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What HIT integration means to meaningful use, ACOs, ICD-10

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- The integration of health information technology systems and services can improve patient services, but how do healthcare organizations and providers overcome the technical challenges related to such programs as meaningful use, accountable care, and ICD-10?

Healthcare providers today face a daunting number of challenges when it comes to the changing regulatory environment and rapidly evolving technology. For example, the financial incentives for the meaningful use of certified electronic health record  technology (CEHRT), the implementation of new accountable care payment models, and the transition to the ICD-10 coding standard all require healthcare organizations to figure out how to integrate applications, cloud services, mobile platforms, and more.

On the one hand, organizations struggling to meet this challenge must divert resources away from improving patient services. On the other hand, solving the integration challenge can directly and indirectly benefit patients.

Integration in meaningful use

Satisfying the requirements for meaningful use will directly benefit patients through greater portability of health and insurance records. However, the requirements for meaningful use include complex IT processes such as recording patient information as structured data and exchanging summary care records.

READ MORE: Federal Opioid Commission Seeks PDMP Health Data Exchange

While many service providers and consulting firms are developing solutions to assist healthcare organizations with their adoption of certified EHR technology, these solutions often have proprietary interfaces that are difficult to use, and the data is typically siloed, causing compliance and application interoperability headaches that can be solved only through integration projects.

As a result, meaningful use compliance has been slow for EHR technology, unnecessarily consuming resources while delaying the implementation of this beneficial technology.

Integration in accountable care

Accountable care organizations (ACOs) have the potential to dramatically improve patient services, but they are also subject to a new payment model that replaces direct payment for services rendered with a system that rewards providers based on the overall health of a population rather than the quantity of services provided.

The IT challenge for accountable care payment models is the ability of providers to coordinate their activities through the advanced sharing of information, such as EHRs and the Physician Quality Reporting System (PQRS), across the variety of legacy on-premises applications that providers have and the new cloud applications they are adopting — all while ensuring the security of this information as it travels beyond each organization’s firewalls.

READ MORE: Few WI Providers Using EHR-Integrated PDMP Link to Full Potential

Integration in ICD-10

ICD-10, the latest revision of the International Statistical Classification of Diseases and Related Health Problems (ICD) will be implemented on Oct. 1, 2014. In theory, the more granular information captured by ICD-10 will result in improved patient diagnoses and outcomes, as well as more accurate and impactful population studies. However, ICD-10 represents a potential threat to provider revenues because its requirements are stringent and providers are fearful that inaccurate coding of ICD-10 forms by individual healthcare professionals could result in a loss of revenue.

The IT challenge for ICD-10 is to provide technology solutions that improve the ease and accuracy of coding by, for example, allowing immediate bedside and exam room notation and dictation through the use of tablets with new easy-to-use interfaces instead of desk-based notation hours after an examination. By streamlining the coding process and increasing the accuracy of coding, providers will be assured of receiving the revenue they are due, making them more likely to invest in new and enhanced patient services.

Why application integration is the key

Whether it’s developing new tablet interfaces to make recording information easier and more accurate or sharing information among multiple providers to better coordinate care, solving each of these challenges requires an application integration effort by the IT department.

READ MORE: CMS Finalizes Changes to Hospital Meaningful Use Requirements

Such integration efforts are not new. IT has made use of “middleware” solutions for decades. Traditional middleware, however, was not designed to support cloud-to-cloud and cloud-to-on-premises integrations, and most middleware development projects are expensive and can take months or even years — time that healthcare organizations simply don’t have. But a new application integration solution has come to prominence that can help IT departments meet the challenges of the evolving healthcare environment faster and less expensively: integration platform as a service (iPaaS).

iPaaS providers enable IT to build, deploy, and manage application integrations in any combination of cloud to cloud, cloud to on-premise, on-premise to on-premise or electronic data interchange (EDI) for integration between different organizations.

Offered as a service, iPaaS solutions require no software or hardware installations, so development can begin almost immediately, and most iPaaS providers offer a drag-and-drop interface, so integrations can be developed without hardcoding or other special skills. It should be noted that despite this “speed to value,” some iPaaS solutions have relatively deep feature sets related to assurance, compliance, and security.

Accelerating IT integration projects related to meaningful use, accountable care, and ICD-10 will enable providers to more easily ensure both regulatory compliance and optimal revenue, allowing them to focus more resources on improving patient services. Successful projects will also directly benefit patients through increased portability of medical and insurance records as well as improved diagnosis and treatment.

Chris McNabb is the general manager of Dell Boomi, an integration service business unit of Dell, where he is responsible for operations and strategic direction. He was previously senior VP of software engineering at SunGard Higher Education, with responsibility for software delivery to 1,600 customers. He’s also been a project management consultant for Pennsylvania Blue Shield.



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