The Future of Healthcare IT

Transcription

1 The Future of Healthcare IT Foundation is Laid for Long-awaited Advances in Healthcare Information Technology by Cassel Salpeter & Co.

2 Getting the Ball Rolling After years of talk about the significant technology lags in the U.S. healthcare system, the healthcare industry and the federal government have finally begun taking critical steps toward much-needed advances in healthcare information technology, according to industry thought-leaders attending the Healthcare Information and Management Systems Society conference last week. The momentum was evidenced by the thousands of companies, large and small, exhibiting their new technology platforms at the annual event. The venue was abuzz with excitement about this long-awaited development and its potential to increase quality and efficiency while decreasing costs. the healthcare industry and the federal government have finally begun taking critical steps toward much-needed advances in healthcare information technology Legislation Prompts Adoption of New Technology During the past two decades, advocates have been pushing healthcare providers to implement electronic medical records (EMR) to replace paper-based systems, citing benefits that include lower administrative costs, reduced storage space for paper records, and shorter billing cycles, along with improved patient outcomes and access to federal grants. A big impetus came in 2009 when the U.S. Government passed the Health Information Technology for Economic and Clinical Health Act, which provided $31 billion in incentives to healthcare providers that adopt and meaningfully use electronic medical records. In order to receive incentive payments, providers must successfully demonstrate Stage 1 meaningful use of an EMR and meet the allowable-charges threshold. Adoption of EMRs by physicians and hospitals has increased significantly since the passage of the HITECH Act and, with lingering reimbursement cuts for those who don t implement EMR technology, rapid adoption is expected to continue. 1

3 EMRs Key to Overcoming Regulatory Hurdles Using EMRs to capture and enter health information into patients records improves the overall quality of documentation in terms of granularity and specificity. This documentation will be particularly important to overcome two substantial regulatory hurdles that the industry will face this year: ICD-10 coding compliance, and Stage 2 Meaningful Use. Beginning October 1, ICD-10 billing codes must be implemented nationwide to replace ICD-9, which will result in tens of thousands of new codes. Effective software tools can mitigate the pain for providers, as cash flows will likely be adversely impacted by denials of claims during the transition phase. Improved documentation can also be used to support achieving Stage 2 meaningful use EMR Incentive Program criteria, which are more complex than Stage 1 in terms of integration and patient engagement. Many providers had hoped for delays in implementation and were disappointed when it was revealed that the attestation period would only be extended through Finally, by enhancing connectivity, interoperability and quality reporting, these platforms also improve compliance with quality initiatives and performance objectives required by value-based reimbursement models. Overcoming Roadblocks to Information Flow Avoiding Common Frustrations However, many of the early, legacy EMR systems were not designed very well and many providers are quite frustrated. What providers desire is intuitive, simple workflows and deep, specialty content. Often, those solutions actually slow patient encounters and lack integration between systems, creating roadblocks in sharing information with hospitals and other health systems. What providers desire is intuitive, simple workflows and deep specialty content. Data sharing is also essential for care coordination and collaboration. The whole care team needs to view, document and exchange data with one another as well as hospitals, labs, pharmacies and payors. Attributes of Effective Solutions Agile, purpose-built systems Scalable deployment and hosting options Client-driven innovation models Superior services and ongoing support Open architectures 2

4 Foundation Laid for Future Progress Although the amount of change in the industry has been substantial during the past decade, it is only the equivalent of laying the foundation to a house. The more meaningful progress will now come as the industry will capture all the data to begin achieving goals such as having data drive clinical decisions, not just document them. The end game is changing the care of patients to improve outcomes, or adjusting the patients behaviors toward more desirable adherence patterns. This means providers are going to need the expertise of systems integrators to connect EMRs with analytics offerings. The most successful business intelligence implementations will be those that can transfer statistical and correlation data from the transactional systems into the cloud, which will require cloud-based analytics software, supported by outsourced enterprise integration teams. Just like the Internet 1.0 boom-and-bust cycle in the late 90s and early 2000s, there will probably be a shake-out of winners and losers in the HIT business community, but the survivors will experience rapid growth and will likely help complete the build-out of a more robust and efficient healthcare industry. 3

5 Cassel Salpeter & Co. is an independent investment banking firm that provides advice to middle market and emerging growth companies in the U.S. and worldwide. Together, the firm s professionals have more than 50 years of experience providing private and public companies with a broad spectrum of investment banking and financial advisory services, including: mergers and acquisitions; equity and debt capital raises; fairness and solvency opinions; valuations; and restructurings, such as 363 sales and plans of reorganization. Co-founded by James Cassel and Scott Salpeter, the firm provides objective, unbiased, results-focused services that clients need to achieve their goals. Personally involved at every stage of all engagements, the firm s senior partners have forged relationships and completed hundreds of transactions and assignments nationwide. The firm s headquarters are in Miami. Member FINRA and SIPC. Cassel Salpeter & Co., LLC 801 Brickell Avenue Suite 1900 Miami, Florida Member FINRA SIPC 4