,

Comparing EHR Impact on Hospital-based and Office-based Physicians

mobile charge capture

A recent study compared the interactions of hospital-based physicians to EHRs to the perceptions of office-based physicians. After analyzing comments submitted in response to the 2014 Rhode Island Health Information Technology survey, here are the results of their qualitative analysis.

Overall, when comparing themes across settings, the researchers found that hospital-based physicians more frequently commented on the use of electronic health records (EHRs) to feel more prepared for the clinical encounter, while office-based physicians more frequently commented on alteration of workflow and the depersonalization of relationships.

Four main themes emerged for both groups:

  • EHRs meant less time spent with patients and more time spent on the computer
  • EHRs reduce quality of the interaction and patient-physician relationship.
  • EHRs have no effect on patient interaction.
  • EHRs improve information access.

In terms of spending less time with patients, both groups differentiated the time spent on documentation that resulted in less time in the exam room or at the bedside, compared to the time spent looking at the computer during the clinical interaction itself. Hospital-based physicians were more likely to describe the lesser time in terms of the exam room or bedside, while office-based physicians commented more about time spent looking at the computer and not the patient.

The second most common theme among hospital-physicians revolve around the negative impact of EHRs on the quality of interactions with patients.

Here’s a typical comment: “Negatively affections interactions. Interacting with computer rather than my patient. Like having someone at the dinner table texting rather than paying attention.”

Decreased eye contact was also mentioned.

My nose is now burrowed deep into my computer interface, leaving markedly reduced time to make eye contact and actually interact one on one with my patient.”

Another sub-theme was the depersonalization that EHRs caused. Comments by physicians included words such as: intrusive, impersonal, limits, interferes, distracts and disruptive.  As one physician put it: “The art of medicine and treating is lost in the process.”

Some hospital-based physicians did express their view that the EHRs had no impact on their patient interaction. The primary reason – the physicians had figured out ways to work the EHRs into their workflow and thus had become less intrusive.

Finally, hospital-based physicians described how easy access to information has had a positive impact on their interactions with patients. For example, several of them noted that viewing problem lists and lab results helped them prepare for the clinical encounter and made them more efficient. In addition, physicians also saw EHRs helping with communication by allowing the patient and physician to review test results together and by providing ready access to educational materials. Office-based physicians noted that EHRs allowed for more communication through patient portals.

Pelland K.D, Baier R.R, Gardner R.L. ‘It is like texting at the dinner table’: a qualitative analysis of the impact of electronic health records on patient–physician interaction in hospitals. J Innov Health Inform. 2017;24(2):216–223.
,

Physician Handoffs and Electronic Tools

Can physician handoffs in hospitals be improved with electronic tools?

That was the thrust of research conducted in 2014 by a group that looked at different research projects from 2008 to 2014.[1] Specifically, the researchers wanted to see the evidence on the effectiveness of electronic solutions used to support shift-to-shift handoffs.

Handoffs are a potentially life-threatening event. According to the Joint Commission in 2013, 63.5% of all adverse events involved miscommunication between health care providers. In fact, in a hospital survey by the Agency for Health Care Research and Quality in 2014 53% of the respondents endorsed the statement – “important patient care information is often lost during shift changes” and 47% endorsed the statement – “shift changes are problematic for patients in this hospital.”

IMPROVEMENTS TO PHYSICIAN HANDOFFS

The researchers found 37 unique articles with relevant research related to electronic tools designed to support physician shift-to-shift handoffs. In 22% of the included studies, respondents reported increased or improved handoff content, while the same number also reported high provider satisfaction with the use of an electronic handoff system. Other studies showed similar results. For example, in one study residents used three different handoff protocols (written, electronic and face-to-face) and they self-reported face-to-face handoffs had the lowest protocol deviations, while written handoffs had the highest. Electronic handoffs fell in the middle.

In other studies, perceptions of patient safety with respect to electronic tools were studied. In nine studies, for example, 24% of the participants perceptions of better patient safety, quality of care, better patient management and fewer near misses were reported. However, another study showed no statistical difference between using electronic tools and improved patient safety.

In terms of time devoted to activities related to handoffs, most studies showed reductions in time spent on the activity, while other studies reported that participants overwhelmingly reported that they would use the electronic system over other systems. Another study reported that 78% of respondents said that an electronic handoff system improved communications.

PHYSICIAN HANDOFFS AND PATIENT OUTCOMES

Patient outcomes were also analyzed.

One measured general medical emergency team calls and weekend discharges 12 months prior to and 12 months after implementation of an electronic handoff system, finding a decrease in calls and increase in weekend discharges. Another study found a significant decrease in median length of stay after 2 weeks of implementation of an electronic handoff system.

BARRIERS TO ELECTRONIC PHYSICIAN HANDOFF SYSTEMS

Some of the studies also noted the barriers to implementation of electronic shift-to-shift handoff system. Some of those included:

  • Clinical resistance to change
  • Perception that the handoff tool might interfere with direct physician communication
  • Duplication of work or more work
  • Errors created by free-text entry
  • Cost
  • Lack of integration with HER
  • Lack of specialty-specific format

Based on the results of their literature review, the researchers suggested that those designing electronic handoff tools to optimize the amount of data pulled from existing records, eliminating error introduced by humans retyping information. They also suggested key stakeholders be included in design efforts, and they emphasized the opportunity for user feedback and adequate training.

Their overall conclusion – the majority of the 37 studies had results supporting electronic handoff tools.

[1]J Grad Med Educ. 2015 Jun;7(2):174-80. doi: 10.4300/JGME-D-14-00205.1.
Evaluating Outcomes of Electronic Tools Supporting Physician Shift-to-Shift Handoffs: A Systematic Review.
Davis J, Riesenberg LA, Mardis M, Donnelly J, Benningfield B, Youngstrom M, Vetter I.
[2]The Joint Commission. 2014. Sentinel event data: root causes by event type.http://www.jointcommission.org/assets/1/18/Root_Causes_by_Event_Type_2004-2Q_2014.pdf. Accessed October 10, 2014.

To learn about patient assignment software — ASSIGN for Physicians — designed to improve continuity of care, click here

,

Nurse Empowerment and Better Patient Outcomes

With hospitals around the U.S. looking at nurse burnout and how it might be affecting patient care, researchers in the past several years have looked at which factors have most contributed to the nurse malaise. Are there some factors that seem to have more impact on nurse dissatisfaction and thus directly impact health outcomes? Or is too difficult to pinpoint one area of concern versus another?

Nurse staffing has become an important consideration in terms of nurse burnout and patient care. In recent study, for example, higher number of nurses were associated with improved survival rates among patients that were very seriously ill. In another study, an increase in nurse numbers was linked to better survival rates in ICU.

But there’s been another thread of study that ties patient outcomes to a nursing work environments. The premise for all of these studies is – a better working environment results in higher nurse satisfaction, which in turn results in better patient safety and outcomes.

BETTER WORK ENVIRONMENT

Two particular studies appear to confirm this hypothesis.

In one study canvassing nurses in 137 Pennsylvania hospitals, researchers looked at whether or not improvements in nurse work environments over time were associated with lower rates of burnout, intention to leave one’s current position and job dissatisfaction. The results showed that the percentage of nurses with high burnout across hospitals decreased by about 5% between 1999 and 2006 when work environments were improved. Similarly, the percentage of nurses who reported intention to leave diminished from 22.4% to 14.2% during that same time frame and job dissatisfaction decreased from 40% to 31.5%.[1]

But what constitutes an improved work environment and what factors or factor could be deployed to make it happen?

Researchers in Canada tried to tackle that question and the conclusion they reached was – empowered workplaces significantly improved and supported positive outcomes for both nurses and patients.

The researchers looked principally at structural empowerment – those elements within an organization or team that enable an employee to get work done. The also looked at two different structural factors – a formal environment in which power was achieved from specific roles within an organization and informal factors, which were achieved through personal alliances and connections within the work setting.

What did they conclude?

NURSE EMPOWERMENT IS THE KEY

Structural empowerment, mediated through group processes, significantly impacted a variety of patient outcomes.[2] That is, when managers gave employees the opportunity to take more responsibility, initiate or make decisions without having to ask someone, complete a task in one’s own time frame, and take calculated risks without fear of repercussions, a higher level of care was achieved.

The researchers also noted that there were several ways in which managers could foster nurse empowerment. These included:

  1. Increase opportunities for professional growth
  2. Ensure access to information required for care
  3. Provide support and guidance
  4. Provide the necessary resources such as time and equipment to get the job done
  5. Provide regular feedback on performance or change assignments to ensure growth opportunities.

The results of the study suggest that “empowered work environments are predictive of nurses feeling autonomous and self-efficacious, which meant they felt their work was more meaningful and thus contributed to their overall job satisfaction.

[1]Int J Nurs Stud. 2013 Feb;50(2):195-201. doi: 10.1016/j.ijnurstu.2012.07.014. Epub 2012 Aug 14.
Changes in hospital nurse work environments and nurse job outcomes: an analysis of panel data.
Kutney-Lee A1, Wu ES, Sloane DM, Aiken LH.
[2]Br J Nurs. 2017 Feb 9;26(3):172-176. doi: 10.12968/bjon.2017.26.3.172.
Effects of work environment on patient and nurse outcomes.
Copanitsanou P1, Fotos N2, Brokalaki H3.

To learn more about MedAptus’ patient assignment software — ASSIGN for Nurses — that saves time and balances workloads, click here

 

,

Hospital Medicine: Physician Burnout Roundup

Here are some of the latest stories on physician burnout:

A simple but effective tip for physician leaders: Ask your patients what they want.

Too often physicians are looking at computer screens instead of into the eyes of their patients, said Steven Strongwater, M.D., president and CEO of Atrius Health. His organization is trying to reduce burnout by creating so-called communities of practice—hubs that create a sense of community and enable healthcare professionals to interact with their colleagues and promote interaction not isolation in the workplace. (FierceHealthcare)

Ernst & Young Survey: Small Hospitals Struggling With Switch to Value-Based Models

Healthcare spending keeps climbing, but much of America’s health report card gets poor grades: chronic disease rates are rising, gaps between rich and poor are widening, and last year life expectancy fell for the first time in decades.

What’s going on? Ernst & Young sought to find out through its 2017 Health Advisory Survey, which gathered insights from 700 chief medical officers, clinical quality executives, and chief financial officers at health systems across the country. (AJMC)

Physician burnout: Running on an empty tank

If you are feeling utterly exhausted and disconnected from your patients, perhaps even wondering if you still want to be a doctor, then rest assured – you are not alone. Chances are these days that your colleagues may be feeling the same. (Medical News Today)

Physician heal thyself: Simple coping strategies for pervasive physician burnout

The proverb, ‘physician heal thyself,’ is probably more relevant today than it was in biblical times with the fast pace of life, the impact of multitasking and the unending bombardment of information, which have made emotional exhaustion almost certain. And this is especially true for obstetricians and gynecologists who experience professional burnout rates between 40 to 75 percent. (Science Daily)

To learn more about how Medaptus’ ASSIGN for Physicians software significantly improves the patient assignment process, click here

,

Teamwork, Hospitalists and Hospital Medicine

Teamwork is one of the most important elements in hospital medicine. And yet, it continues to be one of the greatest challenges and roadblocks to improved patient outcomes. There are numerous reasons. First, hospitals are complex organizations, requiring interaction from a number of people – often under tense and life-threatening circumstances. Second, teamwork training is limited, both in medical school and in acute care settings. While most people agree that teamwork is necessary for positive outcomes, little time is carved away for actual team training. There simply isn’t enough time in the day to take care of patients and conduct team-building exercises.

Hospitalists are at the center of any discussion about teamwork.

Not only must they bridge the work of specialists, consultants and other care providers, but they must try to work with the patients themselves as a care coordination team. They are often juggling multiple and overlapping roles, both as a team “leader” and as part of an overall team of care. In other words, they must maneuver through and around an entire array of interpersonal relationships that are critical to the success of their patients’ care.

Researchers have long been interested in how hospitalists work within a total hospital medicine setting. For example, a group of researchers wanted to know what formal and informal strategies they used to “effectively enact teamwork and care coordination.”

To answer that question, the group conducted fieldwork in 2011 in which they observed the work of four hospitalists in three hospitals, closely studying the behavior of the group in their everyday context. While the overall sample was small, each setting was different, giving researchers a broad view of the physicians in action.

FORCES WORKING AGAINST TEAMWORK IN HOSPITAL MEDICINE

Here is what they found.

Not surprisingly, hospitalists had to face a number of different forces that worked against them to bring about care coordination. There were three primary drivers towards dysfunction.

First, a hospital’s spatial organization created a difficult environment for hospitalists to work closely with their teammates. They were often assigned patients located in different areas. In fact, observers found some circumstances where patients were located on every floor of the hospital. As a result, they often interacted with a different care team depending on the location of the patient.

Another problem for hospitalists revolved around multiple internal information systems. While electronic health records have improved the overall distribution of patient information, researchers found that some information was not recorded. In fact, they noted that in one instance, “no one record system captured all of the needed information around any one patient, nor did the formal systems show a complete picture. As a result, care coordination was not fully realized.

Another roadblock getting in the way of hospitalists achieving better care coordination revolved around uncoordinated teams, often the result of the loose coupling of units, services and professions within the hospital. This lack of interconnection, especially between professions and specialties made it difficult at times for the hospitalists to even determine who was on a patient’s “team.” As the researchers noted, when each hospital unit or specialty department assigned patients to a given provider for the day,  “these allocations were often not communicated to other groups or reflected in their record.” In fact, researchers also said that providers could go through at least some of their shift not knowing who else was on their patients’ teams for the day.

Finally, researchers noted that processes that were intended to be relatively automatic, such as ordering standard tests or procedures, were not very reliable in practice. As a result, hospitalists often had to resort to personal contacts and relationships to keep track of an order placed in the system. One example – during a handoff from the night to day shift, two hospitalists discussed a computerized tomography (CT) scan that should have been done overnight, but was not.

All of these roadblocks not only compound the challenges of building cohesive teams within a hospital setting, but they “pose serious threats to patient safety.”

COPING WITH TEAMWORK ROADBLOCKS

How did the hospitalists in this research cope?

For some, rounding became an important routine for team building. By establishing their physical presence throughout the hospital, these somewhat-predictable encounters helped establish dialogue and association with the various team members. Just “being there” was sometimes the most expeditious way to be the basic, necessary information about who else is caring for their patients.

Another way of bypassing the roadblocks was simply having local knowledge of the hospital’s diverse microsystems. This provided hospitalist with very practical ways to manage their patients’ care.

And finally, some hospitalists developed ad hoc systems of cataloguing their local knowledge. For example, one rounding physician carried a handwritten sheet of important phone numbers that she might need at any given time, information which was not readily available on any standard phone directory she could carry around.

In summary, navigating the many potholes and roadblocks associated with providing true care coordination and teamwork in hospital medicine requires stamina, ingenuity and strong interpersonal communication skills. Researchers confirmed that getting a team approach to work often requires the individual attitude of each physician, especially since the internal systems themselves often don’t advance the cause.

J Health Organ Manag. 2015;29(7):933-47. doi: 10.1108/JHOM-01-2015-0008.
How hospitalists work to pull healthcare teams together.
Chesluk B1, Bernabeo E, Reddy S, Lynn L, Hess B, Odhner T, Holmboe E.

To learn about how our patient assignment software — ASSIGN for Physicians — can improve care coordination, click here

,

Physician Burnout and Medicine as a Calling

Could physician satisfaction and burnout be tied to whether or not that person sees medicine as a calling?

That was the question researchers wanted to answer – the degree to which seeing medicine as a calling is a bellwether of a physician’s mental state as it relates to the job.

Physician burnout is clearly a hot topic in healthcare today. Not only do surveys indicate that it’s affecting more physicians than ever before, but it’s also causing some physicians to leave the profession altogether. And the problem is not isolated to a few specialties. For example, emergency room physicians continue to report the highest level of burnout among their peers (60%), but rheumatology has also seen a big jump in burnout as well. While approximately one-third of rheumatologists reported burnout in 2013, that number jumped to more than one-half in 2017.

Physician burnout has been attributed to a number of different causes — chief among them (at least reported by the physicians themselves) the added burden of having too many bureaucratic tasks. Other factors that lead to burnout: spending too many hours at work, increasing computerization, income that is not high enough, and the feeling that physicians are just a “cog in the wheel.”

Researchers at the Mayo Clinic wanted to look at a different cause – the physicians’ sense of calling.

MEDICINE AS A CALLING

Medicine as a calling has a long history and has been an important element for both physicians and patients. For individual physicians, those who identify with medicine as a calling are typically more engaged in their work and experience less turnover. From a societal standpoint, the general public benefits from having physicians who are motivated to do work that goes beyond their own self-interests. In fact, trust in medicine has been built on this sense of altruism.

But over the past decade or more, concerns have grown that the changing face of the healthcare landscape is eroding the professional identify often associated with medicine as a calling. With a growing frustration of physicians about how their time is being spent in their profession, it’s no wonder physician burnout has been increasing. This raises the question – is there an association between physician burnout and a medicine-as-a-calling attitude.

To answer this question, researchers associated with the Mayo Clinic survey a canvassed a large group of U.S. physicians in 2014 and received completed responses from 2,263 (63% response rate). Among those respondents, nearly 29% of them self-identified themselves as having burnout syndromes. They also had physicians self-report their attitude towards medicine as a calling. Some of the six true/false questions used were:

  • I find my work rewarding.
  • My work is one of the most important things in my life.
  • My work makes the world a better place.
  • I enjoy talking about my work to others.
  • I would choose my current work life again if I had the opportunity.
  • If I were financially secure, I would continue with my current line of work even I were no longer paid.

THE ASSOCIATION BETWEEN BURNOUT AND A SENSE OF CALLING

Multivariable logistic regression associated with the results showed a significant association between the degree of professional burnout and each of the 6 calling items the researchers used. For example, compared with experiencing no burnout – experiencing at least one symptom of burnout was associated with lower odds of identifying with each of the 6 calling items. Physicians who were completely burned out had even lower odds of identification with those characteristics associated with medicine as a calling.

The type of specialty the physician was associated with had no bearing on the results, with the exception of pediatricians – who had higher odds of reporting that they would continue with their work if they were not paid for it. Also, those in medical school setting had higher odds of seeing their work as one of the most important things in their life.

The bottom line according to the researchers – physicians who experienced greater professional burnout were less likely to see medicine as a calling. One potential consequence of this association, according to the researchers, is that physicians who are burnt out may be less intrinsically and socially motivated because they see medicine more as a job and less as a calling—a way to simply earn a paycheck. The researchers concluded that payers, policymakers and physician leaders should “take care to foster a workplace environment that promotes physician well-being and should implement performance-based incentives that support this sense of calling.

Mayo Clin Proc. 2017 Mar;92(3):415-422. doi: 10.1016/j.mayocp.2016.11.012. Epub 2017 Feb 8. Association Between Physician Burnout and Identification With Medicine as a Calling. Jager AJ, Tutty MA, Kao AC

To learn about how our patient assignment software — ASSIGN for Physicians — might help with physician burnout, click here

,

Continuity of Care in Hospital Medicine

Continuity of care continues to be an important concept in hospital medicine. Not only has it been demonstrated to improve patient satisfaction, but there’s plenty of evidence to suggest that it improves health outcomes as well.[1] Furthermore, continuity of care has been associated with a reduction in resource utilization and costs and was even woven into the fabric of the Affordable Care Act (ACA).[2]

But the concept has meant different things to different people, and its use in hospital medicine has proven to be somewhat sporadic. For example, it wasn’t unusual for continuity of care to mean that a primary care physician would follow his or her patient to the hospital and check up on that person’s progress or care. In those circumstances, the primary physician would often consult with each specialist and be kept informed, often in face-to-face meetings, with the patient’s diagnosis or treatment.

Times have certainly changed.

Now, most primary physicians no longer follow their patients to the hospital. Instead, an attending physician at the hospital (a hospitalist or some other designated physician) has overall responsibility for care of that patient and the primary physician is typically kept appraised of care through electronic communications, usually after the fact. Meanwhile, while the hospitalist is now the one who is in regular contact with the specialists and consultants, there are still communication gaps.

Continuity of Care & Discharge

This is particularly true for discharge.

For example, one study indicated that direct communication between hospital physicians and primary care physicians occurred infrequently (3%-20%). In addition, discharge summaries also lacked important information, such as diagnostic test results, treatment or hospital course, discharge medications, patient or family counseling and follow-up plans.

Researchers concluded that “deficits in communication and information transfer at hospital discharge are common and may adversely affect patient care.” [3] New models of collaborative care have been proposed, but implementation has been slow. [4] Once again, the ideal of a continuous thread of continuity of care has yet to be realized.

This is of particular concern for care of older patients, who often face a plethora of fragmented care as they age and seek more help for a variety of ailments. Interpersonal continuity of care is particularly valued by older and more complex patients with worse health status, and higher continuity of care is directly associated with greater patient satisfaction, trust in a clinician, a greater sense of security and partnership in their care. [5]

Trust clearly plays an important role in healthcare. For example, a patient (and his or her family) is more like to accept the recommendations of treatment if trust is high. Conversely, a lack of trust may put treatment in serious jeopardy. How much does trust affect care? In one study of primary physicians in the United States and the United Kingdom, patients were asked how long they had been seeing their primary physician and whether or not that length had any impact on their trust of that physician. The results – the length of time in the relationship and the importance of continuity were the strongest predictors of trust.

Continuity of Care & Patient Assignments

In the hospital environment, it’s not unusual for a patient to be assigned a completely new physician on back-to-back days. Furthermore, it’s also not unusual for the physician or assignment handling assignments to know which physician might have attended to a particular patient in previous days, primarily because that information is generally not available during the assignment process. Rather, a patient list is generated from the EHR that morning and then the process of matching physicians up with patients begins anew.

What could be a new paradigm for better handling continuity of care within hospital medicine? One solution would be a robust software program that not only keeps track of physician assignments from one day to the next, but also uses that information to actually assign patients to physicians who have seen them in the past. This can even be done for readmissions as well.

In other words, patient Betty Jones would be assigned Dr. Taylor again because the software program would have remembered that while Ms. Jones was in the hospital once before, it was Dr. Taylor who was her attending and automatically makes the connection again (assuming, of course, Ms. Jones was happy with Dr. Taylor and was glad to see the same physician again).

This way of handling continuity of care does several things.

First, it provides that level of security and comfort that patients are often looking for. Hospitals are scary places for patients and their families. A familiar face can go a long way towards comforting the sick. Second, it helps the physician. Good care often begins at the personal level, where physicians get to know and understand a person (and his or her family).

That familiarity speeds up diagnosis and treatment and it provides a certain level of satisfaction to the physician as well. Taking care of people is a lot more rewarding when there’s continuity and familiarity.

No software program will solve the myriad of issues surrounding continuity of care, both within and outside the hospital setting, nor does it guarantee better outcomes. But it could be one more way in which technology works hand-in-hand with the personal touch to help make healthcare work better for all. That in itself would be a good step forward.

[1]Ann Fam Med. 2004 Sep; 2(5): 452–454.
doi: 10.1370/afm.84
Patient-Physician Shared Experiences and Value Patients Place on Continuity of Care
Arch G. Mainous, III, PhD, Meredith A. Goodwin, PhD, and Kurt C. Stange, MD, PhD
[2] www.ajmc.com/journals/issue/1999/1999…/jun99-869p727-734/
Continuity of Care: Is it Cost-Effective? Michele Raddish, MD, MPH; Susan D. Horn, PhD; Phoebe D. Sharkey, PhD.
[3] JAMA. 2007;297(8):831-841. doi:10.1001/jama.297.8.831
Deficits in Communication and Information Transfer Between Hospital-Based and Primary Care Physicians
Implications for Patient Safety and Continuity of Care
Sunil Kripalani, MD, MSc; Frank LeFevre, MD; Christopher O. Phillips, MD, MPH; et al
[4] The New England Journal of Medicine; Boston372.4 (Jan 22, 2015): 308-309.
Bridging the Hospitalist-Primary Care Divide through Collaborative Care
Goroll, Allan H, MD, Hunt, Daniel P, MD
[5] doi: 10.1370/afm.1739 Ann Fam Med March/April 2015 vol. 13 no. 2 123-129
Effect of Continuity of Care on Hospital Utilization for Seniors With Multiple Medical Conditions in an Integrated Health Care System, Elizabeth A. Bayliss, MD, MSPH, Jennifer L. Ellis, MSPH, Jo Ann Shoup, MA, Chan Zeng, PhD, Deanna B. McQuillan, MA1 and John F. Steiner, MD, MPH

To learn about how our patient assignment software — ASSIGN for Physicians — can improve continuity of care, click here

MedAptus Partners with Mingle Analytics to Maximize Medicare Reimbursement Bonuses

Partnership focuses on Merit-based Payment System (MIPS) implemented in January, which focuses on hospital performance.

MedAptus®, a Boston-based healthcare technology company, has partnered with Mingle Analytics to help hospitals maximize Medicare reimbursement bonuses and avoid significant penalties under the new Merit-based Payment System (MIPS) program.

Under MIPS, which began in January, it will no longer be enough for hospitals to just report quality data. Performance will now be measured and penalties could reach as high as 9 percent under the new program.

MIPS combines several programs developed by Medicare, including PQRS, Value Modifier and Meaningful Use into a single program. But the combination created a complicated set of requirements, including: confusing time frames, overlaps in requirements, wasted resources, and inconsistent measurement and payment adjustments for quality and cost of healthcare.

“Because the payment landscape is changing so rapidly, it’s critical that hospitals and other providers have the latest reporting tools at their disposal,” said Gene Schneider, CEO of MedAptus. “Hospitals can definitely improve their revenue through proper reporting. But get it wrong and the reverse is true—they could see a significant hit to their bottom line. As a result, we did an extensive search to align ourselves with an organization who could help our customers navigate through these complicated reporting requirements.  In the final analysis, we picked Mingle Analytics as our partner.  This partnership allows us to offer the highest level of MIPS support to our customers.”

MIPS Solutions™ by Mingle Analytics helps health organizations navigate through the complexities of the new requirements for reporting by providing three levels of service that increase the probability of earning value or merit-based incentive payments under the Merit-based Payment System (MIPS) and help avoid penalties. The three levels are: Essentials Edition, Performance Edition, and Enterprise Edition. Each edition is tailored to practice service needs.

With the Essential Edition, customers will participate in MIPS to avoid penalty by reporting for one quality measure, the base ACI measure, or an improvement activity.

With the Performance Edition, customers will fully participate in MIPS to become incentive and bonus eligible. In addition, they may analyze up to nine measures, plus report IA and ACI categories. Customers may produce quarterly reports to track and improve performance.

With the Enterprise Edition, customers will be able to maximize potential for MIPS and APM incentive and bonus payments. Users can analyze up to 18 measures with continuous performance reporting.

Mingle’s solution integrates with MedAptus Charge Capture solutions and receives other input from the various hospital and physician practice systems necessary to comprehensively meet the stringent MIPS reporting requirements.

,

MedAptus Introduces Software to Improve Charge Capture for Infusion Services

automatic infusion coding

MedAptus®, a Boston-based healthcare technology company, has developed new software that improves the capture of charges for infusion services.

Charge Capture INFUSION replaces the paper-based system often used by hospitals today, which can cause coding errors and prevent nurses from spending more time with patients.

By improving coding and charge capture efficiencies, the software significantly improves coding accuracy and reduces compliance risks.

It also allows hospitals to find additional revenue that might have otherwise gone unreported.

For example, in an audit conducted of 140 charts in one hospital, 120 of those charts were underreported revenue opportunities. Another hospital audit showed that at least half of its charts contained missed opportunities.

Charge Capture INFUSION is a major improvement for hospitals,” said Gene Schneider, CEO of MedAptus. “Not only does it help find new sources of revenue, but it’s especially valuable for nurses since it frees them up to spend more time with patients.”

Charge Capture INFUSION builds on Medaptus’s 18 years of experience delivering charge capture solutions for hospitals across the United States.

Developed to be fully integrated with all of the major EHR systems (including Epic, Cerner, MEDITECH and Allscripts), Charge Capture INFUSION, is also designed to handle the complexity associated with the hierarchy of codes associated with infusion by applying the correct codes to the appropriate services in the proper order.

While infusion centers will likely benefit the most from Charge Capture INFUSION, other departments within a hospital are likely to take advantage of the software as well.

“Emergency rooms will benefit from Charge Capture INFUSION as well,” said Dan Nottingham, Vice President of Product Management. “Hydration times can now be better captured because of our software.”

Charge Capture INFUSION has also been developed to integrate with the latest infusion “smart” pumps that hospitals are now adopting, providing even faster and more efficient coding and billing.

To learn more about Charge Capture INFUSION, click here or call (617) 896-4000.