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Wednesday, October 30, 2013

Tips on Adopting EMR for Your Office

Like any new software, EMR and EHR can be difficult to implement in a small practice. You have to get your staff acquainted with the system, and work through any kinks they may find. Along the way, you’ll also likely to need support in-house and over the phone.

There are shortcuts to find and your staff will need to adjust to a new method of doing things. The end result will be to personalize patient care and, actually, there may be Federal incentives for you to implement EMRs in your office.

Start Small

Your staff will benefit most from small introductions that get them interacting with EMR software. Start by ditching the photocopier and having staff enter patient information into your electronic medical record software. Inquire with your provider about training documentation, which is often included with the costs you pay for the software, and arrange for staff to spend an hour each day going over training materials and interacting with the software.

Break your staff up into teams that are responsible for different aspects of patient care. Depending on the size of our practice, you may have someone who handles patient intake, and someone else who handles prescription data.

Make sure everyone in your office understands how to retrieve medical records. It also helps to designate staff to go over each other’s work and check it for accuracy.

Designate a Go-To Person

Choose a member of your team to thoroughly train on the program and let that person break the software.

You need someone technologically capable, as well as someone who can patiently work through troubleshooting. Designate this person as a point of contact, and refer all EMR challenges to her.

Find the Shortcuts

Create a master list of shortcuts that cut down on keystrokes and clicks to get to what the staff needs.

Simple keystrokes like copy (Ctrl+C) and paste (Ctrl+V) will help save time. You can usually press “Tab” to cycle through the various text fields and speed up data entry, instead of clicking a mouse.

Encourage information sharing on free cloud services like Google Docs or Microsoft SkyDrive. Have staff maintain spreadsheets and documents online for keystrokes and tips. Creating a central knowledge base will give staff a safe space to learn more about the EMR if they choose.

Have a Backup Solution

Keep any patient data on a local hard drive, an external hard drive and in the cloud. You can purchase a reasonably large external hard drive or NAS server from any online retailer for less than $300. Cloud storage can be pricey, depending on what you need to store, as they often charge by what you need. The advantage is you pay for what you need, but you will end up spending more money over time. You will also need to scale those services as your practice grows, which may entail switching providers or upgrading plans.

If possible, have your IT staff create an automated backup system. Smaller practices without an IT staff should consider outsourcing the work to someone from the Web. Web based EMR applications typically have a backup system in place that requires almost no input on your part beyond initial setup.

Other Tips

Use templates and pre-written statements to fill in common patient symptoms and save time. Once your staff has entered the patient’s prescription, you can tell the patient that her prescription has already been sent to the pharmacist, which is great for patient satisfaction.

Government incentives, like the Medicare EMR Incentive program can help ease the transition with some extra cash. In the case of the Medicare EMR, you receive $44,000 over 5 years, which can cover the costs of purchasing the system or paying for training.

The above guest post is a guest blog entry.

Saturday, October 26, 2013

Importance Of The New Breath Test and Medical Coding Training in Diabetic Care

According to the U.S. Center for Disease Control and Prevention (CDC), 26 million people are affected with certain conditions and nearly 5.7 million are un-diagnosed. Diagnosis for conditions such as diabetes and hypoglycemia is dependent on several tests, which are mostly invasive or cost intensive (due to frequent use).

However, an alternative has been developed that relies on normal human breath to monitor diabetes.

Researchers have known for a long time that people who suffer from diabetes have a characteristic fruity odor which increases at the time of glucose deficiency. This fruit smell comes from a compound known as acetone. The acetone breath test is conventionally used in the status quo to determine alcohol toxicity of drunk drivers.

Background to the test

A hallmark feature of diabetes is that due to lack of insulin, the metabolic pathway of the body is affected. This leads to conversion of fatty acids to ketones. The increased levels of ketones such as acetone cause acidity in the blood, which is medically termed as ketosis or ketoacidosis.

Thanks to advancement in biosensors and nanotechnology, the acetone biomarker can be used for diagnosis of diabetes, remarkably lowering its costs of detection.

Benefits to the medical community


The obvious benefit is for the patient, but other important stakeholders are professionals in the healthcare community. The large scale distribution of this test means development of a new line of diagnostics, and possibly a new specialization, in the discipline of ‘breath diagnostics’.

Moreover, students who want to pursue successful healthcare careers but are financially constrained can target this area in an integrated manner. Careers such as diagnostics, coding and technician based courses are dependent on innovation in the field.

Online education courses and medical coding training provide students ample incentive to pursue coding and diagnostic careers while simultaneously gaining career rewarding certificates. On an administrative level, medical coding training will strengthen medical databases. On the macro level, new diagnostics help researchers analyze how different compounds produced within the human breath have a role in pathogenesis.

For instance, researchers are also evaluating how acetone and volatile compounds (VOCs) are characteristic for indicating respiratory disorders during diabetes. This is important since diabetes affected patients are often riddled with co-morbidities (i.e. other diseases arising from the condition).

Sol-Gel Model

Researchers at University of Pittsburgh have been able to develop a model of the breath analyzer that can be used at a global scale. While there are other models in production, this one gathers attention due to its interesting design.

The model successfully employs principle of physics and nanotechnology to good use. It uses titanium dioxide: commonly found in cosmetic products. This compound is merged with small carbon nanotubes, which have a very minute diameter. From then on, it transforms into a sensor.

The titanium dioxide in the nanotube has light illuminating properties, while the carbon nanotubes have electrical properties. The sensor can be activated with light to produce an electrical charge. Therefore, the acetone vapors in the human breath can be detected to very small limits.

Since diabetes patients have to monitor their glucose level routinely, this test becomes an ideal alternative to cost intensive diagnostics.

Financial aspect

Living with diabetes is a financial burden, especially with respect to the current economy. To monitor diabetes, a lot of people rely on glucose meters. The majority of patients pay through their insurance providers for the device. Sadly, the coverage would limit the kind of model or the strip that you can use.

So with such constraints, the breath test for diabetes comes as a very viable option. Especially with a device that is basically a biosensor that doesn’t need to be replaced (like strips), it makes a lot of sense.

Secondly, this test is not only beneficial from the screening aspect, it also helps in diabetes management. By monitoring routinely without having to fear for cost, the test can assist patients in streamlining their glucose levels. The breath test also falls in line with the innovative the A1C test.

The levels of acetone in diabetic patients also give a comparative analysis on a number of indicators. Ketoacidosis in some cases can lead to a coma or death. Furthermore, increased acetone levels would indicate serious electrolyte losses in your body. The most important of these are sodium and potassium.

This leads to the patients developing abdominal pain, excessive stress levels and nausea. The breath test can immediately point out such indicators.

In these ways, the breath test for diabetes would make life easier for diabetic patients across the globe.

The above entry is a guest blog entry.

Monday, October 07, 2013

Medical Procedure Financing: Saying Yes to More Patients

It’s no secret that the 2008 credit crisis hit the medical field hard, and even five years later, a lack of access to financing options can create a barrier between doctor and patient. Day after day, doctors are forced to turn down care for solely financial reasons.

Whereas third-party financing companies once served as an effective ally by loaning patients money to afford procedures they desperately need, tightening approval rates have slashed the number of leads doctors can accept. When middleman financiers are employed, it is entirely possible that only 20-25% of interested patients can end up booking a surgery.  Not to mention that the approval often comes with a 6-10% discount fee paid to the financier.

For doctors looking to expand their business and offer care to more patients, the third-party financing paradigm is looking less and less viable. It’s no wonder many have taken matters into their own hands by setting up their own in-house financing programs. If executed correctly, an in-house financing program can grow the business in terms of the number of procedures performed, while saving money paid in third-party discounts, and even create new revenue streams as interest comes in on monthly payments.

While providing loans in house means taking on a bit of risk, implementing smart payment plan practices can greatly reduce said risks. For example, say a patient seeks a $6,000 procedure, $1,500 of which covers hard costs (such as the surgery center or office overhead, etc.). If the practice requires a down payment of at least $1,500, they’ll still be covered even if the patient defaults immediately after the surgery.

If insurance can cover a portion of the procedure, the numbers become even more favorable. Say the patient is left with a $2,000 co-pay on the above procedure, and can’t pay out of pocket. Since the insurance is already paying $4,000 — covering our hard costs, and then some — a payment plan can be used to cover the gap. Since hard costs are covered, the down payment can be more modest, but it’s still prudent to collect something incase of a default.

The above solutions are both possible with third-party financing, but keep in mind a third party financier will often require 6-10% of the entire payment, including that crucial down payment. Thus, if a $6,000 procedure requires a $1,500 down payment, the practice is required to pay out $360-$600 to their financing company. And that’s only if the patient is approved for financing in the first place. While the practice assumes slightly more risk by extending their own credit to the patient, many doctors we’ve spoken to assert that the immense upsurge in their number of office visits more than made up for it.

The added administrative work that comes with tracking and billing payment plans can be a concern as well, but modern advances in patient-financing software takes care of this process by automating all the billing along with providing tools to keep patients on track.

With the proper tools and framework, many doctors are seeing in-house financing software as a realistic alternative to traditional methods, allowing them to say “yes” to more procedures, while growing their practice at a comfortable rate.

The above entry is a guest blog entry.