Medicare Compliance & Reimbursement

Texting may improve your practice intake, but make sure it's compliant first.

What the healthcare market continues to suggest is that today's patient doesn't like to wait. From smartphones to tablets to laptops - people are on the move. And if you want to keep patients engaged, you will need to go mobile.

"The next generation of patient engagement uses mobile platforms and applications like instant messaging," stresses John Squire, President and Chief Operating Officer at Amazing Charts. "These technologies better fit the staccato lifestyles of today's patients." He adds, "Patients love the ability to ask questions using short snippets of text and avoiding lengthy turnaround times."

Reminder: New CMS guidance outlines texting between providers (See p. 9), clarifying when and when not to use the communication platform. Among practice staff, texting is ok, but it is never to be used to transmit physician's orders, the agency says. CMS prefers that providers either hand write their orders in patients' medical files or utilize computerized provider order entry (CPOE).

However, messaging remains popular between patients and providers despite the fact that SMS texting is not secure. Many vendors offer HIPAA-compliant messaging programs connected to their EHR offerings with applications that offer technical support and education for staff and business associates.

MACRA measures: Since Medicare payment has been tied to adopting Certified EHR Technology (CEHRT) for a while now, most providers and their partners are already cyber-friendly. Taking the next step to utilize patient strategies that implement texting is inevitable, and that is likely one of the reasons why secure messaging is a reporting option under MACRA's IT component, Advancing Care Information (ACI). See the ACI reporting options at: https://qpp.cms.gov/measures/aci.

Ask yourself these four questions before you send your first text:

1. Are your current and prospective patients ready for messaging to be part of your communication with them? Even older patients are tech savvy today and prefer an interface that allows for quick access to health information, provider updates and services, and easy payment options. So, don't assume they aren't ready just because they are older, experts caution.

2. What are other providers in your geographic area and specialty doing about boosting patient engagement by texting? Look at your revenue across the past year and see where you're losing patients. It could be your technology or the lack thereof. If the internist next door sends his appointment reminders via text but your practice is still on dial-up, it might be time for a revamp.

3. Will the cost of making your practice more mobile and in sync with new technologies be worth it? If you're satisfied with your current level of patient-provider communication and would rather focus on quality measures or other health IT upgrades, that's fine. But if you and your staff run into a lot of problems, glitches, and HIPAA issues - that cost both money and time to fix - it might be time for a new system.

4. Can your EHR vendor offer easy, affordable options that include messaging and education? Texting continues to be the most popular form of communications for patients, experts suggest. Now is the time to integrate these measures into your practice systems. Your vendor may be able to activate the mobile features built into the EHR, making it simpler and cheaper for you to take the plunge.

HIPAA reminder: Before you embark on a complete messaging-system overhaul, consider revisiting the HHS Office for Civil Rights (OCR) guidance and reviewing the HIPAA Security rule, particularly the "Technical Safeguards" section with language devoted to the integrity and transmission of ePHI. The Office of the National Coordinator for Health Information Technology (ONC) also offers advice on how to safely and securely integrate mobility into your office protocols.

Remember: "The growth of innovative technologies can lower the cost of delivering healthcare, and provide for better patient outcomes and patient satisfaction." explains Michael DeFranco, founder and CEO of Lua, a leader in healthcare mobility.

Resources: To review the HIPAA Security rule, visit www.hhs.gov/hipaa/for-professionals/security/laws-regulations/index.html.

To utilize the ONC's mobility guidance, visit www.healthit.gov/providers-professionals/your-mobile-device-and-health-information-privacy-and-security.