Friday, December 26, 2008

MMIS, HIPAA, medical records automation ought to generate jobs during new administration: but seekers are hitting moving targets


Today, I made a posting about the grim financial condition of Medicaid in many states, given the crisis, and I wondered about how Medicaid MMIS jobs are doing now.

From 2002 to 2004 I got calls about MMIS jobs in many states, but never qualified because in most cases the individual states required five years MMIS experience, even though the hiring was done by private contractors (in one case, the contractor was Verizon). I had 19 months of MMIS with Bradford National in New York before deciding to move to Dallas in 1979, and MMIS has certainly changed a lot since then. I had worked on MARS (not the planet; it stood for “Management and Reporting Subsystem” and comprised about 40 reports, many having to do with federal reimbursements, which were politically controversial even then, especially for nursing homes). Another subsystem was SURS, or Surveillance and Utilization Review. When I went on to Dallas and worked for CABCO, the Blue Cross and Blue Shield consortium, I worked on designing a unified SUR-like system, but the turf-oriented plans didn’t want that kind of “solidarity.”

Here is a jobs board for MMIS openings, and state plans have also moved into the C and Unix area, it looks like (here is link),

Another growth area for health care IT jobs has to be fine-tuning HIPAA (the Health Insurance Portability and Accountability Act), which will certainly have to happen under the new Obama administration.

But the biggest plum for jobs has to be complete automation of medical records, which is certainly complicated by HIPAA. Even in my own experience, particularly with Medicare, I see enormous waste from the fact that physicians cannot easily get accurate records on prescriptions or easily get access to cat scans or MRI’s ordered by other specialists, without a lot of mail or fax transfers of paperwork or (sometimes) digital CD’s. Scheduling of appointments, while often outsources, has become inefficient and the referral of patients to the appropriate specialist is often difficult. Integration of medical records would save 20% of the cost of Medicare by eliminating unnecessary or redundant care. I don’t understand why we haven’t done this.

One problem is matching the job skills to the need. Staffing firms are met with rigid requirements in years of experience with specific skills – often making frequently past job-hopping a negative factor now for applicants – but complicating the hiring process and being able to staff projects that require real innovation, as automation of medical records surely will.

This is another problem for the new administration to ponder, after the outright negligence of the previous one. Job seekers may have a hard time figuring out the best strategies in the mean time.

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