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 MACRA, MIPS, and Meaningful Use. She is the SRS liaison with government policy makers. Representing the voice of specialists and other 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.

OBSERVATIONS FROM AAOE 2016

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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alcatrazAAOE was nothing short of amazing—and not just because the show took place in beautiful San Francisco. In fact, what happened inside the expo halls rivaled many of the sights of the City by the Bay.

As always, attendees were excited about the opportunity to network, learn from industry experts, and be inspired by the keynote speakers. The exhibit hall was crowded, giving us a chance to meet new AAOE members along with spending time with old friends and valued clients. The majority of orthopaedic executives we spoke with were concerned with the same challenges: How do they

  • remain profitable in a value-based world?
  • collect more data without being slowed down?
  • unravel the complexities of regulatory compliance?
  • demonstrate the value of their services through analytics and outcomes?

This made the introduction of our new patent-pending Smart WorkflowsTM Data Platform a big hit. More than simply our latest release, this revolutionary technology helps high-volume specialists bust out of the cage of traditional data capture and practice medicine the way they believe is best. For some, that is as liberating as escaping from Alcatraz itself.

How can an HCIT solution provide such freedom? By putting specialists back in charge of the data capture process instead of allowing them be held hostage by it.  The Smart Workflows Data Platform is designed to capture relevant data at the point of care—based on role, specialty, or practice requirements. In other words, it lets the specialists decide when, where, and by whom data should be collected. The result? Dramatic increases in productivity and efficiency, and an enhanced ability to focus on patient care rather than data input. In addition, Smart Workflows gives specialists the power to determine exactly which discrete data points are relevant to their practice, and to change those data points if and when desired. This eliminates the risks of being locked into one system in a constantly changing regulatory and compliance landscape.

Orthopaedists at AAOE didn’t have to take our word for it—as they visited our booth, they saw first-hand the difference Smart Workflows can make in their practices, and it felt good to see the reactions of physicians and executives as they learned more about Smart Workflows. The platform is the first major achievement of our client-collaborative development process, which makes it a significant leap forward, but it’s also just another step by SRS in helping to prepare our clients for success, both now and in the future.

Of course, we are more than just a technology company, as many AAOE attendees learned when they heard our own Lynn Scheps unravel the complexities of MACRA/MIPS. One of the foremost experts in the industry, Lynn is constantly diving into the ever-changing rules surrounding compliance. Her knowledge helps inform our updates from a regulatory standpoint, and she also provides our clients the human guidance they need to ensure their compliance.

A lot has happened since my last blog post. At AAOE, we were finally able to share the latest breakthrough innovation we’ve been alluding to for months. I was truly proud to unveil our Smart Workflows Data Capture Platform. I hope that, like a lot of the AAOE attendees who stopped by our booth, you are ready to unshackle yourself from the cognitive-data burden that has been dragging you down and coming between you and your patients. If so, we’ve got the key

Free-Flow Workflow: How Did This Help with Data Collection?

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

data-flow“Being flooded with information doesn’t mean we have the right information or that we’re in touch with the right people” – Bill Gates

We are able to collect a wealth of information today, thanks to technological improvements over the last couple of years. For a long time, specialists struggled to get the most out of earlier EHR solutions due to the limited data available. This was not so much the fault of EHR vendors but rather of the inherent limitations of the technology at the time. Additionally, the first “templated” EHR systems were specifically designed for primary care and family practice doctors. These systems were not suitable to meet specialists’ different data needs and handle a much higher volume. I did a post recently on the evolution of data capture (read it here).

When it comes to submitting meaningful use data to CMS, however, with all this data available, identifying and collecting it generally takes a long time. There are studies that show an increase in the number of physicians who spend more than one day a week on paperwork, and that indicate many physicians still feel that EHRs do not save time. Although this technology is allowing practices to comply with meaningful use requirements, the cost seems to be too high.

What are we seeing here? Physicians are spending more time capturing data due to regulations, and this is taking up the time available to see patients. How did we get to a point where the physician is spending more time staring at the screen than looking at the patient? I’m not a doctor, but I can imagine that they went into the profession to actually help people as much as they can, so more face-to-face time with the patient is the end goal here.

What is the solution to handling this volume of data? Certainly not reducing the amount of data—it would be hard and time-consuming to distinguish which data to get rid of. The solution must focus on making it quicker to handle this data. This is where free-flow workflow comes into play. Rather than having to go through the laborious process of submitting the data to each application, it essentially reduced the repetitive steps involved, thereby streamlining the submission of data.

This big time saver helps to alleviate the pain, but there are still limitations. Fortunately, we are now at a point where we can get a workflow that isn’t just free-flow, but also adaptive. To find out more about this development and other future trends, you can read our white paper.

MACRA and MIPS: They Promised Simpler!

Lynn Scheps

Lynn Scheps

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

open-book-formulaThe proposed MACRA rule is here. With the goal of changing the way physicians are paid, this rule proposes how CMS intends to move toward increasingly rewarding value—meaning high quality care at a cost-effective price—over volume.

CMS claims that MACRA will simplify life for providers, (although I’m a little suspicious since it took 962 pages to explain the “simplification”). However, there is no question that the world is about to change. These proposed regs are scheduled to be finalized in November and then be effective on January 1, 2017—a rather ambitious schedule which leaves little time for planning your approach to compliance.

While I haven’t read the entire rule yet, MACRA—Medicare Access and Chip Reauthorization Act—provides two paths for physicians and other clinicians. In the long-term, APMs (Alternate Payment Models, like ACOs) will be a popular route—higher risk/higher reward—but for now, most physicians will participate in the MIPS (Merit-Based Incentive Program) option. So let me provide a few teasers about MIPS, as currently proposed:

  • If you expected an end to Meaningful Use, PQRS, and the Value-Based Payment Program, you will be disappointed for certain. MIPS just changes the names, rolls them up into one program, and adds (yet another) set of required activities.
  • Providers will be scored on a 100-point scale and compared to other providers—this year’s weighting would be 25% MU-type measures, 50% quality measures, a la PQRS, 10% cost, and 15% Clinical Practice Improvement Activities. (The rule spells out how a provider’s score is calculated and the payment adjustment is determined, but you might need an advanced math degree to follow that discussion!)
  • MU is now “Advancing Care Information”. It will have fewer required measures (proposing to eliminate CPOE, CDS, and multiple Public Health reporting requirements), no longer be all or nothing, and will provide some choices to clinicians for how they demonstrate success. CQM reporting will not be part of this component.
  • Quality measure reporting (like PQRS) will be the bulk of the score, but only 6 measures will be required. Like under the Value-Based Payment Program, performance will count, i.e., impact the provider’s score.
  • Assessment of cost will be done by CMS—providers won’t have to report anything. This is similar to how CMS currently attributes a cost factor to providers in calculating the V-BPM.
  • The new category, Clinical Practice Improvement Activities, offers providers a choice of approximately 90 activities from which to choose to earn points in that category.
  • MIPS would be reportable as an individual provider or as a group.

Stay tuned to EMR StraightTalk for more in-depth analysis of MACRA in upcoming posts. We welcome your initial comments.

 

Patient-centric Data Capture—Where Is It?

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

hc-prof-blog-image-v2We all know how increasingly important the patient experience is becoming in clinical trials and healthcare. With more emphasis being placed on quality care and patients’ active participation in their own treatment, it follows that this will have an effect on what solutions and services are required to satisfy consumers in this market. Consumers nowadays have a flood of information available at their fingertips—an amount unimaginable even just 15 years ago. And while the ability to look up symptoms online in the middle of the night has undoubtedly increased the number of hypochondriacs, it has also led to a higher number of truly educated patients, and an accompanying need for specialists to respect and involve them in the diagnosis and treatment process.

But what does it mean to be patient-centric? Our good friend Wikipedia defines it as “support[ing] active involvement of patients and their families in the design of new care models and in decision-making about individual options for treatment.” Not much help, is it really?

The Institute of Medicine defines it as “providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions.” The difference in definitions seems to come down to how involved the patient gets in their healthcare. The first definition suggests that the specialist is at the center of decision making, but supports the patient involvement as well. The latter, at least in my opinion, implies that the specialist actively collaborates with the patient by empowering them with the necessary data to make their own treatment decisions.

By either definition, however, data capture is currently falling short of what it takes to be truly patient-centric, despite how far it has come over the last decade. Electronic Health Record (EHR) solutions have been widely adopted in a variety of healthcare specializations, and although the way they collect data can create friction and inefficiencies with specialists’ workflow, they still provide enormous benefits. They streamline access for the specialists to vast quantities of patient data more quickly than traditional paper-based systems, and they eliminate need for patients to fill out the same forms again and again at each specialist’s office.

With the power of technology growing at an exponential rate, new technology solutions are coming out every day, but the challenge is to figure out how to use these technologies to address the real problems that medical practices are facing. In other words, to provide the right technology solution, one that really works for practices. At the moment, more often than not, EHR software interferes with and takes time away from the doctor-patient interaction. However, by giving specialists data-capture tools that allow them to focus on their traditional role of caregivers and that reduce the time and energy that is diverted away from patients, everyone benefits: specialists win, and therefore so do their patients.

There are already good vendors out there who are designing solutions with specialists’ requirements in mind, and some of these certainly help to give specialists more time with patients. However, to achieve a truly patient-centric solution, data capture will need to both predict and adapt to the data being fed into it in real-time. This would give specialists relevant, up-to-date information right at their fingertips, which they could use both to inform their own decision-making process and to educate the patient on their particular condition. The result would be a collaborative, evidence-based plan of care that—because the patient had participated in creating it—would lead to an increased patient commitment to the plan and a better outcome overall.

That’s what providing a truly patient-centric solution looks like.

To find out more about the evolution of data capture and what to expect in the future, you can read our recent white paper on this topic.

What is HCIT Friction?

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

Latest posts by Khal Rai (see all)

wheelThe Truth Is Stranger Than Friction

I just returned from two eye-opening experiences: HIMSS, the largest health IT event in the industry, and AAOS, the country’s largest orthopaedic conference. Of course, I heard about the amazing benefits of many new technological and medical breakthroughs . . . But what really got my attention was hearing some physicians say that when it comes to productivity, they wish they could return to the days of paper charts.

What? Since when do medical professionals want to turn back time on medical technology advancements like productivity solutions? All of those innovations were designed with an important goal in mind: to help doctors have more time to help more patients. However, due to many reasons, the data collection process is getting in between doctors and patients. That friction is rubbing both parties the wrong way—and the need to get beyond that friction was the clear message I took away from both HIMSS and AAOS.

Friction isn’t inherently bad: it is the force that allows our tires to grip the pavement, lets us steer the way we want to go, and enables our brakes to stop us from crashing. However, excess friction hinders movement and wastes energy: that’s what’s happening right now in the world of EHR solutions. What we need are systems that work with—not against—physicians while they perform their very important work. By creating smarter solutions, we can transform friction into traction: positive momentum that takes us where we want to go, faster—in a way that enhances, instead of interferes with, the doctor-patient experience.

In order to really help advance healthcare, the next generation of EHR solutions must do more than just capture data. They must be intelligent technologies that go beyond frictionless, creating the traction to:

  • Operate in the way that best supports each doctor’s work style, so that physicians can concentrate on patients, not iPads
  • Enable seamless data collection during patient interactions, so that doctors are not spending hours recording data later
  • Leverage mobile platforms and predictive technologies that not only keep up with busy specialists but actually help move them forward

Turning meaningless friction into meaningful traction is the driving force behind what we are calling Smart Workflows. Living and practicing in the Information Age, the only way to go is forward—not to reduce the technology involved, but to reduce its intrusiveness by developing software that easily captures required data while actually prioritizing the physician’s role in medicine. That’s something no EHR has ever done—nor any paper chart, for that matter.

To frictionless and beyond!

~ Khal Rai