MACRA's Impact on EHR

Question: Should I be concerned about how MACRA might impact my Electronic Health Records system?
Answer:  The highly anticipated and oft-maligned MACRA Final Rule is impacting more than just healthcare providers. IT experts believe that the data-reporting requirements imposed by MACRA are going to put added pressure on smaller IT vendors to meet certification requirements. Beginning in 2018, physicians must use EHR technology that is certified for 2015. However, recent studies have shown that more than 75% of the providers participating in the Medicare EHR Incentive Program as of July of this year had 2014-certified edition technology. Therefore, IT vendors will need to adapt quickly and adapt their platforms to ensure 2015 certifications. Experts agree that this requirement is likely to burden small EHR vendors and the practices that employ their EHR. This situation is particularly troublesome for providers who have invested in an EHR that does not acclimate to agile change at scale. While large EHR vendors like Allscripts have announced that they will deploy 2015 versions of their EHR well in advance of the MACRA requirements, vendors are not required by MACRA to update their technology and so physicians will be at their mercy. The practices most at risk are small practices, which already face the toughest challenges from MACRA. The certification rule’s 2015 requirement is likely to disproportionately affect small practices that may have invested in one of the smaller and most cost-effective EHR vendors that have no plans to recertify their technology in time. Practices are urged to contact their EHR vendors to ensure that they will be ready to meet the certification requirements of MACRA in advance of the implementation date to avoid being penalized.

Weekly Charting Tip:

In New York, if you are registered, you may provide a prescription for your patient to receive an acceptable form of medical marijuana if they have one of the following diagnoses: Cancer, HIV Infection or AIDS, ALS, Epilepsy, Inflammatory Bowel Disease, Neuropathy, or Huntington’s Disease.

Here is the catch: You patient MUST have associated or complicating conditions that ONLY include: cachexia (wasting syndrome), severe or chronic pain, severe nausea, seizures, or severe of persistent muscle spasms. CAUTION: It is NOT sufficient to have a diagnosis JUST of severe or chronic pain! It must be associated with one of the listed diagnoses. Additionally, the diagnosis MUST be severe, debilitating or life threatening that is also accompanied by one of the acceptable diagnoses. For example, somebody diagnosed with Basal Cell Carcinoma probably would not qualify. A neuropathy MUST have notations in your chart that specifies how and where the neuropathy is causing severe pain or is debilitating. The nature of the pain? What the patient can do, or no longer do must be charted as well. It is not enough just to list a diagnosis and some symptoms. Go into detail. This is another example of how to avoid a problem; have a complete and accurate chart! - Until next week, Larry Kobak, Esq.

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