The CMS (Center for Medicaid and Medicare) incentive program is being rolled out in 3 stages. Stage 1 requires the use of Electronic Health Records or (EHRs) by 2015. Stage 2 requires integration with Clinical Decision Support systems (CDS). Then Stage 3 requires providers to demonstrate outcomes with the data collected. The idea behind CDS is to use the data collected and have it assist physicians with all elements of care. Many physicians contend that it makes the process more convoluted. Others say that it helps them ask the right questions, and has the potential to prescribe more effective affordable drugs thus reducing cost.
There are studies on both sides of the argument making their case. One important thing to note is that the studies demonstrating a reduction in cost and improved care, based on EHRs, are extremely large studies. They often show that Hospitals using EHRs have better outcomes and reduced costs. The flaw with that correlation is that these hospitals willingly incorporated the system into their workflow without being required to. These are hospitals that were ahead of the game and often times trailblazers in their field. Many articles correctly point out that the most important part of a Clinical Decision Support System is its deployment. If the model of your organization is not based around this CDS system, then it will not work. If you need to go into separate systems to bill, order tests, or still rely on dated material, this will merely be a time waste. More often than not it ends up costing the hospital money. Numerous studies involving individual hospitals and their deployment show that they have increased administrative time spent, and no positive care received correlation.
It is for that reason that it is more important now than ever for hospitals to analyze their work flow and truly incorporate these systems into their operation. Many interviews with Doctors find that they are are willing to use this technology but not if it is merely something else they need to do. It needs to integrate with your current systems, or replace them. Otherwise it will end up taking more time and costing the hospital money. If your organization is implementing an EHR system merely to avoid penalties on reimbursements, then it will likely not produce its intended results. It will leave your doctors feeling frustrated with its complexities and it will end up costing your organization money. It is for that reason that we must take some time to map out the work flow and ensure that the integrations are seamless. Then, and only then, will it do what it is intended to do for your organization.
At the moment in New Jersey, the medicaid payment process for nursing homes and assisted living facilities works the way you would expect. The state has a qualification process for skilled nursing care and Medicaid qualified patients are able to select from those facilities that best suit them, whether it is due to location, size, friends, or just the atmosphere. This means that when you are looking for a facility for mom or dad, you get to choose the facility that suits them best.
All health care providers are striving to comply with the many changes required by the Patient Protection and Affordable Care Act. DKA has been very successful in helping clients identify the many emerging opportunities that will result from the changes resulting from the Act, including: