The Growing Importance of I.T. in Addiction Treatment
For many addiction treatment center owners, the mere mention of the word “technology” is enough to make you shudder. It immediately conjures up images of increased costs, added headaches and the mysterious unknown of just how much it will actually help your operations.
Yet, deep down inside, you know that you need it, and that your business will benefit tremendously once it’s successfully implemented. The entire process reminds me of someone who desperately needs to hire an assistant, but is far too busy to actually take the time to conduct interviews. He or she hems, haws and fights his/her way through to finally getting it done, only to find themselves relieved and abundantly more efficient once they finally do. Often, they’ll find themselves wishing they’d taken the time to complete the hire much sooner.
However, your initial reticence is nonetheless genuine and well-placed. Just like hiring the correct assistant, selecting the right technology can be an intimidating — yet necessary and ultimately rewarding decision.
Naturally, you probably have a lot of pressing questions.
What kind of technology do I need?
How much will it cost me?
How quickly can my staff be trained to take full advantage of the new software or application?
These are only but some of the many daunting questions, particularly for many of the smaller owner-operators that serve as the backbone of our industry.
Most of you founded your facilities with the simple desire of helping individuals re-gain their sobriety. However, the evolving landscape of addiction treatment is mandating all of us to take on the trappings of additional technology in order to perform our primary purpose. There are numerous existing reasons, and an ever-growing avalanche of new ones, which make it clear that more highly specific integration of technology will become the norm in operating addiction treatment and care facilities, regardless of scale.
The Concept of Doctor-Patient Privilege Is Almost As Old As The Hippocratic Oath Itself
Protection of patient information took on a rigorous scope with the passage of the Health Insurance Portability and Accountability Act (HIPAA) in 1996. That law made it illegal to share personally identifiable health care information without the specific consent of the patient (for good reasons). HIPAA also interestingly mandated the creation of unique national patient identifiers (NPIs), a move that could have greatly facilitated patient matching needed for safe nationwide interoperability.
However, two years later, Congress de-funded the creation of NPIs because of privacy concerns.Thus in 1996, operating addiction treatment centers became more onerous, but still manageable, for most small and large operators around the country.
The absence of interoperability (the ability of EMRs to share patient information with each other) in health care places a significant added burden on both the patients and health care facilities. Up until recently, most of that data was transported manually, via printed pages, faxed records, radiography films, data disks, and the like. Moreover, many medical facilities typically engage in “data-hoarding,” making it difficult for patients to change treatment locations because of the hassle involved in actually making the move.
That is all slowly starting to evolve. The latest trends involve greater use of secure cloud computing, making it easier to safely and securely share critical information — but fearful reluctance still persists because of the material liability associated with even the inadvertent and innocent release of private patient information.
One of the key reasons medical facilities began to relent is the active involvement of insurance companies. Insurance is essential for a successful medical industry, which could not finance its operations otherwise, but has proven to be a double-edged sword, with expanding rules, regulations and paperwork required to substantiate patient care. There is significant push-back on reimbursements if documentation does not meet their rigid guidelines.
Treatment centers have therefore been overwhelmed by “I.T. creep” in their organizations, necessary to comply and sustain the lifeline of insurance payments. It’s an ongoing arms race of sorts, requiring constant augmentation and forcing management into difficult decisions between whether it’s best to outsource these functions or continue to handle them in-house.
The Next Great Change in Addiction Treatment Technology
The next great change facing our industry looms large on the horizon, with the proposed elimination of the Fee For Service (“FFS”) model which has been the under-pinning of modern day medicine for over a century.
The concept is simple: the more services, the more fees. However, The Centers for Medicare and Medicaid Services plans to begin phasing out this model starting in 2018 and many insurance providers have made announcements that they too will follow suit. Instead, FFS will slowly be replaced with a success-focused model, tying payments to healthcare outcomes.
This will be particularly challenging for our industry, in which a high level of patient relapse is an unfortunate reality on the addicts’ roads to recovery. This will be implemented over several years period and will rely heavily on documentation, and consequently, the increased need of technology designed to ensure full compliance for reimbursements.
Moreover, we cannot ignore the recent presidential election and the forces of uncertainty it has unleashed. President Trump comes from a results-oriented business background, and I believe we can expect that sentiment to permeate whatever changes might be implemented with respect to the Affordable Care Act, whether it’s just modified or repealed-and-replaced.
We can take a modicum of relief from the fact that early indications point to the continued mandatory inclusion of people with pre-existing conditions. However, much still remains to be revealed. Regardless, it seems inevitable that whatever the final format, increased use of technology for the sake of efficiency is a given and will be a common theme.
One key indicator in considering our future, is a look back at our recent past. Within the last few years, the US government has spent in excess of $27 billion on Health Care I.T. for the purpose of creating a digital health care system. According to the Surescripts 2015 National Progress Report, e-prescriptions have increased 300% since 2010. In California, nearly 75% of all pharmacies are setup to receive e-prescriptions. This should have a material impact on the over-prescription of Opioids.
The expanded use of e-signatures, storing patient files in the “cloud,” electronic appointment scheduling (the use of which the healthcare industry was inexplicably one of the last to adopt), and many other innovations have brought down costs considerably as they’ve become more prevalent. The incredible wave of efficiency that it brings to your addiction treatment center can have a major impact, and is typically very cost effective at the end of the day. Therefore, it is probably about time you took a serious look at your organization and consider whether or not you’re taking full advantage of what the current environment has to offer.
A well placed investment could pay tremendous dividends and aid in all aspects of your treatment center operations.
As always, I’d love to hear your thoughts. I invite you to reach out to discuss the issues I’ve raised and I will assist you in any way I can.