How Can Hospitals Improve Their Patient Referral Management By Complying With Meaningful Use

What is meaningful use?

Meaningful use (MU) is a health information technology (HIT) term that defines minimum U.S. government standards for

  • Using electronic health records (EHR)
  • Exchanging patient clinical data between health care providers, between health care providers and insurers, and between healthcare providers and patients

It has a set of rules known as meaningful use measures or meaningful use criteria. It determines whether or not a healthcare provider receives federal funds from the Medicare EHR Incentive Program, the Medicaid EHR Incentive Program or both.

Almost 99% of the hospitals in the U.S. use EHR systems. It is a huge leap by EHRs compared to 31% of hospitals back in 2003. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users. While an EHR does contain the medical and treatment history of patients, an EHR system is built to go beyond standard clinical data collected in a provider’s office and can be inclusive of a broader view of a patient’s care. EHRs can:

  • Contain a patient’s medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory and test results
  • Allow access to evidence-based tools that providers can use to make decisions about a patient’s care
  • Automate and streamline provider workflow

Impacts of EHR on Care

Electronic Health Records create a greater and more seamless flow of information within a digital healthcare infrastructure. It encompasses and leverages digital progress and transforms the care delivered. With EHRs, hospitals experience improved,

  • Patient Care and participation
  • Care Coordination
  • Diagnostics and Patient Outcomes
  • Practice Efficiencies and Cost Savings

Three stages of Meaningful Use (MU):

Meaningful use is divided into three stages.

Stage 1, which began in 2010, focused on promoting the adoption of EHRs.

Stage 2, finalized in late 2012, increases thresholds of criteria compliance and introduces more clinical decision support, care-coordination requirements and rudimentary patient engagement rules.

Stage 3, which the CMS is writing from late 2014 through early-to-mid 2016, will focus on robust health information exchange as well as other more fully formed meaningful use guidelines introduced in earlier stages.  

What are the incentives and penalties for meaningful use?

Under the HITECH Act enacted under the 2009 Recovery Act, incentive payments are available to eligible professionals who successfully demonstrate meaningful use of certified EHR technology.

The Recovery Act specifies three main components of meaningful use: The use of a certified EHR technology

  • In a meaningful manner
  • For electronic exchange of health information to improve quality of healthcare
  • To submit clinical quality and other measures

According to Medicare and Medicaid EHR incentive programs, the practices receive incentives if they meet the meaningful use requirements. If they do not meet the meaningful use requirements, they will be penalized.

Medicare EHR Incentive Program

Medicare incentive payments are equal to 75% of a practice’s annual Medicare Part B allowed charges up to a maximum yearly amount.

After 2015, providers who were eligible for the Medicare Meaningful Use program but did not successfully demonstrate Meaningful Use were penalized. The penalty started at 1% of Medicare Part B reimbursements and increased each year to a maximum of 5%.

Medicaid EHR Incentive Program

In the case of Medicaid patients, a practice can earn up to $63,750 in incentive payments over the six years that they choose to participate in the program.

If you start in 2015, you can earn incentives through 2020. Practices can consult their state’s agency for information about a specific payment schedule.

Providers who are eligible for Meaningful Use under the Medicaid program are not subject to payment penalties unless the provider is also eligible under the Medicare program.

How can a Patient Referral Management Referral Management enhance an EHR system to achieve meaningful use?

FQHCs prefer working with EMR/EHR systems because they are comfortable with it. So they do not wish to move out their EHR/EMR system. An EHR/EMR system has many advantages but when it is complemented with a Referral Management software practices can experience many more benefits.  

How great it would be if a Patient Referral Management software could integrate seamlessly with an EMR/EHR system? It can help in ensuring end-to-end Patient Referral Management without disturbing the existing system.

HealthViewX Patient Referral Management solution provides easy steps to integrate with a practice’s EMR/EHR system. It also enables easy and safe transferring of patient demographics, diagnostic reports, test results or any sensitive information. The solution is HIPAA-compliant with complete data security.

HealthViewX can enhance a practice’s EHR capability by making it achieve meaningful use. The practice’s scoring can also improve by using HealthViewX Patient Referral Management solution.

HealthViewX Patient Referral Management solution features

It has the following features,

  • Inbound and Outbound Referrals – HealthViewX Referral Management Solution can integrate with both the receiving and referring end. For inbound referrals, it helps in channelizing various sources into one single queue. In case of outbound referrals, it facilitates integration with the existing system to read the patient data and send out referrals.
  • Referral Timeline – Any referral has a timeline, to capture the progress of the referral. It is common to the referring and receiving provider. A referral will be mapped to a status which helps in tracking it better. For e.g. – If a patient does not show up for the appointment, the status of the referral can be changed to no-show and an appropriate reason can also be given. With the help of a referral timeline, the providers can always be aware of what is going on with the referral.
  • Workflow and Task Management – A workflow can be defined on how the referral flow must be(business rules). Providers can create tasks to manage referrals by assigning it to the respective person.
  • Improved communication – HealthViewX Referral Management Solution supports messaging and calling features for the referring and the receiving providers to stay connected.
  • Data Management – The solution is HIPAA compliant and enables secure data exchange of all patient-related documents.
  • Seamless Integration – The solution can seamlessly integrate with any EMR/EHR/RIS or Third Party application thus providing minimal disruption in the existing referral flow.
  • Referral Data Consolidation – The consolidated data regarding the referrals and the referral history of any patient can be printed as a hard copy at any time in pdf/excel.
  • Smart Search – HealthViewX Referral Management solution has a smart search facility that helps in finding the right provider for the treatment required.
  • Referral Data Analytics – Referral data-centric dashboard gives clear figures regarding the number of referrals flowing in and out, the number of referrals in various status, patient follow-ups, etc.

HealthViewX Referral Management solution helps in building a secure referral network in no time. Our expert team will guide you in changing to a Patient Referral Management Software with minimal effort. Schedule a demo with us to know more about our solution.