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How exactly do Electronic Health Records benefit patients? Click to enlarge the graphic and see for yourself!

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Cybercrime has been plaguing the IT industry since the release of the first computer and with the rise of cloud based computing and EHR the healthcare industry is no exception. In fact the Healthcare industry is the highest at risk for Cyber-attacks and IBM reported one hundred million records that were compromised by hackers in 2015 alone.
 

With such a large number of attacks being reported we may ask, what is the motive behind all of these cyber-crimes against the Healthcare Industry? Even though hackers cannot steal money directly from most EHR there is a lot of valuable information they can use for identity theft, selling information and even take your data for ransom!
 

Although security should be the number one concern all the time, what a better time to raise awareness than National Cyber Security Awareness month! October is National Cyber Security Awareness Month which is an annual campaign to raise awareness about cybersecurity. The security of your precious patient information should not be taken lightly and even if you think you have the tightest security it should still be constantly reviewed.
 

Virtual Officeware cares about the integrity and security of your data, which is why we are constantly analyzing our hosted services security and want the same for our clients who do not host their data with us. We obtained the following link https://www.healthit.gov/sites/default/files/Top_10_Tips_for_Cybersecurity.pdf which is a list of tips from the HealthIT.gov website to assist you to be more proactive with the security of your EHR.

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As one of the proud partners of Rio 2016 Olympic and Paralympic Games, GE has supplied the International Olympic Committee (IOC) with innovative health data management software to create Electronic Medical Records (EMR) for all athletes and patients who visit the Polyclinic in the Olympic Village. GE has been supporting team doctors and more than 10,500 athletes competing at the Games. This year’s use of the EMR system has already tracked over 4,000 medical records, including 1,085 diagnostic imaging exams that were performed at the Polyclinic in the Athletes Village as well as at the emergency centers in the competition arenas. Six hundred and ten MRI, 345 X-ray and 130 ultrasound examinations were performed since July 22, when the operations at the Polyclinic started.
 

The EMR allows doctors to track and analyze in real-time thousands of data points – from imaging scans to medications, dental examinations and allergies of each of the athletes treated at the Polyclinic. The digital solution provides reliable information and helps ensure that clinicians know the medical history of the athlete so they can plan for the best possible outcome. More than 1,000 physicians are involved in caring for the U.S. Olympic team alone.
 

This year marks the first time team doctors from around the world are able to manage health records through a single system, which enables the unification and analysis of all athletes’ information in the same cloud platform. The system is offered entirely in English as well as Portuguese, in compliance with the Brazilian health laws.
 

“The gold medal of medical services is a comprehensive, integrated health solution for lesion prevention,” said Dr. Richard Budgett, medical and scientific director for the International Olympic Committee. “Without an adequate medical record, it is difficult to predict which lesions will be more common in given sports in the future.”
 

A version of Centricity Practice Solution (CPS), the EMR being used at the Rio 2016 Games, was developed specifically for the United States Olympic Committee (USOC). The USOC used CPS during the London 2012 and Sochi 2014 Olympic Games, with outstanding and critical results.
 

“In the Sochi 2014 Paralympic Winter Games, we had an athlete with a medulla lesion caused by his fall in the snow, which compromised his breathing capacity,” said Dr. Bill Moreau, managing director of the sports medicine division for the USOC. “The athlete was taken to Frankfurt, Germany for additional care, but when he arrived, he was not able to speak. When I accessed his health record, I could verify that he had allergies, which would influence his treatment, and I could see the number of anticoagulants he had ingested,” Moreau said. “It is hard to imagine that just one or two years ago, we would not have been able to access this information.”
 

Among the advantages of the EMR is the information quality and near real-time analysis and response, increasing the chance of avoiding unnecessary procedures. According to the USOC, the U.S. Women’s Olympic wrestling team saw a 60 percent reduction in surgeries (primarily a result of shoulder lesions), after the adoption of the EMR. This reduction can be at least partially attributed to the ability of the EMR to translate data into insights and identify trends in causation that can inform changes in training and care.
 

About GE Healthcare

GE Healthcare provides transformational medical technologies and services to meet the demand for increased access, enhanced quality and more affordable healthcare around the world. GE Healthcare (GE) works on things that matter – great people and technologies taking on tough challenges. From medical imaging, software & IT, patient monitoring and diagnostics to drug discovery, biopharmaceutical manufacturing technologies and performance improvement solutions GE Healthcare helps medical professionals deliver great healthcare to their patients. http://www.gehealthcare.com.

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It is important to disable logins for any employee that leaves your practice. If this is not done, an employee could potentially still connect in remotely to your system. This opens your practice up to a serious cyber security threat. This risk is so great that the FBI and Department of Homeland Security (DHS) recently issued a public service announcement, saying the “increase in insider threat cases … from disgruntled and/or former employees poses a significant cyber threat to U.S. businesses due to their authorized access to sensitive information and the networks businesses rely on.”

 

How can you comply with regulatory obligations to protect sensitive data or PHI if ex-employees can still enter your systems and delete or modify data? Fines and legal costs can be substantial.

 

Being proactive is key to protecting your data and your business. To help you do that, we recommend you:
 
• Conduct regular reviews of employee access, and terminate any account that individuals don’t need to perform their daily job responsibilities.
 
• Terminate all accounts associated with an employee or contractor immediately upon their dismissal.
 
• Change administrative passwords to servers and networks when you terminate IT personnel.
 
• Avoid using shared usernames and passwords.
 
• Avoid using the same login and password for multiple platforms, servers or networks.
 
• Notify third-party service companies that provide email or customer support when an employee has been terminated.
 
• Restrict Internet access on corporate computers to cloud storage websites.
 
• Restrict employees from downloading unauthorized remote login applications on corporate computers.
 
• Maintain daily backups.

 

To protect your business, it’s important that you pay close attention to who has access to what data. Most offices don’t think about this until something happens but you should focus on this [immediately], then you won’t have to worry going forward.

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Relevant and meaningful information regarding the management of your Revenue Cycle (billing and Accounts Receivable) is vital to your practice.
 

By Rob Feldman
 

Let’s start with our first, and in my opinion, most important topic….measurement.
 

If “The Promised Land” is optimal cash flow, there are several KPI’s (Key Performance Indicators) that are commonly utilized as a road-map to measure if your practice is indeed falling within benchmarked “best practices”. After all, don’t we need a road map to know where it is we want to arrive?
 

Virtual Revenue Solutions (VRS) utilizes several simple but powerful benchmarks, all geared and linked to providing the answer to that bigger question, am I maximizing cash flow? These tools, indicated below, are the undercurrents to arriving at the ultimate cash flow conclusion:
 

1. Gross and Net Collection Ratio
 

a. Gross collection ratio is a simple calculation that compares monthly gross collections divided by total charges. It is a calculation that does not take into account your fee schedules.
 

b. Net collection ratio does take your contractual adjustments into account by dividing your payments by your net charges (charges less adjustments).
 

2. Aging Analysis
 

a. Aging of A/R can be measured in so many ways. Two measurements stand true:
i. No more than 5-7% should be greater than 120 days
ii. At least 65% of the A/R should be less than 30 days
 

b. Aging can also be measured by payer, financial class, and trended over time to make some very interesting and eye popping (somewhat unexpected) results.
 

3. Cash Lag Analysis
 

a. This is one of the more complicated benchmarks to measure. Its primary essence is to evaluate “when your money comes in relation to when it is billed”.
 

b. It usually requires a savvy spreadsheet.
 

c. It is great to know when the lion-share of your money comes in relation to the date you bill it.
 

4. Accounts Receivable Days Outstanding
 

a. This is the most critical and telling of all the measurements as it ties the other three KPI’s together.
 

b. This measures the average number of days charges that still remain in your Accounts Receivable.
 

c. The calculation is not very difficult and we are happy to provide that to you, just click on the email link below and we will forward the worksheet.
 

5. Denial Management
 

a. The billing team must be able to track many aspects of denials:
i. Denial types and dollar types associated with those denials
ii. Working of and refiling of all denials on a timely basis to facilitate collection and reduce the risk of timely filing deadlines
iii. Trending all denial types monthly; see below common denial types:
-Intake and Registration
-Billing
-Coding
-Credentialing
 

b. Denials should be reported to senior management as many denials are not always (or usually for that matter) the fault of the billing team and can reveal a more deeply rooted problem.
 

c. No more than 5% of your charges should be denied for any reason.
 

While there are many other measurement tools, these are the top 5 to really get a sense as to the efficacy of your Revenue Cycle Management (RCM) and ultimately your cash flow.
 

VRS offers substantive RCM analysis. If your practice has any concerns or may feel as though you are coming up short on these measurements, do not hesitate to get the help you need to increase your cash flow. Short or long term deliverables are just a phone call or email away.
 

Interested in a free assessment? Contact Virtual Revenue Solutions at info@vrsmed.com or 412.424.2265.

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To ensure your practice does not leave money on the table, proper credentialing is a must.

By Shelly K. Schwartz

Physician credentialing is, by anyone’s measure, a tedious task. Practices that wish to contract with third-party payers must attest to the competency and qualifications of their doctors through a process that involves data collection, source verification, and committee review. For starters, they must verify their license, experience, certification, education, training, malpractice coverage, clinical judgment, and character. They also must obtain hospital privileges, successfully enroll their doctors in health plans as participating providers, and research any malpractice or adverse clinical occurrences.
Such legwork helps ensure patient safety, but it also creates an administrative burden for office managers. “It is a time-consuming process, but an absolutely critical one,” says Ken Hertz, a consultant with Medical Group Management Association Health Care Consulting Group. “It always takes longer than the practice thinks it will, and if you don’t do it right you run the risk of not getting paid.”
Indeed, physicians who are not properly credentialed by an insurance company may not be reimbursed, or paid on time, for treating patients covered by that plan — a direct hit to revenue. The patients the physician does see may also be charged a higher out-of-network copay and deductible, which are harder to collect. “Some practices just absorb that as a loss, and some try to collect the higher deductible from the patient, but a great deal wind up in collections,” says Gerry Malloy, a partner with medical practice consulting firm Global Health Management Services, noting inefficiency can also contribute to higher administrative costs. “That’s how it impacts your bottom line. Many practices underestimate the importance of proper credentialing, but it can have a major impact on your revenue cycle.”
Here’s how the experts say your practice can perfect the credentialing process.


MONITOR AND TRACK


The initial submission of credentialing applications for a new physician is a labor-intensive process that can take between 90 days and 180 days to complete. But that’s merely step one. Most payers, hospitals, and surgical facilities also require periodic recredentialing of specific documents. “Recredentialing tends to be staggered, so the smart practice will literally use an Excel spreadsheet to develop a database of every provider in their practice, with information on their licensure, their Drug Enforcement Administration numbers, their Medicaid and Medicare numbers, anything that will need to be resubmitted, and when the renewal dates are,” says Hertz.
Larger groups and those with deeper pockets often invest in credentialing software or Web-based solutions, which help to automate work flow and integrate practitioner quality data. Others outsource the credentialing process entirely.
But smaller practices typically handle such submissions manually, making it all the more important to designate a point person to manage and maintain the provider database on an ongoing basis. Your “credentialing czar” should be detail-oriented, says Hertz, and able to submit on-time and accurate forms as minor mistakes can delay the process or cause applications to be rejected. He should also be skilled at cultivating a professional relationship with the points of contact at payers, hospitals, and healthcare agencies. “Make friends with these people because these are the people you are going to need,” says Hertz. “We all know very well from everyday living that if you’ve got a good relationship with somebody it’s remarkable how things get done that were otherwise impossible.”
The best internal systems use an electronic tickler file, giving your practice a heads-up when renewal deadlines draw near. Don’t wait for the payers to notify you. “You might get a calendar pop-up 90 days before the deadline that tells you Dr. Smith’s Medicare number or state licensure needs to be renewed,” says Hertz. “You can’t leave it to chance. It’s your duty as the administrator to make sure that that happens properly or to hold the person whose job it is accountable.”


COORDINATE AND COMMUNICATE


Physician credentialing is a lesser undertaking for small practices, notes Hertz, as there are fewer providers to manage. “Larger practices sometimes get into the position of hiring a physician and the only way the billing department finds out there’s a new doctor is they start getting charges from them, but they haven’t been credentialed,” says Hertz. Thus, larger medical practices need to emphasize coordination and communication between human resources, upper management, and the practice manager. “All of these pieces are connected,” he says.
Where new recruits are concerned, practices should begin the credentialing process right away to allow for processing time and ensure they can begin billing for the physician’s services on day one, says Patrick Boyle, vice president and director of managed care for Catalyst Consulting. Don’t wait for their start date. “You want to make sure you get a head start as soon as possible,” he says. To encourage the swift submission of key signatures and copies of diplomas by the physician, practices might also consider tying the receipt of those documents to the physician’s start date.
Boyle notes that Medicare does not allow practices to submit a credentialing application any earlier than 60-days prior to a new physician’s start date, but it is also one of the few payers that will credential physicians retroactively, meaning your practice can retro-bill for Medicare patients seen before the doctor was officially credentialed. Many of the commercial payers will not. As you bring new physicians into your fold, then, it may make sense to allow them to phase in their schedule as payer credentialing comes through.
To ensure your practice does not leave money on the table, proper credentialing is a must. The most effective managers put timelines in place, create physician databases, and assign a point person to keep well ahead of the deadlines. “It’s not brain surgery, but it does need to be thoughtfully addressed in an organization and standardized in a concrete fashion,” says Hertz.

Copyright© 2015 by UBM Medica, PhysiciansPractice.com. All rights reserved. Republication or redistribution of Physicians Practice content, including by framing, is prohibited without prior written consent. Physicians Practice shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.

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Don’t let your EHR drag your medical practice down. Here’s how physicians and staff members can learn to use the technology in smarter ways.

By Aubrey Westgate

EHRs are no small investment, so it’s important to get your practice back up to speed as quickly as possible post-implementation. But that’s proving to be very difficult for many of you.
Only about 47 percent of the more than 1,400 respondents to Physicians Practice’s 2014 Technology Survey, Sponsored by Kareo, said their EHR made their practice’s work flow more efficient; 21 percent said it has remained about the same, and 33 percent said it has decreased.
While it’s very rare that practices will see a boost in the number of patients they can accommodate per day due to an EHR implementation, Jeffery Daigrepont, senior vice president of the Coker Group, a healthcare consulting firm, says those that have seen a decrease may not be using the system as efficiently as they could. In general, he says, if a practice has gone through a smart selection and training process, it should be back to normal levels of productivity within four weeks to six weeks after implementation.
If your practice has failed to meet that mark, don’t be discouraged. According to Daigrepont and other technology experts, making a few small tweaks to how you use the technology could make a big difference. Here are 10 ways your practice and physicians can pick up the pace.

1. Use shortcuts when appropriate
Think about some of the more repetitive tasks your physicians perform in the EHR, and then consider how they might be able to complete those tasks more quickly, says Daigrepont. “Most doctors have very rigid standardized treatment plans, so if they can pick their top five or 10 things that they see and treat the most, and build very efficient templates that can be consistent with what they’re going to be working on most commonly, then that will improve efficiency.”
Similarly, create “triggers” within your EHR to help physicians document more quickly, says Daigrepont. “When a physician says, for example, ‘review of systems normal,’ that one statement alone or that one click alone could trigger a default or a standardized set of text or statements or language that could explode automatically into the note on their behalf.” While these shortcuts can be great timesavers, make sure your physicians are not overusing them, cautions Daigrepont. HHS Office of Inspector General, Medicare, and other payers are on the lookout for documentation missteps, such as “cloned” notes.

2. Consult your vendor
If you’re not sure how to get started when it comes to templates, shortcuts, and triggers, ask your EHR vendor to spend the day in your practice watching how physicians and staff use the system, says Rosemarie Nelson, of the Medical Group Management Association Health Care Consulting Group. “Let them observe you, let them follow you around for those 20 patients and see what it is you do over and over, and then have them help you create that shortcut abbreviation,” she says. Though this in-office vendor observation might come at a cost, Nelson says it is much more effective than any vendor assistance you would receive over the phone, as the vendor will better understand “the nuances” of how you are using the system. “Remember the old adage, ‘You get what you pay for,'” says Nelson. “… If you want to gain efficiencies, pay for the help to do so.”

3. Pick up a portal
A portal can help your physicians satisfy the patient engagement requirements in Medicare’s EHR Incentive Program, and it can also cut down the time physicians and staff spend documenting patient information, says Nelson. For instance, if the portal is integrated with your EHR and your patients use it to enter information such as their health histories and current medications, that information can be seamlessly pulled into the system. Similarly, consider implementing a patient kiosk in your reception area so that patients can input health information while waiting for appointments, says Marsha Hopper, senior clinical team lead at Regent Medical Solutions, a medical practice consulting firm.

4. Consider add-ons
The portal is not the only piece of technology that can streamline EHR documentation. Physicians can use “smart” pens, for instance, to write text on a computer or tablet, which can then be converted to text within the EHR. Or, they can use speech recognition software that fills in areas of the record as they are speaking, says Daigrepont. “It used to be that you would just dictate kind of a paragraph of text, now you can use your voice to put text in certain fields.”
If physicians are really struggling with documentation, consider merging traditional transcription services with EHR data entry, says Daigrepont. For instance, a physician might use the EHR to document patient data, but he might have the visit note transcribed and then merged into the system. “Maybe they’re only using it for the consult letter or the treatment plan but it’s OK to [merge] your transcription with your [EHR] if you’re struggling or if you’re losing patient volume,” says Daigrepont. “You might want to look at that as a short-term fix until you can get yourself back to normal levels.”

5. Find other features
Consider additional elements of the EHR you may not be using that could help improve efficiency. Hopper says many practices overlook tools built into their systems, such as messaging features that help physicians and staff communicate in real time, reminder or calendar options that help physicians stay on time and/or focused on high priority tasks, and referral tools that streamline the referral process. “… There are so many [often underused features], whether it’s action items for yourself as your personal to-do list, messaging between staff and providers, setting up your letter templates for reminders, or any other type of letters, like letters of medical necessity,” says Hopper.

6. Get staff to step up
Physician time is precious, so consider what tasks they are completing in the EHR that could be delegated to staff. In advance of appointments and prior to physicians entering exam rooms, for instance, nurses and/or front-desk staff could capture the patient’s history of present illness, health history, and so on, says Nelson.
To ensure staff knows exactly what to capture (and so physicians aren’t spending their time correcting errors and filling in missing information due to poor staff documentation) have physicians spend a few hours training them on the appropriate methods, says Nelson.

7. Train, train, and train again
Fully utilize all vendor training resources available to your practice, such as any webinars, whitepapers, or training modules. Otherwise, you might be overlooking key details that could help you better utilize the system, says Hopper. “I think a lot of practices are under the belief that when they go through implementation they’re going to know everything they need to know about that software, which is never the case,” she says. In fact, she says, “… It’s almost impossible for that practice to learn that in a week’s worth of training …”

8. Stay up to date
Ensure that your practice is always aware of changes and improvements the vendor makes to the system. That way, you are always using it in the best ways, says Hopper. She recommends asking a “super user” to regularly review new information and guidance released by the vendor, such as information released through the user portal.

9. Be resourceful
Take advantage of your vendor’s user groups. “People love to help each other so they are always posting how they do things,” says Nelson. “Why reinvent the wheel if someone else spent a lot of time doing that? Maybe they even built a template that they’ll share with you.” Also, observe a similar medical practice using the same EHR, says Daigrepont, noting that other practices have likely faced similar challenges. “I actually think the knowledge sharing of visiting other sites that are using the same software would be more beneficial than having a vendor come in, because the vendor is going to be a little bit more protective of what they think is the best way [to use the system],” he says. “Another physician practice that’s similar, they will relate to each other, and they will have, I think, a better opportunity to see how [the EHR is] actually performing in another office versus how a vendor thinks it should be performing.”

10. Ask your team
Increase EHR-specific communication within your practice, as that might reveal areas of improvement you are missing. Nelson recommends setting aside some time for physicians and staff to meet to discuss challenges, frustrations, and opportunities. “The one thing that the doctors don’t think about is approaching the work flow from a team perspective,” she says. “They know that their nurse is involved but they don’t consciously think about it, so I would actually encourage them to just take half an hour every week and talk to their nurse about, ‘How could we do this better?'”

Copyright© 2015 by UBM Medica, PhysiciansPractice.com. All rights reserved. Republication or redistribution of Physicians Practice content, including by framing, is prohibited without prior written consent. Physicians Practice shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.

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Having a patient portal and using it efficiently are two different things. Here’s how to get your patients on-board in four simple steps.

By Audrey “christie” Mclaughlin, RN”

I had the pleasure of speaking at the semi-annual Practice Management Institute Conference this May.
Can you guess the biggest hurdle practices in attendance were facing? Patient portal engagement. So we talked, brainstormed, and shared insight on the topic. And here are some of the top ideas that came up with to increase portal engagement:

1. Direct patients to access return to work or school slips on the portal.

This tip even works for say general or orthopedic surgeons that see many patients one time — maybe — for follow up.

2. Get tablets and train on-site.

Have a staff member walk patients through signing into the portal and sending a message to the nursing staff, letting them know why they are in the clinic today. This is a great teaching moment for patients and can be done in the waiting area or exam rooms while patients are waiting to see the provider.

3. Promote it.

Most patients would find a portal quite useful, if they knew it was there, what it was, and how it benefits them. Make sure when marketing your portal that you are letting patients know they can send and receive messages from the staff, check lab results, and request refills without waiting for call backs.

4. Get the doctors in on it.

This works in two ways. First, have doctors talk with patients about it, even if it’s simply letting them know when their prescription runs out they can request a refill via the portal or to check for their lab results. You can also have the physician ask patients to check for a message from the clinic to see how they are doing after the visit.

Second, according to an article in Medical Practice Insider it is noted that patients are about 90 percent more apt to open an e-mail from the actual doctor than from the practice. Now having spent many years in practices, I know that is not likely that the physician would send every e-mail to patients. But, it is as simple as having the e-mail address reflect the name of the doctor rather than the practice.

Copyright© 2015 by UBM Medica, PhysiciansPractice.com. All rights reserved. Republication or redistribution of Physicians Practice content, including by framing, is prohibited without prior written consent. Physicians Practice shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.

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