Introduction
Do you find it challenging to locate clinical information about new and out of network patients you are treating?
If so, you are not alone – nearly all practices, from solo-practitioners to thousands of provider organizations, primary-and-specialty care, say this is an issue they struggle with.
The reasons are many: variations in where, what, how and who is involved in requesting and sending this vital information leads to a complex challenge nearly all practices face. Finding the time to identify, research and install a solution is time most practices simply do not have.
Physicians and their staff want to treat patients, and they want to provide the best and most complete care possible. Getting new patients in the door for treatment, and then making sure that everyone involved in treating your patient is in alignment can be among the biggest hurdles for practices to overcome.
Fortunately, while seemingly slow, the process of healthcare is changing because of new technology, new ideas and forward-thinking healthcare participants to make the process of obtaining and making clinical information available for clinicians a faster, easier process – and one with much better results.
Forward thinking practices now have an opportunity to vastly improve an essential and vital part of their healthcare delivery process.
Why is it so difficult to find and obtain clinical information in the age of the internet and smart phones?
Regulations, like HIPAA
Share data, but don’t share data! Healthcare regulations are some of the most complex in the world and not easy to navigate. Some rules say don’t share and some say to share, so some may conclude the best option is simply to do nothing.
Lots(!) of Participants
With so many participants, coordination is difficult and almost impossible.
As a result, clinical data is all over the place, sometimes in different formats and getting it requires knowledge of a particular practice’s people, policies, procedures and software.
Everyone is different
Practices, even some who are a part of the same health system, have different ways of doing the same thing, use the same or different software or configure the same software to work slightly differently.
Working Together – a realistic expectation?
While medical practices want what is best for the patient, they have to run their businesses too. Clinicians will provide other clinicians with medical information when it’s done for treatment reasons, but generally view other non-affiliated practices and health systems as competitors. There is a built-in bias to not want to make it necessarily easy or convenient to find or get the clinical information they have about a patient.
Perhaps, more importantly, the same is true of different EMR vendors. They are fierce competitors and generally do not want to assist someone using a competitor’s product.
An agnostic business and tool that’s independent of all practices and EMR vendors can help bridge this divide.
Healthcare is complex
With all its regulatory, safety, billing and reporting requirements, healthcare is highly intricate. This complexity makes changes difficult to coordinate among all healthcare participants.
For a variety of reasons, some of the healthcare providers have fully embraced and implemented requirements, while others, for reasons such as lack of resources, intransigence, among others, have not.
Practices are busy places and finding time to identify where improvements should be made and then making those changes that are actually beneficial for their practice is challenging.
EMRs get us only halfway there
EMRs for the most part do a good job of managing the health data about your patients, but are not experts at finding and exchanging medical records with providers outside of a given clinical network.
Like EMRs, HIEs help – some of the time
Health Information Exchanges, or HIEs, are good at exchanging records with those who are directly connected, but they don’t work that well or can be very complicated to use when needing information from a practice not on the HIE.
Inertia – it’s not easy to change and make changes
Some of how we do things, especially when we’ve done them “like this” for so long, can be more difficult and even scary to change, even when we know we should make improvements. Once we’ve convinced ourselves that improvements are necessary, then we still must convince others to try a new idea.
Change requires courage, but risk can be mitigated by seeing the demonstrable results others have obtained by making a change we’re considering.
The healthcare industry is BIG: it has lots of moving parts composed of tens-of-thousands of practices, facilities, payers, and government bodies. It takes a long time to make and see changes for the better.
Some practices can exchange clinical data electronically, whereas others aren’t able and must use FAX, which is still the most common way of exchanging medical records. Practices need a solution that accounts for and accommodates practices where they and everyone they work with are at technically and philosophically.
Today’s process has many bumps
Practices today have miracle workers who manage to somehow “make it work” despite the many challenges faced when trying to simply get all the clinical data for a patient for an upcoming appointment or for monitoring the patient’s health. These magicians (typically medical assistants) somehow manage to remember whom to call, what is needed when asking, how and where to obtain medical records, among other things, and then, remember when a follow-up call is necessary because the records weren’t received.
But, what if the patient went somewhere we don’t know about? What if the patient has conditions we’re not aware of that the patient forgot to mention that could potentially be harmful to the health of the patient or detrimental to a patient’s treatment plan?
How things are done today assumes that something is known about where the patient has been and whether the practice has previously worked with the other practice the patient has been to in the past. When the practice hasn’t previously worked with the other practice, it’s necessary to find out: the contact number and name, what is necessary to make a request, how to ask for medical records and, finally, obtain the records. The bigger problem: when we are unaware of where a patient may have received prior treatment(s), this results in a gap in our understanding of a patient’s clinical story and could result in sub-optimal treatment, patient harm and duplicated tests or treatments.
Once the electronic or faxed records are received, the clinician then must go through what can be hundreds, even thousands of pages, of information to try to extract what is important for clinical review.
By the way, the clock is ticking! All of this must be done before the patient can been seen.
What are consequences of delayed, missing, or incomplete medical records when you want to treat a patient?
Simply put, the consequences can range from a delayed appointment with little clinical impact to ineffective or delayed treatment, which could cause harm to the patient.
Practices may miss or delay a revenue opportunity, and perhaps a chance to provide a good first impression with the patient and their loyalty and recommendations to friends and family.
What would a good solution to handle sending and receiving all medical records do?
Clinicians treat and help those who need help, and clinicians need tools that ensure they can find and retrieve clinical information for a complete clinical understanding of all their patients.
As we discussed earlier, the healthcare industry hasn’t made it easy for clinicians to find, obtain and analyze clinical information for new patients.
With the wide adoption and advances in EMR technology, most medical practices and facilities in the US can store and manage clinical information about their patients and even share this information within their local clinical network or HIE. It’s when data exists outside of this local environment, that it becomes necessary to go hunting for information.
Here are some important components of a good medical records management tool clinicians and their staffs can use to streamline the process of medical records exchange for treatment reasons.
Remembering and tracking requests for medical records
An important component is keeping track of all requests for information, whether we are requesting, or someone is requesting information from us.
Logs of activity, alerts when a patient’s visit is close and the information hasn’t been located and being able to store information over-time and from disparate sources about the patient are essential for streamlining the process, freeing up valuable clinician’s time and making sure clinical information is found and in place for the provider.
Access to Electronic data
A good solution must be able to go hunting for data on behalf of the practice and search all the national and local clinical networks, or HIEs, looking for data about a given patient.
This ability is vital and important, for example:
- It helps us to “fill in the gaps” of clinical treatment and conditions we may not be aware of.
- It helps provide a chronology of care.
- It helps us construct a treatment’s effectiveness gauge – are the patient’s condition(s) improving or getting worse.
- It helps us see what tests and medications have been administered and prescribed.
As more practices contribute data to these national and local clinical networks, we should expect more digital clinical data to become available; however, these networks are still not truly integrated with each other, so having a solution that can search all of them, is a must.
While getting information digitally is ideal, it’s likely that a truly fully integrated national clinical network is several years away, and this makes it necessary to be able to handle the tried-and-true fax.
Fax
Because so much of the healthcare world still uses fax, a good solution would integrate a fax solution along with an electronic solution to bridge where the world is coming from (Fax) to where it’s going (electronic data).
In some practices, faxes still come in on a fax machine. A good medical records solution integrates receiving medical records faxes electronically – no more collating and scanning.
It’s important for clinicians to have a single tool to track, locate and obtain medical requests – regardless of whether they are electronic or fax – as a single comprehensive tool is ideal.
Integrated and Comprehensive
A single tool that finds and obtains all electronic data available about a patient, along with managing medical records exchange via fax provides a holistic approach where all vital clinical information available about a patient is available for clinical staff review and for physician clinical decision support.
It means that we can work with all healthcare participants regardless of how big or small, type, where they are located or and technological capability.
Finding what information is needed and getting it in front of the provider in time for an encounter.
There is a very real possibility that some patients may have thousands of electronic data elements and hundreds or thousands of pages of fax pages of information.
After obtaining medical records, most practices then start a very tedious review process – page by page, highlighting, and perhaps even rescanning or copying-and-pasting information to find what is needed and extracting it to put into a form for the physician to see.
Because both electronic data and faxed information are electronic, a good solution provides you with the ability to search and “grab-only-the-information” you want to export for the physician. A solution that “remembers” the key things you look for as a bonus!
Easy to install, easy to use, built for clinicians with world-class support
Modern technology allows for solutions to be implemented without the need to install software and deal with local machine configurations.
A good solution is software-as-a-service, SaaSto eliminate the need for clumsy, local installation. With a SaaS based solution, you don’t have to worry about configuring local machines.
It should be as simple as going to the web site, authenticating to gain access, working with easy to navigate and clinician-tested workflows to find the information you need.
We sometimes say or hear that healthcare is unique; the fact of the matter is that it really is. Having access to support and experts who have been in healthcare for decades and who understand how healthcare works is essential for the ongoing success of a change like this.
Finally, this is healthcare, so it must be safe and secure and only accessible to those who are authenticated and 100% authorized to do so.
Conclusion
Your practice is being measured, whether directly or indirectly: by someone inside and by someone outside of your practice.
Patients:
- How easy was it to make an appointment and see the doctor?
- Was I able to see the provider in a timely way to ensure best health outcomes?
- Did the practice make it easy for me to transition to their care?
Providers:
- Is my staff optimally scheduling for both revenue generation and time to provide quality care to those patients entrusting me with their health?
- Do I have all the necessary clinical information to successfully treat the patient?
Payers:
- Is this practice providing quality care at or below costs associated with best performing practices?
- Is this practice duplicating previous tests?
Competition:
Is the practice seeing more patients than me?
Does the practice have higher or lower patient satisfaction scores?
It’s worth the time to review how your current process of requesting, retrieving, and preparing clinical information for new patients and for patients you’re monitoring works (or sometimes doesn’t) to determine if it’s time to improve this process so that valuable clinician time can focus on a much more important task: making sure patients who want and need care are seen by your practice. Hint: most practices haven’t looked at this process and assume there is no other way, but there is a better way!
Vivlio Health wants to revolutionize how you obtain, retrieve, and use clinical information for all the patients you provide treatment for.
Vivlio Health’s single, comprehensive tools provide a way for you:
- to track and manage all medical records requests,
- to access all the major and local HIE’s having vast amounts of clinical data,
- to handle your faxed medical records, and
- to provide you with tools to find, slice, and dice the information inside all the information that was found so you can export it and make it available for providers.
In many cases, clinical data can be found in seconds, so the only question is what will your staff do with that spare time?
Your practice can not only embrace the challenge of seeing more patients in a safe, cost-effective way, but do so with better results that will enhance your ability to participate in performance and value-based care and reimbursement programs.
Treating patients is what your practice does. See more of them and have more information about them while improving your operational performance.