MGMA 2011: Monday’s Highlights

Monday, October 24th, 2011
This post was written by Patricia Donovan

The world’s best managers are most productive when they play to their strengths and neutralize and manage around weaknesses, reports Marcus Buckingham, today’s keynote speaker. Buckingham is an independent consultant and author of several books on strengths in the workplace.

It’s a concept physician practice leaders might want to keep in mind when engaging staff in the new technology, care delivery systems and reimbursement models that are part of a value-based healthcare system.

Not surprisingly, the accountable care organization (ACO) delivery model is getting a lot of attention at this year’s conference. “The ACO time frame is short and the learning curve steep for organizations that enter the ACO field late,” notes Deborah Walker Keegan, president of Medical Practice Dimensions, during a session on the structure, operations and financial strategies of ACOs. “The ACO train has left the station.” In the room of about 300 people, only three or four raised their hands to indicate they were already participating in an ACO.

Keegan explained the four flavors of ACOs currently in demonstration or pilot form, setting the stage for Bruce Johnson’s explanation of ACO models available to practices interested in pursuing the model. Johnson, JD, MPA, a partner and shareholder in Polsinelli Shughart, Denver, described the final ACO rule released last week by CMS as “kinder and gentler.”

How to prepare for the ACO experience? Practices should begin to innovate so that they can demonstrate accountable care, recommends Walker Keegan. These innovations should begin with expanding patient access through the use of patient portals, expanding the role of the nurse, anticipating needs, and rejecting the sequential visit as “historical.”

Patient portals are also useful in streamlining workflows in the use of EHRs, notes Ron Anderson, who led a session on optimizing EHR and practice management workflows to improve efficiency and the bottom line. While about half of the room’s participants are already using EHRs, none felt they were optimizing them.

Anderson encourages practices to have all active users involved in analyzing and revamping workflows when the EHR is introduced. “Don’t just ask them for support; demand involvement.”

Staff should be trained on new equipment and programs first, before the physicians, he suggests.

Down the hall, Dr. Farzad Mostashari, National Coordinator for Health Information Technology, answered a range of questions on meaningful use, whether quality measures could be “harmonized” across all federal quality initiatives, health information exchanges (HIE) and patient ID cards.

Inroads have been made on some of the protocols and standards for HIE, but the business case and privacy, security and trust requirements must still be defined, he said.

Down in the Innovation Pavilion, I heard how one DO is using a smartphone app for e-prescribing developed by NaviNet. Leonard Sukienik, DO, Primary Care Solutions, said he uses the app on his iPhone and iPad during the patient visit. Because the app provides a full picture of the patient’s compliance, its use “opens the door to a lot of conversations we as physicians need to start having.”

Far from being upset that they weren’t being handed a paper copy of the prescription, his patients were thrilled that the prescription was sent directly to the pharmacy. (He can still print out a paper copy for the patient, as well as generate “care messaging” tailored to the patient’s needs.)

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