Are you ready for the upcoming standards on electronic attachments?
Changing payment models, quality programs, disease management, care coordination and so on have necessitated dramatic changes for the exchange of clinical data between providers and health plans. Administrative and financial data is by and large standardized, and the technology is in place for that interchange. However, clinical data is much less so, complicated by the need for both images and text-based documentation, and the availability of technology that can facilitate that interchange is often lacking. As a result, healthcare is still very much a paper- and manual-based industry. By one estimate, hospitals spent over $9B last year alone in fax-related activities.
For providers, who typically interact with more than a dozen health plans, clinical data can be requested about patients in a variety of methods. If that isn’t enough, there are stories of several departments within the same health plan requesting essentially the same information about the same patient. In the case of fax transmissions, where there is no acknowledgement of receipt, a medical practice may fax the same information about the same patient multiple times, frustrating both the sender and receiver.
The industry is anxiously awaiting CMS to release a notice of proposed rulemaking (NPRM) on the standard for electronic attachments, which is expected to occur in August. While this release is both welcome and important, what I’m advising my clients, is that the standard alone is not the panacea that many are seemingly expecting it to be. There are deeper issues with clinical data exchange including the intricate balance between an organization’s workflow, process and integration. Both healthcare payers and providers need to evaluate and correct internal processes first while anticipating likely changes, so they can effectively utilize these incoming standards.
Technology serves as an enabler, not the means to an end. The hard work is tackling the business processes, making them more efficient, effective and timely. Does your organization have its ducks in a row when it comes to clinical data exchange?
