Interoperability Challenges in Healthcare
Healthcare providers continue to seek a unified electronic view of patient’s health data, one that is comprehensive and fully accessible across the enterprise. Considered the health IT holy grail for many hospitals, the benefits of such are far reaching. A unified platform for communication and data collection facilitates better collaboration among care teams, increased productivity, and improved performance across the healthcare continuum.
Progress toward this objective has been a challenge for providers because of the lack of effective methods to capture and manage unstructured data that typically resides outside the EHR. Hospitals struggle to integrate information needed from ancillary systems as well as from disparate sources, such as paper files and even verbal exchanges. Only when data from these sources are aggregated and accessible through a single repository can a truly comprehensive view of the patient’s path across the spectrum be achieved.
Recent advancements in health information exchange and integration, however, have positioned the industry closer than ever to meeting this goal. With new options for solutions that facilitate the secure exchange of health information and management of healthcare communication, providers are within reach of a single integrated platform to view all patient data.
Providers can now document all interactions – phone calls, faxes, web visits, medical records, and even face-to-face conversations – tie them to the patient record, and centrally store them for viewing, processing and retrieval. By combining the capture and management of all communication types, hospitals are able to close gaps in documentation processes and create for themselves a complete view of patient information available and exchangeable across the organization.
Taking such steps has implications not only at the point of care, but also in the revenue cycle. As hospitals continue to invest countless resources to ensure full and accurate reimbursement for services, there are ever-present nuances and variables affecting this process. Documentation of the hospital’s communication surrounding payment, therefore, can protect the investment being made to secure these hard-earned dollars.
Of course, this is just one example of many improvements realized from a unified view of patient data. The following are additional opportunities for health systems to better leverage health information and communication management systems for improved performance, workflow and quality outcomes.
Performance in denials remains an area of concern for many hospitals. Nearly two-thirds of errors leading to initial denials originate in patient access departments and issues associated with eligibility, authorization, or demographic information. Systems that document hospital efforts to
secure authorization – verbal, fax and electronic – can be leveraged to prevent and overturn denials, shorten appeals, and reduce cost to collect.
Documentation of the agreed-upon level of care also helps hospitals avoid retro denials for lack of medical necessity, translating into countless thousands in savings for the hospital.
Physician and Staff Alignment
Lost physician orders cause frustration among physicians, increased wait times for patients, and bottlenecks throughout the hospital. Routing fax and electronic exchanges through a central platform allows providers to receive and manage all orders in one location. In so doing, the hospital improves workflow, process times, and service to both physicians and patients. For example, with fax and electronic orders in a single location – searchable by patient and available enterprise-wide – physicians and staff can confirm in advance that orders are complete and accurate for all patients prior to service. Whenever and wherever the patient arrives, staff are able to immediately locate and process the order, reducing delays and cancellations that can result from missing orders.
Centralizing fax and electronic communication also gives providers the opportunity to reduce costs and risks associated with standalone fax machines. By converting to an electronic process, providers gain the benefit of a digital audit trail of individuals who have accessed each record,
reducing the risk of a HIPAA violation caused by unauthorized access to paper files. Converting to an electronic fax process can also reduce document delivery costs such as maintenance and paper by up to 90 percent.
Studies have shown that more than 50 percent of patients say that good communication is the primary reason they chose a hospital or clinic. Similarly, a patient’s rating of provider communication skills has been shown to be the strongest predictor of overall HCAHPS scores. Creating a positive patient experience means managing the hospital’s message from the first point of contact to the last. With systems available to capture and centralize all patient encounters – phone, electronic and in-person – providers can review interactions to improve quality, conduct service recovery, and reinforce communication best practices across departments for a better overall patient experience.
Hospitals need convenient access to patient records while ensuring that protected health information remains secure. Secure sharing of records between systems and team members can eliminate time-wasting and error-prone processes. A central point of access to patient data reduces duplication, rework, and back-and-forth between departments.
Patient Safety and Quality
Movement toward a value-based delivery model has placed even greater emphasis on care coordination. Systems that streamline the process of getting the right information to the right people mean faster response times, better care transitions, and possibly improved continuity of care. With quality assurance programs to ensure compliance with hospital policies and procedures, providers can better protect patient safety and promote better outcomes.
Hospitals can now close several gaps in documentation through an enterprise-accessible patient record. Real-time, seamless access to critical patient information fosters an environment for better care outcomes and improved revenue cycle performance. There are clear benefits to
aggregating communication and capture systems and pairing them with the electronic health record to tell the full tale of the patient’s story from the moment of entry to the time of exit.
Lindy Benton is president and CEO of Vyne Corporation.
For more information about Vyne Medical’s innovative revenue cycle management solutions, contact us to schedule a call with one of our healthcare solution experts today.