Health IT Pulse

Dec 28 2010   7:45AM GMT

Electronic medical records may help the SSA with claims processing

AnneSteciw Profile: AnneSteciw

electronic health records
National Health Information Network

Health care institutions aren’t the only ones aiming to go digital this year: The Social Security Administration (SSA) has been advised to move the majority of its business transactions online. A technology guidance report by an SSA advisory panel says an electronic self-service model appears to be the only way the agency will be able to process the heavy volume of transactions predicted for the next 20 years.

Interestingly, the panel also recommends that the SSA “lead in developing a Nationwide Health Information Network, Health Information Exchanges, and the adoption of electronic medical records.” Why does the SSA have a vested interest in EMR adoption, health information exchange and the Nationwide Health Information Network (NHIN)? The advisory panel believes that having access to comprehensive electronic medical records will allow the SSA to streamline and expedite the disability claims process.

According to the report, the SSA currently has a backlog of disability claims. Claim denials and appeals require a great deal of study and human judgment, and the process is time-consuming. If the SSA can access all of a claimant’s electronic medical records via the NHIN, this could help ensure that the right decision can be made at the early stages of the disability claims process, resulting in fewer appeals and a shorter overall process. The advisory panel believes the NHIN has great potential for reducing the amount of time needed to process disability claims.

The SSA — which was the first federal agency to use the NHIN — also is experimenting with the use of ¬†personal health records (PHRs). In August, it announced it would test the use of Microsoft’s HealthVault software for assessing disability claims. Because PHRs are maintained by consumers, not health care providers, it’s unclear how the SSA would use these records for claims processing.

The panel predicts that in the future, the majority of consumers will log on to the system using smartphones and other mobile devices. Therefore, the SSA should develop applications that can be accessed by both PCs and mobile devices. The agency must also provide other channels of service for consumers who are unable or unwilling to use the online system.

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  • Jenny Laurello
    SSA has a vested interest in #EMR adoption - Electronic medical records may help the SSA w. claims processing #HealthIT
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  • NHIN Watch
    EMRs may help the #SSA with claims processing | #HealthIT #EHR #NHIN
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  • EHRWatch
    EMRs may help the #SSA with claims processing | #HealthIT #EHR #NHIN
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