There has recently been a spate of items in the news about breaches in the privacy of patient information. It seems that electronic records, while transforming the accessibility (not to mention legibility) of patient information, have also presented a new set of security headaches for practices and hospitals alike. It’s therefore essential for those health professionals considering automation or upgrading an old system to shop around for HIPAA-compliant practice management software that has advanced security measures, not only to protect patients from the mishandling of their identity and personal information, but also to protect physicians or their practices from litigation.

Tools to look out for include user-defined permissions, which allow administrators to give users different levels of access to data, and audit trails, which produce a permanent record of which authorized users accessed a patient’s chart at what time. Additionally, some application service provider (ASP) models feature better protection from hackers than others – those that are Internet-based (as opposed to Web-based) create a private platform between you and your data rather than channeling it through the very public forum of the World Wide Web.

 Technology can be misused and abused, but it can also be implemented as an effective tool to safeguard information privacy. Making sure your medical management system is secure will help prevent future lawsuits against you or your practice.

The International Classification of Diseases (ICD) has been existence in various forms for over a century and was originally designed to help facilitate comparisons in mortality statistics across the world. These days, however, version nine of the ICD is perhaps most familiar as a way to ensure that medical providers are being reimbursed properly for procedures. Across the U.S., medical billers and coders and medical software providers alike are quaking in their boots at the news that  ICD-9 codes are to be replaced with the updated, more comprehensive ICD-10 codes by October 2011.

This change is neither arbitrary nor unexpected; most of the rest of the world is already using ICD-10 codes (World Health Organization member states started using ICD-10 as long ago as 1994), and the update will be a useful tool to increase accuracy as the number of codes available will increase from about 17,000 to 150,000

The transition to ICD-10 will not be a painless one. Apart from the obvious discomfort of adapting to the new codes, there is also the nagging concern about how these changes are going to be incorporated into software. A Medical Group Management Association (MGMA) survey found that 95 percent of respondents would need to upgrade or replace their practice management software, and almost two-thirds thought they would need to buy code-selection software. Practices and medical billing companies that have invested in medical software that is delivered in “software as a service” (SaaS) format, especially ones such as NueMD that have a built-in coding module, can at least have the comfort of knowing that this major upgrade will be completed remotely with little participation their end. Unfortunately, those with client-server systems may be faced with the prospect of paying a hefty price to update their soon-to-be-obsolete systems.

It looks as though all those jokes (and lawsuits) that have centered around doctors’ terrible handwriting may soon be a thing of the past. Medicare’s recently passed law HR 6331, which gives providers financial incentives to e-Prescribe, has strengthened the growing trend of medical practices moving toward a paperless office.

It’s not just the prescription pad that is falling by the wayside. An increasing number of practices and payers alike are recognizing that documenting and charging for a patient visit electronically through a practice management software system is the most efficient method of operation. The benefits for providers are numerous - electronic medical billing can dramatically reduce rejected claims and shorten the reimbursement cycle, and electronic medical records keeps organized (and legible) patient information at a care provider’s fingertips. But there are advantages for payers too. They might not benefit from fewer rejected claims or having to reimburse providers more quickly, but they do benefit from a streamlined claims process that requires less administrative support. In a system where the take-up rate of innovations depends greatly on payers’ acceptance, completely paperless medical offices might be commonplace within a decade.   

In today’s economy, providers face a tough challenge in balancing appropriate reimbursement for their health care services while maximizing their one-on-one time with their patients. Streamlining patients’ visits and enabling them to have the most time with their provider (rather than waiting around, filling in paperwork or lining up to settle their co-pay) solves one of those challenges. This can be facilitated by using the reporting tools available within your practice management software system, and tracking patient flow to eliminate bottlenecks, as we’ve mentioned before in this blog. The reporting and analysis function within a PM system can also help with the other side of the conundrum – declining reimbursements. Rather than accepting lower reimbursements for your most common procedures, a recent article in Medical Economics suggests being a little more assertive with insurance carriers and presenting them with a report comparing dollar amounts offered by each payer for a procedure to start the renegotiating process. Harnessing the power of reporting to assess your operational and financial challenges makes good business sense any time, but with a shaky economy, it may be even more vital for your practice.

Last week’s issue of Medical Economics featured an “ask the expert” article about changing codes for tobacco cessation counseling. The practice that submitted the question had found that claims submitted under two particular codes had started to be denied. The coding expert confirmed that these codes had changed at the beginning of this year.
 
If this sounds like a familiar scenario, you may be interested to know that coding tools are available with NueMD that automatically keep the CPT®, ICD-9 and HCPCS codes contained in your coding list up to date. This means no more rejected claims when the codes change – and no delay in reimbursement.

The results of analysis published yesterday show that those who use smoking cessation aids are up to 2.4 times more likely to successfully quit smoking than those that go “cold turkey” and rely on willpower alone to quit. Researchers also found that cessation aids were underused due to a lack of widespread access.

This information, which was compiled from a total of 69 different studies on smoking cessation, is particularly relevant to those colleges and universities trying to reduce cigarette smoking by students to below 10.5 percent, in line with the Healthy Campus 2010 goals. Health centers may choose to focus additional resources on promoting and making readily available such cessation aids as nicotine nasal sprays, nicotine patches and varenicline and bupropion tablets to maximize students’ chances of quitting. Additionally, many campuses are banning smoking on campus in an attempt to change students’ perceptions of how common smoking is amongst their peers, although to what extent this contributes to a lower smoking rate among students is a topic of some debate.

Health centers wishing to perform their own clinical studies on the effectiveness of smoking cessation aids for student smokers may find Nuesoft Xpress’ practice management system of use. The application includes a clinical studies tool that allows tracking, reports and analysis of participating students.