Legal
CareCloud is an Internet-based EHR system, which implies that “the physician does not store the EHR data on his/her servers, but rather the vendor stores the data on the internet (in the clouds)” (Neal, 2011, p. 44). Based on this, the major legal concern associated with the system use is the ownership of data. As a software as a service provider, CareCloud is liable for controlling and storing the outsourced patient data throughout the contract period without compromising hospitals’ access to essential information. At the same time, the vendor complies with legal regulations by ensuring practitioners’ total ownership of patient data.
Privacy and Confidentiality
Since CareCloud use implies access to almost a limitless amount of data in a commercial cloud by both healthcare providers and third parties, it raises some privacy and confidentiality issues. However, the cloud-based EHR is associated with a similar level of data security as regular storing systems and strives to ensure a high level of privacy and confidentiality for its customers and to minimize the incidence of adverse events through several security measures: development of secure transmission protocols (e.g., PCoIP), integration of access control lists and digital signatures, and so on. Additionally, to maintain a high level of data privacy, the vendor utilizes standardized encryption algorithms.
Performance Measures
The practice management tool incorporated into the software can help hospitals gather accurate analytical information. For instance, the program allows identifying such key performance indicators (KPIs) as “median days gross fee-for-service charges in accounts receivable,” “median total operating cost per FTE physician,” “median total operating cost as a percent of total medical revenue,” and so on (CareCloud, n.d.a, para. 1).
KPIs can be used by hospitals to improve outcomes in many areas of performance including patient experiences. According to McCance, Hastings, and Dowler (2015), the measurement of patient- and employee-centered KPIs, namely, patient satisfaction, staff learning and growth, clinical performance, and so on, can be effectively used in the improvement of care and overall organizational environment and structure. CareCloud allows hospitals to choose performance indicators by their specific needs and retrieve data reports as frequently as possible.
Core Measures
When choosing the type of data to report and analyze, one may select various core sets related to particular morbidity and mortality indicators. Hospitals may identify those measures based on population and patient characteristics (e.g., adult or pediatric, etc.) and considering both organizational financial and care priorities, as well as national public health issues and policies. For instance, some of the recommended core measures for children and adolescents are immunization status, nutrition counseling, and weight assessment, preventive screening for mental disorders, use of asthma medications, and so on.
Quality Measures
Along with the mentioned core measures, clinical quality measures may help hospitals integrating CareCloud track the effectiveness of care and dynamics of service improvement over time. Some quality measures include “health outcomes, clinical processes, patient safety, efficient use of healthcare resources, care coordination, patient engagement, population and public health, and adherence to clinical guidelines” (CareCloud, n.d.b, para. 1).
Recording of the given measures is aligned with the Merit-Based Incentive Payment System (MIPS), which is part of the Quality Payment Program (QPP) intended to reward practitioners according to the quality of for rendered service. As Rosenkrantz, Nicola, Allen, Hughes, and Hirsch (2017) state, “for the MIPS program to achieve its intended impact of improving the quality of care, it is important for the measures to reflect the actual work of the physicians under evaluation” (p. 318). Therefore, a set of specialty-relevant quality measures should be identified for every practitioner individually.
CMS Reporting
CareCloud provides hospitals with an opportunity to fulfill the Centers for Medicare & Medicaid Services (CMS) reporting requirements, which promote meaningful use of EHR systems, i.e., with the purpose of quality improvement. To be qualified for CMS check cuts and show meaningful use, practitioners should report a minimum of 9 out of all 64 clinical quality measures falling under at least 3 out of 6 healthcare policy areas such as clinical effectiveness, public health, patient engagement, and so on (CareCloud, n.d.b). CareCloud interface and properties significantly facilitate the reporting process by including a Meaningful Use reporting feature.
Reporting Capabilities
CareCloud has multiple operational features including workflow management tools (e.g., ePrescribing), charting, reusable datasets and templates, comprehensive patient summaries, and so on. The functions of all the instruments are integrated and backed by a clinical decision making support system, which provides real-time hints regarding various practice issues such as medication prescription. Additionally, a smart analytics system helps monitor business results and intervene in performance to make it more effective and efficient. The CareCloud Advanced Analytics system integrates financial and clinical data and presents it in an accessible and readable way.
The tool is characterized by a high level of flexibility: it allows customization of the analytical process by adding and removing various filters and indicators. The analyses conducted via the software can be plotted and compared with deviation values established by the hospital and, in this way, may help recognize performance warnings and take appropriate actions towards improvement.
References
CareCloud. (n.d.a). Key performance indicators: Do you know yours? Web.
CareCloud. (n.d.b). What are clinical quality measures? Web.
McCance, T., Hastings, J., & Dowler, H. (2015). Evaluating the use of key performance indicators to evidence the patient experience. Journal of Clinical Nursing, 24(21-22), 3084-3094.
Neal, D. (2011). Choosing an electronic health records system: Professional liability considerations. Innovations in Clinical Neuroscience, 8(6), 43–45.
Rosenkrantz, A. B., Nicola, G. N., Allen, B., Hughes, D. R., & Hirsch, J. A. (2017). MACRA, MIPS, and the new Medicare Quality Payment Program: An update for radiologists. Journal of the American College of Radiology, 14(3), 316-323.