Robin Ntoh

As COVID-19 cases rise around the United States, the welcomed uptick in appointment volume that many physician practices experienced in August and September is in danger of evaporating. At this point, all we know for sure is that the coming months present a number of unknowns. Given the insecurity, it’s critical that organizations put a strategy in place to think through probable risks and how best to address them.

The pandemic took many practices by surprise, disrupting day-to-day operations as well as long-term strategic goals. Now, practices have the opportunity to learn from this experience and limit the chaos going forward by dedicating time to risk assessment and mitigation. Not only can a proactive mindset reduce the impact of the unexpected, but it can also enable the continuation of safe, consistent patient care and practice operations.

Here are a few tactics to consider as you contemplate emerging risks and refine your COVID-19 response. 

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This is a designated group that takes ownership of your practice’s crisis management effort. If you haven’t already established this type of team, now is the time.

Comprised of clinical, administrative, and operational leaders, the group should meet to discuss emerging risks and potential ramifications, assigning ownership for any mitigation strategies. This ensures a well-considered response to the dynamics of COVID-19 and helps the rest of the practice know who to contact if and when unexpected issues arise.

It’s highly recommended that the group engage in a holistic review of potential risks and response procedures to ensure the practice has the right infrastructure in place to avoid threats and pivot easily when a crisis evolves. For example, given the increase in cybersecurity attacks during the pandemic, a practice should consider shifting to cloud-based technology that affords greater protection against intrusion.

These solutions allow practices to manage clinical and business processes from anywhere, easily enabling remote work that may be necessary during the crisis.

After the Centers for Medicare & Medicaid Services (CMS) relaxed its telehealth rules at the start of the pandemic, many physician practices implemented a virtual care program using common communication platforms such as 

. Unfortunately, privacy and security issues emerged quickly, causing frustration for both patients and providers.

Now, there are more sophisticated telehealth options available that can be directly accessed from electronic health records (EHRs). These are designed specifically for telehealth, prioritizing patient privacy and accessibility. Since these solutions are tied into the EHR, which already has sophisticated security protocols in place, they are safer than traditional communication platforms. These solutions are fully HIPAA compliant, so an organization doesn’t have to worry about violating privacy and security rules, even after CMS reinstates its stricter telemedicine regulations.

By moving to a specially designed telehealth solution, a practice can be more confident in its ability to offer secure and patient-friendly virtual care, which is especially important should the country return to stricter orders.

Since it’s difficult to predict whether patient volumes will return to normal or continue to fluctuate, practices must ensure they receive full reimbursement for the visits that do occur—whether those are offered via telehealth or in person. As such, it’s wise to prioritize revenue integrity efforts, such as ensuring full and appropriate documentation and coding for services rendered.

While conducting audits can be helpful, a more proactive approach is even better. By leveraging technology that streamlines documentation and coding while fostering specificity, you can be confident your claims are accurate and clean, leading to optimal reimbursement.

The pandemic has given patient payments a one-two punch. First, the virus has increased the need for contactless payment to reduce the risk for staff and patients. Second, as more people lose their jobs—and their employer-sponsored health plans—they are having to pay more for care, pushing the need for financing vehicles that extend payment terms.

Practices should review their current payment strategies and determine whether they address these two dynamics. For example, when your patients can make payments or sign up for payment plans directly through their patient portal, it allows for greater payment flexibility and easy sign up while minimizing physical contact between patient and provider.

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As things continue to evolve, it’s important to communicate regularly with patients, letting them know how your practice is responding to new developments and working to keep them safe while providing the care they need.

Well-timed texts, appointment reminders and secure texts or emails are critical to reassuring patients and building confidence in your organization. It’s recommended the emergency response team develop a communications plan to ensure patients receive timely insights or announcements, should new dynamics emerge. When sharing information, it’s ideal to use patients’ preferred communication methods and check that content is timely, relevant and easy to understand. Using a patient portal is especially effective because it supports secure, bidirectional communication.

No one knows for certain what the future will bring. However, those organizations that have embraced risk management and put a plan in place to weather the unexpected will be in a better position to navigate whatever comes next.

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Tactics to consider as you contemplate emerging risks and refine your COVID-19 response.

Mitigating risk as the pandemic persists

During their time in education and training, healthcare providers are taught that patients and their health are of the highest priority. They later find providing care has an unusual competitor-charting.

As healthcare organizations embrace value-based care, they are moving toward a more proactive approach to care delivery, which involves an emphasis on wellness, chronic care management, and patient engagement. There is also a push for greater collaboration among providers across the care continuum.

Healthcare organizations are simultaneously being tasked with regularly and reliably reporting performance measures that demonstrate care quality, costs, and innovation. Providers must submit these measures as part of the Merit-based Incentive Payment System (MIPS)-the flagship program of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

Although the concepts of value-based care and quality reporting are meant to go hand in hand, many healthcare organizations struggle to realize success with both endeavors. In an effort to collect the required data for robust quality reporting, providers get bogged down and sidetracked during the patient care episode.

That’s not only a patient dissatisfier but can also negatively impact care quality if healthcare providers misses key information from the patient. As such, healthcare organizations may fall into a vicious cycle as they strive to effectively report quality but miss opportunities to improve it, thus falling short in achieving target performance levels.

Part of the reason why providers are having so much difficulty balancing the two efforts is that many of the technology systems used to support patient care and quality reporting are out of date. Today’s healthcare professionals are now discovering the versions they use, which were created early in the digital healthcare era to meet the timely requirements of Meaningful Use, were not designed to keep pace with the accelerating rate of change. A number of the electronic health records (EHRs) currently in use consist of clunky interfaces, limited data analytics, and inefficient layouts that necessitate several clicks to navigate are only some of the troubles providers face.

Though these EHRs were created to fit an earlier industry need, CMS has acknowledged the frustration they now give to the healthcare industry and that advances are needed to reduce barriers for providers. This leaves a majority of healthcare organizations wondering what to do to resolve current issues without delaying future progress.

Fortunately, exciting opportunities await. The 2019 MACRA requirements dictate that healthcare organizations upgrade their technology to a system with 2015

. With this in mind, now is an optimal time to review the technology offerings available in the marketplace.

Consistent frustrations over inefficiencies have pushed the industry toward recent advances, and new systems are changing to enable easier access, smoother documentation, clearer reporting, and increased interoperability.

Here are four key ways new EHR technology will help providers simultaneously meet the goals of improved patient care and better reporting.

Historically, EHRs have not been overly flexible in what content they capture and how they record it. However, new solutions give healthcare organizations the ability to fully customize screens by provider preference and patient needs.

Systems are now able to tailor the drop-down menu to include only relevant choices based on patient history and problem list, and EHRs can follow the provider’s preferred flow. Ophthalmologists, for example, could see pertinent information for their specialty that applies to the particular patient being seen, and it would be displayed in a way that follows the provider’s favored workflow.

This customization yields more efficient charting without sacrificing accuracy while also reducing time providers spend on documentation.

 Predictive charting can determine whether a patient qualifies for preselected MIPS measures in real time and then present providers with related data fields during the patient encounter. That technology helps providers collect the appropriate information while patients are still in the room.

By simplifying data collection while preserving accuracy, the technology frees providers to spend more time with patients and less time collecting data. This can yield higher quality patient visits that ensure focused care and greater patient satisfaction, two MIPS reporting categories.

Cloud-based technology lets providers remain up-to-date with the latest compliance regulations as well as the tactical functionalities without having to go through cumbersome upgrades. A vendor can make changes in the cloud so new features are immediately available for use the next time providers log into the system.

Cloud-based solutions also support greater access from anywhere. Providers with multiple offices can travel freely between locations and have immediate access to patients’ medical records without losing information in transit. They can also respond to patients’ need more quickly if they receive an urgent call outside of regular business hours.

The technology enables better communication among colleagues, as any provider with the proper credentials can access patients’ records. Increased communication fosters more collaborative care and facilitates reporting on past procedures and next care steps, resulting in more holistic, long-term care plans. Altogether, these capabilities help providers deliver responsive and patient-focused care while supporting effective reporting.

New technologies include sophisticated data analytics and reporting features that draw from clinical, financial, and operational databases. When healthcare providers run reports from these systems, they can more easily identify areas of strength and weakness.

Not only does this allow providers to pinpoint the best possible measures for reporting, it also helps them identify ways to improve patient care. Instead of the EHR functioning merely as a repository for clinical data, analytics capabilities turn the system into an essential resource for clinical and operational improvement.

Healthcare providers must seek a mindset of innovation. As technology continues to progress, it’s important to avoid the roadblocks healthcare organizations ran into before, such as burdensome data entry processes, lengthy software updates, unbalanced actions of reporting, and providing quality patient care.

By employing this type of forward-facing technology, healthcare organizations can achieve a balance between value-based care initiatives and quality reporting, ensuring they respond to patient needs while optimizing reimbursement.

Robin Ntoh serves as a senior professional services consultant at Nextech Systems, Inc., and has more than 20 years of experience working with healthcare providers. She has guided clients as a Nextech implementation trainer and now leads the professional services consulting team for Nextech Products.

Four ways advances in EHR technology can help providers achieve mandated MIPS target performance to not only report but also improve patient care.