By now, we know physician practices have slightly different rules when it comes to their IT, and just as their technology is different, so are the challenges they’ll face in the upcoming year.
Whether it’s meaningful use or simply finding the right personnel, 2012 promises to be chock-full of tricky IT issues for physician practices. Bob Dean, vice president of technology at ChartLogic, gives us the top 10 challenges for physician practices in the new year.
1. Choosing the right technology. According to Dean, physicians will face a significantly increased number of data reporting requirements in 2012 and 2013. “For practice leaders, the decision is not whether to purchase an EHR, but what type is right for their office,” he said. “In addition to the technology, customer service will play a key role, since many small medical groups are unable to hire a full-time, or even part-time, IT staffer.” And when it comes to meaningful use requirements, Dean said providers should keep in mind they’ll have to collect vital signs during patient visits, in addition to nurses and medical assistants. “The surgeon will need to document his evaluation of the patient. So, surgeons should look for an EHR system that can speed up the data entry process through dictation or click minimization.”
2. Finding skilled, affordable IT personnel. Studies have shown the demand for consultants is at an all-time high, which is due in part to the rapid growth of the industry. “For example, the EHR market is projected to grow from $973 million in 2009 to $6.5 billion in 2012,” said Dean. A report from CHIME also found IT staffing shortages were putting projects at risk, and it noted a project shortage of 50,000 qualified IT personnel in the next two years. “The CHIME survey found that out of CIOs looking for personnel, 71 percent said they had open positions in clinical software implementation and support,” said Dean. So what’s being done to combat the issue? “On the positive side, the federal Office for the National Coordinator for Health Information Technology has initiated four IT workforce development programs,” said Dean.
3. Monitoring payments for ANSI-5010 compliance. “As of Jan. 1, 2012, all physicians and hospitals will be required to submit bills using the ANSI 5010 transaction standards,” said Dean. “The move to the new electronic transaction standards was required by the coming 2013 deadline for ICD-10 codes.” Many practices are depending on their practice management vendor or medical billing company to upgrade their system, he said, and although most vendors will be complaint, some smaller firms may not be ready for January 1. “In addition, it’s possible some payers may experience glitches in the first few days of the system,” Dean noted. “For these reasons, ask your PM vendor or billing agency for reports on key metrics.”
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4. Qualifying for meaningful use. Dean outlined how qualifying for meaningful use starts with implementing a certified EHR, which means the EHR has been tested by an organization designated ONC-ATCB (Office of National Coordinator, Authorized Testing and Certification Body). “There are more than 350 certified EHRs across two categories,” he said. “In-patient and ambulatory. And, there are two categories of ONC-ATCB: full and modular. A fully certified EHR enables a practice to earn meaningful use payments without any other software system.” An EHR with modular certification, Dean added, is only approved for certain tasks, and a medical group will need to purchase at least one, or two or three, modular systems to qualify for meaningful use payments.
5. Moving to cloud computing. Although few physician practices are using cloud computing, “this new service holds tremendous potential in terms of expanded services and lower costs,” said Dean. He said for a small to medium size practice, SaaS is easier to install and maintain, and no backup hardware is required. “All you need is an Internet connection,” he said. “Most cloud-based software vendors offer concierge telephone support and extensive training tutorials.” And in addition, the practice may see a reduced need for on-site IT support staff. “Finally, with SaaS, you can access needed clinical information from remote locations, including your home or a hospital.”
[See also: Physician Practices and Ambulatory Care News Briefs.]
6. Meeting tighter HIPAA standards. Due to the increased enforcement of HIPAA laws in 2012, Dean suggests basic HIPPA practices, like encrypting all data on laptops and storing servers in a locked room or cabinet, for small and large medical groups alike. “In addition, proposed new rules will increase a patient’s right to medical information,” he said. “One proposed rule would give individuals the right to obtain a report of everyone who accessed their protected health information.” Such a report, he said, would include a list of everyone who accessed a patient’s EHR, including all employees and other third parties working on behalf of covered entities. “This includes medical groups, hospitals, and health plans,” Dean added.
7. Preparing for ICD-10 compliance. “This change will have a major impact on practice billing,” said Dean. “Medical group executives will have two challenges to make the transition successfully.” First, they should make sure their EHR and PM vendor has prepared for the switch. And second, they must be sure their physicians and support staff has been properly trained. “The vast expansion of coding possibilities will require new ways of documenting patient care,” he said.
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8. Using patient portals. Under new meaningful use rules, a physician’s office must provide clinical summaries to patients within three business days of the visit, and printing and mailing the summary is a costly option. “One cost-effective alternative is to install a patient portal,” said Dean. “It’s a Web-based application that allows patients to interact with their providers. Many, but not all, certified EHRs come with patient portals.” He added when a practice installs a portal, staff can upload the clinical summary to the web site to be viewed by the patient. “Note the current meaningful use standards don’t require patients read or download the clinical summary,” he said. “It just needs to be ‘provided,’ generally interpreted as sent electronically.”
9. Incorporating mobile technology. “Clearly, use of tablets and smartphones will increase,” said Dean. “For practice managers, the challenge will be to integrate there devices safety and securely into the EHR.” A recent survey found many physicians are interested in owning tablets because of the ability to download patient data. The report also found that top concerns for physicians were patient safety, physician liability, and lack of reimbursement for time spent using the technology. “As noted earlier, EHRs available through SaaS offer the advantage of storing data remotely,” said Dean. “If a device is lost or stolen, no data is disclosed.”
10. Sharing data with HIEs and ACOs. According to Dean, HIEs are a key technology component of ACOs because they enable sharing of patient data, including lab results, prescriptions, and care summaries online. “Although there are 75 fully operating, multi-stakeholder HIEs around the country, the number is expected to significantly increase,” he said. “With the introduction of the National Health Information Network (NHIN) Direct, physicians with advanced EHRs can exchange clinical data with little difficulty.” Moreover, he said, advanced EHRs can be configured to accept direct messaging without creating interfaces or buying additional software.
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