to restrain the growth of Medicare spending on physician services. The SGR threatens to impose a 24.4 percent reduction to the Medicare physician fee schedule (PFS) effective April 1, 2014.
Lawmakers from the House Ways and Means, House Energy and Commerce, and Senate Finance committees have worked together to consolidate separate bills that their respective committees passed toward the end of 2013. The result is H.R. 4015, the SGR Repeal and Medicare Provider Payment Modernization Act of 2014, which was introduced by Rep. Michael C. Burgess, a Texas Republican and physician on Jan. 6, 2014.
HIMSS Analytics publishes the results of the 3rd Annual HIMSS Analytics Mobile Survey, examining the use of mobile devices in provider patient care improvement initiatives. For the first time this year, the survey questions were modified to closely align with the six areas of the mHIMSS Roadmap, a strategic framework for providers to implement mobile and wireless technologies.
The roadmap sections encompass key areas of consideration healthcare organizations should focus on when developing and implementing a mobile strategy within a healthcare organization: New Care Models, Technology, ROI/Payment, Legal & Policy, Standards & Interoperability and Privacy & Security.
The survey findings offer examples of the progress made and hurdles that providers face when integrating mobile technologies into their facilities to improve patient care. Respondents indicated that the top benefit to having mobile technologies in their facilities was increased access to patient information and the ability to view data from a remote location. Funding limitations topped the list for barriers. Many providers are also still early in their adoption and implementation of mobile technology. For example, 69 percent use a mobile device to view patient information while only a third (36 percent) use mobile technologies to collect data at the bedside.
“The mobile health market is one of the fastest growing areas in the health IT space. We recognize the growing importance of mobile technologies and its impact to transform the delivery of patient care,” said David Collins, senior director of mHIMSS. “The survey reflects mobile technology as a transformational tool, as demonstrated by nearly all of the respondents supplying mobile technology to clinicians. This is a great example of how providers are integrating mHealth into today’s healthcare workflows. There is still work to be done by formally embracing mobile implementation strategies and measuring ROI.”
A day removed from the chaos (and wonderment and bliss) of HIMSS14 I thought I’d provide you with some of my thoughts about my experiences at the event. First, it was a wonderful, albeit tiresome experience. I was glad, and proud, to be back.
I attended the show twice before – in 2011 and 2012 as a vendor – and this third time as a reporter. In sum, I enjoyed it much more being there as a member of the press. It was more enriching and engaging and I was able to learn more about what’s actually going on in the space.
My only regret: Not being able to connect with colleagues of mine in the blogosphere. If truth should be told, I would have liked to have personally met as many as possible. The presence of several at the show was noticeable and lively. I crossed paths with several of them, but was not actually able to shake hands and say hello. I take full responsibility. Perhaps I’m a bit shy and introverted.
However, I met many other great people and had great conversations at the show. Omnicell, Verisk Health, Allscripts, ZirMed, MedSys Group and SAS stand out. I saw some great displays and some great IT. However, there were many times in which I was bored. One vendor, for example (with what can probably be described as having the biggest social media presence on Twitter while there) did not live up to the hype, and likely needs some ongoing communication training to help its officers learn how to stay on point and drive a story home; a totally missed opportunity from this reporter’s perspective.
Overall, I tend to agree with John Lynn. I saw very little that was truly exciting and innovative; nothing that really knocked my socks off.
Following this morning’s announcement by CMS administrator Marilyn Tavenner that there will be no further delays or extensions with regards to Stage 2 meaningful use, the College of Healthcare Information Management Executives (CHIME) has issued the following response:
Statement from CHIME president and CEO Russell P. Branzell, FCHIME, CHCIO, and CHIME board chairman Randy McCleese, FCHIME, CHCIO:
“The College of Healthcare Information Management Executives (CHIME) welcomes CMS Administrator Marilyn Tavenner’s announcement this morning, acknowledging the need to provide relief for our nation’s providers. Such relief is vitally important for the future success of Meaningful Use, as ICD-10 deadlines and continued shifts in payment policies demand an ever-increasing amount of IT and workforce resources. If the expansion of the office’s EHR Hardship Exceptions provides the kind of relief the industry desperately needs, CHIME pledges to assist policymakers in every way possible. Should CMS choose to define the new hardship exceptions in a way that does not address the core concerns of our industry we will continue to seek the kind of flexibility that nearly 50 national healthcare organizations communicated to HHS Secretary Kathleen Sebelius on February 21, 2014.
“Policy leaders at CHIME pledge to continue their work with CMS and ONC to chart a course that drives interoperability and patient engagement, and facilitates delivery transformation. It will be CHIME’s highest policy priority to ensure that providers receive the kind of relief they need in order to deliver quality care.”
Don’t forget that the end-of-the-year reporting of Health Insurance Portability and Accountability Act (HIPAA) breaches of unsecured protected health information (PHI) discovered in 2013 is due Saturday, March 1, 2014.
Healthcare providers and health plans that are covered entities under HIPAA must report breaches of unsecured PHI affecting fewer than 500 individuals annually to the U.S. Department of Health and Human Services, Office for Civil Rights (OCR). These small breaches should already have been reported to each of the affected individuals, and reports to the OCR should include the actions to mitigate and remediate any breaches, even those affecting a single individual. Reports to the OCR of large breaches (those affecting 500 or more individuals) are made at the time of reporting to the affected individuals—that is, without unreasonable delay and in no case greater than 60 days.
Covered entities may report small breaches electronically at the OCR’s website: www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/brinstruction.html.
In a letter to HHS Secretary Kathleen Sebelius, the College of Healthcare Information Management Executives (CHIME) and 47 other of the nation’s largest healthcare provider organizations issued a joint call for additional time and flexibility in the meaningful use program to ensure its continued success.
While underscoring the meaningful use program’s invaluable role in advancing technology adoption among hospitals and physicians, the letter states that strict adherence to current program requirements endangers overall success of the EHR program, disrupts providers’ healthcare operations and potentially jeopardizes patient safety.
“Given that we have just celebrated the anniversary of HITECH, we can look back at the last five years with great pride and take stock of how far we’ve come – as an industry and as a nation,” said CHIME President and CEO Russell P. Branzell FCHIME, CHCIO. “But we must look ahead and recognize the immense work in front of us. Now is the time to make much-needed course corrections to ensure that we continue this success well past HITECH’s 10th anniversary.”
The letter reiterates many points made by several organizations dating back to May 2013, including letters from CHIME; the American Hospital Association (AHA); the American Medical Association (AMA); the Medical Group Management Association (MGMA); the American College of Physicians (ACP); the American Academy of Family Physicians (AAFP); and the National Rural Health Association (NRHA).
The latest letter, the first to be issued jointly by more than 40 organizations, comes in response to concerns that the nation’s 5,000 hospitals and 550,000 eligible professionals must adopt the latest certified versions of EHR technology and meet more difficult program requirements to remain in compliance with the Medicare and Medicaid Electronic Health Record Incentive Program. Hospitals only have until July to adopt, implement, test and train staff to meet either Stage 1 or Stage 2 Meaningful Use requirements in 2014. Eligible professionals have until October to begin collecting data to attest to meeting program requirements.
At the HIMSS Annual Conference and Exhibition in Orlando, HIMSS released the results of the 2014 HIMSS Nursing Informatics Workforce Survey, which examines the roles, responsibilities and outlook for nursing informatics professionals. The 2014 Survey captures current professional status and practice trends, while identifying changes that have occurred over the last nine years in the nursing informatics workforce.
The survey, supported by the HIMSS Nursing Informatics Community, continues to suggest that nurse informaticists play a crucial role in the development, implementation and optimization of information systems and applications including clinical documentation, computerized practitioner order entry (CPOE) and electronic medical/health records.
Another key finding of the survey is the overall growth in the nursing informatics field. Based on the responses of more than 1,000 nursing informatics specialists, 70 percent have titles that specified an informatics position, which is double the amount from the last HIMSS Nursing Workforce Survey conducted in 2011. The survey results also showed that professionals in the nursing informatics field experienced an increase in salaries and interest in pursuing additional training within the field.
“The industry demands for more robust clinical documentation and analytics – such as those associated with meaningful use – have increased the need for informaticists across the entire care spectrum. This year’s Survey showed a marked growth across the field of nursing informatics, as well as a deeper understanding and recognition of informatics as a nursing specialty,” said Joyce Sensmeier, vice president of informatics for HIMSS. “Nearly two thirds of respondents have a post-graduate degree and 28 percent have a Master’s degree or PhD in informatics which points to the fact that the field is rapidly maturing. System optimization/utilization was a new option in the 2014 Survey and selected by 39 percent of respondents, suggesting that we may be moving beyond simply implementing systems towards leveraging their value.”
Day 2 at HIMSS14 was much the same as day 1: Lots of walking, talking and great meetings with great organizations. I can’t thank enough vendors like Verisk Health, Omnicell, Amazing Charts and SAS for the great information they’ve shared, and for the perspectives about the market, trends and what’s ahead (and what’s behind).
Electronic health records are now foundational, and in many cases, they’ve lost their sex appeal. Though there’s an obvious and huge presence by them here, this year’s HIMSS doesn’t seem to have the same energy around the technology, from my point-of-view, that they did two or three years ago, for obvious reasons. Though their importance is still great, as we all know, other issues are taking center stage. ICD-10 is the obvious elephant in the room.
“Risk” is the biggest buzz word I’ve heard here in Orlando. I’ve heard it dozens of times. “Patient engagement” seems overcooked, according to those I’ve spoken to; an aspirational concept, yes, but actionable in an an entirely different story. Lofty goals and strategy, fewer practical best practices approaches for proceeding.
Patient engagement has only just begun, or at least is just developing past its infancy, and I look forward to seeing how it matures as a concept. Remember, just a couple years ago, those with vested interest claim patient portals would solve the ever elusive patient engagement issue. Portals clearly have not done so. Why would they? I remain skeptical that the actual patient is at the heart of this conversation rather how a systems can implement “best practices.” We’ll see, I suppose.
That said, HIMSS14 remains a wonderful experience and I’m glad to be here and meeting some wonderful people. I look forward to what today brings. Likely, more walking!
In a letter to HHS Secretary Kathleen Sebelius, the College of Healthcare Information Management Executives (CHIME) and 47 other of the nation’s largest healthcare provider organizations issued a joint call for additional time and flexibility in the meaningful use program to ensure its continued success.