- When keeping up with EHR and health IT news, it’s easy to get lost in the whirlwind of hot-button topics.
From different emerging federal incentive programs to new thoughts on how EHR data can or should be used, there is always something different to learn about in the health IT industry.
That said, there are topics that frequently pop up, demanding regular attention. Below, EHRIntelligence.com has outlined a guide to understanding some of the most importent topics in the health IT and EHR industries.
Health data interoperability
Interoperability is not just a buzzword ringing throughout the healthcare industry – its nearing a full-fledged movement, with 90 percent of the nation’s EHR vendors and five of the largest health systems signing an HHS-led interoperability pledge at HIMSS 2016.
The push for interoperability does not end there. Organizations left and right are recognizing the need for seamless transfer of health data between disparate systems and are working together to do something about it.
Earlier this year, the Office of the National Coordinator for Health Information Technology (ONC) announced its tech lab for health IT developers working on interoperability projects. HL7’s FHIR is also hosting myriad health apps that work on different technologies.
Along the same wavelength as interoperability, healthcare professionals are focusing on the problem of health data blocking.
Just last week, ONC’s Karen DeSalvo testified that the surge in EHR adoption since the passage of the EHR Incentive Programs has brought to light the need for action against data blocking. DeSalvo says state data blocking laws need to sync so that physicians can exchange information with little difficulty.
"You are touching on the challenge that has emerged since we have been adopting electronic health records and moving to a digitized system — that is, that state laws vary and there is some need to harmonize that," DeSalvo said to the House Committee on Oversight and Government Reform.
The American Hospital Association (AHA) has also called on Congress for better clarification on data blocking laws, and last year the Office of the Inspector General (OIG) discussed potential consequences for data blocking.
EHR replacement and optimization
As the healthcare industry shifts to outcomes-based, patient-centered care, their health IT needs are shifting, too. In identifying EHR-related challenges to their employees’ clinical workflows, healthcare executives are seeking solutions in EHR replacement and EHR optimization.
They key to executing a successful EHR replacement or optimization project is identifying the problem at hand and then carefully developing a solution to mitigate it. Experts say EHR replacement project leaders should take a slow and calculated approach to this.
"We take a little more time — six months — and what we do in that timeframe is to put forward an objective process," said Mark Hess of Stoltenberg Consulting Group in an interview with EHRIntelligence.com. "When we go into these kinds of events, there is a natural bias towards a direction. When we have those clients who ask us for a 90-day process on a significant decision — a $40- to $50-million decision — that bias is actually something in the past that affected the way they thought before."
This slower approach helps facilitate collaboration amongst the many hands that should and often do contribute to the EHR replacement or EHR optimization projects. Likewise, slow and steady EHR replacement project trajectories help project leaders technically execute the different components of the project – such as data migration – with success.
Ultimately, this pushes hospital leaders and providers alike to be invested in the project, thus leading to better provider buy-in.
"The best part of this is the implementation goes more smoothly," Hess argued. "When they have this collaborative approach, they are all bought in before it even starts. We're seeing better results through the implementation cycle, through the optimization cycle. The executive team doesn't tear and that cycles all the way down to the end-users."
The EHR Incentive Programs and MACRA
The buzz around federal health IT programs is not necessarily new. Since the 2011 start of the Centers for Medicare & Medicaid Services (CMS) EHR Incentive Program, healthcare professionals all over have been discussing federal incentives for health IT adoption.
Most recently, discussion of the third and final stage of the EHR Incentive Program have taken over. In October 2015, CMS released the long-awaited final rule for the Stage 3 Meaningful Use, which was met with significant provider pushback.
The agency received notable backlash from professional organizations including the American Medical Association (AMA), College of Healthcare Information Management Executives (CHIME), the Healthcare Information and Management Systems Society (HIMSS), and even members of Congress.
"We urge CMS to use the additional public comment period provided for Stage 3 to further improve the program and consider changes related to the Medicare Access and CHIP Reauthorization Act, which was signed into law earlier this year," said Steven J. Stack, AMA president.
"We also want to make sure that EHR vendors have the time they need to further test products for interoperability, usability, safety and security. We hope that health IT certification is nimble enough to accommodate future technology innovations and that the program not seen as final at this time."
Since then, CMS has made several buzz-worthy announcements regarding Stage 3 Meaningful Use, specifically at the JP Morgan Healthcare Conference earlier this year. At the conference, CMS’s Andy Slavitt announced significant changes to the program.
“The CMS meaningful use program as it has existed will now effectively be over, and replaced with something better,” Slavitt announced. The program is apparently slated to make changes that would put providers in control of EHR incentives, focusing on patient-centered outcomes and results-based incentive payments.
Although that announcement sparked a sigh of relief across the healthcare system, meaningful use still functions as is, as professionals anxiously await CMS’s planned changes.
Healthcare professionals are also gearing up for new federal health IT programs such as the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS). These programs offer a chance for incentive payments based on several different quality assessment programs, scored on a scale of zero to 100:
Meaningful use: 25 points
Physician Quality Reporting System/Value-based Modifier: 30 points
Value-based Modifier Cost: 30 points
Clinical Practice Improvement: 15 points
Ideally, these programs will support outcomes-based payments and shift the healthcare industry away from a box-checking mentality toward health IT use. Through adequate understanding of and prescription to these incentive programs, providers can help push the industry toward outcomes-based, patient-centered care.