Shocked Baby

To be fair: this guy’s shock is probably because he lacks object permanence and has nothing to do with electronic records.

On June 3rd (2016), we were lucky enough to get a presentation on telemental health from Jay Ostrowski. You can view the whole thing here (no reg or payment required.) He didn’t just talk about telemental health, though!

Being as close to the machine of change as Jay is, he dropped some pretty big pearls that most of us didn’t know about. I’d like to emphasize a couple of them and do a little interpreting for us all.

1. Jay said: “Mental health pros will probably be added to ‘Meaningful Use'”

You’ve probably heard of “Electronic Health Records,” or “EHR.” Well, to make a long story exceedingly short, EHR is a government-created jargon term for a nationwide network of electronic record systems that can all talk to each other. That’s the long-term goal, at least.

You may have noticed the growing excitement and concern around American health care professionals sending patients’ health records over the Internet more and more frequently. That is, for the most part, from the nationwide EHR system.

Computer Monitor With Text Saying "Health Record"Meaningful Use is the name of a program run by CMS (the Medicare people) wherein they provide monetary incentives and Medicare reimbursement penalties for medical practices who do or don’t adopt certified EHR systems and then “use them in meaningful ways.”

If you’ve ever heard about some kind of legal requirement to use EHR systems (and you’re not in Minnesota), you were most likely hearing about Meaningful Use.

If you need more clarification to get caught up on what Meaningful Use is, check out our article, Electronic Health Records in Mental Health: Are They Required or Otherwise Necessary?

So, Jay said that in the future, there is a good chance that mental health clinicians will be added to the Meaningful Use program. What does that mean for us?

It depends on a lot of things, but there are a few things it could mean:

  • Mental health professionals who are Medicare-eligible will become eligible to get cash payments from CMS if they properly adopt an EHR system in their practices.
  • The same professionals may see penalties in Medicare reimbursement if they don’t adopt EHR systems in their practices.
  • The health care system in this country will generally assume that everyone and her cousin uses interoperating EHR systems (as if they don’t assume that already.) That may add some extra weight to item 2 in this article.
  • Those of us who are not Medicare-eligible will be left behind. That means us professional counselors and marriage and family therapists. Both AAMFT and ACA have big planks in their legislative action platforms to fix our exclusion from Medicare, so make sure you’re supporting those organizations with your membership!

Surprised KidA lot of social workers and psychologists who are reading this right now might tell me that they’re already required to adopt EHR systems for Medicare. They’ll say this is nothing new.

The finer fact is that social workers and psychologists are still not Eligible Professionals in the Meaningful Use program. Those who work with Medicare or Medicaid, however, have to submit quality measures. Often, this is most easily done through EHR systems.

Thus there are places and circumstances where social workers and psychologists find themselves needing to adopt EHR systems for Medicare-related reasons. If social workers and psychologists were to be added to the Meaningful Use program, this would make the onus of adopting EHR easier on them because they would become eligible for cash incentive payments from CMS.

Clinicians from all professions who work in integrated care settings may be using EHR already because their work setting has physicians, nurses, and others who are part of Meaningful Use. Thus the setting’s administrators expect all clinicians to use the same EHR system. In this case, even non-Medicare-eligible professionals may find themselves pushed to use EHR. Once again, the onus of adopting that EHR system could possibly be reduced by Meaningful Use incentive payments. For LPCs/LMHCs and LMFTs, that would first require an act of Congress making us Medicare-eligible.

So, as you can imagine, adding mental health pros to Meaningful Use (besides psychiatrists and psychiatric nurse practitioners, of course — they’re already included in the Meaningful Use program) could have a pretty big impact on our field.

2. Jay said, “In the future, referrals will only come through secure messaging.”

Magic Effervescent EmailsActually, I’ve heard this one before. It was also stated by people who are close to the engine of change, so I think it’s worth taking very seriously.

Jay was referring mostly to referrals from doctors, nurse practitioners, and other medical folks. Most have already started to ditch faxes and are becoming accustomed to using electronic secure messaging systems to send referrals.

As time marches on, the ability to use the secure messaging features of EHR systems will make it even more likely that a medical professional will not want to venture outside of her electronic record system to send a fax or pick up the phone. Even if they have to go visit your website/practice portal to send you documents, they will likely prefer that over fax or phone.

Secure messaging doesn’t have to just be through EHR, though. Even a basic practice management system, that isn’t a certified EHR, can provide other professionals with the ability to send referral documents to you securely. If you’re interested in looking up practice management systems, we recommend the practice management system reviews at Tame Your Practice.

You can also provide potential referrers with secure messaging through a secure email service. You can find some examples of secure email services in our article, Email and HIPAA Compliant Practice: Is It Possible?

I do want to take this moment to remind everyone that even as it becomes more and more difficult to avoid electronic records, you should still take any transitions at your own pace.

Thinker On BenchAlso, if you find yourself still getting referrals and still getting paid despite keeping all paper records, then you may not need to change anything!

Remember what Yoda said: “Difficult to see. Always in motion is the future.” The best we can do is to get a glimpse of what is coming and do our best to prepare in the ways we each need.

We highly recommend watching the recording of Jay’s presentation. It’s free in all ways, and you can buy 1 CE hour for your time spent learning!

View the Webinar Recording Here→
Purchase the Self-Study Course Here→
If you purchased CE credit already, you already own the course! Click here to go directly to the self-study CE course!


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