Prior to the regulations that were imposed by the HITECH Act as part of ARRA (American Recovery and Reinvestment Act) in 2009, the first quarter of the year composed primarily of concerns related to taxes, but past that, providers were able to focus on the most important thing, their patients and building their practice.  Fast forward to 2015 and things are frantic in the medical community, regardless of discipline.

The Problem with MU and PQRS

After going through two stages of certification and supporting our users through a number of years of attesting for Meaningful Use as well as reporting PQRS, several things have become apparent in the industry…the process creates a tremendous amount of stress.  The process of Meaningful Use and PQRS is a huge drain within the clinic and requires additional steps in order to ensure that these measures can be met, when in most cases, these required steps that take additional time and staff have little to no benefit for the provider or the patient.  But the looming threat of deductions has been a successful fear tactic employed by the government.  But we have noticed that the threat is starting to have an unexpected ripple throughout the medical communities.  It has started some serious dialog as to whether this additional burden placed on the providers is worth the cost required to their practice.

The Numbers

PracticeStudio has been ahead of the curve for Meaningful Use Stage 2 from the beginning.  After the shell shock of going through a wavering process for Stage 1, we wanted to be sure that we were well ahead of the timelines for Stage 2.  As such, we were among the first of EHR vendors who were certified for Stage 2.  When we accomplished this, we thought it would be a “feather in our cap” and continue to set us even further apart from our competitors.  It did in part, but as the government imposed deadlines came closer, and barely a fraction of EHR vendors had certified, CMS started to change the rules and extended Stage 1.  This only created more chaos as they also changed some of the measures for Stage 1 after providers had been working towards the previously stated measures during their periods, causing many to scramble to try and get those numbers up.

In the end, the numbers of those who reported have been telling.  At the Nov. 4 Health IT Policy Committee meeting, representatives from the Centers for Medicaid and Medicare Services (CMS) detailed  the latest statistics available – Noting that fewer than 17 percent of the nation’s hospitals have demonstrated Stage 2 capabilities and only 2 percent of the eligible professionals have demonstrated Stage 2.  Only 2 percent, that is a staggering number!  There are several reasons for this.  First, CMS has allowed providers to submit multiple years on Stage 1.  This was due to the high volume of EHR vendors that could not keep up with the government regulations.  Secondly, a number of providers have elected to take their chances with the penalties.  Whether it be intentionally or just due to not being well informed of the process there is a trend growing there.  Stage 2 requires even more from the providers, their staff, and now the patient, so it is no wonder that they continue to attest for Stage 1 as long as they can.

The Reality

We will be publishing more blog articles discussing the effects that MU and PQRS has on providers and what trends we see going on as this process becomes more and more entrenched within the medical community.  As the old adage goes, there are two things that are guaranteed in life, death and taxes.  I would categorize this under the taxes banner.  The truth is that the incentive money tempted quite a few people, but it was more of a Faustian bargain than anything.  Of the $30 billion set aside for incentives and building this process, precisely $0 is left.

Thousands of new federal employees were hired to oversee and audit the attestation process.  It was estimated that roughly 10% of all those who attested would be audited.  But since so few people attested, the audit numbers have been much higher than previous expected.  So there is an extremely high chance of being audited after attestation, just one more thing to deal with.  In fact, some articles have mentioned that it isn’t a matter of if, but when you get audited.

But the stark reality is that this isn’t going to go away anytime soon.  If your practice is going to continue to take Medicare or Medicaid, then expect to continue to deal with this process year in and year out.  Stage 3 is just ahead, and though many in the industry think that it won’t happen, I think that it will.  Incentive money is gone, Stage 2 has been a flop, and in Stage 3 even more emphasis is being placed on a technology for interoperabilty (DIRECT Exchange) that has not been successful.  As much as I would love to see the government throw in the towel and relieve some pressure on the industry, I just don’t see it happening before Stage 3 becomes a reality.

The Answer

Through the process of helping our users attest for MU and report PQRS, we see a number of things that we can continue to do to help relieve the burdens placed on providers to meet these daunting requirements.  And though PracticeStudio already has many tools to help make this process run more smoothly, we continue to do more.  We will be rolling out some new enhancements to help automate some of the processes that require a fair amount of time and energy.  Additionally, we will continue to introduce new features that make the meeting of MU as seamless as possible.  The reality is that MU isn’t going away any time soon, but we understand the burden placed on your practice and we are dedicated to making this process as painless as possible.

Here are just a few features that will be introduced this year to better aid in this process:

• Automated CCD uploads to portal as part of a nightly process or upon finalization of an encounter.
• Enhanced Encounter Review that allows templates to be applied to any encounter.  Use templates created by MicroFour, create your own, or even share with other providers.  This allows most of the MU requirements as part of an encounter to be applied with a single click.  Any element that requires numeric entry will be presented within the Encounter Review without having to go to each screen.
• Enhanced reporting tools to better monitor MU process day to day.

Just know that we are your partner in this process and though we did not place this burden on you and your practice, we are definitely in the fight with you to relieve the pain.