South Florida Hospital News
Thursday November 23, 2017
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December 2011 - Volume 8 - Issue 6

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An Alphabet Soup of IT Requirements Drives Implementation of Electronic Health Records

Electronic Health Records (EHRs) are an evolving concept in the continuing quest to lower costs and improve the quality of patient care in the nation’s almost $2.7 trillion per year healthcare system.
 
When implemented over the next few years, EHRs will move with the patient – from the primary care physician to the specialist, hospital, emergency room, laboratory, surgical center or nursing home – in the next state or across the country. These records may include all the key administrative clinical data relevant to the patient’s care, including demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data, radiology reports and advanced directives.
 
“EHRs can improve the availability, timeliness, accuracy and clarity of medical records and reduce treatment delays and duplication of tests,” said Lawrence Schimmel, M.D., managing member of Marcum Healthcare, a consulting group that recently began operations in South Florida. “By streamlining communication from one provider to another, EHRs will result in more coordinated, patient-centered care.”
 
Schimmel noted that healthcare providers, payers and patients alike will reap the benefits of fully functional EHRs. “These records will simplify reporting procedures and reduce paperwork for doctors,” he said. “Increased accuracy of reporting will enable payers to reimburse doctors more quickly. And patients can log on to their records to take a more proactive role in their own health and wellness.”
 
An alphabet soup of IT requirements is key to the successful implementation of the EHR, with its basic goal of having providers talking to payers through a standardized format with the secure interchange of data. Traditionally, the healthcare industry has lagged behind other industries in the development of IT infrastructure. While hospitals and managed care organizations have IT departments with systems administrators, physician practices and other providers generally don’t have IT infrastructure, and must rely on software vendors for upgrades and support.
 
The Health Information Technology for Economic and Clinical Health Act (HITECH Act), part of the 2009 economic stimulus package, set “meaningful use” of EHRs in the healthcare system as a critical national goal, and created incentives for its adoption. Meaningful use refers to the use of an EHR in a meaningful manner, such as e-prescribing and other ways that can be measured with standardized quality indicators. Starting in 2015, hospitals and doctors will be subject to financial penalties under Medicare if they are not using EHR.
 
Prior to the implementation of EHR, providers must upgrade from IT electronic data submission standards that were created by the Health Insurance Portability and Accountability Act (HIPAA) of 1996. While the current transaction standard is the X12 version of 4010A1, the government has mandated that the industry upgrade to the HIPAA transaction 5010 standard by January 1, 2012 to improve the consistency of data flow.
 
“This upgrade was announced in tandem with the January 2009 final rule requiring an update of the International Statistical Classification of Diseases 10th Revision (known as ICD-10”), a medical classification list coding of diseases, signs and symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as maintained by the World Health Organization (WHO),” said Schimmel. “The ICD-9-CM diagnosis codes are 3-5 digits in length and number over 14,000, but the new the ICD-10-CM codes are 3-7 characters in length and total 68,000.”
 
The implementation of ICD-10, mandated by January 2013, cannot occur without the upgrade to the HIPAA 5010 standard, required by January 1, 2012.
 
“This is a trying time for healthcare providers, because all these requirements are not open for debate – they are reality,” said Schimmel. “While hospitals and managed care organizations have IT departments to implement the changes, doctors do not, and may be overwhelmed by the upcoming challenges.”
 
 Schimmel recommends that doctors do their due diligence in selecting a software provider for 5010, EHR and ICD-10. “They should do research on available systems, request demonstrations from three or four vendors, and consider getting advice from a knowledgeable consultant to help them make a final decision. The most important thing is for them to be comfortable with the training and ongoing support the vendor will provide.”
 
Once the software is selected, Schimmel noted that doctors will need to adapt their practices to the new environment. Office work flow, staffing, billing and collections may need to be realigned to best utilize the new systems.
 
“EHR will make it easier for doctors to practice medicine,” Schimmel said. “Some understand this, but some look at it as a burden at this time. But once they take the first step and choose their system wisely, they will be able to practice more efficiently and provide better patient care.”

For additional information about EHR and related IT requirements, contact Larry Schimmel at lawrence.schimmel@marcumhealthcare.com or (305) 995-9801.

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