The Medicare and Medicaid incentives for adopting Electronic Health Records, or EHRs, have been around for at least half a decade at the time of publication, but many small and rural hospitals have been reluctant to adopt electronic systems, despite the $107,750 maximum payout. The value of adopting EHRs goes far beyond money-back deals from the feds; EHRs are an essential part, but only one part, of hospital management information systems, or HMIS.
As of this writing, HMIS are in such wide use that hospitals behind the HMIS adoption curve are at risk of being acquired by another hospital or hospital chain. A total of 193 such acquisitions and mergers took place in 2013 and 2014. Call hospital consolidation the "Obamacare Effect" if you will -- the Wall Street Journal did in April 2015 -- but by any name, it's today's hospital reality.
Yes, a rural hospital may be breaking even -- breaking even because it didn't install an HMIS, its administrators might think -- but the acquisition trend is leaning away from snapping up failing hospitals and toward "improving operational efficiencies, creating clinically integrated care delivery networks, and accessing sufficient populations for population health management," Healthcare Finance reported in June 2014.
It's challenging to comply with every jot and tittle of the Health Insurance Portability and Accountability Act of 1996, which sets out stringent requirements for patient privacy in electronic records. Even so, a hospital can save money and grief by using an HMIS.
The Centers for Medicare and Medicaid began, in October 2014, to penalize hospitals that have made slow progress in implementing EHRs -- at least, if the hospital has not requested a hardship exception. The penalties affect the rates of reimbursement for Medicare or Medicaid patients' care and are pegged to the first year a hospital fails to make "meaningful progress" in EHR use.
The 11-hospital chain Sentara, of Virginia and North Carolina, had a return on investment of almost $54 million back in 2011 after it committed $237 million over 10 years for an HMIS, according to U.S. News & World Report. More important, the HMIS spared its patients some 180,000 potential medication errors and any lawsuits that could have occurred as a result.
An HMIS allows administrators to check occupancy levels, staff on duty and even patients' outstanding bills with a few keystrokes. With linked records from patient registration to discharge and beyond, an HMIS can save administrators plenty of paperwork headaches. For example, one HMIS company, Chennai, India-based Quintegra Solutions, includes modules in its core software for patient administration, doctor and nurse staffing, wards, surgical theaters, laboratory management, radiology management and "user management." The 14 "supporting modules" range from billing to pharmacy, dialysis and even housekeeping.
An HMIS makes for tailored, precise and speedily compiled accounting reports, which help revenue-parched hospitals. With an HMIS in place, administrators can quickly see which insurers owe how much money for which patients and which patients have yet to pay their bills, speeding the collection process.
Insurance plan quality ratings, heavily based on electronic data, are already a part of Medicare plan choice. Hospitals are on the same path, with hospital management information systems themselves serving as quality indicators. As of this writing, Medicare.gov's "find a hospital" feature cites whether the hospital is "able to receive lab results electronically" and "able to track patients’ lab results, tests, and referrals electronically between visits."