Today's Wound Clinic - Spring 2008 - (Page 22)

intech advance in the last 3 years is the implementation of Evidence Based Medicine guidelines directly in the EMR. By simply charting the patient’s history and physical findings, the EMR helps with live time quality assurance by unobtrusively suggesting appropriate clinical pathways to the clinician, removing the obstacle of out-of-sight, out-of-mind. patient headshot for a second method of patient identification, and complete medication reconciliation. THE CHALLENGES OF IMPLEMENTING AN EMR The data management dividends of implementing an EMR are enormous, but so are its implementation challenges. Every article about EMR implementation emphasizes the critical importance of training for the physicians and clinical staff.With a paper system, documentation errors, which could result in reduced reimbursement, will not be recognized (if ever) until weeks have passed. With an EMR, documentation errors link directly and immediately to problems with billing and coding and can bring clinic operations to a standstill until they are corrected.There is also a fear factor for less technologically sophisticated staff members, but even the most technologically reluctant come on board when improved efficiency becomes apparent. Significant time can be saved by simply not having to hunt for charts anymore. Clinic workflow does change with an EMR, because somewhat more time (about 10% to 15%) is spent in the room with the patient (usually increasing patient satisfaction). In exchange, far less time is spent completing tasks later. Documentation is complete when the staff exits the room.As a result, this author’s clinic has been able to put an end to staff overtime. DATA MANAGEMENT Since 100% of all patient data is collected, data can be analyzed and reported in an almost infinite fashion. Reports can be generated on billed revenue, profit loss statements, product utilization, referring physician utilization, patient outcomes, quality assurance, healing rates, marketing effectiveness, and so on. Furthermore, data from one facility can be compared to BILLING AND CODING EMRs like IntelliTrak qualify as Interoperability Level 4 programs, meaning that the majority of data is not stored as blobs of data in text fields but in discrete, machine interpretable data fields. This empowers the EMR to automatically calculate the level of service based solely on the clinical documentation, which ensures 100% coding compliance. For example, Intellicure calculates facility level of service based on over 100 aspects of nursing documentation according to a system validated on over 5,000 wound care visits (OWM, Jan 2007).The physician level of service also is calculated based on documentation performed in the areas of history, physical examination, and clinical decision making, as specified in the 1997 Medicare Physician Documentation Guidelines. Neither the clinic staff nor the physicians perform any additional work specifically for the purpose of determining the billed level of service, so no staff time is spent to ensure documentation compliance. In addition, the physician and the facility documentation correlate with each other. When staff members sign off using their electronic signature, they are immediately able to see the calculated level of service so feedback as to the relationship between documentation and billing is immediate. “There is a fear factor for less technologically sophisticated staff, but even the most technologically reluctant come on board when improved efficiency is apparent.” aggregate data from all clinics using Intellicure, to provide benchmarking services.With the consent of the facility, data which has been de-identified according to HIPAA requirements becomes part of the Intellicure Research Consortium (IRC), now the largest repository of complete medical information on wound care patients in the world. These data are used by the Centers for Medicare and Medicaid Services (CMS), many CMS Fiscal Intermediaries (Fls) and Carriers, the Food and Drug Administration (FDA), as well as numerous individual investigators researching various areas of wound healing. For more information about Intellicure and the IRC, visit the website www.Intellicure.com. NOT A PRODUCT BUT A PROCESS What helped us the most was to think of the medical record not as a product, but a set of processes supported by technology. The EMR has become our living operations manual, which helps standardize these functions. Implementing an EMR is inherently a process automation and systems integration task.The goal is not to create the ultimate medical record, but an entirely better clinical process. Caroline Fife, MD, is co-editor of Today's Wound Clinic, Board Member at the Association for the Advancement of Wound Care, and Chief Medical Officer at Intellicure, Inc. Fife is the past Medical Director at the Texas Wound and Lymphedema Center. She can be reached at cfife@intellicure.com. THE JOINT COMMISSION IntelliTrak helps our center comply with The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) regulations with features like an allergy alert each time the electronic record is opened, a 22 Spring 2008 Today’s Wound Clinic http://www.Intellicure.com

Table of Contents Feed for the Digital Edition of Today's Wound Clinic - Spring 2008

Today's Wound Clinic - Spring 2008 Contents InTroduction InBusiness Documentation: The 30,000-Foot View Documentation: Clearing Up the Role of Compliance InTech InPhotography InFluence InStruction InNews InCentive Ad Index

Today's Wound Clinic - Spring 2008

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