7 Key Tips for Conducting a Medical Documentation Audit

Most people think a medical documentation audit is checking boxes and following rules. However, what if the secret to a better audit is embracing new, sometimes unconventional strategies?

As a medical professional, you know how vital thorough documentation is for client care. Even experienced auditors can feel overwhelmed by the volume and complexity of records.

In this article, we'll explore expert tips to elevate your medical documentation audits. These audit efficiency tips go beyond the basics, offering innovative solutions to improve your programs.

1. Use Predictive Analytics to Preempt Issues

Predictive analytics can forecast potential documentation errors by analyzing past data. By looking at previous audit results, you can spot patterns that suggest where future problems might occur.

For instance, if certain errors often appear in specific departments or at particular times, predictive models can help you focus on these areas.

To implement predictive models, start by collecting and analyzing data from past audits. Use software tools like Alleva designed for big data analysis. These tools will help create models that predict where issues might happen.

Regularly update these models with new data to keep them accurate. This approach helps you catch problems early, enhancing audit accuracy and overall compliance in healthcare.

2. Integrate NLP for Documentation Review

Natural Language Processing (NLP) is a powerful tool for reviewing clinical notes automatically. It checks for compliance and accuracy by processing large amounts of text quickly. Unlike manual reviews, NLP can find subtle errors that humans might miss.

For example, NLP can flag inconsistent terms or detect missing information crucial for compliance. To use NLP, train the software to recognize relevant medical terms and compliance needs. An NLP:

Speeds up the review process
Increases accuracy
Ensures all documentation meets necessary standards

3. Develop a Robust Cross-Functional Audit Team

A strong cross-functional audit team is essential. Include diverse roles like:

Clinicians
IT specialists
Compliance officers

Each member brings unique skills and perspectives, helping to find and fix documentation issues more effectively.

Prioritize effective communication. Regular meetings and clear communication channels ensure everyone understands their roles. Encourage open discussions and the sharing of insights from different fields.

We recommend that you use the team's collective knowledge to improve the audit process and solve issues thoroughly.

4. Utilize Blockchain for Immutable Record-Keeping

Blockchain technology is a game-changer for medical records. Each record is stored in a block, and these blocks link together in a secure chain.

Blockchain technology is known to make it nearly impossible to change any single record without altering the entire chain. As a result, blockchain provides a secure and unchangeable system for keeping records. Using blockchain builds trust and transparency in audits.

At Alleva, we use the latest and newest technology to maintain that transparency. Our portal and dashboard offer clear views of any changes that may occur. Auditors can check that records haven't been tampered with since each change is documented and timestamped.

5. Implement Real-Time Dashboards

Real-time dashboards are very helpful. They give you instant insights into the audit process, helping you monitor progress and spot problems quickly. At Alleva, we've developed dashboards to show key metrics and visualizations, like:

Number of records reviewed
Compliance rates
Error frequencies

For example, a dashboard might display a graph of compliance rates over time or highlight departments with the most documentation errors. By using these visual tools, you can track audit progress and address issues as they arise.

6. Conduct Root Cause Analysis for Recurring Issues

Performing root cause analysis on recurring documentation issues is crucial. Such an analysis helps you find the real reasons behind these problems, so you can fix them effectively and prevent future errors.

To conduct a root cause analysis, follow these steps:

Identify the recurring issue
Gather data and evidence related to the issue
Analyze the data to find common factors or patterns
Determine the root cause of the issue
Develop and implement solutions to address the root cause
Monitor the effectiveness of the solutions and make adjustments as needed

At Alleva, we recommend this methodical approach to ensure that you address the core of the problem. We have seen a proven record that leads to lasting improvements in our client's documentation processes.

7. Apply Continuous Improvement Methodologies

Continuous improvement methodologies like Lean and Six Sigma are valuable for ongoing enhancements in medical documentation processes. Lean focuses on eliminating waste and improving efficiency, while Six Sigma aims to reduce errors and variation.

Lean Methodology

Lean streamlines processes and removes unnecessary steps. In medical documentation, this means identifying and cutting out redundant or time-consuming tasks that don't add value.

For example, if you find that multiple people are entering the same information into different systems, Lean principles would suggest finding a way to enter that information once and share it across systems. You are likely to save time and reduce the chance of errors.

Six Sigma

Six Sigma focuses on reducing errors and ensuring consistency. It uses a data-driven approach called DMAIC, which stands for Define, Measure, Analyze, Improve, and Control. Here's how you can apply it:

Define the problem or the area where improvement is needed
Measure current performance to establish a baseline
Analyze the data to identify the root causes of issues
Improve the process by implementing solutions to address these root causes
Control the new process to ensure it remains effective over time

Combining these two methods sets your program up for success. As a result, you will see happier clients and a more effective workforce.

Master Your Medical Documentation Audit

Improving your medical documentation audit process involves leveraging advanced technologies and innovative methodologies. Using these tips and innovations, you can ensure accuracy and security.

Don't just take our word for it. Here's what one of our clients at Healthy U Behavioral Health in San Diego, CA, has to say:

"Alleva is user-friendly, and the customer service is impeccable and provided by the best professionals around. They offer evidence-based treatment modalities, easy and quick documentation modules, and complete clinical system integration."

Explore how Alleva EMR can elevate your audit process and help you maintain top-notch medical records management. Schedule a demo today!

July 11, 2024

ASAM Criteria, 4th Edition: Raising the Standard of Care for Addiction Recovery

This November, the distinguished American Society of Addiction Medicine (ASAM) will release the Fourth Edition of The ASAM Criteria, which sets the standard for clinical care in addiction recovery. Guidelines for placement, continued stay, transfer, or discharge are followed by behavioral health programs to ensure quality care. The latest release has been informed and vetted by diverse stakeholders in response to the developing needs of the healthcare field. As a result, the updated standards for treatment help care managers make better, more objective decisions based on the established guiding principles.

The updated continuum of care promotes:

A CHRONIC CARE MODEL - Ongoing care for those in remission.
INTEGRATION OF CARE - Incorporating biomedical and psychosocial services for withdrawal management and continued care for clients with acute biomedical concerns.
CO-OCCURING CAPABLE CARE - Integrated care for mental health conditions.
ACCESS TO RECOVERY SUPPORT SERVICES - Coordination between addiction treatment programs and recovery residences.
HARM REDUCTION - More patient involvement in goal setting, preferences, and access to addiction medication.

The Fourth Edition offers operating standards for the Level of Care Assessment (used to determine the recommended level of care) and the Treatment Planning Assessment (used to develop the comprehensive treatment plan.) Each multidimensional assessment must consider biological, psychological, social, and cultural contexts. A thorough evaluation of problems and strengths is vital to developing a successful, patient-centered treatment plan.

The ASAM Criteria Dimensions updates make it easier to understand and share these standards while keeping up with the changing terminology in the field. The subdimensions introduced will help the clinician make recommendations based on their findings and the patient's willingness to engage.

New chapters in The ASAM Criteria include:

Early Intervention and Secondary Prevention
Telehealth and Other Health Technologies
Integrating Recovery Support Services
Integrating Trauma-Sensitive Practices, Culturally Humble Care, and Social Determinants of Health
Addressing Pain
Addressing Cognitive Impairment

The behavioral health programs that adopt these standards and track their metrics are more equipped to provide evidence-based care for their clients. A task-based workflow that charts progress and automates documentation improves outcomes. Alleva’s data-driven EMR helps optimize and streamline the standards compliance process. Compiling outcome data with our advanced business intelligence tools and built-in task-based documentation options helps reduce error and burnout.

If you want to learn how Alleva’s state-of-the-art EMR platform can upgrade your program to meet the highest standards of care, book a quick, hassle-free demo tailored to your needs.

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June 20, 2024

What is a HIPAA Violation? 26 HIPAA Violation Examples and How to Avoid Them

What Is a HIPAA Violation: 26 Examples and How to Avoid Them

Find out what a HIPAA violation is, how they are reported, and how to prevent them from occurring.

What Is a HIPAA Violation?

As a healthcare provider, it is essential to do everything you can to avoid HIPAA violations. A single HIPAA violation can cost you up to $50,000, may result in loss of license, and, in rare cases, up to a year in prison.

But you might be wondering, "What is a HIPAA violation?" A HIPAA violation is any action that violates the Health Insurance Portability and Accountability Act (HIPAA). This act protects the right to privacy regarding medical documentation.

All providers must ensure that they comply with HIPAA regulations. Fortunately, there are ways to avoid making one of these costly errors. We'll review 26 of the most common HIPAA violation examples and what you can do to prevent them.

HIPAA Violation Examples

1. Employees Divulging Patient Information

Patient information needs to be kept private. Employees talking about patients to coworkers or friends is a HIPAA violation that can land you in a world of hurt. Employees can't share patient information with friends, family members, third-party vendors or organizations . Also, employees should only discuss patient information in private places and only with other medical personnel. There's no reason to share such information with anyone else.

2. Medical Records Falling into the Wrong Hands

Mishandling patient records is one of the most common HIPAA violations. This frequently occurs when a clinic uses paper records or charts. This can result in the clinician accidentally leaving the record in the patient's room, resulting in another patient seeing it. Patient records should always be kept in a locked space so they can't be stumbled upon by others.

3. Stolen Items

If an item containing PHI, such as a laptop or smartphone, is lost or stolen, that's also considered a HIPAA violation and can result in a hefty fine. To safeguard against this, any device containing PHI should be password protected. Be sure to lock down any device with PHI once you're done using it. A password doesn't do any good if the laptop is left open and logged in while you go do something else.

4. Lack of Proper Training

One of the best ways to avoid a HIPAA violation is to train your employees with the proper policy. You need to establish policies that ensure patients' information is protected and kept confidential at all times. Employees who are properly trained on how to avoid HIPAA violations are much less likely to make such mistakes.

However, mistakes will be made. When such a breach occurs, you need to have a plan on how to appropriately handle it. Trainings should be held regularly to make sure all employees, old and new, are well aware of your policy. Training all new employees on your policy and hold quarterly trainings to keep it fresh in all employees' minds.

5. Texting Private Information

While texting patient information may seem fast and effective, it also gives hackers the ability to get their information. You can't put a patient's name or information in a text. If you do and you're caught, it can be a 5k fine per violation per text. And legally, you're required to report those violations. There are programs that encrypt the information which allow it to be texted without concern. But the problem here is that it needs to be installed on the wireless device of both parties, and it rarely is.

A good electronic medical record (EMR) software will provide ways for clinicians to transfer such information efficiently and in accordance of HIPAA. Check with your EMR provider to see what can be done to make your communications compliant. If you're looking for a new EMR, we'll give you a free demo here. You can also learn more about the features of our EMR here.

6. Passing Patient Information Through Skype or Zoom.

Texting isn't the only common kind of communication that's a HIPAA violation. Skype is another way clinic employees frequently communicate about patients, but the same problems apply. Hackers can easily obtain that information. This is part of why it's so important to have a good EHR. If you're looking for a new EHR software, you learn what to look for here.

7. Discussing Information Over the Phone

Another potential HIPAA violation that's easily overlooked is discussing information over the phone. But it's vital. When you're discussing a patient's information on the phone, you need to be in a private place where others can't hear you. Talking about a patient in a public area where others can hear you is a HIPAA violation.

8. Posting on Social Media

You absolutely can not post photos of your patients on social media. It's a definite HIPAA violation even if no names or information is posted. People can easily identify the patient and the doctor, which can reveal unwanted information about their health. This should definitely be taught in policy training. No matter how harmless the intent, this can result in huge fines and is very easy to prove.

9. Employees Accessing Patient Files and Charts Without Authorization

This is a very common HIPAA violation and frankly, it doesn't matter the cause. Employees can only access patient information when they've been authorized to do so. It's illegal to do so even if it's purely out of curiosity or to help a friend.

10. Using PHI for Personal Gain

This should go without saying that using or selling PHI for personal gain is illegal. In addition to a large fine, it can also result in prison time. Again, make sure this is taught in your training to new employees and quarterly trainings.

11. Written Consent

Before PHI can ever be disclosed for purposes other than treatment, payment, or healthcare operations, you must get written consent. If you or one of your employees aren't sure, it's always best to err on the side of caution and get written consent.

12. Home Computers

It's not uncommon for doctors and nurses to use their own computers to access patient information after hours for notes. In itself, this isn't a HIPAA violation, but it can very easily turn into one if the screen is left on and a family member sees the patient's information. As we mentioned before, laptops, computers, and smartphones should always be powered down and password protected when you aren't using them. Again, make sure this is taught in your policy trainings.

13. Inquiries in Social Settings

It's very common for people to approach clinicians in a social situation asking about someone they know who is a patient. When you think about it, it makes perfect sense. Patients, their friends and family members have no reason to know HIPAA law. But that doesn't make revealing PHI in these settings HIPAA compliant. The best way to avoid this is by having a planned response for these types of situations that doesn't involve any personal information.

14. Poor Reporting Timing

No matter how well-trained or experienced a healthcare provider is, they can still have HIPAA violations from time to time. What's crucial is to make sure the issue is responded to and resolved as quickly as possible.

HHS requires notification with extensive documentation within 10 days of the data breach with a minimum of 15 detailed components that relate to the entity's internal investigation.

15. Releasing Records After Authorization Date

Patients have the ability to set an expiration for their authorization. Releasing confidential patient records after the date they set is a HIPAA violation. It's important to pay attention to the details.

16. Missing Patient Signature

Patients can often miss a signature when filling out HIPAA forms. However, if the forms aren't signed, they're invalid. And if they're invalid, releasing information is a HIPAA violation. The solution to this is simple and obvious. Make sure all HIPAA forms are signed.

17. Providing Security With Too Much Information

Security personnel in health clinics need to know the name and room number of patients so they can guide friends and family members to their rooms. That information is compliant. However, they don't need any information like treatment or diagnosis.

18. Nurses "Need to Know"

Nurses need access to private information for the patients he/she is responsible for in his/her unit. But giving a nurse PHI to patients in another nurse's unit is a violation of HIPAA. There's no need for them to have access to information for patients they aren't responsible for.

19. Regulations for "Minimum Necessary"

Health insurance companies typically need to know how many visits a patient has had to the clinic but nothing beyond that. They aren't allowed to see the patient's entire history. This can be easy to overlook as you already have to give the health insurance company some information about the patient and it may seem necessary to give more. But don't.

20. Sending Private Information Via Email

Another common HIPAA violation is sending PHI in an email. This is for the same reasons as the other communication issues we discussed. For those of us that aren't internet hackers, it might seem harmless. But hackers are able to easily access your email, making a patient's information vulnerable.

21. Media Interviews of Patients

From time to time, a member of the media may want to interview a patient for a story. This happens less frequently, but you can't allow the media to interview substance abuse patients. Doing so is a HIPAA violation. The reason is that it violates their privacy. Even if a patient is okay with it, we'd still recommend staying away from the idea completely.

22. Releasing Information Without Consent

This may seem obvious, nevertheless it happens. Releasing information about minors without parental consent is a HIPAA violation. Not only that, but it can cause issues with the parents or guardians and even result in a law suit.

23. Releasing The Wrong Patient's Information

This is where you have to be extra careful. Anybody can make a mistake, but that doesn't make it legal. If you or one of your coworkers releases information to the wrong patient, it's a HIPAA violation. This tends to happen when you have patients with the same or similar names. Make sure you train your staff to double check what information they're releasing.

24. Right to Revoke Clause

Any and every form your patients sign need to have a "right to revoke" clause. If they don't, they're not valid. And if they're invalid, any information you release to a third party organization violates HIPAA.

25. Releasing Information to an Undesignated Party

You're only allowed to give patient information to the exact person authorized on the form. Releasing it to anyone else violates HIPAA regulations.

26. Disposal of Records

When you dispose of a patient's information, it has to be unrecognizable. Shredding is a great way to dispose of paper records.

How Are HIPAA Violations Detected?

HIPAA violations are commonly detected through audits, complaints, and internal reports. The Office for Civil Rights (OCR) performs random audits and investigates complaints from patients and employees. Additionally, you can invest in an internal monitoring system to identify and report potential breaches, ensuring compliance with HIPAA regulations.

How to Avoid HIPAA Violations?

To conclude, HIPAA violations carry hefty fines and consequences. In order to avoid HIPAA violations, hold regular trainings on your policies and procedures, double check who you divulge information to, and password protect everything. As you can see, there are so many ways to violate HIPAA. Make sure you and your coworkers don't discuss patient information in a way that others could hear or obtain it.

Lastly, and maybe most importantly, get an EMR software that makes communication easier. If your current EMR does that, make sure your staff is trained on using it in accordance with HIPAA. If it doesn't, we would strongly consider getting an EMR that does.

How Can Alleva EMR Help

At Alleva EMR, we empower your clients to take charge of their medical records with our advanced EMR and CRM software. Our platform provides behavioral health specialists with a secure platform where they can organize all their medical documentation and optimize task management. Our platform is designed for the needs of providers who treat substance abuse and includes an addiction treatment planner that your clients can access after they leave your care. This allows you to easily share your client's treatment plan for substance abuse securely without worrying about HIPAA violations.

What's The Difference Between EMR and EHR

Electronic medical records (EMR) are digital medical charts from a single provider. In contrast, an electronic health record (EHR) contains a client's entire medical history from multiple providers. Both are valuable tools. However, while digital medical records can provide easier access to essential information, they may expose you to more risk regarding HIPAA violations. When you choose Alleva EMR, we will make it easier to secure these records.

Protect Your Practice From HIPAA Violation Fines Today

Don't let a HIPAA violation damage your reputation or your practice. Contact us today to learn how our record management solutions can help protect your business.

June 1, 2024

How to Talk to Children About Addiction

Addiction is a struggle that not only affects the person involved but also his or her family and close friends. It is not a solitary struggle and so it is important to be open with those affected by addiction, including children.

While it is for parents to decide when and how to explain their own addiction or that of a close relative to their children, there is some information that should be included in that conversation. A recent article in the Chicago Tribune outlined some key points when it comes to speaking with your children about addiction:

The child is not at fault. Young people often blame themselves for things outside of their control and may internalize addiction and see themselves as the cause. Let them know that they are doing everything they are supposed to be doing.
Explain that addiction is a disease and talk about like you explain diabetes or cancer to a child. Explain that there is a treatment.
Encourage children to speak up. It’s ok to express feelings of anger, sadness, or confusion. Let them know who they can talk to like a school social worker, grandparent, or other “safe adult.”
Help them to never start using substances as they will be at a higher risk or addiction.
Children should know that they can ask for help. If they ever find themselves in a situation where drugs are presented to them or they feel themselves slipping towards addiction, they can ask for help and do not have to overcome it alone.
Teach self-care. Encourage healthy eating and exercise. Leading a healthy lifestyle will help them to avoid addiction and be happier.
Children are loved. Through the struggles, it can be difficult for children to feel loved when addiction can change the disposition, attitudes, and behaviors of their loved one. Let them know that they will always be loved.

Children may be deeply affected by addiction but they can be involved in recovery without being in the dark.

July 8, 2022

Why Relapse?

After beating the odds and conquering the demons of addiction, why would anybody voluntarily choose to return to their previous self-destructive state? It is not uncommon for those in recovery to experience sobriety for a long period of time, and on an impulse restart the self-destructive cycle. This is what we call relapse.

Although the behavior may seem inexplicable, understanding brain chemistry sheds some light on the situation. Because the effects of drugs are so powerful, it changes the brain structure and chemistry of the user. Prolonged usage of such addictive substances leads to a reprioritization of what the brain ranks as important. With time the addict’s brain can even prioritize the use of the drug above natural survival responses such as eating and sleeping. The addict’s brain convinces itself that the consumption of the drug is more important than their life.

Our survival responses are powerful, to say the least. We are hard-wired to do whatever it takes to ensure the preservation of our lives. I once witnessed a mouse stuck in a trap chew off its own arm to escape. Just like the mouse, any of us would go to undeniably extreme measures to survive in a life-threatening situation.

Because of the effects of reprioritization, addicts will go to similarly extreme measures to ensure they can continue the usage of their substance. In short, addiction knows no limits. There is no price too expensive, no situation too dangerous, and no risk too great. Even after enjoying years of sobriety, there is still a danger of relapse. This is why addiction treatment must extend beyond the sphere of treatment centers. Truly, quitting the use of the drug is just the first step.

May 31, 2022

Alleva’s Telehealth Solution Which Enables HIPAA Compliance Surpasses 30 Million Minutes of Essential Care, Improving Mental Health Outcomes

Behavioral Health facilities using Alleva's telehealth feature are able to reach thousands of isolated clients in despair using their built-in Zoom Video technology.

LAGUNA NIGUEL, Calif. (PRWEB) May 20, 2022-- In the wake of COVID-19, the U.S. not only faces a devastating death toll of over 980,000 lives lost from the virus but a staggering number of over 100,000 additional “deaths of despair” from alcohol abuse, drug overdoses, and suicide. This is a 28.5% increase in overdose cases from before the pandemic. With the burden on behavioral health facilities continuing to build, Alleva teamed up with Zoom Video Communications, Inc. in 2017 to offer a comprehensive telehealth solution that enables behavioral healthcare companies to meet HIPAA compliance requirements while delivering exceptional care.

Even before the pandemic, Alleva recognized the utility of Zoom’s unified communications platform and its application for healthcare facilities. Since its implementation, clinicians have been able to stay in contact with their clients who are unable to attend in-person sessions and those who prefer remote treatment. Before Covid, Alleva's customers averaged around 60 thousand telehealth minutes a month, but in April of 2020, and the onset of pandemic restrictions, that number jumped to almost 2 million minutes a month. Even as Covid risks have diminished, telehealth has not tapered off.

“The demand for telehealth shows no signs of slowing,” said Paul Magnaghi, Global ISV Program Leader, Zoom. “It’s crucial to provide a simple, frictionless, and secure experience for everyone involved–from provider to patient. Our platform incorporates security controls to help enable customers to satisfy the HIPAA Security Rule. We are pleased to have Alleva join Zoom’s ISV Partner Program and provide a simple and quick way for people to get connected to the care they need.” With the integration of Zoom’s convenient technology and the Alleva EMR, treatment centers can sync calendar appointments, and send invitations and reminders via texts directly to the Alleva app on their client’s cellphone, all while enabling HIPPA compliance.

Steven McCall, CEO of Alleva, said, "The fact that we were among the first EMR platforms to add the telehealth feature back in 2017 meant that we were agile and responsive when clinicians' circumstances and needs changed. Alleva is all about offering the latest technology and making life easier for caregivers.”

Alleva’s telehealth feature has allowed substance abuse and behavioral specialists to connect to their clients during increasingly challenging times. With options for individual, group, family, and admissions sessions, the telehealth feature allows people to connect effortlessly through digital means, with room for continued innovation. Moving forward, Alleva is looking to expand their solutions to further streamline communication and connect substance abuse specialists to those who need it.

For more information about Alleva, its built-in telehealth solutions, and how its solutions are shaping the behavioral healthcare industry, visit HelloAlleva.com.

About Alleva

Alleva provides world-class software to the behavioral health industry. Made up of a team of licensed therapists, industry professionals, and experienced software developers, they seek to use their industry background and passion to help the helpers give better care by providing them with supportive technology.

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April 17, 2020

Harnessing Technology for Good: Most Important Therapy Apps

It has long been a challenge for those in the substance abuse and mental health professions to get their clients to engage in treatment in the time between sessions, or for those in a residential facility, to keep them on the right track after discharge. Especially in the wake of COVID-19, clinicians are searching for ways to help their clients seek and access the resources available to them at home.

While on some levels, technology can seem to lead us to disconnect from others in favor of virtual versions of ourselves, it also presents us with innumerable supportive resources to assist clients with taking ownership of the recovery process, while dedicating time and attention to caring for themselves on a mental, emotional, and physical level.

The following is a summary of four types of apps that can be helpful resources for your clients, while in therapy and long after.

Meditation Apps

Mindfulness and meditation are taught in therapy as a means of connecting clients to internal resources to harness healing outside of the session.

An integral part of meditation is eliminating and/or directing awareness away from distractions. Meditation apps do this wonderfully by changing technology from a distraction into a tool. By facilitating meditation practices and activities, meditation apps also increase the self-efficacy of clients and confidence in their mental awareness.

The following are meditation apps available today:

Insight Timer- Insight Timer offers the unique experience of several forms of guided meditations for various needs. Music, guided imagery, and muscle relaxation are some of the few forms of meditations available on the app.

10 Percent Happier- 10 Percent Happier is a wonderful app for those who are new to mediation. Courses and coaches set this app apart from more independent meditation apps.

Reading Apps

Bibliotherapy refers to the use of literature in the healing process of counseling or therapy. Some therapists prefer to assign materials for clients to read based on treatment goals. However, some may encourage clients to simply explore as they feel comfortable, as for the ever-anxious, picking up a fantasy fiction novel may be the perfect distraction to get them out of their heads for a while.

In addition to Audible or Kindle, consider some additional reading apps for use in your therapeutic process:

OverDrive- The OverDrive app offers app users the chance to connect with local libraries in order to browse and read any of the volumes available nearby, in addition to the books on file with OverDrive.

Nook app- The Nook reading app from Barnes & Noble offers a large selection of literature spanning multiple genres.

Sleep Apps

Research on sleep hygiene and its connection to mental health and wellness is growing rapidly. In fact, a routine question in mental health services intakes is: “how many hours of sleep do you get on average?”

Sleep apps are available to promote proper sleep hygiene by helping clients set alarms for sleep and wake times, tracking REM (deep sleep) cycles, noting restless periods of sleep, prompting appropriate times to turn off lights and technology, and offering music to assist with falling asleep.

The following are a few sleep apps available to assist you with establishing and maintaining important sleep hygiene habits:

Slumber- The Slumber app uses both meditations and music to assist app users to attain restful sleep. Some of the “techniques” available on the app include: “mindfulness, breath control, guided imagery, and progressive muscle relaxation.”

Sleep Cycle- The Sleep Cycle app is an innovative app created to tailor the morning alarm to your stages of sleep. The app maintains a record of your sleep cycles and uses this information to wake you in the lightest stage of sleep. Thus you’ll wake feeling rested, rather than the alternative where you’re abruptly pulled from a deep sleep.

Time Management Apps

Depending on the presenting concerns of clients, time management may be a targeted skill in therapy. While this may not appear to be a primary issue, learning and embracing effective time management can contribute to reduced stress and anxiety.

Counselors and clients alike find it helpful to tackle some of the practical issues with daily life before diving deeper into the therapeutic process. Time management apps, much like personal assistants, are available to provide a central place to track the important events and tasks in life while allotting time for self-care.

Below are a few current time management apps to assist with organizing and following through with life tasks to promote healthy efficiency:

MyLifeOrganized- My Life Organized is a time management platform offering users tools for prioritizing tasks in a daily planner and various formats. This app encourages optimizing your time by helping you manage the tasks entered and organized in the app.

Remember The Milk-Remember the Milk is an application designed to help keep track of the tasks and appointments in life that may slip by. This app is designed to “get to-dos out of your head” to reduce stress and increase concentration on the tasks you want to prioritize.

An App for You: Alleva

After helping your clients find and access apps that are supportive of their recovery, try one of your own: Introducing Alleva, the friendliest EMR platform around. Alleva not only has a client app meant to keep clients connected during and aftercare, but you will also be able to easily send out text surveys and have access to the latest in telehealth technology.

Speaking of time-management skills, Alleva’s built-in, real-time alerts will also remind staff to dot I's and cross T's to ensure compliance. Alleva is the perfect example of harnessing technology that allows you to spend more time where your heart is -serving those in your care. Request a demo today.

May 31, 2019

What is HL7?

What is HL7? It stands for Health Level-7 and is a set of international standards, rules, and definitions used to exchange and transfer medical information between health care providers. This is commonly done through electronic health records (EHRs). It's called level 7 because it focuses on the application layer, also referred to as layer 7.

HL7 has a structure for exchanging and sharing health care information electronically. Its standards set in place how that information is exchanged between health care providers and that includes the language, data type, and structure.

What are HL7 standards?

Standards for HL7 have been grouped into seven different sections. Here's a synopsis of each section for you:

Primary standards: These are the most common/popular standards. You can learn more about the specific primary standards here. Keep in mind that these are the most frequently used for system integration and compliance. So, it's a good place to start.
Foundational Standards: These are the basic tools or fundamentals the standards were built on and the technology that you as a medical professional implementing HL7 standards has to manage.
Clinical and Administrative Domains: This is where you will find standards on HL7 documents and messaging. Typically, you will have primary and foundational standards in place before getting into standards for clinical specialty standards.
EHR Profiles: The standards for EHRs make it possible for you to build an electronic health record system with models and profiles. If you're looking for a new EHR, here's a blog post on how to choose an EHR. It deals specifically with how to choose a behavioral health EHR but the principles apply to all EHRs.
Implementation Guides: This section helps you implement and support documents that were made for the purpose of a current standard. Each document here will be used as supportive material for one of the other standards.
Rules and References: These are the programming structures and guidelines for the growth and expansion of standards and software.
Education and Awareness: In this section, you'll find the Standards for Trial Use (STU) and other projects currently happening. There are also various tools and resources here to help you understand HL7 and put it into practice.

HL7 Messages

A lot of questions dealing with HL7 revolve around HL7 messages. So I want to answer a few of these questions for you. Some of these include "what is an HL7 message," "how are HL7 messages transmitted," and "what are HL7 message types?" I'll answer these questions to help you get a better understanding.

What is an HL7 message?

The whole point of HL7 messages is to transfer data electronically between various health care providers. These messages are sent whenever events happen with patients, such as when you admit a patient into your clinic. These messages are comprised of segments in a specific sequence. However, these segments are sometimes optional, sometimes required, and sometimes they're repeatable.

Message Types

Message types are present in every HL7 message as they explain why you're sending the message in the first place. Each message type has a specific code of three characters and they trigger an event. Now you're probably wondering what a trigger event is. Simply put, it's an actual, real-life event that sparks the communication needed for a message to be shown. It's shown along with the message type. You will find the trigger event and message type in the MSH-9 part of the message.

For example, if you see ADT-A04 in the MSH-9 section, ADT is the message type and A04 is the Trigger Event. In the HL7 standard, ADT-A04 would signal the message of "patient register." There are a lot of different message formats to keep up on. You can see more examples here.

I'm not going to go into every single message type but here are some of the more commonly used ones:

ADT - Admit, Discharge, Transfer
ACK - General acknowledgment
BAR - Add or change the billing account
MDM - Medical document management
DFT - Detailed financial transaction
ORM - Order (for treatment or pharmacy)
MFN - Master Files Notification
QRY - Query, original mode
ORU - Observation results unsolicited
RAS - Pharmacy/treatment administration
RGV - Pharmacy/treatment give
RDE - Pharmacy/treatment encoded order
SIU - Scheduling information unsolicited

You can see the full list of HL7 message types here.

How are they transmitted?

Now that you know what some of the HL7 message types are, I'll explain how they're sent. First, you'll need to create a listener so you can receive the messages. This may sound complicated but it's just a TCP listener. Then you'll need to make another thread that sends HL7 messages or else the listener won't be able to get the messages. When your listener has received a message then it needs to send a message back. This is commonly referred to as an "acknowledgment."

Here are the steps you would go through to receive a message and send back an acknowledgment:

Create console application: File > New > Project. Choose the console app, give it a name like HL7 Listener then click OK.
Make a class for your messages: Make a new class and name it message or something similar.
Form a Segment class: Next, you need another class that contains the information of the segment. An easy way to do this is to create a new class and simply name it Segment.
Manipulate Your Segment Class: By adding fields, methods, and constructors, you can easily control your Segment. This is something you can do by holding the fields by utilizing a dictionary object. The fields use a certain type of message that have very specific locations in the segment.

You can see more detailed instructions on how to receive messages and send an acknowledgment.

How has HL7 improved interoperability?

Now you know what HL7 is, how to read the codes, and how they're transmitted. But how does all of that improve interoperability? In order for modern health care to be effective and efficient, information needs to be shared with other health care providers. This has been a problem in the health care industry for a long time. Accountable Care Organizations work mainly to improve communication between providers and EHRs play a huge part in this as well.

Legacy Systems

Legacy systems have their networks hidden behind closed walls. If you work in a legacy situation, this makes it incredibly difficult to share information. In the past, legacy organizations had to put information into a text file and try to safely send it to another organization. So, if you have a legacy system, you need to have file formats to write health data on and use your EHR to exchange the data with other health care providers. All of this had and has to be agreed upon with the other organization.

With HL7's universally agreed-upon messaging standards, it's much easier for you to group that information in a file and securely send it to the organization you need to communicate with.

Online Systems

Online systems are essentially constructed the opposite of legacy systems. For example, internet systems are built to be open and shared easily, and because of that, the information they share needs to be secure when it's exchanged. Online health systems are growing and will continue to grow. And while online-based systems don't use legacy or HL7, they need to be able to send and receive HL7 documents and messages for backwards compatibility with legacy systems.

In short, HL7 improves your interoperability by making it easier for legacy systems to securely share medical information while also making web-based systems compatible with legacy.

How to learn HL7

If you're looking to learn HL7, HL7.org has various 12-week courses throughout the year you can register for. The courses are designed for people that are novices at HL7 and help you learn through hands-on guided exercises. Oh, and it's a self-paced course allowing you to learn at your own speed.

Once you've finished the course, you will know how to do the following:

Read and understand the most commonly used HL7 standards
Understand HL7's controlled vocabulary
Know when to use messages and documents
Handle projects with interoperability problems across different health care systems and more

HL7 Summary

HL7 is a set of standards and definitions used across the globe to exchange medical information between medical care providers, commonly used in EHRs. There are seven different types of standards. The message types are based on a series of letters and numbers that indicate various actions such as admitting or discharging patients. You can take a course online to help you learn how to understand and use HL7 codes.

If you're in need of a behavioral health EHR, we offer the best software on the market! You can schedule a free demo here.

May 18, 2019

How does an ACO work? What is an ACO? The Ultimate Guide

What is an ACO? How does an ACO work? Workers in the health care industry need to know about ACOs. ACO stands for Accountable Care Organization and they're comprised of groups of doctors, hospitals, and other providers of health care. These medical professionals voluntarily coordinate with each other to provide quality health care to patients on Medicare, Medicaid, and commercial insurance according to CMS.gov.

Do you think ACOs are working? Comment below with "yes" if you believe they are or "no" if you don't think they are. I'm curious to know what your thoughts are on the subject.

If you're a medical provider, you would do this to help your patients get the right care at the best time. Doing this can also help you steer clear of providing services your patients have already received which can consequently prevent other health care errors. When ACOs work effectively in providing good care and while cutting spending, they share the savings.

You can see the obvious benefits of participating in an ACO, which is why the Affordable Care Act (ACA) incentivized this for health care providers. Since 2011, approximately 6 million Medicare beneficiaries have joined an ACO. Combine that with the private sector, a minimum of 744 various health care providers have become ACOs themselves, according to Health Affairs in 2015. As of that date, about 23.5 million Americans were being served by ACO.

https://youtu.be/3rs8kpoXmWw

How does an ACO work?

Now that you know what an ACO is, you also need to know how an ACO works. When the ACA passed into law, it created the Medicare Shared Savings Program. ACOs then provide financial incentives for medical professionals who provide good care. But, ACOs only work if you and the other participating providers do a good job of sharing patient information.

It should be noted that you have to share patient information in a way that doesn't violate HIPAA. You can learn more about how to avoid HIPAA violations here. Under the ACA, every participating ACO must manage the health care for at least 5,000 patients on Medicare for a minimum of three years.

ACOs that provide high-quality health care while also saving money (and that should happen if you're sharing information well) get to keep a chunk of the money they saved. When entering an ACO program, you have a couple of options to choose from:

Aim for a bigger return at the risk of losing money if you don't meet certain standards
Get a lower, more attainable goal with no risk of losing money

ACOs and HIT

With one of the main goals of ACOs being to cut costs, you can use meaningful use in Health Information Technology (HIT) to improve patients' self-care. HIT tools, such as Electronic Health Records (EHR) make your patients' information more available to health care providers. This also makes it easier for physicians to communicate patient information so the patient doesn't have to.

ACOs can also use patient-facing tools referred to as "patient portals." These allow patients to see their medical information that has been recorded in the EHR. This way, your patients can check their test results, get educational self-care materials, and more. You can learn more about the features and benefits of our EHR here.

Are ACOs only for Medicare?

This is a common question and the answer is no. ACOs work with Medicare, Medicaid, and private insurance companies. However, there are three different plans in Medicare ACOs.

Pioneer
Medicare Shared Savings Program
Next Generation

While the Next Generation model is similar to the Pioneer model, patients will have different experiences depending on which model they participate in. When health care providers save money in Medicare they get to keep a portion of those savings.

Medicaid ACOs

Medicaid ACOs differ from state to state as their approaches are designed at the state level. Some Medicaid ACOs are similar to Medicare ACOs while others follow a more traditional Medicaid managed-care structure.

Some states that currently have Medicaid ACO plans include Utah, Colorado, Oregon, Illinois, Minnesota, Vermont, Arkansas, New Jersey, Maine, and Iowa. Other states have announced coming out with Medicaid ACO models.

Commercial ACOs

Commercial ACOs have the most variety of all ACOs. People with private health insurance that is part of an ACO should see a drop in the amount they pay for premiums and out-of-pocket costs. This decrease most likely won't be seen immediately. It should also be noted that consumers could see a rise in costs depending on if their provider requires preventative health care or disease management programs.

If you're enrolled in a private ACO, you might also have a change in your network provider. This is because some plans have very specific provider network providers.

What are ACO quality measures?

CMS.gov established ACO quality measures for 2018 and 2019 to make it easier for you and other medical providers to understand. Quality performance measures or benchmarks are certain performance standards an ACO must hit in order to earn points for that specific measure.

The system starts with the 30th percentile and ends at the 90th percentile. In the Shared Savings Program regulations, you will encounter circumstances where the benchmarks are flat percentages. These flat percentages are used to help your ACO get high scores. Once your ACO has a high score, it can earn the max amount of points.

You can see all the points scoring system and quality measures here. Keep in mind that all your "pay-for-reporting" needs to be 100% complete and as accurate as possible.

Are ACOs working?

The results have been mixed.

The purpose of the ACA in 2010 was to stop health care costs from continuing to skyrocket. ACOs are an important part of this. However, ACOs had not saved the government money, according to a report in 2015, five years after the ACA was passed into law. The 333 ACOs in the Shared Savings program and 20 in the Pioneer program reported huge savings of $411 million. However, that was before they took into account paying bonuses. Including bonuses, these ACOs actually had a net loss to the Medicare trust fund of $2.6 million.

However, the Pioneer program in Medicare ACOs did save some money for CMS as it cut spending by 1.2%, according to the New England Journal of Medicine.

Today, many believe ACOs are working very effectively, and some definitely are. That being said, there are a lot of people out there who believe ACOs are just a temporary fix until we can find a more permanent solution.

ACO problems

In order for ACOs to work, they had to make some big changes that required big investments in order to share data seamlessly. These changes frequently included new care coordination and care management systems, and those aren't cheap.

Needing such large investments in the beginning stages meant you could only join an ACO if you had lots of money to begin with. So, once you met Medicare's standards, you could still very well be in financial trouble, according to Kaiser Health News. In fact, you can actually be worse off financially.

What if an ACO doesn't save money?

You've most likely heard the saying, "it takes money to make money." With ACOs, it takes money to save money. But what if your ACO invests money with the hope of improving care and saving money but they don't actually save money? What if you hire more nurse managers or invest in some other type of new care management system that doesn't end up saving you money?

Unfortunately, you might have to eat those costs. And, if you don't meet the quality care and savings standards of the higher-risk option, you may have to pay a penalty.

Fortunately, if your ACO is sponsored by a rural provider, you can apply to obtain payments in advance for the purpose of building the necessary infrastructure to create a high-performance ACO.

If you're going to get in the ACO game, it's imperative you make it work. Below are some tips I've included on how high-performing ACOs achieved success.

How successful ACOs work

We've established that there can be some problems with ACOs. But, some are extremely profitable and work really well. Here are some takeaways from successful ACOs:

The longer ACOs are in the program, the better they tend to fare. Any time you participate in a new program, it will take some time to understand how to navigate it and make it work for you. This is no different here
Physician-led ACOs typically outperform hospital-ed ACOs. The reason for this is that bigger companies are more likely to have business incentives that conflict with the program
Reducing high-skill nursing and in-patient hospital services while continuing with high primary care use has been one of the key factors for ACOs to get good results. ACOs that have shifted focus in these areas have surpassed others in improving quality health care and reducing costs.

But there's more to it than that. Health Affairs interviewed 11 of the 21 most successful ACOs in 2018 to see what made them the best. They found that the highest achieving ACOs had these three things in common:

Worked to have a "high-value" culture
Developed population health management programs
Came up with a process of accountability to make sure performance continues to trend up over time.

Be Innovative with population health management

One of the first things ACOs do is aim to better manage patients that are chronically sick and high cost. Successful ACOs did this. And if you're new to the ACO game, I strongly recommend this as a first step. High-performing ACOs have tried testing different strategies for their staffing models. Some tried placing care managers in community health centers to focus on face-to-face patient management. Others centralized their staff to emphasize telephonic care coordination.

This resulted in many care managers thinking outside the box to improve patients' self care. Some ACOs put procedures in place to educate patients to know the difference in something that can be managed at home vs a situation that requires a hospital visit.

One of the keys to having a successful ACO is being innovative and thinking outside the box. Focus on what you can do to provide better care for patients and help them avoid unnecessary hospital visits and costs.

How do ACOs affect patients?

The goal of an ACO is to provide better care for Medicare patients while curbing rising health care costs. So with the goal of providing better, higher quality, more timely, well-coordinated, patient-centered care comes change in how that care is received.

A common issue for medical patients today is getting uncoordinated treatment. If you're the patient, you already have to schedule the appointments, potentially share test results with your clinicians, and get them to communicate with each other, not to mention deciphering through the various recommendations doctors give you. That's a lot to ask of someone looking for treatment.

The whole point of an ACO is to fix this problem, according to National Partnership. When done properly, your primary care doctor will communicate with the other medical professionals you need to be in contact with. A lot of ACOs actually have personnel that work specifically on coordinating care. This makes things so much easier for the patient.

ACO benefits for patients

There are a lot of benefits for patients in ACOs

Patients don't have to coordinate visits between doctors
Clinicians communicate with each other so patients don't have to share information
Educated patients spend less time and money on hospital visits with better self-care
Doctors recommend health care specialists for patients to see although patients are still allowed to choose a doctor that's not in their ACO

The downfall here is that many patients, if not most, don't know their provider is part of an ACO. However, an easy way to find out if you're part of an ACO is to simply ask your doctor.

Summary

What is an ACO and how does an ACO work? ACOs are Accountable Care Organizations that consist of doctors, insurance providers and hospitals with the purpose of providing better health care to patients through communication and coordination while saving the health care provider money. If those tasks are accomplished, the government will dole out bonuses to the ACO.

In order to have a successful ACO, you have to do a good job of sharing and coordinating patient information. While not all ACOs save money, the most successful ACOs focus on being innovative.

If you're a health care provider, having a really good EHR can help you achieve these goals in your ACO. Click here to schedule a free demo of our mental health EHR or simply fill out the form below.

April 29, 2019

What is Meaningful Use?

What is Meaningful Use? It's a program enacted by the US Federal Government in 2009 to incentivize eligible medical professionals with payments to use a certified electronic health record (EHR), according to HealthIT.gov. The Meaningful Use program was designed to improve health care for patients by making it safer and more efficient. It's separated into three stages that we'll go over in a bit.

How does a clinic or clinician qualify for Meaningful Use? In order to become eligible, you need to show that you are meaningfully using it to improve the care your patients receive. Your hospital has to show the Centers for Medicare & Medicaid Services (CMS) that it has adopted, upgraded, and implemented certified EHR technology.

Participation in the Meaningful Use program comes with definite financial incentives. If you're looking for a certified EHR, you can learn more about how to choose an EHR here.

How does Meaningful Use improve quality of care?

The program is dependent on five priorities of health care policy, according to the CDC including:

Reducing health care disparity by improving efficiency, safety, and quality
Engaging with patients and their families in their health care
Improving health care coordination
Improving public health
Protecting patients personal health information (you can read more about how to do this here in our post on HIPAA violations and how to avoid them)

How much are payments and fines?

Your health care facility can get a lot of money for working toward these goals through an EHR. In fact, incentive payments start at $44,000 over a five-year period for Medicare Providers. Medicaid providers can get $63,750 in incentives over a six-year period. Those amounts are nothing to scoff at. However, keep in mind that these amounts depend on when a facility starts meeting the requirements.

Participation in the program started out as voluntary but that has since changed. It started out by simply giving incentives to physicians that participated. Now, providers who don't participate will be penalized with reduced Medicare reimbursements. So, not only does it pay to get in on the Meaningful Use program, but it also hurts you if you don't.

A really good EHR will also help you avoid HIPAA violations. And those can cost up you up to $5k per violation depending on the state you're in. All the more reason to have a really good EHR.

How many Meaningful Use stages are there?

There are three stages to this program and the stages build on each other over time.

Stage 1

Stage 1, launched in 2011, focuses on proper electronic data sharing through an EHR. The criteria for stage 1 consists of 15 core requirements and 10 menu requirements. Providers must meet all of the core requirements but only five of the menu requirements are needed to complete this stage.

If you want to get 100% of the incentive, you have to meet the standards of meaningful use for a minimum of 90 days.

Stage 2

The emphasis here is on properly exchanging patient information and care coordination. In order to meet the requirements for stage 2, you must continue meeting the requirements of stage 1. Stage 2 launched in 2014 and requires health care professionals to reach a larger number of their patient populations through their EHR.

To qualify for payment in stage 2, Eligible Professionals (EPs) need to qualify for 17 core objectives and 3 out of 6 menu objectives. Eligible Hospitals (EHs) and Critical Access Hospitals (CAHs) need to qualify for 16 core objectives and 3 out of 6 menu objectives.

One of the core requirements for EPs is to have the capability to submit electronic data for immunizations. For EHs, one of their core objectives is to be able to submit electronic data for immunizations, Reportable Laboratory Results, and Syndromic Surveillance.

Stage 3

The third and final stage of Meaningful Use is all about improving patient outcomes. But remember, you have to continue stages 1 and 2 in order to receive payment for stage 3.

Stage 3 has eight required objectives for clinicians to meet in order to avoid penalties and receive incentives. The eight objectives are as follows:

Protected Health Information: Also known as PHI, physicians have to conduct a "security risk analysis" to prevent patient PHI data leaks. This is also a HIPAA requirement, which, if violated, can result in huge fines
Electronic Prescribing: You need to send at least 80% of your permissible prescriptions to pharmacies electronically
Clinical Decision Support (CDS): This is a two-part objective. The first requires implementing five CDS interventions and the second requires active checks on drug and drug-allergy interaction
Computerized Provider Order Entry: EPs need to meet the following three standards: medication, lab, and diagnostic imaging orders
Patient Engagement: At least 80% of patients need to be able to view and download their health records through your EHR. You must also provide educational information to at least 35% of your patients
Coordination of Care: This is meant to increase patient engagement through three processes. 1) Have at least 25% of patients use your EHR. 2) A minimum of 35% of your patients must obtain secure digital information from a health care provider. 3) You need to get data from a minimum of 15% of patients through fitness trackers/wearable devices. EPs need to shoot for all three standards but only meet the requirements for two
Health Information Exchange: The focus here is twofold. 1) At least 50% of care record-transition must be done electronically. 2) When seeing a patient for the first time, you must receive health records electronically no less than 40% of the time
Public Health Data Reporting: Here, you need to choose three of five EHR destinations to submit data. The options include a public health registry, clinical data registry, syndromic surveillance, cases, and an immunization registry.

MACRA and Meaningful Use

What is MACRA?

The Medicare Access and CHIP Reauthorization Act, or MACRA, gives EPs and EHs more tools to provide patients with better care. MACRA created the Quality Payment Program (QPP), which is designed to benefit providers that provide great health care. QPP gives you various payment options as well.

The QPP is designed to do the following according to CMS.gov:

Repeals Sustainable Growth Rate formula. This was predicted to make cuts of 25-30% each year for the services you and other clinicians make to Medicare beneficiaries
Gives bonus payments to participating providers with alternative payment models (APMs)
Makes multiple quality programs faster and more efficient under the new Merit-Based Incentive Payments System (MIPS)
Requires all Social Security Numbers be removed from Medicare cards by April 2019
Changes how clinicians are rewarded for value and volume by Medicare

You can participate based on the following factors:

Size of your practice
Specialty
Patient population
Specialty

In short, MACRA created a way for health care providers to be paid for Medicare beneficiaries. It also set rules for data sharing.

What are MACRA's data sharing rules?

The CMS's Qualified Entity (QE) program helps your organization get Medicare claims data and this can be used to determine the performance of the provider. If your organization is or has been approved as a QE then you're required to produce and publically provide reports approved by the CMS.

QEs are also allowed to make non-public analyses and sell it to users that have been authorized, and you're also allowed to give out or sell combined data/information, including Medicare data at no cost to authorized users. The CMS certifies and monitors QEs that receive this data. You can see which QEs the CMS has certified, the region they're in, and the date of certification here.

How Meaningful Use and MACRA work together

When MACRA came out, Meaningful Use turned into part of MIPS, another part of MACRA. If you're a clinician, you won't participate in the Meaningful Use program for Medicare Eligible Professionals. Instead, QPP has incentives for clinicians to use certified EHR technology and includes categories based on performance like Advancing Care Information and Quality Measures Reporting in MIPS.

MACRA's new payment system aims to make it easier for your organization to simplify payment models and value-based health care delivery. Starting in 2019, if you treat Medicare patients, you will most-likely have to choose between using MIPS or APMs as your payment track. I say "most likely" because not clinicians will have to choose between these two tracks.

Under the new rule, you will get reimbursed based on a performance score on the following four factors:

Quality measures (30%)
Resource use (30%)
Meaningful Use (25%)
Clinical practice improvement activities (15%)

MACRA provides a path for you and your clinic, if eligible, to receive reimbursements through APMs or MIPS. But this isn't all new. Health care providers have been reporting on quality measures for a long time now under different programs, including Meaningful Use, Physician Quality Reporting System, Value-Based Payment Modifier program, and e-prescribing.

Are MACRA and Meaningful Use good for health care providers?

There have been a lot of reactions to MACRA and Meaningful Use, as is the case with any government regulation. Some health care professionals and clinics have lost money as a result while others have seen significant gains.

But are these programs good for health care? I believe they are. Obviously, I'm a huge fan of doing things that help hospitals be more efficient and help more people get treatment. I strongly believe that a great way to improve health care and get people the treatment they need is through having a really good EHR.

While I believe EHRs are a great way to improve health care, I also strongly believe that you have to use the EHR that's right for you and you need buy-in from everyone who will be working with it. If you're looking for a substance abuse or mental health EHR, you can also get a free demo of ours here.

How has Meaningful Use affected you?

We want to know what your thoughts are on the effects of Meaningful Use. Has it been positive or negative? If you think it's been good, comment with the word "good" below. If you think it's been bad, comment with the word "bad" below. I'm just curious about how many of you approve or disapprove of it.

Conclusion

In conclusion, Meaningful Use is a program created by the Federal Government with the purpose of incentivizing clinicians and health care providers to improve health care by using a certified EHR. It has three stages, each of which builds upon the previous stage. and has seen some significant changes since its inception in 2009.

Even if hospitals and clinicians weren't incentivized by the government to use an EHR, I'd still strongly recommend using one as I've seen providers increase their revenue by as much as 30% after switching from a paper to a digital EHR.

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