Guest post by Donald M. Burt, MD, Chief Medical Officer, PatientKeeper, Inc.
Don Burt
Many physicians and revenue cycle professionals at healthcare provider organizations are suffering acute ICD-10sion as the calendar flips relentlessly toward October 1.
For all the complexity associated with ICD-10, there are some relatively simple things healthcare providers can do to prepare the front-end of their revenue cycle for the change-over. By “front-end” we mean physician charge capture, the origin of much of a practice’s revenue. The key to success is to make physician charge capture as tailored, flexible, and straightforward as possible for physicians, billers and coders.
A system is tailored when it exposes only relevant codes to physicians in a particular specialty or department, and when it provides fine-tuned code edits. It is flexible when it lets physicians enter charges on the device of their choice – a computer in the office or at home, a smartphone in the car, a tablet anywhere – and when it gives physicians the ability to use familiar clinical terminology to look up codes. And a charge capture system is straightforward when it is seamlessly integrated into physicians’ workflow via the EHR, and into the finance staff’s workflow via the billing system, necessitating fewer clicks, taps and swipes by all users.
An organization that knows this firsthand is Stony Brook University Physicians on New York’s Long Island. This academic practice affiliated with Stony Brook University School of Medicine has 17 clinical departments through which patient care services are rendered and billed.
For a variety of business reasons, the group’s administrative arm, called the Clinical Practice Management Plan (CPMP), implemented an electronic charge capture solution 10 years ago. A return-on-investment (ROI) study of several departments showed that, over a six month period, charges increased by $2.5 million ($5 million annualized) and claim volume increased by 29 percent. Overall, these departments saw a 50 percent reduction in lag days. One department with particularly dramatic results saw its number of claims increase by nearly 70 percent, while the number of coding issues actually declined by six percent. Clinicians can now quickly and easily record charges for services they deliver – at the point of care, in the office, or anywhere in between.
Along the way, Stony Brook CPMP gained valuable insight into the critical elements that make up a successful charge capture system.
In this series, we are featuring some of the thousands of vendors who will be participating in the HIMSS15 conference and trade show. Through it, we hope to offer readers a closer look at some of the solution providers who will either be in attendance – with a booth showcasing and displaying key products and offerings – or that will have a presence of some kind at the show – key executives in attendance or presenting, for example.
Hopefully this series will give you a bit more useful information about the companies that help make this event, and the industry as a whole, so exciting.
Elevator Pitch
PatientKeeper provides workflow applications for physicians that transform hospital EHRs from what they typically are – a distraction or hindrance topatient care – into what they should be: an intuitive support system for physicians.
About Statement
PatientKeeper, Inc. is a leading provider of healthcare applications for physicians. PatientKeeper’s highly intuitive software streamlines physician workflow to improve productivity and patient care. PatientKeeper’s CPOE, physician documentation, electronic charge capture and other applications run on desktop and laptop computers and popular handheld devices and tablets. PatientKeeper’s software integrates with many existing healthcare information systems to help provider organizations drive physician adoption of technology, meet Meaningful Use, and transition to ICD-10. More than 60,000 physicians across North America and the UK use PatientKeeper software.
Market Opportunity
PatientKeeper plays in two different market segments: (1) EHR optimization, and (2) revenue cycle optimization. In the former, we target 100+ bed community hospitals and hospital networks that rely primarily on affiliated physicians (vs. employed physicians) for patient admissions – clinicians whose loyalty (and business) must be “courted” and competed for – and which have not deployed or committed to an Epic EMR system. In the “Revenue Cycle Optimization” side of our business, we target physician practices of 25 doctors or more (but typically larger academic medical groups), and hospitals with a significant corps of employed physicians.
Health IT pain points seem to be lingering long despite the never ending promises and hope eternal new technology innovation seems to offer. Every sector has its prickles, no doubt, and much is left to overcome in healthcare, but given the complexity and the copious amount of change and development here, it’s of little surprise that pain is being felt.
What may be surprising, though, is that like patient engagement, there seems to be a different type of pain, and severity of pain, depending on who you ask.
With that, for greater clarity, I decided to ask some of health IT industry insiders what they’re pain points were and why. Their responses follow:
Dr. Trishan Panch
Dr. Trishan Panch, chief medical officer, Wellframe
One of the biggest pain points for hospitals is that we’ve come across a health system’s inability to scale care management resources. They are effective in improving outcomes when patients are engaged, but because of limitations around existing models (i.e. human interaction via phone or in-person) only a small proportion of the patient population can be engaged. That’s why organizations are turning to technology solutions to scale care management resources to reach more people.
One of the biggest pain points for physicians today is the lack of interconnectivity between different IT systems. Participation in the meaningful use program has helped create some common standards for communication but, for a variety of reasons, these have not yet lead to widespread, effective clinical data sharing. Few physicians can operate in the ecosystem of a single electronic medical record, since they often work in systems that are different, from practice, various hospitals and other places of care.
Interoperability is a pain point in healthcare IT, particularly when it comes to transitions in senior care. Connecting the care delivery ecosystem to provide safer transitions of care is critical to long-term care. While some individuals may require short-term rehabilitative care, others may need home-based care, assisted living or long-term and hospice care. As seniors move through these different stages or between acute care and post-acute care, these transitions pose challenges for healthcare providers. Ideally, all the information that clinicians need to treat the individual will be available when he arrives at his new destination. However, this is not always the case. Healthcare providers, both long-term and acute, must invest in an infrastructure that supports seamless transitions of care; interoperability plays a vital role. Connecting healthcare providers across the care continuum will allow for better health outcomes, help reduce unnecessary hospital re-admissions, as well as keep healthcare costs down.
There are various statistics about the negative impact paperwork has upon providing healthcare. The AHA has estimated it adds at least 30 minutes to every hour of patient care provided. A main pain point continues to be the ability for IT to implement efficient EHR systems. At the core of any EHR system are its image capture capabilities. It must be simple to use throughout the workflow process. This includes image capture, editing, saving and sharing. The capture, or scanning, must be speedy. Editing features must be clear in how to use. This minimizes learning curves at the start. It also optimizes the speed of processing documents during the life of its use. Easy saving to local or network locations should also enable simple and secure sharing too. When one, some or all of these areas stall, it can cripple the realization of benefits from digital document management.
PatientKeeper provides workflow applications for physicians that transform hospital EHRs from what they typically are – a distraction or hindrance topatient care – into what they should be: an intuitive support system for physicians.
