Archive for October, 2009
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2 EHRs and the Future of Healthcare Quality Standards
Oct 31, 2009. Today.Is a system-wide electronic health record system a new demand to attain high-quality healthcare delivery? It might very well be.
A new study conducted by Thomson Reuters and published in Modern Healthcare announced its latest Top 10 ranking healthcare systems. Interestingly, each of these systems shared three factors in attaining higher-quality outcomes:
1) A corporate-level coordinating committee;
2) Involvement in planning from front-line caregivers; and
3) A system-wide electronic health record system (EHR).
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4 What to Expect from an EMR System
Oct 30, 2009. Insight.Maintaining and storing of paper records is a big hassle. However, it can be made a simple and easy task through a separate electronic storage designed for this particular purpose. Unfortunately, many practices find the cost of an EMR system to be prohibitive and a number of physicians think they will not be able to profit from this typically significant investment.
Practices still using the traditional methods such as maintaining paper records have to struggle with managing space in their administrative office. Additinally, storing all data offsite can cost you a lot of money and waste precious time that can be used more productively. The good news is that technology like Electronic Medical Records (EMRs) are available to put an end to all your storage and paper clutter problems.
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1 Healthcare Consumers: Taking on the Clipboard Nation with PHR Technology
Oct 30, 2009. Health Information Technology, News, PHR.“If everything seems under control, you’re just not going fast enough.” – Mario Andretti
Are you going fast enough to catch up in the field of health IT? If clinical medicine putters to adopt health IT, consumers might very well independently surpass it with widespread adoption of personal health records (PHR).
A recent movement for consumer-directed PHR adoption was spearheaded by Howard University in Washington D.C. They encouraged hundreds of patients living with diabetes in the Washington area to adopt an online personal health record (PHR) from NoMoreClipboard.com. The results of this movement have been quite positive, showing consumers are actively using their PHRs to communicate with doctors and manage their diabetes.
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3 EHR and Privacy: an Entitlement or Absolute Prerequisite?
Oct 29, 2009. Health Information Technology, Insight.“Privacy is not something that I’m merely entitled to,
it’s an absolute prerequisite.” -Marlon Brando
Marlon Brando might be on to something here. Is privacy an entitlement or “absolute prerequisite?” In the case of EHR technology, this is certainly a hot topic.
While we know EHRs can improve patient quality of care/safety and reduce healthcare expenditures, questions remain on how to manage and prioritize patient’s privacy in the digitized world. In addition, there is intense debate on exactly what defines a significant breach in privacy to which patients should be notified.
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2 E-Prescribing in Rhode Island: Connecting Public Health and Clinical Medicine
Oct 28, 2009. ePrescribing.Public health and clinical medicine have different models of care. While little similarities exist between them, health IT may finally present a common thread.
The core principles of public health are focused on preventing and reducing the burden of disease on communities or entire populations. Public health is concerned with health and wellness; prevention of disease; reduction of morbidity and mortality; and identifying and isolating health threats to populations.
The most recent example of public health in action is the identification, control and prevention of the H1N1 (“Swine Flu”) pandemic. Public health professionals must identify and track each case of H1N1 to first, determine how the disease is spreading; second, ascertain how to isolate it; and third, strategize the development and deployment of a vaccine.
Clinical medicine is more concerned with individual health. A physician might receive a rationed number of H1N1 vaccines and disperse the vaccine as a prevention strategy to high-risk patients. Most of clinical medicine is focused on diagnosing and treating disease. If a patient presents to the physician with symptoms of H1N1, they do the blood testing to confirm the diagnosis, and if the results are positive, provide drug therapy to treat the H1N1 virus.
As you can see, it takes both public health professionals and clinical medicine practitioners to both PREVENT and TREAT disease. But because they have different models of care, it’s sometimes difficult for the two disciplines to play nicely together. However, looking at a case study of Rhode Island’s health IT developments, it seems technology in e-prescribing has brought them into accord.
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3 Getting the Best System for Your Practice Using Effective EMR Reviews
Oct 28, 2009. Today.The way health care technology has integrated into people’s lives is simply amazing. It has made the world a more convenient, if not better, place to live. More and more physicians and healthcare providers are becoming more open to the idea of implementing a comprehensive EMR or Electronic Medical Record system to help them with their practice. A large number of practices making their choice through end-user EMR reviews, forums and product updates.
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1 Consumer Involvement in Health IT Development
Oct 27, 2009. Health Information Technology.“Make a habit of two things: to help; or at least to do no harm.” – Hippocrates
Why do I bring up Hippocrates? Well, I believe the “father of medicine” would have an opinion on how Health IT could impact the patient, as it may influence the covenant of the Hippocratic Oath. Most discussion about adopting EHR technology is focused on the ROI for the physician or medical practice. While this is a justifiable priority, one may also consider how Health IT could affect the patient, their responsibilities, and the traditional patient/provider relationship.
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2 Health IT and the Dreaded Word: Change
Oct 26, 2009. Health Information Technology.It’s my first day at EHR Scope, and posting on this blog will be one of my routine activities. I have a graduate degree in Health Communications, but surprisingly feel somewhat left behind in this rapidly growing health IT industry. That being said, I might have a lot in common with you, the physician, administrator, health care professional, or lay person knowledgeable about health IT, but in a tailspin trying to keep up with the quickly changing information available. I invite you to join me on this blog, as I deeply explore the evolution of health IT and its most newsworthy changes.
Today, I’d like to discuss one of the major barriers to the adoption of EHR technology in the medical office: Change.
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0 Scanning Options for Patient Charts
Oct 13, 2009. Companies in Action, Implementation, Insight, Spotlight.Once a medical practice has implemented an Electronic Medical Record system or Practice Management system it becomes very easy to manage new patients. The new challenge is how to efficiently and cost-effectively migrate important paper chart information into this new system.
The fastest way is to use a scanning services company to setup on-site, image, link to patient database, and import into the implemented EMR system. The Optiscan ChartWorx system has been created for this purpose. This option is also cost-effective when considering projected paper chart handling and storage. Check out our presentation for more details.
Regards,
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Michael Hawkins
Business Development
Optiscan Inc.
http://www.optiscan.net
B: 602-789-7800
C: 602-882-3364 -
4 Hints and Tips for Medicare Billing
Oct 13, 2009. Today.We recently attended the annual meeting for the Carolinas Medical Directors Association in Charlotte, NC. One of the sessions focused on the challenges of billing for Medicare according to requirements set by the Centers for Medicare and Medicaid Services (CMS). Producing compliant notes and selecting the correct evaluation and management (E&M) code is a problem that vexes many practices today. Although the presentation was focused on the long term care environment, the information here should apply to most practices. We will focus on three main components: medical necessity, documentation requirements, and patient complexity.
Medical necessity is the most basic and important criteria. Each note should contain a rational, medical explanation for why you are seeing the patient. This is most often documented under the chief complaint. Physicians should be careful to use active verbiage in their notes. For instance, physicians should avoid using “reviewed” in favor of “assess,” and substitute “patient continues to exhibit…” instead of “stable.” Determine, measure, evaluate, verify, and examine are examples of good words to use. Use active voice in your notes instead of passive. For example, instead of saying “was reviewed,” state “I am instructing the nurse to measure.” The entire note should show the medical necessity of your visit and support the chief complaint.
In addition to medical necessity, CMS requires a certain amount of documentation for each E&M code. Generally speaking, higher levels require more documentation. Chief complaint is required for every level. Your note should have sections for history of present illness (HPI); past family and social history; physical exam and review of systems; and medical decision making. For example, an expanded level of coding generally requires at least four areas of HPI. Including information for each of these required areas can help you bill higher levels. If you are audited, CMS will look for each of these categories in your note.
Patient complexity is determined by risk and medical decision making. The more complex your patient is, the higher you can generally bill. For instance, if your patient suffers from an ingrown toenail, you won’t be able to code very high. On the other hand, if your patient has “one or more chronic illnesses with sever exacerbation or progression,” then you will qualify for a higher level. Also be sure to document work you do, such as reviewing or ordering lab tests, obtaining old records, etc. It can have a substantial impact on your coding and compliance.
Purchasing an electronic medical record (EMR) will help you code correctly and produce compliant documentation. Hand-written or dictated notes are often incomplete or illegible, but an EMR can help you fill out required information and pass an audit. In addition, an EMR can help you capture previously undocumented work you already perform. As a result, you can usually code at a higher level, leading to better reimbursements. If you are still using paper, now is the time to switch to EMR.
If you would like to test your coding knowledge, take our short quiz.
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Ryan Ricks Security Officer
