CMS and OIG Meaningful Use Audits Increase, HIPAA Breaches factor in. What’s your Strategy?

April 27th, 2015

Medicaid and Medicare providers are being subjected to new audits.  If your organization has a HIPAA breach in any year when stimulus funds for EHR were received, or are to be received, these must be remediated to be eligible for the stimulus funds.  New regulations as of 2014 require providers who have a HIPAA breach to state whether the breach caused harm.

If your hospital is notified by CMS that is auditing your organization for you Meaningful Use (MU) attestation you will need a clear action plan and the advice of experienced people who have led MU audit defense work.  An adverse audit decision can be overturned.  You can avoid having to return potentially millions in 2011, 2012 or 2013 EHR Incentive Payments. We recommend that your facility file an appeal using specific guidelines that have worked for other health care providers.



Mobile, Analytics, Cloud, Value-Based Care, Social Dominate News at HIMSS15

April 21st, 2015
HIMSS 2015

HIMSS 2015 featured The Internet of Things for Health™, the Intelligent Hospital, the Intelligent Medical Home (i-Home™) as well as mobile, cloud, social, analytics, population health and value based care.

Record attendance at HIMSS 2015 in Chicago – over 43,000 people.  Now that HIMSS15 is over, take a look at some of the trends that dominated the headlines, the social buzz and the chatter at after show cocktail parties.

Of course, there were the overarching themes of interoperability, and population health, but there were some key themes that received the most attention. Here are the five areas that stood out:

  1. Value based care and population health mergers and acquisitions
  2. mHealth – HIMSS 2015 mobile health survey and ROI issues as well as HIPAA Privacy and Security.
  3. Emerging technologies focused on referrals, eligibility and personal health engagement / patient engagement.
  4. SMAC – Social Mobile Analytics and Cloud, including ICD-10
  5. While there is work being done to break down the data and process silos in healthcare, much more work needs to be accomplished to realize the promise of these solutions.

The health care industry continues to rely on X12 EDI claims data because it is standardized.  Though clinical data is increasingly structured (‘discrete data’ per Meaningful Use of EHR regulations) it is not standardized as to specific content such as blood pressure (systole and diastole can be expressed as 120 / 80, “blood pressure in normal range” etc). Therefore, it can still be difficult at times to query and manage populations using clinical data.  It’s needed though if we are going to deliver on the promise of value based care and  population health.

Read the full story here in GovHealthIT.

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