Five Common Gaffes of Healthcare Providers in an EHR selection

March 5, 2014 by Ango Mark Leave a Comment

Hunting for a right EHR?

Partnering a vendor for your electronic medical/ health record (EMR/ EHR) journey is no easy task for your medical practice. Based on the views of industry experts, I have something to advice you about the common flaws that you might make while selecting an EHR.

The deciding factors:

Various factors including practice size, type of medical specialty, adeptness in adopting advanced technologies, budget, etc. determine the choice of a perfect EMR/ EHR for your clinic or hospital. Keep these criteria in your mind along with awareness on the common mistakes in selecting an EMR/ EHR for your care center.

Errors and Points to consider:

#1: Selection of an EHR vendor with restricted support:

Most of the EMR/ EHR vendors get you tethered through their software selling, but they may direct you to procure the compatible hardware or support from a third party. Don’t get entrapped! Once you encounter a problem one vendor points out the other one, finally putting you in dilemma.

Always prefer a vendor who can provide you the full-scale solutions for your Revenue Cycle Management (RCM) process along with the EMR/ EHR support.

#2: Selection of interfaced systems:

Industry experts state that it is best to go with the fully integrated system with EMR or EHR, practice management and interoperability modules rather than interfaced systems. Handling dual systems for sharing common data like ICD-9/ ICD-10, CPT and HCPCS codes, record templates, etc. mayn’t practically feasible as the vendors state. Inbuilt ticklers and essential clinical alerts in one system can fail to be produced in the other system.

#3: Ignorance on hidden costs:

When choosing an EMR/ EHR, it is crucial to estimate the cost involved in the EHR/ EMR including software purchase, monthly subscription, annual maintenance, software upgrades, hardware costs, installation, implementation, training and any pertinent third-party charges.

So, don’t choose an EMR/ EHR just looking at the initial price label.

#4: Overlooking the worth of specialty templates:

Though self-designed clinical documentation templates fit best for your medical practice, it has several disadvantages:

A. It is an arduous and time-consuming task.

B. All other providers perceive your templates as strange designs.

C. Incorporating the in-house template ideas into software (designed by an external vendor) can be difficult.

Thus, the wiser option is to purchase the customized systems with inbuilt template libraries that best suit your specialty practice needs.

#5: Missing point-of-care modules:

Most EHR/ EMR systems are not focused on point-of-care documentation. The patient data can get duplicated at the pharmacy, frond-end or laboratory – leading to medical errors and even medico-legal complications. This may pose risk to your ROI of EHR/ EMR and intention to adopt the technological advancements like using a tablet or smart phone.

Purchase the exact EMR/EHR and ramp-up the productivity and profitability of your medical practice.

Time for medical practices to go active on social media!

February 25, 2014 by Ango Mark Leave a Comment

A thousand “Likes” for socially active hospitals!

Are you a physician who thinks social media is not for serious people? That it is only meant for frivolous gossip and friendly banter? You have a second thought coming! Healthcare professionals are taking to social media in a big way.

It helps people across the healthcare continuum, connect with their peers, stay updated about current changes in the industry and most importantly, engage with patients.

Dealing with frustrated patients…

Hospitals that are active on social media are ahead of the curve and more patient friendly. For years patients who were unhappy with their physicians, waited till the next visit to the doctor’s office to vent out their frustrations. Now it is just a matter of logging into their FB and rant…

A hospital that is on Facebook gives its patients an opportunity to share their concerns with providers in a healthier way.

They’ve postponed MU again?

Medical care professionals who have social media accounts are more likely to be in the know. One of the very important uses of being on social media is that they help in keeping healthcare professionals updated, in an ever evolving industry. It builds awareness about key issues and helps in disseminating vital information.

We are family!

There is a growing need for physicians to galvanize and speak up against draconian regulations and reimbursement cuts. To reassert their need for EHRs that is built around their workflow requirements and practice needs. To remain silent is to comply. And that is why it is more important than ever for medical professionals to be on social media.

It builds a sense of community and can empower users. It can encourage networking with peers and working as a collective force.

Being close to patients!

It is impossible for a medical practitioner who sees around 30 patients a day, to follow up on every one of them and offer personalized care. Being on social networking platforms means, patients are just a click away. It helps to connect with patients and drive up patient engagement.

You can educate patients on using patient portals and offer health advice, without the pressure, of another patient waiting in the reception.

Handle competition deftly!

At the end of the day medicine is business. Social media is the best way for medical practices to promote themselves. When there is heavy competition amongst peers, it is the most socially engaged medical practice that wins!

ICD10 costs are a whole lot higher than expected! Will physicians be ready by October?

February 20, 2014 by Ango Mark Leave a Comment

Eyes to the skies! ICD-10 costs are skyrocketing!

The titters have died down! Forget those jokes about walking into a lamppost and macaw bites. ICD-10 is going to bite medical practices much harder. With the deadline for implementing ICD-10 looming closer. It is time for medical practices to do more than just wait for the next pushback announcement.

As every day, news trickles about the cost of implementation and the impending deadline, physicians are shaking in their boots. But there is little hope for another deadline shift.

The shocking increase in costs over the last four years!

The approximate cost for implementing ICD-10 in 2008 was $83290. Four years down the lane the costs have escalated to $226,105.

Medium sized practices are going to feel the pinch as well; from costs estimated to be 285,195 in 2008 it has now skyrocketed to 824,735. And the costs are going to be as much as 8 million dollars for large sized medical practices.

The costs come as a sticker shock for medical practices that are still reeling under the pressure of accommodating the enormity and breadth of ICD-10. Medical coders who were using a coding system for several years are now faced with the challenge of working with codes that are absolutely foreign to them.

Though people on the other side of the wagon argue that greater specificity can help researchers and increase reimbursements, long term pay offs mean short term losses.

It is not going to be an easy transition…

Well almost everybody knew it! Right from the day ICD-10 was announced there have been voices of dissent. But as the deadline draws near it is clear that physicians have been caught off guard. It is going to change the workflow of medical practices and medical practitioners are justifiably, freaked out.

Still don’t have an ICD-10 coder?

Practices cannot afford to bill without a trained coder. Hiring novices means struggling under a deluge of rejected medical claims. An increasing number of medical practices are thinking of hiring virtual coders. Or, fall back on the time tested solution of outsourcing.

It is the hour of reckoning and practices should either ramp up their implementation process or stay behind. Complaining about the costs is not going to help physicians. Trying, to find ways to protect their revenue stream, and, investing in the new coding system, will.

5 Common Patient Collection Flaws to Avoid

February 19, 2014 by Ango Mark Leave a Comment

Is Your Collection Rate Unhealthy?

Many clinical and non-clinical departments of the medical practices overlook the payment collection from the scratch and most of the times you may combat for the collectibles at the eleventh hour. If it is so, you have some useful stuff here, to hone your collection strategies.

Small mistakes cost you more…

Collecting your hard earned money shouldn’t an end term activity. The collections of physicians, pathology or radiology labs, pharmacies, if unattended on-the-dot, your Accounts Receivable (ARs) would become unmanageable leading to piled-up bad-debts. Thus, point of service (POS) payment is very crucial for a robust healthcare business.

Notably, most physicians want to stay away from the financial dealings and deem that time involved in the finance management could be utilized for patient care and updating the clinical knowledge. But finally, you may land up in big troubles like unmet payroll, unrewarded hard work, dwindled profits or increased bad-debts.

Take care of your funds with these collection tips:

#1 – Ignorance of co-pays

Physicians need to be more attentive and understand that co-pay collection from the patient must be a demand instead of being a patient’s choice. As per the insurance payer contract, the doctor must collect the co-pay from the patient in each visit.

#2 – Bill Generation for Co-pays

Another common co-pay collection mistake is that you may bill the patient’s co-pay which once more goes against the payer contract policy. Missing the POS collection calls for unnecessary addition of the administrative cost in bill generation, follow-up and collection.

#3 – Information Deficiency

It is the highly frequent yet imperative issue due to the negligence of the front-end staffs. Important patient’s information like date of birth, insurance carrier and policy details, scanned copy of insurance cards, exact billing address, contact number and many demographic data, if left out at the patient check-in, eligibility issues may arise and hamper your reimbursements.

#4 – Lack of Payment Pattern Discussion

Mailing the bills directly to the patient and upon patient’s rejection seeking the help of the collection agency may help you, of sure. But, conversing with the patient up on encounter, to make payment arrangement is a much better option to collect your dues.

#5 – Missing Further Step

When your collection methods are not working out, you need to proceed further either through collection agency or legal proceedings. Of note, this is the point at which doctor-patient relationship may get broken. If the aforesaid 4 steps are followed impeccably, you won’t find any lapse in the serene patient care.

Why are physicians disillusioned with their EHRs?

February 13, 2014 by Ango Mark Leave a Comment

40% of physicians are unhappy with their EHRs! The reason behind their disillusionmen

The healthcare industry is poised for change. Archaic paper records are making way for svelte, new electronic medical records that can transform the way physicians work. Sounds like a perfect dream.

Except for the fact, several physicians find working with EHRs a nightmare and would rather go back to paper records. Critics say that it is a passing fad. A case of “I hate my EHR too”. But there is a screw loose somewhere…

Point, click and wait till patients lose their cool!

Having to put up with bad hardware, cumbersome templates and poorly designed interfaces are one reason why physicians hate their electronic records with a passion. And God forbid if there is a power outage or fluctuating bandwidth. Stuck with a workflow that doesn’t work or flow is the reason for such widespread dissatisfaction.

Qualifying for Meaningful Use is a huge task in itself. EHRs that do not match MU requirements compound the problem further.

Doctors don’t belong to the stone ages…

Contrary to what people think physicians are not averse to using technology. From, using lasers, fiber optics and scanners to iPhones, physicians have always been tech savvy. The argument of healthcare professionals falling behind times doesn’t hold any water.

Physicians find EHRs clunky and the fact that they are not mobile. Most EMR systems have been frustratingly slow in going mobile and some of them haven’t even taken the first baby steps towards mobile technology. It is not technology but how complicated and expensive it is that is the major problem.

Well-intentioned but the outcome counts as well!

There is no doubt that healthcare technology is liberating, more integrated and super quick. The major shortcoming of EHRs is that that they are not centered on the needs of physicians. It is on the other hand governed by federal mandates.

EHR vendors should stop playing by the rules of bureaucrats and develop systems that benefit their end users. Healthcare professionals are consumers of HIT. And should be given the kind of importance, consumers of other products enjoy. That could probably be the only lasting solution to the problem of disgruntled EHR users.

Is you EHR customized to your needs?

February 6, 2014 by Ango Mark Leave a Comment

EHR templates and why it makes little sense to work with them!

EHR templates are getting a lot of bad press. They are being blamed for poor documentation and reduced patient engagement.

Template generated notes are reducing patient data into a series of boxes to be ticked and blanks to be filled out.

At the end of the day, relying on templates is not just lazy documentation, but can also have a negative impact in the medical decision making process.

Missing the forest for the trees…

Point and click templates consume a lot of time thanks to the extensive output they generate. Information that has no clinical relevance, unnecessary, redundant data leads to note bloat. And a frustrated physician who cannot find what was documented during the patients’ previous visit. Cloned notes and upcoding add another layer of complexity to an already complex tale.

Templates that are not well designed can be hazardous to patient health & if overused can cost lives. The death of a patient in Manhattan, due to a template that limited information and narrowed down diagnostic choices, is an example of how hazardous templates can be. Instead of being comprehensive and informational, most EHR templates are complicated and of little use.

Which box do I tick?

There is another more dangerous charge thrown at EHRs. It is that they limit the physician’s ability to think and interfere with open diagnostic thought.

Improper diagnosis poses several medical-legal problems for medical practices.

Structured and inflexible data inputting options can put medical practices at risk.

Less rigid data platforms that give physicians enough space to explore varied diagnostic and treatment, plans and options are the need of the hour.

Limiting and cumbersome!

In a better world EHR templates will give physicians easy access to healthcare information, reduce data entry tasks and increase patient engagement. But going by the number of people complaining and riling against EHRs, most EMR systems leave a lot to be desired.

Going back to paper?

Several medical practices use paper records to document regularly performed procedures, patient history and progress notes.

It is impossible for EHR vendors to create a unique template for every single disease or medical condition.

And that is why it is essential that physicians do not depend blindly on their templates’ parameters and work within its framework.

Customizing EHRs according to the patient population, treatment options and the most commonly performed procedures, of a medical practice. Can trim the fat, save up on time and lead to better medical decisions.

EHR Usage and Good Medical Practice Congruence

February 4, 2014 by Ango Mark Leave a Comment

The Charismatic Scenario:

Going paperless was a formality or fashion and pointless saddle earlier in the medical practices. But now, the picture has changed and the adoption of electronic health records (EHR) is becoming increasingly obligatory. Many small practices and even hospitals are in the right move towards EHR espousal. This is due to the federal coercion and improved understanding of EHR implementation benefits by the healthcare providers.

Patient Centered – Interconnected:

The electronic medical/health records are no more the property of an individual care provider and EHR is no more the physician-centered tool. The involvement of various providers in proffering the comprehensive patient care is compelling the providers to make EHR – the patient-centric tool.

The modern clinical workflow pattern in small practices and hospitals involves the healthcare data sharing across the practices. This sort of interconnection provides fast, easy and accurate medical information exchange through HIPAA-compliant and professionally secured conduit.

“Charts” & EHR:

The shift in healthcare delivery pattern from single practice to widespread care delivery across small clinics to large hospitals, both physicians-owned and hospital-owned gave rise to community charts and enterprise charts. These charts enable interconnected health data access by multiple care delivery settings within hospital departments and also between assorted care centers.

Enterprise EHR like Epic has its widespread utility across the hospitals and the practices affiliated with them. Kaiser EHR makes a single chart accessible everywhere.

Good Medical Practice – The Further Take:

Despite medical data storage, large Enterprise Charts (e.g. Kaiser) could be used to gain insights into disease trends, epidemiology studies, clinical care quality and good medical practice (GMP).

Missed-out health records of patients, maladroit diagnostic data and specialty consult notes, hidden operation notes, obscure insurance information – Won’t these displease your patient care?

American Medical Association (AMA) says “Good physicians care for patients” as the primary domain of competency.

For a perfect patient care, the clinical documentation is more than crucial. Is it right?

Thus, EHRs with no ‘note bloat’ would buttress the physicians to follow Good Medical Practice through adequate essential medical documents:

Good clinical documentation
Good knowledge on patient health
Good patient care
Good Reimbursement & Good Medical Practice.

“Next Generation”:

Even the best EHRs available in the healthcare market have not addressed certain vital features:

Rapid encounter documentation: Physicians busy with the encounters find less time to create electronic health records. The “next generation” EHRs must have in-built medical transcriber and the physicians could avert spending much time in creating documents.

Unified patient portal: A modern EHR must ease the patient’s ingress into the electronic health records through unified patient portal. It must support easy access of various documents, reports, messages and other communications by all interconnected provider settings.

Open API access: EHRs must allow the vendors to access appropriate internal documents through application program interface so that the practices could accomplish the resource demands, clinical quality measures and disease trends.

Thus, current era EHRs need further “optimization” to satisfy the stakeholders of healthcare ecosystem.

Make wait times in your medical practice a better experience!

January 20, 2014 by Ango Mark Leave a Comment

How to make wait times at your medical practice a better experience!

How often have you seen patients fuming in the reception and have been able to do nothing about it? With hundreds of newly insured patients and limited staff it is getting tougher by the day for small and medium sized medical practices, to handle appointments. There is nothing worse than seeing patients, in need of medical care, waiting listlessly for it.

A third of staff time is spent on scheduling, handling no-shows and rescheduling appointments. There are ways to make appointment scheduling and patient wait times, smarter and shorter.

Make use of apps…

There are applications and software’s that can help physicians get a handle on their numerous appointments. Web based tools such as MedWaitTime help physicians to streamline everyday workflow and manage appointments. The more effectively you manage appointments, the easier it is to shorten wait times.

Is your medical practice a Wi-Fi zone?

How many of us read magazines strewn at a reception desk? Very few! Flipping through pages randomly can be frustrating after a while. A Wi-Fi enabled wait room can keep patients engaged. It may also help them to complete office tasks or keep tabs on them, while waiting in your office. This will make wait times more productive and fun.

Get paperwork out of the way!

Filling out medication lists or making patients fill myriad forms is a time drainer. And make the wait time for patients longer. Encourage patients to fill out information online a day or two prior to the visit. Have patient information and other pertinent details in hand, before meeting patients.

Make use of patient portals to share and receive vital information. Built into your EMR or integrated with it, work with patient portals to save on time.

Keep your patients in the loop!

Inform your patients about how long it will take to see them. Have the front office staff update patients periodically on what’s going on in the physician’s room. If there is delay state the reason for the delay and how long it will take to get things back in order. Knowing the reason for the wait, will let patients know their time is being valued.

Keep in touch!

A follow up mail that thanks your patients for visiting, for waiting for your medical care and how important each visit is to you, can make all that wait worthwhile. Never forget to ask for feedback and suggestions. It will increase your referrals and ensure there is a steady stream of loyal patients!

Here’s a presentation view about how you can accomplish your medical practice in full flow.

Will Obamacare result in better care across the healthcare continuum?

January 7, 2014 by Ango Mark 1 Comment

Is Obamacare backing patients into a corner?

There has been a lot of controversy surrounding Obamacare ever since it was launched. It has drawn criticism from all sides. Physicians are cribbing about the tremendous amount of paperwork they have to put up with. And, the pressure to comply with, several federal regulations.

Obamacare which was hoped to improve healthcare outcomes and give the uninsured a new lease of life has been accused of not delivering its promises.

No card no service!

This is the arithmetic of the current healthcare scenario. Many patients have no idea whether they are insured or not. Several of them have walked out of hospitals, despite ailments, fearing a huge bill.

There is no way for patients to prove that they’re insured and this has led to mayhem, untreated patients and frustrated doctors. The sticker shock patients face, gives rise to one pertinent question, whether Obamacare is another failed promise?

Technology will drive healthcare costs down…

Healthcare IT has emerged as the biggest hope for the healthcare industry to cut down on costs and move towards a better model of working. Bending the cost curve isn’t easy but certain medical specialties like radiology have seen a drastic decrease in procedural expenses. From being one of the most expensive specialties, radiology has now managed to become less expensive and contain costs.

Even the skeptics have agreed that the Affordable Care Act can be a harbinger of change. Despite it’s, shortcomings, and a very worried American public.

Here is why the ACA isn’t so bad after all!

The act has empowered patients and has aided them in choosing providers and services that better suit their requirements.
The ACA has standardized medical billing and documentation to a large extent.
It has provided medical practitioners the impetus to explore newer revenue and workflow models.
Risk sharing pay systems can help physicians move away from the traditional fee for service model.
The ACA has made the entire healthcare industry more tech-driven. This means better patient communication and care.

MU 2 timeline shift; what it means for your practice?

December 20, 2013 by Ango Mark Leave a Comment

Yet another MU 2 pushback; but is there a reason to cheer?

There seems to be a new government announcement every single week. The latest update to cause major ripples was the recent MU2 extension. As with all other healthcare updates it was received with skepticism, hope, and a whole deal of confusion.

The dust has settled now and Eligible Professionals (EP) are back to preparing for MU2. It is clear that MU2 has been extended through 2016 but there will be absolutely no shift in the start dates. But this will definitely give EPs enough time to formulate a more solid Meaningful Use plan.

Some breathing room…

2014 is going to be a trying year for physicians. Meaningful use deadlines, ICD10, and freezing on a payment model that works, there is going to be a lot on the plate. The early birds who are going to attest in 2014 will get an extra year in 2016. EHR vendors can also have enough time to better their systems and focus on the Achilles heel of most EHRs, interoperability.

More time for MU3…

The timeline shift will offer medical practices some amount of breathing space and flexibility. There will be additional time to prepare for Meaningful Use stage 3. And a wee bit more flexibility when it comes to certification.

Can the shift impact ICD 10 implementation?

Unfortunately, yes. Healthcare industry experts suggest that now there is absolutely no possibility of yet another delay to implement ICD10. October 1^st 2014 is a date set in stone according to senior health insurance specialist at CMS, Denescia Green. “This is a firm date” she said, earlier this month.

Hopes dashed!

Physicians who were hoping for a delay in ICD 10 are in for bitter disappointment. The government cannot afford another delay, so there is going to be increased pressure on physicians to transition to the new code set. One major plus would be that practices can utilize and focus their resources, on ICD 10 alone. There wouldn’t be as many deadlines jostling for attention.

Have great staff on board?

This is one question that most practice owners forget to ask themselves. Human resources, seems to be a grossly overlooked factor. With 2014 being a rollercoaster year, not focusing on hiring or training staff, can be the perfect recipe for disaster. Most medical practices are caught up with improving their technical infrastructure and exploring new business models.

But for sustainable success and change, having the right people on board, is the only solution. So, practices can rely on trained personnel and not pushbacks for meeting deadlines.

Here’s a brief presentation on Meaningful Use for medical practice.

Join The webinar

Lisa Maciejewski-WestCMC, CMOM, CMIS, MCS-P