Too many cooks spoil the broth…

Being spoilt for choice, may not be such a good thing after all. The market is packed to the capacity with emr, ehr systems and smooth talking salesmen. Most physicians who jumped on to the emr bandwagon regret, making a brash choice. Interoperability issues in particular, have made hospitals lose millions of dollars in fixing up a faulty system.

A certified emr is good, a top rated one is even better, but will it be the best choice for your practice? Physicians will have to work with emr consultants and spend a minimum of 3 months, researching on emr systems, before making a decision.

Don’t pull my Dictaphone away!

A research conducted in 2008 concluded that about 90% of medical records were documented using dictations and transcription. Physicians find dictations comfortable and less time consuming. As ehrs provide a tight framework and more structured, rigid data entry options, physicians find it terribly restricting.

But, yes, MU matters!

Now, this is where it gets tricky. To qualify for Meaningful Use the ehr system needs to interact and communicate within itself. Dictations can lengthen the path to achieving MU criteria. Collecting and comparing data becomes complicated, as is pulling out vital information. To receive the incentive dollars, physicians will have to find a way to work in tandem with their ehr, to come up with workable solutions.

This is how the ground lies…

Physicians will have to reconcile to the fact that they must adapt or be left behind. The pros an emr offers, far outweighs the cons. And to make the most of a technology that promises a healthier future to the healthcare industry. Physicians will have to strive to create solutions that fit their needs. If it is not available in the market, do it yourself!

Narrations VS inputting values!

Who said you have to choose one! Dictate narrations and store them in your ehr for reference. But also remember to input values into templates. It certainly helps when you are lolling about in your couch while dictating and don’t remember the medication your patient took!

The good old days…

There was a time when physicians just had to send their dictations to a transcriber. And, relax without worrying about empty templates and blank fields. But that was when the world was a simpler place to live in!

EHRs, physicians complain, have increased organizational complexities and data entry tasks have added about 120 minutes, to every single working day. That is two hours of time that could have been spent meeting patients. Or, anything, more productive, than, monotonously, entering data.

Wait. Click. Wait. Click. Get frustrated!

Now, instead of dictating that a patient with “stage 1 cancer, er/pr positive”, a physician has to click on every item individually and wait for the system to load. And then progress to the next field. Every click is a time drainer and we all know how frustrating it is to sit, and stare at a loading screen.

To add another log to the fire, physician inputted data can lead to errors that can result in increased risk to patient safety. A recent study of direct text input into an emr found that 60% of patients reviewed had data input errors. That is a staggering 7.8 errors per patient!

The best of both worlds!

It is important for physicians to merge the old with the new. Medical dictations consist about 60% of a practice’s documentation. They form the basis for important healthcare delivery functions such as quality measurement.

Physicians will have to work to find a solution that answers their medical transcription needs, in conjunction with their ehr.

Order a latte, fries and cappuccino!

Most doctors recommend the “happy mix” approach. Just like how you walk into a restaurant and order what you need, doctors can choose the best of the options available to them.

• Use the voice recognition feature in emrs for quick snippets.
• Hire a professional medical transcriber to handle dictation files and conduct quality audits
• Work with the templates in the emr but customize it to the practice’s requirement.
• Train transcribers in working with the ehr to save on data entry time

a.   There has been nearly a 20% drop in the number of independent practitioners from the beginning of the new millennium up until now.

b.  1/3^rd of the remaining practitioners would sooner than later start considering offering alternatives forms of services, such as subscription-based service, tele-consulting or online consulting.

c.  A majority of them are seriously considering leaving Medicine itself for good.

d.  Nearly 70% of them cited financial troubles, keeping up with electronic healthcare mandates, lower reimbursements from insurers as the major reasons.

Expert Billing Solutions For Private Practices!

As a medical billing and medical coding company which takes pride in the number of private practitioners availing its plethora of outsourced healthcare services, iSource has been of late noting with increasing alarm the plight of this segment of physicians.  Although currently it’s medical billing services and medical transcription services rates are one of the lowest in the outsourced healthcare vendor segment, the think-tank at iSource felt an increasingly overwhelming desire to help independent physicians further by going that extra mile.  The result was an offer that no one can refuse.

Free EMR Subscription Offer

“iSource now offers an EMR product, along with its installation and support, completely free of cost to practitioners intending to use our medical billing services.  Even if they already have one, once they start availing our services, we will pay for their subsequent future subscriptions of the said EMR product”.

It is iSource’s sincerest hope that by extending the above proposal it can help stem the dying out of a breed of healthcare practitioners so vital to the survival of the very fabric of healthcare in this country.   Call us at 1-888-571-9069 for a telephonic rendezvous.

Personalized Billing Support

The main topics the caller touched upon were 5010 issues (we had quite an influx of those at the beginning of 2012 understandably), and the difficulties in billing correctly for diabetic shoes, and a biller being able to distinguish between routine and non-routine foot exams, and thus the appropriate use of Q codes.   The caller went ahead and offered to personally guide our personnel here over Webex, during the 2 week free trial

period that we had offered him.

As it transpired, although we kept open the offer of his training us via Webex, we never had to resort to it.  As first and foremost a technologically savvy organization, Isource had been amassing this huge volume of data over the months leading upto and beyond the 5010 deadline, about the manifold roadblocks that had been taking a toll on providers and payers alike, with special focus on the providers.   The following were the most routine ones seen by us:

a. Provider billing staff on very long holds (upto 2 hours) with the various payers, thus eating into their time (Isource tackled this with Predictive Dialer and other sophisticated call center technology).

b. Many providers being delinked from their enrollment database with Medicare (Isource used its round-the-clock enrollment team to get the providers back on the grid).

c.  A 999 file being accepted by the payer, but no corresponding 227CA status response being generated, thus in effect nullifying the claims submission.   Our dedicated A/R callers ensured that the payer became aware of such drawbacks and corrected the same at their end.

Q-codes

The podiatrist was also heartened to see that the Billing Manager was eminently aware of the differences between a routine foot exam and a non-routine one, the latter necessitating the use of E/M or surgery codes.  Also the podiatrist was very happy when Steve on his own disclosed the bit of know-how about cast supplies being the only DME item billable to Medicare Part B, whereas all others had to be billed to the DMERC office.

It is no wonder then that the nice podiatrist is still with us today, in fact alive and very much kicking after he recorded a three-fold increase in his reimbursement percentage.   Call Isource at 1-888-571-9069 for a detailed discussion about the nuances of podiatry billing.

Not enough staff?!

Small orthopedic practices in particular face severe staffing shortage. Apart from expensive imaging equipment and the operational costs of an emr, there are a million other factors that come to haunt the orthopedician on a tight budget! Containing costs, taking care of patients and running a secure practice, though tough is certainly an attainable dream.

Choosing a smart emr!

It is important that physicians notice the cracks before they are too big to mend. One of the major mistakes orthopedicians make is to invest in equipment’s that don’t contribute much to the running of a practice.

Most ortho specific emrs come with advanced imaging options and can integrate with PAC systems. Choosing an emr, that can handle major tasks such as image transmission. An, emr that can bring the different aspects of a workflow in one platform can save orthopedicians the money spent on implementing expensive software’s and equipment’s.

A little more time on operative notes!

This is one common area where most physicians lose money. But orthopedicians in particular are prone to making costly mistakes. Orthopedicians find dictating a particularly challenging task.

Incomplete information on whether a procedure was open or arthroscopic, or not mentioning whether the treatment is an initial, revised or staged, one, are just, one of the few oft repeated, mistakes.

Dictate right!

Physician dictations are the first step towards creating error less medical documentation. It is best practice to transcribe dictations. A transcript can help not just in documentation but as a great source of information during the billing process as well.

Outsourcing transcription requirements can be a great cost saver. It can help practices save on money and if there is one thing ortho practices need to concentrate on, it is saving money!

PrognoCIS The orthopedic features cover a lot of ground. It is highly intuitive and just what orthopedicians need in their emr. The arthroscopy integration, EMG integration and interactive ROM forms can structure and quicken the workflow of ortho practices. As it is cloud based orthopedicians needn’t worry about intimidating servers!

Phoenix The phoenix emr offers a host of features but the one feature that orthopedicians are going to fall in love with, is the optical mark recognition technology. It helps staff to enter medical information, swiftly in a streamlined platform without the major headache of staff data entry. It also offers integrated pacs and ris, which going by the amount of time orthopedicians spends searcing for images, a great asset.

Merge It merges into the workflow of a practice and doesn’t cause any major changes. It reflects the daily workflow and offers great image storage options. Images are a major aspect of orthopedic practices and as merge emr is largely image centric it is a good fit for ortho clinics.

Exscribe It is in all probability one of the most flexible ehrs around. Templates can be designed according to the convenience of users. The adaptable workflow and documentation options give orthopedicians the flexibility they need. It is also a very cost effective ehr.

Allmeds This is one of the few emrs that boast of high client retention rate. It’s got orthopedic based protocols and algorithms. The orthopedic centric cpt and icd codes can make medical billing that much easier and it by and large accommodates the features orthopedicians most look for such as orthopedics specific prescription hotlists.

Practice Fusion Pf is onc-atcb certified and that is one major plus. The practice fusion emr is free, on the cloud and offers great integration options. Whether it is continuing with your in-house biller or orthopedic transcription services provider, it offers the possibilities and options that top every orthopedicians wish list.

In the age of robotics

Well robotic systems that help in  medical care and surgeries, is not exactly breaking news. But using a robotic arm interactive orthopedic system is more common in the orthopedicians office than it ever was. As the costs of providing medical care increases the need for minimally invasive surgical techniques and shorter hospital stays have gained prominence. From knee replacements to three dimensional imaging it is robotics all the way.

Going generic…

Implants are the biggest money spinners in an orthopedic practice. But they are expensive and most billing mistakes in an orthopedic practice involve implants. Needless to say they’re costly mistakes! Generic implants that come with the assurance, of several years of tests, and proven results are a step in the right direction. It is widely believed that generic implants can make implants, less dear, for patients and physicians.

PACking a punch!

Ortho pacs have been around for almost a decade now. But the latest pacs are certainly something to write home about. Visualization tables, multi touch options, ability to offer diagnosis from anywhere, anytime, and pre surgical templating options, have brought about a sea change in the way ortho practices function. They’ve lessened the footsteps in the everyday workflow of a practice and drive more efficiency.

Up in the clouds!

 With cloud technology leaving strong footprints in all fields, orthopedics has also joined the cloud bandwagon. Managing medical images has always been a challenging task for orthopedicians. And yes they do cram up hard disks. Now latest cloud technologies allow users to store, share and transfer images effortlessly using tools in the clouds. It could mean lesser amount of money spent on workflow management software’s and tools.

Change for the better…

Being an expensive sub specialty orthopedicians, are doing everything in the book to reduce operational costs. Whether it is shifting to newer technologies or outsourcing transcription or billing needs the major criteria is to improve efficiency without cutting corners.

What is DRT?

It is a technique whereby narrative dictations are transformed into discrete XML-embedded data elements (after getting transcribed), which subsequently is auto-populated into the respective EMRs.  In some cases the EMR can reuse these elements for subsequent visits of the same patient, thereby decreasing the amount of time spent by both the physicians and the transcriptionists in getting the encounters dictated and transcribed respectively.  Also, the physicians are spared the turmoil of any “point-and-click” protocols and experience satisfaction in having documented their patient’s complete history, rather than having to curtail such a practice in light of the meaningful use criteria of EMRs.

The Benefits of DRT

1.  As already seen above, the time and money saved in the form of shorter dictations and lesser lines transcribed, transcription costs cut by 50%.
2. Physicians get to do more of actual patient care than rote documentation.
3. Physicians are not forced to allot time and learn any new EMR technology, they can continue with their narrative dictations, thus they have 25% more time for actual patient care.
4. Structured data is fed into the EMR, whereas some of the traditional integration methods like HL7 just feed unstructured data into the EMR system.
5. Practices that are yet to join the EMR race, can do so without the fear of not eventually being able to show meaningful use.
6. Physicians can share discrete data elements with their colleagues and other institutions for purposes of a study.  DRT facilitates trending.

DRT and iSource

iSource’s tryst with DRT was inevitable considering the experience in integrating our proprietary dictation capture and storage system (Report Vault) with various EMR’s via the HL7 route.   Thus, as someone who believe in staying ahead of the curve, we are already providing transcription support via the DRT channel to over 20 clients across the country.  Our experiences with EMR integration technologies have stood us in good stead in this new & exciting arena of healthcare.

Doing the math beforehand

Before starting a medical procedure it is advisable to match CPT codes and do the math. It will help in planning and designing an orthopedic procedure that can reduce costs. And it can also help in discussing with your patient treatment options and open the window for better patient communication. Too much of arithmetic? You don’t have to sit down with the calculator every time. Draw up a list of the most common orthopedic procedures you perform and do a cost analysis.

Digitized work space

Invest in pacs even if you are sacred of the long time digital equipment’s take to return your investment and start seeing concrete profits. In the long run it automatizes your workflow and gives staff more time on their hands, to concentrate on more pressing tasks, instead of searching for that misplaced scan.

The most expensive needn’t be the best

If you run a busy ortho care office chances are you spend most of your time purchasing equipment. But the most expensive on the shelves needn’t be the best. Take into consideration the size of your practice, the roi of your latest investment and whether there are low cost options available. Whether it is surgical instruments or the latest multipurpose orthopedic table there are several smart deals out there!

When in doubt outsource

Nothing can save as much money and time as outsourcing. Outsourcing tasks like transcription or ar calling can reduce the workload on you. Spending less time worrying about clinical documentation and other administrative tasks means you have more time to spend with patients. And also it can help you achieve your main goal of lowering costs and bettering your patient care.