Healthcare IT News - April 2008 - (Page 35)

www.HealthcareITNews.com management solutions April 2008 ■ Healthcare IT News 35 get more involved in IT deployment, the challenges become more complicated – not only from a system standpoint, but from an operational one as well. Learning the tenets of a new software program is hard enough without having to place it in a larger context, such as sophisticated workflow schematics, Medicare reimbursement schedules or care management initiatives. That is IT consulting adds new dimensions to healthcare a By John Andrews, Contributing Writer S HEALTHCARE PROVIDERS maintaining data and having it flow to the right pieces. Bottlenecks are where the frustration sets in. If you’re a physician clinic, you may have great practice management software, but extending it to the physicians may be a challenge.” In the hospital environment, Thomas cited an example of how an integrated delivery network had a disconnect between radiology and physicians. “Radiology didn’t have the capability of transmitting results to the “our clients want us to show them how to take technology and make it non-technical so that their people can understand it.” – Don Thomas why many consulting firms are evolving along with the healthcare industry to offer more focused, specialized expertise on IT matters, consultants say. To be sure, healthcare providers are facing a broader, deeper set of challenges than ever before, says Don Thomas, president of Irving, Texasbased SoftLight Development. “Our clients are faced with a number of challenges, whether it’s technology, process flow, logistics or clinical,” he said. “Basically though, they want us to show them how to take technology and make it non-technical so that their people can understand it.” Although the situations are highly varied, most problems share the same root cause, Thomas said – data flow. “Let’s face it, data is king – it’s what pays the bills and is what’s important to everyone,” he said. “Most challenges center around physicians – they would burn the images to a CD and have it couriered over, which can take days,” he said. “With the technology available today there is no reason to wait that long. We are able to take information like that and provide a technical scope. We look at our arsenal and figure out how we can provide the solutions our clients need.” De-mystifying meDicare As Thomas referenced, “data is what pays the bills,” and there is no bigger bill payer than the Medicare program. There is also no bigger source of bewilderment than its tangled web of policies and reimbursement matrices. Complicating matters further is a carrier consolidation plan that will shrink the number of Medicare administrative contractors from 48 to 19 over the next three years. So it’s no surprise that healthgenetic samples! There is no evidence provided to prove that the data is “de-identified” or in what way re-identification occurs without consent. There is no way to determine how secure the data is in Perlegen’s data banks, and there is no way to know to whom Perlegen will sell patient data or results. This is a horrific abuse of patient privacy and we can expect to see a flood of this kind of for-profit “research” UNLESS Congress restores the right to health inforpatient’s DNA ever be collected, much less used, without their prior, written and fully-informed consent. That is the law, and Perlegen is firmly committed to following it in both letter and in spirit. In fact, we will only have access to de-identified data fields, from which we can sort those case records covering patients from whom we believe a DNA sample might be useful in understanding their variable response to treatments they’ve already received. We then work through our EMR provider, who in turn works with both care organizations are flooding Stamford, Conn.-based IVANS with a river of questions. “Since the passage of the Medicare Modernization Act in 2003, our project management team has been working closely with fiscal intermediaries, carriers and Medicare administrative contractors to migrate healthcare providers over to the new contractor and to ensure these providers have the connectivity they need,” said Tara Mondock, IVANS group vice president of sales for healthcare. “Realizing that many of these providers are very confused by what the Medicare initiatives mean and are not sure what to do, last year we created the Medicare Transition Program. This free program is designed to manage the providers’ migration, educate them about the changes and guide them through the process of updating their network connectivity for Medicare access.” The MTP program includes free Webinars, informational guides, software and testing connectivity as needed. The consulting team takes clients through the various steps to ensure that their access remains intact and that the migration does not result in an interruption of claims payment, Mondock said. “It has been our goal to make the Medicare transitions run as simple as possible and the response to this program has been overwhelming,” she said. Healthcare IT consulting firms are evolving – along with the healthcare industry – to offer more focused, specialized expertise for their clients. inDian option “Offshoring” is a concept that is often seen as a low-cost option for rudimentary back office functions mation privacy. Actually, I would bet this sort of arrangement is widespread already. Patients do get some compensation - but there is major coercion for them to participate because their doctors are compensated for secretly offering them up as research subjects. How much do the doctors know about the EHR company that sells their patients’ PHI? Deborah C. Peel, MD Founder and Chair Patient Privacy Rights the medical facilities and physicians that treat those patients. Before those institutions re-identify any patient, the treating hospital or clinic must receive IRB approval for the study. Only at that point may patients be contacted and informed that preliminary review indicates they might be suitable for the study, and asked if they then consent to further review of their records by their physician. Sincerely, Bryan L. Walser, MD, JD Chief Executive Officer Perlegen Sciences, Inc. in other industries, though healthcare hasn’t traditionally been one of its subscribers. Due to healthcare’s complex nature and demand for highly trained professionals, provider organizations haven’t seen outsourcing to places like India as a viable strategy. But Hoboken, N.J.-based Care Management International wants to change the perception that Indian labor isn’t a good fit for the American healthcare industry. Granted, it may not be suitable for most providers, but it definitely has some applications for the payer community, said company president Matthew Michela. “We serve a spectrum of organizations that need clinical oversight, case management and analytics,” he said. “We prefer to call it ‘smart sourcing,’ which is designed to increase productivity and output by utilizing highly skilled labor to complement an organization’s processes.” CMI has divided its service com- ponents into five categories: • Post-discharge follow-up: Deploys clinicians who make calls to recently discharged health plan members to asses their risk for readmission and provide follow-up care. • Pharmac y management: Educates health plan members about the efficacy, availability and savings associated with lower cost medications. • Case management: Identifies patients requiring the most immediate care and presents a prioritized plan for focused clinical intervention and follow-up. • DRG audit services: Detects incorrect DRG assignments, recouping lost dollars. • Disease management: Helps prioritize patients’ needs by determining risk factors. Once determined, the program suggests the amount of resources that should be allocated to each patient. ■ more at healthcareITnews.com e Connect: coNsultiNg 0408 ● PeeL Continued from page 8 their genetic samples were taken or used or that their health records were data-mined and sold to Perlegen by the EMR vendor. This is the new Tuskegee - forced research participation without informed consent or even notice. The doctors are contacted when a candidate for genetic tests is identified by Perlegen and then are COMPENSATED after re-identification of patient records and PerLegen Continued from page 8 appropriately consented DNA sample sets that has effectively stymied this effort. Our collaboration for de-identified EMR access is designed to solve this bottleneck, in a way that is absolutely consistent with patient privacy and each individual’s right to self-determination. To reiterate the point we made in our press release - Perlegen will never have access to the specific identity of any patient, nor will any e ● Connect: mobiledesk 0408 http://www.HealthcareITNews.com http://www.HealthcareITnews.com http://www.healthcareitnews.com/story.cms?id=9038 http://www.medcarts.net http://www.medcarts.net http://www.healthcareitnews.com/eConnect.cms?id=9032

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Healthcare IT News - April 2008 Contents New Media Push Stepping Down BI Headaches Decision Grants Safety Alerts Summit 08 Growing an EHR Year 24

Healthcare IT News - April 2008

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