Did you feel a chill go up your spine a couple weeks back? It may have been due to the Centers for Medicare and Medicaid Services (CMS) rolling out a new proposed rule for the 2019 Inpatient Prospective Payment System (IPPS) that has big ramifications for healthcare organizations around the country.
As with all such rules, this pronouncement has filled hospital leaders and those in the healthcare IT sector with equal amounts excitement and trepidation. The ruling proposes a variety of changes for hospital reimbursement rates, an updated policy as pertains to price transparency and rebrands Meaningful Use itself to the more welcoming, potentially more accurate ‘Promoting Interoperability.’
We’ve carefully reviewed the proposed rule and what it could mean for our software and our customers, and one section in particular stood out to us: the CMS’s approach to electronic health records (EHRs). By 2019, CMS wants to require hospitals to supply all patients with their EHR the day they’re discharged from the facility.
For most organizations, this is enough to cause heart palpitations. While the vast majority of facilities have transitioned to some type of EHR, it’s an entirely different ballgame to make data readily accessible to patients in a downloadable and sharable format the day they leave through the front doors.
Regardless of the final rule that eventually comes of the proposal, it’s important to understand that this consumer-oriented approach to care isn’t going anywhere anytime soon. CMS and other agencies have doubled down on EHR interoperability and accessibility, and companies like ours have committed to creating the IT infrastructure and software compatibility that make this possible.
Today, we want to talk to those hospitals that aren’t necessarily ready to flip a switch and hand over the patient’s EHR on the day of discharge. We’ve compiled a few steps that can make the transition easier, and they’ll help you understand the obstacles you’ll face and, more importantly, the right path toward compliance.
This is important, particularly if your transition to an EHR is in its infancy.
It’s true that this is just a proposal at this point, and we’ve seen previous deadlines pushed in order to allow organizations time to comply with the requirements.
But as we mentioned above, this increased emphasis on modernizing the current healthcare system is here to stay. In just a few years, younger patients (the Gen Z’ers and millennials of the world) will marvel that patient charts used to be composed of scribbled provider notes. Sophisticated, interoperable EHRs are where the industry is going, and the further that train gets down the tracks, the more momentum it picks up.
Here are a few questions to ask about your current processes to identify potential shortcomings:
- What are the capabilities of your EHR?
- Can your EHR readily generate patient reports in a format that can be shared with other providers?
- Can your patients readily access their medical record data beyond just a basic patient portal?
- Can your EHR pull reports needed for population health programs, e.g. can you create a disease registry based upon facility-defined parameters?
Start working with vendors and investing in the IT infrastructure it takes to get your modern EHR running smoothly and securely. If you’re not yet at the point where you can make it available to patients on their day of discharge, this is the time when you ought to start meeting with key stakeholders, including executives, your IT team and other leaders to develop a strategy for implementing the processes needed to make it happen.
Make the Process Visible
When you’re optimizing the system you have in place, you’ll need to train staff on the new methodology, get buy-in from everyone within your organization and provide assurances that this is for the best for everyone, provider and patient alike. Because of this, it’s critical to make every step of the process highly visible to all parties.
Company newsletters, meetings, question-and-answer sessions and other means of open communication are great methods for getting the word out and, perhaps even more importantly, gathering feedback from your staff.
What you’ll discover during these listening sessions is potential challenges from your frontline staff that you might not have thought about. They will have concerns that address an issue you maybe hadn’t considered, but they will also have solutions that make the endeavor a more positive experience for all involved.
Your Vendor Is Your Biggest Ally
It’s critical to open up a dialogue with your EHR vendor when deploying your solution or improving your current EHR process. While you may be undergoing this kind of transition for the very first time, vendors like Epic, Cerner and others have been working through the potential challenges and getting their own structures up to speed. By 2018, the problems inherent with meeting modern standards should be mostly addressed and vendors should have offerings that provide comprehensive support to hospitals.
Your vendor is going to have insights into the process that make life easier, and that typically includes software solutions. In many cases, a specific tool that you may have overlooked years prior when you first rolled out your EHR has received a variety of software updates or been revamped entirely. This is one of the big advantages of companies moving to the Software-as-a-Service business model.
When you start down the road to day-of-discharge EHR availability, talk to your EHR vendor (or the vendor you’re thinking of partnering with). They’ll be able to talk you through the process and explain precisely what you need to do to hit your benchmarks.
Work with Your Post-Acute Providers
As you make the transition, be sure to keep your post-acute providers in the loop. Explain to them the changes in your process and how this will affect your referrals moving forward. Emphasize that your movement is a positive development for everyone, PACs included.
Even as you make PHI available to patients the moment they leave your front door, you gain the ability to send that information to every other provider they may encounter. Patient discharge software aids the transition experience by making these details instantaneously available to post-acute providers of all kinds, including hospice facilities, nursing homes, at-home health agencies and more.
You’re gaining a lot by evolving your organization, and so are the places you work with on a regular basis.
Post-acute providers are not off the hook either. As more and more facilities commit to instantaneous EHR information, it will be incumbent upon PACs to move away from the fax machine and embrace modern software applications. Although not a requirement at the moment, we recommend that post-acute providers also look into updating current strategy to allow for the widespread introduction of EHR as the primary means of communicating patient information.
Work with Patients
In addition to an improved patient experience, there’s one other huge positive worth mentioning: this is actually a great marketing opportunity for your organization.
The modernization of your hospital and the benefits it creates for patients are something you ought to be talking up across multiple mediums. In commercials, in posters throughout your facility, on billboards and just about anything else you can think of, you can emphasize your dedication to patient empowerment, transparency and optimum care.
Being able to provide an EHR to a patient the moment they leave your facility is something that matters to consumers, who want ease of use and immediacy when it comes to patient portals and provider communication. It’s up to you to phrase things in the right manner and, once you do, your organization can reap the rewards of that messaging.
EHR and You
Day-of-discharge EHR isn’t a pipe dream. It’s where we are in the healthcare industry, and it’s more important than ever to do the legwork needed to set your system up for success.
Questions or insights? Let us know the challenges you’ve encountered in ensuring your EHR conforms to modern standards, why day-of-discharge EHR availability remains out of reach, tips for others going through this process right now, and more in the comments!