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Major initiatives in Health IT in 2013

As the push for infusing information technology into the healthcare space continues, each year is expected to have its own share of activities and initiatives which get implemented. All of these are finally expected to synergize and lead to a highly efficient and cost effective healthcare system in the future. Each such initiative has a starting time keeping in mind the change it is expected to bring about and the contribution it would make to the system over time. Also, all such initiatives are expected to have certain gestations periods to start offering real benefits. However, the build-up years are bound to result in certain levels of uncertainty and heartburn amongst all concerned stakeholders – owing to major changes affecting the status quo at any point in time.

Year 2013 saw some such Health IT initiatives getting implemented. A few of those were in response to concerns arising on the way and a few with the foresight of where the industry wants to reach. The important wants are as follows:

The HIPAA Omnibus Rule:
Healthcare testing servicesAs an expansion to the Health Insurance Portability and Accountable Act, four new rules have been implemented. Contractors, subcontractors and other business associates of healthcare entities who deal with patient data are now expected to protect it as otherwise a provider would. There are penalties in place as well for cases of non-compliance. Also, how patient information is to be used for marketing purposes and for raising funds have defined guidelines to follow no. In short, no patient information can be sold without the required permission in place. With the digital world in a perennial expansion mode, the new rule is expected to protect patient privacy and safeguard patient health information.

Guidance for Mobile Medical Application:
This was provided by the Food and Drug Administration after an almost 2-year wait. The guidelines are enforced only on a certain percentage of apps which pose a threat to patients if they fail to perform what they intend to. Thus, only a small subset of the overall app market falls under its purview. In its current state, the oversight is on all those mobile medical applications which are aimed at being used as accessories to regulated mobile devices or which are likely to transform mobile platforms into regulated medical devices. The agency has been very particular to apply those regulatory standards which it otherwise applies to medical devices. This clarity is also very relevant to the developer community as they build newer and more effective solutions. There were some omissions in the guidelines which include:

  • definition of what are regulated i.e. how to determine what requires regulation and what necessitates enforcement discretion
  • defining the levels of risk for mobile devices & their accessories
  • disease intended uses compared to unregulated, wellness intended uses
  • exact meaning of an accessory to a medical device

Meaningful Use Stage 2 deadline extension:
Senators may have asked for a reboot of the system, some senior leaders might have questioned its true benefits; MU is here to stay. However, there is widespread consensus on some of the issues which stand as hurdles in its implementation – with the major one concerning the timeline. As a response to this, CMS proposed Meaningful Stage 2 implementation to be extended through 2016. This will result in the roll out of stage 3 getting pushed to 2017. There has however not been a shift in the start date resulting in drawing flak from some CIOs. They are not convinced about the intent of such a move – that of allowing time for fine tuning for the next stage by extending the deadline and not bring in flexibility in the start date which seems to be the need of the hour. Effectively, it means that those providers who do not start on time will miss out on a payment cycle.

Use of Big Data:
It might be early days for big data usage in healthcare systems; providers who have started using them for their clinical and administrative work have already started noticing the benefits. From reducing mortality rates, bringing down instances of readmission to performing evidence-based budgeting, there are predictions already of saving close to $450 billion in healthcare costs if the right usage of big data is made. People from some sections of the industry are however not overtly excited in jumping to such conclusions although they acknowledge the positives which are visible.

What will be new in 2014? Healthcare testing services would be in demand. Because of the large number of initiatives being rolled out and newer changes affecting healthcare, testing would peak during the year. Certified testing team would help you stay in line with your business goals while ensuring delivery of accurate healthcare solutions.

We provide healthcare software development services. If you would like to hire EMR software developers from us, we would be glad to assist you at Mindfire Solutions.

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The essence of Value-Based Care

healthcare software development servicesThat healthcare is changing at a fast pace is a reality all the stakeholders are coming to terms with. Irrespective of their preferences, they are left without a choice but to adapt. The transition taking place is evolving it from being proficiency-based art to a data-driven science. Physicians are shifting from being freelancers to being employed by hospitals. The delivery methods are changing from being one-size-fits-all community hospitals to vast hospital networks which are organized around centers of excellence. There is however, a certain level of criticism from the provider community towards this demand for change – almost to the extent of being reluctant to accept it. This could well be the result of their realization that the shift will finally result in better care outcomes for patient and less inflow of money for them. This is where the fraternity needs to take a step back and look at what lies at the core of their profession – that of helping people overcome their health related ailments. One cannot deny the fact that the profession has a certain degree of nobility attached to it. As much as it is important for physicians to gain financially, the overriding factor which draws people to take up this profession is expected to be a deep desire to serve humanity by curing people of their health related problems. Infact the ones who have realized it and connect to it are eagerly looking forward to days where they would have satisfied patients with lower expenses and they would be proud of their work. The tension which now exists between patients and physicians does not please the majority of the people in the profession and they would expect the new model to give way to trust and happiness for the providers. This is not to say that physicians are expected to lead lives of monks with no desire to gain financially from their services but to let money play the most important role in the system would be going against the core tenets of the profession.

In order to emphasize on this shift in focus from a volume to a value based care, the Centers for Medicare & Medicaid Services (CMS) incorporated value-based purchasing rules which tied acute care Medicare reimbursement of hospitals to quality performance starting in the year 2012. To give this approach a push, 1% of the payments under Medicare for 2012 was put aside and later given away as bonuses to those hospitals which scored above a certain score in some identified measures. Patient satisfaction was the determining factor for about 30% of the incentive payments while the rest 70% was based upon improved clinical outcomes. Noticing the positive difference the approach brought about, a further modification was brought in that resulted in enhancing the payment under the hospital value-based purchasing program (VBP) starting October of 2013. As per the new rule, there was an increase in the payment rates to general acute care hospitals by 0.9 percent, after allowing for other payment and regulatory changes. Although it was suppose to result in increasing the Medicare spending by approximately 175 million, its real benefit was the thrust it was expected to provide towards the adoption of a value based model. There are also penalties in place for hospitals for excess readmission for certain ailments like heart attack, heart failure and pneumonia unless they are planned ones. Also, moving forward there are likely to be more such rules in place to penalize hospitals for conditions acquired during the course of treatment. These steps are intended to bring about more focus towards infection control and prevention.

As much as the reasons appear compelling for moving to a value-based model, early experiments have shown mixed results. The success of value-based approach is hinged on making everything measurable and quantifiable and this is precisely where the hurdles start. Each patient is unique and so the impact of the same disease on a population is not going to be similar. With some patients, things might get a bit more complex resulting in higher expenses. Regardless of whatever incentives are created to make it move faster, a complete shift to this new model will take time. This is going to be driven primarily by the need to bring about some changes in the overall setup. For instance, it has to first and foremost start with getting the buy-in from physicians who are willing to embrace this approach. Furthermore, a successful transition from volume to value will require investment in advanced analytics and clinical information to evaluate performance data, as well as holding all stakeholders – clinicians, staff and patients, accountable for quality improvements.

We provide healthcare application testing & healthcare software development services. If you would like to speak to one of our certified software developers, please reach out to us at Mindfire Solutions.