The shift in how oncology practices are being reimbursed in caring for cancer patients is demanding more and more of the practices' oncology electronic health record (EHR) systems. This means oncology practices need to evaluate their legacy oncology EHR systems to meet the data demands and reporting requirements of value-based care now and in the future.
In "
The Future of Cancer Care Reimbursement," McKesson's Marcus Neubauer, M.D., describes the attributes of value-based cancer care through the lens of CMS' Oncology Care Model. The participation requirements rely heavily on health information technology (IT). Among them are providing Medicare patients with 24/7 access to clinicians who have 24/7 access to patients' medical records and using data to drive continuous quality improvement in patients' cancer care.
The expanded use of health IT to improve care and align reimbursement based on outcomes also flows through the set of
proposed federal regulations recently published by CMS to implement the Medicare Access and CHIP Reauthorization Act passed by Congress last year. The regulations would require physicians to choose one of two paths to participate in Medicare: the Merit-based Incentive Payment System (MIPS); or, Advanced Alternative Payment Models (APMS). Each path comes with varying levels of demand for health IT.
These examples highlight how Medicare is fundamentally changing the way it pays physicians and the role health IT plays in that transition. Oncology practices need to assess their current oncology EHR systems to ensure it meets the demands of value-based care. The demands fall into four general performance categories, each with a series of items that oncology practices should be asking of their oncology EHR vendors.
Oncology EHR Vendor Checklist
- Does my oncology EHR vendor help my oncology practice deliver high-quality cancer care?
- Provides comprehensive clinical support featuring a continuously updated library of oncology treatment regimens, drug availability and clinical outcomes
- Includes evidence-based clinical guidelines and pathways at the point of care
- Offers up-to-date treatment options integrated with information on treatment costs, insurance coverage and reimbursement data
- Provides advanced data analytics capabilities that generate actionable patient information at the point of care
- Does my oncology EHR vendor increase my oncology practice's ability to collaborate with other stakeholders?
- Enables electronic access or shares all patient information with other clinicians and ancillary services within my oncology practice
- Enables electronic access or shares all patient information with other clinicians, hospitals, ambulatory sites, pharmacies and other providers outside of my oncology practice
- Does my oncology EHR vendor personalize my oncology practice's clinical workflows for individual clinicians?
- Provides 24/7 secure access to up-to-date patient information from any computer or mobile device
- Includes customized patient information on personalized dashboards that reflect my priority and hierarchy of clinical information
- Optimizes the visual appearance of my dashboards for any computer or mobile device
- Is backed by training, implementation and ongoing support services
- Does my oncology EHR vendor help my oncology practice improve regulatory compliance with clinical and financial reporting requirements?
- Incorporates and updates the latest oncology-care quality measures required by public and private payers
- Automates the process of collecting the latest oncology-care quality measures and reporting them electronically to public and private payers
- Includes and updates the latest diagnostic and billing codes for oncology care
- Automates the process of verifying the accuracy of diagnostic and billing codes for compliance purposes
- Meets "meaningful use" requirements and all future payer requirements for EHR capabilities
An oncology practice should make sure that its oncology EHR system passes the above checklist by answering "yes" to each of the 15 items under the four performance categories. Only by checking yes to all of the items will oncology EHR systems enable oncology practices to provide the best care for cancer patients and the best business results as the industry transitions to value-based care models.
Oncology practices will have an opportunity to ask those questions of oncology EHR vendors exhibiting at the upcoming
annual meeting of the American Society of Clinical Oncology. ASCO's annual meeting will be held June 3-7, 2016 at the McCormick Place convention center in Chicago.
Editor's note: Read the KLAS report to learn how your current oncology EHR solution compares
Related: Learn about McKesson's Oncology Electronic Health Record Solution