Doctors: Not a Jack of all Trades… A Master of One!

Doctors: Not a Jack of all Trades… A Master of One!As the leader of a high-performance marketing team, I strive to stay abreast of the latest developments and best practices in the HIT industry and my chosen profession. But, no matter how prepared I am, I cannot be successful at what I do if I am expected to be an expert in every aspect of marketing. My expertise in leadership, building teams that excel, and developing professionals to reach their highest abilities, does not prepare me to be successful at writing HTML code, or designing graphics in the latest style. I need a team of experts to contribute their individual talents if we are to succeed.

This is even more apparent in the medical profession. In today’s world doctors are expected to not only be experts in their particular medical field, they are also expected to be experts in human resources, business management, and a plethora of other disciplines that serve their practice needs and government requirements. Besides earning an M.D., they practically need an M.B.A. in order to run a profitable and growing business. They also have to be policy analysts and experts to even have a chance of understanding the volumes of regulations the government has enacted and with which they’re expected to comply. In addition, they are expected to be IT specialists in order to meet data exchange and interoperability demands. And don’t even get me started on the statistical analysis required to understand outcomes and value-based reimbursements.

I expect that one of the reasons that doctors chose their profession in the first place was because they had a passion for science and service. So, to focus on the profession for which they have been educated and prepared, doctors need to find other experts to support them by focusing on the business of medicine.

It all comes down to one thing… the patient. In order to best serve your patients’ needs you must spend your time mastering the art of medicine, while letting your team of experts master the art of your business.

A final prognosis: building a strong team of experts will ensure the health of your patients and practice.

Where is your focus directed?

90-Day MU Reporting: Just What the Doctor Ordered

Rules & RegulationsJust as physicians were considering abandoning Meaningful Use and surrendering to future Medicare penalties, CMS issued a proposed rule for 2015 that breathes new life into the program. If full-year reporting was perceived as the insurmountable obstacle, the proposed reduction to a 90-day reporting period should recapture interest.

Although a proposed rule is not final until it is codified as a final rule—not anticipated until August—past experience has demonstrated that the major structural features typically survive as proposed. The shortened reporting period was announced as CMS’ intention in January and formally proposed last Friday. I think it is fair to say that one can be reasonably confident in this particular provision of the rule.

As for the other features of this proposed rule: In a former EMR Straight Talk post, I wrote, “Even more intriguing to me than the change in reporting period is . . . the intention to “modify other aspects of the program to match long-term goals, reduce complexity, and lessen providers’ reporting burdens.” CMS has come through in this regard and proposed changes for 2015 through 2017. The revisions encourage a focus on the advanced use of EHR technology to support health information exchange, consumer/patient engagement, public health reporting, and quality improvement. This is the narrowed focus that stakeholders, (including SRS on behalf of physicians), have been demanding since the program’s inception.

The following are some other highlights of the proposed rule for 2015 through 2017:

  1. Reporting would be streamlined: Many Stage 2 measures would not be individually reportable, particularly the paper-based or box-checking measures. Caveat: this does not, however, mean that the data would no longer be required–the information would still be necessary for the patient portal, for the summaries exchanged between providers, and for CQM reporting.
     
  2. Patient engagement measures would be dramatically revamped:
    • The threshold for “VDT”, (View, Download, or Transmit), would be reduced from 5% to “one patient.”
    • Secure messaging would have to “be enabled,” but there would be no threshold to meet.
  1. To simplify the overall MU structure for practices that have physicians in different stages, all physicians would report on the same measures—a modified set of Stage 2 requirements. Stage 1 providers, however, would be able to exclude measures which go beyond the requirements they were expecting to report.

If you want to ensure that the above changes are included in the final rule, submit a comment to CMS by June 15. CMS receives plenty of comments opposed to particular components of its rules, but specifically asks for positive comments on the features that stakeholders do support.

Travel and Technology: It all Comes Down to Comfort

airplane-blogI have a confession. I am a travel snob. When I travel, I want to travel with as much luxury and as many conveniences as possible. You may ask yourself, is there really a difference between Boarding Group 5 and Boarding Group 1? Yes—absolutely. Sitting in that marginally larger seat and sipping that complimentary pre-flight beverage makes the next several hours of claustrophobic internment so much more bearable.

Recently, returning home from the annual meeting of the American Academy of Orthopaedic Surgeons (AAOS) in Las Vegas, I faced a travel-snob dilemma. I had a six-hour red-eye flight back to New Jersey, but not enough status with the airline for a free upgrade. The question was, was it worth paying for the upgrade to have the extra comfort and the extra sleep, and maybe a more productive next day at work? Or should I just keep my money in my pocket, grin and bear a middle seat, and suffer the jet-lag consequences? After all, I would end up at my destination either way. As so often happens, I was well aware of the problem, but I wasn’t sure if I was willing to devote resources to the solution.

I heard similar dilemmas voiced by many of the physicians as I walked the floor at the AAOS conference: “The experience with my current EHR is a nightmare. It’s so hard to use that I’m spending hours every evening just finishing up the work I should have done during the day! When I do try to use my EHR during the visit, it interferes with my interaction with the patient. Why do I have to use this thing if it creates so many problems?”

Just like budget travelers sitting in the back of the plane next to the bathroom and looking up at first class, many physicians with bad EHRs end up thinking: “I should have spent more time considering what a less-than-ideal solution would cost me, not just the price tag. It would have been worth it to invest in an option that works for me.” The cost of saving on an airline ticket is only a few uncomfortable hours and maybe a bit of jet lag. But ask yourself this: What is the cost of choosing the wrong EHR?

Dreams vs. Reality

“I want to be a doctor when I grow up.”superman

What did you want to be when you were growing up? I wonder how many of today’s physicians, knowing what they know now, wish they could turn back time and change that childhood ambition. That calling. That innate drive to help people. Because after devoting countless grueling hours to schooling, internships, and residencies… after earning a reputation based on providing personalized care, one patient at a time… after building a business based on an immeasurable combination of talent and knowledge, suddenly the field of medicine is being commoditized. No wonder physician burnout is on the rise—up 16% in two years, according to this Medscape Physician Lifestyle Report.

The government is telling doctors that an EHR can absorb mass data and spit out the right answer better than they can. Doctors are paying more to run their practices, earning less, and are still expected to provide quality care for record numbers of patients. And those patients have no idea what is going on behind the scenes, so their satisfaction levels are at risk. As physicians aim to fulfill their Hippocratic Oath in this world where they also are required to mitigate their own legal risks, direct their attention away from humans and toward technologies, and follow data directives based on masses instead of their own professional insights, the people on both sides of the examination table are feeling it.

In a recent survey, PhysiciansPractice.com published a list of things physicians wish patients knew. Here are some of the findings:

• “I wish they knew why physicians usually run late.”

• “I wish they knew that I do care about the pain they are having… even if I seem busy or preoccupied.”

• “I wish they knew how often we have to fight with their insurance companies just to get paid for services we’ve rendered.”

When it comes to practicing medicine, there are no limits to the differences that can exist between cases—and allowing physicians to discern those nuances is critical to providing the best patient care. Rather than getting caught up in the negativity surrounding these ongoing changes, I’d like to ask these professionals for whom I have tremendous admiration to weigh in.

Doctors: What changes would make practicing medicine more in line with the reasons you chose to become a physician?

Providers’ MU Prayers Answered?—Quarterly Reporting for 2015?

Meaningful Use

In the inimitable style of government-speak, CMS recently announced its “intention to consider proposals” to shorten the 2015 meaningful use reporting period from a full calendar year to 90 days. While I would advise providers to be cautious about changing their plans until the relevant rule is published (anticipated in the spring), I think it is fair to assume that CMS would not have issued even such a noncommittal-sounding announcement if it were not planning to actually implement this change.

CMS has finally yielded to the relentless lobbying by the AMA and an alphabet soup of other professional societies and HIT organizations, all of which remain concerned about provider readiness and the challenges presented by an insufficient infrastructure to support Stage 2 requirements. Objections to full-year reporting for 2015 date back to last spring, when comments were submitted in response to the (then-proposed) 2014 Flexibility Rule. At that point, CMS adamantly rejected the overwhelming number of comments that recommended—or pleaded for—quarterly 2015 reporting. Currently, however, in addition to this external pressure, the dismal number of Stage 2 attestations to date has got to have CMS worried about the future of its MU program.

The devil, as always, will be in the details:

  • When will the rule be available, and will its timing be early enough to avoid creating the aura of uncertainty that characterized last year’s mid-year revisions? (We are already one month into the 2015 physicians’ reporting period, four months into the hospitals’.)
  • Would quarterly reporting be available to all providers, even those still at Stage 1?
  • What happens to “harmonization’ with PQRS, which remains a full-year program? (This has been one of the reasons CMS has stated for its resistance to quarterly reporting.)

Even more intriguing to me than the change in reporting period is the second of the three proposals enumerated as being under consideration—that is, the intention to modify other aspects of the program to match long-term goals, reduce complexity, and lessen providers’ reporting burdens.” Is it possible that CMS is taking the advice of the AMA and other organizations to increase flexibility, reduce the number of measures, add more choice, and maybe even eliminate the all-or-nothing nature of MU? Wouldn’t that be something!

Let us know what you think by submitting a comment below.

You Say You Want a Resolution…

resolutions-blogOK, I’ve taken some liberties with one of John Lennon’s most famous lyrics, but it’s the first blog post of the year, so I thought I’d need a little extra attention-getting power to break through the post-holiday fog. Chances are, only a few days ago you were pondering how you would implement change in your life in 2015. You may even have proclaimed those resolutions loudly and proudly as the ball dropped in Times Square. Seven days in, how well are your new year’s resolutions doing at becoming reality? I’ve kept mine so far . . . ;)

All kidding aside, we’re doing more than just hoping that the changes we want to effect at SRS will happen this year—we know they will happen, because we have a system in place to ensure that we keep our promises to ourselves and to others. It’s not complicated, and it’s something anyone can use at home or at work to help ensure that their “Say/Do Ratio” remains high. Simply, there are four key elements: communication, transparency, collaboration, and accountability.

Lose weight. Work out more. Eat better. Since health is always one of the top New Year’s resolutions, let’s start with that example. Experts say it takes 21 days to turn something into a habit, but why do some resolutions become habits while others become failed attempts? Because commitment must be systematized for maximum success. So if my resolution was to get to the gym three times each week, the first thing I’d do is communicate that goal . . . to everyone, not just to whomever happened to be around on New Year’s Eve. It’s easy to tell yourself something and then forget about it. By telling my whole support network—my family, my friends, my team at the office—my motivation to do what I said I’d do is increased immeasurably. In terms of transparency, I’d start posting somewhere (perhaps on Facebook) each time I worked out as a proof point. I’d collaborate with others by starting or joining a workout group, maybe even implementing some sort of competition within the group. Finally, I’d enable true accountability, empowering my supporters to check in on my progress.

At SRS, healthcare is our core focus—and so our corporate fitness is critical to helping our clients strengthen their productivity while remaining focused on the wellbeing of their patients. At our User Summit in October, we discovered what was most important to our customers and then we created a system of actionable initiatives to ensure that our promises become the change we all want to see. And we are doing it by following this same four-step system.

No matter what your resolution is, big or small, by supporting it systematically with these four key elements, you’ll do more than wish for something to be different . . . you’ll turn a resolution into a revolution.