Contributed by Andy Draper, senior vice president of business development and strategy for Bluegate Corp., a Houston-based provider of healthcare IT solutions.
As a result of the Stark Safe Harbor guidelines that were finalized in October, health systems must seriously consider whether they should provide physicians with IT tools as part of their broader financial and IT strategy.
The new Stark guidelines enable health systems to provide physician practices with IT tools – such as software licenses for electronic medical records and e-prescribing, support fees, connectivity and implementation, training and support and help desk service – with the goal of increasing practices’ use of EMR and clinical information technology.
Supporting physician practices is crucial to increasing the efficiency and financial viability of all providers. Most patient care occurs in ambulatory settings. In an aging population with long-term management of comorbidities and diffusion of pharmaceutical treatments, care management is more complex than it was five to 10 years ago.
In light of the increase in consumer-direct payment for treatments, including pharmaceuticals, it is clear that a hospital’s lack of complete information on medications and treatment plans can be harmful to the patient and makes it nigh impossible to create strategies to effectively manage chronic disease costs.
Currently it isn’t possible to compile information from various practices into a comprehensive EMR because most physicians haven’t invested in the IT infrastructure, EMRs and other technologies needed for their practices to efficiently communicate and share data with health systems. Approximately 80 percent of all physician practices do not have an EMR, and even fewer practices with less than 10 physicians have automated records.
Many small practices use “the cousin of the office administrator” or other non-professionals as their IT consultants. Most physician offices do not have office networks, let alone managed virus scanning and other IT basics. Lacking adequate security, most practices are security risks for hospitals that want to include them in their networks.
The quick answer for physician connectivity is to give physicians an EMR and make them happy. However, the Stark Safe Harbor changes present an opportunity for health systems and their boards to develop a complete outpatient IT strategy, similar to the journey that started years ago with inpatient computerized provider order entry.
Because physicians play a major role as revenue and profit centers for hospitals, facilities should look to create comprehensive, sustainable models for managing the interactions they have with physicians. As hospitals pursue clinical integration strategies with physician practices, IT outsourcing can enable them to be on the “same side” of the table as a partner-sponsor-advocate for change, rather than on the “opposite side” of the table as the defender of code and services and an IT provider accountable for delivery.
By extending IT investment from health systems’ services line strategy into physician practices, hospitals can be in a position to manage the data across the entire continuum of care, creating one data set that is normalized across care settings. For example, when a cardiology patient’s data from the cardiologist, the cath lab, the hospital, the pharmacy, a consult and his or her physician are consolidated into one data set that truly represents “one source of truth,” the resulting process is more efficient – the physician has access to better data and services, the hospital has better data, and overall patient care improves.
Providing physicians with IT tools definitely has a price tag. Independent practice associations and physician-hospital organizations may be available to assist in offsetting a portion of the cost; there are other sources of capital available, such as gain-sharing programs.
However, for many health systems, the benefits will far outweigh the costs. The implementation of a comprehensive outpatient IT strategy may enable the hospital to define its brand and value proposition in new ways to healthcare purchasers and physicians. Coupled with enhanced patient care and reduced costs for care, the opportunity that the Stark Law changes offers will likely have significant positive bottom-line impact for the health systems that thoughtfully plan their strategy and execute swiftly.