The most recent delay in the ICD-10 transition was due, in part, to issues with vendor readiness. Another delay is extremely unlikely, yet readiness remains a potential issue with some suppliers. In fact, a recent survey from The Workgroup for Electronic Data Interchange (WEDI) revealed that only 40 percent of healthcare providers have “complete” solutions for ICD-10, an improvement of just 15 points compared to 12 months earlier, despite the extra development time. Specialty practices that rely on the remaining 60 percent of vendors whose solutions are not complete for ICD-10 should consider two key questions: How can I gauge whether my vendor will be ready in time? What represents sufficiently “complete” vendor software and services?

As specialty practices become increasingly reliant on information technology, effective “onboarding”—systems training for new hires—is essential to productivity. Unless a new hire has used exactly the same set-up previously, there is an important learning process for each system to be used, whether electronic medical record (EMR), practice management, revenue management or patient engagement. Think about how much everyone in the practice had to learn at initial implementation; each new hire must go through that same process—without the benefit of group learning. Here are six best practices that will improve both the speed and effectiveness of onboarding: Assess the new hire’s computer skills during the hiring process. Don’t assume that everyone needs training only in specific systems. If a new hire worked previously at a primarily paper-based practice, determine whether you need to line up supplemental computer training or have other additional resources available as the start date approaches. Prepare for training in advance of the new hire’s arrival. To ensure that all helpful materials are available from day one, assemble vendor training materials and identify vendor resources appropriate for the new hire’s job function ahead of time. Practices should look for a vendor that provides unique training for each specific job function, ensuring new employees are able to leverage the system in a way that meets their unique workflow needs. Encourage peer-to-peer training. Nobody wants to begin work by pouring through training materials. One-on-one, real-time training from proficient users who perform the same function invites question-and-answer skill building and quicker mastery of specialty and practice specifics. Focus strictly on the new hire’s function. Very few people within any specialty practice need to use every feature of an EMR, for example. Plan onboarding around what the new hire must master to succeed in the assigned role. Set realistic expectations and communicate them clearly. As was the case with initial system implementations, not everyone learns at the same rate. Give a clear indication of the time expected for learning, and invite the new hire to ask for help when specific areas prove challenging.

Going to a user conference, attendees can predict that they will hear from a multitude of company appointed speakers as well as industry thought leaders. The knowledge gained is valuable and expected for someone looking to get a better understanding of the product they are using. Although this aspect of attending a software user conference is of paramount importance, another component not to be minimalized is the opportunity to get insights from fellow EMR and practice management users to help improve your own usability.

While most discussion of the October 1, 2015, transition to ICD-10 focuses on the billing function, ICD-10’s impact will extend significantly to the clinical side of practices as well. Documentation captured in electronic medical records (EMRs) must give coders information that supports the new coding standard if claims are to be accurate and complete. Fortunately, providers have less learning ahead than coders do. And unlike coders, they don’t have to wait until the transition date to begin actually performing in ICD-10 terms. They can, and should, start soon. Clinicians who are not yet familiar with the impact of ICD-10 on their function can read a two-page summary titled “Effects on Clinical Documentation” in the CMS ICD-10 Implementation Guide for Small and Medium Practices. In addition, each practice will want to form a game plan for readying clinicians for the effect the transition will have on its particular specialty.

Physicians increasingly expect the ability to access EMRs on their mobile devices. As we relayed in this space in July, a recent survey found that 100 percent of physician practices that are considering switching EMRs view mobile access as a requirement for their next system.

The differences between ICD-9 and ICD-10 stem from the aims of the newer coding standard. Of particular interest to specialty practices, ICD-10 will much more adequately and accurately describe care and will serve much better for reimbursement purposes, for which ICD-9 was never intended. For ICD-10 to deliver these advantages, it must offer a much larger number of codes. ICD-9’s smaller format restricted its code capacity, which had simply hit its limit. That’s why ICD-9 is being retired on October 1, 2015, in the transition to ICD-10, which affects coding for patients covered by any health insurance, not just Medicare or Medicaid. Specialty practices with insurance reimbursements need to focus only on ICD-10-CM, which is for all diagnosis coding, and can ignore hospital inpatient coding’s ICD-10-PCS.

As more and more physicians adopt an electronic health record (EHR) system, it would seem that the government’s plan to incentivize EHR use is paying off. The question, though, is for who? According to a recent survey conducted by Medical Economics, more than two thirds of today’s physician-operated practices have implemented an EHR into their daily routine but many of them aren’t so sure of its payoff. With that being said, as the industry works to find a systematic way of documenting and managing healthcare, providers are now making the move to switch systems to find the perfect fit for their style of practice. Citing pain points such as less-than-desirable functionality and the lack of preparedness for meeting compliance deadlines, the Medical Economics survey says 67 percent of their nearly 1,000 respondents are dissatisfied with their current system, driving their search for a more suitable solution equipped to meet the daily challenges providers face. So, what should physicians look for to make their replacement vendor better than their current? Here are some points to consider before jumping ship:

Meaningful use holds a catch for specialists; some requirements are inapplicable to certain specialties, yet there are no “blanket” exclusions for which any affected practices can qualify. CMS publishes a specialist tipsheet that helps in identifying which exclusions may apply, but specialist practices are completely responsible for evaluating “whether they meet the exclusion criteria for each applicable objective.” As specialists who participated in meaningful use Stage 1 prepare to advance to Stage 2, there are two important factors to consider regarding the choice of an electronic medical record (EMR) technology partner: The EMR must be ONC-ACB certified for meaningful use Stage 2. The EMR should also ideally be designed specifically to support the practice’s specialty.