Tag Archives: medical referral

How Can A Hospital Tackle Their Operational Problems With The Help Of A Software?

Hospitals are crucial in giving care to patients who come to them with various problems. With increasing health problems, the number of patients visiting the hospital is also increasing. As per the survey by Statistics Portal, Community hospital expenses per inpatient stay in the U.S has been increasing. Are hospitals doing enough to manage the increasing number of patients? Many hospitals are still managing their process and workflows manually. So what challenges do they face in handling such huge patient data and process manually?

Challenges faced

Let us a scenario based example to understand the challenges better. James is suffering from a headache for the past two days. He thought it would get better if he takes rest but it only became worse. He realized that he was running a high temperature and decided to visit the doctor.

  • The patient is trying hard to fix an appointment with the doctor – James had heard about a famous doctor nearby. Nothing was mentioned online about their opening or closing hours or if they were working today or not. Luckily he found the contact details. James calls up the doctor. The line was engaged. It was a holiday so many patients were trying to reach the clinic. He tried for half an hour before his call got connected. By that time most of the appointments were booked for the doctor. James finally got a slot to meet the doctor at 4 pm. This did not go well with James as he was already suffering from a severe headache. He felt that the hospital must have some means of scheduling appointments without any hassle during busy days.
  • Patient waiting to visit the doctor – James reached the clinic at 3.30 pm. He thought that his visit would be fine as he had already booked an appointment. He was surprised by the crowd. He found that there were ten more patients before him waiting to visit the doctor. He was not happy with the clinic as he had to wait for one more hour to visit the doctor. Why should he wait even after having booked an appointment? He regrets choosing this clinic as his headache is getting worse. The clinic had nothing interesting like magazines or tv to while away the time. That one hour of waiting was really bad for James. After meeting the doctor, James felt better. He finally came out of the clinic at 5.30pm after getting his medications.
  • Patient engagement – The clinic does not collect patient feedback about their visit to their health. James was looking for something like a feedback to make the clinic aware of his concerns. It seemed like they were too busy to hear him out. He went out of clinic thinking to never return to this place.

It is obvious that James is going to tell some other friends and family about his bad experience in this clinic. The chances of patients visiting the clinic after listening to him are less.

The above were the challenges faced by patients. But what challenges prevent the clinic from meeting the patients’ expectations?

  • Appointment scheduling – The clinic has an outdated method of fixing appointments over phone calls. There are no systematic methods of collecting patient requests and processing it as appointments. There is an extent to which appointments can be managed manually. When the number exceeds and when managed manually, it leads to patient dissatisfaction and also affects the workflow of the clinic.
  • Patient no-show rates – Many patients do not show up for appointments. The reason can be anything. The patient might have forgotten, visited another doctor or might have got better. There is no way of tracking which patients did not show up and why. The patients do not get reminders of the appointments which is an important reason for the increasing no-show rates.
  • Remote patient monitoring – There is no chance for the patient to get in touch with the physician in case of an emergency. Physicians are usually busy and are not available to patients for support. Though they are busy, it is good to make them available to the patients. It might be a case of emergency and the doctor’s advice might be crucial in that case.

How can a Software help in solving the challenges in the healthcare industry?

With the above-mentioned challenges, it is not good for a practice to manage its workflow manually. This is when Information Technology can help. Many physicians are skeptical about the cost a software will incur. They are not aware that healthcare software can solve their challenges and thereby reduce manpower. HealthViewX solution has the best features that can easily solve the problems of any practice.

  1. No change in the current process – The HealthViewX solution can be integrated with EMR/EHR and can write data of referral into any system if required. It is almost zero deviation from the current workflow a practice is using.
  2. Appointment scheduling and management – The HealthViewX solution has an application for the patients. They can conveniently fix appointments with the doctor depending on the schedule. The application also gives timely reminders to the patient and the physician about the appointment. It reduces patient no-show rates, patient waiting time and patient leakage. It has a positive impact on the workflow and patient’s experience.
  3. Electronic Care Plans – The solution enables care plan creation. It helps in monitoring patient’s vitals, measurements, etc. If required, it can also be printed and handed over to the patient. This feature is in order to keep the patients engaged and encourage them to stay healthy by adhering to the care plan.
  4. Audio and Video Calling features – It has an inbuilt audio calling and messaging application which is secure and enables faster communication. In case of an emergency, the patients can easily contact the doctors.
  5. Patient Reported Data – Patients can record data for all attributes in the care plan. Summary graphs and table data helps the provider in monitoring the patient’s vitals. The patient medical records can be anytime printed in pdf or excel report form.
  6. Health Device Integration – HealthViewX solution can integrate with any wearable device like Fitbit, Apple watch, etc. Hence the patients need not waste time in logging data in the application if they are already using wearables.
  7. Report Consolidation – The data regarding the patients’ health attributes can be printed as a report anytime in pdf/excel form.
  8. HIPAA compliant data security – The solution is HIPAA compliant and offers secure data exchange. It supports almost all formats of files and keeps the patient documents safe.

HealthViewX software solves most of the challenges faced by the practices. It increases the revenue and efficiency reduces manpower. Do you want the solutions HealthViewX offers in detail? Schedule a demo with us.

 

References

https://www.statista.com/statistics/459772/community-hospital-expenses-per-inpatient-stay-in-the-us/

 

Why Is HealthViewX The Next-generation Software In Patient Referral Management

What is Patient Referral Management?

When patients need advanced treatment or additional diagnosis that is not available within the practice, physicians refer them to a specialist/imaging center. The process of managing all the patient referrals that are received or sent is called patient referral management. It is a laborious process for FQHCs who refer patients to other specialists or imaging centers.

Challenges faced by FQHCs

One of our established clients based out of California is an FQHC who faced the following challenges in their patient referral network.

1. No single system for Referral Coordinators

The PCPs can create referrals on their EMRs. However, the referrals coordinators have to extract the referral lists that have been tasked on to their workgroup. They must manually pull down respective documents from patient chart to get the referral packet ready for Insurance pre-authorization. Then the referral coordinators must manually bundle the referrals and send those to the insurance company via fax. Post receipt of pre-auth acceptance, they have to manually track the rest of the activities. They have to communicate and coordinate with the specialist and patient, etc thus driving the referral to closure. In this workflow-intense process, the referral coordinators must hop through multiple systems like EMR, eFax, and spreadsheets etc. There is no system for the Referral coordinators to maintain and track the further status of the referral through the rest of its life cycle.

2. Cumbersome Insurance Pre-Authorization

Our FQHC client sends about 600 plus authorization requests per day to 15 plus different payers. Every authorization or referral packet has 14 plus pages. Some payers have their own physical forms that have to be manually filled in. These forms must be attached to the rest of the patient documents pulled from the EMR manually. Some payers have online portals for the above process. Considering the volume of authorization requests sent every day, it is not advisable to rely on a fully manual function. It makes the process cumbersome and prone to errors.

3. Specialist & Patient Referral Communication

From their EMR, referral order letters go to the patient. But the EMR has issues with its patient referral order template. Hence the referral coordinators have to manually design the template using MS Word and send it out. Specialist cover letters and reminder notifications in the EMR do not meet the requirements of the referral coordinators. They wish to customize and automate it.

4. Referral loop closure

Following up with the Specialists, receiving the reports back from the Specialist, and attaching it back against the patient chart in the EMR are completely manual time-consuming. Relying on only Fax & phone based communication for the same makes it cumbersome to manage as it has no effective means for tracking

5. Meeting Meaningful Use (MU) requirements with the EMR Share feature

Though the EMR SHARE’s main purpose was to help providers meet the MU requirements. In order to meet MU, the FQHC has to get the specialists to enroll on a direct message service so that they can use SHARE to transfer all orders. Though the FQHC already has the technology to meet the MU requirements, the issue is on the specialists’ side. Hence the EMR SHARE is not helping them meet the MU requirements.

HealthViewX is the Next-Generation Patient Referral Management Solution

1. End-to-End referral lifecycle management with bidirectional EMR/EHR Integration HealthViewX platform supports dynamic forms, workflows, task lists, reports, data visualization and has great integration capabilities. It has enabled our FQHC client to automatically pull referral orders from their EMR in real-time. It has also helped them in configuring all other referral coordinator workflows and tasks with maximum automation. Thus our platform has helped them achieve an efficient end-to-end referral management system.

2. Payer-specific prior authorization process automation

 HealthViewX platform has a payer management module that maintains and manages

  • different payer details
  • their modes of prior authorization
  • direct authorization procedures
  • payer forms
  • online portal links

With this information already present, it provides the referral coordinator the capability to automate

  • prior authorization submission
  • status checks coupled
  • fax integration

3. Automated Specialist / Patient Notification & Reminders with Customizable templates and configurable channels of communication

HealthViewX – Template engine platform along with the communication engine gives the flexibility to the referral coordinators to

  • choose the relevant format and mode of delivery for Specialist / Patient communication
  • tie it along with the referral workflows by setting trigger rules and reminder rules.

4. Secure Online referral portal for Specialists with easy touch points via Fax /SMS/Email

HealthViewX clearly understands the specialists’ referral preferences by,

  • Multi-channel referral consolidation that brings all the referrals from every possible source into a single queue.
  • Detailed referral information through which that the Specialist receives all the necessary referral details.
  • Ability to communicate back and forth (electronically or via fax) in a simple and secure way.

These are few notable features of HealthViewX that have enabled referral loop closure from the specialist side.

5. Free secure Specialist online accounts with both sides integration capabilities to meet Meaning Use requirements

As mentioned earlier, the problem with MU requirements was not, it was not met by the specialists. HealthViewX solution provides free online accounts for such specialists. It was highly useful to our FQHC client as we supported seamless integration between both ends. It helped the specialists meet the MU requirements.

HealthViewX Patient Referral Management application is the next-generation software for patient referral management. It has provided the best solution to the challenges faced by FQHCs. To know more about HealthViewX solution, schedule a demo with us. Our patient referral management experts will guide you through our HIPAA compliant solution.

All That You Need To Know About Patient Readmission Rates

What is Patient Readmission?

Patient readmission happens when a discharged patient is again admitted to the hospital within a specified period. CMS used different time frames for research purposes, the most common being 30-days, 90-days and 1-year readmission. They define patient readmission as “An admission to an acute care hospital within 30 days of discharge from the same or another acute care hospital”. It uses an “all-cause” definition, meaning that the cause of the readmission need not be related to the cause of the initial hospitalization. The CMS set the time frame to 30 days because readmission during this time is a result of the care given at the hospital and how well they coordinated the discharges.

Why does Patient Readmission happen?

Before knowing why readmission happens, there are two terminologies that we must know to understand it better.

Index Hospitalization – The original hospital stay i.e when a patient gets admitted for a treatment in a hospital is “index admission”.

Hospital Readmission Rates – The rate at which a hospital readmitted its patients is a “hospital readmission rate”.  In other terms, it is an outcome or a quality measure of care given by health systems.

Here are the top four reasons for patient readmissions,

  1. Importance of paying heed to the physician – Mr. Hayden got admitted to a hospital for a knee surgery. The physician advised him to take complete rest. He did not listen to the physician and strained himself resulting in severe leg pain. Now Mr.Hayden is then re-admitted to the hospital. In this case, the patient should have paid attention to his physician’s advice.
  2. Recovery Instructions – Dr. Adams is a cardiologist. He performed an open heart surgery on one of his patients. Since Dr. Adams was busy with many other surgeries on the same day he couldn’t give the patient instructions regarding post-surgery clinical exercises. He entrusts a nurse with the job. The nurse forgets to instruct the patient about the prescribed exercises. The patient then gets readmitted to the hospital complaining of chest pain. It is the responsibility of the specialist to give the required instructions to his patient and help them recover quicker.
  3. Communication between the patient and the specialist – Mr. Mark gets admitted to the hospital for ulcer treatment. The patient fails to give his complete health problems to the specialist. The specialist does not probe much and gives the usual treatment. Mark is fine for a week after discharge but is then re-admitted for the same problem. It is important for the patient to share all his problems with the specialist and it is the duty of the specialist to understand the complete health history of the patient.
  4. Continuous care to the patient after discharge – Dr. George is an Orthopedic specialist. His patient is suffering from arthritis. The patient needs continuous monitoring and care. The specialist is mostly not reachable over the phone for doubts. Here arises the need for technology, a software that can help both the patient and the specialist in continuous assessment.

Patient readmission risks

Readmission rates decide the quality of care given by the physicians. The CMS introduced the Patient Protection and Affordable Care Act in 2010 penalizing the health systems having higher than expected readmission rates through the Hospital Readmission Reduction Program. They specifically designed the program for incentivizing hospitals that had higher readmission rates of 20% in 2010. CMS reduced the reimbursements of the hospitals depending on the rate of the breach which was effective in reducing the readmission rates by 2% in 2013.

Ways to Reduce Patient Readmission Rates

A study presented by the Harvard Business Review found that on average, a hospital can reduce its readmission rates by 5% if it simply prioritized communication with patients while also complying with evidence-based standards of care. The following steps are a great initiative in cutting down the readmission rates.

  • Scheduling follow-up appointments – After a patient gets discharged it is essential to get in touch with him to inquire about his well-being. The appointments need not be face-to-face always. The physicians can conduct appointments through audio or video calls or sometimes even through messaging or e-mails. It will help the physician in knowing how well the patient is after the treatment or surgery.
  • Long-term relationships with patients – Patient engagement is the key to reduce patient readmission rates. Rehabilitation programs, good nursing team, home care, wellness programs etc can improve patient engagement and thus reduce readmissions.
  • Technology to play a vital role – A software to monitor the patients continuously can really help in solving the readmission rates problem in a cost-effective way. It also provides many other advantages and reduces manual work.

How can technology help in curbing readmission risks?

Information Technology is everywhere, so why not in healthcare? HealthViewX Care Management Solution helps the providers in monitoring and providing care to patients anywhere. It allows the provider to create a care plan for the patient. The care plan comprises many vitals, activities, treatments etc. The provider can select the appropriate ones and create a care plan. The patient who has a mobile application gets notified about the care plan. He can go about recording data for the vitals or measurements given. Both the patient and the provider can view the data in form of graphs or tables which will help the provider to keep an eye on the patient’s vitals. The following features help the hospitals in monitoring the patients easily and thus reducing the readmission risks.

  1. Electronic Care Plans – Care plans to monitor patient’s vitals, measurements, etc. If required,  it can also be printed and handed over to the patient.
  2. Patient Reported Data – Patients can record data for all attributes in the care plan. Summary graphs and table data helps the provider in monitoring the patient’s vitals. The physicians can print reports at any time in pdf or excel form.
  3. Health Device Integration – HealthViewX Care Management Solution can integrate with any wearable device like Fitbit, Apple watch, etc. Hence the patients need not waste time in logging data in the application if they are already using wearables.
  4. Follow-up Appointments – The solution enables to schedule follow-up appointments and sends reminders to both the patient and the provider. It also has inbuilt audio and video calling features to support such meetings.

HealthViewX Care Management Solution offers a range of advantages and lessens the chances of a patient getting readmitted. To know more about our solution, schedule a demo with our expert team who will guide you through the process. Schedule a demo with us to learn more.