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”.

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

Latest posts by Scott Ciccarelli (see all)

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

Buzzword of the Day: Value-based Payment

ekg-moneyThe buzzword of the day is “Value-Based Payment”, and everyone is talking about the transition from volume to value. Recently, Becker’s—the leading source of cutting-edge business and legal information for healthcare industry leaders—interviewed SRS’ Lynn Scheps and Lester Parada as part of an article exploring this very important subject. The article discusses what “value-based” means, how the recently proposed regulations supporting the implementation of the MACRA legislation will impact orthopaedists, and how EHRs must evolve to facilitate practice success in the future. Read Value-based payments are coming for orthopedics: Are you ready?

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.

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.

Top 5 Observations at HIMSS16

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

HIMSS16

With a conference that draws over 50,000 attendees, 1300+ vendors, 300 educational sessions, and interesting keynote speakers, there is always plenty of food for thought. So much so that it can take a while to really assimilate all the information and process it into key observations.

Our team has just returned from the show, so I just wanted to quickly share our top 5 observations at HIMSS16:

  1. Value-based payments: There was much discussion on the shift to value-based payment. The MACRA/MIPS regulations are expected in the spring, which could mean as early as March or as late as June, with the Final Regulations mandated to be published by November 1. While the goal of MIPS is to simplify life for providers (by rolling up all the various current programs into one streamlined program), it’s a good bet that things will get more complex before they get easier. All of this begs the question: How will physicians be ready to comply beginning on January 1, 2017?
  1. Interoperability: No surprise that everyone was talking about this! This was reinforced when big-name healthcare technology providers promised to use standardized APIs to make access to patient information easier. Interestingly enough, this also ties in with the HHS wanting to expand its oversight of electronic health record vendors. The proposal they released on March 1 would allow the agency to review how certified health IT products interact with other products, with the aim to prevent data blocking, and to review certified HIT vendors if required (and even to take away their certification if necessary!) The comment period for the ONC rule ends on May 2.
  1. Population Health: This is increasingly becoming one of the top buzzwords at this show. More and more people are talking about it, but there does not seem to be a clear definition about what value this brings. After discussions with different attendees and vendors, it was clear how unclear it was: everyone was providing different answers. The term population health is much more widely used than it was back in 2003 when it was defined by Greg Soddart and David Kindig as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.” The management element is using the aggregation of patient data to devise actions that improve both clinical and financial outcomes. But what data should be used, especially when it comes to specialty practices? Clearly this is something that needs to be defined to ensure we are getting real value from these solutions.
  1. HHS and CMS: There was an interesting session with Karen DeSalvo (National Coordinator for HIT, Asst. Secretary HHS) and Andy Slavitt (Acting Administrator, CMS) where the barriers to data sharing was discussed, and 3 commitments were announced:
    1. Consumers will be able to easily and securely access their electronic health information and send it wherever and to whomever they want.
    2. Providers will share information for patient care with other providers and will refrain from information blocking.
    3. The government will implement national interoperability standards, policies, and practices and will adopt best practices related to privacy and security.

This further reinforces the 2nd observation in this post about HHS wanting to expand its oversight of electronic health record vendors. This session also brought up an interesting point about data blocking; DeSalvo pointed out that a year ago there were a “host of organizations who denied that blocking even was happening,” and now these same groups are “willing to publicly say that they want to engage in something now they’ve acknowledged info blocking can exist.” Hopefully, these same groups will follow with their pledges. As Slavitt advised, “I strongly encourage you to recognize those that don’t [live up to their pledges]” (FierceHealthIT).

  1. EHR collides with NFL: Denver Broncos quarterback Peyton Manning, the reigning Super Bowl Champ, gave a speech at the show thanking the health IT community. For a man who has gone through 3 potentially career-breaking, neck surgeries, I think it is fair to say he can “fully appreciate the value of information systems to keep hospitals functioning.” A physician joined Manning on stage, discussing the NFL’s EHR system and their portals, allowing players access to their medical details. Manning put it like this: “Football is a game. Revolutionizing healthcare is a mighty endeavor.” He also mentioned that leaders in any field need to evolve to match circumstances (HealthcareIT News).

Of course, HIMMS is a huge show where other topics were discussed too, such as patient engagement and RCM. The points mentioned above were only our key takeaways from it. We want to understand the latest regulations and trends, and how these will impact healthcare specialists. What were your key takeaways?

The End of MU… Oh, Never Mind!

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

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.