Telemedicine, along with walk-in clinics, are two emerging trends that are disrupting the current delivery of healthcare and we expect their impact will increase significantly over the next few years. While providing more convenience at a lower cost in many cases, they serve many patients quite well. However, these trends hold some risks as these services are often independent of electronic medical records and their clinicians may not have access to critical medication or patient history data.
In this month’s newsletter we have included a case study on the success Avera Health has realized with their telehealth program.
A recent article suggests that employer health plans may be 100% telemedicine enabled by 2020, and if growth continues at its current pace, this will become a major factor in your EHR planning.
Finally, we have two important Quality and Compliance updates in this month’s newsletter. Hope you find this information helpful.
John Haffty, President
As the only consulting company dedicated exclusively to supporting the MEDITECH community, we are often asked by our clients (past and present) to answer questions or clarify information. We consider it a privilege to provide this benefit for our clients as these research activities keep us on top of all things MEDITECH. Also, as the leading 6.1 READY consulting company, we have been involved with almost every new product and feature, providing us with more experience and knowledge than all other certified consulting partners combined.
Over the past two months, we covered a variety of topics and thought some of you might find this of interest:
The financial and operational standard content dashboards contain facility or corporation “view bys” that display a comparison of facilities or corporations for a set of metrics. Additionally, we are creating a series of Enterprise Executive dashboards that are intended, for a high-level audience, to do facility comparisons and aggregations (total revenues, total admissions, etc. for selected facilities or corporations). The Enterprise Executive dashboards will be available at the end of Q3 this year.
We welcome the chance to share what we have learned. If you have any questions on these or other topics, please contact us at firstname.lastname@example.org.
Telehealth has become a hot topic in the news lately, and as more of our clients adopt telehealth it is helpful to hear from health systems successfully implementing telehealth. We recently came across a great case study and webinar that highlights a successful telehealth deployment at Avera Health, an integrated delivery network that includes the Avera Health Plan and Avera Medical Group. Here’s an overview on Avera’s direct-to-consumer telehealth initiative, as well as its nationally recognized business-to-business telemedicine network:
Health systems that are considering implementing telehealth can learn a lot from Avera Health’s success and best practices in both business-to-business and direct-to-consumer telehealth. If you are interested in learning more, please reach out to Avera eCARE for additional information on their services.
We are very proud to have partnered with The Valley Hospital, Ridgewood, New Jersey on their implementation of MEDITECH’s 6.1 EHR. MEDITECH recently posted an article describing one of the many collaborations with this hospital and the following is from the MEDITECH website:
When The Valley Hospital moved forward with MEDITECH’s 6.1 EHR, hospital leaders recognized the potential in its new electronic surveillance tool and agreed to be an early adopter. Less than a year after going LIVE, MEDITECH’s Surveillance solution has earned their confidence for its power and versatility.
With 23 boards in use, Valley counts on Surveillance for everything from identifying and preventing sepsis and other infections, to complying with core measures and improving patient throughput. For example, in March 2016, 100% of HIM-coded septic patients at Valley were found by electronic surveillance.
“Why wouldn’t you want to free staff from performing repetitive tasks or surveilling patient information, when the EHR can accomplish those same functions faster and more easily?” asks Chris Neumann, project specialist at Valley.
Read more about Valley’s journey from early adopter to success story in MEDITECH’s new case study, Detecting the Undetected: MEDITECH’s Surveillance Identifies and Prevents Infections at Valley.
Over the past several years CMS has aligned Meaningful Use (MU), Inpatient Quality Reporting (IQR) and Physician Quality Reporting (PQRS) to share common quality measures and reporting requirements. It has been a slow process and is far from complete, but, for this year and 2017, some major steps have been taken.
For MU in 2016, hospitals are allowed to either manually attest to 16 of the 29 possible Clinical Quality Measures (CQMs), or they may electronically submit results on 4 of 28 possible CQMs. The 28 electronic CQMs is not a typo; the ED-3 measure in MU’s 29 is not an inpatient measure, so it would not qualify for IQR.
The carrot for hospitals is that eReporting requires fewer measures, and a single electronic submission will count toward MU as well as IQR. Independent of MU, for 2016, IQR requires electronic submission of four CQMs, or the hospital will be assessed a penalty in 2018. So if you have to perform an electronic submission anyway, why not become familiar with the process and make it count for two programs?
An additional carrot had been that an electronic submission would only require one quarter’s data, whereas manual MU attestation would require a full year’s data. With the current proposed revisions to MU for 2016, all attestations and reporting would be for a calendar quarter, so this benefit would be removed if the proposed changes are approved. Please note that the eReporting data must come from either CY2016 Q3 or Q4 and be submitted by February 28, 2017.
Although some hospitals will choose to use a third party to submit their results, electronic submissions can be performed by the hospital and would be made through the QualityNet system. CMS requires that data be submitted in a QRDA-1 format, which produces single-patient reports. MEDITECH CQM reports produce their results in that format, so no additional intervention of the results should be required prior to submission.
Preparation for submissions should begin now in order to meet the deadline. The most obvious need would be to assemble your site’s MEDITECH analysts/informaticists, and quality department staff, to begin gathering data and testing reports. Additionally, there are requirements on the QualityNet end, which include:
To beat the end of February rush, plan on submission of Q3 or Q4 data before mid-February 2017.
In the final rule published on August 22, 2016, CMS made several major changes that affect hospitals’ reporting of CQMs for CY2017.
CMS is requiring hospitals to select and submit eight of the available electronic Clinical Quality Measures (eCQMs) that are included in the Inpatient Quality Reporting (IQR) program. They are requiring four quarters of data, submitted as an annual aggregate, for the CY2017 and CY2018 reporting periods.
CMS is removing 15 measures for the CY2017/FY2019 payment determination year. This removal will remain for subsequent years. The rationale behind their removal is that they are topped-out, and further tracking and analysis will not provide additional improvement in patient outcomes. Of these 15 measures, delineated below, 13 are eCQMs, two of which CMS is also removing from their chart-abstracted form.
1. AMI–2 Aspirin Prescribed at Discharge for AMI
2. AMI–7a Fibrinolytic Therapy Received Within 30 Minutes of Hospital Arrival
3. AMI–10 Statin Prescribed at Discharge
4. HTN Healthy Term Newborn
5. PN–6 Antibiotic Selection for Community-Acquired Pneumonia in Immunocompetent Patients
6. SCIP–Inf–1a Prophylactic Antibiotic Received Within One Hour Prior to Surgical Incision
7. SCIP–Inf–2a Prophylactic Antibiotic Selection for Surgical Patients
8. SCIP–Inf–9 Urinary Catheter Removed on Postoperative Day 1 (POD1) or Postoperative Day 2 (POD2)
9. STK–4 Thrombolytic Therapy; in chart abstracted form
10. VTE–3 Venous Thromboembolism Patients with Anticoagulation Overlap Therapy
11. VTE–4 Venous Thromboembolism Patients Receiving Unfractionated Heparin (UFH)
12. VTE–5 Venous Thromboembolism Discharge Instructions; in chart abstracted form
13. VTE–6 Incidence of Potentially Preventable Venous Thromboembolism
14. Participation in a Systematic Clinical Database Registry for Nursing Sensitive Care
15. Participation in a Systematic Clinical Database Registry for General Surgery
This leaves 15 measures available for eReporting in CY2017, which include:
1. AMI-8a Patients receiving primary PCI within 90 minutes of arrival
2. CAC-3 Care plan provided to pediatric asthma patients
3. ED-1 Median time from ED arrival to ED departure for patients admitted to Inpatient
4. ED-2 Median time from admit decision time to ED departure for admitted patients
5. Exclusive Breast Feeding
6. Newborn Hearing Screening
7. PC01 Elective Delivery
8. STK-2 Patients Prescribed Antithrombotic Therapy at Discharge
9. STK-3 Patients Prescribed Anticoagulation Therapy at Discharge
10. STK 5 Patients Administered Antithrombotic Therapy by End of Hospital Day Two
11. STK-6 Patients Prescribed Statin at Discharge
12. STK-8 Stroke Education Provided During Inpatient
13. STK-10 Patients Assessed for Rehab Services
14. VTE-1 VTE Prophylaxis Received
15. VTE-2 VTE Prophylaxis Received in ICU
Additional clarifications in the final rule include:
1. Hospitals can report using an EHR certified to either the 2014 or 2015 edition for the CY2016 reporting period
2. Hospitals must submit eCQM data in a QRDA-I format
3. Hospitals may use third parties to submit QRDA-I files on their behalf
4. Hospitals can use abstraction or they may derive the data from non-certified sources in order to then input the data into their certified EHRs for capture and eReporting
There have been some questions regarding validation by CMS of eCQM results being submitted for 2016 and 2017. It was noted in the Final Rule that CMS is considering review and validation of 200 hospitals, starting in CY2018, but no validations of submitted results would occur for CY2016 or CY2017.
Finally, while it is quite a bit down the road, CMS is considering adding three new quality measures for the IQR program, in addition to considering stratification of IQR data by race, ethnicity, sex and disability. These might take effect in CY2020, would be directed to measuring patient outcomes, including:
1. A version of the NIH Stroke Scale
2. A measure of Antimicrobial Use
3. Inpatient behavioral health measures
Each month we share our KLAS rankings and some comments from clients. We believe KLAS provides the best representation on how vendors are performing in the eyes of their clients in our industry. We hope this serves as a reminder to check KLAS rankings and commentary when considering a consulting company.
In every category we score above the industry average. As of September 12, here are our rankings:
3rd – HIT Enterprise Implementation Leadership – We were awarded “Best in KLAS” for this category for 2015/2016. Please note that only one other MEDITECH READY certified company is even ranked in this category, and our score is equal to our score when we were selected for the Best in KLAS award.
2nd – Technical Services – Our score has improved since year-end as well. This category covers report writing, data repository and proration rules services.
10th – IT Advisory Services – Previously known as Planning & Assessment, where we were “Best in KLAS” for 2014.
15th – HIT Implementation Support and Staffing – for small READY implementations and backfill resources. Note that our score is higher than every other MEDITECH consulting company.
Selected comments from August 2016:
“One thing that went well was that our consultant from Navin, Haffty & Associates left us with a wealth of knowledge and a very detailed list of things that we needed to do in order for us to accomplish our objectives after she left. This list was a step-by-step process list that really helped us after she left. This helped us feel empowered that we could do it on our own.” Director/Physician
“When Navin, Haffty & Associates came in and helped us implement our cost-accounting system, I can’t really think of anything they could have done better. I look at how my staff members are functioning now and how well they understand it, and I understand that is the result of Navin Haffty’s efforts. We have a part-time staff member doing our cost-accounting systems now, whereas before we had a full-timer doing it. They really helped us become efficient at this.” Director/Physician
“One thing I thought Navin, Haffty & Associates did a very nice job at was integrating the educational process with our staff. As they went through and worked on things, they didn’t just fix the problems and hope that we would watch and learn from what they did. They actually would draw us in and show us step by step how to fix certain things. They even would have our staff members fix issues, giving us a hands-on approach. This helped make our staff well prepared for when Navin Haffty was no longer working with us.” Director/Physician
“One thing I really liked about Navin, Haffty & Associates is that the person they brought in was very conscious of the time he spent helping us. He made sure he stayed within the time constraints of what we could afford. They only charged us for the time they were here; they did not nickel-and-dime us. In fact, they even did some work without charging us for it.” Director/Physician
Please note selected commentaries may not represent the whole of provider sentiment related to this product or service. For a complete view, visit KLASresearch.com
Last year MEDITECH combined its Physician and CIO Forums into one session, which was a huge success, providing significant education and helping bridge the understanding of the needs of physicians with the challenges of CIOs. They are repeating this format this year on October 20 and 21 at their new conference center in Foxborough, Massachusetts. Registration is open, and MEDITECH has announced the keynote speakers for this event. Further, MEDITECH has published the agenda and there are four breakout sessions to allow maximum participation. There are 25 separate topics covered in these sessions, including:
CloudWave, Forward Advantage, and NHA will again co-sponsor a welcome reception for attendees the evening before the forum gets underway. The reception will be held October 19 at Bar Louie in Foxborough from 6 to 9 p.m. To request your invitation for the event, please contact Susan LaVita.
To keep up with the demand from our clients, NHA continues to need excellent MEDITECH specialists. We have been named to the Top 100 “Best Places to Work” for the third consecutive year.
We believe there are significant advantages to being part of NHA. As part of the largest consulting company focused exclusively on serving the MEDITECH community, we enjoy an exceptional working relationship with MEDITECH, offer a collaborative work environment and treat each of our staff with respect. Our competitive compensation package includes exceptional medical insurance coverage as part of our extensive benefits as well as on-going education to maintain and develop skills and talent. Our employment approach and focus on long-term business relationships has led to an unparalleled record for consultant and client retention.
If you have interest in consulting and have solid MEDITECH experience with implementing one of their applications, please contact us. We have an outstanding mentoring program for new consultants and the best reputation in the MEDITECH community for training and development of our staff. We are the first company certified in the new MEDITECH READY implementation methodology.
We are also interested in experienced consultants from other companies. As the largest company that works exclusively with MEDITECH, you would be supported as you continue to build your skills. In addition, our management approach has demonstrated a respect for our consultants and created a collegial atmosphere that encourages information sharing and support.
While we have a number of openings, at this time, we are particularly interested in candidates with strong project management experience (6.x preferred), Revenue Cycle and Ambulatory.
If you are interested please contact us at email@example.com or call us at 855-309-9334. See what positions are currently available by visiting the NHA Current Openings page.
Please note that at this time, we are only able to consider those able to travel up to 80% of the time. (Current employees of MEDITECH or of our clients cannot be considered.)
If you are interested in exploring new positions at other organizations visit the client job board section of our website. This is a free service of NHA to the MEDITECH community. Currently, there are many postings from MEDITECH organizations. If you or a colleague are interested, check out what’s open.
If you would like to include your organization’s listing on the NHA website, please email Katie Kelly at firstname.lastname@example.org. (Please note that as this is a courtesy to the MEDITECH community, we will not accept postings from recruiting companies.)