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Healthcare Regulatory Compliance to Sway Medical Practitioners from Patient Care?

April 11, 2013



Medical practitioners, whose immediate concern has been quality patient care or clinical excellence, may be swayed away by a compelling healthcare regulatory compliance.  While regulatory compliance may have been designed to rationalize the entire healthcare delivery, optimize medical expenditure, and improve outcomes for patients, it is still quite a task for practitioners, who may not have been tested for the demands of  as wide and far-reaching  a regulatory compliance as the current one.  Along with a temporary impact on patient care, they may have to remain informed and ready with resources as they embark on complying with multi-dimensional healthcare regulatory compliance regimen.

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  • To begin with, practitioners should have already done with the conversion of their clinical and operational documentation from HIPAA 4010 to 5010. Such conversion is achievable only through proper assessment, development, implementation and testing based on individualistic needs of practitioners. Therefore, it is quite natural to expect a temporary impact on clinical excellence or patient care while you are drawn into the entire process of conversion from HIPAA 4010 to 5010.
  • Following this, you have the ensuing ICD-10 compliant coding, which is going to be monumental task given the extent and specificity of coding involved.  It may require careful analysis and system implementation to support ICD-10 coding. While practitioners may be willing to invest in such transformational systems, they certainly cannot avoid a temporary impact on their clinical care during the transition phase.
  • More importantly, Meaningful Use of EHR will increasingly be mandatory for showing up as being responsible to quality care, and eligible to incentives under ARRA scheme. As a result, practitioners will need to avail ONC-ATCB certified EHR interfaces. Here too, along with the possible capital expenditure, you have to contend with a temporary impact on clinical care during the process of EHR implementation.
  • And, under Accountable Care Organization (ACO) model of care, the participating doctors would be required to exchange health information across different systems in order to provide care, track and analyze results. The IT requirement for a successful ACO may include Enterprise Health Information Exchange (HIE) system to defragment data, Business Intelligence and Analytics While such an array of IT utilities can necessitate effective data sharing across the provider group or network, it would surely involve considerable capital outlay and temporary deviation from clinical care.
  • Last,  practitioners would be bound by a more stricter and imposing HIPPA-5010, which allows zero-tolerance as far as patients’ privacy and security while exchanging data across a host of  Data Privacy and Protected Health Information Health Information Exchange (HIE), social media and collaborative technologies. While the Security Rule Compliance approach enables healthcare plans and provider organizations to understand and mitigate the risks associated with the Security Rule, it would certainly involve considerable review of the existing policies and procedures for documenting and exchanging patient-centric data. Here too, medical practices could be drawn away from clinical focus.

In view of clinical or patient care being affected by an imposing healthcare regulatory compliance regimen, medical practitioners may choose to stay put with clinical focus while their regulatory compliance is looked after by competent outsourcing agency. Medicalbillersandcoders.com whose credentials are well-known across the healthcare industry, offers to connect medical practitioners with right professionals for taking over the entire burden of healthcare regulatory compliance.

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Category : ACA / HIPAA / Reforms