Health Information Compliance Alert

Case Study:

GAO Report Suggests CEHRT May Hamper MACRA Success for Small Practices

Health IT doesn’t have to be a struggle with the right approach.

Today’s physicians are inundated with regulations and rules as well as a steady stream of changes, many of which affect the digital side of medicine. From EHRs meant to help coordinate care to CMS rules designed to protect patients, many initiatives and products have the best intentions of improving healthcare but often hinder it.

Background. The U.S. Government Accountability Office (GAO) published a report in December 2016 that highlighted the struggle small practices are having with interoperability and integrating EHRs into their daily workflow. The research, which focused on practices with 15 or fewer physicians, showed that the technology problems arose from a lack of training, revenue, and staff. Those studied were rarely able to fully utilize the technologies they’d invested in, and therefore, weren’t able to garner the results they’d expected from their original implementations. (Read the GAO report here: http://www.gao.gov/assets/690/681541.pdf)

Without the necessary EHR elements in place, these physicians found their abilities to practice medicine limited. “Small and rural practices need to have access to data that is important for care management and cost control,” the GAO report said. “Also, these practices need to hire and train staff, as well as develop experience using EHR systems and analyzing data needed for participation.”

Top small-practice EHR issues. Common EHR roadblocks emerged after the stakeholders were interviewed in the GAO probe, which might make reporting measures for future value-based care difficult. This is a short list of the health IT issues most small practices faced, the GAO report suggested: 

  • Limited access to other providers’ information
  • Problems with the retrieval of lab results 
  • Vendor challenges related to small practices
  • Issues using e-Prescribing tools
  • Difficulty tracking patient progress and information
  • Lack of data sharing with other providers both big and small

It’s An Attitude Adjustment

Embracing cutting-edge technology both administratively and fiscally might be tough at first, but the advantages outweigh the deficits. “It’s a juggling act, and small practices need to shift their thinking,” says Christine Tremblay, director of product strategy at Amazing Chart, LLC. “They need to figure out how to best leverage what they are going to buy, and then implement it.” 

Vital resource. Accepting that health IT is a necessary part of practicing medicine today is the first step, and that can be daunting for small or rural practices where digital resources may be limited for both provider and patient. 

The GAO study also suggests that the lack of partner organizations to balance some of the risk and training could inhibit small practices from successfully transitioning to MACRA. However, MACRA is in full swing now, so budgeting for an EHR is vital to the success of your business if you are a Medicare provider. 

MIPS requires it. Advancing Care Information (ACI) under MACRA’s Merit-based Incentive Payment System (MIPS) is replacing Meaningful Use for Medicare providers, and though it requires the reporting of fewer measures, small practices will still need to be aware of its requirements when delivering enhanced care. “Under value-based care it is important to be tuned in to all your patients’ activities from visits to the emergency room to seeing specialists,” Tremblay says. “You’ll need to be able to access and relate this information and be able to share it with other providers in your community.”

She adds, “It is critical, especially if you’re not part of a larger health organization with an understanding of the claims process. Your EHR becomes a hub for that claims’ access and the success of your practice.”

Look for a Vendor Who Specializes in Small Practice EHRs

You wouldn’t buy a house or a car without checking out your options. You should follow the same rules when securing a reliable, certified EHR for your practice. Talk to other doctors in your community and find out what is working for them. Make a checklist of what your needs are and balance that with what you can afford.

Vendors with a focus on smaller practices will likely offer cloud-based options as they are often easier to implement and less expensive for providers with limited staff. These EHR firms also understand programs like lower level Accountable Care Organizations (ACOs) and small practice initiatives through both CMS and the individual states. They know how to implement EHR systems on a small scale and “support things smaller practices care about,” suggests Tremblay.

Tip: With the ever changing tide of healthcare, the importance of HIPAA and Medicare compliance cannot be understated. “A vendor’s track record of regulatory compliance is very important,” says John Squire, president and chief operating officer of Amazing Charts, LLC. “Even if you are not fully participating in Medicare or Medicaid, it is important to find a vendor who understands these principles and has a history of supporting them.”

Resource: For more information about Amazing Charts, LLC., visit http://amazingcharts.com.