The Year’s Innovations – Wrap-up & What’s to Come!

Khal Rai

Khal Rai

Senior Vice President, Development at SRS Health
Khal oversees the Software Engineering, Business Analysis, Quality Assurance, and Product Management teams at SRS. His 17+ years’ experience in software development and healthcare IT have resulted in a true passion for collaborating with customers, then translating their needs into innovative solutions and better service experiences. He believes that motivated employees and satisfied customers are keys to maintaining business success. He has a B.S. degree in Computer Engineering from the University of Cincinnati, and an M.S. degree in Electrical Engineering from Purdue University.
Khal Rai

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2017-lightbulbsDepending on your point of view, 2016 was either a year to remember, or one to forget—just look at the nominations for word of the year. Pundits have proposed everything from “surreal” (Merriam-Webster’s) to “post-truth” (Oxford Dictionaries) to “unhinged” (NPR’s books editor Petra Mayer). Which is just to say, it was a year when conventional expectations were overthrown. And 2017 promises to be just as full of surprises.

For all the uncertainty, though, some trends seem sure to continue, at least in healthcare. The movement toward value-based payment is unlikely to reverse itself, which means that the optimum long-term strategy for medical practices remains the same as last year—cut costs by increasing efficiency, maximize patient base by identifying and standardizing successful treatment approaches, and stay limber by not getting locked into a cumbersome, inflexible software system.

Over the years, we have worked closely with our clients to learn what they needed from us, and to gain the sort of specialty-specific expertise that ensures that our solutions are designed around our clients’ workflows, rather expecting them to tailor their workflows to our design.

This past year, however, has been particularly transformative. We have made a quantum leap forward by upgrading our EHR into something far more—an intelligent, data-focused solution that responds to today’s industry challenges and lays a solid but flexible groundwork for the future. It’s a unique, best-of-breed, specialty-focused approach that gives users the power to define and collect whatever data points are relevant to their success while still maintaining their preferred clinical workflow options.

What we have achieved so far – 2016 recap

We entered last year determined to expand our physician-centric approach to include all stakeholders in the outpatient healthcare delivery system. Because we put our clients’ requirements first, we had to take a fresh look at what their needs actually were in this changing landscape. The biggest need? Tools to capture the data they wanted, but only that data, without anything unnecessary that would distract from their primary focus. (Click here to read my other post about how we do data differently.) We realized that, to meet those needs, we had to transform our offering into more than just an EHR.

We achieved this by creating a  connected software system that lets practices distribute the data-collection process over the entire treatment encounter—before, during, and after the patient visit—in whatever way is most efficient and sensible for them. Here is what we have delivered:

  • Flexible Data Platform (FDP) – Discrete data collection and reporting, free from a forced template-based environment.
  • Smart Workflows (SWF) – Guided workflow to help practices optimize their daily schedules by letting them determine who does what best, where and when.
  • Patient engagement platform – A patient-portal solution that seamlessly engages the patient pre-visit. Success is measured by higher patient compliance, lower check-in costs to practices, and greater patient engagement in their own health post-patient visit.
  • Interoperability – An Application Program Interface (API) that allows for efficient data exchange between systems, and that gives practices the flexibility to choose the best solution to any given problem (e.g., clinical, financial) without sacrificing cost and/or productivity.

What’s next? – Even more data!

We have already laid the foundation for what is required today and tomorrow. The next step is to ensure that we maximize the value of what we offer by providing the following additions to fulfill our vision:

  • Regulatory compliance – Prepare clients to understand, comply, and succeed while retaining productivity and efficiency focus (e.g., MU / MIPS, AMC, PQRS reporting).
  • Outcomes – Invest in solutions and technologies to help practices drive, improve, and document clinical outcomes to improve patient care and increase reimbursements
  • Data and AI – Continue to optimize SRS’s recently released SWF and FDP solutions to leverage data and artificial intelligence to optimize clinical workflows.

We understand that no two practices are alike—they all have different rates and style of data collection. One practice may need to automate everything immediately, while another may only automate elements that will drive down costs, and decide to keep other processes manual. Our solution is designed with this level of flexibility in mind—to satisfy each practice’s requirements for today while having the functionality to support their evolving needs in the future.

Wrapping it up

The underlying SRS strategy is a physician-centric approach we call “practical innovation.” We are more than just a solutions vendor . . . we focus on finding a solution to the specific challenges facing specialists. We partner with practices to solve their actual business problems—we help them stay independent, drive revenue growth, lower costs, stay compliant with regulations, and demonstrate clinical quality.

If you’re looking for a partner who will really listen to you and understand your needs, who will help engage your patients and produce better clinical outcomes, who will keep your practice competitive in a changing environment, then SRS is your partner of choice—for today, and for whatever unpredictable tomorrow awaits us down the road.

The Final MACRA Rule: Free Pass or Risk-Free Opportunity

Lynn Scheps

Lynn Scheps

VP, Government Affairs & Consulting Services at SRS Health
Lynn Scheps is a leading resource on meaningful use and the EHR incentives. She is the SRS liaison with government policy makers. Representing the voice of high-performance physicians, she develops strategies to respond effectively to government initiatives.
Lynn Scheps

opportunity-ahead-blogCMS has given providers an early holiday present with the Final MACRA Rule, affording everyone the opportunity to easily avoid a penalty in 2019. This is surely reassuring news and has been widely received with a huge sigh of relief—but before you let your guard down, it is important to acknowledge that the program will build back up to an only slightly modified version of its originally proposed self, with many of the complexities and challenges intact. CMS is calling 2017—and to a lesser extent 2018—“transition years.” Treating them as such offers an opportunity to prepare for the future, while treating them as a free pass only delays the inevitable.

In 2017, eligible clinicians who participate in MIPS can protect their 2019 Medicare fee schedule by merely reporting any ONE of the following:

  • 1 quality measure, or
  • 1 Improvement Activity (formerly called Clinical Practice Improvement Activities), or
  • The 4 required Advancing Care Information (formerly Meaningful Use) measures.

Anyone who has participated in Meaningful Use and/or PQRS has already far exceeded these requirements, and will find this an extremely low bar. So why not aim for one of the more advanced “pick your pace” participation options and potentially benefit from an upward adjustment to your fee schedule? All it takes is reporting anything more than the above for a period of at least 90 days, and you could earn a “small” adjustment in 2019. Participate more fully—for anywhere from 90 days to a full year—and you could be eligible for the maximum, albeit “modest,” payment adjustment. (Note that it is performance that drives the payment adjustment, not the length of the reporting period.)

The downside of this new flexibility is that these “small” and “modest” adjustments for successful MIPS participants will now be very small or modest in 2019—far short of the originally planned 4%. Congress mandated that MACRA be budget neutral, so with dramatically fewer losers in 2017 to fund the gains of the winners, bonuses will be scaled down. Near-term financial rewards are unlikely to be a strong motivator of compliance this year.

However, by 2020, the difference between the most and least successful providers will exceed 18% (i.e., 2022 payment adjustments will range from -9% to +9% with potential additional bonuses available for the highest performers). So while it might be tempting to sit back and relax next year, consider using 2017 instead as it was intended—as a transition from MU and PQRS to MACRA. If you have been successful in the past, now is a good time to experiment with new workflows, new technologies, and/or alternate measures or reporting methods that might improve your performance. If you’ve never participated in these programs before, you can start now and get off the penalty track.

You can view the 2017 Final Rule as a free pass or as an opportunity—the choice is yours.

The Hills Are Alive…With the Sound of a New SRS!

Scott Ciccarelli

Scott Ciccarelli

CEO at SRS Health
Scott Ciccarelli, Chief Executive Officer at SRS, has more than 20 years of diverse management and operations experience garnered as a senior executive at GE, where he headed two of the company’s businesses—most recently, GE Healthcare’s Services, Ambulatory and Revenue Cycle Solutions. His areas of expertise include business strategy, leadership development, operational rigor (Lean Six Sigma), and the delivery of enhanced value for customers through quality improvement and innovation.
Scott Ciccarelli

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mountain-blogI love that our annual event is called the SRS User Summit – because this year, the news was so good that I wanted to shout it from the top of the tallest mountain! (Or, maybe sing it, but I’m no von Trapp family member…) Every member of the SRS team felt the same way. Thankfully, after hearing our big news, so did the clients who attended.

Here’s the shout-worthy news: SRS has completely transformed into an intelligent data-focused solutions provider. Our days of being a document management company are behind us. And rather than tweaking existing template-based systems as many of our competitors have chosen to do, we pioneered a specialist-oriented solution that simply doesn’t exist elsewhere. We have invented a new approach to data that is totally revolutionary – balancing speed, efficiency, data collection and sharing.

Why? Demands on medical practices have become even steeper, and the main path followed by other HCIT vendors won’t help specialists reach their goals. That’s why SRS is carving out new trails in order to provide the level of partnership that is needed today and tomorrow. Together, we will achieve:

  • Better patient engagement
  • Better clinical outcomes
  • Better operational efficiency

I know that’s a lot to claim. That’s exactly why I was so excited to unveil the new SRS at the User Summit: because as someone with a high say/do ratio, I’m thrilled to say that we can back up every claim we are making! Here are a few examples of what’s available now, and what is coming soon:

TODAY

  • Patient Engagement Platform– streamline the registration process by enhancing the digital intake experience and reduce appointment “no shows” with automated reminders. Influence patient behavior through meaningful engagement in both pre and post visit by customizing patient forms to practice requirements, and leveraging patients to complete forms online before their appointment.
  • Smart Workflows –our revolutionary patent pending Smart Workflows allow you to collect more data and quickly document patient encounters with customizable workflows, provide standardized care efficiently through protocols, drive compliance with regulatory and quality improvement initiatives, and demonstrate the value of your services through analytics and outcomes.
  • Data Interoperability – capture then share discrete clinical data with other information systems across all parts of the healthcare network through the use of our APIs.

TOMORROW

  • Flexible Data Platform –capture the data you want, when you want, and how you want with our data capture platform. It empowers users to drill down and capture and report on any discrete data point that is truly relevant to them.
  • Integrated Best of Breed – enjoy the seamless user experience of our tightly integrated healthcare IT ecosystem—including EHR, Practice Management, Patient Portal, and Transcription—each selected for their ability to serve high-performance specialists and to easily integrate with your practice’s other HCIT solutions.
  • Patient Population – improve patient outcomes through tailored outreach campaigns that educate them post encounter, as well as setting up reminders and sending out surveys to collect more relevant data.

Of course, some things about SRS remain the same – and we promise, they won’t change! For example, we will continue to guide you through regulatory compliance, thanks to our own governmental Sherpa, Lynn Scheps, who has already dug into the 2,398 pages of the new MACRA rule released a week ago.  Plus, the superb client service for which we are known will continue to be core to the SRS experience.

We understand that the future will continue to be an uphill climb. But with SRS by your side, you’ll have the right tools on the right paths. Now that is something to sing about!

MIPS: 5 Things You Can Do Now to Prepare

Lynn Scheps

Lynn Scheps

VP, Government Affairs & Consulting Services at SRS Health
Lynn Scheps is a leading resource on meaningful use and the EHR incentives. She is the SRS liaison with government policy makers. Representing the voice of high-performance physicians, she develops strategies to respond effectively to government initiatives.
Lynn Scheps

5-things-mips-blogEven though the final MACRA rule is not expected until November 1, 2016, you would be well advised to start putting an action plan in place now. As proposed, the first performance year begins on January 1, 2017, a mere 2 months after the expected release of the Final Rule—you won’t have sufficient time to prepare if you wait until then. Yes, CMS has hinted about a possible delay or a shortened reporting period (in response to numerous concerns expressed in the 4,000 comments to the proposed rule), but you cannot bank on that until it is finalized. There are things you can do to start planning your strategy and improve your chances of success when this first regulatory foray into value-based payment begins:

  1. Focus on 2016 PQRS reporting: Quality reporting carries a 50% weighting next year, which makes it the most important of the 4 MIPs performance targets, (the others being Advancing Care Information, aka MU; Clinical Practice Improvement Activities; and Resource use, aka cost). Take advantage of the next 4 months to improve your quality measure workflow and reporting.
  1. Think about whether to report MIPS as individual physicians or as a group: It’s important to look at your practice’s current MU and PQRS performance as a predictor of which option might be more beneficial. You may already be reporting PQRS as a GPRO—success here makes a strong argument for reporting all categories as a group. (Remember, as proposed, you must report consistently across all 4 MIPS categories.)
  1. Develop workflows to support success: Identify the ACI patient engagement and health information exchange (HIE) measures that are of most interest or relevance to your practice. Analyze and try to enhance the workflows that support these measures. Ask your EHR vendor for a professional services evaluation—they may be able to offer assistance in this regard.
  1. Review the list of Clinical Practice Improvement Activities: Review the list provided in Table H of the Proposed Rule. Are there activities that fit your practice or possibly some that you were considering, even before MACRA?
  1. Evaluate your current technology resources: Is your EHR up to the job—or is it killing your productivity, particularly when you use it to meet the government requirements? If you are not satisfied, now is a good time implement new technology.

The most important step to take now and in the coming months is to keep yourself educated and up to date as the regulations evolve and the start date approaches, (But you clearly know that, since you’re reading this post!) On cms.gov, you will find Quality Payment Program Resources pages. You can also consult your professional societies/academies for specialty-specific guidance or reach out to your EHR vendor for training. I invite you to watch (or watch again) my webinar titled, “MACRA/MIPS: 962 Pages in 30 Minutes”, which is available on demand.

The Right Tools for Relevant Results

Adam Curran

Adam Curran

Product Marketing Manager at SRS Health
Adam Curran is a Product Marketing Manager at SRS. He oversees marketing intelligence to support the development of strategic marketing plans. Prior to joining the organization, he was a key member of a pharmaceutical software company’s Clinical Development Business Unit, specializing in the clinical data management elements of the drug development lifecycle. He was also the editor for their microsite’s blog. Adam has also held roles at the UK’s National Energy Foundation and Skills Funding Agency.
Adam Curran

surgical-tools-315pxThere is discussion in the industry about the effectiveness of healthcare information technology (HCIT) solutions. And so there should be; although we have seen improvements in HCIT solutions, a significant number of physicians are not happy with their current systems. Perhaps it is because some vendors feel that they know what’s better for their practice, and build the system around their vision at the expense of how the doctor likes to do things. Or maybe it’s because vendors sell practices solutions that aren’t specialized to their requirements—leading to complexity, fatigue and frustration. In either case, doctors are forced to use tools that are inappropriate to their needs and slow them down.

It’s not rocket science: doctors want tools that help them do their job effectively. Like the stethoscope—it’s one of the oldest medical tools still in use today, but it continues to perform an essential task, even in an era of high tech, and there is nothing complicated about it. Although it was originally invented to spare a young physician the embarrassment of putting his ear directly up against the chest of a young woman, it turned out to have enormous diagnostic value. Because of that, the stethoscope quickly caught on with other doctors.

Another good example is molecular breast imaging (MBI). Mammography was a good way to detect breast cancer, but MBI turns out to be three times more effective at finding tumors in dense breast tissue. MBI is simply a tool that has produced better results.

What about laser surgery? Developed at first for eye and skin surgery, it has expanded its range to include different medical and cosmetic procedures, from cosmetic dermatology to the removal of precancerous lesions. Laser surgery allows doctors to perform certain specific surgeries more safely and accurately—again, a new tool that provides better results.

When it comes to HCIT solutions, however, the reception has been decidedly less enthusiastic. Maybe that’s because, in contrast to the examples above, it hasn’t been clear what the purpose of HCIT solutions actually were. To help doctors collect data on patients, or to help administrators collect data on doctors? To make practices more efficient, or to simplify the government’s monitoring of public health? Without a clear task to perform, it’s not surprising that HCIT solutions have produced mixed results. It’s hard to assess the value of a tool when you aren’t sure what it is supposed to do.

It turns out that, like the stethoscope, electronic health record solutions were a tool designed for extra-diagnostic reasons, and then later repurposed. However unlike the stethoscope, the adoption of EHRs has been driven not by doctors who found them helpful, but by hospitals, insurance plans, and government agencies who sought to control skyrocketing costs and standardize healthcare. This disparity has been an underlying cause for ineffective workflows within the systems. And even when EHRs were designed with physicians in mind, they were designed for primary care physicians, leaving the specialist community underserved.

What is clear is that, when an HCIT solution is designed with the primary purpose of helping doctors, the industry does see value in them. According to the latest Black Book survey of specialty-driven EHRs, 80% of practices with specialty-distinctive EHRs affirm their confidence in their systems. The same survey reported that satisfaction among users who had switched to specialty-driven EHRs has shot up to 80%. And finally, 86% of specialists agreed that the biggest trend in technology replacements is specialty-driven EHRs due to specialist workflow and productivity complications.

The statistics show what we already knew; doctors want the technology and tools that give them relevant results. Like earlier great medical inventions, HCIT can play a vital role too. One positive development is that EHRs, like the lasers used in surgeries, have evolved to serve a variety of specific purposes. Just as there isn’t a single type of laser that is used by both ophthalmologists and dermatologists, EHRs are increasingly specialty specific.

This means that specialists are no longer forced to use systems designed for primary care physicians that collect every piece of data that every type of doctor might possibly need. That sort of all-inclusive data collection doesn’t lead to better results; if anything, too much data causes unnecessary clutter, making analysis more difficult. What is crucial is having more RELEVANT data. Specialists need EHRs that collect the data that is relevant to them, and only the data that is relevant to them. They need an HCIT solution that is driven by their specialty, that respects their workflow, and that has the flexibility to handle their practice’s unique requirements.

To find out more about developments in HCIT solutions that are improving patient care, check out our latest whitepaper, “Healthcare: How Moving from Paperless to Frictionless is Improving Patient Care”.

90-Day MU Reporting: Deja-Vu All Over Again!

Lynn Scheps

Lynn Scheps

VP, Government Affairs & Consulting Services at SRS Health
Lynn Scheps is a leading resource on meaningful use and the EHR incentives. She is the SRS liaison with government policy makers. Representing the voice of high-performance physicians, she develops strategies to respond effectively to government initiatives.
Lynn Scheps

flag-money-stethLast week, in keeping with what seems to have become a mid-year tradition, CMS issued a proposed rule that—amidst its 700-plus pages related to hospital payments—reduces the 2016 MU reporting period from the full calendar year to any 90 consecutive days. (Note that this applies only to providers participating in the Medicare, not Medicaid, EHR Incentive Program, and has no effect on PQRS reporting.) Would it have been better if the announcement had come in a more timely fashion—i.e., at the beginning of the year instead of the middle? Absolutely! But don’t let that keep you from taking advantage of this opportunity.

This is good news for providers who had given up on MU for 2016—or who got off to a slow start on the program this year. Here’s an opportunity to get back in the game and avoid the 2018 payment adjustment (3% or 4%, to be set at the discretion of the Secretary of HHS). It also provides a bit of a breather for those who are successfully demonstrating meaningful use and may be able to identify an already-completed 90-day period during which they met all the requirements. These providers can now turn their attention to preparing for MACRA, which is proposed to be effective on January 1 and in which MU (renamed “Advancing Care Information”) is only one of the four components.

So, what accounted for this change? Is it an indication of a kinder and gentler CMS to come? The CMS Fact Sheet states that CMS is trying to “assist health care providers by increasing flexibility in the program.” Was it in response to the deluge of comments to the MACRA rule that screamed “Help!,” or to the repeated requests for relief submitted by providers, organizations, and members of Congress? Let us know below what you think brought about this change of heart.