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Should More Doctors Think About MACRA Like Med School? – MACRA Monday

Posted on November 7, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

While at the recent MGMA Annual conference I ran into Dr. Robert Wah at the CSC Health booth. Dr. Wah has a fascinating background as the former President of the AMA and was also the first Deputy National Coordinator for Health IT back in the Brailer days before now becoming Global Chief Medical Officer at CSC. No doubt he’s seen the full evolution of healthcare IT.

During our chat, Dr. Wah expressed some concern about doctors decision to not properly prepare for MACRA. Between the Pick Your Pace options which basically mean doctors don’t have to fully participate in 2017 and the MACRA final rule being published with a comment period, many doctors have decided to just sit back and not worry about MACRA for now. Those doctors argue that they should wait until the comment period is over to see if the final rule will be changed or they just figure they’ll worry about MACRA in 2018 when they have to fully participate.

Dr. Wah explained to me that this is a dangerous strategy for doctors to employ. He then compared this strategy to medical school. Dr. Wah said that medical students realize pretty early on that they can’t just cram for a class the day before the test in medical school. If students get behind in their studies, then it’s really hard for them to catch up before the test.

Dr. Wah argues that this is what many doctors are doing with MACRA and it could lead to problems. Much like in medical school, it won’t be possible to “cram” for MACRA right before a doctor must fully participate in 2018. Instead, doctors need to use 2017 to appropriately “study” for the MACRA test that’s coming in 2018.

Thanks to Pick Your Pace, CMS have given doctors a pretty big window to make sure that they’re ready for everything that’s required with the full MACRA requirements in 2018. Those that sit on their hands in 2017 will be complaining about how hard MACRA is in 2018. Those that fully participate in 2017 will likely not worry much about the MACRA requirements in 2018.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

Can Health IT Reduce Readmissions?

Posted on August 15, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

We who work around health IT know it can do some great tricks, but it’s always nice to see examples of how it can actually save money.  One example of how health IT can be a cost-saver is in helping to reduce readmissions, according to a new study from CSC.  Here’s a summary of how it might work, courtesy of CMIO magazine:

Reducing readmissions will require identifying patients at risk for readmission, carefully orchestrated care management programs and patient-specific transition pathways. While this type of patient tracking, collaboration and patient-centeredness has been historically difficult to achieve, health IT should enable more organized care management through tools such as e-prescribing, master patient indexes and electronic clinical communication.

The report notes, however, that this works much better if hospitals and health systems have integrated EMRs that extend from the facility into community medical practices.  And that’s just common sense. After all, hospitals aren’t equipped to check on patients regularly once they’re discharged, aside perhaps from a few that are experimenting with remote monitoring.

The thing is, given that hospitals and medical practices are seldom running the same systems, it’s unlikely (OK, almost impossible) that they’ll be able to share much in the way of digital information. Sure, they’ll get faxes galore, but if that was an efficient way to share docs we wouldn’t be having these conversations.

Oh well. It’s always good for deep thinker types to point the way ahead. Unfortunately, I think we’ll have to wait a while for coordinated care planning via health IT to really find its place. Maybe John’s predictions for Direct Project will help us get part of the way there.

Top 10 Meaningful Use Challenges

Posted on April 27, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

CSC report lists top 10 challenges that doctors face when it comes to meeting the stage 1 meaningful use requirements. Here’s the list:

1. Capture the data–that includes collecting and entering data in a structured formats so that data can be sorted and selected for reporting purposes, said Zywiak.

2. Establish effective workflows to reinforce data entry, including medication reconciliation. For instance, “often, an organization’s workflow needs to be modified to make sure data is entered,” while patients are being cared for, whether it’s vital signs like blood pressure or allergy updates, said Zywiak.

3. Drive provider involvement in adoption of the EHR. “The primary users of these systems need a say” in what’s selected, said Zywiak.

4. Computer-based provider order entry (CPOE). “In ambulatory settings, 80% of orders, including tests, referrals and medication prescriptions, will need to be entered electronically,” he said.

5. Start e-prescribing. “Do this as soon as possible,” he said.

6. Develop a process for managing clinical decision support. This could include different clinical reminders for individual doctors in the same multi-specialty practice. For instance, a primary care doctor might need different alerts than a dermatologist caring for the same diabetic patient.

7. Implement patient health information exchange workflows. As a healthcare provider, “you’ve got to provide patients access with information–but will you do this via a patient portal or through a [third party] personal-health record” site, such as Google Health, said Zywiak.

8. Formulate a provider health information exchange strategy. “How will you exchange patient summary data with hospitals, specialists?,” he said.

9. Ensure privacy and security compliance. “Most primary care organizations haven’t been on an EHR, so they think of HIPAA in terms of protecting paper-based information,” he said.

10. Initiate EHR-based quality performance measurement support.“You’ll need to report quality measures to Medicare and Medicaid,” he said.

How does this list make you feel about the meaningful use guidelines?