Clinical labs should be tests for your patients, not a test of your patience.
I chose the title for this blog a bit tongue in cheek. You see, there are numerous blog posts about how to “properly” redact PDF files. While all of those other blog posts correctly explain the challenges that makes redacting PDF files difficult and outline all of the steps that one must take to ensure private information is completely and irreversibly redacted, all of those blog posts fail to mention one critical idea that anyone tasked with the important job of redacting electronic documents should be aware of -- automation.
Previously we have discussed in general what happens when your center comes under regulatory scrutiny and what you can expect. Today, we will begin to look in greater detail at what a System Improvement Agreement (SIA) entails, the items that the hospital commits to fulfill and some strategies for addressing them.
The System Improvement Agreement (SIA)
In our previous post, we discussed what happens when your program receives a letter from either the United Network for Organ Sharing (UNOS) or the Center for Medicare and Medicaid Services (CMS) and your program's initial response. Today we will focus on what happens if CMS does not accept your mitigating factors application.
I recently spent three days driving across the northern Midwestern States and through a good part of Canada with a longtime friend as we headed to a once-in-a-lifetime wilderness adventure. As you might imagine our conversations spanning those 72 hours took as many twists and turns as did the roads we traveled. However, one saying my friend repeated several times stood out among many insightful remarks he’d made, “Your judgement is only as good as your information.“
Despite massive adoption of electronic medical records over the past several years, the promise of easy and nearly effortless chart abstraction from electronic medical records enabled by an interconnected web of interoperable EMRs sharing standardized data has yet to be fully realized. You need to look no further than the media tab to see the evidence that we have yet to arrive at this Utopian future.
Should you receive a letter from the Centers for Medicare and Medicaid Services (CMS), the focus will likely be on a failure to meet one of the Conditions of Participation, most likely related to either graft or patient survival relative to expected results. Under the authority of 42 CFR §488.61, a transplant program may request that CMS consider mitigating factors in the re-approval process. There are three general areas that will be reviewed to determine whether a program can be approved based upon mitigating factors. These areas include, but are not limited to, the extent to which the outcome measures are met or exceeded, the availability of Medicare-approved transplant centers in the geographic area or extenuating circumstances that may have a temporary effect on the program's ability to meet the Conditions of Participation.
Recently, Andy Slavitt, the CMS acting administrator, announced that CMS will likely end the Meaningful Use program this year.
Does that mean that the hopes of an internet-worked healthcare system that’s able to seamlessly share health information are completely dashed before interoperability truly got off the ground?
There’s no question that users rely on the EMR In Basket for day-to-day workflow management. The “In Basket” or “Inbox,” depending on what EMR you’re using, provides a centralized location to receive notifications and important patient information, such as admission and discharge notifications, new lab results, refill requests, patient calls, appointment reminders, patient portal communication and much more.
Do you frequently find yourself searching for and routing documents, whether paper or electronic, to colleagues, care team members or departments that need them? Or, worse do you find yourself waiting for documents to be routed to you? In our work, helping hospitals to automate clinical data abstraction, we're struck by the hours of time lost each day to inefficient workflows involving "loose" records that we often find ourselves helping our customers extract data from.
If you've ever managed an EMR data conversion, you likely know how painful data conversions can be. They require someone with intimate knowledge of the old EMR to write complex queries to extract the data in the format that the new EMR requires it to be in. In addition, at some point in the process you have to transform the old values into the new system's values (assuming they can be mapped at all!). Even if you have experienced, intelligent people and excellent vendor support during this process it is expensive, time-consuming, risky, and can delay your go-live. So, what if you don't have experienced people and good vendor support for your healthcare data conversion? Believe me, it's gonna get ugly.