If you've ever been on the billing and coding side of a medical practice, chances are you've heard a version of this question: "what do we call this for billing?" On the other hand, during peer-to-peer conversations, healthcare practitioners seem to explain clinical scenarios very well. What happens in this daily process that converts such a detailed description into something like "unspecified abdominal pain”?
We decided to dig a little deeper into the forces behind the transition to ICD-10. Not surprisingly, one of the largest proponents of the new codes were government organizations. However, non-governmental organizations like insurance companies, patient advocacy groups, and health information technology associations also played a large role in the shift. Let's take a look.
Increasingly, electronic health records have the potential to make care mobile. Pulling up PACS images, analyzing labs and vitals, even computerized physician order entry can routinely be done remotely. But this more streamlined, now routine, care is only the beginning. True EHR mobility encompasses both acute and chronic care decisions, inside the hospital and outside the hospital.
In recent years, healthcare has learned a harsh truth: it will be just as affected by customer-satisfaction as any other industry. Health systems have responded by sprinting toward what seems to be a conversion from hospital to hospitality. Some are investing enormous amounts of money into providing luxurious accommodations with plenty of amenities, seemingly prioritizing customer service over any other aspect of operation.
Since hearing about the concept, I personally have been a fan of the direct primary care (DPC) model. The benefits of the system are obvious, as it facilitates patient-centered care and physician autonomy, both of which seem to be neglected in the typical high-paced primary care setting. Despite DPC being a spawn of concierge medicine, it is not only for the rich. In fact, many of the practices using this model are very affordable for middle-class families.
After reading a book about conducting good business, you’ll likely review the concept of adequately meeting demands for clients or consumers. Whether a company is thriving due to lower pricing or higher quality, in the world of business, the golden rule is provide value or go bankrupt.
Let’s imagine you’re watching a re-run of Law and Order, and you’re following along with how the investigation and proceedings take place. The key that makes or breaks each case is… you guessed it – evidence. The quality and quantity of the evidence, how well the story fits the evidence, and where the evidence leads paints a strong picture of what may or may not have happened.
Over the last year or so, the direct primary care model has begun to show its strength. Increasingly, PCPs are showing an interest in boosting their relationships with health insurance companies and working directly with patients, collecting a monthly fee per patient rather than struggling to collect reimbursement checks. While DPC does come with some challenges, pioneering doctors are increasingly demonstrating that the model is manageable, research suggests.
Let's face it, physicians are already in the background of patient care. Nurses, medical assistants, case managers, social workers, and cafeteria employees probably all see the patient more than the doctor does. In fact, most work is done prior to or after the patient encounter, especially in hospitals. With exception of a quick subjective summary from the patient and the physical exam, nearly all of the physician progress note can be completed without even seeing a patient. The remaining information is already readily available within the electronic records. So why not push it one step further?
With Meaningful Use continuing to drive the adoption of healthcare information technology, it’s no surprise that one of the major developments in this year’s HIT market is a marked increase in patient portal adoption.