Electronic Health Records (EHRs) still struggle with key issues. Those issues include the ability to confidently share data, achieving the next level meaningful use, improving cash flow and margins, reducing claim denials, impact of ICD-10 coding and billing errors, trustworthy data integrity and information security. All of these elicit stress and worries that reverberate throughout the healthcare continuum.
The industry response so far has been analogous to pulling the covers over its eyes and hoping for the best, and understandably so, according to Udo Fischer, CEO of DUOLARK, a software development company in South Florida which offers a solution to keep patient data clean and healthy.He notes that while these issues seem complex and costly—they are neither. In addition, public policy and healthcare reform cement the inevitability that these issues are confronted, and most administrative staff just do not have the efficiencies, the knowledge training and the operations to handle these different nuances.
Looking at the issue from a triage perspective, most healthcare providers have approached margin compression, cash flow, and poor revenue cycles as if these issues were related to causation when, in fact, they are merely symptoms.
“The truth is, the lack of data integrity and accuracy of your EHR data is the root cause, and it is flowing to every extremity of your organization," says Fischer. “In fact, thinking of data as if it were blood running through the arteries of your organization perfectly describes the scope of impact.”
Coding and medical billing errors are especially prevalent because it can be complex and time consuming. Transitioning to ICD-10 is going to change everything. Providing the right detail information is going to increase the value of the data and treatment plans improve proportionately. If you are not up to date on these changes, your reimbursements will be affected. In addition, in the rush to implement EHRs and now ICD-10, little time is taken to analyze patient data before it is entered into the database, resulting in “dirty” data.
Keeping Your Patient Database Clean and Healthy
The quality and accuracy of your coding and patient database is highly dependent on your billing and coding staff. Data entry and filing claims are essential to attaining every dollar you are due, yet many healthcare organizations are not tackling this chore with the attention to detail it requires. Not only do claims need to be “clean” – meaning that they have the right information and billing codes – they need to be filed in a timely manner.
There are two forms of data entry errors: errors of omission, such as a lab technician forgetting to enter blood test results in a patient’s record, and errors of commission, such as a care manager entering incorrect patient insurance ID. These errors often delay your reimbursement or worse, create an adverse event due to unnecessary patient tests or incorrect medicine dosage. Not only does incorrect data lead to money being left on the table, but you are also putting your patient safety at great risk.
“Healthcare entities, such as emerging Accountable Care Organizations (ACOs), still face a lot of EHR adoption and implementation issues that result in compromised data integrity within the EHR application databases,” says Fischer.
Correcting and Maintaining Patent Data Integrity
Until now, the private sector has all but failed to provide a middleware that seamlessly and harmoniously joins the healthcare providers’ expertise of providing excellent quality of care with the business and technology expertise that every profitable business entity must possess.
Through its software, MED-DETECT, providers can greatly improve database integrity to avoid errors that could negatively impact patient care and cash flow. The innovative software, available as a subscription-based solution or installed onsite, was designed to analyze all medical demographic issues, provide direction on how to correct those errors, and provide training solutions to prevent them from recurring.
“We believe our software is unique,” adds Karl Norris, founder and software architect of DUOLARK. “While developing our software and researching the market for over three years, we could not find anything remotely similar. MED-DETECT provides you a structured remediation with correction priorities for the errors found. Once we find an error in your database, our software can correct it and actually protect the corrected record so the stored data is not only trusted, but it’s verified, which is rare in the healthcare industry.”
Once installed, MED-DETECT creates a catalogue system that can find, automate, match, log and display the results to the authorized user. Norris and Fischer call their software the first product to create one digital master data patient record that can validate multiple patient records against multiple patient identities within multiple EHR databases. One trusted and verifiable master patient record can then be used across the healthcare continuum, which has an immediate impact on reimbursement and patient safety.
Saving Providers Time and Money
Fischer estimates that on the low end, their software can help a provider recoup about one month of net revenue annually.
“We’re significantly improving revenue cycle management by shortening the timeframe in which claims that can be successfully submitted and reimbursed,” he says. “At the same time, we are improving the accuracy of claims before they are submitted the first time so they don’t have to be bounced back once or twice to correct it.”
Aaron Britt, director of finance for DUOLARK, says most clients can see a return on investment within hours of the software implementation.
“When these data errors are captured and displayed in real time, the personnel in charge of remediating those errors or rejections are automatically given an advantage of seeing where the error exists and how to approach correcting it,” he says. “So the savings essentially start within the first hour of implementation because that individual can spend less than hour to correct the problem.”
Another economic benefit of MED-DETECT is that it can significantly increase your back office efficiency, adds Fischer. The solution is low cost and user friendly to ensure adoption, and in addition, does not disrupt or require that the provider’s current operating procedures be changed to compliment the solution, which significantly undermines the provider’s decision.
“We’re helping the administrative staff not to look for the needle in a haystack anymore when a claim is being bounced back or rejected,” he explains. “Now they can go into the patient database finding out immediately why it was rejected and what they need to do to correct the error. This can likely take five minutes unlike the four to eight hours we estimated it took in the past. Oftentimes, your coding and billing department didn’t even know where to start or what to look for when a claim was rejected. We address the issue before the claim is submitted in a very unique way.”
Norris notes that the difference their software makes is to help healthcare providers keep their doors open.
“Our software is specifically designed to impact the business side of healthcare,” he says. “You can now be proactive instead of reactive. We can help providers increase revenue and stabilize cash flow because we can speed up the payment of reimbursements, reduce errors in billing and increase patient safety. We also control costs because it takes less man hours to effectively bill accurately and effectively.”
