Tara Vail

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In 2009, hospitals and doctors were given financial incentives to adopt electronic health records (EHRs) through the Health Information Technology for Economic and Clinical Health (HITECH) Act. Ambulatory surgery centers (ASCs) were not eligible for these funds, and were therefore not incentivized like the rest of the healthcare system to implement the technology. The consequence of that differentiation is that the majority of ASCs are still charting on paper, even while the rest of the health system has moved to digital records.

As the health system continues to evolve and grow their managed care networks, hospitals and health systems are 

 into the ASC industry as a solution for cost-effectiveness, capacity, and better patient outcomes. EHR adoption is essential for ASCs to be seen as attractive partners in the managed health care space, with the ability to manage and share accurate data and in a secure and timely way, and to share and benchmark data on patient health outcomes.

Here’s four reasons why it’s absolutely essential for ASCs to adopt EHRs to remain relevant and competitive in the managed care environment:

ASCs Need EHRs to Be Ready to Handle Increased Case Volume

 
The mindset needs to change within ASCs and reset expectations for staff that are still used to working with paper - EHRs should be viewed as an attractive way to improve workflow. Many outpatient surgery cases can be done safely outside of a hospital and are much more cost effective for patients and payers. 

Advances in technology allow for more minimally invasive procedures, while advances in pain management have allowed patients to be treated effectively but sent home the same day to recover safely and comfortably in their own home. Payers are recognizing this benefit, as ASCs are often reimbursed at a much lower rate than it would cost for an inpatient procedure. Because of this, Medicare is expanding the number of procedures each year that are approved for an ASC setting. 

Some payers, such as 

 are taking a more active role in pushing eligible cases into the ASC setting. EHRs and the right practice management software solutions allow ASC staff to avoid the risks of manual data entry and paper records management. With EHR systems in place, ASC staff can move faster and also have improved ability to track and understand case costing data, optimize scheduling, and conduct benchmarking.

 
Tracking quality metrics and reporting to federal and state regulators becomes significantly less burdensome with EHRs, making it easier to avoid common pitfalls that can occur with manual entry. Data management becomes more consistent and streamlined, which also helps improve patient care, and can also help ASCs to remain compliant with changing regulations. A good data platform will allow technology to flow through the patient care process and not get in the way.

EHRs Are a Key Component in Interoperability.

 
As ASCs move toward integrating or aligning with other health system entities, or contracting with managed care plan networks, the use of an EHR system is critical. ASCs are structured differently than hospitals, so in any interoperability consideration, systems will need to integrate with the hospital's system rather than convert 

 the hospital system. 

Furthermore, as new applications provide Artificial Intelligence capabilities for the healthcare setting, ASCs should be poised to benefit from this. AI features will unleash a host of patient safety and information analysis benefits that improve health outcomes and improve efficiencies.

Fax Machines are Out, Online Technology in Healthcare is Here to Stay.

 Many ASCs are used to doing business a certain way and the idea of changing from paper to electronic can seem overwhelming when it’s completely new. However, many of the newer, younger nurses and physicians coming into the ASC setting are already trained in using EHRs, and are often shocked when they see ASCs still using paper charting. 

It’s standard practice in most medical schools now to train students to be familiar with EHR use, so the main challenge lies with modernizing staff that have been used to doing things in a way that is now outdated for the rest of the health system. Fortunately, ASCs are organized to be more efficient and nimble. While moving to an EHR can seem daunting for ASCs that are used to conducting their business in a certain way, a good vendor will provide options for implementing solutions that flow through, rather than completely halt, business operations.

Selecting technology that is scalable, adaptable, and designed to meet the needs presented by an ever changing healthcare landscape is a necessity when it comes to meeting modern expectations from patients, physicians, and payers. By taking steps now to modernize technology, ASCs can ensure they remain competitive, sustainable, and in compliance with health system requirements, while ultimately benefiting their true bottom line -- patients.

is Chief Growth Officer at HST Pathways, a leading provider of end-to-end technology solutions in the ASC setting. She has deep expertise in helping healthcare organizations leverage information technology to improve operational efficiency and optimize revenue cycle management.

Articles

To remain relevant in managed care, adoption of EHRs are crucial for outpatient surgery. Included are four reasons it's essential for surgery centers to adopt.

Electronic Health Record Adoption is Essential for Outpatient Surgery 

World Congress 2019 Care Coordination & Technology Congress

 earlier this year Richard Wild, MD, JD, chief medical officer of CMS noted that using digital technology to better coordinate patient care can help to save money and deliver more efficient care.

One of the healthcare stakeholder groups that has embraced digitization is the ambulatory surgery center (ASC) industry. ASCs are increasingly attractive choices for managed care as a means of ensuring high-quality, efficient outpatient surgical care. In 2005, 59% of outpatient surgeries were performed in hospital outpatient settings and 41% in ASCs; by 2020, that number is 

 to be reversed, with only 40% of outpatient surgeries performed in hospital settings. Research shows that patients at ASCs are 

 to seek emergency room or hospital inpatient care after a procedure, and the ASC 

To ensure that the gains resulting from ASC technology are sustainable and yield meaningful benefits for managed care organizations, ASCs with business acumen are taking deliberate steps to train staff on using electronic systems correctly and consistently.

Today, most ASCs function as sophisticated, technologically complex health organizations, using electronic practice management software solutions. Though there’s a significant gap compared to large health systems, the ASC industry is also moving toward greater adoption of fully integrated electronic health records (EHRs). Advancements in technology have led to great improvements for ASCs in terms of timely and accurate billing and collection. Technology has subsequently benefitted the managed care provider organizations in terms of cleaner claims, identification of gaps in care or areas of improvement, and comprehensive cost data to demonstrate savings.

With most technology-related challenges, the primary barrier to smooth adoption is confusion about functionality. Managed care organizations working with ASCs must take the time to prioritize staff education and training. The Office of the National Coordinator for Health Information Technology (ONC) offers 

 for office staff and clinicians on EHRs, including using vendor training to develop an internal core group of “super users’- staff who can navigate EHRs quickly and support other internal staff and clinicians.

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However, ASCs should also establish a regular pattern of training and updates for other users in order to maximize IT benefits. To ensure that health IT is not underutilized or abandoned, ASCs should revisit user roles on a regular basis. Rather than constantly shopping around for new IT resources, it is recommended that ASCs focus on training to ensure that staff understand how to use existing platforms effectively. This is especially important as clinical personnel are promoted or change roles. As a best practice, user role assignments should be reviewed at least quarterly and “as needed” when there are personnel changes. Even when lateral moves occur, such as a nurse moving from pre-op to post-op, user roles should be reviewed and updated.

ASCs should use software systems that demonstrate cost-savings. Research already demonstrates that ASCs can be up to 

 than hospitals, so creating incentives for  patients to have their  procedure done in the most appropriate setting-ASC or hospital-is critical to ensuring that the managed care system works as intended.  

Safe and secure cloud-based platforms also help ASCs safeguard personal health information, prevent avoidable data breaches, and comply with privacy regulations-critical considering recent healthcare breaches. Using cloud-based technology over traditional servers can also ensure data is still available in the result of a disaster such as flooding or earthquakes, which can knock out decades worth of healthcare information if these modes of storing data are not properly backed up.

By prioritizing IT standardization and software systems that align incentives at contracted ASCs, managed care organizations can benefit from the market shift to outpatient surgery centers in the form of better patient outcomes, effective onboarding in the event of staff turnover, and ultimately, cost savings.

Tara Vail, MBA, is the chief operating officer of HST ASC Software, the top-ranked software solutions company for the ASC industry. She has deep expertise in helping healthcare organizations leverage information technology to improve operational efficiency and optimize revenue cycle management.

Ambulatory surgery centers can aid managed care in closing gaps in services, smooth adoption, and coordinate training.

Tara Vail

Articles

Electronic Health Record Adoption is Essential for Outpatient Surgery

The Role of Ambulatory Surgery Centers