Technology for Accountability: Who’s in charge and who benefits?

Dr.Steven J. Kraus

If someone offered me $44,000 just for doing what I knew I needed to do anyway, I’d be the first in line. Now, this is precisely what the government is doing. And, in August, they told us who will certify the electronic health records (EHR) software systems making DC’s eligible for incentive payments. Does that grab your attention? It sure grabbed mine.

The HIT Policy Committee has ruled that the current governing body is the Certification Commission Health Information Technology (CCHIT). However, they acknowledge that multiple certification bodies can exist. For now, the CCHIT organization will be creating a special certification related to the American Recovery and Reinvestment Act, particularly the HITECH section of the Act to allow for EHR’s to meet the meaningful use and HIT Policy guidelines for EHR. The CCHIT will qualify EHR systems to assure they meet the standards required to allow DC’s to be eligible to receive up to $44,000 in incentive payments.

The sooner you adopt the right technology, the fewer objectives you’ll have to meet.

Before this August’s announcement, we didn’t have the complete picture of exactly who was going to be certifying the EHR…. Now, we know it’s a three-tiered qualification:

1. Your EHR must be certified by designated entities, one currently approved is CCHIT.

2. You must be using your EHR meaningfully.

3. You are required to report on Medicare-defined quality measures, with some possible examples being pain assessments for quality, region and intensity, as well as outcome measurement assessments.

Doesn’t sound too tough, right? That is, as long as you have the correct EHR system in place to make complying turnkey. Place the burden on your software partner, and make sure they are not only dedicated to the chiropractic profession, but are also committed to keeping your system current. Qualifying factors for “meaningful use” become more compounding in subsequent years, with additional criteria added in 2011, 2013 and 2015. Just because you’re compliant the first year doesn’t mean you’ll continue to qualify. That’s why your software partner needs to be committed to keeping up with all the programmatic criteria, so you don’t have to worry about them. Some consideration for adopting in later years is being contemplated by the HIT Policy committee.

The sooner you adopt the right technology, the fewer objectives you’ll have to meet. If your true EHR is not in place by the end of the first quarter of 2010 (and you’re not employing meaningful use and reporting), you may likely be too late to cash in on 2011’s payments—up to $18,000. Eventually, you’ll be penalized (receiving lesser Medicare reimbursements), if you don’t comply.

But what’s meaningful to you might not be to the next person. In all actuality, it doesn’t really matter what “meaningful” means to you (or the next person)—the government gets to define that. And, if you’re looking for the full $44,000, it’s best to know and employ that definition by making sure your software partner does the same.

However, before you get concerned about the government dictating what is meaningful, you should understand that the HIT Policy Committee developed its “meaningful use” guidelines to benefit three parties: the payers, the practitioners and the patients. This means we’re all working toward the same goal—more accountability that leads to better patient care.

You see, if you’re meaningfully using a true EHR, you’ll realize substantial office efficiencies, producing outcome-based assessments and proven courses of treatment with better clinical decision making right at the point of care. This leads to increased patient compliance and better results…which lead to greater reimbursements—from the government and other third-party payers. Plus, satisfied patients refer new patients. There is simply no downside here.

In order to make this topic easy for you to swallow, I’ve created a top 10 checklist for you to consider when purchasing compliant EHR software. These are just a few of the items that can contribute towards meaningful use. Make sure your system…

1. Captures patient demographics

2. Reports on quality measures, such as pain assessment

3. Provides outcome assessments with pre-loaded questionnaire tools

4. Follows the back pain recognition program guidelines in treating LBP

5. Keeps allergy and medication lists current

6. Can record history and health conditions

7. Sends demographic health information to other providers electronically

8. Electronically reports to patients the findings of their radiology or lab results

9. Offers diagnosis-based handouts/videos—provided to patient and documented in the chart

10. Is interoperable with other diagnostic equipment in your office, such as digital X-ray or inclinometer ROM devices.

All of the above position you well for government incentive payments. The list doesn’t stop there. But don’t just do it for them—adopt the technology to benefit you and your patients. It doesn’t have to cost you a pretty penny.

Reports indicate the average cost for a medical physician to adopt and integrate qualified EHR is between $40,000 and $60,000. The average cost for a chiropractic physician to do the same is $12,000 for the software (plus any hardware you might need). This could be due to a variation in what the respective markets will bear. Take that as you might, but it means you’re positioned for full reimbursement for your software, hardware, training time and conversion to digital.

When you adopt technology that will make your life easier, better the patient experience and outcome, as well as position you for improved third-party reimbursement, you can be confident that you’re being accountable to the EHR federal qualifying criteria, but also to your practice and to your patients. And that’s a win-win-win scenario.

Dr.-Steven-J.-KrausDr. Steven J. Kraus is CEO of Future Health, Inc., a company that partners with chiropractors to deliver a comprehensive clinic management solution, including fully-integrated EHR. Dr. Kraus is a recognized expert in building successful clinics, having developed and sold 18 practices of his own and provided strategic consulting services to more than 400 healthcare businesses. He offers leadership to numerous industry associations and currently serves as the Chairman of the Iowa Board of Chiropractic. Contact Dr. Kraus at [email protected] for more information.

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