GE Healthcare Camden Group Insights Blog

Optimize EHRs to Engage Patients and Providers

Posted by Matthew Smith on Jun 4, 2015 10:41:00 AM

By Soledad Prete, Senior Consultant, and Carmiña Nitzki, Senior Consultant, The Camden Group

ehremr_large.jpgOnce medical practices have familiarized themselves with and utilized their Electronic Health Record (“EHR”), they develop a basic understanding of its functionalities and generate ideas on how to improve its efficiency. In order to do so, it is necessary to conduct an assessment of overall practice performance. Optimizing an EHR too soon after an implementation may lead to additional worries and confusion, so administrative and clinical staff should spend the first two-to-three months getting comfortable working through the EHR. You can’t improve on what you don’t know. Below are some thoughts on how to proceed with optimizing an EHR and the reasons behind the recommendations:

Engage Patients in their Care

In recent months, The Camden Group has been written several articles about Patient Access.  Just as patients need access to local care, they also need access to their EHR. Choosing not to provide patients the ability to view their EHR puts practices at a disadvantage. To provide better care and achieve desirable outcomes, practices need to provide patients the ability to become engaged in their medical care. Patients will soon expect this. If practices don’t provide it, patients may look elsewhere for a practice that does offer these conveniences. 

For example, a colleague who recently moved into the community was evaluating multiple family practitioners. After much research, she narrowed her decision to two equally qualified physicians and chose the one that had a fully implemented patient portal.

Enable Patient Reminders

Patient reminders are another way to provide better care for patients. This feature allows for reminders to be sent to patients in advance of important preventive care testing as well as follow-up care to manage their chronic conditions. Patients must be reminded to follow up on their healthcare. Providers who have not optimized the patient reminder functionality waste valuable time and staff resources to accomplish this task.   

Promote Provider Communication

Electronic provider-to-provider communication is often neglected during the initial implementation of an EHR. Optimizing the full functionality of this portion of the EHR will allow real-time health information exchange about a patient’s condition among providers and other care team members. If providers and care team members do not communicate in a timely manner, unnecessary repeat testing may occur or important patient information may be delayed. Without proper communication, patients are often referred to specialists who do not receive any of the test results from the primary care physician. The specialists re-order all of the tests—including expensive radiological exams. Ultimately, the insurance companies may deny payment for the duplicated procedures or tests..

These are just a few benefits of optimized EHRs. Best practices suggest that a medical practice establish specific goals it wants to achieve and then start with an assessment to identify and address the gaps in order to meet those goals. Once a direction is determined, practices should seek advice from the EHR vendor, peers, and consultants to develop an implementation work plan with realistic expectations. A successful optimization will result in increased satisfaction among both administrative and clinical staff as well as patients. The medical practice will also experience improved revenue, reduced cost, and compliance with government incentive programs.

This is the first of a three-part blog series surrounding Electronic Health Record optimization. Part 1 focuses on engagement, Part 2 on build-out, and Part 3 on maintenance.

Soledad_Prete_headshot.pngMs. Prete is a senior consultant with The Camden Group and has over 25 years of comprehensive experience in Healthcare Information Systems and multiple site EHR implementations. She has in-depth knowledge of eClinicalWorks, NextGen, athenahealth, and Epic and has worked with many physicians and administrators in facilitating successful EHR program development, evaluation of system functionality, and defining optimal implementation approaches. She may be reached at sprete@thecamdengroup.com or 312-775-1700.



Carmina_Nitzki_headshot.pngMs. Nitzki is a senior consultant with The Camden Group, with over 20 years of experience working with medical groups and physician practices and has strong practical knowledge of a group’s revenue cycle processes and managed care contracting. Her thorough understanding of multiple practice management and EHR systems helps practices improve billing/collections processes, establish effective front office procedures, and improve financial performance. She may be reached at cnitzki@thecamdengroup.com or 312-775-1700.


Topics: EHR, EMR, Patient Engagement, EHR Optimization, Soledad Prete, Carmina Nitzki, EMR Optimization

SGR is Fixed! What's Next?

Posted by Matthew Smith on May 7, 2015 1:23:00 PM

By Mary Witt, MSW, Senior Vice President, The Camden Group

sgr.pngThe Medicare Access and CHIP Reauthorization Act (“MACRA”) became law last month, and the repeal of the of the sustainable growth rate formula (“SGR”) was official. As important, MACRA reinforces Medicare’s move away from fee-for-service and into pay for value. The major impact on medical groups includes:

  • Provides a 0.5 percent annual update to Medicare rates from 2015 through 2019.
    • The 2015 update will occur July 1, 2015.
  • Moves all providers (physicians, nurse practitioners, clinical nurse specialists, midwives, certified registered nurse anesthetists, and physician assistants) into value-based payments in 2019, either through the Merit-Based Incentive Program (“MIPS”) or through bonuses for participation in an Alternative Payment Methodology (“APM”). All providers will be incentivized through MIPS if they do not qualify for bonuses under APM.
  • MIPS consolidates and streamlines current Medicare quality programs (Physician Quality Reporting System [“PQRS”], Meaningful Use, and the value-based payment modifier and sunsets the penalties associated with each of the current programs in 2018.
    • MIPS will reward providers based on performance in four categories: quality, resource use, meaningful use, and clinical performance improvement.
    • It creates a composite score based on the four categories and, depending on how it compares with a performance threshold (based on the mean composite score of all eligible professionals), eligible providers will receive a bonus, a penalty, or no adjustment in payment. Those scoring in the lowest quartile will receive a penalty and bonuses will be proportional depending upon the score.
  • Provides a five percent bonus for 2019 to 2024 for eligible professionals who are a “qualifying APM participant.”
    • Qualifying APM categories include accountable care organizations, patient centered medical homes, bundled payments, or other models developed by the Centers for Medicare and Medicaid Services (“CMS”).
    • In 2019, a qualifying APM participant must have at least 25 percent of payments attributed to services furnished under an eligible APM. It increases to 50 percent in 2021, and 75 percent in 2023 and beyond.
  • Reverses CMS’ decision to eliminate the use of 10- and 90-day global day surgical codes.

So Does MACRA Mean We Don’t Need to Do Anything Different?

The answer is a resounding "NO!"  

This legislation is another signal that payers have moved away from fee-for-service to pay for value, and medical groups need to assess their readiness and act now. Waiting until the payment methodology changes is too late. Instead, medical groups must begin the work of redesigning their practices now to be successful in the future.

Must Dos

  • Improve patient access to increase patient satisfaction and prevent leakage to new competitors
  • Maximize operational efficiency
    • Analyze your performance on quality and cost and develop a performance improvement action plan now
    • Document and assess your current work flows for all key practice processes:  check-in, check-out, physician visit, and visit discharge to identify waste, barriers, duplication, and missing steps
    • Maximize patient throughput
    • Develop work flows to effectively use team members to maximize physician effectiveness
    • Optimize electronic health records utilization
  • Re-examine your physician compensation plan and add incentives for quality, patient satisfaction, and efficiency
  • Use the current Medicare value-based payment initiatives to help you build the foundation for success under MIPS
    • Participate in PQRS

witt_headshot.pngMs. Witt is a senior vice president with The Camden Group and has over 25 years of healthcare experience. She has held management positions in hospitals, health systems, and management services organizations (MSOs). She has extensive experience in medical group and integrated delivery system development and management. This includes developing patient-centered medical homes, practice management, performance improvement, physician compensation, managed care, strategic planning, healthcare marketing, and physician recruitment. Ms. Witt leads medical group development, performance improvement, and turnaround projects for integrated delivery systems, medical groups, and academic residency programs throughout the country. She may be reached at mwitt@thecamdengroup.com or 424-201-3971.

Topics: Mary Witt, Sustainable Growth Rate, SGR, Medicare Access and CHIP Reauthorization Act, EHR Optimization, MACRA

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