Are You Preparing for Appropriate Use Criteria Compliance?

Barbara Mullarky

Barbara Mullarky

Director, Product Management at SRS Health
Barbara has had a successful career in the healthcare industry, working for both vendors and healthcare provider organizations. She has held roles in sales, marketing, product management and professional services, working with EMR and department-focused solutions for the laboratory and imaging.

Prior to becoming the Director of Product Management at SRS, Barbara was with GE Healthcare (now GE Digital), where she held the positions of Senior Product Marketing Manager for Centricity imaging products, Product Marketing Manager and Customer Collaboration Leader for what is now Caradigm, and Upstream Marketing Manager for Centricity Laboratory. Barbara also worked at the University of Arizona Medical Center, where she managed a team that was responsible for implementing and maintaining 27 departmental IT solutions, the ambulatory EMR and the patient safety initiatives.

Originally from New Jersey, Barbara now lives with her husband in Tucson, AZ. She is a graduate of the West Virginia University College of Medicine and is a registered Medical Technologist. When not at work, she loves traveling, taking photographs, watching football and spending time with her two Brittanys.
Barbara Mullarky

auc-blogAppropriate Use Criteria (AUC) is a lesser-known government law that will affect everyone who orders advanced imaging procedures—a staple of orthopaedic practices. AUC is part of the Medicare Physician Fee Schedule regulations.

The law will impact the ordering, performing, and payment for advanced imaging procedures beginning January 1, 2020. The initial year (2020) will be an educational and testing year that will not affect payment.

Included in the advanced imaging procedure category are MRI, CT, PET, and nuclear studies. While certain specialties may not order many PET or nuclear studies, MRI and CT are staples in the diagnostic pathway and help determine care.

How does the law work?

The government is mandating that before any advanced imaging procedure is ordered, the ordering provider must consult an approved Clinical Decision Support Mechanism (CDSM). The CDSM will consider multiple factors on the patient and provide a recommendation as to whether or not the ordered procedure is appropriate or whether an alternative would be better.

At this point, providers have the choice to continue with the original order or to follow the CDSM recommendations. Information provided in the CDSM recommendation must be provided to the furnishing provider (imaging facility). The imaging facility must then include this information on the claim to the payer, and data on the choices made by the ordering provider will be stored in the CDSM for future auditing purposes.

Those who do their own in-house imaging will be impacted on the ordering and furnishing side. Your EHR, Radiology Information System (RIS), and claims management system will all need to be updated with new software to manage this.

We encourage you to speak with your EHR vendor to make the process of remaining compliant and meeting the requirements as seamless and minimally invasive as possible.

Customers or Clients… What’s the Difference?

Catherine Armstrong

Catherine Armstrong

Director, Communications at SRS Health
Catherine brings over 20 years of marketing, communications, and brand stewardship experience to her role as Director of Communications at SRS. She has worked for nationally recognized brands in the healthcare information technology, real estate, hospitality, and luxury automotive industries, including SRS Health, BMW North America, WCI Communities, Cendant, and Orient Express Hotels. She has a passion for understanding the challenges facing her audience, and connecting them with their ideal solutions. Catherine has a B.S. degree in Communications, and is currently working on her M.F.A. in Creative Writing.
Catherine Armstrong

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I have read a lot of books on customer service, including, J. W. Marriott’s The Spirit to Serve and Without Reservations, as well as Hug Your Customers by Jack Mitchell, upscale clothier to the rich and famous. Both describe the service culture, personal attributes, and dedication required to build a trusted brand and to create an exemplary customer experience that keeps customers coming back.

A lot can be learned from these entrepreneurs and the organizations they’ve built. In fact, we at SRS Health have a lot in common with them in striving to create an experience that exceeds expectations. But there is one important difference. While these trusted brands sell a product or service, we are charged with offering our clients ongoing professional guidance and support.

In short, customer service involves a one-time transaction (which may be repeated if there is a good experience) while client service involves an ongoing relationship (which may not go on very long if there is not a good experience).

With the healthcare landscape changing at a rapid pace, a good client experience requires an atmosphere of mutual trust so that medical professionals can rely on their healthcare IT partners to advise them. Just as financial counselors are charged with ensuring their clients are informed and prepared to make sound investments decisions, HCIT partners are charged with ensuring that their clients have the insight to make sound decision regarding their healthcare IT investments.

But that is not all—we are also charged with providing expertise in regard to compliance, operational efficiency, patient engagement, and more. As trusted advisors, we need to know where the industry is headed, and to provide the solutions that prepare our clients to succeed in that future.

At SRS, we like to say that our expertise is helping specialists practice their expertise—we provide solutions that take care of the business side of medicine so that medical professionals can take care of their patients. In practice, this means integrating intelligence within physicians’ workflows—where it can be seen and used to help them make informed patient care decisions efficiently and effectively.

And it doesn’t end there—we also provide the business intelligence within the administrative workflow, so that business leaders can utilize the data to improve operational efficiencies, lower cost, build their practice reputation, and improve their bottom line.

A continued passion for, and commitment to, ensuring that our clients are prepared to achieve their patient care and practice profitability goals—that is how we grow our relationship and earn their trust each and every day.

Does your healthcare IT partner make you feel like a customer or a client?

Spring at SRS Brings New Growth

Khal Rai

Khal Rai

CEO at SRS Health
Khal Rai brings over 20 years of leadership experience to his role as President and CEO at SRS. He possesses a breadth of knowledge and expertise in the healthcare and technology sectors earned through a career that has spanned the globe. His passion for collaboration, strategic development, and delivering healthcare IT solutions that make it easier for medical professionals to deliver care while navigating the ever-changing healthcare industry, inspires and motivates his team, while positioning SRS Health clients for current and future success. Khal has a B.S. degree in Computer Engineering from the University of Cincinnati, and an M.S. degree in Electrical Engineering from Purdue University.
Khal Rai

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ceo-spring-blogThree months have passed since I took over the reins at SRS Health, and what I have enjoyed most over that time is sharing in our clients’ successes, as well as learning about the challenges they face, their experiences, and their visions for the future. So far this year, I have had the pleasure of speaking with many of them on the phone and off traveling around the country to meet others in their practices or at conferences like ADAM, AAOS, AAOE, The OrthoForum, and HIMSS.

One recurring theme that has been a part of every conversation is the need to embrace change—to look forward, to anticipate, and to strive for improvement. Our mission is to help our clients do just that. We are excited to share the innovations SRS has been working on to help our clients excel at the practice and the business of medicine. Here are a few examples:

SRS Health launches the first end-to-end integrated clinical and financial solution suite for high-performance enterprise practices

I am pleased to announce that SRS recently debuted a unique and powerful new addition to our end-to-end software suite that leverages both clinical and financial expertise. What makes this solution unique is the integration that addresses true episodic care. SRS’ roots in the orthopaedic market combined with the new financial management capabilities offers a seamless set of tools for enhancing workflows, adapting to regulatory changes, adopting risk-based models, managing the increase in patient economic responsibility, and expanding programs in the employer market.

The Opioid Crisis and Drug Monitoring

As you know, the opioid crisis has become a top-of-mind political, social, and policy challenge. SRS has committed to joining the fight by being the first specialty EHR to offer PDMP (Prescription Drug Monitoring Program) checking and documentation integrated within the prescribing workflow—delivering a 67% time savings over current methods. More than 40 states already have PDMP mandates and it won’t be long before they all do. This is a great step in keeping our clients ahead of the curve.

Improving Our Clients’ Experience

While working on innovation, we haven’t forgotten about our clients’ day-to-day experience. To ensure their success, we have been formalizing the structure of the SRS Client Success Program. This year we’ve launched the Client Success Training Program and the Features Improvement Team. In addition, we have increased our clients’ ability to integrate with registries, HIEs, and more. These programs ensure that they have the knowledge and skills to fully leverage their HCIT solutions, the facility to share knowledge across their organization, and the connections to exchange information with optimal efficiency.

Medicine continues to put more and more demands on physicians, clinicians, and other healthcare professionals, and we’re excited that our integrated solutions suite optimizes performance and care before, during, and after the patient encounter. Our goal is to help our clients by taking care of the business of medicine, so they can focus on what matters most—their patients.

The Opioid Crisis

Barbara Mullarky

Barbara Mullarky

Director, Product Management at SRS Health
Barbara has had a successful career in the healthcare industry, working for both vendors and healthcare provider organizations. She has held roles in sales, marketing, product management and professional services, working with EMR and department-focused solutions for the laboratory and imaging.

Prior to becoming the Director of Product Management at SRS, Barbara was with GE Healthcare (now GE Digital), where she held the positions of Senior Product Marketing Manager for Centricity imaging products, Product Marketing Manager and Customer Collaboration Leader for what is now Caradigm, and Upstream Marketing Manager for Centricity Laboratory. Barbara also worked at the University of Arizona Medical Center, where she managed a team that was responsible for implementing and maintaining 27 departmental IT solutions, the ambulatory EMR and the patient safety initiatives.

Originally from New Jersey, Barbara now lives with her husband in Tucson, AZ. She is a graduate of the West Virginia University College of Medicine and is a registered Medical Technologist. When not at work, she loves traveling, taking photographs, watching football and spending time with her two Brittanys.
Barbara Mullarky

It’s not news that America is facing a crisis with opioids and narcotic abuse—public service announcements are running on every network; the president has declared it a health emergency; and an increasing number of Americans have had personal experiences with a family member or friend who has become addicted.

Laws have been put in place or are being considered at every level of the government to help address the problem. One approach to helping doctors continue to care for their legitimate patient requests while identifying drug seekers or “doctor shoppers” is the PDMP, or Prescription Drug Monitoring Program.state-of-market-041718-600px

1 Interstate Data Sharing: http://www.pdmpassist.org/pdf/Interstate_Data_Sharing_20170920.pdf
2 PDMP Hub-to-Hub Interoperability Updates: http://www.pdmpassist.org/pdf/Interstate_Data_Sharing_20170920.pdf
3 PMP Gateway: https://apprisshealth.com/solutions/pmp-gateway/

PDMPs are state-run databases containing patients’ prescription histories. PDMPs now exist in all states, and more than 40 states have laws making it mandatory to check the PDMP before prescribing a narcotic. Some states require documentation that the doctor not only checked the PDMP, but also counseled the patient. And some states are starting to identify doctors who prescribe high numbers of narcotics, and are putting programs in place to counsel those providers. The College of Healthcare Information Management Executives (CHIME), a branch of HIMSS, recently met and recommended that the Center for Medicare and Medicaid Services (CMS) include the use of Electronic Prescribing of Controlled Substances (EPCS) as part of the MIPS portion of the Quality Payment Program (QPP) in 2019. They also recommended that CMS and Office of the National Coordinator (ONC) focus on interoperability and removing the burden for clinicians.

Another method to help control the crisis is the use of EPCS. Unfortunately only 17 percent of physicians in the US are EPCS enabled. [1] While 90 percent of standard prescriptions are processed electronically, only 14 percent of controlled substance prescriptions are electronically delivered. [2]

Does your EHR offer PDMP connectivity? Does it allow for EPCS? The technology to automatically complete PDMP checking and documentation does exist—today—providing physicians with the option of making their prescribing and compliance workflows seamless. Providers who use EPCS with PDMP should automatically be presented with the patient’s prescription history any time they prescribe a narcotic. The system should also automatically connect to the state database, retrieve the history, display it to the physician, and record that the physician checked the PDMP. This can be up to a 67 percent time savings over the current process of logging into the PDMP directly. [3]

SRS has committed to joining the fight by being the first specialty EHR to offer PDMP checking and documentation integrated within the prescribing workflow. This is a great step in keeping our clients ahead of the curve.

What are you doing to address the opioid crisis?

 


Better Patient Reported Outcomes Lead to Better Outcomes

Barbara Mullarky

Barbara Mullarky

Director, Product Management at SRS Health
Barbara has had a successful career in the healthcare industry, working for both vendors and healthcare provider organizations. She has held roles in sales, marketing, product management and professional services, working with EMR and department-focused solutions for the laboratory and imaging.

Prior to becoming the Director of Product Management at SRS, Barbara was with GE Healthcare (now GE Digital), where she held the positions of Senior Product Marketing Manager for Centricity imaging products, Product Marketing Manager and Customer Collaboration Leader for what is now Caradigm, and Upstream Marketing Manager for Centricity Laboratory. Barbara also worked at the University of Arizona Medical Center, where she managed a team that was responsible for implementing and maintaining 27 departmental IT solutions, the ambulatory EMR and the patient safety initiatives.

Originally from New Jersey, Barbara now lives with her husband in Tucson, AZ. She is a graduate of the West Virginia University College of Medicine and is a registered Medical Technologist. When not at work, she loves traveling, taking photographs, watching football and spending time with her two Brittanys.
Barbara Mullarky

Outcomes is a hot topic in the healthcare industry. It is one of the criteria being used to define value-based reimbursement strategies and, more importantly, to drive better care for patients.

For some time now, payers and government agencies have been using traditional measures to evaluate outcomes, assessing the number of patients who were readmitted within 30 days, or how many post-surgical infections occurred. For the most part, this data was retrospectively analyzed; it was used to put process improvements into place, but it seldom took into account patients’ own opinions on how they were doing. Ultimately, how can we claim a successful outcome if the patient doesn’t subjectively experience an improvement in health and well-being?

outcomes-blog-v2Many EHRs provide some level of clinical decision support—reminding doctors of how long it has been since an osteoporosis patient’s last bone scan, or when it’s time to review an arthritis patient’s therapy and order blood tests for his or her medications. Some might put this in the category of outcomes, but to me, they are really alerts. Can they affect outcomes—of course! But do they really tell us how the patient is doing?

To change this paradigm, practices are moving toward collecting and measuring patient reported outcomes (PROs). The National Quality Forum defines PROs as, “any report of the status of a patient’s health condition that comes directly from the patient, without interpretation of the patient’s response by a clinician or anyone else.” PROs provide data on what patients are able to do and how they feel by asking questions. They not only cover the clinical aspects of pain, swelling, and range of motion, they assess the patient’s reported status for physical, mental, and social well-being.

In orthopaedics, standardized surveys such as PROMIS, HOOS, and KOOS have been designed to collect patient-reported information before and after surgical procedures. This allows physicians to prospectively and retrospectively evaluate data provided by their patients.

Prospectively, the surveys can be used to determine the factors that will drive a better outcome for the patient. Using best practices standards, physicians can make a determination prior to taking action as to how successful the outcome will be. By discussing potential outcomes, lifestyle factors, and behavioral changes with the patient before surgery is scheduled, doctors can better predict the outcome and recommend the best path—all while controlling costs. For example, if a patient does not have reliable transportation to get to follow-up appointments and physical therapy, physicians might provide information on local transportation services or decide on inpatient versus outpatient rehab.

Retrospectively, if a patient reports unsatisfactory results, doctors can gauge the patient’s feedback against the original expectations of the treatment plan. It might be that the patient is meeting, or even surpassing, the predicted outcome. That little piece of information might change the patient’s outlook and get him or her back on the path to success. Alternately, doctors can determine what could have been done to either reach a better outcome, or develop a more accurate prediction. These learnings can be implemented as best practice to drive better outcomes for future patients.

PROs can also be used as a benchmarking tool, as a way to gauge success against others in the same practice or the same market.

Today, only 35% of orthopaedic practices are collecting outcomes data. Part of this is due to the complexity of managing the process—of collecting, analyzing, and making the data relevant. The most critical step is of course getting the patient to respond to surveys, but equally important is presenting that data in a way that orthopaedists can review it and share it with the patient at the point of care, during the appointment. This allows them to intervene quickly when a negative outcome is reported. Imagine a future when a patient reporting a pain level of 9, a knee that is red and swollen, and an inability to stand without assistance automatically triggers a message to your office to call and intervene. Not only can this save the patient an unnecessary trip to the emergency room, but it can potentially save the practice money if it is doing bundled payments.

At SRS, we believe that the process of collecting and acting on patient reported outcomes should be as automated as possible, and should all take place in the same system you work in, day in and day out—your EHR. That is why we have made this vision a reality with our integrated Outcomes solution.

Are You PDMP Ready?

According to the United States Centers for Disease Control and Prevention, opioid addiction claims 115 lives and sends more than 1,000 people to emergency rooms every day, and has killed 64,000 people in 2016. It is the leading cause of death for Americans under 50 years old.

Prescription opioids are a main factor in the crisis. Although there has not been an overall change in the amount of pain reported by Americans, opioid prescriptions have quadrupled since 1999.

What’s being done to help?  Prescription Drug Monitoring Programs (PDMPs) are state-run drug-monitoring programs that collect and track controlled-substance prescriptions in a searchable database. They provide physicians with intelligence about prescribing and patient behavior that can help them make appropriate prescribing decisions. Learn how you can get PDMP ready:infographic-srs-pdmp

The More Things Change, The More They Stay The Same

Lester Parada

Lester Parada

Vice President of Operations at SRS Health
As the Vice President of Operations, Lester brings over 10 years of increased management experience in operations and product management to the team having held roles in Product Management, Business Development, and Project Management. Lester often visits clients to ensure their SRS Health experience is positive and that they are optimizing their solutions to meet the needs of their practice. Lester frequently attends conferences and tradeshows where he shares his vast product and industry knowledge to educate, while learning from clients and attendees as well.

Lester earned a BS Finance and Management from Montclair State University and an MBA in Marketing Management from Rutgers. In addition, he is a certified PMP (Project Management Professional), CSM (Certified Scrum Master) and CSPO (Certified Scrum Product Owner).
Lester Parada

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Earlier this month, SRS Health attended the 2018 American Academy of Orthopaedic Surgeons (AAOS) Meeting. For us, it is an opportunity to spend time with our clients, make new connections and most importantly keep our finger on the pulse of the industry. Each year, we come back home with a list of hot topics or trends and ensure that we are addressing them. This year however, I felt a sense of déjà vu. So, I went back to the 2017 post-AAOS blog and found that the high level topics were almost identical to what I would have written myself.

  • prescription safety
  • data mining/outcomes;
  • cost reduction/operational efficiencies; and
  • MACRA/ MIPS readiness.

Does this mean there has been no progress in the 12 months since the last conference? Not at all.

Prescription Safety – in 2017 really translated to Electronic Prescription of Controlled Substances (EPCS). In 2018, we find that although 91.9% of pharmacies now support this technology nationwide, only 22.9% of providers are EPCS-enabled. More importantly, in 2018, new complexities have been added as many states now also do or will require checking Prescription Drug Monitoring Programs (PDMPs) before prescribing certain medications.

Outcomes in 2017, outside of hospital and research settings, was limited to the basic assessment for the purposes of meeting some requirement like a quality measure, CJR or BPCI. In 2018, adoption by larger groups is starting to gain momentum. Rather than just focusing on the minimum government requirements, practices are beginning to see the value in being able to improve the quality and efficacy of care through evidence and solid data.

Cost Reduction/Operational Efficiencies in 2017 meant actual hard cost-cutting or expanding business lines to bring more of the continuum of care under the practice’s control. In 2018, not only do we see a continuation of those two strategies but more and more practices are looking to justify spending. They are looking at the value of each technology, each partner, and deciding what they can change, combine or cancel.

MACRA/MIPS in 2017 was a transition year and HCIT vendors warned providers not to be complacent. We warned that you should be ready to jump into the program in 2018 and beyond. Well, in 2018 Congress enacted the Bipartisan Budget Act of 2018. This act pushes out the full implementation, effectively making 2019, 2020, and 2021 three more transition years.

Although change management, especially in healthcare, is often slow, having the right technology to address the challenges and opportunities we face—at the right time—is key to optimizing patient care, practice performance, and population health.

At SRS Health, we’ve developed and delivered a specialized end-to-end solution that addresses the topics above, so that we are ready when you are!