Electronic Health Records
Maximizing document management for EHRs
By Dennis Amorosano, Vice President, Business Imaging Solutions Group, Canon U.S.A., Inc.
Paper. It’s at the core of nearly every healthcare process. But as the industry evolves, how we manage, store and use documents within general office and clinical workflows must also change. New legislation and Meaningful Use guidelines, combined with tighter budgets and increased patient demands, mean providers must act quickly and strategically to streamline their day-to-day processes while reducing costs and maintaining a quality, care-focused practice.
Implementing document management solutions can help establish these efficiencies. Consider the following reminders when instituting these technologies to help maximize the investment and support EHR compliance efforts.
Remember, paper still prevails
While we are working in an era in which the amount of digital healthcare information is increasing, paper-based processes are still heavily dominant. Technology is available today that can not only support healthcare office workflow, but can also be leveraged to deliver paper-based clinical data into EHR systems.
Most important, data input can take place virtually anywhere throughout the workflow – at a multifunction printer (MFP) or a scanner at an individual workstation – with this information being recorded and added to a singular EHR database. Regardless of the existing network structure, document-based technologies can be tailored to fit individual needs for maximum impact to aid healthcare organizations in meeting these objectives.
Consider security early and often
With patient information comes the responsibility to secure access. This holds true whether the information is in digital form or being copied, printed or scanned. Comprehensive security policies must take a holistic approach, evaluating risks well beyond user access controls from connected PCs, tablets and smartphones. To help preempt potential security breaches, traditional office equipment technology must also be considered, including the access methods for these technologies as well as the manner in which activities are tracked and audited.
Be mindful of new technologies
Accessing patient information and data is no longer handled in one place, at one device, by one team. Indeed, the beauty of EHRs resides in their near-term potential: when a provider with appropriate clearance can seamlessly access and input patient records wherever he or she may be working.
As mobile technologies continue to gain popularity within the clinical setting (IDC estimates this will nearly double between 2001 and 2016), implementing a technology platform that offers built-in security measures, is easy to use, helps to safeguard information and supports the use of mobile technologies can bring new efficiencies to healthcare document workflow and, by extension, to patient care.
ICD-10
ICD-10 extension spurs opportunities, concerns
Now that the mandated ICD-10 transition deadline has been pushed back until at least October 2015, what are healthcare organizations doing with the extra lead time?
Results from a recent survey sponsored by Edifecs and conducted by eHealth Initiative (eHI) and the American Health Information Management Association (AHIMA) reveal that the majority of affected organizations are investing in clinical documentation improvements, workforce training and partner testing. But concerns over financial impact and readiness remain – in fact, 45 percent of respondents in this study don’t have a good sense of what their partners’ readiness status really is.
Key findings from the survey of 349 vendors, payers, clinic and physician practices, acute care hospital reps and others include:
Most organizations are prepared to begin testing soon. Forty percent of respondents reported they would begin end-to-end testing by the end of 2014, and 25 percent reported plans to begin by the end of 2015. Forty-one percent of those who said they had no plans for end-to-end testing admitted they actually had no knowledge of how to perform testing.
Workflow, productivity and revenue concerns mount. Thirty-eight percent of respondents reported they believe revenue will decrease, while 14 percent believe revenue will remain neutral. Only six percent believe revenue will increase due to ICD-10.
Extensions = training opportunity. Sixty-eight percent of respondents stated they plan to conduct additional training and practice, and 31 percent plan to hire more coders to assist with the transition.
Clinical documentation improvement (CDI) gets harder. Documenting and coding patient encounters is expected to be the most challenging task after the ICD-10 transition. About 61 percent of respondents said they are planning to use the extension time to improve clinical documentation integrity.
There are expected, tangible benefits. Respondents stated they plan to leverage the more specific code set for claims processing and billing (65 percent), quality improvement (62 percent) and performance measurement (51 percent).
Learn more at www.edifecs.com.
U.S. hospitals: Half prepared, half will wait until 2015
According to a recently published Black Book survey of 650 U.S. hospital technology and physician leaders, 51 percent of hospitals say they will be ready to meet ICD-10 challenges head on with coding education, IT solutions, managed services partners, staff training and physician cooperation. The other half will wait until next year to implement outsourcing technology and clinical documentation improvement (CDI) programs.
The survey results, found in the Black Book Rankings report “Top Ranked Clinical Documentation Improvement Vendors,” indicate that the number of hospitals contracting for external CDI services will triple before the October 2015 deadline. Twenty-four percent of hospitals now outsource clinical documentation audit, review and programming. By Q3 2015, 71 percent of hospitals plan on having a CDI services partner help them adapt and survive under the new code set.
Interestingly, even before ICD-10, 88 percent of hospitals with 200 or more beds that currently outsource CDI say they have realized significant (over $1M) gains in appropriate revenue and proper reimbursements following the implementation of their CDI program.
Learn more at www.blackbookrankings.com.
Security
How-to guide for cutting information risk
Feel like you need a blueprint to improve the security and management of all your data, or maybe just some good advice? “A Practical Guide to Information Governance,” a free report developed by a group of records and information management professionals in the financial services industry and published by the storage and information management company Iron Mountain, aims to show you how it’s done.
Information governance makes every employee accountable to ensure compliance, says Sue Trombley, Managing Director of Thought Leadership for Iron Mountain, while also allowing the organization to mine critical information stores for trends and analytics that can deliver bottom-line value.
Key areas covered for building information governance programs include:
Defining key principles. More than just records and information management, information governance includes roles, policies, processes and metrics, along with 11 core principles that make up a successful program.
Defining value. Organizations define value in different ways. For some, it’s reducing the risk of information exposure or loss; for others, it can be mining data for customer trends and revenue generation. Answering the value question can ensure buy-in from executive leaders to help build successful information governance programs.
Creating leadership success. Establishing an Information Governance Council, a group of executive-level business leaders that has oversight over the design and implementation of a program, is critical.
Bringing programs to life. This guide presents real-life stories of success and failure.
Get your copy of the guide by going to Iron Mountain’s knowledge center at www.ironmountain.com.
Document Management Solutions
NSi Mobile enables healthcare organizations to securely capture, process and route all health, patient and financial documents at patient admittance, point of care and discharge with mobile phones and other smart devices. With streamlined workflows, this solution helps reduce potential HIPAA violations with HL7C-CDA-compliant software and addresses security risks often found with scan, fax and email. Print jobs can be submitted from inside or outside the firewall on both iOS and Android devices, then securely released at a networked printer using authentication. Notable Solutions
The imageRUNNER ADVANCE C350iF/C250iF MEAP (Multifunctional Embedded Application Platform) printers provide compact, color multifunction office systems with advanced workflow capabilities. The devices also introduce V2 Color, a new color profile that produces vivid, vibrant images and expands the color reproduction range of each model. The award-winning Desktop Quick Printing Tool allows for easy document assembly and enables users to drag and drop documents for quick access to preferred or frequently used tools. Canon U.S.A., Inc.
Policy management gets a hand
PolicyNavigator allows executives, administrators and healthcare legal professionals to create, exchange, review, approve and share knowledge and documents quickly and easily. It can be implemented as a standalone solution or with an organization’s existing workflow as a seamless extension of Elsevier’s Mosby’s Skills and Performance Manager. It encompasses document creation, document management, electronic review and approval workflow, search and browse content online, and archival of polices with the ability to retrieve prior versions. Elsevier Clinical Solutions
Central scanning with a PC-free network
A new line of network scanners from Kodak Alaris provides organizations with a central document scanning and routing solution that doesn’t need a dedicated PC. The KODAK Scan Station 700 Series connects directly to a network and sends data to multiple destinations simultaneously, including network drives, printers, FTP sites, email, portable USB drives and Microsoft SharePoint. A remote administration utility allows administrators to manage, configure and maintain multiple scanners from a single location. Kodak Alaris
The Nuance PowerShare Network securely connects physicians, patients, government agencies, specialty medical societies and others via the cloud to share essential medical images and reports as simply as people exchange information using social networks. Made possible through the acquisition of Accelarad, this medical imaging exchange used by more than 1,900 provider organizations eliminates the costly and insecure process of managing images on CDs and removes silos of information. Anyone can join the network regardless of IT systems in place.
Nuance Communications
Faster processing = faster workflow
The DocuMate 5445 and 5460 document scanners now include On-Board Acuity, a built-in chip that makes it faster for office workers to create clean, black-and-white images of original documents. Functions such as cropping and removing blank pages are controlled by the chip rather than a connected PC, nearly doubling scanning efficiency. The scanners also offer ultrasonic double-feed detection and “dog-ear” detection, which stops scanning due to a folded corner or extreme skewing. Xerox
Roentgen Works with enhanced image sharing
Roentgen Works 2.2, the 100-percent browser-based platform for enterprise PACS/RIS, now provides the ability to generate QR codes in reports that link to study images. With the increasing use of mobile devices to view medical images and information, the QR codes provide a quick, simple and secure link to the DICOM study for patients or physicians. A new Upload Request tool allows a user to send an email link to upload studies or reports via the Roentgen Cloud. BRIT Systems
Safe and secure PHI exchange
MRO Corp., a leader in disclosure management and health information exchange, has achieved full accreditation with the Direct Trusted Agent Accreditation Program (DTAAP) for its HISP solution called MRODirect. Accreditation is given by DirectTrust.org and the Electronic Healthcare Network Accreditation Commission (EHNAC) to recognize excellence in health data processing and transactions, and ensures compliance with industry-established standards, HIPAA regulations and the Direct Project. MRODirect equips providers with tools to ensure secure, compliant and efficient exchange of PHI. MRO Corp.