Doctors are being driven daffy by electronic health records, or EHRs.
Updated: January 16, 2019 – 12:13 PM
Sally Pipes, for the Inquirer
That’s the takeaway from a recent report in the Journal of the American Medical Informatics Association. Seven in 10 Rhode Island doctors surveyed who used electronic health records said that the technology stressed them out. Those who reported health information technology-related stress were anywhere from 1.9 to 2.8 times as likely to burn out. In Pennsylvania, 45 percent of physicians report feeling burned out, according to a separate survey from Medscape.
They can thank the federal government for these professional headaches. A decade ago, the Obama administration pushed doctors to adopt electronic records in hopes they’d speed up the provision of care and improve health outcomes. Ten years on, these mandates have delivered much the opposite.
The federal mandate that doctors adopt electronic health records was included as part of the American Recovery and Investment Act — more colloquially known as the 2009 stimulus package.
The feds yielded a variety of carrots and sticks. Doctors that demonstrated meaningful use of the technology were awarded part of $17 billion in incentives. Doctors who didn’t risked having their payments from Medicare and Medicaid slashed.
President Obama boasted that the program would “cut waste, eliminate red tape, and reduce the need to repeat expensive medical tests.” The idea was that a mass upgrade of the nation’s health IT would facilitate the sharing of information among physicians and hospitals — and ultimately lead to more accurate diagnoses and more effective and efficient treatment.
The information technology revolution had transformed so many other parts of the American economy. Why couldn’t it do the same for health care?
The government’s carrots and sticks worked. From 2009 to 2015, the share of hospitals using a basic electronic health records system increased from 12 percent to 84 percent.
They may have adopted electronic records. But that doesn’t mean the technology works — or that it’s improving patient care.
The programs on the market are often clunky, time-consuming, and insensitive to the complexities of modern medicine. Physicians, who already face suffocating administrative burdens, are logging ever-increasing amounts of data that have little clinical relevance. Time with patients is disrupted by an endless flood of alerts and messages.
Two-thirds of doctors say electronic records degrade their patient interactions, according to a survey from the Physicians Foundation. More than half of physicians report that the records reduce efficiency; more than a third say they diminish the quality of care.
Screen time has replaced face time. Only one-fourth of the average doctor’s day is spent face-to-face with patients. Half is devoted to electronic health records and other administrative tasks, according to a study published in the Annals of Internal Medicine.
Our country can ill afford to have physicians spending three-quarters of their time on things besides patient care. Our population will require more and more care as it ages. That’s among the reasons the Association of American Medical Colleges projects that the United States will be short as many as 120,000 doctors by 2030.
The shortage could grow even worse if doctors react to the burdens federal pressures have foisted upon them by leaving the profession. The Physicians Foundation found that roughly eight in 10 doctors had reported feelings of burnout. Nearly half of doctors are looking to change career paths.
Rolling back the federal electronic health records mandate won’t stop doctors and hospitals from incorporating health information technology into their practices and facilities. Instead, it will allow them — not the government — to decide how to balance patient care and technology use. In theory, clinicians will use technology to improve their ability to deliver high-quality patient care — rather than using technology simply to satisfy the government.
Doctors choose their profession because they want to heal people, not fill out paperwork. It’s time for the government to get out of the way and let physicians actually practice medicine.
Sally C. Pipes is president, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is “The False Promise of Single-Payer Health Care” (Encounter 2018). @sallypipes.
Posted: January 16, 2019 – 12:13 PM
Sally Pipes, for the Inquirer
Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing, Medical Transcription, Scribe Services, and AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #MedicalTranscription #AzaleaHealthEHR #RevenueCycleManagement #MDSofKansas #MedicalBillingService #MedicalScribes
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Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing, Medical Transcription, Scribe Services, and AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #MedicalTranscription #AzaleaHealthEHR #RevenueCycleManagement #MDSofKansas #MedicalBillingService #MedicalScribes
Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing, Medical Transcription, Scribe Services, and AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #MedicalTranscription #AzaleaHealthEHR #RevenueCycleManagement #MDSofKansas #MedicalBillingService #MedicalScribes
With copy and paste rampant, UW Health chief medical information officer Shannon Dean says toolkits and vendors can help, but physicians need to take responsibility for proper clinical documentation.
Overuse of copy and paste in electronic health records is a problem. Sure, it’s convenient. And it’s entirely understandable why it’s a common shortcut used by scores of physicians. But it often results in note bloat – unwieldy patient records overflowing with repetitive documentation – that can potentially lead to serious safety risks.
“Copying or importing text increases the risk of including outdated, inaccurate, or unnecessary information, which can undermine the utility of notes and lead to a clinical error,” wrote researchers in a 2017 study in Journal of the American Medical Association.
The practice of copy and paste has to be reigned in, and one chief medical information officer, writing for the Agency for Healthcare Research and Quality, says that has to start with the physicians themselves.
Shannon Dean, MD, CMIO at University of Wisconsin School of Medicine and Public Health, penned a column this month for AHRQ’s Perspectives on Patient Safety. She began with an example of what can happen when notation gets lazy.
She cites the case of a 78-year-old man who, “with an alleged history of ‘PE’ (interpreted by the clinicians as pulmonary embolism) received an unnecessary CT scan to rule out a suspected ‘recurrence’ of pulmonary embolus.
“As it happens, years earlier, the abbreviation ‘PE’ had been used in the electronic note to indicate that the patient had had a physical examination, not a pulmonary embolism!” said Dean. “In a vivid example of copy and paste, once the diagnosis of pulmonary embolism was mistakenly given to the patient, it lived on in the EHR.”
Beyond the risks to patient safety, that also points to the unnecessary costs that can pile up when unwitting clinicians order tests that are based on erroneous and repetitive data.
Nonetheless, said Dean, too many clinicians still copy and paste as a habit: “Perhaps we are complacent about copy and paste because we remain unconvinced that there is a correlation between its use and patient safety.”
In her article, she surveys more than a dozen studies on the subject, and finds that published research into adverse outcomes isn’t as voluminous as one might expect, even if it’s understood, intuitively, that the practice isn’t ideal.
So “it is clear that much work remains to be done,” said Dean. She points to toolkits like the one put together by AHIMA, and the fact that Epic has rolled out functionality that can “identify the source of every character within a note, whether it is newly typed, imported from another source, or copied and pasted.”
Still, “I am aware of very few organizations that are actively using these tools to educate and mentor clinicians in a systematic way to improve documentation quality,” she said.
While more academic research would be welcome on the correlation between copy and paste and patient safety, she said, it’s fairly widely accepted that it’s a shortcut that should only be used sparingly and in specific instances.
Healthcare organizations need to start making use of resources such as AHIMA’s toolkits, Epic’s auditing features and innovations like natural language processing technology to help physicians do better with their EHR documentation.
She also points to the OpenNotes initiative, which continues to gain momentum, as another big opportunity: Giving patients the ability to read their own doctor’s clinical notes allows them to “hold us accountable for quality documentation.”
But at the end of the day, “physicians need to reestablish ownership of the accuracy of clinical documentation,” said Dean. “We must stop blaming the EHR for our carelessness and start educating ourselves about how to use documentation efficiency tools, including copy and paste, more responsibly.”
Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing, Medical Transcription, Scribe Services, and AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #MedicalTranscription #AzaleaHealthEHR #RevenueCycleManagement #MDSofKansas #MedicalBillingService #MedicalScribes
Most healthcare providers, patients, and industry stakeholders agree EHR technology has the potential to yield marked improvements in population health management, predictive medicine, and clinical decision-making. However, EHR use also introduces new risks to patient safety. A study released in October of 2017 found EHR use has been listed as a contributing factor to patient injury at an increased rate over the past decade. Poorly-designed EHR systems combined with human error have resulted in patient safety problems in an increasing number of malpractice claims from 2007-2016. Here are a few steps providers and IT developers can take to deter this rising trend.
Online medical diagnosis and treatment
Limit use of copy-paste functionality
Shortcuts built into EHR systems have been embraced by provideders as a way to reduce the amount of time spent at their monitors. However, one shortcut could potentially pose a threat to patient safety.
Researchers in a 2017 JAMA study found providers may be increasing the risk of patient harm by entering repetitive or inaccurate EHR clinical data into physician notes using copy-paste functionalities.
Ultimately, researchers found resident physicians used copy-paste to enter more than half of all data into physician EHR notes. The prevalence of copied information in physician notes increases the likelihood of repetitive, nonspecific, and irrelevant data existing in EHRs.
“Copying or importing text increases the risk of including outdated, inaccurate, or unnecessary information, which can undermine the utility of notes and lead to a clinical error,” researchers stated.
Researchers recommended healthcare organizations and health IT developers consider ways to limit the amount of copied information in physician EHR notes by inhibiting certain information from being saved.
“This finding could spur EHR design that makes copied and imported information readily visible to clinicians as they are writing a note but, ultimately, does not store that information in the note,” researchers stated.
The National Institute of Standards and Technology (NIST) also cautioned providers against relying too heavily on the copy-paste functionality for clinical documentation.
Along with the ECRI Institute and U.S Army Medical Research and Material Command’s (MRMC) Telemedicine and Advanced Technology Research Center (TATRC), NIST offered recommendations for reducing copy-paste-related errors.
Specifically, researchers recommended implementing EHR designs that enhance the visibility of information being selected for copy and paste to prevent users from inadvertently copying certain unrelated or unwanted areas of information.
Additionally, authors recommended locking certain areas or sources of information to prevent copying altogether. For example, organizations could disable the copy-paste function when providers are entering data into a blood bank information system to prevent errors related to blood transfusions.
Limiting or restricting over-use of the copy-paste functionality during clinical documentation can help to reduce patient safety threats stemming from irrelevant or redundant information.
IMPLEMENT A SIMPLE, UNCLUTTERED EHR INTERFACE
Simple EHR interfaces are best, according to a recent report from Pew Charitable Trusts.
Convoluted or overly-complex EHR designs can confuse providers and negatively impact clinical productivity. Poorly-designed EHR interfaces can also inhibit providers’ ability to quickly find information.
Furthermore, EHR interfaces that lack key information altogether can cause clinicians to search for data in multiple places, which may slow down patient care delivery.
“Important design principles include knowing what users need for a simple interface, removing complexity, using simple and clear terminology, emphasizing key elements, and using color effectively to draw users to important areas,” advised the authors.
By extension, healthcare organizations should also refrain from excessive EHR customization.
“These customizations — which may be requested by a health care facility or staff — may not have undergone rigorous testing by the care team or the product developer to detect potential safety concerns,” the research team wrote.
Keeping EHR design simple improves EHR usability and enables providers to view information in as clear, concise, and straightforward a manner as possible. Ensuring EHR data is clear and accessible can help to reduce the chances of clinical errors and EHR-related safety risks.
IMPROVE PHYSICIAN EDUCATION SURROUNDING EHR USE
EHR system design can play a hand in heightening the risk of patient safety problems, but human error is more commonly the culprit.
Reducing safety risks related to human error require improved physician education about EHR technology and use. At the 2017 ONC Annual Meeting, a panel led by ONC Chief Medical Officer (CMO) Andy Gettinger discussed the importance of understanding how EHR software works.
In an effort to increase provider understanding of EHR technology, ONC is working to develop a “Usability Change Package” focused on building a tool provider organizations can use to gain a base level of knowledge about usability.
The resource will provide informational materials to EHR users in a variety of settings to help them assess and improve the usability of their systems.
“Now with ONC and this change package work, we’re seeing much more attention around implementation and what is happening there,” stated Raj Ratwani, National Center for Human Factors in Healthcare Senior Research Scientist and Scientific Director.
Educating providers about the affect implementation decisions can have on the overall usability of their EHR systems can help to avoid costly, long-term software problems.
ENCOURAGE HEALTH IT DEVELOPERS TO IMPROVE HEALTH IT STANDARDIZATION
While healthcare organizations bear responsibility for EHR use-related errors, health IT developers and certification bodies can also help to reduce liability risks.
“We became aware of the potential liability risks related to the use of EHRs shortly after their introduction, and we anticipated that EHRs would become a contributing factor to medical professional liability claims,” wrote authors in a 2017 report from the Doctors Company.
Researchers suggested most EHR-related problems could be attributed to a lack of widespread standardization among health IT developers early on after EHR adoption became common.
“Many EHR-related problems could have been avoided if the federal government had developed vendor standards for EHR use and interoperability and required beta testing in the healthcare environment to ensure usability and safety before the HITECH Act mandated its widespread adoption in 2009,”they wrote.
Improving standardization and usability testing could help to reduce or avoid EHR-related patient safety risks. Additionally, researchers suggested health IT developers take provider concerns and other feedback into account when designing EHR technology in the future.
“Physicians and other healthcare workers played a minimal role in the initial design of the EHR, and their concerns have been largely ignored,” stated researchers.
Improved communication between health IT developers and providers could serve as a way to reduce provider frustrations with EHR use and limit patient safety risks through more streamlined, standardized system design.
Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing, Medical Transcription, Scribe Services, and AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #MedicalTranscription #AzaleaHealthEHR #RevenueCycleManagement #MDSofKansas #MedicalBillingService #MedicalScribes
More than 90% of hospitals and 80% of physicians’ offices now have electronic health records (EHRs) – and while the digitization of medicine has improved patient safety, it also has a dark side. Today The Doctors Company, the nation’s largest physician owned medical malpractice insurer, published a new study showing that EHR-related malpractice suits are on the rise.
The study reveals that claims in which EHRs are a factor grew from just 2 from 2007 through 2010 to 161 from 2011 through December 2016. Typically, the EHR is a contributing factor in a claim, rather than the primary cause, according to David B. Troxel, MD, study author and medical director at The Doctors Company.
It’s the second study of its kind by The Doctors Company, which recognized early on that despite the potential of EHRs to advance the practice of good medicine and patient safety, there would be unanticipated consequences from this rapidly adopted new technology. The latest research compares 66 claims made from July 2014 through December 2016with the results of the first study of 97 claims from 2007 through June 2014.
Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing, Medical Transcription, Scribe Services, and AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #MedicalTranscription #AzaleaHealthEHR #RevenueCycleManagement #MDSofKansas #MedicalBillingService #MedicalScribes
A new survey from SelectHub, a technology selection management company, examined the thoughts of medical professionals and patients regarding electronic health records.
The team interviewed 1,007 Americans who have access to EHRs, as well as 107 healthcare professionals, including nurses, physician assistants, administrators, technicians and medical laboratory scientists. In an email, Chris Lewis, a creative partner of SelectHub, said the survey results were not limited to users of a certain EHR vendor or system.
Apparently, healthcare workers and patients both have a fairly positive sentiment of EHRs — at least according to the survey.
Among healthcare professionals, 53.5 percent said they had a positive outlook on EHRs, and 33.7 percent indicated they had a very positive stance. Approximately 10.9 percent had a neutral opinion, 2 percent expressed a negative opinion and 0 percent had a very negative outlook.
These results are surprising, given that electronic health records are often considered something healthcare workers love to hate.
Despite these favorable viewpoints, EHRs don’t seem to be cutting down on the amount of time professionals spend on health records. Among those who switched to using an EHR system, the average number of hours per week spent on health record work only decreased from 19.7 hours to 18.6 hours.
Additionally, 81 percent of professionals said EHRs have increased general workplace productivity.
The SelectHub survey included a wide range of healthcare participants, such as administrators, medical laboratory scientists and office receptionists. But it is interesting to note that a study out of the University of Wisconsin and the American Medical Association found that at least among primary care physicians, EHRs are time-consuming and only complicate matters. According to that study, EHR-related tasks take up nearly half of the average PCP’s workday.
Among patients included in the SelectHub survey, 60.4 percent expressed a generally positive opinion of EHRs, and 19.7 percent had a very positive opinion. Additionally, 16.6 percent had a neutral stance, 3 percent had a negative opinion and 0.3 percent indicated a very negative opinion.
“Perhaps the most surprising aspect of our research though was the reasoning behind patients’ support of EHR technologies,” Lewis said via email.
Seventy-six percent of patients said they believe their doctor’s use of an EHR has either a positive or very positive impact on the healthcare they receive.
“Furthermore, those who received thorough instructions on EHR use and access reported accessing their records more than twice as frequently, suggesting a potential need for more information resources for patients,” Lewis added.
Photo: Mutlu Kurtbas, Getty Images
Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing, Medical Transcription, Scribe Services, and AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #MedicalTranscription #AzaleaHealthEHR #RevenueCycleManagement #MDSofKansas #MedicalBillingService #MedicalScribes
As many as 80 percent of all medical claims submitted to insurance carriers contain mistakes estimated at $68 billion (1). Approximately 55 percent of evaluation and management (E/M) claims are incorrectly coded resulting in $6.7 billion in improper Medicare payments.(2) Providers looking to avoid lost revenue and serious consequences are raising the training standards of its administrative staff seeking out those who have completed specialized training and certification offered by Practice Management Institute (PMI).
Watchdog agencies, enforcement, and penalties are on the rise, creating a high-risk environment for physicians. Tighter screening measures adopted by the Affordable Healthcare Act have resulted in 17,000 providers losing their license to bill Medicare (3). Doctors have ultimate responsibility for all claims billed under their unique provider number, and a physician’s signature on any claim is held as verification of the accuracy and legitimacy of each claim (4).
Increased scrutiny has prompted doctors and healthcare facilities to require their employees to become certified. From an enforcement perspective, staff who knowingly submit fraudulent claims for payment can be held liable (5).
David Womack, President and CEO of PMI, says, “It’s critically important that providers have well trained staff. The physician needs to have confidence that their personnel are running the business correctly so they can focus on quality patient care.”
Physicians dedicate their careers to quality patient care; most have had little exposure to the increasingly complex world of medical claims management. They rely on their billing and administrative staff to stay on top of the guidelines set forth by Medicare and third parties. PMI helps providers adopt higher training standards with specialized courses and certification exams that address these high-risk areas of practice administration.
Womack says, “Taking steps to successfully train and certify staff in these areas means physicians are more likely to submit accurate claims and receive correct payments for their services, and ensure that practice liability is minimized.”
About Practice Management Institute (PMI):
For more than 30 years, Practice Management Institute, also known as PMI, has helped physicians, hospital systems, medical societies, and educational institutions provide comprehensive education and training to medical office staff nationwide. By offering a variety of educational programs and professional certifications, PMI helps to build competency, compliancy, and effectiveness that assures the continued success of their clients.
Since PMI’s formation in 1983, more than 20,000 individuals have earned certification in one more areas of expertise. PMI is recognized by both the Centers for Medicare and Medicaid Services and the Department of Labor for training in: medical coding, third-party billing, office management, and compliance. PMI training helps ease the burden of running a successful medical practice through thorough education and up-to-date training for non-clinical staff, allowing physicians to focus on patient care to improve the experience of the patient. For more information, visit http://www.pmiMD.com.
About David Womack:
David Womack, President and CEO, has been instrumental in PMI’s continued success since 1991. He has helped PMI transition into a cutting-edge leader in medical office staff education and training while developing key relationships with healthcare organizations, hospitals, colleges, and medical societies across the country. His commitment to excellence has helped PMI become an industry leader recognized by both governmental organizations and healthcare systems across the country.
Sources:
1. “Incorrect Medical Coding Corrupts the Core Data Used by Health Care Facilities, Has Negative Consequences Throughout Health Care Industry.” Integrated Healthcare Executive. N.p., n.d. Web. 05 May 2017.
2. “55% of E/M Claims Incorrectly Coded – What’s Your EMR Software Doing to Help?” HealthFusion, June 24, 2014.
3. The $272 Billion Swindle.” The Economist. The Economist Newspaper, 31 May 2014. Web. 05 May 2017.
4. College, From The. “Who Is Liable for Coding Mistakes?” The Rheumatologist. N.p., 01 Oct. 2010. Web. 05 May 2017.
5. U.S. Department of Justice Memo, “Individual Accountability for Corporate Wrongdoing” aka, the Sally Yates Memo, September 9, 2015.
As we get ready for National MT week, let’s take a look at the importance [still] of the Medical Transcriptionist in today’s healthcare industry:
A skilled workforce produces quality documentation. Healthcare documentation specialists (HDSs) and medical transcriptionists (MTs) ease the documentation burden from physicians.
HDSs and MTs consistently achieve documentation accuracy rates higher than 99%,¹ and by harnessing this workforce’s expertise, clinicians’ time, coding, and revenue are optimized and the data governance strategy is strengthened.
The narrative allows physicians the opportunity to add the qualitative information that provides context to the patient’s medical history and care. HDSs and MTs understand the complex story-telling of patient care and are experts in document standards and data capture.
Your healthcare documentation team are highly skilled, analytical quality assurance specialists who provide risk management support in capturing healthcare encounters and making sure they are documented in a way that promotes clinical clarity and coordinated care.
HDSs and MTs need to be positioned to ensure accurate documentation of care encounters and to identify gaps, errors, and inconsistencies in the record that may compromise care or compliance goals.
HDSs’ and MTs’ body of knowledge is vast and includes pharmacology, human disease processes, anatomy and physiology, HIPAA, privacy and security, and diverse technologies used to capture health data.
Certify to healthcare delivery that HDSs and MTs have the training and expertise to be valued among the allied health and HIM delivery teams by earning and maintaining your professional certification.
#NMTW #PrecisionMatters
Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing, Medical Transcription, Scribe Services, and AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #MedicalTranscription #AzaleaHealthEHR #RevenueCycleManagement #MDSofKansas #MedicalBillingService #MedicalScribes
#MDSofKansas will once again be at the #KMGMA2017 Spring Conference (04/20/17) and we are looking forward to seeing YOU! Please stop by our booth and check out some of the great giveaways, and learn what we’ve been up to! We are saving many clinics and businesses lots of money on everyday fees. If you would like to save money, too, stop by and ask us how!
Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing, Medical Transcription, Scribe Services, and AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #MedicalTranscription #AzaleaHealthEHR #RevenueCycleManagement #MDSofKansas #MedicalBillingService #MedicalScribes
Certified Medical Scribe Support Can Alleviate Physician EHR Burnout Concerns; Certify Today
CONTACT: Kristin Hagen
President/CEO, American College of Medical Scribe Specialists
(657) 888-2158
ORANGE, CA., July 6, 2016. According to a new analysis by the Mayo Clinic and American Medical Association researchers of a nationwide survey of physicians, computerized provider order entry and electronic health record use are a major source of burnout for physicians. The study found that physicians who used EHRs and CPOE had greater rates of burnout than those who did not, an issue that Certified Medical Scribe Specialists (CMSS) have been shown to help alleviate.
“This study makes it clear that physicians are frustrated with the drop in productivity resulting from electronic health record use and the time takes away from true, face-to-face interactions with patients,” said ACMSS Executive Director Kristin Hagen. “The revolution in our healthcare system toward value-based, individualized medical care and treatment cannot happen if the EHRs meant to help facilitate these changes are a major source of physician dissatisfaction. Certified Medical Scribe Specialists assist practices and clinicians in real time, assisting innovative workflow and efficiencies, providing necessary tools and resources.”
A study published last fall in ClinicoEconomics and Outcomes Research found that physician productivity in a cardiology clinic was 10% higher for physicians using medical scribes. This improved productivity resulted in 84 additional new and 423 additional follow-up patients seen in one year. That study also found that the physicians using medical scribes finished most or all of their work during clinic hours and they did not have to spend additional time to complete documentation after their standard working hours.
“The clinical documentation and practice efficiencies certified scribes provide have been shown to ease the clerical burdens of CPOE and EHRs, and give physicians back the time and attention they need focus on their patients,” Hagen said. “Providers need to ensure that they use certified medical scribes, meeting CMS requirements, revolutionizing clinical care and creating sustainable outcomes together.”
The ACMSS certification program meets current and proposed CMS certification requirements toward use of electronic health records. ACMSS works in compliance with CMS to meet national goals and initiatives of Meaningful Use, Merit-Based Payment Incentive System (MIPS) and Medicare Access and CHIP Reauthorization Act (MACRA). Certified medical scribes also meet the “qualified people” standard in Certified Electronic Health Record Technology (CEHRT). If not the clinicians themselves entering the data, eligible personnel must be certified, meeting the CEHRT Meaningful Use (MU) Personnel standard.
The ACMSS certification program meets current and proposed CMS certification requirements toward use of EHRs through its Medical Scribe Certification & Aptitude Test (MSCAT). ACMSS provides specialty certifications in vascular medicine, dermatology, oncology, primary care, internal medicine, emergency medicine and general patient care, enabling access to all across the specialities. ACMSS enables same-day certification for practices to meet Meaningful Use attestations, presently at 2%, and offers ongoing webinars to assist prospective individuals with key information about ACMSS, regulations, and innovations to meet healthcare goals through Volume Certification Packages.
Building integrative systems design for prevention and disease reversal for patient care most heavily impact family practice, primary care, and urgent care, followed by all the specialities. MIPS and MACRA allow the current traditional healthcare system and providers to focus on their much-needed goals today in independent practices of working to assist patients in disease reversal and prevention toward wellness.
The American College of Medical Scribe Specialists offers five separate pathways for Certified Medical Scribe Specialists. Please contact ACMSS directly atsupport@theacmss.org or 657-888-2158 if you have any questions regarding the ACMSS program and/or materials.
About ACMSS
The American College of Medical Scribe Specialists is the nation’s only nonprofit professional society representing more than 17,000 Medical Scribes in over 1,700 medical institutions. ACMSS partners with academic institutions, non-profit partners, and medical scribe corporations to offer both education-to-certification and employment-to-certification pathways. ACMSS advances the needs of the medical scribe industry through certification, public advocacy, and continuing education. To learn more about ACMSS, please visit: theacmss.org
Certified Medical Scribe Specialists (CMSS) credentials and certification are enabled via the Medical Scribe Certification & Aptitude Test (MSCAT), recognized by CMS, meeting the Personnel Measure of Eligible Personnel of “who” may document in the EHR.
Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement #MDSofKansas #medicalbillingservice
“We are very excited about Azalea’s telehealth solution and love how it’s fully integrated with our EHR and patient records. We immediately can increase care coordination, communication and even patient safety, which all leads to improved care quality, better outcomes and increased patient satisfaction.”
Leigh Ritorto, VP of Clinical Services, Women’s Telehealth
Azalea Health now offers fully integrated telehealth functionality within its certified electronic health record (EHR) solution. Azalea Health is the first health IT company to successfully integrate telemedicine functionality into its EHR solution and provide innovative services to its users as a part of a complete interoperable cloud-based health IT platform.
This additional functionality allows for increased physician-patient engagement through live streaming video calls via a secure, HIPAA-compliant videoconferencing platform. Azalea’s telehealth features allow direct media streaming, not only between care providers and their patients, but also between healthcare providers in other organizations. These features are accessible using a mobile/smart phone.
Since Azalea’s virtual care solution is an integral part of our comprehensive health IT platform, it has the essential and inherent integration into all clinical, financial and administrative workflows. Our solution is not only fully integrated with our certified EHR, but also fully integrated with our patient portal, mobile apps and billing to facilitate patient engagement, care coordination and capitalize on chronic care management reimbursement guidelines.
To learn how you can get started with Azalea EHR with Telehealth functionality, contact us atInfo@AzaleaHealth.com or call 877-777-7686.
Telehealth Benefits
Increased accessibility and convenience of providing patient consultations and physician collaborations
Increased reimbursements through CMS’ Chronic Care Management program
Improved clinical operations due to integrated software and hardware workflows
More efficient care delivery than traditional visits alone
Opportunity to reduce readmission rates
Improved care coordination
Enhanced patient engagement
Increased reimbursement rates
Telehealth Features
Easy-to-use
Live streaming video calls via a secure, HIPAA-compliant videoconferencing platform
Direct media streaming
Accessible using a mobile/smart phone
Fully integrated with Azalea’s certified EHR, patient portal, mobile apps and billing functionality
Azalea® Telehealth Solution screenshots:
Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement #MDSofKansas #medicalbillingservice
JOHNSON CITY, TN — Of the estimated 2.1 billion patient encounters documented in the United States in 2015, approximately 32%, or over 670 million documents, were generated by dictation and transcription, according to a new market analysis from WebChartMD.
The analysis (click here to access) breaks out the clinical documentation market into the three main documentation methods most often used by healthcare providers: 1) Provider Entry, in which the healthcare provider enters data him/herself into the EHR; 2) dictation and transcription; and 3) Scribe Entry, in which Medical Scribes enter data into the EHR. Front-end speech recognition usage was not included in the study.
Provider Entry is the leading clinical documentation method, with an estimated 61% market share, followed by dictation and transcription, with an estimated 32%. Scribe Entry trails with an estimated 7% market share.
Dictation and transcription, the second most-used modality, had its heaviest concentration of usage in ambulatory specialty care and hospital-based documentation. The medical transcription industry had estimated 2015 sales of $2.2 billion, or 20.6 billion annual lines. About 30% of all US-based physicians – or just over 300,000 – continue to use dictation and transcription for some percentage of their clinical documentation, according to a recent WebChartMD estimate.
A notable change in the break-out of market share has been the rise of the Scribe Entry segment, which has grown from a few thousand to over 20,000 Scribes nationwide in just the last few years. Scribes currently process an estimated 143 million patient encounters annually, or about 7% of the entire clinical documentation market.
One take-away from the analysis? “The government has spent billions of dollars since the 2009 HITECH Act to incent physicians to adopt EHR-based clinical documentation tools. Despite that, there remains a sizable minority of healthcare providers who continue to use dictation and transcription,” said Christensen. “While transcription will never return to its former levels of usage, I believe there are a number of specific reasons why it will persist as a clinical documentation modality.”
WebChartMD, a software development company specializing in clinical documentation workflow applications, partners with over 100 MTSOs nationwide, which in turn serve over 8,000 physicians via the WebChartMD platform.
Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement #MDSofKansas #medicalbillingservice
GomerBlog highlights the major points from tonight’s State of The Medicine Address given by the President of Hospital Administrators, Mr. Cutter Salary.
Hospitals now have the highest patient satisfaction in the history of healthcare and probably correlates to increased quality of care according to patients and lawmakers
WiFi, fast food restaurants, and pianos are distributed throughout hospital lobbies replacing exam rooms and useless medical equipment
Doctors now spend 50% of their time coding which is a vast improvement over last year and has led to spectacular reimbursement rates to enable hiring of more administrators. Remember Caring IS Coding!
Unnecessary Nurse bonuses were removed in a major cost saving move this year. To save even more money, cuts will start with the nursing staff and end with the nursing staff
Drinks were finally stripped from the Nursing Station. This year we must continue with stripping any fun or laughter from the Station. We don’t want our patients thinking we are making fun of them
Breaks are vanishing from the workplace and we need to continue that for our medical providers. Foley catheters were distributed to staff to help our providers perform flawless and uninterrupted care
Surgeons are required to perform 3 more surgeries a day and leave when it is dark outside. Skin cancer rates are drastically down in our employees now thanks to this move.
Patient to Nurse ratios are at an all-time high providing a challenging and dynamic work environment to our nursing staff, which we know they enjoy
The new Secretary of The Medicine, Dr. Oz, continues to utilize his charismatic charm to educate the public before they come to the hospital
And finally, our budget has been passed and includes hiring another 1.2 million hospital administrators to oversee and provide outstanding medical care to our hospitals!
“God Bless The Medicine and God Bless my obnoxiously large pension!”
Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement
The ICD-10 Compliance date is looming and it is imperative that healthcare providers be prepared to make the transition. It affects everything from claims processing, physicians’ workflow, and patients’ access to care. Many organizations may be rallying employees and resources in order to make the switch from the ICD-9 to the ICD-10 coding for medical diagnoses and inpatient hospital procedures before the implementation date of October 1, 2015.
To make matters worse, the transition is not easy, but a major undertaking with nearly 19 times as many procedure codes and almost five times as many diagnosis codes in the ICD-10 than in the ICD-9. While the ICD-10 switch is definitely necessary, as the outdated and clinically inaccurate ICD-9 has not been updated since its installation, in 1979, the ICD-10 stands to enhance the quality of healthcare, improve data for epidemiological research, as well as enable physicians to make better clinical decisions. However, this is dependent on the ability for the healthcare industry to make a smooth and accurate transition to the new International Classification of Diseases, according to Richard Milam, president and CEO of EnableSoft
In order for healthcare providers to successfully meet the ICD-10 deadline, Milam suggest five best practices to ensure an expedient, smooth ICD-10 transition:
Richard Milam, president and CEO of EnableSoft
1. Employ Robotic Process Automation That Does the Work for You
“You” is meant to imply the entire organization because that is how many resources it will take to have the ICD-10 switch completed by the deadline if Robotic Process Automation is not used to update and add the multiple new codes into EMR, NDC, medical billing, and claims processing data systems. Certain softwares may have to upgraded or replaced to support the 68,000 diagnoses codes and nearly 87,000 procedure codes; however, through a series of human-directed scripts, Robotic Process Automation technologies will populate the specific fields in the data systems with the ICD-10 data required. The already costly transition to the new ICD-10 can be mitigated by not having to outsource or hire new employees to enter the new codes manually. Furthermore, the data transition can take place over the course of a few days, not a few months, ensuring healthcare providers will be ready to transition to using the new ICD-10 codes.
2. Test Your Software
Not only should you confirm with your clearinghouses, billing service, and payers that they will be upgraded and compliant with the ICD-10, but when they will be ready for testing to occur. Robust end-to-end testing must occur with your software in order to ensure claims are being accepted properly and processed by insurance contractors, Medicaid, Medicare, and other payment processes are operational. Test internally to ensure transactions can be generated and sent with the ICD-10 codes and test externally to ensure the transactions are successfully received by payment providers and that the payment can be processed correctly. After October 1, any ICD-9 codes used in transactions will not be accepted for services and will be rejected for payment. Failure to test your software properly can result in disruptions in patients’ receiving the treatment they need and receipt of due payments.
3. Educate or It All Falls Down
The updated, enhanced medical coding that is to enhance and improve patient diagnoses, performed procedures, treatment, and billing will not prove capable of these abilities without humans to employ its codes, terminology, and procedures appropriately and correctly. You must educate your staff about the changes to the ICD-10 and perform practices and routines in order to prepare for the change. Have each of your staff participate in educational seminars in order to become informed of the changes and how that will affect their position, the procedures patients are to undergo based on the new diagnosis codes, as well as the improved treatments that patients are to have performed. Assist and inform staff by identifying the 50-100 most commonly used ICD-9-CM diagnosis codes based on specialties and determine the equivalent ICD-10-CM codes, and have this information accessible before and after the implementation of the ICD-10. Having your staff prepared and knowledgeable about the ICD-10 will reduce delays in patient care and procedures, which is the reason for the ICD-10—to deliver improved diagnosis and advanced medical treatments that will enhance patients’ quality of care.
4. Implement an Effective Communication Method and Coordinate Conflict Resolution
While making the data transition and update to the new and diverse medical coding that is in the ICD-10, it is imminent that there may be delays in processes, confusion over coding and form completion, as well as workflow changes. Make sure your employees know who they can contact or call on if they are unsure of what code to report, how to complete a form, or other transitory questions that may arise following the implementation of the ICD-10. Identify leads and supervisors for each workflow and specialty area that will be available for their staff requests and questions, and make sure those individuals are highly educated on the ICD-10 and have the authority to execute a resolution. Additionally, determine how transactions handled just prior to the compliance date will be handled in order to ensure payment processing will occur—and more importantly—patients are covered financially and receive the best treatment. Identify critical areas or procedures that may be challenging to transition to using the ICD-10 and have practical resolutions for those practices ready to be executed if, and when, needed.
5. Obtain the correct medical documentation and update your forms to support the ICD-10.
Patient intake forms, EMR forms, insurance forms, and superbills must be updated to support the ICD-10 codes. In order to have patient medical records completed correctly and treatments performed effectively, in addition to have payments process, healthcare providers, clearinghouses, and payers must update their forms to reflect the codes in the ICD-10. Physician forms must be updated with the new medical terminology and diagnoses and procedural codes, along with superbills. Identify categories of uncommon services and diagnoses and determine units, time, and cost for each category in order for physicians to be able to report in the EMR and on superbills. Determine and have readily available a list of common or most frequently used abbreviations to ensure they are utilized correctly and correspondently with the ICD-10 terminology and codes. Lastly, and this goes without saying, obtain the updated and correct documentation that will stand as educational and reference material in regards to the ICD-10. The American Medical Association publishes the ICD-10 codebook and other supplementary documentation on topics such as anatomy and physiology, mappings, and coding workbooks. Make sure to have these ICD-10 Bibles available, and in all areas, for staff and physicians to reference when needed or desired.
The healthcare industry is about to embark on an intense change in treatment, reporting, and payment processes as the ICD-10 Compliance date approaches. While the ICD-10 is definitely necessary to reflect advances in medicine and detailed diagnoses, the change is extremely disruptive for healthcare providers. By employing efficient technologies and engaging effective strategies, healthcare providers can execute the ICD-10 transition quickly and accurately by the compliance date. READ MORE
Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement
That’s the takeaway from a recent report in the Journal of the American Medical Informatics Association. Seven in 10 Rhode Island doctors surveyed who used electronic health records said that the technology stressed them out. Those who reported health information technology-related stress were anywhere from 1.9 to 2.8 times as likely to burn out. In Pennsylvania, 45 percent of physicians report feeling burned out, according to a separate survey from Medscape.
They can thank the federal government for these professional headaches. A decade ago, the Obama administration pushed doctors to adopt electronic records in hopes they’d speed up the provision of care and improve health outcomes. Ten years on, these mandates have delivered much the opposite.
#MDSofKansas will once again be at the #KMGMA2017 Spring Conference (04/20/17) and we are looking forward to seeing YOU! Please stop by our booth and check out some of the great giveaways, and learn what we’ve been up to! We are saving many clinics and businesses lots of money on everyday fees. If you would like to save money, too, stop by and ask us how!
