The following is a guest blog post by Mitchell Woll, Instructional Designer at The Breakaway Group (A Xerox Company). Check out all of the blog posts in the Breakaway Thinking series.
Healthcare organizations face numerous challenges in 2015: ICD-10 implementation, HIPAA compliance, new Meaningful Use objectives, and the Office of the National Coordinator’s (ONC) interoperability road map. To adapt successfully, organizations must take advantage of numerous opportunities to prepare.
Healthcare leaders must thoroughly assess, prioritize, prepare, and execute in each area:
- Meaningful Use Stage 2 objectives require increased patient engagement and reporting for a full year before earning incentives.
- The ONC’s interoperability road map demands a new framework to achieve successful information flow between healthcare systems over the next ten years.
- There are 10 months left in which to prepare for the October 1 ICD-10 deadline.
- HIPAA compliance will be audited.
1. Meaningful Use
For those who have already implemented an EHR, Meaningful Use Stage 2 focuses new efforts on patient access to personal health data and emphasizes the exchange of health information between patient and providers. Stage 2 also imposes financial penalties for failure to meet requirements.
CMS’s latest deadline for Stage 2 extends through 2016, so healthcare organizations have additional time to fulfill Stage 2 requirements. Stage 3 requirements begin in 2017, so healthcare organizations should take the extra time to build interoperability and foster an internal culture of collaboration between providers and patients. For Stage 3, Medicare incentives will not apply in 2017 and EHR penalties will rise to 3 percent.
CMS has also proposed a 2015 EHR certification, which requests interoperability enhancement to support transitions of care. Complying with this certification is voluntary, but provides the opportunity to become certified for Medicare and Medicaid EHR incentive programs at the same time.
Meaningful Use Stage 2 and the ONC roadmap require that 2015 efforts concentrate on interoperability. Healthcare organizations should prepare for health information exchange by focusing efforts on building patient portals and integrating communications by automating phone, text, and e-mail messages. After setting up successful exchange methods, healthcare organizations should train staff how to use patient portals. The delay in Stage 2 means providers have more time to become comfortable using the technology to correspond with patients. Hospitals should also educate patients about these resources, describing the benefits of collaboration between providers and patients. Positive collaboration and successful data exchange helps achieve desired health outcomes faster.
The three-year goal of the ONC’s 10-year roadmap is for providers and patients to be able to send, receive, find, and use basic health information. The six and ten-year goals then build on the initial objectives, improving interoperability into the future.
Congress has also shown initiative on promoting interoperability asking the ONC to investigate information blocking by EHRs. Most of the ONC’s roadmap for the next three years is similar to Meaningful Use Stage 2 goals.
Sixty-four percent of Americans do not use patient portals, so for 2015 healthcare organizations should focus on creating them, refining their workflows, and encouraging patients to use them. Additionally, 35 percent of patients said they are unaware of patient portals, while 31 percent said their physician has never mentioned them. Fifty-six percent of patients ages 55-64, and 46 percent of patients 65 and older, said they would access medical information more if it were available online. Hospitals need their own staff to use and promote patient portals in order to conquer the challenges of interoperability and Stage 2.
3. HIPAA Compliance
In 2015, the Office of the Inspector General (OIG) will audit EHR use, looking closely at HIPAA security, incentive payments, possible fraud, and contingency plan requirements. Also during the HIPAA compliance audit, the Office of Civil Rights (OCR) will confirm whether hospitals’ policies and procedures meet updated security criteria. Healthcare organizations should take this opportunity to verify compliance with 2013 HIPAA standards to prepare for upcoming audits. Many helpful resources exist, including HIPAA compliance toolkits, available from several publishers. These kits include advice on privacy and security models. Healthcare organizations and leaders can also take advantage of online education, or hire consultants to help review and implement the necessary measures. It’s important that action be taken now to educate staff about personal health information security and how to remain HIPAA compliant.
4. ICD-10 Deadline
The new ICD-10 deadline comes as no surprise now that it was delayed several times. In July 2014, the US Department of Health and Human Services (HHS) implemented the most recent delay and set a new date of Oct. 1, 2015, giving hospitals a 10-month window to prepare for the eventual ICD-10 rollout. Because healthcare organizations are more adaptable than ever, they can use their practiced flexibility and experience to meet these demands successfully.
As Health Information and Management Systems Society (HIMSS) suggests, communication, education and testing must be part of an ICD-10 implementation plan. Informing internal staff and external partners of the transition is a crucial first step. ICD-10 should be tested internally and externally to verify the system works with the new codes before the transition. Healthcare organizations should outline and develop an ICD-10 training program by selecting a training team and assessing the populations who need ICD-10 education. They should perform a gap analysis to understand the training needed and utilize role-based training to educate the proper populations. Finally, organizations should establish the training delivery method, whether online, in the classroom, one-on-one, or some combination of these to teach different topics or levels of proficiency. In my experience at The Breakaway Group, I’ve seen that the most effective and efficient education is role-based, readily-accessible, and offers learners hands-on experience performing tasks essential to their role. This type of targeted education ensures learners are proficient before the implementation. As with any go-live event, healthcare organizations must prepare and deliver the new environment, providing support throughout the event and beyond.
These challenges require the same preparation, willingness, and audacity needed for prior HIT successes, including EHR implementation and meeting Meaningful Use Stage 1 requirements. ICD-10, HIPAA compliance, Stage 2, and interoperability all have the element of education in common. Healthcare organizations and leaders should apply the same tenacity and discipline to inform, educate, and prepare clinicians for upcoming obligations.
Targeted role-based education will best ensure proficiency and avoid comprehensive, costly, and time-consuming system training. Through role-based education, healthcare organizations gain more knowledgeable personnel who are up to speed on new applications. These organizations probably already have at least a foundation for 2015 expectations, and they should continue to recall the strategies used for prior go-live events. What was successful? It’s important to plan to replicate successful strategies, alleviating processes that caused problems. This is great opportunity to capitalize efforts for organizational improvements. Healthcare leaders must let the necessity of 2015 government requirements inspire invention and innovation, ultimately strengthening their organizations.
Xerox is a sponsor of the Breakaway Thinking series of blog posts.