It’s crunch time for getting in line to collect Meaningful Use incentives and that can carry a nice payoff or be substantially disruptive, negating most of the intended benefits. Consumers and professionals both to feel the outcomes, both good and “interesting”.
Meaningful Use incentives in mental health and substance abuse treatment mean revenues of over $63,000 per prescribing doctor over the course of five years. If an organization has ten prescribers, they could conceivably pay for an Electronic Health Record (EHR) just out of the incentives.
That’s not where the payoff ends, consumer and professional benefits abound.
A well implemented EHR can improve care simply by delivering the availability of treatment documentation. A lot of agencies treat folks with a team approach. The great benefit of that to the consumer is they get help from specialists in a number of disciplines, and they all know what the rest of the team is doing. If treatment is documented by the line counselor, then the next professional in line, say a psychologist, has a foundation knowledge of what the consumer needs before they go into a session. The psychologist can then refer the consumer to the psychiatrist if medication prescribing is a good idea (also handled electronically so the medication will be waiting at the pharmacy when the consumer gets there). Subsequently, other professionals like nurses and vocational rehabilitation specialists can be involved, and they all know what’s been done before without a team meeting and without picking up the phone, saving time and getting a clear picture with a simple review of the consumer’s EHR.
Agencies who provide care who have effectively implemented the EHR like it because it enables the current staff to help more consumers. Theoretically, better care can be provided to more people by the current staff.
Audits can be easier if the implementation accounts for the needs of the auditors, and at least an internal audit will likely revolve around Meaningful Use incentives. There are also a ton of different government and professional agencies policing consumer care these days, so proving that all of their requirements are met can be a challenge without the ability to sit the auditor at a consumer screen or handing them reports that give them exactly what they want. All this needs to be set up during implementation.
Meaningful Use incentives are offered to assure the effective use of the EHR. By now you’re getting the picture that no matter which software and company an organization of professionals contracts with, the implementation makes the difference between an EHR that’s effective and dismal failure. The agency serving the consumer takes on the responsibility for that effectiveness in deciding to pursue Meaningful Use incentives, using the EHR as a vehicle to help deliver ever-increasing quality of treatment while maximizing efficiency and revenue. Both parties, the agency and their vendor, share responsibility to create a partnership in the interest of a successful implementation. Hesitancy on either end of that equation can lead to a failed implementation, and escape of the desired outcomes.
A number of products out there have matured into solid, well functioning EHRs. Just being able to sell a product that’s compliant with HIPAA and HITECH and meets Meaningful Use incentive requirements is a tremendous feat.
Tons of software companies are striving to enable agencies to meet the first 15 Meaningful Use requirements. For them, the functionality is the thing. Where a lot of software products let shoppers down is the lack of a design tool controlled by the user, cementing the partnership for success. A good design tool these days can make software do pretty much what you want it to do. If it can’t, it’s not a very good tool, is it?
When a shortcoming in a business process that involves the EHR comes to light, the natural tendency for those working with the software is to come up with a better process, which means a change will likely be required in the software. Going to the software manufacturer for programming usually carries a price tag, which agencies want to avoid…it can put the finance folks ill at ease. It’s much better in their eyes to have somebody who’s already collecting a paycheck design the solution to that faulty business process, then implement it, then fine tune it, leading to a resolved problem.
There are ton of details involved in an implementation, and in order to meet requirements for Meaningful Use incentives, fifteen more have been added. Get help.
I’ll talk about these requirements and how they affect both the professional and the consumer soon.Read more →
Perhaps I have been proven wrong…
Recently I looked into SmartPhones in medical use, and commented that I felt the applications were not ready for prime time due in part to questionable security (passwords and a secure connection). If it was my mental health data being broadcast across the planet, I’d want to be sure that the distance between the server and the SmartPhone being used by the professional helping me was a secure connection, and my confidential healthcare data would not be intercepted by somebody else.
Well, the proof arrived from Andrew Isham, the director of development for A-CHESS. That’s the SmartPhone app being developed for treatment facilities by the University of Wisconsin. Data coming from and going to the fileserver, whether it’s from a workstation with a secure network, internet connection or SmartPhone, is forced to a login page that sets up the VeriSign security certificate, assuring data encryption. VeriSign is an old hand at this sort of work. I’m not a real tech nurd, however I am pretty tech-savvy, and the explanation satisfied me that the security concern I mentioned in conjunction with SmartPhone connections is no cause for anxiety attacks. All is well. Breathe.
I heard on the radio (one of the wonderful news programs on National Public Radio (NPR) that SmartPhone app development is the fastest growing segment for jobs in the tech industry and looked into it. It turns out that it’s so popular that the traditionally required experience and education is being ignored in the search for people to do this sort of work for software companies. It’s a big deal. My marketing and sales background tells me that even though we’ve seen this sector grow with leaps and bounds lately, we are at the tip of the iceberg.
The question of how appropriate EHR products are to deploy on the SmartPhone and other hand-held devices has come to my attention for a number of years. At least 20% of the organizations I’ve talked with over the past 5 years have a professional on staff who asks about this technology. A friend of mine who runs a mental health and addictions treatment oversight agency has been so serious about using hand-held devices for EHR purposes he developed his own application for this purpose years ago. He was ahead of his time, and I’m certain he’s happy to see this trend.
As I implied above, a commercially viable SmartPhone product needs to synchronize with an agency’s EHR housed on a server. That way the data is available to others treating the consumer, provided the consumer has signed off a Release of Information for them to see the treatment documentation. ACHESS is the product closest to deployment I’ve seen, and most professionals in this business are not likely to develop their own apps like my friend mentioned above. I predict a well-researched app for SmartPhones could be a small part of an enterprise EHR system that will make or break system sales to new agencies very soon. Now that I know security is not a problem, I’m eager to see how they work in scheduling appointments and collaborative development of assessments, treatment planning and progress notes with consumers.
Let me know if you see any mental health and addictions treatment EHR’s that have this sort of functionality working for professionals and consumers in the field. I, for one, am very happy to see some movement in this direction; and my interest was prompted by the silliest thing: learning to send text messages to my kids on my SmartPhone.Read more →
How much does it cost?
We have a tendency to move in that direction when we first start investigating a purchase. Unfortunately, the cost of a thing doesn’t necessarily tell us anything about its value. So, whether I’m buying an egg or an Electronic Health Record (EHR), I need to divert my thinking from cost to what I get out of it. I have to watch my cholesterol, so I watch the eggs, and when I help agencies buy EHR’s, I look for comparative benefits to the consumer and professional.
There are tons of books out there on negotiating (just Google it), and if you’re making a large purchase, from a car to an EHR, and it’s not a bad idea to know a salesperson’s perspective before going into negotiations. I found Roger Dawson’s book an easy read and illuminating for that purpose.
The EHR purchase affects both consumers & professionals because the facility always needs to purchase more outside services & schedule training, f/u with all staff to assure they’re using system and using it right in order to get the value out of the system.
The consumer feels the effects of an EHR when service is disrupted due to lack of training, or because a form that’s supposed to speed an intake doesn’t work right and it just takes too much time to finish the paperwork…or worse, a problem leaves the consumer in the waiting room, without the help he’s asking for. These troubles can usually be avoided during implementation if the agency is wise in not cutting corners on services to implement the system. Earned wisdom includes hiring or assigning a full-time, experienced internal person to tend to agency business and assure the consumer experience is not disrupted.
The real negotiating point for the price software is the license. Most companies that sell software are manufacturers, so the cost of the building the software has been reconciled by selling enough system licenses to pay for that cost. If this is not the case, you may want to re-think the company you are working with from the angle of experience and that earned wisdom I mentioned above.
In this sector a ton of companies manufacturing EHRs (84 good ones started in my last search process for a customer). Many were born at a mental health facility as a home-grown system. They’re probably fine, provided the company has spun off from the original agency. If a company can’t stand on its own two feet and keeps going back to the mother company to meet payroll, they may not be around long. It really makes people grouchy when their helpful software people just disappear one day. Agencies buying software need to be conscious of this.
Impelementation services like importing existing data into the new system, configuration, training and fine tuning are really no place to cut corners. It always seems staff needs more help, and when they can’t get it because the facility didn’t pay for it, they get can get grouchy. In addition to the original problem of making the software work right, consumers feel this, simply because the EHR is part of their treatment experience. When a consumer needs help, the last thing he wants to run into is resistance due to software or user problems when somebody has offered to help them in the first place; It’s a no-win situation. A good negotiating point is to plan to add optional services, they will likely be needed.
An agency also needs to pay attention to things like the HITECH Act the software support reputation (call a bundle of references, not just their preferred customers), and their internal experts available to successfully implement the software.
My jaded and self-interested advice is to hire a professional. A good consultant can counsel the entire staff, bottom to top on how to get a product that proves to be a good value: An EHR that improves the consumer experience, satisfies documentation requirements, improves the quality of the agency and doesn’t make people grouchy and defeat the purpose of mental health improvement.Read more →