Showing posts with label healthcare reform. Show all posts
Showing posts with label healthcare reform. Show all posts
Tuesday, April 5, 2011
Medical Transcription - The Gold Mine
While EHRs are going in rapidly across the country, it's important to remember that the demand for value in reducing costs, improving patient safety and providing access to more Americans still leads the charge when it comes to why we move to electronic systems in health care. One of the best ways to enhance the value in EHR systems data mining and research is to keep a robust, detailed record of each individual patient who has a unique history unlike any other. Medical transcription/editing captures details provided by clinicians that are crisp and precise filled with data and information that can get us to the goal of improved patient outcomes through the application of secondary healthcare data. There are a number of reporting agencies that are making results available to anyone who is interested in taking a look. Organizations like the Leapfrog Group, Health Grades, Bridges to Excellence along with a score of others, provide information on various diseases and outcomes. Some secondary data use reporting is required such as core measures reporting. And when I say required, I mean that there is a 2% penalty in market-basket outcomes if you choose not to report. It is probably reasonable to anticipate that the number of hospitals reporting outcomes and the agencies to which they report will also increase. This is why it is a key fundamental and logical approach that the use of dictation and medical transcription or medical editing with speech recognition tools will be the best way to capture these necessary details and be able to produce content-rich results when reporting outcomes to continuously improve care. Nine of 10 Healthcare executives agree in a survey conducted by Pricewaterhouse Coopers (PWC) that secondary use of health information will significantly improve the quality of care and that those benefits will improve in the future. A clear two/thirds anticipate a huge increase within the coming two years. (1) Consider the AMIA findings of the gains that can be made from the expansion of knowledge about diseases, treatments and make strides in public health along with advances in privacy and security. (2) There is much to be gained as we move into this era of using secondary data to advance healthcare and this can best be achieved if we continue to capture the details provided by clinicians through the dictation and interpretation process. The outcomes, however, will only be as good as the content from which the information comes - that's why dictated/transcribed reports are a gold mine of information. To in any way short-cut details will severely limit the wide-range of benefits.
Tuesday, May 18, 2010
EHR Process: Speak Your Preference
EHRs and meaningful use (MU) are getting so much publicity. There is the carrot (financial incentive) and stick (reduced reimbursement) approach to get them in place by 2014 with the promise of reducing costs, improving patient outcomes and patient safety. Through all of this publicity, seems we haven't heard enough from the chief care giver - the physician.
Many of the EHRs that have been approved by CCHIT don't include a dictation/transcription option. CCHIT may not ultimately be the approval body. Interestingly enough, MU definitions haven't been finalized. So there are goals to meet that haven't been fully defined and timelines that associations like the AMA and AHA along with a host of other national groups that have spoken clearly about how the all or nothing MU criteria plan is ill-advised. They agree that the timeline is not realistic.
We probably all can agree that EHR implementation without meaningful use doesn't get us to the goals promised. And we understand that it is a given to migrate away from paper records. However, the rush to get it done seems to put physicians and a practical improved approach to healthcare delivery in the system that we have, in the backseat.
Let's look at this from an objective perspective. Now we have healthcare reform. That's great news for so many who don't have healthcare today. It means that an additional 32 million (estimated) Americans will have access to healthcare who previously did not or did if their conditions became critical enough for them to present to the ER. What will healthcare reform do to physician case loads? To hospital census? Let us not forget that we have an aging population with baby-boomers approaching retirement. Do we have enough physicians for all this increased volume?
Now let's look at how many EHR systems approach healthcare documentation. They are designed for the physician to become the data entry clerk - and in truth, many are operating this way today. VA's VISTA system, Kaiser Permanente, and there are a host of EHRs designed for ambulatory settings and physician office practice that utilize the same approach.
Here's a thought. Do you see the president of a bank entering deposits and counting out cash at his bank? No, so why would we ask our most highly educated member of the healthcare delivery team to become a data entry clerk?
Currently 1.2 billion patient reports are created by expert medical transcriptionists who have trained and many have become credentialed in their field. Narrative dictation captures the unique circumstances of each individual patient. No two patients are alike in their history and even presenting symptoms. And to leave out important details of the patient's additional illnesses can most certainly impact hospital and physician revenue. So why would we A. slow physicians down entering the detail and B. risk lower reimbursements?
The purpose of this blog post is just simply this. Consider: The physicians who are mostly going to be time and resource-impacted by EHR implementation need to speak out in favor of the ability to continue to document patient encounters in the most efficient and complete way. Physicians' voices must be heard in this evolution to electronic records. What EHR systems must do is provide an avenue for physician choice in documentation practices.
If physicians want to self-enter - then that should be an option. However, for those physicians with a patient case-mix that is complex and those with multiple medical problems, their option to continue to dictate will mean the difference in their ability to increase the demand on their time as patient loads increase.
Physicians - please speak up - be sure that you have options in how you document patient encounters. You are the CEO of the healthcare delivery team and the process needs to provide better patient safety and ensure that your time is optimized while ensuring appropriate reimbursements for all you do.
Many of the EHRs that have been approved by CCHIT don't include a dictation/transcription option. CCHIT may not ultimately be the approval body. Interestingly enough, MU definitions haven't been finalized. So there are goals to meet that haven't been fully defined and timelines that associations like the AMA and AHA along with a host of other national groups that have spoken clearly about how the all or nothing MU criteria plan is ill-advised. They agree that the timeline is not realistic.
We probably all can agree that EHR implementation without meaningful use doesn't get us to the goals promised. And we understand that it is a given to migrate away from paper records. However, the rush to get it done seems to put physicians and a practical improved approach to healthcare delivery in the system that we have, in the backseat.
Let's look at this from an objective perspective. Now we have healthcare reform. That's great news for so many who don't have healthcare today. It means that an additional 32 million (estimated) Americans will have access to healthcare who previously did not or did if their conditions became critical enough for them to present to the ER. What will healthcare reform do to physician case loads? To hospital census? Let us not forget that we have an aging population with baby-boomers approaching retirement. Do we have enough physicians for all this increased volume?
Now let's look at how many EHR systems approach healthcare documentation. They are designed for the physician to become the data entry clerk - and in truth, many are operating this way today. VA's VISTA system, Kaiser Permanente, and there are a host of EHRs designed for ambulatory settings and physician office practice that utilize the same approach.
Here's a thought. Do you see the president of a bank entering deposits and counting out cash at his bank? No, so why would we ask our most highly educated member of the healthcare delivery team to become a data entry clerk?
Currently 1.2 billion patient reports are created by expert medical transcriptionists who have trained and many have become credentialed in their field. Narrative dictation captures the unique circumstances of each individual patient. No two patients are alike in their history and even presenting symptoms. And to leave out important details of the patient's additional illnesses can most certainly impact hospital and physician revenue. So why would we A. slow physicians down entering the detail and B. risk lower reimbursements?
The purpose of this blog post is just simply this. Consider: The physicians who are mostly going to be time and resource-impacted by EHR implementation need to speak out in favor of the ability to continue to document patient encounters in the most efficient and complete way. Physicians' voices must be heard in this evolution to electronic records. What EHR systems must do is provide an avenue for physician choice in documentation practices.
If physicians want to self-enter - then that should be an option. However, for those physicians with a patient case-mix that is complex and those with multiple medical problems, their option to continue to dictate will mean the difference in their ability to increase the demand on their time as patient loads increase.
Physicians - please speak up - be sure that you have options in how you document patient encounters. You are the CEO of the healthcare delivery team and the process needs to provide better patient safety and ensure that your time is optimized while ensuring appropriate reimbursements for all you do.
Monday, September 14, 2009
The EHR in Prime Time
Did you happen to catch CBS Sunday Morning yesterday, 9/13/09? Well if you didn't here's a link but the lead story was the EHR and all its benefits. David Blumenthal, MD, National Coordinator, spoke and others who are leading the charge. The move to the EHR is part of President Obama's healthcare reform initiative, Title XIII of ARRA that was signed into law in February. And we need to get this done.
There is little doubt that the improvements that a fully integrated and nationally linked healthcare system can bring to us as a country. Improved outcomes, less waste, faster information available when every minute counts - all of these are crystal clear, valid and important to achieve. My only concern is that we don't want to fail to capture the critical details of the patient's unique set of circumstances at the risk of getting it done faster.
There have been plenty of articles written about some of the shortcomings of new systems as well as the merits of others. This is a decision that cannot be lightly made nor should it be made hastily without all the considerations a decision of that magnitude should receive.
I am confident that these decisions will be well-made and that meaningful use will help ensure that these goals are optimally met. We do need to utilize enabling technologies like Health Story project to preserve the details of every patient's story and include this through technological solutions so that no critical issues are overlooked or left out. Physicians have so many pressures on their time with increasing patient loads. Allowing them to continue to document in this manner will help them continue to focus on the work they do best - and that is diagnose and treat their patients. You can have transcribed reports that are fullyl minable in an EHR.
Check out the story on CBS Sunday Morning and tell me what you think.
There is little doubt that the improvements that a fully integrated and nationally linked healthcare system can bring to us as a country. Improved outcomes, less waste, faster information available when every minute counts - all of these are crystal clear, valid and important to achieve. My only concern is that we don't want to fail to capture the critical details of the patient's unique set of circumstances at the risk of getting it done faster.
There have been plenty of articles written about some of the shortcomings of new systems as well as the merits of others. This is a decision that cannot be lightly made nor should it be made hastily without all the considerations a decision of that magnitude should receive.
I am confident that these decisions will be well-made and that meaningful use will help ensure that these goals are optimally met. We do need to utilize enabling technologies like Health Story project to preserve the details of every patient's story and include this through technological solutions so that no critical issues are overlooked or left out. Physicians have so many pressures on their time with increasing patient loads. Allowing them to continue to document in this manner will help them continue to focus on the work they do best - and that is diagnose and treat their patients. You can have transcribed reports that are fullyl minable in an EHR.
Check out the story on CBS Sunday Morning and tell me what you think.
Thursday, August 6, 2009
ACE Summary!
Gaylord Opryland, Nashville, TN – Music City USA was the scene for the 31st annual AHDI Annual Convention and Expo. And what an event it was. We kicked the event off with a Wednesday night welcome reception and everyone showed up in their jeans and boots to learn a few line dances from 3 very talented instructors. Later (once we had a few steps figured out), we were entertained by Les Richardson and County Line. What an awesome event and everyone was there!
Thursday morning we heard from our opening keynote, Donna Hartley who shared her incredible story with the message being that you can be more than a survivor, you can really thrive even in tough situations. She shared 9 tips you can do to get the most out of your career and your life.
At 10:00 AM the exhibit hall opened and our exhibitors were there with new offerings and great solutions for our members. Next followed the afternoon educational sessions with 3 tracks, medical, industry and MT practice. There were so many wonderful sessions to attend that it was really difficult to choose. What I did was buy the CD so I wouldn’t miss a thing.
Thursday afternoon was the continuation of the QA Summit (first launched in Louisville, KY at the MTIA meeting) and the summit leaders spent time in lively discussion on blanks and how best to address that segment of what is often a dissatisfaction indicator. Our next steps are clear and we will continue on towards a white paper on quality for our industry standard.
Friday morning early Nick van Terheyden, MD spoke on the Health Story Project (www.healthstory.com). This is the solution that uses CDA language to deliver narrative text in a format that is searchable data in the EHR. This is one of the single most important developments for our sector and every one in our profession should know about and begin to talk about how this will get implemented at every MTSO and every hospital across the nation. This is what builds the bridge from dictation and allows physicians to continue to be efficient (dictate, their preferred method of documentation by over 80%) and still allow the information to be formatted for EHR systems.
Next, we had the opportunity to hear from Bruce Mast, our Thursday morning keynote on the evolution of our role. That was a powerful, eye-opening session that proposed many possibilities based on the knowledge of our professionals – not the method of how we do it.
Then on Saturday morning, we were incredibly fortunate to have Jonathan Perlin, MD, PhD speak to us about what’s happening in healthcare and the opportunities that will abound with healthcare reform. His background and experience with both the VA and currently as the Chief Medical Officer for HCA puts him in a key position to share his insight with our members. He has also been named one of the top 10 physicians in America.
Then with an afternoon filled with outstanding educational sessions, it was time to wrap it all up with our first ever, Integrity Awards Red Carpet event and after party. The paparazzi was there snapping photos of our members who were dressed to the nines and everyone looked fabulous! The awards were presented then everyone moved over to the Gaylord’s Fuse nightclub for music, food and beverages. There was more dancing and fun for all there and as the main part of the conference concluded, we all agreed that this was one of the best events ever. The Gaylord facility was filled with greenery, waterfalls and blooms from all over the world. And speaking of the “world” their waterway complete with boat rides shares water from 17 countries worldwide.
For those who just didn’t get enough of the conference, Sunday morning the Managers and Supervisors special interest group conducted their annual event (8:00 – 11:30 AM) with great attendance and content-rich topics about how they are working and evolving in this new generation of EHR systems with SRT technologies and it was an excellent event with panel discussions and idea sharing.
When it was time to leave, I anticipated a feeling a sadness that it was over, but surprisingly, most of what I was thinking was how great the event was and how much more there is to look forward to. Our sector is evolving and as we prepare for this future, gaining knowledge and being involved in these changes at this level is something I treasure. For those who could not attend, I encourage you to get as much information as you can. If you aren’t a member, consider joining your professional association because there’s never been a more important time to be connected. The next few years are going to be amazing and we all need to be involved in securing our place as the knowledge worker for the future. Our roles will evolve, and the more visibility we have, the more opportunities we’ll have to stake our claim and say, “Yes I can do that – I have the expertise.”
Thursday morning we heard from our opening keynote, Donna Hartley who shared her incredible story with the message being that you can be more than a survivor, you can really thrive even in tough situations. She shared 9 tips you can do to get the most out of your career and your life.
At 10:00 AM the exhibit hall opened and our exhibitors were there with new offerings and great solutions for our members. Next followed the afternoon educational sessions with 3 tracks, medical, industry and MT practice. There were so many wonderful sessions to attend that it was really difficult to choose. What I did was buy the CD so I wouldn’t miss a thing.
Thursday afternoon was the continuation of the QA Summit (first launched in Louisville, KY at the MTIA meeting) and the summit leaders spent time in lively discussion on blanks and how best to address that segment of what is often a dissatisfaction indicator. Our next steps are clear and we will continue on towards a white paper on quality for our industry standard.
Friday morning early Nick van Terheyden, MD spoke on the Health Story Project (www.healthstory.com). This is the solution that uses CDA language to deliver narrative text in a format that is searchable data in the EHR. This is one of the single most important developments for our sector and every one in our profession should know about and begin to talk about how this will get implemented at every MTSO and every hospital across the nation. This is what builds the bridge from dictation and allows physicians to continue to be efficient (dictate, their preferred method of documentation by over 80%) and still allow the information to be formatted for EHR systems.
Next, we had the opportunity to hear from Bruce Mast, our Thursday morning keynote on the evolution of our role. That was a powerful, eye-opening session that proposed many possibilities based on the knowledge of our professionals – not the method of how we do it.
Then on Saturday morning, we were incredibly fortunate to have Jonathan Perlin, MD, PhD speak to us about what’s happening in healthcare and the opportunities that will abound with healthcare reform. His background and experience with both the VA and currently as the Chief Medical Officer for HCA puts him in a key position to share his insight with our members. He has also been named one of the top 10 physicians in America.
Then with an afternoon filled with outstanding educational sessions, it was time to wrap it all up with our first ever, Integrity Awards Red Carpet event and after party. The paparazzi was there snapping photos of our members who were dressed to the nines and everyone looked fabulous! The awards were presented then everyone moved over to the Gaylord’s Fuse nightclub for music, food and beverages. There was more dancing and fun for all there and as the main part of the conference concluded, we all agreed that this was one of the best events ever. The Gaylord facility was filled with greenery, waterfalls and blooms from all over the world. And speaking of the “world” their waterway complete with boat rides shares water from 17 countries worldwide.
For those who just didn’t get enough of the conference, Sunday morning the Managers and Supervisors special interest group conducted their annual event (8:00 – 11:30 AM) with great attendance and content-rich topics about how they are working and evolving in this new generation of EHR systems with SRT technologies and it was an excellent event with panel discussions and idea sharing.
When it was time to leave, I anticipated a feeling a sadness that it was over, but surprisingly, most of what I was thinking was how great the event was and how much more there is to look forward to. Our sector is evolving and as we prepare for this future, gaining knowledge and being involved in these changes at this level is something I treasure. For those who could not attend, I encourage you to get as much information as you can. If you aren’t a member, consider joining your professional association because there’s never been a more important time to be connected. The next few years are going to be amazing and we all need to be involved in securing our place as the knowledge worker for the future. Our roles will evolve, and the more visibility we have, the more opportunities we’ll have to stake our claim and say, “Yes I can do that – I have the expertise.”
Saturday, July 25, 2009
Nashville, Here I Come!
As the song goes..."Well my bags are packed and I'm ready to go"... And I couldn't be more excited about annual conference this year. ACE at the beautiful Gaylord Opryland is going to be one of the most amazing conventions we have ever had. We are doing so many new things this year. AHDI is always looking for more ways to share the latest information with attendees and this year there are many events with a new flair.
We are for the first time, doing a simulcast of a panel discussion with our closing keynote, Bruce Mast, Linda Yanisiewski, MTIA president, Peter Preziosi, CEO of AHDI and MTIA and me. One of the reasons we thought this was important is because we understand that times are tough and not everyone can travel to a convention. But we thought it would be innovative to take some of the convention to you.
This year our initiatives have been clear from January 1, 2009! We must produce an SRT curriculum and it is ready. We must update the QA standards for our industry - that collaborative work is well underway to be complete this year and we are having a face-to-face meeting in Nashville to continue to advance the work. We must continue to be visible in Capitol Hill. This work continues not only at our summit, but meetings have continued all year long and we have retained a lobbying firm, Dewey Square Group to ensure our voices are heard. We must develop our future roles that will evolve with the EHR and that work is well underway. We need to draft an open letter to all MTs to unite for the purpose of a louder, stronger voice in showing tremendous value we bring to healthcare and that has been drafted. And we must do all of these things and more for every person working in this sector and help support them in getting credentialed because it is high-time for us to join the rest of the healthcare field in doing that and having better tools/resources such as the Interfix Knowledge Base (KB).
We know that these are challenging times. We also know that if we sit quietly on the sidelines, that change will take place without our input or consideration. As the saying goes, out of sight, out of mind and it does happen when we are silent and invisible regardless of our many contributions. We can let change happen to us, or we can actively participate in ensuring that healthcare reform includes healthcare documentation professionals.
We are for the first time, doing a simulcast of a panel discussion with our closing keynote, Bruce Mast, Linda Yanisiewski, MTIA president, Peter Preziosi, CEO of AHDI and MTIA and me. One of the reasons we thought this was important is because we understand that times are tough and not everyone can travel to a convention. But we thought it would be innovative to take some of the convention to you.
This year our initiatives have been clear from January 1, 2009! We must produce an SRT curriculum and it is ready. We must update the QA standards for our industry - that collaborative work is well underway to be complete this year and we are having a face-to-face meeting in Nashville to continue to advance the work. We must continue to be visible in Capitol Hill. This work continues not only at our summit, but meetings have continued all year long and we have retained a lobbying firm, Dewey Square Group to ensure our voices are heard. We must develop our future roles that will evolve with the EHR and that work is well underway. We need to draft an open letter to all MTs to unite for the purpose of a louder, stronger voice in showing tremendous value we bring to healthcare and that has been drafted. And we must do all of these things and more for every person working in this sector and help support them in getting credentialed because it is high-time for us to join the rest of the healthcare field in doing that and having better tools/resources such as the Interfix Knowledge Base (KB).
We know that these are challenging times. We also know that if we sit quietly on the sidelines, that change will take place without our input or consideration. As the saying goes, out of sight, out of mind and it does happen when we are silent and invisible regardless of our many contributions. We can let change happen to us, or we can actively participate in ensuring that healthcare reform includes healthcare documentation professionals.
So as many of us gather in Nashville, (making this our first ever green conference in keeping with that socially responsible initiative) for those of you who can't make it this year, I wanted to be sure you know that AHDI is working for all of you who are working at home, in offices and in hospitals and clinics and we will continue to work on your behalf to secure a great future.
Monday, June 29, 2009
Hope: Where to Find it
We have talked about change - now let's shift the focus to another word that we must keep close at hand and that's "hope." In difficult times when the economy is down, it's hard to remain hopeful when the headlines are less than encouraging. But if you have your health, a job, and a place to live, you are ahead of about 1/3 of the world's population. We've heard growing up that it is so important to be thankful for all we have, but often it is easier to see what we don't have and what would be nice to have and we lose focus on all that is right with our lives, our jobs and our future.
The other day, I signed up online for a 401K plan with my employer. It was a great process and the 401K plan itself is a great one with a well-known company with many offerings. But I was less than excited to see the return rate of the investment choices. All but 2 were in negative numbers (and had been for longer than 2 years) and the 2 that weren't were less than 2 points each. Pretty discouraging and I nearly considered not signing up. But then I got to thinking that this big economic situation we are in won't solve itself. It is going to take each of us to do a few things to help us turn this thing around. We have to keep on moving forward every single day. So where do we find hope?
Suggestion #1. Watch President Obama on Wednesday night, 7/1 during his live Town Hall meeting. Better yet, submit a question and get involved. I agree that we can't fix the economy without fixing healthcare at the same time - it is too great an issue and this is something that not only affects everyone, it costs everyone. Let's get it solved.
Suggestion #2. I read somewhere recently that we have to give up all hope of creating a better yesterday. Yesterday is gone, but there is still time today to be the best you can be, make a difference for someone else, contribute where you can, and take a first step of many to have a hopeful, realistic tomorrow. Tell someone you appreciate them and ask your boss how you can help your company be more successful. You may be surprised at the response.
Suggestion #3. No matter your current situation, challenge yourself to create a positive outlook for tomorrow. Rather than seeing things as hopeless, envision that this is a difficult situation and then set out to make tomorrow better than the day before. Ask yourself what should I do next to get back on track.
We cannot undo the past and we also should not worry about the future. The past is gone, the future is not here yet, but our opportunity today is large and alive. Healthcare reform will happen. We have had the opportunity to speak to the decision-makers about meaningful use and we have continued to speak up and our voices are being heard.
What if we all decided that the most important thing we could do is work together as a profession and help healthcare decision-makers realize how valuable our contributions are? What if we help make the point that healthcare reform can take place better with us meaning that EHR systems are in use, nationwide with narrative text? What if we decided that the issues we sometimes take issue with in this profession are really not big issues at all? What if we all finally realized that as healthcare evolves, we need to be right in step with it and engage in the process? That's meaningful use of all of our time. That would spell a very hopeful future!
The other day, I signed up online for a 401K plan with my employer. It was a great process and the 401K plan itself is a great one with a well-known company with many offerings. But I was less than excited to see the return rate of the investment choices. All but 2 were in negative numbers (and had been for longer than 2 years) and the 2 that weren't were less than 2 points each. Pretty discouraging and I nearly considered not signing up. But then I got to thinking that this big economic situation we are in won't solve itself. It is going to take each of us to do a few things to help us turn this thing around. We have to keep on moving forward every single day. So where do we find hope?
Suggestion #1. Watch President Obama on Wednesday night, 7/1 during his live Town Hall meeting. Better yet, submit a question and get involved. I agree that we can't fix the economy without fixing healthcare at the same time - it is too great an issue and this is something that not only affects everyone, it costs everyone. Let's get it solved.
Suggestion #2. I read somewhere recently that we have to give up all hope of creating a better yesterday. Yesterday is gone, but there is still time today to be the best you can be, make a difference for someone else, contribute where you can, and take a first step of many to have a hopeful, realistic tomorrow. Tell someone you appreciate them and ask your boss how you can help your company be more successful. You may be surprised at the response.
Suggestion #3. No matter your current situation, challenge yourself to create a positive outlook for tomorrow. Rather than seeing things as hopeless, envision that this is a difficult situation and then set out to make tomorrow better than the day before. Ask yourself what should I do next to get back on track.
We cannot undo the past and we also should not worry about the future. The past is gone, the future is not here yet, but our opportunity today is large and alive. Healthcare reform will happen. We have had the opportunity to speak to the decision-makers about meaningful use and we have continued to speak up and our voices are being heard.
What if we all decided that the most important thing we could do is work together as a profession and help healthcare decision-makers realize how valuable our contributions are? What if we help make the point that healthcare reform can take place better with us meaning that EHR systems are in use, nationwide with narrative text? What if we decided that the issues we sometimes take issue with in this profession are really not big issues at all? What if we all finally realized that as healthcare evolves, we need to be right in step with it and engage in the process? That's meaningful use of all of our time. That would spell a very hopeful future!
Subscribe to:
Posts (Atom)