By Catherine O’Leary, RN, managing director, healthcare advisory/CDI, KPMG.
Catherine O’Leary
COVID-19 is imposing a humanitarian and economic toll around the world, and healthcare providers are on the front lines of the response. New COVID-19 medical codes that went into effect on April 1 have an important part in clinical decision making, disease surveillance, population health management and research on the pandemic.
The new codes allow healthcare officials, clinicians, and researchers to capture claims data and use the information to better inform a course of action tied to COVID-19, whether that is for setting aside more beds, creating special units to handle the highly contagious viral infection, routing ambulances to facilities that can handle the emergency or other responses.
Because of the evolving situation, codes are rapidly changing. With every coding update, it is vital for everyone involved in the reporting of claims data, such as coding professionals, clinical documentation improvement specialists, healthcare IT professionals and coding auditors to respond to the changes.
All COVID-19 confirmed cases, documentation of a positive COVID-19 result, or a presumptive positive COVID-19 test result should be coded as U07.1, COVID-19. As a general rule, it is still imperative to follow the Official Coding Guidelines in the selection of principal or first-listed diagnosis (i.e., sepsis, obstetrics, etc.). Furthermore, it is important to report the other conditions/co-morbidities to present the overall severity and risk of mortality of a patient. If a patient presents with signs and symptoms with no definitive diagnosis, there are codes available to capture the reason for the encounter.
This is the guidance that we’re receiving on telehealth:
Services provided do not need to be COVID-19 related and can be offered in all settings, including a patient’s home.
Payers will not enforce the requirement that patients will have an existing relationship with the physician (clinician?) providing telehealth.
Physicians in one state may provide services to patients in another state, but state licensure applies.
Providers will be reimbursed at the same rates as if the service was provided in person.
Telehealth claims should properly reflect the place of service code (02-Telehealth).
With the coding guidance from CDC, the onus is still on healthcare providers to stay informed about the current regulations, as well as potential changes to ensure that COVID-19 encounters are recorded appropriately. Also, the data gathering helps with clinical decision making for quality patient care, disease surveillance, population health management, research and regulatory mandates.
By Rick Halton, vice president, marketing and product, Lumeon.
Since it was first recorded late last year in China, the spread of COVID-19 has accelerated around the world, rapidly creating a global pandemic. The number of new cases is increasing exponentially, putting the western hemisphere in particular on a frightening trajectory, as health systems struggle to battle the virus.
Though billions of individuals around the world are undergoing mandated lockdowns and committing to physical distancing, hospitals continue to be engulfed in an onslaught of COVID-19 patients. One of the most significant impacts of this virus is how rapidly it is overwhelming health systems, consuming critical resources including inpatient beds, intensive care ventilators and importantly, care teams themselves.
Fortunately, technology has incredible potential to help automate and coordinate care communication and tasks. By taking advantage of agile technology platforms, health systems can rapidly deploy new use cases to help deal with the crisis – from early risk identification, screening and patient sign-posting, to helping patients reduce anxiety and self-manage their symptoms.
By leveraging automation, health system leaders can control the curve far more efficiently than ever before. The promise of automation is to ease the COVID-19 burden on staff and resources, giving them the arsenal to fight this disease and ensuring that any future outbreaks never get the chance to evolve from an epidemic to a global pandemic. When it comes to applying automation in the fight against COVID-19, four particular use cases come to mind:
Automated Awareness Campaigns
Tech capabilities that are already prevalent in the public-health sector can also play a critical role in controlling the current pandemic and future outbreaks. For instance, most health systems use Population Health Management (PHM) or Business Intelligence (BI) software that can quickly create and segment cohorts of patients. These solutions can help to identify people and communities at highest risk of COVID-19 complications, based on variables that go beyond the patient’s medical history. Different cohorts with varying degrees of risk can be created, such as the elderly, those with a pre-existing disease including respiratory problems, or those residing in high-risk locations.
Campaigns can then be directed at these cohorts and tailored to address their frequently asked questions or wide-spread myths surrounding COVID-19, as well as advising on how to protect against the virus and self-manage symptoms. Campaigns might also include tips for social distancing or advice about the risk in their specific communities. A critical consideration is how effectively the data can be anonymized with respect to the patient’s consent, along with opt-in/out preferences.
Depending on communication preferences – often found in the Electronic Health Record (EHR) system – email, voice and SMS campaigns can be sent out to each cohort. Using these communication tools while targeting specific cohorts of the community can go a long way toward providing reassurance and preventing panic visits to health centers and hospitals.
Automated Screening
Automation technology can also enable more comprehensive screening solutions that proactively assess risk. In this use case, a cohort of vulnerable patients is automatically engaged with a survey that screens for symptoms and, depending on the results from the survey, may then be proactively monitored for the next several weeks. If a patient’s symptoms increase in severity or frequency, they might then be directed to a nearby clinic, with the system automatically generating a list of potential locations based on the patient’s zip code.
This form of automated proactive screening can significantly improve detection of the highly contagious virus and eliminates exposure by allowing doctors to evaluate patients’ symptoms and triage without direct contact. It also limits hospital intake to patients who are most likely to be diagnosed with COVID-19, instead of flooding providers unnecessarily and straining limited resources.
LocumTenens.com asked physicians and advanced practitioners about their experiences with healthcare consolidation as part of its 2019 Compensation and Employment Survey. It can take years to determine success or failure, but one thing is certain: consolidation impacts an organization’s staff and patients.
The results of the survey are insightful. First, 41% of respondents had been employed at an organization where there was a merger or acquisition, and 16% of those respondents were laid off as a result.
Although 42 percent of respondents believe their organization gained access to additional resources, technology or expertise because of consolidation, only 23% reported quality of care has increased, which can be tied back to reduction in staff.
Layoffs often mean remaining providers are seeing more patients than ever. As one internal medicine physician from the northeast wrote, there’s “pressure on doctors to see more patients, [which means] less time for office visits.” This physician, who has been practicing for almost 30 years, was part of an organization that experienced layoffs. Although she was able to keep her position, she plans on making a job change within the next six months.
Unfortunately, the pressure to see more patients can lead to provider burnout and decreased quality of patient care. This is especially true if providers have less face-to-face time with their patients.
One of the motivating factors for consolidation is the desire to launch new or enhance existing service lines. Utilizing locum tenens clinicians in these situations means patients are being seen much sooner than they would if an organization hired new permanent staff members, which can take months or years. Locum tenens providers have worked in a variety of settings, where they’ve picked up best practices that can more readily be incorporated into a newly consolidated organization with a malleable culture. They’re available and ready to work in a pinch, allowing organizations to profit faster.
One troubling statistic that came out of the survey is only 14% of respondents felt valued by the larger organization post consolidation. Lack of feeling valued can also lead to a higher incidence of clinician burnout and hinder the success of the consolidated organization. We explore ways hospital and practice administrators can ensure their healthcare providers continue to feel valued after a merger or acquisition, and ways administrators can demonstrate they place value on the shared culture of the consolidating facilities, on our website.
It was almost 10 years ago that five roadblocks to patient care were defined, including the following:
Cost
Integration of technology
Technology
Organization culture
Relevance
When I look at that list of roadblocks now, I wonder if we can really claim to have overcome any of them. But rather than look at this list as what we haven’t achieved, let’s look at it as an opportunity to improve healthcare for patients, practitioners, and organizations.
There are still clearly issues with the first three roadblocks (cost, integration of technology, and technology). I don’t have to tell you that healthcare payment and reform is a major issue of the U.S. presidential campaign. Looking back at the recent past, even with the passage of the Affordable Care Act and the beginning of the integration of electronic health records, healthcare probably doesn’t cost appreciably less for patients than it did in 2011.
Still, almost a decade after these roadblocks were identified, many electronic health record systems cannot communicate with other such systems. This communication also does not even begin to consider data privacy protection and the need to meet HIPAA regulations.
However, artificial intelligence, new imaging modalities, better prosthetics, and more illustrate how technology is moving healthcare forward.
The last two roadblocks, organizational culture and relevance, come down to patient communication and what patients want and need. We finally have the technology to help practices communicate with patients in ways that are convenient for the patient, not just the practice. Fortunately, the ways in which practices communicate with patients has evolved significantly over the last decade.
Patient relationship management
Organizational culture and relevance are the two roadblocks where real change may be happening. With the further widespread use of communications technology for patients and evolving patient relationship management software for practices, healthcare practices now have the ability to find out what patients want, what kind of care they require, and how the practice is doing in their eyes.
Did you know that around 7% of patients will find a different healthcare provider if they aren’t satisfied with their care or some other aspect of their experience at an office, including how a practice communicates? If a practice has 2,000 patients, that’s 140 patients that may leave each year. And when those patients leave there is additional time and expense in administration and in marketing — just to stay at the same level the practice was at previously.
Patient relationship management (PRM) software can help a busy practice understand patient satisfaction and build better relationships. As an example, a practice can use its PRM software to develop a short survey for its patients. The practice might want to know about a new provider in the office, the front-desk experience, what new services the practice should consider adding, and more.
Better communication and compliance
An October 2019 report in Medical Economics stated that 83% of practices that used PRM technology said they were able to communicate better with their patients and 81% of practices that used PRM software now had a no-show rate of 10% or less.
What this means for practices may be no less than a revolution in how healthcare is communicated to patients. Patient relationship management software, fully integrated with a practice management system, offers the opportunity to increase patient treatment compliance, increase practice efficiency, and boost a practice’s revenues.
By Chris Plance and Kunal Patrawala, healthcare experts, PA Consulting.
Artificial intelligence tools, such as natural language processing (NLP), can be applied to unstructured data to produce real-time and nuanced insights. NLP can be applied to many types of unstructured data in a provider setting, however, the ideal approach is to apply these tools to a non-clinical source of unstructured data first.
Non-clinical unstructured data provides organizations with a perfect platform to develop their skills. Two well-known sources of such non-clinical unstructured data are consumer assessment of healthcare providers and systems (CAHPS) and hospital consumer assessment of healthcare providers and systems (HCAHPS) surveys. Applying NLP to CAHPS and HCAHPS surveys can help providers improve their top-box scores, build confidence and capabilities in their data skills, increase revenue, and allow organizations to take the crucial first steps towards the journey of unlocking 100% of their data.
CAHPS and HCAHPS Surveys play an important role in today’s Healthcare environment and are a substantial source of structured and unstructured data
Similarly, private payers are also tying these metrics to reimbursement. The advent of healthcare consumerism has also led to patients extensively using tools such as CMS’s Star Ratings to make informed decisions. As a result, CAHPS and HCAHPS surveys have downstream effects on reimbursement, star ratings, and brand loyalty which makes improving top-box CAHPS and HCAHPS scores vital to a provider’s financial and operational health.
CAHPS and HCAHPS contain both structured (numerical ratings) and unstructured data (patient comments). These patient comments are accessible, and approximately 50% of the patients who take HCAHPS surveys leave comments. Unlocking this unstructured data can provide more comprehensive and specific information that cannot be gauged from only structured numerical ratings.
By Andriana Moskovska, content curator and contributor, Legaljobsite.net.
With every technological advancement, we’re working toward a mostly digitized healthcare system. And, if the current results are anything to go by, the future is bound to be an exciting one. That said, though, we’ve still got a long way to go.
Healthcare is slowly embracing AI and other technologies to improve services to clients. Six out of 10 healthcare companies already use some form of internet of things (IoT).
We could do better when it comes to incorporating AI, but at least we’re making some progress. In this post, we’ll look at how higher levels of digitization will improve the healthcare industry.
More Digitization Means More Personalized Service
It seems paradoxical, but our current drive toward better efficiency has ignored the human aspect. Doctors today receive a lot of information, most of it digital. Their concern is that by needing to analyze these reams of data, they’ve got less time to deal with their patients.
Digital measurement standards being applied often leave doctors frustrated. They feel that they have to work toward standards that have little relation to the overall quality of work.
Artificial intelligence could change that. Not only can AI speed the diagnosis of conditions, but it can also provide a more rounded analysis of a doctor’s performance. AI can assess a range of factors quickly and easily.
Using AI can make it possible to assess how rules affect doctors at the ground level properly. That could lead to more rules that make sense once implemented, which, in turn, could lead to the scrapping of onerous regulations that get in the way of successful patient outcomes.
Digitization Can Fill Healthcare Data Gaps
If we look at the way that healthcare systems collect data, we see huge gaps. Most of the time, data is only collected when patients interact with the system. That is when they’re ill and need to see a doctor. This leads to a system of reactive treatments.
A genuinely useful healthcare system, though, should be able to predict potential health risks, give patients advice on how to manage those risks, and to collect as much data as possible when the person is feeling well.
We’ve had a range of monitoring tools for some years now. Fitbits, home blood pressure checkers, daily blood glucose monitoring kits are all examples of monitoring tools most of us have access to. Many of these tools can now be connected online. That leaves us with a wide range of options that can give our healthcare system a far more complete picture of our health.
Your Fitbit, for example, logs how many steps you walk on any given day. Your blood pressure kit can point out times when your blood pressure is particularly high.
Information that the machines can’t provide, such as how much food you ate, or how you’re feeling, could be entered into an app built for the purpose.
Many people drink alcohol for varied reasons and on different occasions. For some people, alcohol is part of their dinner. Others drink because they enjoy how alcohol makes their brains a little fuzzier. For some people, alcoholic beverages relax constant worries in their minds while making things funnier.
However, alcohol consumption may start as a simple way to have fun and relax but end up being a serious problem. Today, many people are battling alcoholism after starting with a glass of wine at dinner or occasional drinking. And, the addictive nature of alcohol makes quitting a major challenge for most people.
But, it gets to a point where a person decides to quitting drinking without AA information at AddictionResource. This can be due to varied reasons including health problems and the desire to embrace a healthy lifestyle. Unfortunately, there is no easy moment to get sober. However, a global pandemic presents a moment when a person can get sober. Here are some of the reasons why people should try to get sober during quarantine.
Immune System
Research indicates that alcohol affects the immune system negatively. It particularly makes the body more susceptible to respiratory illnesses like pneumonia and acute respiratory stress syndrome. COVID-19 is a dangerous respiratory disease.
Therefore, drinking alcohol can compromise the immune system when a person needs it the most. Getting sober during quarantine is, therefore, important to ensure that a person has a strong and effective immune system at the time of coronavirus pandemic.
Relationships
Most people in love relationships are better when sober. Drinking loosens up the tongues of most people. As such, some people say bad things when drunk and blame it on alcohol when sober. Unfortunately, this makes life hard for partners, especially at this time when they have to stay at home.
Quitting alcohol can, therefore, improve the relationships of some couples. Life is already hard during quarantine when some partners have to be together 24/7. As such, picking unnecessary fights due to alcohol influence can only make life miserable for such couples. On the other hand, quitting can improve the life of partners because they can engage each other meaningfully.
If your skin itches, breaks out or has other unusual symptoms, it’s often difficult to discern the cause. If the problem persists, then it may be a chronic skin condition. The best thing to do is to see a dermatologist because there are more than 3,000 possible diagnosis options.
Here are some possible ways a dermatologist could help you:
Tell you about your skin type so that you can build a skincare routine.
You need to know your skin type before you can select the right product. Is it dry? Is it oily? Do you have sensitive skin? Unless you know your skin type, you won’t know how to shop in a cosmetic aisle or may use an online skincare hack that makes your skin worse.
Suggest at home-treatments for skin problems that don’t respond to medication.
If you do have a chronic issue that won’t respond to medication, you might benefit from home phototherapy, which can effectively treat a variety of conditions, such as severe eczema, vitiligo, and psoriasis.
Give you guidelines on how to take care of your skin.
Here are some general guidelines that dermatologists suggest for all skin types:
Wash your face twice every day, once in the morning and once in the evening.
Get enough sleep at night. While the average amount of sleep a person needs is about eight hours a day, everyone is slightly different. You will know if you’re not getting enough sleep if you show signs of sleep deprivation.
Avoid toxic environments, such as places with heavy tobacco smoke or chemical pollutants.
Exercise regularly — 30 minutes at least three times a week.
A skincare routine consists of cleansing the skin, moisturizing twice a day, using an anti-aging skincare product, and wearing sunscreen when you go outdoors.
Cleansing: While it’s important to wash your face every day, don’t overdo it. Twice a day is enough. Also, don’t wash your face until it is squeaky-clean because this will also wash away the natural, protective oils on your skin. Use a mild cleanser, either one for your specific skin type or one that works for all skin types.
Anti-aging products: There are many effective serums for reducing signs of aging. They usually contain peptides, growth factors, and vitamins C and E.
Sunscreen: Since most skin damage occurs due to sun damage, skincare experts recommend wearing sunscreen with at least 30 SPF. Apply it at least 15 minutes before heading outdoors.
If the idea of creating your own skincare routine is overwhelming because you have no idea what products to buy or how to follow a skincare process, consider using a skincare kit. Many brands bundle all the right products and give you clear instructions on how to follow a complete skincare kit.
In conclusion, if you have skin problems, see a dermatologist rather than just making an educated guess. After an examination, they might recommend medications and give you advice on how to create a skincare routine for healthy skin. A dermatologist will also tell you about
your skin type. By knowing your skin type, you can choose effective products. Even if an advertised product is excellent, it may not be the right one for you. In fact, choosing the wrong product for a cleanser, serum, or moisturizer may make your skin worse, causing breakouts or blemishes.
Since it was first recorded late last year in China, the spread of COVID-19 has accelerated around the world, rapidly creating a global pandemic. The number of new cases is increasing exponentially, putting the western hemisphere in particular on a frightening trajectory, as health systems struggle to battle the virus.
LocumTenens.com asked physicians and advanced practitioners about their experiences with healthcare consolidation as part of its 2019 Compensation and Employment Survey. It can take years to determine success or failure, but one thing is certain: consolidation impacts an organization’s staff and patients.
By Chris Plance and Kunal Patrawala, healthcare experts, 