Tag: EHR

Can CMS Kill the Golden Triangle?

  Project managers often refer to the Iron Triangle. The Iron Triangle says that there is a balance between Scope, Resources and Schedule. You can choose any of the two, but not all three. This principal holds true for almost any project from software development to construction. We will modify this theory for ambulatory revenue cycle…


Healthcare’s Wake-up Call for 2013-2014

Our industry is on the eve of confluence among four major technology drivers. When considered as a whole, they may represent the Perfect Storm/Y2K/Tsunami of changes leading to negative impacts on productivity and profit margins for healthcare providers.  These drivers are PQRS, Meaningful Use Stage 2 (MU2), ICD-10, and Health Insurance Exchanges (HIX). Any one…


Healthcare’s Wake-up Call for Current Clients in 2013-2014

Our industry is on the eve of confluence among four major technology drivers. When considered as a whole, they may represent the Perfect Storm/Y2K/Tsunami of changes leading to negative impacts on productivity and profit margins for healthcare providers.  These drivers are PQRS, Meaningful Use Stage 2 (MU2), ICD-10, and Health Insurance Exchanges (HIX). Any one…


Create Interoperability Now for Changes Ahead

As the use of various technology systems continues to increase within medical practices, interoperability between those systems becomes critical. An article called, “Interoperability a Key to Effective Communication” on the AAPC website states, “Disparate computer systems must communicate structured data in a way that both systems understand.” Consequences of having disparate systems could mean a…


Even with EHRs, Practices Continue to Manually Code

In a recent report by the Office of Inspector General (OIG), OIG auditors observed that the majority of physicians who have adopted EHRs continue to code Evaluation and Management (E/M) services manually—even though most major EHR vendors offer technology that will code E/M services automatically.

For the past decade, the OIG has kept a close eye on E/M coding because the level of E/M visits reported are trending higher at present than in previous decades. EHR adoption is intended to increase the accuracy of medical coding (e.g., E/M codes); however, this report suggests that physicians still prefer to code E/M visits the “old fashioned” manual way rather than adopt a new technology to automate the process. 

The OIG report did not offer any insight as to why physicians are still coding E/M visits without the help of EHR tools. Some theories include: E/M modules cost more money on top of an already expensive EHR system, E/M templates are not user friendly to the physicians, or physicians may not trust any EHR system to code for visits that affect such a large percentage of the revenue. Regardless, physicians often code E/M visits incorrectly, resulting in either over or underpayments.

If EHRs are not proving useful in coding this area of medical services, then physicians must look to other sources to avoid coding errors during claims review.

 


Healthcare Technology Selection Guide and Guidance

Physician practices are concerned with finding EMR software that meets the needs and requirements of their particular organization. CTS Guides, a research company located in Rockville, MD offers a free Medical Software Selection Kit to help healthcare practices compare and review software options, define needs, prepare questions to ask vendors during demos, and gain more control over the software selection process. The kit provides software reviews, comparative product ratings including over 800 features, and a template to plan and rate vendor demos. To find out more about CTS and access the kit, click here.

Of course, no EMR or PM system is perfect. Ideally, each practice would employ an EMR and PM system vendor that would create a version to completely fit their situation. Without a perfect option, you should choose the best option for your circumstances. The following articles will help prepare you for the technology selection process ahead:

  • Want a plethora of Medical Group Management Association’s (MGMA) EMR/EHR recourses? Visit a list here.
  • How should you selecting the right EMR vendor for your circumstances? HIMSS’ article explains.
  • What should you consider before changing PM systems? Read about this here.
  • Want to know one vital component most EMR vendors offer but most practices fail to use, leading to denied claims? Read this article. 

The Ongoing Search for the Perfect Practice Management System

I speak with clinics representing as many as 30 specialties, ranging from small practices of a few providers to practices consisting of hundreds of providers, nearly all of which have one thing in common: They are adopting new practice management systems.

No Such Thing as Perfect PM System

One thing is certain, no two clinics are alike. Not in workflow, billing needs, or in what they see as priorities for their organizations. In an ideal world, each system would be implemented in a fully customized fashion to meet the needs of a practice. Unfortunately, we don’t live in such a world. There is no “out of the box” perfect practice management system for a clinic. There is, however, a best solution for each individual clinic. 

Ask: Why are you Changing?

Too often I speak with clinics that are in the process of changing PM systems that are unable to answer the question, “Why exactly are you changing systems?” The few who answer often reply with a vague: “the physicians wanted to,” “we feel like there is a better solution out there,” or “the clinic next door just signed paperwork with a new system.” 

If you are thinking of changing, consider the following steps to start the decision process:

  • List specifically what you are looking for in a new system.
  • Read it out loud. If it makes sense, evaluate. There is certainly an advantage to knowing your options.
  • Take a questionnaire that walks you through the new vendor/PM selection process
  • Ask your current vendor for a list of features and functionality they have customized for your clinic over the years. Make sure any alternative systems can accommodate established clinic workflow and procedures.   
  • Consider: Are you maximizing your current system? You may find that some or all of your desired functionality already exists in the system you have already paid for!

Years are spent perfecting current workflows, processes, and procedures around existing technology in order to create the perfect practice management system. If an EHR is driving your purchase, is it worth the disruption to implement a new practice management system as well? Or, would you consider taking the “best of breed” approach?  

Choosing a New PM System

If you decide to choose a new PM System:

  • Be sure the new vendor can accommodate your clinic’s requirements.  
  • Ask for several references of the new system.
  • Ask clear and specific questions about the new system and vendor.

Unfortunately, clinics often experience tremendous disappointment after implementing a new system—usually a result of not completing enough new vendor research. While it is easy to believe purchasing a new system will solve all current frustrations, clinics often find that they are simply replacing their known problems with a new set of frustrations.   

I challenge clinics to do their homework. Take a step back and look at the bigger picture. Take a moment before valuable time and resources are invested in a new system and answer the question, “Why are you looking to replace your current system?” Are you using your current system for everything it has to offer?

— Shelley Scarbrough, Client Account Representative, White Plume Technologies