2016 Top 10 (Plus-1) Healthcare Issues

Jan 01, 2016


The last few years have been challenging, to say the least. You've probably seen more changes in the way your practice runs in the last two years than you had in the previous ten. As we look ahead, as you might expect, there is both good news and not-so-good news. However, our objective is to view each new challenge as an opportunity to improve.

As partners in your success, our job is to be your expert healthcare information technology (HIT) service provider; while yours is to manage your day-to-day clinical practice as cost effectively and clinically excellent as you can.  So with that in mind, let’s take a look at some things that could impact your practice this year and action you might consider initiating to improve clinical and financial outcomes.




1. HIT Outsourcing: Ready for Prime Time?

Today, it takes a lot of support and coordination - highly skilled and experienced technical support - to keep a modern physician practice running smoothly. When a clinical practice  — whether a small, independent group, or a hospital-run practice considers outsourcing any portion of their IT operation, there are many unknowns and concerns to assess. Often, organizations feel overwhelmed when exploring such important and complex decisions without some guidance.

It’s important for the practice to understand what any IT outsourcing option should offer: the solution should take complex and time-consuming tasks off your plate; and it should free your employees’ time so that they can focus on more productive, operation-improving and patient experience enhancing activities.

A quick review of news stories indicates that while outsourcing isn’t a new concept, its adoption has increased and is accelerating rapidly. The main reason? Outsourcing vendors can combine a wide range of expertise with the ability to flex staff when needed, while maintaining state-of-the-art technology to improve efficiency and drive cost savings. In addition, Health IT service providers have become more adept at providing the services practices need, when they need them.

As Health IT providers have become more adept and expert at providing what practices need, when they need it, providers have become more comfortable turning Hosting, Application Support, DR, RCM and other functions over to HIT vendors.

At the same time, providers have become more comfortable turning over many critical IT functions to trusted and proven 3rd parties.  Examples are: Application Support, Revenue Cycle Management, Cloud Hosting, Disaster Recovery, or even a comprehensive Managed IT service program.

An ideal HIT service provider will be one that can offer coordinated, broad-ranging integrated services — one-stop-shopping, if you will. That way, your practice will be interacting with a single point of contact that addresses the needs and personality of the practice, and that offers a tailored package of options. No need to go “shopping” for a variety of vendors, and have your staff spend most of their time trying to coordinate differing and even conflicting service providers.You also may want to consider looking for a vendor that is growing with you — one that continually innovates to stay on top of the most current technologies and benchmarks for services.

Learn more about the NPS Managed IT and their comprehensive suite of outsourcing service offerings.

2. Workflow Automation: Means-to-an-End

Increasingly, physician practices are absorbing the burdens of ever-changing regulatory requirements that force them into workflows that are not efficient, and that demand a lot of time and attention. 

An important first step in making this process work for you and your practice is to conduct an effective workflow analysis — one that takes into consideration the goals of your particular practice and the needs of your clinical providers and staff. [Read more here.]

So let’s start with the Who: who should be involved in this analysis? Obviously, organizational leadership needs to support this effort, and help articulate the financial and clinical goals of the practice. Next, each step of each process needs documentation and analysis. This means not only a step-by-step review of how things are done today, but also recognition of where bottlenecks and inefficiencies are impacting workflow and morale.

Your practice will have to continue to provide the kind of care your patients are used to— or even improve it — without sacrificing relationships be-tween patients and providers.

Identify staff from each area of the practice—from the front desk, to the clinical practice, to the back office—who have a broad and deep understanding of each department. Finally, it’s important to take into consideration the needs and desires of the patients themselves. Your practice will have to continue to provide the kind of care they expect from your organization—without sacrificing provider-patient relationships.

The What piece of the puzzle is difficult, because it requires navigating the landscape of business options required to effectively manage the workflow processes outlined above. It’s hard to choose automated solutions when you’re not even aware of what’s available, and why you’d choose this option over that one.  Consulting a trusted 3rd party to objectively evaluate each work stream to uncover improvements is a wise choice for moving forward.

Next, there’s the How. How will your practice transition from the way things are currently done to managing tasks in an automated environment? Training is required. Planning is essential. When will “switches” be flipped and which workflow switches should be turned on first? How will transition blocks be navigated? And, how will you know when you’ve “arrived?”

Finally, there’s When. When to begin your workflow automation project without total disruption of your day-to-day clinical business, and when to implement a proven technology. When to wait for an updated application; or maybe even when to look at an entirely new offering coming on the market that looks promising.

If all of this sounds both exciting and daunting, it should. It is. However, an experienced HIT service provider can help with the process by efficiently walking you through the entire progression and effectively managing workflow changes.

Learn More about the NPS Advisory services and how they can help with workflow automation and improvements.  


3. Privacy & Security: It’s Not Getting Easier


Healthcare is the number one target of invasive cyber-attacks. Of course, you are aware of this problem. More likely you knew it was a vulnerability, but perhaps you didn’t know how severe a problem safeguarding Protected Health Information (PHI) is today.

Attacks are serious not only because of the sheer volume of data collected on patients, but also because of the sensitivity of that data. And, it’s not just your data storage unit that’s at risk. Increasingly, simple front desk transactions are vulnerable, as well.

Why is this data so vulnerable? Simple - it has market value; particularly PHI, which contains so much information that can be used for Medicare and Medicaid fraud. PHI is a target for both internal and increasingly, external data theft.

Every practice will need to ask itself a few simple, but critical PHI questions:

  1. What sensitive data does my practice have in its possession?
  2. Who uses this information and who has access to it?
  3. Where is this data stored?
  4. How and when is this data transmitted?

Attacks are serious not only because of the sheer volume of data collected on patients, but also because of the sensitivity of that data. And, it’s not just your data storage unit that’s at risk. Increasingly, simple front desk transactions are vulnerable, as well.

At each data access point, a detailed operational plan needs to be in place in order to protect the information. In addition, an emergency recovery plan needs to be prepared, should a breach occur. A starting point for all of this is a good risk analysis profile.

Beyond that, practices also have to be aware of the latest Payment Card Industry Data Security Standard (PCI DSS). This is the standard that all entities accepting credit and debit cards are required to meet in terms of liability. These standards change over time and require that you stay current on a regular basis.

You’ll find very useful information for physician practices to read through when educating providers and staff about data security issues here.

Since healthcare providers' responsibilities under HIPAA, Meaningful Use Programs, and other government and private regulations are so complicated and constantly evolving, the security area is one where most physician practices will need two things:

  1. Awareness of their responsibilities
  2. Assistance with measuring and monitoring privacy & security best practices

Learn more about the NPS Disaster Recovery services and how it can help protect your sensitive healthcare information database.


4. Incentive Programs: Changes Required

Accountable care, Value Based Payment Modifier, CAHPS, MSSP — if it feels as though you’re in a sea of both incentive program acronyms and new programs, it’s because you are!Medical_Incentive.jpg

More and more, your practice will be required to manage incentive programs as a measurement of success — and your financial health will depend upon how well you navigate these waters. More and more, providers will be expected to build an infrastructure that provides better outcomes and quality care, while reducing costs.

And, while it is important to understand what you’re up against when managing provider and staff incentives, it’s a good next step to find an HIT service partner that can help establish workflow and other systems that will keep your practice functioning at a high level of care — the kind of processes these incentive programs are built to reward. An article that links to important resources to help you get started can be found here.

Learn more about the NPS Advisory services and how they can help guide your incentive program strategy by leveraging your information technology resources.


5. Cloud Hosting at the Tipping Point?

About one year ago, 83% of physician practices were using at least some form of hosted IT platform Forbes.com. “Hosted” can be as all-encompassing as “the Cloud,” or as simple as an individual application or data storage platform your practice uses. 

HIT Cloud Hosting
What’s truly important about healthcare hosted services today is that: a) you can expect to use some form of hosting in the very near future (if you are not already), and should begin planning for it; and, b) you should approach it from the standpoint of a partnership with the hosting provider.

You’ll have to be prepared with what questions to ask and how to set proper expectations with everyone in the practice.

Understand that any hosting solution is neither all good nor all bad: HIT comes with inherent risks, whether it’s being managed internally or through a 3rd party. So, know that while the cloud isn’t “the answer” to all your HIT hopes and dreams, it’s also not a tightrope act. It’s not inexpensive, yet it doesn’t have to be a budget-buster. And, while your hosted solutions will most likely include HIPPA-compliant applications and services, not all hosted services will be - nor can be - HIPPA-compliant (such as email, as well as many business and financial functions).

If you haven’t already take the hosted leap, or have just stuck a toe or two into the water, prepare some questions for the providers you’re considering: 

  • Can you customize your solution to meet my specific needs, particularly as they relate to HIPAA?
  • How can you prove that my PHI is safe in your cloud-hosted facility?
  • Are you willing to get involved in the case of an OCR audit? And, to what extent?
  • What is your risk assessment process?
  • How proactive is your support team in identifying and responding to potential problems?

And first and foremost, seek an experienced hosting provider who has a significant level of experience and expertise in the healthcare IT space.

Learn more about the NPS Cloud Suite.


6. Independent Practices Fight Back

A recent report in Becker’s Hospital Review indicated, “A growing trend shows a shift away from traditional mergers and acquisitions toward affiliations, joint ventures and partnerships.”

As hospitals become healthcare centers, and medical centers become regional complexes, the initial thinking is that overhead costs — particularly costs of shared services such as business, payroll, and even some clinical practices, will be driven down as redundant operations are eliminated. That is true, to a point. Yet, as that same study makes clear, the “critical mass” required to support these mega-centers has become an ever-growing target, and profitability remains surprisingly elusive.

More and more, smaller independent practices are seeing the benefit of aligning with other similar-sized practices with a wide range of services, rather than merging into the anonymity of a regional healthcare complex.

More and more, smaller independent practices are seeing the benefit of aligning with other similar-sized practices with a wide range of services, rather than merging into the anonymity of a regional healthcare complex. By doing so, they’re able to offer high-level quality of care at contained costs, with the added benefit of a more patient-centric culture.

One of the chief reasons this is possible is that the quality of healthcare IT can be comparable, regardless of the overall size of the facility. Top-tier clinical services, ICD-10 certified coding and billing operations, and reduced or eliminated costs for in-house IT personnel can all help an independent physician practice stay competitive in cost and quality, while maintaining a provider-patient relationship that means better, more timely patient care.

Learn more about the NPS Advisory services and how they can leverage information technology to help your practice maintain its independence.  


7. The Patient as Consumer

Patients are becoming more actively involved in the clinical and financial decisions related to their healthcare services. There are so many reasons for this shift: patients have easy access to medical information; direct-to-patient advertising for medications, treatments, and care choices; empowering consumer technology; affordable in-home testing and even patient access to medical records. 

All of these changes have sculpted the healthcare landscape in ways that influence how providers will be interacting with patients now and into the foreseeable future. More than ever, patients are active consumers, making choices in their own health management.


Providers and practices will need to be prepared for a more informed and sometimes misinformed consumer. They must be able to answer a more diverse range of questions, offer treatment alternatives and be familiar with the most current treatment plans.  In addition, providers have to incorporate mobile and digital devices as well as patient portals, online appointments, prescriptions, etc. into their daily practice operation.

The physician practice will need to respond with a new “system of engagement,” which is well defined in this recent HIMSS article.

Learn more about the NPS Advisory services and how they can leverage information technology to ease the transition towards a patient-as-consumer, office model.


8. Analytics & Population Health: Get Ready!

Data collection and analysis is fast becoming a tool as essential as the stethoscope - and eventually, as emblematic as an active provider! Both practices and patients will need the benefit of data collection and analysis — population statistics and outcome information — that can help both the provider and patient make the right choices at the right time.

Analytics.gifIn fact, healthcare information, its management, distribution, and analysis, is becoming one of the most critical tools in your healthcare management delivery kit. The question is: will all this data simply overwhelm your practice with empty chatter, or will it provide meaningful information to help you reduce costs, manage outcomes, meet legal and governmental regulations, and improve patient care? Read more about this topic here. Working with an HIT provider that has proven experience in data collection and analytics is no longer a “nice-to-have” practice feature; it is an absolutely-must-have requirement for a practice to stay competitive.

Learn more about how NPS Application Support team can help you turn your healthcare data into useful and actionable information.


9. Wearable Mobile Devices Now a Hot Holiday Gift?

How many of your patients got a FitBit or Apple Watch for a holiday gift? Wearable fitness/healthcare technology was one of the best-selling new personal devices this past year, and Apple’s App Store stats indicate that there was a huge Christmas boom in sales, based on App downloads.


Is your practice prepared to manage the mobile personal device explosion? At this point, integrating 3rd party data from wearable devices into your EHR system is still a challenge, and once the data is available, it may still need to be “translated” into actionable information for a medical practice (does the device provide real data or merely trends, for example?). What are the regulatory and legal implications of accepting such data?

The potential for at-the-moment data tracking, particularly for high-risk patients, is tremendous, but there is a great deal still to learn. Regardless, your practice will need to have the kind of IT support and expertise that will help you make the right transitions, at the right time. Here’s an article that highlights the story mobile devices are starting to tell.

Learn More about how NPS Technical Support services and how they can help manage your wearable device information strategy and information integration.


10. Generation-to-Generation

It’s hardly surprising that younger people tend to be early adopters of new technology. It’s inevitably more difficult to swap out tried-and-true (and long practiced) methodologies for new ones, particularly those that rely heavily on technology.

InvisibleDigital.gifNow add to that trend, the “invisibility” of digital technology. It’s not paper. You can’t file it in a drawer or flip through it before a patient consultation. It’s “out there” somewhere, and it requires you to change your approach to patients, and to clinical and business information.

With increasing government regulations, rapidly changing reimbursement requirements, population health analytics, and many more healthcare information drivers, getting a handle on the latest and greatest technology will be critical for your practice to survive and thrive into the future. Here’s an article that reviews impact the digital generation is having on healthcare delivery.

It stands to reason that the younger members of a practice can be invaluable resources in the evaluation, selection, implementation, and ongoing monitoring of new technology. And with improved, cutting-edge technology coming online routinely, your practice will need to be constantly in the process of scanning the field for technological improvements that can impact patient care, your workflow, and your bottom line.

All the more reason to be partnered with a Healthcare IT provider who can cover all the bases, from the Front Desk, to the Clinical Practice, to the Back Office — so you can focus on patient care.

Learn more about how NPS Advisory services can leverage information technology to work easily with the digital generation.


Plus-1 Physician Compensation: Treading Water

In this case, we didn’t really save the “best for last.” The new healthcare ecosystem is admittedly not as financially advantageous to providers as it has been in the past. ICD-10 promises less per-service reimbursement; incentive programs have proved hard to meet and some are expiring; documentation requirements have sky-rocketed, so providers find themselves spending less time in the exam room and more time on paperwork.Medical_Finance_Stranglehold.jpg

All of this spells increased overhead and longer hours just to maintain a consistent income or see a slight increase for most specialties going into 2016, as highlighted in this industry article.

Our objective is to minimize that pocketbook hit to the extent possible through the intelligent use of Healthcare IT - everything from improved patient care and outcomes to streamlined coding, billing, reimbursement and comprehensive revenue cycle management. And, doing it all as efficiently and effectively as possible.

Let’s face it, Healthcare IT companies will only be as successful as their clients, so we want to ensure the financial success of our valued customers. Together, we can make 2016 a very good year!

Contact NPS to schedule an NPS RCM Services exploratory phone conversation and let us help you get ahead of the financial curve.

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