No sleight of hand

EHR im­proves qual­ity, com­pli­ance, pro­duc­tiv­ity

Modern Healthcare - - FROM THE C-SUITE - Wayne Win­is­tor­fer

Peo­ple of­ten imag­ine that health­care in­for­ma­tion tech­nol­ogy works a bit like “The Wiz­ard of Oz,” where a ge­nius be­hind the cur­tain does mar­velous, mys­te­ri­ous things. But the real ben­e­fit of health­care IT is that it pro­duces very downto-earth re­sults: bet­ter pa­tient care, greater physi­cian sat­is­fac­tion, higher re­im­burse­ment and im­proved qual­ity and com­pli­ance.

In short, health­care IT solves or­di­nary prob­lems in ex­tra­or­di­nary ways.

In the hos­pi­tal re­ha­bil­i­ta­tion set­ting, for ex­am­ple, one of the big­gest prob­lems with pa­per doc­u­men­ta­tion has been poor leg­i­bil­ity. Physi­cians con­stantly com­plained that they couldn’t read the ther­a­pists’ notes—or that they didn’t un­der­stand ther­a­pist buzz­words and acronyms such as “IADLS not PLOF” (which means “in­stru­men­tal ac­tiv­i­ties of daily liv­ing not at prior level of func­tion­ing”).

Pa­per charts also made it easy for ther­a­pists to in­ad­ver­tently vi­o­late the eight­minute rule, un­in­ten­tion­ally billing more units of ser­vice than the to­tal time of the treat­ment ses­sion. With­out “red flags” to pre­vent this type of er­ror, once charges are en­tered they flow to a bill, leav­ing the fa­cil­ity vul­ner­a­ble to com­pli­ance vi­o­la­tions.

In ad­di­tion, pa­per chart­ing was a pro­duc­tiv­ity night­mare, forc­ing some staff mem­bers to spend the ma­jor­ity of their day en­ter­ing charges into the elec­tronic billing mod­ule, or pho­to­copy­ing and fax­ing records. At our fa­cil­i­ties, we also used elab­o­rate, man­ual pro­cesses to catch charges that ther­a­pists sim­ply “for­got” to record.

It was highly la­bor-in­ten­sive, and vir­tu­ally im­pos­si­ble, to im­ple­ment thor­ough au­dit­ing pro­ce­dures be­cause the typ­i­cal re­ha­bil­i­ta­tion depart­ment han­dles hundreds of charges a day.

So when the time came for our re­ha­bil­i­ta­tion depart­ment to go pa­per­less, we weren’t look­ing for a wiz­ard, just a so­lu­tion to some ev­ery­day prob­lems.

Here are some achieve­ments of adopt­ing an EHR for our re­ha­bil­i­ta­tion ser­vices that flows to our hos­pi­tal’s main sys­tem:

Physi­cians have in­stant ac­cess to pa­tient data. About 75% of our re­hab out­pa­tients are re­ferred by physi­cians who are em­ployed or con­tracted within our in­te­grated health sys­tem. They are now able to view a ther­a­pist’s notes as soon as the ses­sion has ended. There’s no time wasted pho­to­copy­ing or fax­ing notes, and they’re 100% leg­i­ble all the time. Plus, the EHR we use au­to­mat­i­cally con­verts ther­a­pist acronyms and ab­bre­vi­a­tions into full text that the physi­cians can un­der­stand. We re­pur­posed em­ploy­ees. Our depart­ment has been able to rede­fine the roles of em­ploy­ees whose pri­mary tasks were data en­try and fax­ing. They’re now freed to do more pro­duc­tive, pa­tient­fo­cused tasks that help im­prove the pa­tient ex­pe­ri­ence.

We im­proved reg­u­la­tory com­pli­ance. Our depart­ment is now con­fi­dent we can han­dle any Re­cov­ery Au­dit Con­trac­tor au­dit be­cause the EHR soft­ware au­to­mat­i­cally flags things such as eight-minute rule vi­o­la­tions. That helps en­sure that er­rors are caught be­fore they flow to a bill. And we’re now able to eas­ily gen­er­ate daily au­dit re­ports span­ning hundreds of charges and cor­rect the few re­main­ing charge er­rors on the spot.

We im­proved the qual­ity of care. Best of all, the re­ha­bil­i­ta­tion EHR has helped us sharpen our pa­tient fo­cus. One of the best ways to en­gage with a pa­tient is to doc­u­ment things elec­tron­i­cally in the pa­tient’s pres­ence. That way, there are no sur­prises when the pa­tient vis­its the re­fer­ring physi­cian and to­gether they re­view progress in ther­apy. And physi­cians don’t have to waste valu­able time de­ci­pher­ing sloppy hand­writ­ing or ther­a­pist lingo.

All these ben­e­fits add up to an ad­van­tage that ev­ery hos­pi­tal chief fi­nan­cial of­fi­cer can ap­pre­ci­ate: im­proved charge cap­ture and en­hanced re­im­burse­ments. In our case, the re­im­burse­ment and pro­duc­tiv­ity im­prove­ments were far greater than what we put in our orig­i­nal busi­ness plan. In con­trast to most IT raz­zle-daz­zle, our project un­der­promised and overde­liv­ered.

Im­ple­ment­ing a re­ha­bil­i­ta­tion EHR may not be as glam­orous as some other projects, but in our CFO’S view, it’s real-world wiz­ardry. Wayne Win­is­tor­fer is di­rec­tor of re­ha­bil­i­ta­tion ser­vices at Affin­ity Health Sys­tem, based in Me­nasha, Wis.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.