Synopsis - Integrated solution for Revenue Cycle Management and Medical Records
Overview
Physician practices are being called on to do more than ever before. Today’s physicians must treat more patients, document interactions more meticulously, wrangle with more complex managed care rules, keep track of an ever-expanding array of drugs, submit and track claims and pay rising malpractice insurance bills. In many cases, physicians must treat 20 percent more patients than they did five years ago to generate the same revenue. In the face of these burdens, some practices are struggling to remain financially viable. For many practices, the biggest impediment to meeting these challenges is continual administrative burden, a lack of automated clinical documentation, and inefficient practice workflow systems. Despite the dramatic advances in many areas of healthcare technology over the past several years, most physician practices—especially small and midsize ones—are still using the same manual and paper-based office management systems they’ve used for decades. With mounting pressure from insurers, government agencies, and patients, physician practices need to reexamine the ways they work and interact. As physicians see more patients and insurers demand reformed documentation for rapid processing of claims, the manual healthcare systems that were adequate in the past will become less and less able to meet new demands.
The problem
The paperwork burden among solo/small group physician...
Over the last several years, electronic medical records are becoming more prominent in health care facilities, replacing traditional written records. As many electronics are becoming more prevalent with the invention of numerous smartphones and tablet devices, it seems that making medical records available electronically would be appropriate for the evolving times. Even though they have been in use to some extent for many years, the “Health Information Technology for Economic and Clinical Health section of the American Recovery and Reinvestment Act has brought paperless documentation into the spotlight” (Eisenberg, 2010, p. 8). The systems of electronic medical records mainly consist of clinical note taking, prescription and medication documentation,
For years now, the healthcare system in the United States have managed patient’s health records through paper charting, this has since changed for the better with the introduction of an electronic medical record (EMR) system. This type of system has helped healthcare providers, hospitals and other ambulatory institutions extract data from a patient’s chart to help expedite clinical diagnosis and providing necessary care. Although this form of technology shows great promise, studies have shown that this system is just a foundation to the next evolution of health technology. The transformation of EMR to electronic heath record system (EHR) is the ultimate goal of the federal government.
Nothing is perfect in the world of clinical systems implementation, so a Chief Informatics Officer is always on the go. He travels around the country to attend meetings in order to figure out how to best balance compliance, security, ease of use, automation of manual processes, and safety in electronic medical records systems and other hospital software systems. Clinicians have constantly evolving needs and often come to the Chief Informatics Officer with a clear idea of the problem they want to solve, but no idea of how to solve it. Reliably the pen records lessons from the meetings and concerns of clinicians as it travels with him. It crafts written reports to advise senior management on how to face the endless stream of projects, so that those which can accomplish the greatest good for the most people over the longest time period can be
Historically, physicians and nurses documented patients’ health information using paper and pencil. This documentation created numerous errors in patients’ medical records. Patient information became lost or destroyed, medication errors occur daily because of illegible handwriting, and patients had to wait long periods to have access to their medical records. Since then technology has changed the way nurses and health care providers care for their patients. Documentation of patient care has moved to an electronic heath care system in which facilities around the world implement electronic health care systems. Electronic health records (EHR) is defined as a longitudinal electronic record of
The implementation of electronic health records (EHR) continues to make an impact on nursing and patient care throughout the country. As a part of the American Recovery and Reinvestment Act of 2009, all public and private healthcare providers were required to implement electronic health records in their facilities by January 1, 2014. By demonstrating “meaningful use” of the electronic medical record, facilities are able to maintain Medicaid and Medicare reimbursement levels. Providers who show that they are meeting the “meaningful use” criteria during EHR use will receive an incentive payment from Medicare and Medicaid. “Meaningful use” is “using certified technology in EHR implementation to improve quality, safety, efficiency, and reduce health disparities; engage patients and families; improve care coordination; and maintain privacy and security of patient health information” (Centers for Medicare & Medicaid Services, 2013).
In 2009 President Obama, through the American Reinvestment and Recovery Act, pledged to provide incentives to the nation’s physicians and hospitals to convert to an electronic healthcare system in attempt to improve the quality of care and reduce cost (Freudenheim, 2010). By converting to an electronic system, we have the opportunity for improved communication between all healthcare providers and decreased cost to our healthcare system. The goal is to improve communication across all aspects of the service chain (Horan, Botts & Burkhard, 2010). Almost two years later, the conversion progress continues to be slow. Only one in four physician’s offices, mostly large groups, have implemented the electronic record system (Freudenheim, 2010).
“An electronic health record (EHR) is a digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users.” (healthit.gov) The EHR mandate was created “to share information with other health care providers and organizations – such as laboratories, specialists, medical imaging facilities, pharmacies, emergency facilities, and school and workplace clinics – so they contain information from all clinicians involved in a patient’s care.” ("Providers & Professionals | HealthIT.gov", n.d., p. 1) The process has proved to be quite challenging for providers. As an incentive, the government began issuing payments to those providers who “meaningfully use certified electronic health record (EHR) technology.” (hhs.gov) There are three stages that providers must progress through in order to receive theses financial incentives. Stage one is the initial stage and is met with the creation and implementation of the HER in the business. Stage two “increases health information exchange between providers.” ("United States Department of Health and Human Services | HHS.gov", n.d., p. 1) Stage three will be the continuation and expansion of the “meaningful use objectives.” ("United States Department of Health and Human Services | HHS.gov", n.d., p. 1) The hospital, where I work, initiated the HER mandate many years ago. In this paper, I will discuss the progression and the challenges that my hospital encountered while implementing the EHR mandate.
When walking into a hospital, nursing home, or physician’s office, electronic devices are used everywhere. The doctors have pagers, drugs are released from an apparatus similar to vending machines, and the patients are connected to intravenous pumps and monitors, while they lay on beds that move with the touch of a button. Everything seems to be electronic, except for patient charts. A new system, called eHealth, was devised that would make these patient charts electronic. The goal for electronic health is to unite all healthcare by making patient records available to all providers in order to improve the quality of care patients receive. eHealth can be adopted into hospitals, physicians’ offices, and even ambulatory services. A 2006 study found, “Ambulatory EHRs improve the structure of care delivery, improve clinical processes, and enhance outcomes” (Shekelle 61). With professionals working together, procedures, scans, tests, and even visits to the hospital can be eliminated and in turn reduce the hospital’s expenses. However, this reduction may not add up to the investment the facilities will have to make. Adopting this system will cost more the some facilities are able to spend. However, investing in eHealth is a risk hospitals should take to improve patient care. eHealth has to become affordable to all providers for healthcare to reach its full potential.
This article addresses major aspects such as clinical trial, integrated decision support and guidance, inadequacy of paper record, and data entry. The reason that paper records are not a match for modern medicine is that they are not accessible buy multiple health professionals causing a delay in response to health care, confidentiality and security is a risk granted that anyone could physically change the record and it would become official. The author of this article predicted the basic electronic medical record features that are available today, back in 1999 and the features include integrated clinical workstations with the computational power that can assist with clinical matters, financial and administrative topics, research, and scholarly information. This report indicates that having electronic records can provide efficiency throughout the system of health care for instance the example presented in this article was the process of admission, discharge and transfer of a patient can be changed drastically due to it initially taking hours to going from in and out in minutes. This article will provide the foundation of EMR’s and how time for reform had come more than a decade ago and it’s time for reform once again. With the examples and strategic tactics provided, it is fairly simple to display the evolution of Electronic medical records from
The development of information network systems ties healthcare care organizations allowing them to disseminate patient information. However, there have been several key challenges in development, implementation and adoption. Some of the challenges organizations encounter is the lack of standardization between health care entities, patient restrictions in health information and access (Tan & Payton, 2010). Another challenge organizations would face is the initial costs and justifying expenditures on a health management information system (HMIS) (Tan & Payton, 2010). The final challenge organizations would be facing is the involvement from federal legislation advocating for the consolidation of electronic health care records (EHR). A focal point for federal legislation is the promotion of broad based...
“Achieving meaningful use”, a statement that strikes fear in many, also leaves the questions: How do we accomplish putting everything in place to reach the mark? How is our bottom line going to be affected by the change in workflow? Is the change worth the effort? Will patient care improve? These questions, and many others, escalates dread in staff without a capable pilot navigating a well-developed implementation plan. Accomplishing Stage 1 meaningful use in my clinic was a difficult process to complete. Change, in many forms, was necessary to reach the pinnacle of achievement. This paper attempts to outline the alterations made in our clinical workflow to meet Meaningful Use Stage 1.
Chun-Ju Hsiao, P. a. (2014, January 17). Use and Characteristics of Electronic Health Record Systems Among Office-based Physician Practices: United States, 2001–2013. Retrieved April 24, 2014, from CDC: http://www.cdc.gov/nchs/data/databriefs/db143.htm
Unfortunately, the quality of health care in America is flawed. Information technology (IT) offers the potential to address the industry’s most pressing dilemmas: care fragmentation, medical errors, and rising costs. The leading example of this is the electronic health record (EHR). An EHR, as explained by HealthIT.gov (n.d.), is a digital version of a patient’s paper chart. It includes, but is not limited to, medical history, diagnoses, medications, and treatment plans. The EHR, then, serves as a resource that aids clinicians in decision-making by providing comprehensive patient information.
The present environments for healthcare organizations contain many forces demanding unprecedented levels of change. These forces include changing demographics, increased customer outlook, increased competition, and strengthen governmental pressure. Meeting these challenges will require healthcare organizations to go through fundamental changes and to continuously inquire about new behavior to produce future value. Healthcare is an information-intensive process. Pressures for management in information technology are increasing as healthcare organizations feature to lower costs, improve quality, and increase access to care. Healthcare organizations have developed better and more complex. Information technology must keep up with the dual effects of organizational complication and continuous progress in medical technology. The literature review will discuss how health care organizations can provide effective care by the intellectual use of information.
reimbursement determinations. As a result, the camaraderie among physicians has developed into a more aggressive approach to impede competition (Shi & Singh, 2012). Little information is shared with patients in regards to procedures or disease control. The subjects are forced to rely on the internet for enlightenment on the scope of their illnesses (Shi & Singh, 2012). Furthermore, the U.S. health care system fails to provide adequate knowledge on billing strategies for operations and other medical practices. The cost in a free system is based on supply and demand and is known in advance of hospital admission (Shi & Singh, 2012). The need for new technology is another characteristic that is of interest when considering the health care system. Technology is often v...