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Tech Watch: Healthy prognosis for EHR solutions

Heather Clancy

Focused on the compliance-laden field of health care IT, technology service providers report robust consulting business as health care providers scramble into the world of electronic health records.

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That race is, in part, motivated by potential incentives that could be earned by making the switch. But some organizations are driven less by incentives they could earn by changing than they are by potential penalties for failing to comply, solution providers said. What’s more, many organizations are waking up to the fact that technology can help transform many inefficient health care processes, speeding patient care and providing more information directly at the point of care.

“This is a total transformation that we are talking about,” said Robert Drewniak, vice president of strategic and advisory services for Hayes Management Consulting, a services company based in Newton Center, Mass. “We are reinventing some things; we are reengineering some things.”

Some changes are being forced on health care providers in the form of regulations such as the well-known Health Insurance Portability and Accountability Act (HIPAA), which provides a privacy framework for securing and accessing patient health information. Others, such as the adoption of ICD-10, a coding system that doctors use for logging symptoms or disease conditions, are seen as critical for speeding insurance reimbursements and creating a common “language” for health care records.

Mark Bakken, CEO of Nordic Consulting Partners Inc., a health care consulting firm in Madison, Wis., said it took many health care organizations longer than anticipated to lay the foundation for their electronic records strategy. “Most of them right now understand the risk and the costs,” he said. “They are just starting now to get it done.”

Motivation for health care IT change: More stick than carrot
There are many different phases mandated in the transition to electronic health records (EHRs). In order to earn a series of incentives set aside by the American Recovery and Reinvestment Act, health care organizations must prove that they started using EHRs in a “meaningful” way by the 2011 federal fiscal year. The incentives for doing so start at $44,000 and go up to $6 million depending on the size of the organization. It is what will happen if an organization fails to comply by 2015 that will likely have a bigger impact: Provider organizations that blow the 2015 deadline will face Medicare reimbursement cuts.

“We have run into organizations that are not in a hurry for right now. They are focused on 2015 and 2016 when the penalties kick in,” said Gregg Fajkus, service line manager with Houston-based health IT services company Encore Health Resources LLC. “They don’t expect the incentives, so they are taking their time.”

Health care IT services and consulting experts say many health care organizations are using the EHR push as an opportunity to reevaluate all of their systems. Some are moving away from best-of-breed applications to an integrated health care applications suite approach, such as those advocated by Epic Systems Corp. or Cerner Corp.

“Organizations are being driven along a quicker timeline based on the meaningful use goals,” said Fajkus. But even while organizations scramble, there is a push to delay phase two of the deadlines, which heightens the meaningful use requirements. The intention is to help more organizations tackle some of the thorny application integration issues.

Mission difficult: Getting health care apps to talk to each other
“We take it for granted outside of the health care environment that we can cut and paste things from one application to another. But best-of-breed applications have ruled hospitals and it was tough to get them to talk to each other,” said Drew Madden, president of Nordic Consulting Partners.

Nordic, which is just a couple of years young, has seen “white-hot” growth, specifically related to its Epic consulting expertise. There are three job openings for every one services person that has earned Epic certifications, Bakken said. Aside from the integrated approach made possible through Epic software, another factor has been its support for mobile clients. Bakken noted that numerous organizations working with Nordic switched to Epic because of its mobile applications support.

Likewise, Hayes Management has seen an explosion of work related to mobile access as companies rationalize their overall information management strategies, said Drewniak.

“Tremendous progress has been made,” he said. “Seventy-five to 80% of our clients should be meeting the first round of incentives requirements. Where you are going to be challenged is in small community hospitals. … Every organization that I am working in as they are looking at electronic medical records is looking not just at mobility but at workflows . You can’t look at one without looking at the other.”

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