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“ReDoc has been a huge success for Beloit Memorial Hospital. ReDoc enables us to provide more professional reports to our customers and the ability to capture appropriate charges for the work the therapists perform." Laurie Endres, PT, Clinical Director: Beloit Memorial Hospital
What are some good examples of reasonable and measurable goals for replacing my paper record with an electronic medical record?
Many provider organizations have similar goals that motivate them to replace paper with electronic medical records. Some examples include:
Improve Quality of Care – virtually every therapist’s first priority is providing the best possible care for their patient. By providing good clinical content and work flow, an effective EHR provides consistent, comprehensive, and complete documentation, which facilitates continuity of care and ensures that the high quality of care that has been provided is well perceived by referring physicians and payers. This is the first step towards the application of evidence based clinical best practices.
Increase Legibility – this is often the first goal that comes to mind; having a patient chart you can be proud of. Legible, complete, and comprehensive documentation means better continuity of care when patients are seen by other providers, more loyal referring physician relationships, and a lower risk profile during audits.
Increase revenue – one of first noticeable financial benefits is the capturing of charges that are often lost in paper charting. One of ReDoc’s strongest attributes is its ability to prompt the therapist with information on excluded benefits, NCCI edits, and appropriate modifier use. With good point of care documentation work flows, all the care provided to the patient is documented, and the billing is a bi-product of the documentation. This means all procedures are billed (avoiding the ‘peace corps’ syndrome and omissions in data entry); timed procedures are much more accurately billed; and bills are submitted promptly – usually the same day services are provided.
Decrease costs – the ‘hard’ cost elements that can be reduced early and predictably include the supplies associated with creating and maintaining a paper record (normal estimates are $8-12 per chart), a reduction in long term storage of paper charts, and any fees associated with transcription services. In some cases, there can be a reduction in the ratio of support staff to clinicians due to less demand for medical records and billing data entry staff, but many organizations choose to reallocate those staff members and only reduce headcount through normal attrition over time.
Improve compliance – For most providers, hearing that an audit is imminent brings high levels of anxiety; can all the charts called out be located? Are they complete and legible? Do they clearly document all care given, and its medical necessity? By making the electronic delivery of billing information an automated bi-product of the documentation process, and by prompting therapists at appropriate points to document information necessary for compliance purposes, an effective EMR can dramatically lower the Client's risk profile.
Improve staff capacity utilization – How many patients are you scheduling and seeing each month? How does that number change through the year, and how does it compare to the same month last year? Are you getting an appropriate number of billable units per therapist per day? Is your patient no-show rate under control? Most of the questions that plague therapy directors go unanswered, because it is very difficult to efficiently measure and assess their capacity. An effective EHR vendor not only exposes the metrics for assessment, but also helps your leadership team understand how various changes to department work flows can relieve capacity bottlenecks and help optimize capacity utilization.
Improve relationships with referring physicians – In the relationship between the referring physician and the therapy provider, the Plan of Care and other clinical documentation become the ‘product’ that referring physician satisfaction hinges on. Like most consumers of therapy reports, the referring physician can only judge the care received by the documentation they review. When the reports are legible, logically laid out, complete, and comprehensive, their confidence in and loyalty to the therapy provider improves. Further, effective EHR’s enable efficient, easy, and asynchronous communication outside of patient records for non-patient specific questions and issues.
Provide transparency into business and clinical metrics, and an opportunity to think systemically about optimizing outcomes - The paper medical record is an enormous impediment to designing, monitoring, and optimizing best practices, for the simple reason that – even assuming the record is complete and legible - data is still so difficult to audit and extract. Collecting raw data to extract from an EMR and monitor the metrics necessary to optimize financial, clinical, compliance, and even patient satisfaction outcomes is much easier. Done properly, the EMR vendor can also help clients approach performance optimization systemically, and understand the interdependency of many metrics when it comes to changing work flows. As an example, creating longer appointment windows for patient visits may seem to reduce capacity and revenue potential. But if more services are delivered per visit, and more personal care is delivered, then both patient and staff satisfaction may improve. With higher patient satisfaction, the incidence of patients returning for full treatment cycles may improve, which results in better functional and clinical outcomes.
Improve Quality of Care – virtually every therapist’s first priority is providing the best possible care for their patient. By providing good clinical content and work flow, an effective EHR provides consistent, comprehensive, and complete documentation, which facilitates continuity of care and ensures that the high quality of care that has been provided is well perceived by referring physicians and payers. This is the first step towards the application of evidence based clinical best practices.
Increase Legibility – this is often the first goal that comes to mind; having a patient chart you can be proud of. Legible, complete, and comprehensive documentation means better continuity of care when patients are seen by other providers, more loyal referring physician relationships, and a lower risk profile during audits.
Increase revenue – one of first noticeable financial benefits is the capturing of charges that are often lost in paper charting. One of ReDoc’s strongest attributes is its ability to prompt the therapist with information on excluded benefits, NCCI edits, and appropriate modifier use. With good point of care documentation work flows, all the care provided to the patient is documented, and the billing is a bi-product of the documentation. This means all procedures are billed (avoiding the ‘peace corps’ syndrome and omissions in data entry); timed procedures are much more accurately billed; and bills are submitted promptly – usually the same day services are provided.
Decrease costs – the ‘hard’ cost elements that can be reduced early and predictably include the supplies associated with creating and maintaining a paper record (normal estimates are $8-12 per chart), a reduction in long term storage of paper charts, and any fees associated with transcription services. In some cases, there can be a reduction in the ratio of support staff to clinicians due to less demand for medical records and billing data entry staff, but many organizations choose to reallocate those staff members and only reduce headcount through normal attrition over time.
Improve compliance – For most providers, hearing that an audit is imminent brings high levels of anxiety; can all the charts called out be located? Are they complete and legible? Do they clearly document all care given, and its medical necessity? By making the electronic delivery of billing information an automated bi-product of the documentation process, and by prompting therapists at appropriate points to document information necessary for compliance purposes, an effective EMR can dramatically lower the Client's risk profile.
Improve staff capacity utilization – How many patients are you scheduling and seeing each month? How does that number change through the year, and how does it compare to the same month last year? Are you getting an appropriate number of billable units per therapist per day? Is your patient no-show rate under control? Most of the questions that plague therapy directors go unanswered, because it is very difficult to efficiently measure and assess their capacity. An effective EHR vendor not only exposes the metrics for assessment, but also helps your leadership team understand how various changes to department work flows can relieve capacity bottlenecks and help optimize capacity utilization.
Improve relationships with referring physicians – In the relationship between the referring physician and the therapy provider, the Plan of Care and other clinical documentation become the ‘product’ that referring physician satisfaction hinges on. Like most consumers of therapy reports, the referring physician can only judge the care received by the documentation they review. When the reports are legible, logically laid out, complete, and comprehensive, their confidence in and loyalty to the therapy provider improves. Further, effective EHR’s enable efficient, easy, and asynchronous communication outside of patient records for non-patient specific questions and issues.
Provide transparency into business and clinical metrics, and an opportunity to think systemically about optimizing outcomes - The paper medical record is an enormous impediment to designing, monitoring, and optimizing best practices, for the simple reason that – even assuming the record is complete and legible - data is still so difficult to audit and extract. Collecting raw data to extract from an EMR and monitor the metrics necessary to optimize financial, clinical, compliance, and even patient satisfaction outcomes is much easier. Done properly, the EMR vendor can also help clients approach performance optimization systemically, and understand the interdependency of many metrics when it comes to changing work flows. As an example, creating longer appointment windows for patient visits may seem to reduce capacity and revenue potential. But if more services are delivered per visit, and more personal care is delivered, then both patient and staff satisfaction may improve. With higher patient satisfaction, the incidence of patients returning for full treatment cycles may improve, which results in better functional and clinical outcomes.