CMS is Getting Serious About "Promoting Interoperability"
By Justin Sims
June 21, 2018 — Last month, CMS announced a major overhaul of the “meaningful use” EHR incentive program for hospitals. They intend to replace the incentives, in place since 2011, with “Promoting Interoperability” or PI[1], beginning in January 2019. This plan demonstrates a renewed commitment to creating a healthcare ecosystem that actually exchanges health records in support of better patient care.
The approach CMS has proposed is simple: to avoid significant penalties, a hospital must send transitions in care and referrals in digital form and attach the patient’s health record in a format that makes it easier to upload into the receiving provider’s EHR. And when the hospital receives a referral in digital form, it must upload it to its own system.
The industry has, by and large, already adopted a standard format for exporting a record from an EHR. So long as the EHR is being properly used, clinical information including the problem list, lab results and medications can be saved, sent and uploaded into another EHR that meets this standard – regardless of vendor. But the task of getting it to the receiving party is much more difficult. It can’t be emailed because that is an unsecured channel. It can’t be faxed because that is not digital. In most cases it can’t be pulled from a Health Information Exchange because they don’t have widespread adoption. And it can’t be reliably sent through Direct messaging because the majority of clinical staff, particularly outside of a hospital setting, don’t know what Direct is and don’t have a functioning Direct mailbox.
Of course, some hospital EHRs have portals that the receiving clinician can access to view the referral and record, but the last thing a provider wants is an ID and password for Epic, Allscripts, Cerner, eClinicalWorks, etc., not to mentioned having to remember which portal to use when submitting their own referrals to the various hospitals and specialists they work with. And if it is not easy for the provider, it won’t get done. And if it doesn’t get done, the hospital will not achieve its measures and will get penalized.
Innovative services are already emerging that provide the security and EHR-neutral approach needed toscale the exchange of patient records, referrals and transitions in care nationwide. Imagine a service that operates as simply as FedEx - drop off the “package” and it will get there – and while it is in transit, see its progress until it is safely in the hands of the recipient. It works with the EHR, but it realistically cannot bethe EHR because this is a communications challenge and that’s not the problem that EHRs were designed to solve.
To find about how careMESH addresses this challenge, using our NOTIFY and TRANSITION services, please explore this website. Or, please email us anytime to discuss – we’d love to hear your ideas!
Justin
[1]https://www.federalregister.gov/documents/2018/05/07/2018-08705/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the