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Meaningful Use

Painless compliance O

By Jocelyn E. Piccone

ver the past two decades, due to federal man- dates, practice management techniques and IT innovations, the landscape of care management has changed dramatically. Quite simply, health- care today is more complex – and expensive – than ever. For physicians, one of the greatest current challenges is meeting meaningful-use (MU) requirements.

As physician practices are planning their electronic health record (EHR) conversion strategy, they are quickly realizing numerous software choices are overwhelming and the costs discouraging. However, complying with MU doesn’t have to be as complicated, costly and painful as it appears. Regardless of size, many medical practices are finding cloud-based EHR systems to be the ideal solution for meet- ing their clinical needs, as well as compliance regulations – particularly when the EHR is integrated with practice- management systems.

Many practices are concerned about MU compliance due to the level of work involved, which is seen as a distraction from care. This is where cloud-based EHRs are becoming the ideal platform: As requirements change, the software is con- tinuously updated to the latest standards and requirements without the need for manual upgrades. From a chief operat- ing officer’s perspective, the visibility of having all providers on a single instance of software means practice executives can see how all providers are doing on MU and other pay- for-performance (P4P) programs, ensuring a high degree of compliance and identifying issues to focus on. In the early stages of cloud computing, many feared it would not be able to meet the storage and management demands of EHRs. As providers continue to seek ways to do more with fewer resources, the limited hardware expenses, ease of use and growing confidence in cloud computing con- tinue to make cloud-based tools more enticing, according to a May 2012 report from market researcher KLAS. In particular, there has been a lot of buzz about cloud-based EHRs, which allow the user to pay a monthly subscription fee to access their EMR, rather than have to purchase the software and maintain it themselves. Cloud-based EHRs put the responsibility for upkeep and monitoring on the vendor’s side, which frees up physicians to focus on seeing patients and improving outcomes. At Wright State Physicians, the clinical practice of physi- cians affiliated with the Wright State University Boonshoft School of Medicine, concerns surrounding the management and storage capabilities of cloud-based EHRs have been met head on. As the largest physician-managed multi-specialty group in Dayton, several lessons have been learned from

18 September 2012

implementing an integrated, cloud-based EHR to attest for MU, improve daily workflow and increase practice efficiency – no small task with 150 physicians spread across 23 offices. When I first joined Wright State, the organization was us- ing an old DOS-based software program to handle its billing. Very soon afterwards, my colleagues and I began the process of vendor selection for a new practice-management and billing solution. Among the key factors was the ability to centralize billing. We needed a new practice-management system that would eliminate

Jocelyn E. Piccone, M.H.A., CMPE, is the chief operating officer of Wright State Physicians.

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the need to maintain in-house software and allow easy in- terconnection across multiple locations. Running a large practice presents a multitude of challenges, especially given the current healthcare climate. Besides the burden of more paperwork and the need to collaborate across offices and specialties, the practice has dealt with increasingly complex reimbursement procedures, govern- ment requirements – such as MU – and daunting industry transitions – such as ANSI 5010. Wright State has been able to manage all of this and more with the help of a fully inte- grated, cloud-based billing, practice-management and EHR service from athenahealth.

In addition to streamlining the billing and reimbursement processes, there is a greater sense of transparency within the system. Prior to implementing this service, we faced a huge paperwork shuffle between each practice when it came to each patient’s health record. By implementing a cloud-based solution, our providers are able to have instant access to a patient’s EHR across all 23 locations – a benefit that allows for better quality of care to the more than 100,000 patients who visit the Wright State system each year. The more efficient processes are, the greater a practice’s chances are for qualifying for Medicare and Medicaid MU incentives. To date, more than 70 of Wright State Physician’s providers have attested for MU, and the practice has experi- enced a 19.6 percent decrease in days in accounts receivable. There are numerous compliance challenges and demands still on the horizon. With Stage 2 of MU and ICD-10 around the corner, Wright State is able to keep an eye toward the future. With a comprehensive service model in place, it has been able to put policies in place across its multispecialty group to mitigate the impact of the increasingly challenging standards coming in 2014. Wright State is proactively train- ing residents on the appropriate workflows to satisfy MU, preparing the next generation of providers for success. HMT

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