The End of MU… Oh, Never Mind!

chameleon-315pxAccording to a recent speech by Andy Slavitt, Acting Administrator of CMS, “The Meaningful Use program as it has existed will now be effectively over.” Not surprisingly, the media picked up this news—particularly the word “now”—and ran with it, gleefully proclaiming the “End of MU in 2016,” “CIOs Celebrate End of MU,” “MU on Deathwatch,” etc. It was easy to believe that Slavitt was predicting the demise of MU to be imminent since the stated topic of his talk was “policy areas that will affect the healthcare sector in 2016.” However, in Tuesday’s CMS Blog, Slavitt—writing with Karen DeSalvo—walked his statement back a bit. That said, this is still quite significant news: CMS has formally acknowledged what Slavitt himself referred to as the frustration and burden that physicians have been dealing with since the start of MU.

The key phrase in his statement about MU is “as it has existed.” MU is to be, in Slavitt’s words, “replaced with something better”—i.e., a new and improved version of itself. It is not going away. We already knew that MU had been identified as an integral part of a new program called MIPS under MACRA, the regulations for which are still being written by CMS. MACRA, the legislation that replaces the Medicare Fee Schedule’s SGR calculation, becomes effective in 2017, with a new schedule of payment adjustments (a.k.a. incentives and penalties) beginning in 2019.

Slavitt’s “announcement” was clouded by uncertainty, but was greeted, nevertheless, with great jubilation and high expectations, some of which were dashed by the clarifications published in the subsequent CMS Blog. In his speech, Slavitt had provided little insight into exactly how MU will be restructured. It begged the questions: Will the changes to the requirements be radical enough to be perceived by physicians as “something better?” What will become of the Stage 3 Rule, which is currently undergoing finalization and is due to go into effect in no later than 2018? And, will the MU penalties scheduled for 2017 and 2018 remain in effect or be eliminated? The CMS Blog answered some of these questions, to the disillusionment of many providers:

  • The current law requires that we continue to measure the meaningful use of ONC Certified Health Information Technology under the existing set of standards.
  • We encourage you to look for the MACRA regulations this year; in the meantime, our existing regulations—including meaningful use Stage 3—are still in effect.

Despite the myriad details yet to be determined, what we do know about the future is that physicians will increasingly be rewarded for quality over quantity of care. Therefore, a critical component of the new government programs will be the demonstration and reporting of improved patient outcomes (most likely in PQRS fashion). We can also be confident that MACRA (and any new version of MU it contains) will demand heightened interoperability and patient engagement, and physicians will have to meet requirements that support these goals.

The question of timing notwithstanding, should you be excited about this announcement? I would suggest cautiously so. We are optimistic that the anticipated changes will bring some relief from the unnecessary administrative burdens with which physicians have been struggling and let them get back to focusing on the practice of medicine. But unless concomitant changes are forthcoming on ONC’s side to streamline the excessive EHR certification requirements on the books for 2017/2018, EHR developers and vendors will still not have the necessary time or freedom to focus on innovations that would deliver the efficiencies and clinical benefits that would be of maximum value to physicians and their patients.

As always, SRS will keep you up to date on all developments in this area as they are revealed over the next few months. Please feel free to contact Lynn Scheps, Vice President, Government Affairs, if you have any questions.

Have It Your Way

Dr. Armstrong's Starbucks CupHalf-Caf, Half-Sweet, Non-Fat, No-Foam… and a Latte EHR Choices for the New Year

In 1974, Burger King changed the face of the fast food world when they rolled out their first “Have It Your Way” commercial. This slogan represented a completely new way of thinking among burger chains: one that revolved around the customer’s needs. “Hold the pickle. Hold the lettuce. Special orders don’t upset us.” Basically, BK was asking their clients to tell them what they wanted—rather than feeling bad for requesting something special.

More than 40 years later, Starbucks has grown an international empire known for serving up exactly what the individual wants. So my question is, in an age when we can satisfy specialized needs for the average Joe, why would we feel that a one-size-fits-all EHR is right for specialist physicians?

The answer is simple: it’s not. HIT solutions created to satisfy the biggest economic verticals—primary and inpatient care—cannot provide optimum productivity for specialist practices. They simply aren’t designed for it. That’s why, according to periodic AMA surveys, 2014 satisfaction rates fell to a staggering low of 34%. Specialists are especially dissatisfied, using HIT solutions that were simply built for someone else—solutions built to serve the masses rather than highly focused specialist practices.

These high-volume, extremely efficient businesses don’t run better by using an EHR focused on capturing maximum data instead of the right data. Specialists are finding that rather than providing greater productivity, generic systems create friction and get in the way of their patient interactions. Outside influences such as government regulations further dictate the development of one-size-fits-no-specialist “solutions” that are based on meeting unnecessarily cumbersome and challenging MU and PQRS requirements.

The good news is, the New Year brings innovative new HIT tools tailored for specialist practices. It starts with taking a new look at what an EHR really is: the hub where all other technologies connect. Just as specialists have a narrow focus, so does a specialist’s EHR. Given the robust ecosystem of different medical technologies needed to deliver the entirety of modern medicine, it’s a challenge for any single vendor to excel at everything. Focused tools provide physicians with the right means to expertly address each protocol.

To tweak Burger King’s famous tagline, it’s time to “practice your way.” Start by asking questions in four key areas:

  1. Evaluate the physician-patient experience. Would your patients be better served by a physician-centric model that allows you to practice the art of specialty medicine your way?
  2. Compare your legacy-model EHR against newer alternatives. Is your current solution optimized for your specialty, or do you find yourself creating workarounds?
  3. Prepare for frictionless data exchange. Does your specialty care really benefit from collecting more data than you need as you work toward a more seamless data exchange and fulfillment of government requirements?
  4. Future-proof your specialty practice. Is your business positioned for future growth in a way that increases your specialists’ productivity, enhances patient care, and takes advantage of innovative technologies?

If the answer to any of these questions is no, perhaps it’s time to place a different order. Perhaps we can talk about it over a cup of coffee?

Send us your special order!

Can Innovation Be the Cure?

clock-blogTechnology has revolutionized almost everything. From the way we consume music to how we engage in commerce, the entire experience has been dramatically transformed to make our lives better, more efficient, and in some instances to provide us with services that we could only have imagined just a few years ago. Consider how we currently use GPS in our cars versus how we navigated to our destinations just a decade or so ago. However, Healthcare Information Technology (HIT), and EHR in particular, has been one of the few industries that has not taken full advantage of the digital revolution.

Despite this, I believe that all is not lost. Although EHR solutions remain highly inefficient, I am convinced that many real, practical problems that couldn’t otherwise be solved in the analog world—such as identification of drug interactions, clinical-decision support, and machine learning to identify result-driven workflows—are now ripe to be addressed by digital technology.

Why now? The answer might surprise you—it can, at least partially, be credited to the meaningful use regulations. Don’t get me wrong, the negative unintended consequences of the MU programs have been well documented, from the inefficiencies and overhead burdens it has created for healthcare professionals, to the consolidation of the EHR industry, to the commoditization of EHR. There are plenty of cons to go around, but there are pros that, if leveraged properly, could form the foundation that the industry needs to achieve the ultimate goal of better outcomes and reasonable costs for everyone. What are some of these advantages? Patient charts are finally in some type of digital format, information sharing is beginning to be a reality, and interoperability among various systems is not just a buzzword that you read in articles and blog posts and hear at conferences—vendors are now allocating big dollars towards achieving it.

Make no mistake: healthcare professionals will always be at the center of the decision tree when it comes to how you and I are treated for medical issues, but leveraging advancements in computer science such as artificial intelligence (AI) and predictive algorithms can support more informed decision making. With AI, the abundance of data, and the right tools to analyze it, workflows can be better adapted to each professional’s specialty and needs, patients can engage in their healthcare, and treatment plans can be better optimized.

Today, many healthcare professionals hate their EHRs, and over 40% say that “EHRs interfere with the doctor-patient relationship.” It’s time we take on this issue. If providers, vendors, and patients join forces, we might be able to unleash the next generation of solutions and supercharge the healthcare digital revolution. I believe innovation is the just the cure we’ve been searching for!

What innovators are you looking for? What HIT innovation would you like to see?

From the Wheel to Uber: Innovations to Be Grateful For

As Thanksgiving nears, many of us are thinking about the people for whom we are truly grateful. This is also a great time to appreciate some of the life-changing innovations that we now take for granted – from music to medicine. We hope you enjoy this little trip down Memory Lane, and we hope you know how grateful we are to all of our clients, team members, and vendors who make up the SRS family!

Thank you!

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What are you grateful for?

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10 Crucial Questions to Ask EHR References

5 Star RatingToday, we are used to searching for references for everything from restaurants and hotels, to clothing labels and wearable fitness technology. Whether you are planning a party or searching for a new physician, gathering a handful of reviews can help inform your selection.

Collecting EHR references is one of the most critical steps in the EHR search process. To ensure your reference gathering is as effective as possible, make sure several members of your staff are onboard. If each employee makes a few calls, the interview process will not require a large time commitment from any one of them.

Second, both administrative staff and physicians should call and speak to several of their peers at the reference sites to collect a variety of different perspectives and opinions.

Finally, don’t just call the references provided by the vendors—find other practices using the EHRs you are considering by joining professional society listservs such as MGMA’s and AAOE’s.

Once you’ve collected 10 references of similar size within your specialty from each EHR vendor—along with a few practices that weren’t provided by the vendors—ask each reference these 10 crucial questions:

  1. When did you install your current EHR?
  2. How long was the installation/implementation process?
  3. How would you describe the installation/implementation process?
  4. Was the system as easy to use as it appeared to be during the software demonstration?
  5. How has your patient volume changed?
  6. Approximately how much more time do you devote to entering exam data into your EHR as compared to how you documented exams before you began using this EHR?
  7. What percentage of your exam notes are fully-templated?
  8. Do you like the quality of the exam note generated by your current EHR? Does it represent you well?
  9. How have your patient interactions changed?
  10. Would you recommend your EHR to a similar practice?

Asking these questions will give you a clear indication of whether or not a specific vendor will be able to deliver the success you expect from your EHR implementation.

Keep this “cheat sheet” of reference questions handy throughout your EHR search process. It will prove invaluable and provide you with the information you need to save yourself from a potential mistake.

What are some additional questions you would ask of references?

Don’t Be Fooled by Costumes, Tricks, or Treats…

Without These 5 Essentials Your EHR Experience Could Be Scary :O

Walk down almost any street on Halloween and you’ll be greeted by scores of people dressed in costumes. The outward appearance of these revelers is very different from what you find once the mask comes off. The same can happen when you see an EHR demonstration. There are so many things to focus on during the demo that you might be distracted from the most important points. Is it usable? Can it accommodate different workflow styles and data capture needs? And, can it be implemented without sacrificing practice-wide productivity? Although extras bells and whistles can make impressive costumes, they won’t guarantee EHR success.

How do you know if an EHR is a Trick or a Treat?

Beware of:

1-mouse-4568617_s1. Things that go click, click, click in the night. The number of clicks it takes to perform basic functions—such as submitting electronic prescriptions, reviewing basic chart information, or documenting patient exams—is crucial when selecting an EHR system. If the system requires numerous clicks in order to navigate the software and enter clinical information during the patient encounter, and toggle back and forth between applications then the EHR will significantly decrease physician and practice productivity, negatively impacting both revenue generation and patient care.

2-masks-scary-23134188_s2. The legend of one size fits all. The EHR should be flexible enough to serve your specialty, and your unique style of practicing medicine. Your EHR shouldn’t dictate your workflow, rather it should be flexible enough to accommodate many styles, and data capture goals. Knowing how, when, where, and by whom data is entered into the EHR is critical. If the EHR does not provide the flexibility to adapt to and help you improve your current process, then it may not be the right EHR for you.

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3. Losing your way in a house of horrors. We’ve all heard EHR template horror stories about going through a long data input maze only to learn that you missed something and can’t escape without losing all of your work. Rather than suffering the same fate, ask references how flexible and easy the system is to use, and how many hours it took them to become confident with the system. If the other users quote an excessive number of training hours or your staff has trouble learning the software during a demonstration, the system is most likely not usable and therefore will be difficult to implement, and never be fully integrated into your practice.

5-skull-42284534_s4. Alternate realities. Other applications and office technologies should easily integrate into the EHR and be viewable within the same screen. There should be little to no toggling back and forth between application realities—it is inefficient, wastes time, and resources.

4-nightmare-28218534_s5. Recurring nightmares. Navigating, entering data, and generating reports in the EHR should be quick and easy. Diagnostic test results and transcriptions should automatically route into each patient’s digital record. Every paper process (or automated process if you currently have an EHR) that exists in your practice should be replaced by a superior automated process that frees up the physicians’ and staff’s time and allows them to focus their attention on patients.

Avoid these monsters—ensure all physicians and practice staff are included in the selection process—workflow, data requirement, and training time vary among the different departments and staff members. Remember, the EHR you purchase should enhance efficiency, workflow, and productivity throughout the practice. If it doesn’t, then it will not deliver all the benefits that “the right” EHR could bring to your practice. You might even consider your EHR a treat 😀