Tecnico Consulting Information

What you need to know about the HITECH Act

The American Recovery and Reinvestment Act (ARRA), is an economic stimulus package signed into law on February 17th, 2009.

This stimulus includes an allocation of $19 Billion towards the Health Information Technology for Economic and Clinical Health Act (HITECH Act).

These funds are designated as incentives to physicians and hospitals who can demonstrate the meaningful use of Electronic Health Records (EHR) before the incentives' expiration date.

Switching to EHR/EMR is the most effective way for practice owners, or individual practitioners to improve the cost effectiveness of their practice as well as significantly improve daily operations.

Contrary to the incentives, the HITECH Act also signed into law penalties if practices neglect to take advantage of this stimulus in a timely manner.

Tecnico Consulting offers a simple and personal implementation of Electronic Health Records. With our associates working with you and your staff to meet necessary program qualifications as well as maintaining HIPAA compliance without the interruption of practice dynamics.

The HITECH Act has allocated funding for incentives to be distributed amongst practitioners that are willing to implement the use of an EMR interface within the years of 2011-2016. The guidelines for these incentive payments must be met by demonstrating “meaningful use”.

Meaningful use means providers are required to display use of certified EHR technology in ways that can be measured significantly in quality and in quantity. Practitioners must meet objectives, and criteria in order to fulfill the quota of meaningful use, by the use of a certified EHR in a meaningful manner as outlined in the Core Set of Objectives, which most EHR’s have to help complete the attestation process.

Providers which do not begin using Electronic Health Records by the year 2014 will risk lower reimbursement from government insurances including Medicaid and Medicare.

The amount of time saved when performing processes such as Chart Abstraction and Coding, Chart Preparation, Daily progress notes and discharge summary’s yields an average of 33% improvement as opposed to the manual processes. The benefits of switching from paper records to electronic medical records not only reflect in low overheads costs on transcriptions and document management processes, but also improve the quality of health care for the patients.

Administrative and management benefits include but are not limited to:

Reduce or eliminate the costly tasks of creating and managing paper charts.

Provide rapid access to comprehensive information when needed - fewer misplaced or duplicate charts.

Fewer personnel are needed further lowering operating costs.

Lowering of overheads on transcription costs and management processes.

Provide rapid responses to chart/record requests and audits.

Improve and track overall processes with accuracy and effective reports.

Increase Return on Investment (ROI)

By consolidating information across your clinical operations, you increase the pace of information transfer without compromising secure delivery, coding/ billing accuracy, and quality documentation.
Saving time opens your clinic to more patient encounters and processes – all while reducing you operating costs.
Paper-centric communications and poorly connected medical departmental systems proliferate in healthcare organizations, eroding the efficiency of the clinician and preventing effective cost-management gains.
A study by the Medical Group Management Association calculated 4.31 FTE’s (full time employees) per physician which can be reduced to 2.2 FTE’s per physician after implementing an EMR system.

The Medicare EHR Incentive Program will provide incentive payments to eligible professionals, and eligible hospitals that demonstrate meaningful use of certified EHR technology.
- Eligible professionals can receive up to $44,000 over five years under the Medicare EHR Incentive Program..
- To get the maximum incentive payment, Medicare eligible professionals must begin participation by 2012.
- As of 2015, Medicare eligible professionals that do not successfully demonstrate meaningful use will have negative a payment adjustment in their Medicare reimbursement.

The Medicaid EHR Incentive Program will provide slightly higher incentive payments to eligible professionals, and eligible hospitals when they adopt a certified EHR.
- The Medicaid EHR Incentive Program is voluntarily offered by individual states and territories and may begin as early as 2011, depending on the state.
- Eligible professionals can receive up to $63,750 over the six years that they choose to participate in the program.
- Eligible incentive payments may begin as early as 2011. The last year a Medicaid eligible hospital may begin the program is 2016.

The Office of the National Coordinator for Health Information Technology (ONC) has established goals for “the utilization of an Electronic Health Record for each person in the United States by 2014” alongside with the augmentation of a nationwide health information infrastructure that grants for the electronic use and exchange of medical information.

Beginning in 2015, physicians who decide not to use an EMR will be penalized, starting with a 1% Medicare fee reduction. This reduction will persist until an EMR is put into use; otherwise by 2019 a reduction of 5% will be faced.

Penalties will start in 2012, if implementing the use of a qualified ePrescribing system. CMS officials have suggested that they will impose a 1.5% Medicare penalty in 2012 and then an increase to 2% in 2013-2018.

Under HITECH, mandatory penalties will be imposed for “willful neglect”. In definition, “willful neglect” is something that will be determined on a case-by-case basis. This puts a provider with “no story” regarding compliance (or very little of a story that would represent an insolent attitude towards compliance) subject to a great degree of risk. Civil penalties for willful neglect are increased under the HITECH Act. The penalties can extend up to $250,000, with repeated and uncorrected violations to aggrandize up to $1.5 Million.

With better information integration capability, you can facilitate better quality care, and better manage risk, while saving time per patient encounter.

Paper-centric communications and poorly connected medical departmental systems proliferate in healthcare organizations, eroding the efficiency of the clinician and preventing effective cost-management gains.

Saving time on average yields at least a 33% improvement in task completion for all note creation, as well as prescriptions, test results, and referrals for the provider as well as the patient.

A web based EMR allows doctors and healthcare providers to solicit prescriptions and services from remote locations, and in the process lower their overhead costs by as much as 50%. EHR reduces costs by shortening billing cycles and other core administrative and clinical operations – including storage and copying costs of medical records, as well as to compensate for the initial drawback in productivity related to implementation.

Incentives for Medicare and Medicaid Providers which are available now through 2013 are powerful tools for professionals to cover the costs of having to learn and adapt to new practice dynamics. Physicians can qualify for up to $44,000 in Medicare incentives, or up to $63,750 for Medicaid providers.

On the contrary, there are newly placed penalties for NOT integrating the new EMR system. Medical providers who do not adopt an EMR by 2015 will be penalized, starting with a 1% Medical Fee Reduction and increasing to 5% by 2019.

The general benefits to your individual practice include:
- Medical Records are easily accessible to consultants or referred clinicians
- Patient’s health updates and history are available to physician instantly.
- PHR (Personal Health Record) is accessible to patients from home.
- Minimize the issues of incorrect or conflicting drug prescriptions.
- Dissolution and/or obsoleteness of paper medical records, saving time and space
- EMR’s provide doctors the option of interacting with fellow doctors through a computer, without referencing hard copies of patient records
- Doctors have instant access to health records at any time any place
- Effective search of records, which improves tracking, analyzing and/or charting of voluminous clinical medical information and processes.
- A well-integrated patient-oriented information system.
- Substantial time savings on processes (33-100%) Based on study conducted at CPMC in San Francisco, CA.

The general benefits to your office include:
- Reducing costs by shortening billing cycles and other core administrative and clinical operations – including storage and copying costs of medical records
- Increase the pace of information flow including service delivery, coding/billing accuracy, and better document patient encounters and work
- Better decision making, reduced errors, improved outcomes, and lower malpractice risk
- Increase Return on Investment (ROI)
- Provide rapid responses to chart/record requests and audits
- Fewer personnel are required for daily operations.

Tecnico Consulting is there every step of the way of your office's transition to Electronic Health Records, ensuring the success of your transition, and minimizing the loss of productivity.

Here are a few examples of the challenges practices face when choosing to upgrade without the required expertise:

In order for an EMR to be truly successful, proper and timely training must be administered to all who will interact with the system.
Conflicting research findings on the cost and efficiency benefits of EMR implementations will make it difficult, if not impossible, for administration staff to be confident in choosing an effective EMR for their facility.
Until there is adequate research on multitudes of EMR systems that shows causal relationships between facility characteristics and the related EMR components there will not be a sufficient method of EMR selection and implantation.
The variability of results of similar studies on the monetary and efficiency benefits of EHRs indicates that there is no single approach to EMR implementation that will fit all settings.
Variables such as practice size, setting, specialty, prior computer integration, etc. will determine the effectiveness of an EMR dramatically and must be considered in all cases.
Physician who implement health it systems typically experience an initial loss in productivity as they learn how to use the system, and adjust the ways in which they practice.
A study by Miller & colleagues(2005) found that among a sample of 14 small physician's offices implementing a health IT system, the average drop in revenue from that loss of productivity was about $7,500 per physician; thus indicating the need for a stimulus, and individual training.

HITECH Act Essentials
Practitioners
Practice Owners
Incentives
Enforcement
Cost Effectiveness
Operations Improvement Implementation Challenges