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The rush to meet the federal government's stage 1 meaningful use guidelines is fueling demand for health IT consulting services to assist healthcare providers in some of the more complex details of their compliance efforts.
The HITECH Act brought about the creation of 62 federally funded regional extension centers nationwide to assist healthcare providers, especially doctor practices, clinics, and smaller hospitals in their conversion from paper-based patient records to digitized systems.
However, when it comes to the more complex, fine print involved with meaningful use, many larger hospitals and integrated health delivery networks are turning to private sector health IT consulting experts for help.
The level of third-party services being sought by large healthcare providers ranges from assistance in deploying and tweaking EHR and computerized physician order entry systems to examining and testing those systems and related processes for potential data security or patient privacy problems.
Under HITECH, penalties for HIPAA-related privacy and security rule violations have stiffened. Just this week, the U.S. Department of Health and Human Services imposed a $4.3 million civil penalty on Cignet Health of Prince George's County, Md., for HIPAA privacy rule violations.
Deloitte is among the IT consulting firms reporting an uptick in demand from healthcare clients for data security and privacy-related help, including risk management and regulation compliance.
"We're seeing tremendous activity -- there are shortages of experienced people for security," Mitch Morris, a principal in Deloitte's health care and life sciences practice, told InformationWeek. There's increasing competition for security expertise among healthcare providers, hospitals, and even software companies involved with e-health records and other HITECH Act-related technology roll-outs, he said.
"Some projects are being slowed up in the implementation process because of a lack of [people] resources" related to security, Morris said while attending the Health Information Management and Systems Society (HIMSS) event in Orlando this week.
Another company seeing strong demand for health IT consulting services is Encore Health Resources, which was launched in 2009 by industry veterans Dana Sellers and Ivo Nelson, who had previously founded health IT services firm HealthLink, which was acquired by IBM in 2005.
In two years, Encore has signed 37 clients, mostly large academic medical centers and integrated health delivery networks, which include Tenet Healthcare, Oschsner Hospital System, Doctors Hospital at Renaissance, and Cedars-Sinai Medical Center in Los Angeles.
Among other services, Encore helps clients meet the nitty-gritty aspects of meaningful use compliance, as well as advise them on the best way to squeeze out maximum value and return on investment in their health IT deployments.
"They know that when the going gets rough, we'll be there," Encore president and CEO Dana Sellers said in an interview with InformationWeek while attending the HIMSS conference.
"You can't just install the systems, you need to understand the process, capture discrete data, get it back out to aggregate, report on it, and use it," she said. "The HITECH Act and healthcare reform is about improving outcomes."
The work involved with meaningful use stage 1 compliance entails pretty specific details, including calculating numerators and denominators related to the various measures that healthcare providers must meet, such as 30% of unique patients having at least one drug on their medication list ordered through CPOE.
"You need 90 days of continuous compliance" when attesting about meaningful use to the Centers of Medicare and Medicaid for HITECH Act incentive payments, Sellers said.
Healthcare providers who think they're meeting the measures sometimes discover that they're not. For instance, upon analysis, one healthcare provider that was exceeding meaningful use guidelines by achieving CPOE use for 40% of patients during the week was surprised to find that CPOE use dropped to 15% on weekends, Sellers said.
In cases like those, sometimes clinical staff not comfortable with using CPOE systems need to get more training or be reminded to scrap the paper orders.
Deloitte also offers assistance to healthcare providers in their meaningful use attestation processes.
"We'll help make sure you get every dollar you think you should get from the meaningful use program," Morris said. "There's a series of documents you have to sign off on" when completing CMS meaningful use attestation, he added.
If healthcare providers mess up their meaningful use program attestation and receive financial rewards they're not entitled to, they could be found out during later CMS audits, Morris said.
If that happens, "CMS won't call it a mistake, they’ll call it fraud," he warned.