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By David Chou, Digital Health Evangelist, dchougroup, and former CIO, University of Mississippi Medical Center
This article is by Featured Blogger David Chou from his LinkedIn page.
2015 was an eventful year in healthcare for many reasons. For the first time in the nation’s history, all Americans now have some type of health insurance. The ACA has now made healthcare a right for all and has transformed the lives of patients. In addition to expanding the pool of people with coverage, the ACA also subsidizes private healthcare insurance plans, has raised revenues by introducing a number of new taxes, and has reorganized spending of government money on healthcare. With the Affordable Care Act in place, the healthcare industry saw major trends coming into play, and these changes affect healthcare IT.
Electronic medical records (EMR) became a part of healthcare. Information healthcare technology arrived with a great deal of fanfare and with promise of enormous savings, and increased efficiency and accuracy. In 2015, all physicians were warned that they should have EHR technology in their practice by the end of the year. Anyone who did not have the EHR would not be reimbursed and would face added penalties. In addition, Medicare already stated that failure to use electronic billing would result in reduction of reimbursements by one percent. Healthcare professionals were also told that they need to be compliant with Medicare’s Electronic Prescribing incentive program and physical quality Reporting system. This is one method of how Medicare started to monitor physician prescription practices, referrals and quality of care. The primary reason why electronic records became mandatory is because of the potential for enormous savings that will occur from more efficient delivery of healthcare each year. So far, most physicians have felt that health IT initiatives have only increased the workload, but there are many benefits by having legible documentation and the ability to have data captured electronically. We will continue to see an emphasis on EMRs as many healthcare entities are still implementing or converting to new systems.
Bundled Payments: In 2015, the healthcare provider also became aware of bundled payments for certain chronic diseases. No longer would insurance plans and Medicare pay for chronic disorders for repeated blood work or unnecessary duplicate x-rays. Only one reimbursement would be given, and the onus was on the healthcare provider to ensure the patient has a proper treatment plan. Health IT executives will play a major role in this arena by ensuring that the organization has the ability to utilize the data elements in the system. We will have to start pulling together financial and clinical data in order to predict cost associated with the bundle payments. In 2016, Data analytics will be the top priority for healthcare CIO because of the shift towards bundled payments and value based care.
Consumer Healthcare IT has changed the expectation for healthcare providers. Many healthcare websites and health plans started to offer pricing information and quality of services provided. The rules of the game were to make everything open and let the consumer select their care and provider. In turn, providers also needed to release reliable and useful information to remain competitive. We are moving toward an era where consumers are smarter and they will shop for healthcare the same way they shop for retail goods. This is a great opportunity for healthcare IT leaders to shift the mindset toward technology tailored to optimize the consumer/patient experience. Examples of this may be something as simple as a self-service mobile application for scheduling and canceling an appointment the same way we making our dining reservation. We have to catch up and leap-frog the other verticals in order to meet the consumer expectation in healthcare.
Healthcare Consolidation: It feels like there is news of consolidation of health systems weekly, whether it is a small hospital joining a bigger health system, academic medical centers partnering with community hospitals, or an acquisition of medical group. The same trend is also happening in the healthcare IT vendor space, and this trend will continue in 2016. The role of the executive IT leader must extend to incorporate solutions to accommodate consolidation. Does your technology solution allow the organization to grow and scale easily? What is your healthcare IT strategy for mergers and acquisitions?
Healthcare IT Security: 2015 was the year when healthcare IT security was approached with a vengeance by hackers. We must tighten up security, but at the same time, IT security cannot be overly protective to where it cripples the organization. Traditionally IT has been in the business of saying ‘no,’ and that mentality has changed as the CIO role has transitioned to become more business-focused than technology-focused. The world will be more connected than ever with smart devices on the network, and the challenge will be putting together a solution incorporating the wide range of devices in a secure matter.
As we move toward 2016, we are all striving to provide the best quality of care at the lowest cost. This is a simple statement to put forth as the strategy but the solution to get there is anything but simple. We will continue to see the reimbursement decline from CMS, and as this trend continues, we as healthcare IT leaders must be creative in our solutions to help our organization tackle this challenge. These are my top 2015 trends — I would love to hear your top five.
Originally published on LinkedIn