EHR and Health IT Consulting
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EHR and Health IT Consulting
Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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Three Ways Front-Office Staff Can Improve Collections

Three Ways Front-Office Staff Can Improve Collections | EHR and Health IT Consulting |

Cash flow at medical practices can be especially slow in the first and second quarters of the year as many patients with consumer-directed health plans (CDHPs) have not yet met their deductibles.

The cash flow problem is worsening as CDHPs become more popular. According to a National Business Group on Health survey, more than half (57 percent) of employers are implementing or expanding CDHPs. This leaves many patients 100 percent responsible for their healthcare costs until they meet that deductible.

If you’re one of the independent practices — especially one with fewer than 10 staff members — dealing with this issue, here are three ways your front-office staff can help you navigate this growing problem:

1. They can focus on detailed eligibility verification. Train your staff to always confirm if a patient has coverage and if he has a copay or deductible. At a minimum, understand if the deductible has been met, but try to obtain a real-time deductible balance. Your staff should also understand benefit details tied to the services you offer and confirm if you are considered in-network for the patient. The more information on hand, the more you can prepare the patient for what his responsibility may be.

 2. They can be prepared to collect at time of service. Your front-office staff is the most important resource in the process of collecting payments up front and collecting on outstanding bills. With benefits and deductible information in hand before a patient walks in the door, your staff is already in a better position for the conversation. And it’s extremely important to establish the systems to manage and collect money because once a patient walks out the door, collection rates drop to 50 percent to 70 percent for small-dollar payments from insured patients, and to only 10 percent from self-pay patients. Make the money conversation part of your practice’s DNA and you will change your business.

3. They can offer a variety of payment options. When McKinsey surveyed consumers to ask why they would opt not to pay a medical bill, respondents cited a lack of options for payment plans, poor timing of bills, and difficulties coping with confusing statements or policies as barriers. The shift to a retail-centric approach in healthcare is here. Smartphones have built-in one-touch payment capabilities and major retail chains are working healthcare into their daily store offerings. Patients want to know what they owe up front and have multiple options to pay, especially when their responsibility is increasing. Make it easy for your patients. Accept credit or debit cards. Allow payments through mobile devices, cards on file, patient portals, monthly billing plans, or payment by check. Think of your front desk as a point of sale terminal and help your staff shift their mindset to work with patients to collect those funds any way a patient will pay.

Bonus Tip: All of these tips can be leveraged without investing in much more than staff time. Your cash flow should go up and your bad debt should decrease to help reduce your revenue cycle.

I encourage you to investigate tools and software solutions that can help your staff be even more efficient and effective with these steps. There are tools that focus on streamlining the eligibility verification process and that can provide additional insurance details in one place.

Check your EHR system for possible add-ons or leverage other Web-based solutions that focus on not only eligibility but also provide additional features for your front desk such as payment or scheduling. Look for a tool that streamlines work flow and gives you a point-of-sale system that meets your patients’ retail expectations. This can greatly reduce the expenditure on staff time and ultimately create a seamless front-desk experience.

With this continued growth in patient responsibility, practices have to adapt their systems and expect that a larger portion of their income is coming directly from the patient.

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Patient Engagement Rises with Consumer EHR Satisfaction |

Patient Engagement Rises with Consumer EHR Satisfaction | | EHR and Health IT Consulting |
Patient engagement helps consumers view EHRs more positively and encourages them to take charge of their health.

The overwhelming majority of patients believe that electronic health records (EHRs) are useful for physicians and valuable for their care, according to a newly released survey by the National Partnership for Women and Families.  Patients were more likely to rate EHRs as a positive development when they had online access to personal health information through a portal or if they could perform routine administrative tasks like making appointments through the internet.  The survey illustrates the importance of patient engagement while highlighting the spread of health IT and its potential impact on the nation’s health.

The survey reassesses questions about health IT usages and attitudes that were first posed in 2011.  At that time, only 64% of patients had a primary care doctor who used an EHR, but that number has increased to 80% in 2014.  Patients are significantly more likely to see EHRs as a useful tool for care delivery than they are to say the same thing about paper record keeping.  They are also more likely to think that EHRs are helpful for their physicians, and believe that EHRs are also helpful to achieve their own personal tasks and goals.

Online access to EHRs or patient portals has doubled in the past three years, the data found.  Half of patients can now view or share their information online, and more than half of those patients use the ability three times per year or more.   Patients continue to place a premium on the ability to conduct important tasks through their portals.  Access to online scheduling and prescription management features boosted patient opinions of EHRs by 31 percent.  Fifty-six percent of respondents desired email communication with their provider, while 58% wanted to review physician documentation and a similar number wanted the ability to look at their treatment plans.

Patients who frequently accessed their information online also reported higher levels of motivation to improve their own health.  However, survey participants complained that they did not have the right tools to track personal progress towards their goals, which may indicate an opportunity for developers to better integrate lifestyle and chronic disease management into the patient engagement experience.

“As the National Partnership’s new data show, more consumers are accessing, sharing and using their health information, underlining the importance of interoperability of health data and systems. We are focusing our efforts in these areas to empower individuals to address not only gaps in information exchange and interoperability, but also enable them to take steps to improve their health and better manage their health needs,” said National Coordinator for Health IT Karen DeSalvo in a press release.

“The views of patients must be front and center as we take the next steps in implementing health IT,” added Sandra R. Hernández, President and CEO of the California HealthCare Foundation, which funded the new survey. “As we as a nation become more diverse, the imperative to address disparities grows. We need the kind of robust information EHRs provide and the genuine patient engagement they can facilitate.”

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Patients want more from their EHRs | Healthcare IT News

Patients want more from their EHRs | Healthcare IT News | EHR and Health IT Consulting |

Having established a level of trust and familiarity with electronic health records over the past few years, increasing numbers of U.S. patients are looking for more advanced features from their EHRs, according to a new survey from the National Partnership for Women & Families.

The study, "Engaging Patients and Families: How Consumers Value and Use Health IT," follows up on a similar 2011 report that assessed consumer views toward EHRs. A lot has changed since then, with more and more patients comfortable with the idea of digitized records, and easier online access to health information spurring more patient engagement in their care.

In the past year, more than four in five patients with online access to their health records (86 percent) used their online records at least once, according to NPWF; more than half (55 percent) used them three or more times a year.

"To date, the public discourse on health IT has largely focused on the views of doctors, hospitals and vendors," said NPWF President Debra L. Ness in a press statement. "It is crucial to hear what patients have to say about how they experience EHRs and health IT as they receive care and manage their health."

By repeating questions from 2011, the new survey – which lays out seven strategies to help engage patients and families more effectively in their care – identifies trends in patient attitudes since meaningful use has helped fuel EHR adoption. Its new questions yield data on new topics in discussion for health IT policies and programs, such as patient-generated health data, patient care plans and mobile access.

"Engaging Patients and Families" is not the only new report being updated for the first time since 2011: It comes close on the heels of the Office of the National Coordinator for Health Information Technology's new 2015 Strategic Plan, which was published on Monday for the first time in four years.

"As the National Partnership's new data show, more consumers are accessing, sharing and using their health information, underlining the importance of interoperability of health data and systems," said National Coordinator for Health IT Karen DeSalvo, MD, in a statement. "We are focusing our efforts in these areas to empower individuals to address not only gaps in information exchange and interoperability, but also enable them to take steps to improve their health and better manage their health needs,"

Among other key points from NPWF's report, which polled more than 2,000 patients: Patients' online access to their health records has nearly doubled – from 26 percent in 2011 to 50 percent in 2014.

Still, they want even more functionality, including the ability to email providers (56 percent), review treatment plans (56 percent), see doctors' notes (58 percent) and test results (75 percent), schedule appointments (64 percent); and submit medication refill requests (59 percent).

Patients' trust in the privacy and security of EHRs has increased since 2011, and patients with online access to their health information have a much higher level of trust in their doctor and medical staff (77 percent) than those with EHRs that don't include online access (67 percent).

Different populations prefer and use different health IT functionalities. Hispanic adults were significantly more likely than non-Hispanic Whites (78 percent vs. 55 percent) to say having online access to their EHRs increases their desire to do something about their health. African American adults were among the most likely to say EHRs are helpful in finding and correcting medical errors and keeping up with medications.

NPWF suggests that "specialized strategies" may be necessary to improve health outcomes and reduce disparities in underserved populations.

"The views of patients must be front and center as we take the next steps in implementing health IT," said Sandra R. Hernández, president and CEO of the California HealthCare Foundation, which funded the poll. "As we as a nation become more diverse, the imperative to address disparities grows. We need the kind of robust information EHRs provide and the genuine patient engagement they can facilitate."

"We have made progress in leaps and bounds in just a few short years," said Mark Savage, NPWF's director of health information technology policy and programs, in a statement. "But clearly there are barriers still to overcome, and this report breaks down policy implications for the meaningful use program as well as broader delivery system initiatives that must be carried out. And it's an important reminder that meeting the needs of patients and families must always be at the core of health IT design and implementation."

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This is what patient safety means to me

What does patient safety mean to you?

I believe patients get the safest care when

  1. The patient is known as an individual.
  2. The health care team gives the patient their undivided attention.
  3. The team is well-supported with efficient workflows and organized, easily accessible information.
  4. The health professionals find joy in their work.

By being “known” I mean, that the nurses and physicians know the patient as a real person, what their life is like, who are their supports, what are their goals. Inherent in being “known” is continuity — the same medical assistants, nurses and physicians work with the patient at each visit and between visits. Relationship-centered care.

By “undivided attention” I mean that the physicians and other providers can listen intently to the patient and think deeply, without being distracted by multi-tasking, and without being diverted by clerical tasks such as data gathering and data entry.

By “organized, accessible information” I mean an EHR that reduces the cognitive workload of information management; checklists that make it easy to do the right thing; and the supportive use of clinical metrics to empower frontline workers to improve care.

I learned this guiding principles from Borgess Health in Michigan: “We will know who you are and we will be ready for you.” This is a powerful promise to patients; delivering on this promise requires knowing the patient, providing undivided attention, and being well-supported by efficient workflows.

And finally, and most importantly,  I believe the best way to achieve a safe and satisfying experience for patients is to create an environment that is safe and satisfying for the workers, an environment that nurtures the intrinsic professionalism of the physicians and other staff — where the health care team can experience joy in practice. In sum, I believe that achieving the triple aim is dependent on the quadruple aim; that care of the patient requires care of the providers.

I believe that most health professionals come to work each day to serve their patients, to make a difference in their patients’ lives. If the environment helps people meet these professional goals, by making information easily accessible, by limiting the distracting burdens of regulatory compliance, by fostering relationships, then I believe the members of the health care team will give the patients their all, and the results will be safer, more satisfying care.

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Patients want online access to records | Healthcare IT News

Patients want online access to records | Healthcare IT News | EHR and Health IT Consulting |

More than half of people with chronic conditions say the ability to get their electronic medical records online outweighs the potential privacy risks, according to a new survey by Accenture.

Two-thirds, meanwhile, believe patients should have the right to access all of their healthcare information.

The results of the poll suggest a public increasingly frustrated by lack of sovereignty over their own health data.

The vast majority people surveyed by Accenture – 87 percent – say they want to control their health data. But 55 percent report they don't have very much or any control over their medical information.

Accenture polled 2,011 individuals – 918 of them healthy, and 1,093 with either asthma, arthritis, cancer, chronic obstructive pulmonary disease, depression, diabetes, heart disease, hypertension, clinically diagnosed obesity, osteoporosis and stroke.

The survey found chronic patients to be less concerned about the privacy of their electronic health records, 65 percent, than they were about other personal information stored digitally, such as online banking (70 percent), in-store credit card use (69 percent) and online shopping (68 percent).

Still, although they're eager to have access to their records online, roughly half of those with chronic conditions said the top barrier to seeing the data was not knowing how to do so.

Accenture's findings also suggest, depending on the type of chronic illness they have, there are differences in a patient's ability to exercise control over his or her healthcare data. For example, 65 percent of consumers with heart disease reported having some level of control, compared to just 49 percent of individuals with COPD.

The U.S. Centers for Disease Control and Prevention estimates that 47 percent of Americans have at least one chronic disease, but they account for 76 percent of all physician visits.

Nonetheless, these individuals are some of the most actively engaged patients at most stages of patient care, according to the poll – including during medical diagnosis (91 percent), managing treatment (87 percent) and maintaining general health on a day-to-day basis (84 percent).

"Healthcare will need to adapt to a new generation of individuals who are taking a more proactive role in managing their health and expect to have transparency," said Kaveh Safavi MD, who leads Accenture's global health business, in a press statement.

"As consumers continue to demand more access to their personal data online, we expect that patients will gain more power to manage some aspects of their own care," said Safavi. "This will not only make healthcare more effective but also more affordable, as consumers doing more for themselves will free up the system to be more productive."

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3 guaranteed ways to improve patient satisfaction

3 guaranteed ways to improve patient satisfaction | EHR and Health IT Consulting |

With roughly 1 billion in Medicare reimbursement dollars being tied to patient satisfaction, it’s no wonder the focus on patient experience is swelling. Of course there are other factors fueling the focus — the proliferation of online physician ratings websites, ACOs, and CG-CAHPS to name a few.

Over the past decade I have visited 100+ different inpatient and outpatient practices.  Ironically, the patient experience varies even more than the spectrum of low to high end hotels I’ve stayed in.  The facilities that truly stood out as creating a fantastic experience had three things in common. Not surprisingly, none of them are new techniques. In fact, they are all taught in medical schools around the country. Why then do so few practices implements these concepts, especially when research suggests each of these are highly correlated to patient satisfaction?

Here are the three key strategies I have seen measurably improve patient experience. Call me out in the comments if these haven’t improved your scores.

1. Sit down with your patients. Most providers would like to double the amount of time they spend with each patient. Though that typically isn’t possible, it is amazing how simple it is to have your patients perceive that you spent double the amount of time with them. A University of Kansas study showed that when you pull up a chair, patients perceive that you spent roughly double the amount of time with them vs. when the physician stands for the visit. It makes sense, sitting creates a different level of engagement with a patient. They recognize that you are prepared to listen and focus on their health. Take a load off and sit when you are with a patient. That 2 minutes turns into 4 and a 10 minute visit feels like 20 minutes to them.

2. First impressions matter — and the provider is not the first impression 90 percent of the time. Your front desk staff most often interact with patients first. Hire the nicest, most courteous and professional front desk staff you can and then pay to train and retain them. Perhaps the largest complaint category online (after insufficient time listening or in the room with the patient — see point 1) is a rude front desk. If you struggle to find customer service focused individuals, look to the concierge clinics, spas and wellness clinics. You may even consider restaurant employees who have a reputation of excellent customer service and thrive on creating a great experience for their customers. Bring them onto the team and make sure they know their number 1 job is to be cheerful and helpful on the phone and in the office. Help them set appropriate expectations with patients when they come in. Let them get up and interact with the patients in the waiting area if your patients do have to wait. Offer patients water or otherwise make them as comfortable as possible. Ask for and listen to ideas from them to improve the experience.

3. Be on time. The quickest way to get a negative review is to not respect the patient’s time. I’ve even seen patients send physicians a bill like this person did for their wait time. The most damage is done when a provider inadvertently tells patients that their time is not important.

For example, one classic online review indicated that the physician told the patient about the jog he just finished while the patient had been waiting for hours. Sorry for the wait just doesn’t cut it in cases like that. If you can’t be on time, set expectations — have your front desk staff kindly inform the patients that you are running a bit behind. (Can I get you some water or something?) Apologize and explain when you can why you are late — especially if you were spending time with other patients. Then take a seat, listen, and provide quality care.

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