For years, healthcare’s financial incentive framework has been based on a fee-for-service model. This means that providers and hospitals are paid based on the number of healthcare services they provide. A higher volume of tests or procedures results in greater payments to the entities that provide them. The seemingly important element that is left out of this equation is whether the patient, who is being subjected to these tests and procedures, is experiencing improved health.
Earlier this month, Dr. Thomas Starzl, the father of organ transplantation, died at the age of 90. In reading an article about all that he did to ultimately discover what was needed to successfully transplant organs, one cannot help but to be awed by the uncertainty and risk that he needed to “work around” in order to make progress.
Once again I had the pleasure of attending the 24th Annual UNOS Transplant Management Forum for my 4th time earlier this year. As always, it was a flurry of learning, knowledge-sharing, networking, and well-deserved awards for leaders in the industry.
It was as apparent this time as it was every time before, that the transplant community is a close-knit group who all struggle with similar things regardless of their geographical location. These struggles span across many areas, including financial, staffing, regulatory requirements, lack of organs, information technology, reporting, managing the constant deluge of paper, and many more. While I can't claim that Extract can help with all of these, there are two specific struggles that we excel at fixing: extracting discrete results from faxed external lab results and intelligently splitting, classifying, and filing large documents (such as referral packets) into patients' charts.
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.
A consultant who supports analytics for population health and quality of care recently told me that frequently, they can only access 80% or less of the total data needed for these initiatives.
If that data is truly random and characteristic of the whole body of data, than acquiring 80% of it is pretty good, perhaps even great. But what if that 80% comes largely from one population sub-group. What if it represents patients who are local - city-dwellers who live nearby and come directly to your facility for lab work and other tests - while the missing 20% is a completely different population. Perhaps this 20% is defined differently by lifestyle, geography or other variables because that population cannot easily come to your facility?
An ounce of prevention is worth a pound of cure. Or, reduce medical errors through better documentation. Which one of these expressions do we tend to remember? In healthcare we hear quite a bit of talk these days on reducing medical errors. Of course this is with good reason. When getting data into the EMR, errors such as inaccurate or delayed results, can negatively impact patient health and lead to extended hospital stays, unnecessary treatment or worse. As a matter of fact, many healthcare organizations are now striving to eliminate mistakes and streamline efficiency by adopting principles such as Six Sigma and other business practices which are designed to continuously evaluate and improve best practices.
The Centers for Medicare & Medicaid Services regulates laboratory testing performed on humans in the U.S. through the Clinical Laboratory Improvement Amendments (CLIA) to ensure quality laboratory testing. CLIA sets high standards for quality control, validation of data and tests, equipment calibration, proper training and certification of users and clear end result reporting that meets proper lab data requirements.
Tracking data in your transplant care software is a key component of QAPI programs, not only for CMS, but now also with UNOS debating the requirement of QAPI programs. One of the most challenging aspects of transplant program management is ensuring that your Quality Assessment and Process Improvement programs are measuring meaningful and actionable items that lead to program improvement.
As with every study, the article laid out the limitations of this particular study, which focused on blood pressure only, before getting into the detailed results of their work. The seven limitations they named were quite typical, including possible duplicate data and possible non-reporting of improved patients, but the limitation that seemed most unnecessary and raised my blood pressure indeed was, “Sixth, incentive program CQM reporting was based only on the data available in the EHR system of the health care provider. If a patient transitioned to another provider, such as a specialist, the original EHR might not have subsequent, possibly improved, blood pressure values recorded.”
You have successfully set up your outreach program and established a strong local presence (please check out my 4 previous posts on this topic). What now? In order to achieve sustainability, you will have pressures to improve efficiency, reduce costs and demonstrate value. It is important to have in place a methodology by which you track your activity from both a quantitative perspective as well as to be sure that the quality delivered matches the quality of your main program.
In our first three blogs of this series, we discussed how educational outreach can lead to opportunities to facilitate more effective patient care locally and strengthen relationships with referring providers. We have focused on the structure of these efforts; now we will focus on the provision of these services and how to differentiate your efforts from others to ensure your investment pays dividends.
You finally found the perfect solution to the problem of getting data out of documents and into your EMR or other system. It’s a system that automates this data entry and the workflows surrounding the entire document handling and quality assurance processes. So, now it’s time to go ask for permission (budget) to purchase this solution.
As I’m standing in line at my favorite coffee shop, I’m thinking about how baristas have perfected workflow; and now have improved perfection by allowing me to eliminate the line entirely by ordering in advance with my smart phone. It always excites me when I see a sequence of steps refined for optimum efficiency. I know it's odd, but I'm really strange like that.