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Wednesday, February 13, 2013

Flow, meet ebb?

EHR pay boosts revenue but it's beginning to ebb
By Beth Kutscher, February 12, 2013 - 2:00 pm ET
Incentive payments for electronic health records continued to rev up earnings reports last quarter, but the train may be slowing.

Analysts who cover for-profit health systems pointed out that in many cases, EHR incentive payments came in higher than expected, but the impact was not as great as the previous year. In addition, the guidance from publicly traded providers anticipates even smaller payments for 2013.

And while the payments have been a boon to companies that sell EHR software, a challenge in Congress to curtail or eliminate incentive payments could be a roadblock for these players...
Reporter for Modern Healthcare.
Covers quality of care and patient-safety issues, and
regional healthcare business news in Ala., Miss., N.C. and S.C.
Well, the "challenge in Congress to curtail or eliminate incentive payments" has been oddly silent since the days leading up to the 2012 election, but, who knows, it may resurface as DC lurches to its next budget circus show. Beyond that, the front-end loaded, downsloping  schedule of Meaningful Use payments means that the easy money has by now been plucked.

The increased complexity (and upgrade implementation costliness) of the looming Stage 2 coupled with declining incentive reimbursements (not to mention other regulatory imperatives such as HIPAA Omnibus and ICD-10) comprise significant challenges.

New Association of ACOs

These people need some website help. Notwithstanding, a plug of their upcoming conference, snipped from their home page.

Speaking of "associations,"

The 37 vendors of the EHRA (Electronic Health Record Association)

All Meds Allscripts Healthcare Solutions Amazing Charts Amazing Charts  CoCENTRIX CPSI Emdeon e-MDs Epic Systems Corporation GE Healthcare Greenway Medical Technologies Healthland Healthcare Management Systems LSS Data Systems MacPractice McKesson Provider Technologies MedHost Meditech NextGen Healthcare Information Systems, Inc Practicefusion SammyEHR Siemens Medical Solutions SRS Soft STI suncoast Vitera Health Solutions WorkFlow
"The HIMSS Electronic Health Record (EHR) Association is a trade association of Electronic Health Record (EHR) companies, addressing national efforts to create interoperable EHRs in hospital and ambulatory care settings. The EHR Association operates on the premise that the rapid, widespread adoption of EHRs will help improve the quality of patient care as well as the productivity and sustainability of the healthcare system."
Interesting. I'll be looking to speak with EHRA reps at HIMSS13.
Does Health IT Safety Need New Regulatory Body?
Ken Terry, InformationWeek Healthcare, Feb 13th

The Bipartisan Policy Center (BPC), a Washington think tank, has proposed an oversight framework to improve health IT-related patient safety. The BPC report, which grew out of discussions among a wide variety of healthcare stakeholders, lends support to a recent Department of Health and Human Services (HHS) proposal that would avoid creating a new regulatory body to oversee health IT safety.

The BPC report focuses on ways to protect patient safety while promoting continued innovation in health IT. An oversight framework, the organization said, should recognize the role that health IT plays in improving the quality, safety and cost-effectiveness of care; assure that patient safety is a responsibility shared by the entire healthcare system; be risk-based, flexible and not stifle innovation; emphasize the use of existing safety and quality-related processes, systems and standards; and involve the reporting of patient safety events related to health IT in a non-punitive environment...
I downloaded, printed, and read this (pdf) when I became aware of it. Laudable, if a bit short on detail.
Principles for an Oversight Framework for Assuring Patient Safety in Health IT

The following set of principles, which were developed through a collaborative process involving experts and stakeholders across every sector of health care, should guide the federal government’s strategy and recommendations for a regulatory framework for health IT.
  1. Any oversight framework for safety should recognize and support the important role that health IT plays in improving the quality, safety, and cost-effectiveness of care, as well as the patient’s experience of care.
  2. Assuring patient safety, along with enabling positive patient outcomes, is a shared responsibility that must involve the entire health care system.
  3. Any framework for patient safety in health IT should be risk-based, flexible, and not stifle innovation.
  4. Existing safety and quality-related processes, systems, and standards should be leveraged for patient safety in health IT. 
  5. Reporting of patient safety events related to health IT is essential; a non-punitive environment should be established to encourage reporting, learning, and improvement.
Well, yeah, of course. Recall, as noted in my January 8th post citing the Food and Drug Administration Safety and Innovation Act (S. 3187, July 9, 2012):


I swear, I didn't do this.

Nice to know I'm not the only one with an Attitude Problem expressible via Photoshop. Below, my friend, Chuck Webster, MD, MSIE, MSIS:


OAKLAND, Calif., Feb. 14, 2013 -- PRNewswire -- The California Health Information Partnership and Services Organization (CalHIPSO) has launched Health eServices a new suite of low-cost, comprehensive consulting and technical solutions designed to help providers optimize electronic health records (EHRs) and meet Meaningful Use (MU) Stages 1 and 2 requirements and beyond. The launch is part of CalHIPSO's long-range strategy for continuing to assist providers as the organization transitions from federal grant funding to self-sustainability by January 1, 2014.

Long-term Responsibility "It is our mission to partner with California's clinical providers to transform health care delivery through the effective use of technology," says CalHIPSO CEO Speranza Avram. "This is a long-term responsibility that extends beyond our initial four-year federal funding period. While our goal is to assist all of the 6,187 providers in our service area adopt EHRs and achieve MU stage 1 by the end of this year, it is likely that many will continue to need our services in 2014 and beyond."...
Speranza recently, during an interview with EHR Intelligence.
Will the RECs continue to assist programs beyond Stage 1?
Not as the REC program. They’ve been very clear [ONC/CMS] that we are a stimulus-funded program. The stimulus funding was designed to be just that, stimulating. Is there any talk of continuing funding for the REC program as it’s structure? No. However, the ONC and CMS are very clear that this infrastructure that has been developed through the federal stimulus funding can be of incredible value to providers in helping them prepare and be successful for the transition to value-based payments and health reform.

What then will be the role of RECs once the stimulus funding has disappeared?
Getting in the EHR, going through the meaningful use stages — those are just means to an end and the end is fundamentally transforming the way that medicine is practiced, which is incentivized by not stimulus funding but by payment from the health plans and the government which is the largest payer. So we are moving down this road where more and more quickly the payment for health services is designed to reward behavior that isn’t based on volume or transactions but is based on outcomes and data. To do that you need to have that data and that ability to capture and analyze the data at the point of care.

Could organizations like the RECs, who have relationships with providers and vendors and know something about change management and process redesign, are we organizations that are positioned to continue to be of value? I’m certainly betting on that. As we look at our sustainability plan, which is one of the things we’re required to do by the ONC and we started in our first year, we look to where our value proposition forward is in that space and in the space of trying to help the provider community make sense of the changes in payment reform and certainly the changes in technology...
CalHIPSO's proposed "starting from" services and pricing menu here.
Best of luck.


In other news...
Why the federal government must regulate EHR vendors
February 14, 2013 | By Marla Durben Hirsch
, Fierce EMR


More to come...

1 comment:

  1. This is not surprising. The other tragedy is that this easy money has allowed the bad EMR software companies to grow like kudzu, facilitating failed implementations and bamboozled docs.