Science Friction

Innovation ExpoWhen I was growing up, Star Trek was the vision for the future of technology: intergalactic travel, teleportation, and tools that helped doctors heal instantaneously were portrayed as de rigueur. Here in 2015, technology has not quite caught up with the starship Enterprise crew—and while medical advancements since the sci-fi series’ 1966 launch date are extraordinary, there are modern-day tools that can hinder almost as much as they help. That’s science friction, and it can get in the way of the doctor-patient encounter. Is it possible to help physicians reap the benefits of HIT while maintaining the human nuances that define the art of medicine? We think so. That’s our mission at SRS.

We shared our Mission and Vision earlier this month at our annual User Summit, and we received such positive feedback from our clients that I thought I should share it here as well. I’ve been here just over a year, and I am so excited about what has happened during that time—and even more so about what we have planned for the not-too-distant future.

Our Mission is our PACT: Passion, Accountability, Collaboration, Transparency. Far more than just a clever acronym, these core values empower us to deliver on our mission to advance healthcare by providing HIT solutions that allow providers to deliver outstanding specialized patient care. Our Vision is to be the premier HIT solutions partner for specialty practices, and ultimately advance healthcare by introducing frictionless HIT solutions… constant commitment to our core values ensures that we preserve the individuality of specialty practices by designing and implementing innovative HIT solutions that support their unique goals.

Frictionless. This clarity of purpose is deeply routed in what we heard from our clients at last year’s User Summit. Specialty practices agreed with our guiding principles—improve practice productivity, demonstrate clinical quality, increase speed and value of reimbursements, and meet government regulations—but we heard their frustration about HIT getting in the way of their patient encounters. Patients need to be able to look their doctors in the eye—not stare at the back of their heads as they click away on a computer.

So we have adjusted our course. Now, protecting the doctor-patient relationship is our North Star, and our innovative team is literally developing the HIT solutions of the future. Of course, our commitment to productivity, quality, value, and meeting governmental regulations remains steadfast, but our technology will be adding value without subtracting it from the human side.

Those who attended the Innovation Expo at our User Summit got a sneak peek at things to come—and their reactions were otherworldly. We hope yours will be too.

Beam me up,
Scott(y) Ciccarelli

What’s your dream for the future?

New World, New Key Performance Indicators (KPIs)

new-world-blogI am not the first and will most certainly not be the last to discuss the shift from the fee-for-service model to the value-based model. Additionally, I do not claim to have any answers on where we will end up on the continuum between the two. What is obvious, however, is the fact that we need to begin looking at how we measure success today and how it will be measured tomorrow.

Most articles and studies today focus on large, complex health systems because they are at the forefront of the changes. Given the rocky start to programs like the 2-year-old CMS Pioneer ACO program—where 75% of participants failed to earn bonuses—the buzz on the shift to value is less than positive. So the question remains, how do we get ready for the shift and avoid the pitfalls seen by the health systems?

Change your KPI (Key Performance Indicator) perspective!

Practices today are very focused on cost reduction. As with any business, if you reduce unneeded costs, and maintain revenue, you increase profitability. Well, what if we translated that in the value-based world to Cost of Care? Imagine that you start this now and can soon prove that by reducing unneeded tests, prescribing generic drugs, and adding a rigorous pre- and post-surgery education program, your total Cost of Care is lower. This information could be used to gain bundled payment bonuses, not to mention the added benefits of cost reduction itself.

Other KPIs that should change are around patient access and engagement. Most practices have adopted the meaningful use benchmarks as their high-water mark for portal usage. However, we should change the conversation to true Patient Engagement. Rather than X% of providers sending a message to a patient or completing a VDT task (patients viewing, downloading or transmitting their clinical record), track the value added by your portal. Ask yourself if patients with a portal are more loyal? Do they add on more ancillary services that you provide? Do they refer more new patients to your practice? Do they have a better pre- and post-surgery experience? Aside from these more qualitative measure that can increase value, you can track cycle times for clinical and non-clinical processes, which directly impact costs to you in terms of staff time.

Last but not least is something that health systems already track but that can be adapted to the specialty ambulatory setting, Capture Rate. This is the portion of the patient’s total care that is captured by your practice. This means driving adoption of “other” services or simply grabbing market share. This KPI can be driven up by providing advanced access. This may mean having a percentage of the schedule open for on-demand access, or adding e-visits, or expanding hours. You can dovetail this with a portal to provide a more self-serve model. The concept here is that if you can provide more of the touch points in your practices, you can reduce costs along the continuum of care.

Experiment, Adjust, and Communicate.

Defining your KPIs is the first step towards creating a measurable improvement. While the ones above are some suggestions, your team may come up with more targeted KPIs based on your practice goals. A few quick tips as you go forward.

  1. Keep it simple – KPIs are not about data for the sake of data. Pick 1 or 2 and experiment.
  2. Be ready to pivot – We learn the most from mistakes and there is nothing wrong with changing course when you have more data.
  3. Consider both short- and long-term goals – Don’t try to jump to 100% value-based KPIs in 1 step.
  4. Communicate! – The biggest mistake you can make is not involving your entire organization. The full team must understand the end goal and then progress toward it. Nothing kills an initiative like the lack of a sense of ownership.

What are your teams doing to get ready for the shift to the value-based model? Do you have KPIs that you’d like to share?

Patient Engagement: Build a Strategy for Patient Empowerment

dr-patient-selfie-42511727_sRemember the days when the provider-patient relationship was centered primarily on the interactions that occurred during a visit? Whether it was in the exam room, over the phone or at the hospital, these were the places where the provider-patient relationship was built. Now, patient care encompasses more than just the traditional office visit and a physician’s bedside manner. A lot more emphasis is being placed on the patients—engaging and empowering them to partner in the healthcare process.

Patient Engagement is a hot topic in healthcare – a quick google search and you’ll come up with countless references to infographics, successful approaches, and tools to help build a patient engagement strategy. You will also find articles that discuss how patient engagement can have positive effects on improved quality of care and patient outcomes. The frameworks vary from simplistic to more complex, but the common theme is partnering with your patients and building ownership of their health and healthcare. Some examples of an effective PE strategy include: providing patient-specific education, making patients’ health information available online, including the patient in developing care plans and coordinating with other caregivers.

With an increased focus on patient engagement and interoperability incorporated in Meaningful Use Stage 2, many of these suggested practices can be accomplished using your EHR. Although many providers are anxiously awaiting the Final Rule Modifying MU Stage 2 in 2015 – 2017 and hoping for lower thresholds on the patient engagement measures like Patient Electronic Access and Secure Messaging, it is safe to say these measures are here to stay and will have increasing threshold(s) over the next few years.

So if there was ever a time to start building or improving upon your engagement strategy – the time is now! Whether you go at it on your own or use your EHR to help accomplish these goals the resources are abundant. What will your strategy include? Maybe you’ve been actively engaging patients for years and have some best practices to share. What helps to empower your patients?

Choose a Partner, Not a Vendor

tree-blog2In today’s day and age, we are all guilty of looking for instant gratification. When we shop, we want same-day shipping, or we want it to be in stock so we can pick it up. To make matters worse, we can get the same product from 100 different vendors. So if Widget World doesn’t get it to me fast or cheap enough, I’ll just get it from MyWidgets.com. These buying trends force vendors to compete on price alone and reduce the quality of the buying experience and service.

When you are buying a 60 inch TV or a laptop, it’s a non-issue, but is this mentality flowing through into your business decisions? If you are looking for HIT solutions, you’ve no doubt seen that most vendors are starting to sound the same, look the same, claim the same benefits and are simply competing on price and how fast they say they can get you up and running.

I believe we should go back to the days of partnerships! A partner makes the effort to understand the problems that your business faces. They consult with you in order to ensure their solutions meet your needs. Partners value the relationship more than getting you to sign the next contract.

You don’t want another HIT vendor, you want a partner. Partners are the better choice!

  • Their success is your success- they’re not just in it for a quick sale. They’re truly invested in your practice’s growth and success, and will continually offer you meaningful guidance and resources.
  • Your visions align- their mission matches your practice goals. An HIT partner who shares your vision will offer more benefits with stronger and longer lasting relationships.
  • Your voice matters- collaboration, sharing of insights, and engagement is important to them. Your involvement is genuinely valued, and they’ll listen and will take action to improve their products or services based on your feedback because they have your interest in mind.

Let’s face it, what I’m suggesting is not rocket science and yet I often see relationships as a distant second to immediacy. I urge you to stop, take a breath and think. When I have a need, can I call someone that knows my practice? If an issue needs escalation, can I get to second or third level management? Can I have a conversation with the Executive team when I have a question about their vision or direction?

If you need the answers above to be “YES”, make sure you find a partner.

What’s your criteria for choosing a partner?

What is all this talk about “The Cloud?”

cloud-gears-blogOver the past several years, you probably have heard people talking about “The Cloud.”  It sounds very exciting and mysterious! You may have thought:

What is The Cloud?
Am I in The Cloud?
How can I use this whole Cloud thingy?
I want to be in The Cloud!

Let’s see if we can ’demistify’ Cloud-computing and put your mind at ease. In its simplest form, Cloud computing is the centralized sharing of applications, services, data, and resources from a variety of computing devices. What that means is, anything you do on your device is stored somewhere other than in the device itself. Think of The Cloud as a central repository for e-mail, photos, videos, and other data that you can access using the Internet. A Cloud computing company is keeping your data safe and sound for you, so you don’t have to carry around bulky hardware or worry about setting up security solutions. The Cloud also allows you to share or collaborate.

Still confused?

What if I told you that you probably use The Cloud all day, every day? Some simple examples of Cloud- computing include applications like Facebook and LinkedIn, services like Gmail and Twitter, resources like Wikipedia or Google, and all kinds of data. For most of us, every time we snap a selfie, it is stored in The Cloud. All of these aspects of Cloud computing are available to us on almost all of our devices. We can share our personal pictures, videos, and e-mail on all of our laptops, tablets, smartphones, and even our watches!

So how does SRS use The Cloud?

You may be surprised at the answer. Every time you load your main dashboard, shared Cloud resources put together the screen to display your requested data. Every Rx transaction is routed through the SRS eRx Pipeline to be analyzed and submitted for the patient and communicated with the pharmacy. Every ICD-9, ICD-10, or HCPCS code is selected from a shared Cloud data resource. Patient data files are transferred through a routing system called CCX. The SRS Patient Portals are complex Cloud applications offering data to patients whenever and wherever they request it. The benefits of Cloud computing are endless.

So the next time someone mentions “The Cloud” you can confidently respond: “I am all about The Cloud!”

CMS Offers Welcome Relief for Transition to ICD-10

reliefIt’s time for those still advocating a delay of ICD-10 to abandon the fight—but they can take heart in the recent concessions offered by CMS. The AMA, concerned about the complexity of ICD-10, has asked for some measure of protection from potential adverse financial impacts of the transition to the new code set, and CMS recently agreed to a one-year compromise.

Recognizing the challenges for providers, CMS has agreed:

  • Not to deny claims based on the (lack of, or incorrect) specificity of the ICD-10 code, as long as the reported code is a valid code from the right family of codes.
  • Not to subject providers to penalties under 2015 quality reporting programs, (Meaningful Use, PQRS, or the Value-Based Payment Modifier), as long as a valid code from the right family is reported for the measure(s).
  • To create an ICD-10 Ombudsman to help negotiate solutions to ICD-10 related problems.

CMS has also acknowledged realistic challenges on its side, and is insulating providers from resulting financial harm by agreeing:

  • To authorize advance payments if Medicare contractors are unable to process claims in a timely fashion (as defined by CMS) due to problems with ICD-10.
  • Not to penalize providers under MU, PQRS, or the V-BPM if CMS “experiences difficulty calculating the quality scores.”

You can read about the above in CMS’ own words in its FAQ document.

Notwithstanding the above, it’s time to get serious about preparing for the transition to ICD-10, if you have not already begun that process. Fortunately, there are some ICD-10 solutions embedded in EHRs and PM systems that make code selection easier than others, but regardless of the particular system you employ, there is a learning curve for physicians, clinical teams, and billing staff members.

PQRS and Prada: The Importance of Building Your Quality Wardrobe

prada-blogWith summer now in full swing, I’m going through my summer attire and have found myself questioning my fashion style. I feel like it’s time to trade in my classic look for something more stylish!

I see a similar trend when I talk with clients about PQRS reporting—they are looking to revamp their reporting style. With more providers subject to penalties under both the Physician Quality Reporting System (PQRS) and the Value-Based Payment Modifier (V-BPM) programs, there is more riding on quality reporting—so it is important to ensure you are dressed for success.

Why building the right quality reporting “wardrobe” is important to your revenue:

If not reporting PQRS in 2015:

  • All PQRS-eligible providers are subject to a 2% PQRS penalty in 2017 and
  • An additional Value-Based Payment Modifier penalty based on group size:
    • 2% for Solo practitioners and groups of 2-9 providers
    • 4% for groups of 10 or more providers

If reporting PQRS in 2015, practices will be evaluated on quality and cost:

  • Solo practitioners and groups of 2-9 PQRS-eligible providers could see a potential increase of up to 2% in 2017
  • Groups of 10 or more providers could receive between a 4% penalty and a 4% incentive

Select the option that’s the best style and fit for you from the list below:

This chart summarizes the PQRS reporting options. The definitive source of requirements is: www.cms.gov/pqrs.

This chart summarizes the PQRS reporting options. The definitive source of requirements is: www.cms.gov/pqrs.

Are you dressed for quality reporting success? Let us know what ensemble fits you the best!