Top News
Tech Tips
Advances in technology have made learning anatomy a much more dynamic experience. No longer bound by textbooks and 2D images, individuals can now learn anatomy using their Apple device.
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Tech Tip: Send Secure Texts with DocHalo
Sunday, 08 November 2015
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Tech Tip: Acrendo A.I. med 9 May Be What the Doctor Ordered
Friday, 25 September 2015
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Tech Tip: PrognoCIS Improves Office Functionality
Saturday, 15 August 2015
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CDC Releases Tickborne Diseases App
Thursday, 30 July 2015
The Buzz
An 84 year old doctor in New Hampshire who refuses to use a computer has lost her medical license. So reports ABC News.
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Patients Dissatisfied with Denial of Requests
Sunday, 03 December 2017
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Physician Pay in Spotlight
Sunday, 03 December 2017
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Sleeker Note Design Prevents Info Overload
Sunday, 03 December 2017
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Texas Law Makes Medical School Affordable
Saturday, 04 November 2017
Practice Management
If doctors could rely on crystal balls and peer into the genomics of each patient to prescribe the right treatment at the right time, then delivering Personalized Medicine (PM) would be easy and health, rather than disease, would be a way of life.
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Preparing for the ICD-10 Compliance Deadline: One Expert’s View
Sunday, 26 April 2015
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A Solution to the $60B Appointment Cancellation Problem
Saturday, 28 February 2015
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Coding Strategies for Physicians as ICD-10 Deadline Looms
Sunday, 15 February 2015
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Lifestyle Medicine: A Transformative Force in Clinical Practice
Friday, 28 November 2014
News
Most business executives want to see the Affordable Care Act repealed, a survey of CEOs, chief financial officers and other senior-level CPAs by the American Institute of CPAs found.
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AMA Adopts Principles to Promote Safe and Effective Mobile Health Apps
Sunday, 20 November 2016
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AMA Offers New Resources to Help Physicians Amid Changing Landscape
Saturday, 30 April 2016
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American Medical Association Supports Telemedicine Bill
Sunday, 07 February 2016
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AMA, MMS to Host Virtual Town Hall to Discuss Physician Discontent with EHRs
Friday, 25 September 2015
A Solution for Data Aggregation for ICD-10
Wellcentive has developed a software platform that aids physicians in complying with ICD-10 requirements and also helps improve the overall health of patients.
The Wellcentive Advance platform delivers an end-to-end solution for managing and tracking health data. It allows aggregation of information across healthcare partners, including connecting EMR, clinical and claims systems.
The Altanta-based company has thousands of providers and end-users in all 50 states, including more than 1,300 live interfaces that exchange more than 750 million healthcare data messages annually. It allows information to be interfaced with any health information technology system or vendor, with prognostics and health management that can be managed from web-based tools.
Users can track and report on 20,000 medical conditions and diagnosis, and can configure care gap alerts and point-of-care clinical decision support.
Many vendors claim that they offer population management systems (PHM), making it a complicated market. Wellcentive is making a name for itself with its experience, product features and data management capabilities. It is a system to consider when looking for solutions to help succeed with patient-centered medical home, pay-for-performance, accountable care, and other other clinical and financial outcomes improvement programs. It has integration and interfacing teams in place that help connect the Wellcentive system with EMR, e-prescribing, hospital, lab, payer, and other systems.
"Wellcentive solutions can help you attract new patients, with higher publicly reported quality rankings and an enhanced image as a physician who is using today's most advanced HIT tools to take a proactive approach to care," says Dr. Paul D. Taylor, Wellcentive's CMIO and a practicing physician.
While government agencies and payers develop new outcomes reporting requirements and create new reimbursement models, many physicians find that the data they need is stored in many different systems. It appears that Wellcentive is one strong choice to consider to put data to work in your practice and improve the financial health of your group.
webPoisonControlApp: A Handy Tool for Patients & Providers
There is a terrific app clinicians can use themselves and recommend to patients, especially patients with children in their household. It is the webPoisonControl App.
The app is a collaboration of a group of Poison Control Centers (PCC) located in various U.S. states, all under the guidance of the National Capital Poison Center in Washington, DC. It's a free, interactive tool that guides users through a specific poison exposure situation in much the same way it would be done if someone phoned into a poison control center.
Across the U.S., Poison Control Centers provide a critical resource at times of possible ingestion or exposure emergencies. But, with more people turning to the Internet to look up possible solutions to adverse ingestions, there was a need for a reliable and reputable platform. The App also has a similar Web-based version.
When using the App, the user is guided through a "survey the situation" set of questions to establish the demographic of the person ("patient" involved) and the seriousness of the incident. For example, does the incident involve a young child, pregnant woman, older adult, pet or disabled person.
The App also verifies if the incident is a possible suicide attempt. "Yes" or "No" responses to these questions take the user through a protocol, including securing immediate emergency medical attention.
Within the protocol, the App helps the user discern what substance was involved in the incident (e.g., a user can enter the product name, scan a bar code from a bottle, or enter the code imprinted on a pill). It also makes recommendations for action steps to be taken. Additionally, the App provides a list of common symptoms that may arise.
The user will receive follow-up emails about their case within 2 hours and at 8 hours, 24 hours and 3 days after the exposure. However, the app and online version do not replace making a call to a local PCC.
In fact, users will be prompted to make that call before they finish inputting all of the case information. In tandem with the call, the App provides a great way to have a record of the incident that can be referred to at the hospital, if necessary, or fduring ollow-up doctor's appointment.
The App was launched in April 2015 and is free.
Karen M. Rider, M.A. is a freelance writer and copywriter who specializes in healthcare news and technology, integrative medicine, wellness, and health psychology.
Review: Life in the Womb App Ideal for Clinicians, Educators & Patients
Life in the Womb App is an award-winning visual guide to pregnancy that uses 3D interactive features, illustrations and animations to explore the development throughout the 40 weeks of pregnancy.
Medical students, physicians, nurses, clinical and childbirth educators, and expectant parents will appreciate the app for its stunning visual presentation of what is going on both with the mother’s body and the fetal journey from conception to birth.
Now, when a clinician is explaining to patients what is happening at a given time in a pregnancy, they will have at their fingertips a tool to show how a baby develops, and what a baby can experience from within the womb. For example, there are simulations of 'in utero moments,' such the first heartbeat, kicking, when the eyes first open, first time hearing and tasting. In addition to providing excellent information about a baby’s development, Life in the Womb also explains medical processes such as checks and scans.
Life in the Womb was awarded the 2014 World Summit Award-Mobile for its innovation in learning and education. In February 2015, it was honored at the WSA Mobile Global Congress in Abu Dhabi. The app was developed in Dublin, Ireland, by The Science Picture Company in collaboration with Redwind Software and in consultation with The National Maternity Hospital and University College Dublin.
Key Features
- Week-by-week information about you and your baby through the 40 weeks of pregnancy
- Concise infographics explaining medical processes such as checks and scans.
- 3D rotations of baby at key stages of development
- Beautiful images, animations and interactive features showing your baby’s progress each week
Utility
A team of artists, programmers, doctors and writers created Life in the Womb app, with the goal to provide an entirely new educational experience for clinicians and patients. The app is very easy to use in the exam room, classroom or at home. Different features are accessible depending on how the user is holding their device. Holding an iPad horizontally displays all of the 3D visuals that are available for each week.
Users can navigate through each week by swiping their finger or by selecting a week from a handy menu. Turning the iPad vertically displays a combination of visuals and text for a rich hybrid experience.
Suggested Updates for Future Releases
The content of the app is written at a 12th grade reading level and above. Many narrations use scientific language and terms. While that makes the details quite interesting--and relevant context for the medical jargon is always given—users who's first language is not English or who are less educated will have a difficult time following some of the audio and text.
Images are Caucasian-normative; more ethnically diverse skin tones would make the app useful across clinical populations. Since the app was developed in Ireland, the metric system is used, as well as phrases customary to Irish culture (e.g., references to foods, and “minding one’s medications”).
Price: $4.99 iTunes as of 4/2015
Journal Club App Puts Landmark Medical Trials in the Palm of Your Hand
The sea of evidence-based medicine is vast, and wading through volumes of medical journals or digital feeds sent to an inbox isn’t practical.
Journal clubs came into existence to help doctors and healthcare providers efficiently keep up to date with key details of research papers and clinical trials. As enjoyable as it might be to meet with colleagues to discuss trends in research, that information needs to be accessible where doctors spend most of their time—with their patients.
In the last few years a number of digital resources have surfaced with the goal of providing clinicians with the salient points of current medical research. Journal Club app and its Web-based counterpart Wiki Journal Club (WJC) provide a user-reviewed collection of research summaries from medical literature.
These resources put the essential features of landmark medical trials right in the palm of your hand. The developer’s intention was to create a resource that allows clinicians to get the data needed while still being able to focus on direct patient care.
Utility and Main Features
Not unlike SparkNotes for literature, the Journal Club app condenses seminal articles into summaries that clinicians can quickly read and assess for relevance for their clinical needs. All content is written and peer-reviewed by physicians and medical providers.
The app sorts trials by Name, Date, Specialty and Disease, which appear as tabs on the bottom of the screen. The interface is clean and easy to use. Under Specialty, users will find an alphabetical list to scroll through. Clicking on a Specialty will take the user into a more detailed list of choices relevant to that area of medical research.
The same applies for the Disease tab. Clinical trials are also listed by name with helpful subtitles that explain the aim of the trial and year conducted. Browsing by Date pulls up all trials in chronological order.
Article summaries of trials contain the following information:
- Brief Overview, called The Bottom Line
- Major points of the study
- Design
- Population (Exclusion Criteria is noted)
- Interventions
- Outcomes
- Criticisms
- Funding
- Reference Links to original research accessed via PubMed, Full Text, PDF and/or WJC website
The writers of WJC and the JC app “have done an impressive job condensing large research papers into brief summaries without losing too much critical detail,” wrote Tom Lewis, editor of iMedicalApps.
It is not possible to review every Specialty within the app. However, it is important to note that clinicians who are users of the app have shared in reviews/forums that some Specialties have archived only a limited number of papers compared to what may be available in the medical literature at-large.
If there is a specific trial you want, and you can’t find it in the JC app database, that presents the problem of having to locate it in another resource. That being said, JC is updated weekly and has an ever-growing number of articles added to the database.
Journal Club app ($4.99) is designed for both iPhone and iPad as well as Android.
Doctor Loses License for Not Using Computer
An 84 year old doctor in New Hampshire who refuses to use a computer has lost her medical license. So reports ABC News.
The state claims that Dr. Anna Konopka's failure to use the state's mandatory electronic drug monitoring program and other recordkeeping issues are the reason they have taken her license away.
Patients Dissatisfied with Denial of Requests
A new study in the JAMA Internal Medicine finds that doctors who deny patient requests get a lower satisfaction rating. So reports Fierce Healthcare.
Whether the patient wants a referral to specialists, a certain laboratory test or medication, denying that request will lead to the patient rating their satisfaction with the doctor lower.
Physician Pay in Spotlight
Heathcare costs are a major topic of discussion, with critics saying that the majority of medical the costs are related to how much physicians are paid. So reports Forbes.
However, it is important to remember that physician pay only accounts for 20% of the total cost of healthcare spending in America.
Read the full article from Forbes.
Sleeker Note Design Prevents Info Overload
A new study from The Journal of the American Board of Family Medicine finds that having less information in the physician notes section can increase physician productivity. So reports EHR Intelligence.
Using input from physicians, researchers redesigned the notes to provide physicians with a collapsible note that displays assessment, plan, subjective, and objective. This style provides the most needed information to physicians with the least amount of clutter, preventing 'information overload'.
How Genomics & Personalized Medicine May Impact Your Practice
If doctors could rely on crystal balls and peer into the genomics of each patient to prescribe the right treatment at the right time, then delivering Personalized Medicine (PM) would be easy and health, rather than disease, would be a way of life.
From the very first step in the process—collecting personal genomic data through diagnostic testing—to the translation and integration of that data into customized healthcare decisions and optimal therapies for individual patients, personalized medicine is a complex process.
In recent years, PM strategies have evolved from pharmacogenomic interventions to encompass other health and medicine specialties such as nutrigenomics. Proponents of PM say it is the future of medicine. It offers a more targeted treatment approach, specific to the individual patient and, based on their unique genome, provides better opportunity for early diagnoses and intervention, more effective treatment, and more efficient development of medicines and therapies.
In 2013, the FDA demonstrated its commitment to this significant and emerging area of medicine. The agency’s report, “Paving the Way for Personalized Medicine: FDA’s role in a New Era of Medical Product Development" (PDF), outlines steps that need to be taken in order formulate regulatory standards, tools and methods for personalized therapeutics and diagnostics, including the integration of genetic and biomarker information for clinical use and drug development.
Roberta Kline MD, FACOG is a specialist in clinical training and patient education for genomics and personalized medicine. She is co-founder and CEO of both Genomic Solutions Now and the Genesis Center 4 Personalized Health. Through these organizations, Dr. Kline and her partner, Dr. Joe Veltmann help clinicians around the world learn how to understand and apply genomic testing and interpretation in their practices.
Dr. Kline shared her insight with The Progressive Physician about the role of PM in disease risk assessment, intervention and treatment, and how clinicians can start to integrate PM in their medical practice.
Q: What exactly are we talking about when it comes to genomics and the disease process?
A: With genomics, we are not talking about inherited genes where the disease process is inevitable and a person cannot do anything about it, such as cystic fibrosis, BRCA1 and BRCA2 breast cancer, hemophilia, or sickle cell anemia. Genomics is in an entirely different league. We are talking about genes that have altered function, which then predisposes someone to a chronic disease especially if the altered gene function is exacerbated by a toxic environment, poor lifestyle or dietary choices, lack of exercise or a very stressful situation.
Q: What is the role of genomics and PM in disease risk assessment?
A: Knowing a person’s genomic "anatomy" helps reduce or eliminate guessing about chronic disease(s) for which a person may be at risk. Instead of relying on family history, or waiting until disease signs and symptoms appear, genomic testing gives the person and his/her healthcare professional an opportunity to mitigate or even prevent the disease process.
For example, most breast cancer is related to estrogen metabolism, and most women who develop this most common form of breast cancer have no family history, and thus don’t know their risk.
A genomic test can empower a woman with knowledge about her risk and, with the help of her healthcare professional, develop disease-preventing interventions and screening tools that are individualized to her specific health needs.
Q: What about intervention and treatment?
A: Most of medicine recommends a one-size-fits-all approach on eating right, exercising, reducing stress, etc. Conclusions drawn from population-based studies are often in conflict with one another about a particular dietary, lifestyle or exercise recommendation because all study subjects are considered genetically identical. Wrong. While all humans share about 99.9 % of the same genetic information, the 0.1% makes us all unique, and special—extending even to what each person uniquely needs to support his/her health.
Genomic testing, and interpretation of those results, enables a healthcare professional to personalize diet and lifestyle recommendations, supplements and medications. It helps them know how best to monitor the effectiveness of those interventions, and where to focus healthcare resources for screening and diagnostic testing.
For instance, there are many conflicting studies about vitamin D and its impact on health. Vitamin D is a complex hormone (it’s not actually a vitamin) that is involved in many biochemical and metabolic pathways in the body. If an individual has a genomic error (we call them SNPs or single nucleotide polymorphisms) in one or more of the many genes involved in synthesizing vitamin D, delivering it to tissues and finally to a cell, the dosage requirements and measurement standards will be different. Genomic testing helps a healthcare professional know what a particular person needs based on their DNA.
Pharmacogenomics is the study of how a person's genes can influence the potential effectiveness of a medication, whether a person might experience drug-induced side-effects, or how a medication might interact with other pharmacological or over-the-counter medications or botanical extracts. It does not take a long to realize that if pharmacogenomics testing is employed by a healthcare professional before a prescription is filled, it greatly improves outcomes and decreases potential side effects, saving the person and healthcare professional time, money and aggravation.
Q: How can clinicians learn about and integrate these methods into their medical practice? What clinical skills do they require?
A: The one key I have realized in the time I have been using genomic testing is the need to understand biochemistry. Not the type of biochemistry that was taught in medical school, but a very practical and applied approach, which dovetails with the way clinicians process information and look for patterns.
While knowing the basic concepts and biochemical pathways are not a prerequisite to utilizing genomic testing, it certainly helps when discussing nutrigenomic recommendations with a patient, and knowing how to use the information clinically.
Several resources exist for clinicians wanting to learn more about genomics, and I highly recommend taking online courses or going to conferences to supplement your current knowledge. Training in functional medicine will help you not only understand the biochemistry of the various metabolic systems, but also provide insights into lifestyle-based interventions.
I found the best way to shorten the learning curve is to do a genomic test on yourself or other family members. By walking through your own genomics, the "eureka" moments come faster, and you can speak with confidence and authenticity to your patients. Finding a mentor, who has had several years of experience in a clinical environment and can show you how to integrate the genomic test information into a health model, is another way speed up the learning process.
If you are thinking about introducing genomic testing into your clinical practice, I recommend you select a genomic testing company that offers specific test panels for the health concerns you see most often and that best fits your current patient population. Identify one or two patients most likely to benefit from this new technology and your new knowledge. If your patient population currently takes multiple medications, you may want to start with pharmacogenomic testing.
If you have patients with many of the lifestyle-related chronic diseases (cardiovascular disease, diabetes, obesity, or osteoporosis) start with a genomic panel that identifies and recommends evidence-based nutrigenomic strategies. Some genomic test panels are fairly small, some are extensive. Start with a small panel to develop confidence.
It is good to remember that not all genomic testing companies are created equal--use a genomic testing company that understands the clinical implications of their tests, provides useful interpretations and evidenced-based action steps, and presents the information in a user-friendly format. Succinct, concise, and easy genomic test results make it easy for busy clinicians to interpret the data and to convey the most important information to a patient.
Combining a patient's medical history, health concerns and genomic test results is the best way to create plan, prioritizing the most important health issues on the first visit and lesser health concerns in subsequent weeks. The first visit may take longer; patients get really excited about genomic information and ask lots of questions so just be prepared. After going through this process with 3-4 patients, you feel much more proficient and ready to progress to more patients with other health concerns. Ultimately, having all patients do genomic testing as I do in my practice helps personalize and prioritize their care, actually reduces healthcare costs and improves patient outcomes. And, just as important, it makes the life of a healthcare professional much less hectic, because you and the patient have created a personalized plan together.
Sources
"Paving the Way for Personalized Medicine: FDA’s Role in a New Era of Medical Product Development" (PDF)
"Personalized Medicine 101: The Promise" from Personalized Medicine Coalition
Journal Resource for Personalized Medicine
Clinical Research - National Human Genome Research Institute
CDC Office of Public Health Genomics Genomic Solutions Now: For Clinicians, by Clinicians
Preparing for the ICD-10 Compliance Deadline: One Expert’s View
CMS.gov, the website for the Centers for Medicaid and Medicare Services, has a ICD-10 countdown clock running on its website. As of mid-April, it read something like: 170 Days, 9 Hours, 43 minutes and 47 seconds. But many practices are still scrambling to prepare for the Oct. 1 deadline.
Regina Kraus, an expert on Health Information Technology programs and a member of the American Health Information Management Association (AHIMA) and the Ohio HIMA, as well as a board member of the Miami Valley HIMA, said that there are many steps that medical groups and physicians should be taking, especially in testing and training, to be prepared for the ICD-10 compliance deadline.
Among them, says Kraus, is that physician groups need to conduct a “practice inventory” to determine if they have the necessary resources in-house or if they should consider collaborations, outsourcing or a software purchase. She sat down with The Progressive Physician to talk about ICD-10 preparedness.
Q: What questions should physicians be asking themselves as the ICD-10 deadline approaches?
A: Providers at small practices need to build their action plan. This includes reviewing issues such as:
- Most hospital-based practices are anticipating a 50% decrease in productivity, so be aware of the time issues involved in accurate coding.
- What about personnel? Are you prepared to train current staff, hire new staff, or outsource your coding needs? Encourage coders/office manager to join coding and billing organizations to have the best access to information and training materials. Most hospitals have separate physician offices that offer training to their office staff. Consider training in-house staff. There are many opportunities available for enhancing your billing and coding staff.
- If the practice chooses to keep the coding and billing in-house, consider it a valuable and important investment and asset. What is the practice willing to invest to stay in control of their billing and reimbursement? Do you have staff currently on board that can meet the challenge? The first step would be to look at your current staff and identify who can or is willing to step up to the challenge.
Q: What obstacles or possible setbacks might care providers encounter while preparing for ICD-10?
A: A lot will depend on the size of practice, number of patients, physicians, dollars, etc. Some practitioners may choose to outsource their coding needs to a third party and not deal with trying to manage the transition in-house. That is fine, but be aware of the environment out there.
Many vendors are “keen” on promising much but delivering little. Choosing a coding vendor is no different or less important than any other third party vendor you may select. Check out your resources and ask for recommendations. See what other comparable practices are doing.
Another obstacle is the shortage of trained and available coders, depending on geographic location. Stiff competition exists for coders with hospitals offering sign-on bonuses and the option of remote coding positions. This is another reason to look at collaborations in your geographic location or the option of outsourcing.
Additional obstacles include the need for dual-coding. Many hospitals have started with this process of billing or coding for both ICD-9-CM and ICD-10-CM at the same time. Their billing systems can identify issues and problems with codes and documentation before the bill is dropped.
Can physician offices do the same? It may be more possible than you would think.
Q: Dual coding is suggested for the billing and coding workforce in anticipation of ICD-10. Physician practices should dual code and audit their charts for coding accuracy, the necessity of codes, and their documentation. What can an audit include?
A: An audit could include the following:
- Are the codes you have for your patient all necessary and current? The more codes that you have, the more codes need to be converted over to ICD-10.
- Pay attention if you have a lot of patients coming in from the acute care setting and you are treating patients in the post-acute care setting.
- What does your documentation indicate? Does it support the more specific ICD-10 code?
- Documentation needs to be reviewed for disease specificity, acuity, laterality, if applicable, disease stage, etc.
- Physicians need to consider if they are documenting to the level of specificity needed for a given specialty. Example: Your patient is diagnosed with Generalized Anxiety Disorder. Are they still being treated for that? Does the patient exhibit signs and symptoms of the disorder? They were prescribed anti-anxiety pills 10 years ago. Is it still an issue?
- Look at your NOS (not otherwise specified) and NEC (not elsewhere classifiable) codes. With ICD-10, some of those go away or you may need a much more thorough diagnosis/specific diagnosis with ICD-10.
- ICD-10 allows payors to target what they will and will not cover, so pay attention to the coverage determinations of your local insurance plans.
Q: What resources are available for care providers?
A: There are many resources available for care providers, including many reputable educational resources such as American Association of Professional Coders (AAPC) and American Health Information Management Association (AHIMA), and of course, the Centers for Medicaid and Medicare Services itself. In looking for resources (publications), make sure you are purchasing reputable information from a reputable source (CMS, AHIMA, etc.).
Q: What will healthcare most likely look like after ICD-10 is implemented?
A: The needs for healthcare billing, reimbursement, and retrieval of data will demand a much more precise and accurate coding and billing system Health insurance claim rejections are anticipated to be on the rise as both providers and payers “tweak” their billing and reimbursement systems. Hospitals are already dual-coding and running edits on their “anticipated” rejections. Clinical Documentation Improvement (CDI) specialist is one of the fastest growing non-patient related fields, usually held by nursing.
A Solution to the $60B Appointment Cancellation Problem
Cancelled and missed appointments are a daily burden that disrupts the flow of patients and results in a loss of revenue for the medical practice. In fact, as much as $60 billion dollars in lost revenue can result from cancellations and no-shows.
“If you take that $60 billion dollars and divide it by the number of physicians in the United States, that is over $76,000 per physician, annually,” explains Tom Dewane Founder and CEO of Jaystreet Technologies. LLC.
Dewane is the developer of a new solution for the operational and financial drain caused by “empty” appointments: Avenue is a SaaS hosted cloud-based software that seamlessly integrates with existing office technology used for medical practice scheduling. It is available and already running in a variety of medical organizations, most notably in a clinic within the Jefferson University Hospitals system in Philadelphia.
The two biggest drivers for high rates of cancelled appointments are wait times and life itself. Providers have less control over the latter, which can include things like changes in a patient’s work schedule, family matters, and household emergencies that prevent a person from keeping a doctor’s appointment.
“Research shows that patients who expect that they will have long wait times at their practitioner’s office are more likely to cancel at the last minute, or simply not show-up,” Dewane says. “The research [I’ve reviewed] does not indicate what action those patients take; it is pretty safe to assume that they either were seen by another provider or chose not to receive treatment.”
There are many approaches to managing patient wait times as well as dealing with patients who repeatedly cancel or fail-to-show for appointments. Such methods must be customized to the needs of the practice (e.g., urban clinic or affluent suburbia family practice). More important to the workflow in the practice is the fact that these strategies can increase the work of busy medical assistants. Commonly used strategies often involve making additional phone calls to patients. Avenue changes all of this by making it simple and effective to fill the empty appointment without anyone having to pick up the phone.
How Avenue Works
Avenue addresses two problems simultaneously: first, it allows your practice to keep an automated wait-list of patients who want to be seen sooner than the next available appointment. Their name, appointment preferences, and mobile number are stored in Avenue. Now, those patients won’t have to keep calling the office to ask if something has opened up in the schedule. Second, when a cancellation does come in, staff won’t have to waste time calling (and leaving messages for) patients on the wait-list—Avenue will do it for them via text message to patients on the list.
This video illustrates the process that is outlined below.
1. Wait-list patient names and cell phone numbers as well as desired appointment details have already been entered into Avenue. Avenue rank-orders wait-list patients by the preferences entered.
2. Cancellation is phoned in by a patient.
3. Text messages are sent to one patient at a time, inviting them to accept the available appointment.
4. If the wait-list patient replies “yes,” an appointment confirmation message is sent.
5. Avenue generates a pop-up message and sends an email to your scheduler to indicate who has filled the cancelled appointment.
Mr. Dewane explains text messaging is used, rather than an automated phone call to patients, because “far more people are able to answer a text at any given moment…A recent survey indicated that 64% of Americans want their first point of contact for customer service issues (and this is a customer service issue) to be via text.”
Avenue’s Success in Medical Practices
Typically, there is a 90% reduction in the number of empty appointments in less than one month. Avenue is in-place in an array of practice settings ranging from small, independent clinics to large, integrated delivery networks and covers a range of medical specialties.
Each medical practice or organization can choose from two different payment options for the service: pay-per-filled appointment model or subscription model. The former emphasizes the immediate and direct value of the service to the practice. Doctors see the ROI in number of patients seen, average collection of visits, and the cost of the service. A subscription model works best for clinics that need a predictable expense each month—in this case, a fixed price per provider per month—and the ability to have unlimited filled appointments.
Is Avenue Right for Your Medical Practice?
To determine if Avenue is right for your practice, discuss the following types of questions with your staff:
1) How far out is my next available appointment?
2) How many appointment slots are available on my schedule?
3) How many patients did I see today?
4) How frequently are patients cancelling?
If the first available appointment is a week out yet the doctor is seeing less than the maximum number of patients in a day, appointments are being wasted. Avenue can fix that problem.
Resources
- Why We Don’t Come: Patient Perceptions on No-Shows. Lacy NL, Paulman A, Reuter MD, Lovejoy B., Annals of Family Medicine 2004;2(6):541-545. doi:10.1370/afm.123. Accessed 23 Feb 2015
- Waiting Room Remedy: Doctor Pays for Delays (The Doctor’s Perspective). Pamela L. Wible Narratives 2012; (4); January 11, 2012
Coding Strategies for Physicians as ICD-10 Deadline Looms
It’s about 7 and a half months away – the ICD-10 compliance date of Oct. 1. While some organizations are pushing for a two-year set-back, others are urging Congress to avoid further ICD-10 delays.
Either way, if the ICD-10 compliance date isn’t moved, physician practices need to be ready to implement the new code set. Experts recommend complete and clear documentation of each patient so that claim submissions are not delayed; practice testing by coding them both the old system and the new; and charting workflow and contingency plans.
The Progressive Physician spoke with Joshua Berman, director of Business Analytics & ICD-10 Lead, Relay Health Financial, a McKesson company, who has been responsible for RelayHealth’s plans and preparation for the ICD-10 changes impacting our industry.
Q: What steps can medical groups and physicians take now, especially in testing and training, to be prepared for the ICD-10 compliance deadline?
A: I’d highly recommend 3 steps:
- Readiness – build a plan around getting the claim out the door. Make sure your systems are ready, your documentation is deep and detailed, and your coders are ready to code. For the last step, keep in mind that your coders probably only use 100 or so of the new codes for the majority of your business. Focus on those codes. Don’t let the daunting number of codes get in the way of perfecting the system around the codes you use.
- Test – test where you can. If you can’t test, ask the payers to be transparent in their other testing results. You can learn from their other testing. We all understand testing is limited to the resources payers can provide, but sharing that information can help everyone.
- Go Live Preparation – if you aren’t tracking and benchmarking your performance, start to do so now. For example, make sure you know your denial rate and the cause of those denials; understand how long it takes to get a claim out the door; and have a grasp on the amount of time it takes to get remittance from your payers. Create initiatives to improve those metrics now, thus reducing the impact of any failures resulting from ICD10 glitches after 10/1/15. Also, once you have those metrics and benchmarks, make sure you track them through 10/1/15 and after.
Q: What obstacles or possible setbacks might care providers encounter while preparing for ICD-10?
A: I am personally worried that the most simplistic processes are not going to be completed. The largest obstacle will likely be the lack of simple preparation. Everyone is offering advice on how to get ready and it may be easy to get distracted from what really matters. Try to keep your plans and preparation efforts focused on the processes and contributing factors that impact payment. When you boil it down, that is what is probably keeping you up at night.
Q: What resources are available for care providers?
A: There are some fantastic pieces and recommendations on the web, including products such as RelayHealth Financial Diagnostics and free websites such as CMS/Medicare’s http://www.roadto10.org/. Additionally, call on those vendors you are used to working with. Many began to attack ICD-10 many months or years ago, and have a great perspective on the ICD-10 transition.
Q: What will healthcare most likely look like after ICD-10 is implemented?
A: After the dust settles, it will be the same, just with more data available for analysis!!! It is crucial we catch up with the rest of the world in this area. ICD-10 coding will at least allow us to compare our outcomes with world mortality and morbidity rates, and ideally help hone initiatives to improve care in this country.
Tech Tip: Learn and Teach Anatomy with Essential Anatomy 5
Advances in technology have made learning anatomy a much more dynamic experience. No longer bound by textbooks and 2D images, individuals can now learn anatomy using their Apple device.
Apps such as Essential Anatomy 5 give users a seamless and fluid 3D experience. Available on iTunes ($24.99), Essential Anatomy 5 contains more than 8,200 highly-detailed anatomical structures.
The app has 11 complete systems (all accessible from the main screen); Muscular, Skeletal, Connective Tissue, Venous, Arterial (including the Heart), Nervous (including the Brain), Respiratory, Digestive, Lymphatic, Urogenital and Skin.
Along with the structures, each entry includes a detailed description, an audio English pronunciation and Latin nomenclature. There are comparison tools available so individuals can isolate single or multiple structures and compare them with others.
Users can create and save custom views with the bookmark feature and the pin feature that lets individuals make customized pins, add notes, and place anywhere on the 3D model.
In addition, the app lets individuals explore and compare differences between male and female anatomy. And, the app's layering tool allows the user to strip away layers of muscle.
The app is available for iPads, iPhones (iOS7+) and Macs (OSX 10.8+).
Tech Tip: Send Secure Texts with DocHalo
Doctors waste a lot of time playing phone tag with other healthcare providers. Sometimes it would be more efficient to send a text, but without secure messaging, patient health information could be compromised.
Doc Halo is a secure messaging platform designed specifically for the healthcare market. It is available as both an online system and mobile app.
The Doc Halo platform is a HIPAA-compliant, secure services for sending ePHI (electronic personal health information). The system can be scaled for practices with 5 physicians or organizations with thousands of physicians.
Set up is facilitated by Doc Halo and is relatively quick and easy. Doc Halo integrates your contact list of aligned physicians, departmental directory. It even includes branding, adding your name and logo to the system.
The platform can also support customized tabs to reflect your organization's on-call schedule, resources or any other items you think are important. The service includes unlimited secure text messaging, group messaging and distribution lists.
In addition, senders can attach high resolution photos, audio, video and documents. The messaging service works in hospital dead spots and the system ensures that messages are received and read by resending the message until the doctor reads it.
Doc Halo is compatible with PCs, Apple (requires iOS 7) and Android devices. It is available from the Apple Store or Android Market. The app is free to download.
Tech Tip: Acrendo A.I. med 9 May Be What the Doctor Ordered
It can be hard for a smaller practice to find an electronic healthcare system that fits its organization. Acrendo offers solutions designed with smaller practices in mind.
Acrendo A.I. med 9 works well for smaller practices and A.I. med can support a range of specialties. However, even though it is made for smaller practices, it doesn't skimp on features, according to the firm.
Referred to as the "One-Click" electronic health record, the system can do electronic records, billing, document imaging, electronic claims, paperless scheduling, and speech dictation. A.I med is tablet- or laptop-compatible for working on the go. Plus, A.I med is compatible with Dragon dictation making it easy to chart notes.
A.I.med features easy to use 'drag & drop' technology. With hundreds of templates, including 20 specialty templates, A.I med has what you need, and if for some reason it doesn't you have the option of creating your own template.
Share data seamlessly
The system has an electronic lab interface, a hospital interface and a radiology interface. In addition, the system supports drawings & diagrams. Send documents securely with its paperless fax.
You can also ensure the accuracy of your prescription order by filing it electronically with ePrescribing via Surescripts.
The system can increase your revenue and eliminate scrubbing with automatic billing/coding. It even lets your office create a superbill.
Lastly, users can turn over appointment reminder calls to A.I's automated reminder system. The web-based dialer integrates directly with the patient and scheduling system. After appointments have been set, the dialer calls patients at a preset time for each day.
Tech Tip: PrognoCIS Improves Office Functionality
Healthcare providers looking to improve the functionality of their front office may want to consider some of the many options provided by Bizmatic's PrognoCIS.
PrognoCIS EHR, a customizable and scalable electronic health record system, is both ICD-10 compliant and Meaningful Use-certified. With PrognosCIS, you can choose to have your electronic health record system located on your local server or stored on the cloud.
You can also add the PrognosCIS practice management module, which allows you to steamline all the tasks necessary to keep your practice running. That includes verifying that your patients have insurance and reconciling patient payments.
In addition to these modules, PrognosCIS offers add-on services, such as medical billing (revenue cycle management), which can help you manage payments, interact with the insurance and scrub claims.
PrognosCIS lets you collect patient credit card payments by using OpenEdge, which enables you to process payments directly from the electronic health record. That way, you won't need to exit the system to run the payment or rely on a third party system. The data is immediately posted to the patient's account, eliminating potential double entries and payment reconciliations.
Additionally, practices can use the patient portal module to set up an interactive patient portal that allows them to fulfill the new patient engagement criteria.
Because faxing is still necessary in many medical practices, you can PrognoFax, PrognoCIS' in-cloud e-faxing service. It is HIPAA-compliant and allows users to send one-touch faxes. Need documents signed? Use the eSignature feature to get virtual signatures. You can prepare, send and receive the documents right from your computer or mobile device.
PrognoCIS may be worth checking out if you're struggling with some of your front office functionality.
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