Electronic Health Reporter

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.

Although providers got their feet wet with MACRA in 2017, they will need to fully jump in during 2018. Responding to the new legislation should be a top priority for organizations over the next 12 months.

Making progress toward interoperability

The seamless exchange of information between healthcare entities is something with which the industry has wrestled for years. Health information exchanges (HIEs) have sprung up throughout the country, and many of these have started tackling the challenges of sharing information. Also, organizations are acknowledging the need for more data standardization and are working to agree upon standards that will simplify terms and definitions and establish the foundation for smoother information exchange.

While the industry is in a better place than it was three-to-five years ago, progress toward interoperability has been slow. Looking ahead to 2018, the industry is poised to experience further developments. Organizations continue to collaborate on how to overcome the challenges involved with interoperability and are making headway. Vendors are beginning to leverage more modern interoperability standards and engage in dynamic conversations about how to break down existing barriers.

Overall, 2018 is shaping up to be another year of change, and a key element in navigating it will be a robust EHR. Organizations that seek cloud-based solutions, which streamline clinical and financial operations, enable reliable compliance and facilitate interoperability will not only be successful in 2018 but lay the groundwork for strong performance in the years to come.