As 2015 and its promise of loads of cash for providers who adopt EHR technology is not far away now, a close look at providers' IT capabilities reveals how far they have to go in order to be prepared for the high demands that the EHR will place on their systems.
A recent Business Week series that examines some of the technical issues accompanying the rollout of EHR in providers' offices across the country states, "the haste to set-up EHRs could lead to administrative complications, formatting problems, errors and interoperability glitches."
According to the article, last year, only 10% of U.S. health care facilities were using EHRs, but the feds want half of them on board by 2014. If you're aspiring to be in that first half, read on to learn about some of the challenges you'll need to overcome:
Deal productively with the uncertainty to show that you're using EHRs in a meaningful way. CMS has issued its first proposed rule on the definition of meaningful use, which will determine whether a facility or provider qualifies for full incentive payments. The first rule, due out this spring, will focus on capturing health data in a coded format; tracking patient conditions and coordinating care; and implementing clinical decision support tools to facilitate disease and medication management. Experts worry that hospitals and other facilities will feel compelled to meet the deadline for EHR adoption in 2011, so they don't miss out on the first round of money, and struggle to meet the definition of meaningful use too quickly. Without robust IT departments and resources, a hasty rollout of EHR technology could be "disjointed," and that may make for even more difficulties later.
Pace up with multiplying compliance demands in addition to EHR requirements. Providers worry that their IT systems will be crushed by the confluence of several new requirements - only one of which is the EHR rule.
Remember that new ICD-10 code sets are in effect and carry a compliance date of October 1, 2013. Other new standards apply to medical claims and remittances under HIPAA; there are the red flag rules from the FTC; and new electronic medical record (EMR) systems are required in each facility - a requirement separate and apart from the aggregate EHR on a patient that exists across organizations.
Check the IT staff at your organization. IT staff can be low in some places, points out the article, which is worrisome because they won't have the manpower or expertise to implement these complicated systems. The article reads, "EHR implementations are far more complicated for hospitals than for physician's offices as they aren't all-inclusive bundled systems." "Hospitals use piecemeal technology that's rolled out department by department and requires integration. And because many hospitals will not just rip and replace their existing IT infrastructures, they'll be forced to integrate new physician and nurse documentation systems, computerized order-entry systems and relational databases with their existing systems."
Implement CPOE initially. A recent survey by Computer Sciences Corp. indicates that while 70% of hospitals have systems that can support computerized physician order entries, only 8% have such systems throughout their facilities. Implementing a CPOE system is a good place to start on the road to EHR adoption, according to the BusinessWeek series. Such systems can be set up in emergency departments first, before being rolled out to the rest of the hospital, for instance.
Self-Assessment and Networking! According to Sue Reber of the non-profit Certification Commission for Health Information Technology (CCHIT) which certifies EHR systems, "If you aren't evaluating some EHR products and talking to your peers about this, you're going to have a difficult time getting all of your reimbursement payments, and you may even get yourself into the penalty phase." Other experts recommend that you run an audit of the IT systems you already have in place, asking whether they can be certified as they are, and whether there are any technology gaps that need to be remedied.
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