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Massive change is on the horizon for your healthcare organization — in fact, it has probably already started.
For years, industry organizations have departmentalized decision making, enabling different functions to make strategic and tactical choices based on individual requirements. Up until recently, different departments could make unilateral selections and work independently to get things accomplished, whether it was making purchasing decisions or finding and hiring talent. While often not best practice for the organization as a whole; better, more unified decision making processes were not yet the norm.
However, today’s healthcare environment is forcing organizations to rethink how they conduct business. Collaborative, multifunctional, over-arching business processes are being put in place to ensure that individual departments and sites are in sync with the greater organizational goals, strategies and policies.
How are decisions being shaped?
Hard and fast deadlines associated with complicated requirements and an expansive amount of patient and healthcare data require that you hire the right people for your roles to ensure that each is working toward the common goal
Recent government legislation, the need for cost containment and aiming toward higher quality care are shaping corporate decision making and forcing organizations to sharpen the saw.
According to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) healthcare organizations must adopt standards for electronically conducting healthcare administrative transactions that protect the privacy and security of medical information.
HIPAA 5010, the updated version of the healthcare transactions standard, presents substantial changes in the content of the data that is submitted with claims as well as the data available to individuals when submitting claims in response to electronic inquiries.
On Jan. 16, 2009, The Department of Health and Human Services (HHS) approved final rules for HIPAA and set a compliance date of Jan. 1, 2012 for the act’s transaction sets. (Small health plans have an additional year to implement HIPAA 5010, with a deadline of Jan. 1, 2013.)
When HHS approved final rules for HIPAA in January 2009, it also adopted the ICD-10 diagnosis and procedure codes. ICD-10 (International Classification of Diseases, 10th edition) is a set of codes used by physicians, hospitals and allied health workers to indicate diagnosis codes for all patient encounters.
ICD-10 specifies a national standard for medical data storage and develops a permanent structure to govern national interoperability standards through a standardized system of codes describing diagnoses developed and maintained by the World Health Organization. ICD-10 differs from its predecessor, ICD-9, in that it contains more than 150,000 codes, five times the number of codes in the ICD-9 set. While implementation of ICD-10 will improve understanding of clinical data and trends, and is important for claims processing to determine the level of service to be billed to insurers, it will also require significant changes to the software, systems and perhaps procedures that are used for billing Medicare and other payers.
The change to the new system is expected to be the most challenging transition since the inception of coding. Healthcare organizations are required to comply with the ICD-10 code sets by October 1, 2013. Based on the deadline, IT vendors suggest healthcare participants begin ICD-10 transition projects by June 2011.
The government has started issuing money to spur investments tied to regulations and technology initiatives it believes will modernize the healthcare industry with social consciousness.
On Feb. 17, 2009, Congress signed the American Recovery and Reinvestment Act (ARRA), a $787 billion measure that allocates $22 billion toward healthcare investments, including $19.2 billion to increase the use of Electronic Health Records (EHR) by physicians and hospitals. Under the EHR portion of the bill titled, Health Information Technology for Economic and Clinical Health Act (HITECH), all healthcare facilities and medical practices need to replace manual handling of written patient records with an automated, online system that connects physicians and hospitals in a vast and secure network.
In essence, the mandate to utilize electronic systems allows all EHR to be shared among different healthcare entities. It creates an environment where interoperability comes into play and various, disparate software solutions and IT systems can easily exchange information.
In addition to driving EHR, HITECH also mandates standards of privacy. It restricts the use and disclosure of data, prohibits selling patient information and introduces new rules on accounting for the disclosure of data.
To help comply with its mandates, the HHS, as directed by the HITECH Act, will issue annual guidelines on effective and appropriate technical safeguards. While the exact timetable for compliance is yet unknown, healthcare organizations will be faced with the task of implementing these guidelines. To begin the required effort, these organizations will need highly skilled healthcare-focused IT professionals. However, according to 2009 HIMSS Analytics, “there are approximately 108,390 IT professionals in healthcare in the US… To move the entire country to Electronic Medical Records (stage 4) will require an additional 40,784 IT professionals and some 12,000 newly evolved clinical / IT roles.” In fact, according to HIMSS in its 21st annual Executive Leadership study, 15 percent of the executives stated that lack of resources will be their top barrier to achieving their IT implementation strategy.
Adding to the likely high demand, low supply scenario, “National Health IT Czar Dr. David Blumenthal recently predicted that the move toward digitized medical record systems could create 50,000 new healthcare IT jobs over the next several years.”1 Healthcare organizations will be faced with finding new recruits for these positions causing 70% of CIOs to have concerns over the availability of skilled IT resources.2 Moreover, companies will be competing with each other for many of the same skill sets.
Healthcare reform legislation was signed into law on March 23, 2010 in the form of the Patient Protection and Affordable Care Act. This massive piece of legislation, with a cost of $940 billion over the next 10 years, impacts nearly every man, woman and child in America. While certain details of the legislation are still being debated, the overall framework is in place and will be phased in over the next eight years.
The bill expands healthcare coverage to 32 million Americans who are currently uninsured and allows dependent children to receive coverage through 26 years of age. It also prohibits insurance companies from denying coverage to individuals with pre-existing conditions. Further, the bill requires states to establish an American Health Benefit Exchange and imposes limitations on flexible spending accounts. Businesses with over 50 employees that do not offer insurance will be assessed an annual fine of $2,000 per employee and there will be a $695 annual fine for individuals who do not purchase insurance.
New legislation requires the healthcare industry to solve new challenges. Projects must be integrated, data must be shared and all the moving pieces must abide by enterprise-wide standards. Such a shift requires more advanced thought — and more strategic support from healthcare services vendors.
To meet this demand, savvy healthcare services organizations will turn to their recruiting vendors looking for partnerships, asking them to take on additional strategic responsibility in meeting the new sets of challenges. But, not all staffing vendors are the same. And, it’s important to find the right vendor, because the cost of delay is too high of a price to pay.
Gone are the days where separate stakeholders are able to make decisions that sit outside the unified strategy of the organization. It is critical that each unit works together to create a set of strategies that enable the organization to function as a cohesive team with overarching goals in mind. It’s a time to come together and understand that everybody has a responsibility in making this happen.
New regulations require that organizations work as they never had before. Hard and fast deadlines associated with complicated requirements and an expansive amount of patient and healthcare data require that you hire the right people for your roles to ensure that each is working toward the common goal. Industry- specific experience is paramount, as the new mandates are complex and overarching.
Working with an IT staffing and services provider that offers sound healthcare specific recruiting, screening and talent management practices can assist you in finding the right candidates to fill your needs. By orchestrating a unified human capital management strategy that includes each department’s requirements, you are able to work with your premier vendor to solve your critical healthcare challenges.
Author: Allen Kriete, Executive Director, Healthcare Services Vertical at TEKsystems
People are at the heart of every successful business initiative. At TEKsystems, we understand people. Every year we deploy over 80,000 IT professionals at 6,000 client sites across North America, Europe and Asia. Our deep insights into IT human capital management enable us to help our clients achieve their business goals – while optimizing their IT workforce strategies. We provide IT staffing solutions, IT talent management expertise and IT services to help our clients plan, build and run their critical business initiatives. Through our range of quality-focused delivery models, we meet our clients where they are, and take them where they want to go, the way they want to get there.
TEKsystems. Our people make IT possible.
1 InformationWeek, October 2009
2 InformationWeek, June 2010