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Medical Coding, Revenue Cycle Management and the EHR – HIM Scene

Posted on July 31, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

It’s unfortunate, but true that very few healthcare organizations thought about the impact the EHR selection and implementation would have on things like medical coding and revenue cycle management. The later has gotten more attention after hospitals implement an EHR and then run into cash flow problems when they realize their collections have started piling up after the EHR implementation. However, it’s surprising how many coding and revenue cycle management challenges exist post EHR go live.

With this in mind, Healthcare Scene recently talked with Susan Gatehouse, CEO of Axea Solutions, at the HFMA Annual conference about how EHR impacts medical coding and revenue cycle management. She shares some great insights into the topic and some practical ideas for those dealing with these challenges. Plus, we ask Susan what thing stood out to her at the HFMA annual conference.

Check out our interview with Susan Gatehouse:

*Note: This video was originally live streamed to Facebook, so please excuse the poorer quality video and audio.

Be sure to check out all of the Healthcare Scene interviews on YouTube. If you’d like to receive future HIM posts in your inbox, you can subscribe to future HIM Scene posts here.

Healthcare AI Adoption Curve – Where Is Your Hospital At?

Posted on July 30, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.


The above image is the best one I’ve seen when it comes to the adoption and integration of AI into healthcare. Of course, this same chart has been used to describe the integration of technology into healthcare in general. The reason this chart is so relevant is that very few healthcare organizations have reached the point where they are an IT enabled business with IT embedded in business with hybrid, cross-functional roles. If this is true for technology in general, AI is still way out there.

In fact, the one complaint I have about this chart is that it’s missing a bubble that should say “What’s AI?” Ok, that’s a little bit of an exaggeration, but not much for many healthcare organizations. They’d more appropriately ask “How can I use AI in healthcare?” but it’s about the same point. Most aren’t there yet, but they’re going to have to get there. AI is coming and in a big way.

The good news is that most of the AI a healthcare organization will use will be embedded in the IT systems they purchase. This is why it’s so important that healthcare organizations have good vendor partners. Healthcare organizations aren’t going to enable this AI future. They’re going to partner with vendors who bring the AI to bear for them. When David Chou shared the image above, he asked the right question “What is your role as the CIO for the adoption of AI?” How many of you know the answer to that question?

If you’re not sure the answer, check out this other image and tweet that David Chou shared about using AI for automation:

I agree 100% with David Chou that if you want to start thinking about how to utilize AI, then start with repetitive tasks which can and should be automated. Take the mundane out of your healthcare providers lives. That will create some early AI wins that will help you to be able to build an AI driven culture in your organization.

Using Video Cameras in Healthcare to Improve Care

Posted on July 27, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I must admit that I didn’t know exactly what I was getting into when I scheduled this video interview with Paul Baratta, Business Development Manager for healthcare at Axis Communications. However, I was intrigued by the idea that they were using thermal cameras in healthcare to detect various healthcare incidents.

The great news is that Paul Baratta really opened my eyes to a lot of possibilities for how various cameras (standard and thermal) can help a hospital work more effectively. Along with talking about the thermal cameras they’ve implemented in hospitals, we also talk about other ways that cameras can help an organization run smoother and more efficiently. Think about a video camera monitoring an IV bag. That’s cool tech. We also talk about the privacy issues related to cameras and the privacy benefits of using thermal cameras. Plus, I ask Paul about the cost and ROI of cameras and whether they’re reasonable for every size healthcare organization or not.

Needless to say, after this interview, I’m even more confident that video cameras are going to be an important part of the wired room in healthcare. To see what I mean, check out my interview with Paul Baratta from Axis Communications.

Let me know what you think of the use of video cameras in healthcare. Do you disagree with any of the comments I or Paul shared? Do you see other applications where video cameras could make a difference in healthcare organizations? Share your thoughts and ideas in the comments or on Twitter with @HealthcareScene.

If you enjoyed this video interview, be sure to Subscribe to the Healthcare Scene channel on YouTube and view the playlist of all our video interviews.

Patient Safety Market Heating Up with Mergers and New Product Announcements

Posted on July 26, 2018 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

For the past few years the patient safety software market has been stable with little in the way of new products and company activity. That has changed with a flurry of recent announcements:

  1. The merger of two market leaders: Datix and RL Solutions
  2. Health Catalyst entering with their new Patient Safety Monitor™ Suite: Surveillance Module
  3. VigiLanz expanding their platform to include Dynamic Safety Surveillance

When something goes wrong in a healthcare facility it is referred to as an adverse event or a medical error. According to a recent study by Johns Hopkins, 250,000 Americans die each year from medical errors making it the third leading cause of death in the United States. The Journal of Patient Safety estimates that non-lethal adverse events happen 10-20 times more frequently than lethal events. This puts the total number of adverse events somewhere between 2.5 – 5 million per year. The financial cost of these events is enormous. Frost & Sullivan estimates that the financial cost of adverse events in the US and Europe will reach $383.7 Billion by 2022.

Traditionally, adverse events have been recorded and logged in incident reporting systems (sometimes called risk management software) – like those offered by Datix and RL Solutions. These systems rely on voluntary reporting of events by staff members and patients. Once entered, these events are reviewed and analyzed by specially trained risk managers to determine root causes. When patterns emerge, changes are made to policies, procedures and physical environments to prevent similar events from happening in the future.

The most recent Research and Markets report estimates the global patient safety and risk management software market is poised to grow at a CAGR of 10.9% over the next decade to reach $2.22 Billion by the year 2025. I believe there are three key drivers for this this growth:

  1. Hospitals transitioning away from traditional after-the-fact adverse event reporting systems to real-time surveillance platforms that take advantage of the data being collected in EHRs and other electronic repositories
  2. The movement towards value-based care where a focus on patient safety has meaningful impact on reimbursements
  3. Realignment of patient safety as part of overall patient experience vs a function of compliance and legal.

According to a report by the Agency for Healthcare Research and Quality (AHRQ), it is estimated that less than 6% of adverse events are reported voluntarily. This means that healthcare organizations are potentially missing out on 94% of events that are happening within their four walls. In addition, very few organizations have effective ways to capture near misses – adverse events that did not occur because they were stopped BEFORE someone was harmed. There is a better way.

With the exponential growth in the quantity of healthcare data and the rapid increase in computing power, it is now possible to mine medical data to detect adverse events and near misses in real-time. For example, it is possible to look at EHR data to determine if the wrong medication was given to a patient based on their diagnosis. It is also possible to track the number of times the drug-drug interaction warning message is displayed to clinicians (each being a near miss). Justin Campbell of Galen Healthcare Solutions recently wrote an article about mining EHR audit log data to uncover workflow bottlenecks that touches on this same approach – commonly referred to as “real-time surveillance”.

Stanley Pestotnik, MS, RPh, Vice President of Patient Safety Products at Health Catalyst had this to say about this detection methodology: “The current approach to patient safety is like doing archaeology – digging through ancient safety events to identify the causes of harm, which does nothing to help with the patient in the bed right now. Our patient safety suite, along with our quality-improvement services and the Health Catalyst PSO, turns the current paradigm on its head. Unlike other approaches to using analytics within a PSO to identify and address episodes of patient harm, we monitor triggers in near real-time to reveal whether a patient is currently at risk for a safety event, so clinicians can intervene to prevent it. And we provide constant vigilance; no patient encounter goes unnoticed.”

Real-time surveillance of adverse events is the approach that Health Catalyst and VigiLanz have incorporated in their product offerings.

“The RL+Datix merger comes at a time when patient safety events are surging,” states Erik Johnson, Vice President of Marketing at VigiLanz. “It is not surprising that consolidation is happening as companies try to address the needs of the market.”

Johnson points to a recent Frost & Sullivan report that predicts further market consolidation. The report states that by 2022, adverse patient events will lead to 92 million hospital admissions and 1.95 million deaths in the US and western Europe. These avoidable hospital admissions will be a drag on financial performance – especially as we move to a value-based system.

Under the value-based models, healthcare organizations are reimbursed based on patient outcomes and satisfaction scores, not on treatment volume. This means organizations are no longer compensated for patients that are re-admitted or stay longer due to an adverse event experienced at the facility. This has put a spotlight on patient safety initiatives and is a key reason why healthcare organizations are once again investing in this aspect of their operations.

“We are seeing organizations take the opportunity, as they transition from volume to value, to renew their patient safety protocols and technologies to ensure they are capitalizing on the lessons learned from incident data,” continues Johnson. “It’s not just patient incident data either. Adverse events can happen to guests and employees as well. Hospitals are looking to get a better handle on all their events – not only to capture them, but to derive deeper insights on root cause and even further to automate the detection of events through surveillance technology.”

A request for comment from Datix and RL Solutions on their recent merger was politely declined. A company spokesperson pointed back to the press release announcing the merger which states: “the combined company will contain the largest repository of patient safety data in the world, enabling the creation of data-driven insights for healthcare stakeholders across the continuum of care.”

The final driver for growth is the recognition that patient safety is closely linked to patient experience. In the past, adverse event tracking fell to the Risk Management team inside a hospital which typically reported up through the CFO or legal counsel. It was seen as a compliance and back-office function. In recent years, however, there has been a realization that the patient safety function is a better fit under the umbrella of patient experience since the two are closely linked.

“From our perspective at The Beryl Institute, if we approach healthcare from the lenses of those that use the system not only safety, but also quality, service, cost and more are all part of the experience someone has within healthcare,” says Jason A. Wolf PhD CPXP, President of The Beryl Institute – the world’s leading community of practice for patient experience. “To differentiate safety from experience diminishes both, relegating safety to processes and checklists and experience to satisfaction or amenities. Rather, experience is the integration of all the above.”

Wolf cites the recent State of Patient Experience from The Beryl Institute where healthcare leaders acknowledged quality and safety as essential to overall experience. A parallel study, the Consumer Perspectives on Patient Experience mirrored the provider result with 68% of global healthcare consumers agreeing that safety is part of the healthcare experience.

“I see the movement towards aligning patient safety and patient experience as acknowledgement of all that impacts the overall experience,” adds Wolf. “That first and foremost to consumers, their health matters to them and how they are treated both clinically and as a person is essential to their healthcare experience. This too reinforces the expectations patients and families have always had, that their care will be delivered in a safe and reliable manner.”

lt will be exciting to watch the patient safety space as the three drivers of (1) changing technology, (2) value-based care and (3) realignment under patient experience, continue to push investments in this market. I’m curious to see if the Datix + RL merger is a one-off or if other players like QuantrosRiskonnect, Origami Risk, Ventiv, Policy Medical and The Patient Safety Company will merge or be acquired. This market is definitely heating up!

Switch From Epic To Cerner Comes With Patient Safety Questions

Posted on July 25, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Here’s a story in which no health system hopes to take a lead role — the tale of a Cerner installation that didn’t go well and the blowback the system faced afterward.

On October 1 of last year, Phoenix, Az.-based Banner Health switched its Tucson hospitals from Epic to a Cerner system, a move which reportedly cost the health system $45 million.

No doubt, the hospitals’ staff and physicians were trained up and prepared for a few bumps in the road, particularly given that the rest of its peers had already gone to the process. The Phoenix-based not-for-profit, which owns, leases or manages 28 acute-care hospitals in six states, had already put the Cerner system in place elsewhere, apparently without experiencing any major problems.

But this time it wasn’t so lucky, according to an article in the Arizona Daily Star. According to the news item, there were “numerous” reports of medical errors filed with the Arizona Department of Health Services after Tucson-area hospitals in the Banner chain were cut over to Cerner.

The complaints included claims that errors were creating patient safety and patient harm risks, according to one filing. “Many of the staff are in tears and frustrated because of the lack of support and empathy [for] the consequences [to] patient care,” one stated.

Not only did the conversion lead to patient safety accusations, it also seems to have lowered physician productivity and shrunk revenue as doctors learned to use the Cerner interface. While predictable, this has to have added insult to injury.

Meanwhile, according to the paper, the state seems to come down on the side of the complainants. While hospital leaders denied there were any incidents resulting in a negative outcome for patients, “the hospital’s occurrence log for October 2017 showed numerous incidents of medical errors reported to be a result of the conversion,” state investigators reportedly concluded.

While the state didn’t fine Banner or issue a citation, it did substantiate two allegations about the conversion, the Star reported. The allegations were related to computer/printer glitches impacting patient care and an inability to reliably deliver medications and order tests as part of care for critically ill patients.

The article says that Banner responded by pointing out that it has made more than 100 improvements to the Cerner system, resulting in better workflows and greater information access for physicians and staff. But the damage to its reputation seems to have been done.

No, perhaps Banner didn’t do anything particularly wrong when it installed the Cerner platform. However, if its leaders did, in fact, lie to the state about problems it actually had, it was not a smart move. On the other hand, one of the biggest problems you can have during an EHR implementation is users who don’t want to cooperate and make it a success. It’s not hard to see users who were happy with Epic dragging their feet as they shifted to Cerner. Either way, this is an important lesson as hospitals continue to consolidate and they consider switching the EHR of the acquired hospitals.

Clinicians Say They Need Specialized IT To Improve Patient Safety

Posted on July 24, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Hospitals are loaded down with the latest in health IT and have the bills to prove it. But according to a new survey, they need to invest in specialized technologies to meet patient safety goals, as well as providing more resources and greater organizational focus.

Health Catalyst recently conducted a national survey of physicians, nurses and health executives to gather their thoughts on patient safety issues. Among its main findings was that almost 90% of respondents said that their organizations were seeing success in improving patient safety. However, about the same percentage said there was room for improving patient safety in their organization.

The top obstacle they cited as holding them back from the patient safety goals was having effective information technology, as identified by 30% of respondents. The same number named a lack of technologies offering real-time warnings of possible patient harm.

These were followed by lack of staffing and budget resources (27%), organizational structure, culture priorities (19%), a lack of reimbursement for safety initiatives (10%) and changes in patient population practice setting (9%).

Part of the reason clinicians aren’t getting as much as they’d like from health IT is that many healthcare organizations rely largely on manual methods to track and report safety events.

The top sources of data for patient safety initiatives respondents used for safety initiatives voluntary reporting (82%). Hospital-acquired infection surveys (67%), manual audits (58%) and retrospective coding (29%). Such reporting is typically based on data sets which are at least 30 days old, and what’s more, collecting and analyzing the data can be time and resource-consuming.

Not surprisingly, Health Catalyst is launching new technology designed to address these problems. Its Patient Safety Monitor™ Suite: Surveillance Module uses protective and text analytics, along with concurrent critical reviews of data, to find and prevent patient safety threats before they result in harm.

The announcement also falls in line with the organization’s larger strategic plans, as Health Catalyst has applied to the AHRQ to be certified as a Patient Safety Organization.

The company said that he had spent more than $50 million to create the Surveillance module, whose technology includes the use of predictive analytics models and AI. It expects to add new AI and machine learning capabilities to its technology in the future which will be used to propose strategies to eliminate patient safety risks.

And more is on the way. Health Catalyst is working with its clients to add new features to the Suite including risk prediction, improvement tracking and decision support.

I’m not sure if it’s typical for PSOs to bringing their own specialized software to the job, but either way, it should give Health Catalyst a leg up. I have little doubt that doing better predictive analytics and offering process recommendations would be useful.

Optimizing Expensive Medical Device Utilization in Hospital Systems

Posted on July 23, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

At the HFMA Annual Conference, Healthcare Scene had a chance to interview Brett Reed, CEO of Cohealo, where we learned about their unique approach to expensive medical equipment in hospitals and health systems. We loved their novel approach to helping hospitals and health systems save money and better utilize the assets they’ve already purchased since it’s not something we’d seen many healthcare organizations do effectively. Most have been too distracted by their EHR implementations to think about this. Now’s a great time to move past the EHR into other technologies that can help a hospital or health system.

In our interview, Brett shares the origin of the company and how Cohealo can help a healthcare organization with tracking equipment, sharing equipment, and managing equipment requests. Considering the cost of these expensive medical devices, there are a lot of opportunities for healthcare organizations to save or make more money by using these underutilized resources more effectively.

To learn more, watch the video interview below or on the Healthcare Scene YouTube channel.

If you enjoyed this video interview, be sure to check out the full list of Healthcare Scene interviews.

Also, let us know what you thought of our interview with Brett Reed from Cohealo. Do you think this is a valuable solution? Are you doing this type of medical device tracking in your organization? Do you hear the complaints from nurses and providers that there’s not enough medical equipment for them to do their job effectively? Let us hear your thoughts in the comments or on Twitter @HealthcareScene.

Despite Risks, Hospitals Connecting A Growing Number Of Medical Devices

Posted on July 20, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Over the past few years, hospitals have gotten closer and closer to connecting all of their medical devices to the Internet — and more importantly, connecting them to each other and to critical health IT systems.

According to a new study by research firm Frost & Sullivan, most hospitals are working to foster interoperability between medical devices and EHRs. By doing so, they can gather, analyze and present data important to care in a more sophisticated way.

“Hospitals are developing connectivity strategies based on early warning scores, automated electronic charting, emergency alert and response, virtual intensive care units, medical device asset management and real-time location solutions,” Frost analysts said in a prepared statement.

Connecting medical devices to other hospital infrastructure has become so important to the future of healthcare that the FDA has taken notice. The agency recently issued guidance on how healthcare organizations can foster interoperability between the devices and other information systems.

Of course, while hospitals would like to see medical devices chat with their EHRs and other health IT systems, it’s just one of many important goals hospitals have for data collection and analysis. Health IT executives are up to the eyebrows supporting big data transformation, predictive analytics and ongoing EHR management, not to mention trying out soon-to-be standard technologies such as blockchain.

More importantly, few medical devices are as secure as they should be. While the average hospital room contains 15 to 20 connected devices, many of them are frighteningly vulnerable. Some of them are still running on obsolete operating systems, many of which haven’t been patched in years, or roughly 1,000 years in IT time. Other systems have embedded passwords in their code, which is one heck of a problem.

While the press plays up the possibility of a hacker stopping someone’s connected pacemaker, the reality is that an EHR hack using a hacked medical device is far more likely. When these devices are vulnerable to outside attacks, attackers are far more likely to tunnel into EHRs and steal patient health data. After all, while playing with a pacemaker might be satisfying to really mean people, thieves can get really good money for patient records on the dark web.

All this being said, connected medical devices are likely to become a key part of hospital IT infrastructure in hospitals over time as the industry solves these problems, Frost predicts that the global market for such devices will climb from $233 million to almost $1 billion by 2022.

It looks like hospital IT executives will have some hard choices to make here. Ignoring the benefits of connecting all medical devices with other data sources just won’t work, but creating thousands of security vulnerabilities isn’t wise either. Ultimately, hospital leaders must find a way to secure these devices ASAP without cratering their budget, and it won’t be easy.

Remote Release of Information: The Next Step in Secure and Compliant Exchange of Patient Health Information

Posted on July 18, 2018 I Written By

The following is a guest blog post by Patty Sheridan, MBA, RHIA, FAHIMA; SVP, Life Sciences at Ciox & Tarun Kabaria; Executive VP, Provider Operations at Ciox.

Across the industry, there is an influx of health information management (HIM) departments and medical groups moving their HIM operations from hospital main campuses and individual physician practices to centralized, offsite locations to gain efficiencies and make better use of valuable square footage in their facilities. For many organizations, this move began decades ago with the implementation of remote coding and/or the need to free up space for patient care.

These ‘virtual HIM” departments can be located at a separate facility, home-based office or remote vendor locations, and result from the continued adoption of electronic health records (EHR) and pressure to manage costs, offering HIM directors and practice administrators the opportunity to reorganize and form more efficient spaces and processes. Outsourcing functions, such as release of information (ROI), allows HIM staff to focus on other priorities of data governance while maximizing available space.

From a financial perspective, costs associated with regulations, staffing, printing, mailing and square footage are increasing; and in some instances, volumes of requests are increasing due to health plans, lawsuits and the portability of healthcare. Furthermore, allowable fees for releasing medical records are decreasing in some states. As a result of these rising financial pressures, healthcare providers are finding it more difficult to make ROI a profit center in their organizations.

HIM departments are experiencing additional pressures from rising health plan request volumes, requiring flexible operational solutions in order to meet the increasing demand. In a typical year, the volume of health plan requests tends to increase to the order of 20-30 percent, and this year those numbers are expected to triple. With such an influx of requests, moving to a virtual model allows for the onsite staff to be augmented with the remote team, fulfilling these large volume requests without impacting the core ROI and patient requests.

Another prevalent challenge is timeliness. With the advent of rebranding the Meaningful Use program to focus on promoting interoperability and the increase in various governmental and payor audits, timeliness of response to requests for medical records is critical and penalties for non-compliance are steep. As such, healthcare providers are reaching the point of diminishing returns in regards to managing the ROI function on their own, and in some cases, will not be able to meet the time deadlines imposed upon them to gain incentives, avoid penalties and takebacks.

These new industry influences create the need for even faster, more efficient, error-free fulfillment of medical record requests and pave the way for a new approach designed to help your organization meet this demand: Remote ROI.

The Remote ROI Process

The ROI process is a time-consuming administrative challenge for HIM professionals, requiring compliance expertise, secure and efficient technology, and a trained and knowledgeable staff. The Remote ROI process starts at your healthcare facility when requests for release of health information are received. From there, your chosen third party vendor, such as Ciox, receives the request from the hospital or practice via a mutually agreed upon, secure mechanism. Securely connected and able to access the hospital or practice EHR, an offsite ROI Specialist then reviews the requests for proper authorizations, identifies and captures the records to be released, and transmits the medical records from your facility’s EHR in an encrypted electronic format to the third party vendor’s ROI centralized processing center. The release is delivered to the requestor through an automatic print and mail process or electronically via a secured delivery method. Ciox’s process is computer-assisted using artificial intelligence and natural language processing thereby reducing turnaround time, improving patient satisfaction and ROI outcomes.

When creating your Remote ROI process, follow these three fundamental steps to ensure its success:

1. Determine the method of access to the Request Letter/Authorization received by the hospital or physician practice.

There are several mechanisms by which requests and authorizations are securely made available to Remote ROI Specialists for ROI processing. The most common methods include:

  • Requests/Authorizations are scanned into the EHR – Staff at the facility scans the requests/authorizations into the EHR. The Remote ROI Specialist accesses the EHR to view the information and begin the process.
  • Requests/Authorizations are faxed – Staff at the facility faxes the requests/authorizations to a fax-in queue provided by the third party vendor. The Remote ROI Specialist accesses the fax-in queue to view the information.
  • Requests/Authorizations are scanned and placed in a shared folder – Staff at your facility scans the requests/authorizations into a shared folder accessible by the Remote ROI Specialist at the third party vendor’s secure Remote ROI Processing Center.
  • Requests/Authorizations are automatically received via health data exchange or health information exchange.

2. Establish connectivity to the EHR to validate the authorization, review the medical records and process the request.

An acceptable baseline for securing the connection to your EHR system(s) must be established for Remote ROI. The appropriate connectivity scenario depends on the underlying technologies at your facility. When understanding which technologies are at your disposal and establishing connectivity, remember that security is key in this part of the process. Keep that in mind when selecting a third party vendor, as it’s paramount to select a company that makes the security of the exchange of protected health information a top priority. Furthermore, it’s of critical importance to select a vendor that has earned certified status for information security by the Health Information Trust (HITRUST) Alliance. The HITRUST CSF Certified Status ensures that key healthcare regulations and requirements for protecting and securing sensitive private healthcare information are met.

3. Ensure compliance standards to track when and who accessed protected health information.

As an added security effort, it’s crucial to follow compliance standards that allow insight as to who accessed patient health information and when it was accessed. To ensure maximum security, computers located at the third party’s Remote ROI processing facility should be secured utilizing encryption, anti-virus protection and web filters.

Passwords should be provided by the facility for access to their specific EHR and stored in an electronic password vault. The password vault should be linked to the third party’s directory that is only accessible by the ROI Specialist using their directory account. Third parties should provide complete audit trail capabilities to track personnel accessing the EHR and processing medical record requests from your applications.

By moving some or all of the onsite ROI functions to a Remote operation, you can streamline the ROI workflow, reclaim square footage for other purposes and have additional capacity available for request volume fluctuation. As an added benefit, the immediate access to requests and authorizations speeds turnaround times on processing requests, which is particularly important when considering tight timelines for meeting Meaningful Use and audit-related releases.

If you’re looking to make HIM operations more efficient and cost effective, Remote ROI can open the doors to achieving those goals.

About Ciox
Ciox is a health technology company working to solve the clinical data illiquidity challenge by providing transparency across the healthcare ecosystem and helping clients manage disparate medical records and a proud sponsor of Healthcare Scene. When stakeholders do not have timely access to the complete clinical picture of patients, critical decisions about patient care, medical outcomes research, disease prevention, reimbursement, and payments are sub-optimized. Ciox’s scale, expertise, expansive provider network and industry leading technology platform make it the most reliable clinical data company in the US. Through its standards based technology platform, HealthSource, Ciox helps clients securely and consistently solve the last mile challenges in clinical interoperability.  Learn more about Ciox’s technology and solutions by visiting www.ciox.com

Connecting the Data: Three Steps to Meet Digital Transformation Goals

Posted on July 16, 2018 I Written By

The following is a guest blog post by Gary Palgon, VP Healthcare and Life Sciences Solutions at Liaison Technologies.

A white paper published by the World Economic Forum in 2016 begins with the statement, “Few industries have the potential to be changed so profoundly by digital technology as healthcare, but the challenges facing innovators – from regulatory barriers to difficulties in digitalizing patient data – should not be underestimated.”

That was two years ago, and many of the same challenges still exist as the digital transformation of healthcare continues.

In a recent HIMSS focus group sponsored by Liaison, participants identified their major digital transformation and interoperability goals for the near future as:

  • EMR rollout and integration
  • Population health monitoring and analytics
  • Remote clinical encounters
  • Mobile clinical applications

These goals are not surprising. Although EMRs have been in place in many healthcare organizations for years, the growth of health systems as they add physicians, clinics, hospitals and diagnostic centers represents a growing need to integrate disparate systems. The continual increase in the number of mobile applications and medical devices that can be used to gather information to feed into EMR systems further exacerbates the challenge.

What is surprising is the low percentage of health systems that believe that they are very or somewhat well-prepared to handle these challenges – only 35 percent of the HIMSS/Liaison focus group members identified themselves as well-prepared.

“Chaos” was a word used by focus group participants to describe what happens in a health system when numerous players, overlapping projects, lack of a single coordinator and a tendency to find niche solutions that focus on one need rather than overall organizational needs drive digital transformation projects.

It’s easy to understand the frustration. Too few IT resources and too many needs in the pipeline lead to multiple groups of people working on projects that overlap in goals – sometimes duplicating each other’s efforts – and tax limited staff, budget and infrastructure resources. It was also interesting to see that focus group participants noted that new technologies and changing regulatory requirements keep derailing efforts over multi-year projects.

Throughout all the challenges identified by healthcare organizations, the issue of data integrity is paramount. The addition of new technologies, including mobile and AI-driven analytics, and new sources of information, increases the need to ensure that data is in a format that is accessible to all users and all applications. Otherwise, the full benefits of digital transformation will not be realized.

The lack of universal standards to enable interoperability are being addressed, but until those standards are available, healthcare organizations must evaluate other ways to integrate and harmonize data to make it available to the myriad of users and applications that can benefit from insights provided by the information. Unlocking access to previously unseen data takes resources that many health organizations have in short supply. And the truth is, we’ll never have the perfect standards as they will always continue to change, so there’s no reason to wait.

Infrastructure, however, was not the number one resource identified in the HIMSS focus group as lacking in participants’ interoperability journey. In fact, only 15 percent saw infrastructure as the missing piece, while 30 percent identified IT staffing resources and 45 percent identified the right level of expertise as the most critical needs for their organization.

As all industries focus on digital transformation, competition for expert staff to handle interoperability challenges makes it difficult for healthcare organizations to attract the talent needed. For this reason, 45 percent of healthcare organizations outsource IT data integration and management to address staffing challenges.

Health systems are also evaluating the use of managed services strategies. A managed services solution takes over the day-to-day integration and data management with the right expertise and the manpower to take on complex work and fluctuating project levels. That way in-house staff resources can focus on the innovation and efficiencies that support patient care and operations, while the operating budget covers data management fees – leaving capital dollars available for critical patient care needs.

Removing day-to-day integration responsibilities from in-house staff also provides time to look strategically at the organization’s overall interoperability needs – coordinating efforts in a holistic manner. The ability to implement solutions for current needs with an eye toward future needs future-proofs an organization’s digital investment and helps avoid the “app-trap” – a reliance on narrowly focused applications with bounded data that cannot be accessed by disparate users.

There is no one answer to healthcare’s digital transformation questions, but taking the following three steps can move an organization closer to the goal of meaningful interoperability:

  • Don’t wait for interoperability standards to be developed – find a data integration and management platform that will integrate and harmonize data from disparate sources to make the information available to all users the way they need it and when they needed.
  • Turn to a data management and integration partner who can provide the expertise required to remain up-to-date on all interoperability, security and regulatory compliance requirements and other mandatory capabilities.
  • Approach digital transformation holistically with a coordinated strategy that considers each new application or capability as data gathered for the benefit of the entire organization rather than siloed for use by a narrowly-focused group of users.

The digital transformation of healthcare and the interoperability challenges that must be overcome are not minor issues, nor are they insurmountable. It is only through the sharing of ideas, information about new technologies and best practices that healthcare organizations can maximize the insights provided by data shared across the enterprise.

About Gary Palgon
Gary Palgon is vice president of healthcare and life sciences solutions at Liaison Technologies, a proud sponsor of Healthcare Scene. In this role, Gary leverages more than two decades of product management, sales, and marketing experience to develop and expand Liaison’s data-inspired solutions for the healthcare and life sciences verticals. Gary’s unique blend of expertise bridges the gap between the technical and business aspects of healthcare, data security, and electronic commerce. As a respected thought leader in the healthcare IT industry, Gary has had numerous articles published, is a frequent speaker at conferences, and often serves as a knowledgeable resource for analysts and journalists. Gary holds a Bachelor of Science degree in Computer and Information Sciences from the University of Florida.