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New Download: Digital Health Services and Advanced Analytics

Posted by Matthew Smith on Jun 15, 2016 12:51:33 PM

USB_Download.pngAre you unsure of how to start the process of building a data strategy and an information roadmap? Are you worried that you're not aggregating the right data? Are you stuck in neutral and not making any headway with your population health analytics vendor? 

If so, GE Healthcare Camden Group can start you on the right path.

Start here...with our PDF outlining ourDigital Health Services and Advanced Analytics practice.

The PDF includes pages on:

  • Our Philosophy and Approach
  • Reasons Why Healthcare Analytics Vendor Implementations Fail
  • Initial Questions from Leadership and Teams
  • Data Analytics Strategy Components
  • Information Services and Advanced Analytics

Simply click the button below to get started!

Digital Health, Advanced Analytics

Topics: EHR, EMR, Value-Based Care, Data Analytics, Digital Health Strategy, Digital Health Services and Data Analytics

Are Your Primary Care Practices at Risk?

Posted by Matthew Smith on Aug 28, 2015 12:56:41 PM

By Marc Mertz, MHA, FACMPE, Vice President, The Camden Group

primary care, practice managementIf your primary care practices are like most traditional medical offices, they have been designed with the physicians’ preference and convenience in mind. The physician decides which days they will work, the hours they will see patients, the types of appointments they will see, as well as when they will see them. As a result, patients might wait weeks for an appointment. When they do get an appointment, the patient’s experience does not get much better: they wait to be seen, they have to fill out long forms, and they have little face time with the physician. Patients are not the only ones dissatisfied with the status quo. Despite being at the center of the current practice model, primary care physicians are not satisfied with the way their practices are structured; increasing burdens to provide care coordination and quality monitoring while improving patient access makes them feel increasingly overwhelmed and dissatisfied.

An Increasing Pressure to Change

The medical office described above has not changed much in the last 30 years, aside from perhaps the addition of electronic medical records (“EMRs”) or other technologies. Practices have felt little pressure to change their business model, and patients really have not had any other options. That is changing, however, and it is changing very quickly. Retail giants such as Walgreens, CVS, and Walmart are aggressively expanding their clinical services, including primary care. Urgent care centers are popping up seemingly on every corner. The reason for such rapid growth is that these new providers offer patients everything that traditional primary care practices do not: access, convenience, and efficiency.

Is it so farfetched to think that these new providers could ultimately replace primary care as we know it today? Blockbuster probably thought it unlikely that Netflix and its online movie downloads and streaming would drive them out of business. Kodak did not foresee digital photography essentially eliminating the film camera industry. But if these dominant players in long-established industries can be replaced, why not primary care practices?

New Options for House Calls

A primary care practice that continues the status quo ultimately faces a slow death spiral. Every time an established patient gets sick, and they cannot get in to see their physician for several days or even weeks, they are going to go to an alternative provider. And they may never come back. Rather than take the afternoon off from work to see their primary care physician, a patient might stop in and see a nurse practitioner at their drug store after work and be in and out in 20 minutes. Or in some markets, they might use an app on their phone like Amwell to have a virtual visit without leaving their home, or even request an on-demand home visit from an Uber-like service. Patients in major U.S. cities now have multiple options for house calls. Pager is a new service that allows patients in New York to schedule a house call within 2 hours and pay a flat fee per visit. Will your primary care practices be blindsided by Pager just as taxi companies were by Uber?

Retail clinics and other alternative delivery models currently offer a limited scope of services but are expected to expand their services. They will also continue to introduce remote monitoring and telemedicine devices that allow them to engage and monitor patients, as well as manage their chronic conditions, increasingly competing with traditional primary care practices for patients.

Patients are not the only ones looking for alternatives to the current primary care delivery model. Dissatisfied primary care physicians are also looking for more rewarding practice models that do not overwhelm them with long days, an inefficient EMR, and ineffective work flows. Primary care groups risk losing their current physicians and face increasing recruitment challenges.

Where Should You Start?

So where should a primary care practice start? By expanding patient access? Increasing the efficiency of their office and patient flow? Improving patient service? Implementing enhanced technology such as a patient portal and home monitoring devices? Partnering with retail clinics and other innovators? The answer is all of the above. And fast.

Appointment scheduling should be easy, both via telephone and online. Patients should be able to get an appointment when they want it, and that includes the same day. To achieve this, practices must reevaluate the number of types of appointments they offer. They may also have to expand their office hours to include evening or weekends. Physicians need to let go of their perceived control over daily schedules. Rather than cling to a system that does not work for anyone—the patient, physician, or the staff— primary care practices should start over with no more than four appointment types: long and short new patient visits and long and short established patient visits; in many cases this can even be boiled down to two appointment types. Not every appointment will fit perfectly into one of these slots, but the flexibility and simplicity of the scheduling will save time and improve access and satisfaction.

Primary care physicians already use advanced practice clinicians (“APCs”), typically nurse practitioners or physician assistants. In many offices, several physicians will share an APC, who will see the physicians’ sick patients or routine cases. By flipping the ratio of physicians to APCs, a practice can expand access at a lower cost. A single primary care physician can supervise a team of two or three APCs, each of whom manages his or her own panel of patients. The physician handles the complex patients and is available to support the APCs whenever necessary.

Patients do not like to spend two hours in your primary care office, especially when they get just a few minutes with the physician. Every aspect of the patient’s visit and experience should be assessed with a critical eye for any waste or delays. Time studies that track each component of the visit can help identify bottlenecks. Once inefficiencies or waste are identified, engage a multidisciplinary team to redesign the process. Then test and redesign again continuously to improve.

The greatest influence on patient satisfaction is not the physician or the office décor. It is your staff. Recruit employees with this in mind. Train your staff on customer service skills. Physicians must also lead by example. Patients are being seen to receive clinical care, but they must also be treated like customers and human beings.

Optimize the EMR

One of the biggest barriers to office efficiency, as well as a major source of physician dissatisfaction, is the EMR. As new systems have been implemented, practices have modified their procedures and processes to adapt to the EMR design and structure, rather than the other way around by adapting the EMR to serve as a tool to help meet the needs of the practice. This case of the “tail wagging the dog” typically means more work for the physicians and staff— often a lot more work. As a result, efficiency and patient volume have declined, which also reduces patient access. System inefficiency also leads to physician and staff dissatisfaction. Practices need to assess how they use their EMR and identify ways to optimize the system based on efficient work flows and an appropriate delegation of tasks to the lowest cost individuals whenever possible.

Furthermore, consider how your primary care practice will deliver care without requiring patients to come to the office. Relying solely on the traditional face-to-face office visit is quickly becoming archaic. Determine what fits best in your practice: patient portals for secure e-mail messaging, televisits, group visits, home visits, use of other support staff such as educators and pharmacists to respond to patient questions, or partnering with innovators to extend your reach to retail or other settings all must be considered as potential venues for extending the access points for your patients.

Overhauling your primary care practices is no small undertaking. However, failing to do so puts your organization at significant risk, as patients will increasingly seek out providers who offer greater access, convenience, and service. Inefficient and ineffective primary care practices will also make the recruitment and retention of primary care physicians even more difficult than it already is. More than just a defensive effort, redesigning your practices with the patient in the center is good for care delivery and for business.


Mr. Mertz is a vice president with The Camden Group and has 18 years of healthcare management experience. He has 15 years of experience in medical group development and management, physician-hospital alignment strategies, physician practice operational improvement, practice mergers and acquisitions, medical group governance and organizational design, clinical integration, and physician compensation plan design. Mr. Mertz has managed private practices, hospital-affiliated practices, and academic physician practices. The Medical Group Management Association (“MGMA”) has identified practices under his management as “Best Performing.” He may be reached at mmertz@thecamdengroup.com or 310-320-3990.    

Topics: EMR, Primary Care, Primary Care Access, Primary Care Provider, Marc Mertz, EMR Optimization

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

Meaningful Use Infographic | New Attestation Deadline Reminder

Posted by Matthew Smith on Mar 12, 2015 11:54:00 AM

EHR1.jpgEligible professionals now have until 11:59 pm ET on March 20, 2015, to attest to meaningful use for the Medicare Electronic Health Record ("EHR") Incentive Program 2014 reporting year.

The Centers for Medicaid and Medicare Services ("CMS") extended the deadline to allow providers extra time to submit their meaningful use data. CMS continues to urge providers to begin attesting for 2014 as soon as they can.

This extension also allows eligible professionals, who have not already used their one “switch”, to switch programs (from Medicare to Medicaid, or vice versa) for the 2014 payment year until 11:59 pm ET on March 20, 2015. After that time, eligible professionals will no longer be able to switch programs.

Medicare eligible professionals must attest to meaningful use every year to receive an incentive and avoid a payment adjustment. Providers who successfully attest for the 2014 program year will:

Note: The Medicare extension does not affect deadlines for the Medicaid EHR Incentive Program. Additionally, the EHR reporting option for PQRS has been extended until March 20, 2015. 

For help, call the EHR Information Center: 1-888-734-6433

__________________________________________

The following infographic from athenahealth, titled, "Meaningful Use: On the Road to Attestation," presents results from a survey of over 1,400 Epocrates members who shared their concerns and progress on their way to meaningful use success.

A full-sized version may be accessed here (click image to enlarge).

athenahealth_infographic-resized-600

 

Topics: EHR, EMR, Meaningful Use, CMS, Infographic, Electronic Health Record, Electronic Medical Record

Meaningful Use Stage 2 Attestations May Drastically Drop in 2015

Posted by Matthew Smith on Jan 8, 2015 4:39:00 PM

Meaningful Use, MU, Attestation, Medical Practice Insider polled nearly 2,000 physicians to reveal that 55% do not plan to attest for meaningful use Stage 2 in 2015.

The questioning was simple yes/no question: Do you plan to attest for Stage 2 in 2015?

The answer? Doctors are planning to forego Stage 2 by a margin of 994 to 822 participants.

Status check: MU participants
About 75% of office-based primary care physicians had some form of EHR system in 2012, according to the National Ambulatory Medical Care Survey, conducted by the National Center for Health Statistics.

Since the 2009 enactment of the HITECH Act, which established the Medicare and Medicaid EHR Incentive Programs for eligible professionals (EPs) and hospitals, nearly two-thirds of physicians who implemented health IT tools said financial incentives and penalties were a major influence to adopt such systems.

EPs have been paid nearly $10 billion by the Centers for Medicare and Medicaid Services under the meaningful use program to date. Only 3,655 unique Medicare EPs had received payments for Stage 2 attestation as of early December, however, compared to 268,686 EPs for Stage 1.

Individual comments from surveyed providers show a variety of reasons — some financially motivated, others not — for physicians deciding that they've had enough with the meaningful use program and will go no further.

"I did Stage 1 in years one and two, but it is almost impossible to do Stage 2. It requires patients to have emails and engage my EHR,” one cardiologist explained. “Well, I have a lot of patients in their 80s and 90s, and they don’t have computers, let alone email."

A family practitioner who CMS said was in the top 3 percent in terms of readiness and reporting is now at a crossroads.

"I’ve done Stage 1 three times now. I have the option to do either Stage 2 or Stage 1 for the fourth time. I would rather stay with Stage 1 for now because my patients are reluctant to use messaging and I personally do not like the interface for my portal,” the family practitioner noted. “I do not have too many Medicare patients even though I am participating in an ACO, so I am not concerned much about a penalty. I just want the software to be perfected and be more usable."

An internist echoed that last point about usability: "Every night there’s more chart work. I can’t find things in the patient chart easily, and it's hard to compare current and old EKS’s, current and old labs."

A rheumatologist, meanwhile, said that the administrative costs exceed any financial gains, meaningful use incentives and otherwise. “I am re-examining getting on an MU-certified EMR in 2015 as interoperability and eRx systems tend to mature and become more prevalent."

And then there’s the old-fashioned preference for paper.

"Because I don’t use an EMR, my work is easier, profits are better,” a gastroenterologist commented, “and I get my work done in 30 percent of the time it takes EMR-equipped hospital doctors."

It’s important to point out that the above comments are from specialists, a collective that often faces unique meaningful use challenges — particularly when it comes to core, menu and clinical quality measures engineered for providers with a broader swath of patients and services, making it easier to fulfill those requirements.

Topics: EHR, EMR, Meaningful Use, Electronic Health Records, Electronic Medical Records, Stage 2

Infographic: Is Meaningful Use Helping or Hurting EHR Adoption?

Posted by Matthew Smith on Dec 3, 2014 11:14:00 AM

Infographic, Meaningful Use, EHR, EMRWhen the Centers for Medicare and Medicaid Services (CMS) launched their EHR Incentive Programs back in January 2011, the main goal was to reward healthcare practitioners for adopting electronic health records and increasing efficiency within their practice. But one question everyone still finds themselves asking is whether or not the incentives have actually encouraged EHR adoption?

NueMD compiled research from the Department of Health and Human Services (HHS), CMS, and the American College of Physicians (ACP) looking to identify adoption trends and determine potential obstacles to successful implementation. Check out the findings below.

To view a larger version of the infographic, please click here and click on the image once it opens in your browser.

MU, Meaningful Use, Infographic, EHR, EMR, Electronic Health Record

 Infographic provided courtesy of NueMD. 

Topics: EHR, EMR, Meaningful Use, CMS, Infographic, Electronic Health Record, Electronic Medical Record, MU

New EHR Attestation Deadline for Eligible Hospitals: 12/31/14

Posted by Matthew Smith on Nov 24, 2014 3:01:00 PM
Courtesy of Centers for Medicare & Medicaid Services 

CMS, EHR, Meaningful UseCMS is extending the deadline for eligible hospitals and Critical Access Hospitals (CAHs) to attest to meaningful use for the Medicare Electronic Health Record (EHR) Incentive Program 2014 reporting year from 11:59 pm EST on November 30, 2014 to 11:59 pm EST on December 31, 2014.

This extension will allow more time for hospitals to submit their meaningful use data and receive an incentive payment for the 2014 program year, as well as avoid the 2016 Medicare payment adjustment.

CMS is also extending the deadline for eligible hospitals and CAHs that are electronically submitting clinical quality measures (CQMs) to meet that requirement of meaningful use and the Hospital Inpatient Quality Reporting (IQR) program. Hospitals now have until December 31, 2014 to submit their eCQM data via Quality Net.

Note: This extension does not impact the deadlines for the Medicaid EHR Incentive Program.

How to attest?
Medicare eligible hospitals and CAHs will use the Registration and Attestation System to submit their attestation for meaningful use for the 2014 reporting year. The system is open and fully operational, and includes the 2014 Certified EHR Technology (CEHRT) Flexibility Rule options. Medicare eligible hospitals and CAHs can attest any time to 2014 data until 11:59 pm EST on December 31, 2014 to meet the new 2014 program deadline.

Attestation Tips
Here are some steps to help make the attestation process easier:

  • Consider logging on to use the attestation system during non-peak hours, such as evenings and weekends
  • Log on to the registration and attestation system now and ensure that your information is up to date and begin entering your 2014 data  
  • If you experience attestation problems, call the EHR Incentive Program Help Desk and report the problem

Reminder: Medicare eligible hospitals must attest to demonstrating meaningful use every year to receive an incentive and avoid a payment adjustment.

2016 Payment Adjustments
Payment adjustments will be applied at the beginning of FY 2016 (October 1, 2015) for Medicare eligible hospitals that have not successfully demonstrated meaningful use in 2014. Read the eligible hospital payment adjustment tipsheet to learn more.

Note:  CAHs have a different payment adjustment schedule than Medicare eligible hospitals. Review the CAH Payment Adjustment and Hardship Exception Tipsheet.

Resources
The EHR Information Center is open to assist you with all of your registration and attestation system inquiries. Please call, 1-888-734-6433 (primary number) or 888-734-6563 (TTY number). The EHR Information Center is open Monday through Friday from 7:30 a.m. – 6:30 p.m. (Central Time), except federal holidays.

Attestation resources are available on the Educational Resources webpage of the EHR Incentives Programs website.

Topics: EHR, EMR, Meaningful Use, Medicare, CMS, Medicaid, Attestation

Summary of Care Meaningful Use Requirements in Stage 2

Posted by Matthew Smith on Nov 18, 2014 10:42:00 AM

EHR, EMR, Electronic Medical Records, Meaningful UseIf you are an eligible provider participating in the EHR Incentive Programs, you will have the option of reporting the Summary of Care menu objective in Stage 1, but will be required to meet the core objective in Stage 2.

CMS wants to ensure providers are able to meet Measure #2 of the Summary of Care objective in Stage 2. Below is some additional guidance to help you meet the measure.

Guidance for Meeting Measure #2

For Measure #2 of the Stage 2 Summary of Care objective, an eligible professional, eligible hospital or critical access hospital (CAH) may count a transition of care or referral in its numerator for the measure if they electronically create and send a summary of care document when a third party organization is involved so long as:

  • The summary of care document is created using certified EHR technology (CEHRT);
  • The summary of care document electronically transmitted by the eligible professional, eligible hospital, or CAH to the third party organization is done so using EITHER:
    1. their CEHRT’s transport standard capability; or
    2. an exchange facilitated by an organization that is an eHealth Exchange participant.
  • The third party organization can confirm for the sending provider that the summary of care document was ultimately received by the next provider of care.

In instances where a “third party organization that plays a role in determining the next provider of care and ultimately delivers the summary of care document” is involved, the service the third party provides does not have to be certified for the transmission to be counted in the numerator for Measure #2. Nor are there any specific requirements around the technical standards or methods by which the third party delivers the summary of care document to the receiving provider (e.g., SOAP, secure email, fax).

For More Information

For more information, read the updated FAQ. For additional Stage 2 resources, visit the Stage 2 webpage of the EHR Incentive Programs website.

Topics: EHR, EMR, Meaningful Use, CMS, CEHRT, CAH, Critical Access Hospitals, Summary of Care

Hospitals: EHR Deadlines Approaching for 2014 Reporting

Posted by Matthew Smith on Nov 6, 2014 12:53:00 PM

CMS, EHR, Meaningful UseNovember 30, 2014 is an important date for the 2014 Medicare EHR Incentive Program for eligible hospitals and critical access hospitals (CAHs).

Attestation Deadline

Eligible hospitals and CAHs must successfully attest to demonstrating meaningful use by November 30 to receive a 2014 incentive payment. Hospitals participating in the Medicaid EHR Incentive Program need to refer to their state deadlines for attestation.

The CMS Attestation System is open and fully operational, and now includes the 2014 Certified EHR Technology (CEHRT) Flexibility Rule options. Medicare eligible hospitals can attest any time to 2014 data until 11:59 p.m. ET on November 30, 2014.

Reminder: Medicare eligible hospitals must attest to demonstrating meaningful use every year to receive an incentive and avoid a payment adjustment.

eCQM Submission Deadline

Eligible hospitals and CAHs who are electronically submitting clinical quality measures to qualify for that requirement of meaningful use must submit to qualify for that requirement of meaningful use must submit to Quality Net by November 30 to successfully meet the deadline to be evaluated for a 2014 incentive payment. Hospitals participating in the Medicaid EHR Incentive Program need to refer to their state deadlines.

2015 Hardship Exception Deadline

CMS reopened the submission period for hardship exception applications for eligible hospitals to avoid the 2015 Medicare payment adjustments for not demonstrating meaningful use of CEHRT. The new deadline is 11:59 PM ET November 30, 2014.

Eligible hospitals that have never met meaningful use before may apply during this reopened hardship exception application submission period if they were unable to attest by July 1, 2014 AND were unable to fully implement 2014 Edition CEHRT due to delays in 2014 Edition CEHRT availability.

2016 Payment Adjustments

Payment adjustments will be applied at the beginning of FY 2016 (October 1, 2015) for Medicare eligible hospitals that have not successfully demonstrated meaningful use in 2014. Read the eligible hospital payment adjustment tipsheet to learn more.

Note: CAHs have a different payment adjustment schedule. Review the CAH Payment Adjustment and Hardship Exception Tipsheet.

Resources
Attestation resources are available on the Educational Resources webpage of the EHR Incentives Programs website.

Topics: EHR, EMR, CMS, Hospitals, Electronic Health Record, Electronic Medical Record, Hardship Exception, eCQM

Infographic: Utilizing the Cloud to Meet Healthcare Reform Mandates

Posted by Matthew Smith on Oct 3, 2014 9:47:00 AM

Infographic, Cloud, Reform MandateNow that healthcare in America is evolving as rapidly as technology, hospitals are expected to transform their archaic IT systems to meet reform requirements or face significant penalties from the government. Add to the mix a lack of skilled IT workers and an operating system that is already functioning at a loss, and the next few years look very grim. How can hospitals meet the mandates and recover their cumbersome IT systems? This infographic from Innotas outlines what these facilities need to implement to meet a brighter future.

To view a full-size version of this infographic, click here.

Infographic, Reform mandate

Topics: EHR, EMR, HIT, Health IT, Infographic, Health Care Reform

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