Thanksgiving Message

To all of the readers of this blog and to everyone out there the world over, here’s to a wonderful and safe Thanksgiving Day 2013. Hope that you will have a great holiday season and some happy times this long weekend.

Mobile Health Security. It’s finally here!

Let me check my phone and get back to you. I’m sure everyone knows it’s so much more than a phone now. It’s an alarm in the morning, the main form of media that you read with your first cup of coffee; your organizer as you see what you have in store for you during the day and your recorder of memories that you will treasure for a lifetime. With everything happening on a mobile device; from taking pictures of checks to deposit in a bank to reviewing details of your office visit in your medical record app, the question about security of your mobile device in a healthcare setting was bound to be raised.

BYOD policies have been developed over the last few years in order to take into account the loss or theft of devices in a healthcare setting and the consequences they have for a care delivery organization. The ability to auto wipe devices after a certain number of tries is a necessity and care providers may not like the thought of their device losing all of it’s data, but in terms of what the risks of continuing to have that information on the device and the fact that 4 character or digit passwords could be breached after 9,999 attempts is something that care organizations must have a mitigation plan in place. Too many times, the headlines talk about data breaches and the possible compromise of hundreds, if not thousands of medical records due to a provider organization not properly planning for such loss of devices; mobile or otherwise.

Secure messaging as well comes into this environment. There are many organizations now that need to leverage the benefits of secure text messages between the provider and patient and between providers as well. The ability to have secure and confirmed delivery, the data behind it to show how many patients leveraged this form of communication, the audit chain of the messages and last but not least, compliance with HIPAA is what secure messaging communication requires to overcome the regulatory and practice challenges at healthcare provider organizations, with the HIPAA Omnibus rule from September 2013 also added to that regulatory mix. The ability to be more in tune with your patients through this form of communication and be able to engage faster with them brings positive strides to patient engagement metrics.

Ultimately, being able to provide great patient care through technological advances such as practical and timely mobile health solutions is what healthcare information technology teams should collaboratively strive to accomplish.

My EMR. The Resource Hungry Beast!

Over the last 4 years, the number of fixes and updates, initiatives and projects that have inundated IT departments across the country has increased 20 fold. Implementing EMRs in the past was much simpler and easier than now due to the sheer amount of regulatory updates that EMR vendors have to include in their software. Healthcare provider organizations are asked to keep their budgets the same or slightly increased, but have 20 times the amount of work pumped out each year, even though their goal of implementing an EMR solution is to makes life better, faster and cheaper for the triumvirate of patients, physicians or clinicians.

The gap between actual effort and the number of resources required to get that work accomplished on time is increasing. Not enough time to get things done has unfortunately become a norm in healthcare IT organizations regardless of how well they are planned. Each week, the number of initiatives and projects that healthcare information technology professionals have to face becomes more and more as more projects fall on their laps and are required to be completed due to immediate operational pressures behind them. Healthcare IT departments just do not have the time or money to get more of these projects done without much more increased operational and financial support.

What drives analysts to work more hours is part of organizational dynamics. Some healthcare analyst in the IS departments work many long hours and if people wanted to work longer, your manager may let you, depending on their style of functioning. The expectations and the pressures of internal healthcare IT customers (physicians and operational departments) are high and intense in this day and age. Many project analysts make professional moves between different healthcare organizations and the turnover between hospital IT departments has been exceptionally high of late, due to seasoned professionals feeling the effects of many priorities at the same time. Watch out for the resource hungry beasts. Plan for them and make sure that you understand all that you are in for prior to getting yourself in too deep before you realize this. Make sure that operations and the physicians realize this. For many it is too late to turn back now, after hundreds of millions of dollars spent on implementation, but understanding the problem now is at least a step in the right direction.

Fixing it is another blog post entirely…stay tuned, same blog, same location.

Evangelizing Healthcare IT

I was at a meal recently with two Healthcare IT leaders and the discussion over the delicious Mediterranean Chicken Salad was about how the IT department needed to better communicate its successes and initiatives, which they felt wasn’t occuring today.

Is this something that an IS&T department needs to do? After all, aren’t we just focused on achieving organizational objectives anyway?

I believe that there is a role for an IT Communications Manager or Coordinator, depending on how large the care delivery organization is. If it is a single location facility, that role and responsibility can be taken on by a Manager or Director.

Common questions can be about how many resources are working on a project, such as ICD10 and how willnit impact our other initiatives to what are the milestones for another project that the physicians and clinicians should be aware of over the next year.

Being able to communicate,  without initiating email or alert fatigue will depend on external environmental factors associated with each organization.

A well informed organization will more likely be able to better coordinate their multiple initiatives that challenge them in todays healthcare technology world.

What was the 80/20 Rule in the Affordable Care Act?

Has the 80/20 Rule delivered  value? What was it? It is a rule in the Affordable Care Act that holds healthcare payers  accountable to consumers and is supposed to ensure that families receive value for their premiums paid.

Due to healthcare reform, payer organizations now must disclose how much they spend on health care and how much they spend on administrative costs, such as salaries and marketing. If a payer spends less than 80% (85% in the large group market) of the premium on medical care and efforts to improve the quality of care, they must send a rebate check for the portion of premium that exceeded this limit to the consumer.

This rule is commonly known as the 80/20 rule or the Medical Loss Ratio (MLR) rule.  

Consumers are supposed to benefit from the 80/20 rule in two ways:

1)  Benefit upfront because payer organizations now keep premiums lower and operate more efficiently in order to meet the 80/20 rule.

2)If a Payer doesn’t meet the 80/20 rule, then the consumer benefits anf receives a rebate for the amount that exceeds this threshold.

According to CMS, in 2012, the 77.8 million consumers in the three markets covered by this 80/20 rule saved $3.4 billion on their premiums (I got a surprise check from my payer so I can vouch for this)  because of the 80/20 rule and other Affordable Care Act programs.

Payer organizations should have paid the rebates by August 1, 2013.