Tag: urgent care

How Virtual Consults Can Benefit the Emergency Department

By Lee Horner, CEO, Synzi.

Lee Horner
Lee Horner

In urgent care situations, being able to provide timely and quality healthcare is essential to the impact and satisfaction of the ED staff and related EMS team members. Using telehealth, current ED workflows can be enhanced to increase access and make collaboration between onsite providers and offsite colleagues and specialists easier and more timely. Virtual care platforms can rapidly improve the delivery of care, effectively addressing urgent patient needs while reconciling the gap in having available specialists on-hand / in-person for immediate consults. Virtual consults are a viable and valuable solution to helping improve outcomes in emergent care situations.

Providing Critical Care On-Demand in the ED

Seconds and minutes count in the ED. With a virtual care platform, a hospital’s ED staff can quickly access remote specialists and facilitate a virtual consult between offsite specialists and patients. Instead of losing crucial minutes, hours, or even critical days in the ED to call a specialist or wait for an in-person consult, ED staff can quickly reach the first available, designated specialist who can deliver a timely virtual consult and provide guidance as to diagnosis, admission, and/or transfer. With virtual care technology, specialists can provide the needed consult from anywhere and on any device. Key decisions as to whether the patient needs to be admitted, transferred or discharged can be made in minutes (vs. hours or days). The costs involved with keeping a patient in the ED are also contained, and the hours or days which a patient spends in the ED are reduced. As hospitals struggle to have multiple specialists on-hand at any time, virtual consult platforms can empower hospitals to leverage specialists within their networks to support their patient care objectives around-the-clock.

Reducing Waiting Time and Minimizing Leakage in the ED

Virtual care platforms are also being used to reduce waiting times in the ED and deliver routine care to patients with non-emergent conditions. In a recent study published in Telemedicine and e-Health, rural hospitals using telehealth reduced the time between patients entering the ED to receiving physician care, according to University of Iowa researchers.

Virtual care had decreased door-to-provider time by six minutes. The researchers also concluded that the length of stay in the ED of the initial hospital was shorter for patients who were eventually transferred but had initially participated in a virtual care consultation. At New York-Presbyterian/Weill Cornell Medicine, the Express Care program allows patients with minor injuries or non-life-threatening symptoms to be seen virtually by an offsite provider via video. When asked by the Wall Street Journal, “What’s the number one complaint of patients in the emergency room?” Rahul Sharma, the emergency physician-in-chief at Weill Cornell, responded: “Wait time.”

The hospital reported that the Express Care telehealth program has cut the average wait time in the hospital’s ED by more than half; between 35 to 40 minutes. As hospitals struggle to prevent leakage and minimize the chance of patients leaving their ED waiting room for another healthcare setting, virtual consults can help the waiting patients access the diagnoses and care they need in a more timely and convenient manner.

Expanding Impact into the Community

ED staff can also use virtual care platforms to expand their impact within their respective communities.  Rural hospitals face some of the biggest deficits in terms of having a range of specialists on staff. Providers in these hospitals can have access to a greater pool of specialists who can support urgent patient care via video when a particular specialist is not already on staff or readily available in-person.  Giving ED staff the ability to facilitate virtual consults on-demand improves their impact within their own community – regardless of distance between the ED and the specialist. ED staff can also conduct HIPAA-compliant virtual meetings to drive better collaboration amongst the broader care team across the care continuum. Communication can be maintained with the appropriate care team members (including the patient’s PCP, a pharmacist, a coordinator at the next care facility, etc.) to ensure the patient’s overall health needs are regularly discussed and addressed in the ED and during the transition of care – without requiring care team members to drive to/from meetings at different locations and facilities.

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Making the Most of Meaningful Use Deadlines

Guest Column by Val Van’t Hul, Meaningful Use Project Manager, DocuTAP.

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Val Van’t Hul

Providers at urgent care centers around the country are preparing to attest for either Stage 1 or Stage 2 meaningful use this year, and knowing the differences in reporting periods can make a huge difference in the process. Reporting periods vary depending on which stage an eligible professional (EP) is in, and whether a provider is attesting through the Medicaid or Medicare EHR incentive program.

To further explain this process, here are the reporting periods for 2014 indicated by the Centers for Medicare & Medicaid Services (CMS):

Medicaid

An EP must select any 90-day reporting period that falls within the 2014 calendar year. Since Medicaid is state government-based, urgent care centers are tasked with researching any particular rules and regulations that pertain to their location, as these vary from state to state.

Medicare

An EP participating in the first year of meaningful use (Stage 1, year 1) must select any 90-day reporting period. However, to avoid the 2015 payment adjustment the EP must begin the reporting period by July 1 and submit attestation data by October 1, 2014. This grace period is designed to help clinics that are still working out best practices and processes for attestation.

Medicare – An EP who is beyond their first year of Meaningful Use (Stage 1, year 2 or beyond) must select a three-month reporting period that is fixed to the quarter of the calendar year (i.e. July to September or October to December). There is not one quarter that is better than others for reporting, but clinics should keep in mind that there should be ample time to implement any changes in clinical workflow prior to the start of the reporting period. If an EHR vendor is properly certified for Meaningful Use and the urgent care client can begin the process, they may choose a later reporting period to allow time to properly order their workflow.

Meaningful Use Tracking & Reporting

Urgent care centers should monitor clinical workflow progress often to benchmark the eligible professional’s progress in working toward achieving Meaningful Use objectives. It is wise to run meaningful use reports from the EHR software, as well as conduct a provider analysis every few weeks to find out where and how adjustments need to be made in the progression toward these objectives. If EPs are falling below a preferred threshold in any area, this benchmarking provides ample time to get up-to-speed on clinic initiatives.

In addition to implementing tracking measures, it is necessary to understand the importance of delineating between “yes or no” and numerator/denominator reports. While the former are fairly self-explanatory (i.e. as with drug interaction checks), clinics should take careful documentation measures to prove compliance, including taking regular screenshots of what is happening in a clinic’s EHR software system during the reporting period. For example, when pop-ups of patient medicinal allergies occur, a screenshot of this notification, along with a date/time stamp, should be taken and a copy kept on file for up to six years, as this is the standard amount of time for which CMS may audit the eligible professionals.

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