By Courtney Tesvich, vice president of regulatory, Nextech.
Courtney Tesvich
Data interoperability is once again poised to take a giant leap forward and there are many factors propelling this evolution. For example, the Office of the National Coordinator’s (ONC) March 2020 introduction of the interoperability rule as part of the 21st Century Cures Act is set to advance interoperability regulations. COVID-19’s spotlight on the need for data transparency and seamless information exchange to enable efficient care delivery across diverse settings is revealing a critical use case.
The rapid onboarding and use of telehealth to virtually deliver safe and secure healthcare underscores the importance of modernizing interoperable solutions. Given all these factors, the time is right for healthcare organizations to evolve their thinking around data sharing.
While larger, multi-setting health systems may have teams of people dedicated to advancing their organization’s interoperability strategy, smaller entities (including specialty physician practices) are often left to figure out the right path forward on their own. This can be overwhelming, and it may be tempting for smaller organizations to delay work on this issue. However, it will only postpone the inevitable.
Over the next two years, the capabilities and requirements to exchange electronic health information will change drastically. The ONC is allowing two years to implement the new interoperability requirements and technology will likely change in that time. So, starting the effort now can make it easier to adapt as solutions evolve. The bottom line? To meet this deadline, practices need to develop their strategies, update compliance efforts, understand upcoming changes and begin to update processes to ensure they are fully prepared for the near future.
But how can an organization get started? Here are a few steps to consider.
Educate yourself on the intent and nuances of the ONC rule. The primary goal of the interoperability rule is to give patients greater access to their health information and allow them to share the data more easily with all providers. As electronic health record (EHR) vendors continue to develop their products to meet the updated requirements, more information than ever before will be available electronically both for patient use and for exchange. Factors that providers should be aware of include:
Future availability of free text notes in the patient portal as well as nearly all lab, radiology and pathology results. As EHR vendors develop and certify to the US Core Data for Interoperability requirements, patients will see additional data beyond the previously available CCDA information in their portal, including visit notes.
Patients will be able to seamlessly select independent apps to aggregate their own health records.
Ensure your practice understands how to handle requests for information in a timely manner. This includes requests by patients for their data as well as data requests by insurance companies, employers and consumer-facing apps. Develop a policy and train staff before the new Information Blocking deadline of April 5, 2021. Ensure you continue to follow HIPAA guidelines as well.
Practices will also need to regularly update clinician information in federal databases.
These suggestions merely scratch the surface of what the new rule requires. Providers should delve deeper and make sure they are moving towards compliance and not inadvertently standing in the way of information exchange.
Jeff Lew, vice president of product management, Nextech.
The dawn of a new year brings anticipation for things to come—and this certainly holds true regarding health information technology. Electronic health records (EHRs) continue to evolve, and the next 12 months should provide some excitement as new developments emerge. In particular, there are three trends worth watching.
The inescapable shift to the cloud
More and more healthcare organizations are seeking cloud-based EHR and practice management systems, and it appears this trend will continue throughout the coming year. One of the primary reasons for moving to the cloud is the economics of these solutions. An organization does not have to maintain costly hardware and software or allocate resources for upgrades and other technology management functions. Instead, the system is housed remotely and kept constantly up-to-date by the vendor. Users can access the software with any device that has an internet connection, including laptops, tablets and, in some cases, smartphones. A cloud solution is especially cost effective for those organizations that have multiple facilities. Gone are the days of a server in each site—users can bring their laptops or tablets with them as they travel from location to location, logging in to the system from anywhere. Not only can this keep costs in check, it can also promote greater user satisfaction because the tool offers the flexibility to work from anyplace at any time.
Security and protecting an organization’s IT from threats will continue to make headlines like it has in the past year. It is a real and present risk that organizations must be acutely aware of and ensure relevant preventative measures are established and continuously maintained. This requires not just the relevant knowledge and skills, but also focus and resources, that many organizations may not have.
Ultimately, most—if not all healthcare providers—will shift to cloud-based solutions at some point. Although the move may not occur immediately for every organization, 2018 will see many healthcare entities take steps in that direction.
Complying with MACRA
This past November, the Centers for Medicare & Medicaid Services (CMS) released the final rule governing 2018 MACRA participation. The rule introduced several changes that stand to impact physician practices and other healthcare organizations. Here are a few key aspects of the rule of which to be aware for the coming year:
The exclusion thresholds have changed, and this may allow more specialty practices and other smaller organizations to exempt themselves. Note that CMS is now including Medicare Part B drug reimbursement in the calculations for exclusions, which may skew applicability for certain entities. If a physician practice uses a lot of Part B medications, for example, it may increase its revenue amounts and thus preclude the practice from exclusion.
For the first time, practices must submit cost measures, and these will represent 10 percent of an organization’s MIPS score. That percentage will rise to 30 percent in 2019. Since organizations will need to demonstrate cost performance, they may want to review that performance and see how it relates to their peers as well as the quality of care they deliver. Even if cost numbers are high, if they can be tied to good quality, then they are likely justifiable.
Organizations must start submitting cost and quality measures on January 1 and submit for the entire calendar year. They also must achieve a composite score of at least 15 out of 100, which is up from last year’s three out of 100.
