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In its second year, the clinical documentation program at Jupiter (FL) Medical Center was able to increase DRG reimbursement by 75% over the previous year.
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Telemedicine has long been recognized for improving access to care as well as access to specialist expertise, particularly in rural facilities.
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Although a recent study at the University of Rochester (NY) seems to indicate that telemedicine could eliminate many pediatric ED visits, a pediatric ED physician with extensive experience with telemedicine believes that its applications are not broad enough to have a significant impact on ED overcrowding.
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There is a significant amount of research that demonstrates ED crowding due to boarding is responsible for poor outcomes, says Tom Scaletta, MD, president of Emergency Excellence, a Chicago-based organization that improves patient care and efficiency in the ED while controlling costs. He also is medical director of a high-volume community hospital in a Chicago suburb.
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If your documentation assurance program focuses on reimbursement alone, you're not going far enough. With pay-for-performance initiatives on the rise and increasing mandates for public reporting of hospital data, it's critical that the medical record accurately reflect the severity of illness and the services provided to your patients.
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Regular audits and continuing education are the keys to a successful documentation assurance program, says Liz Youngblood, RN, MBA, vice president, patient care support services at Baylor Health Care System in Dallas.
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"When I conduct an initial review of the chart, I read it from the beginning, like a story starting with the emergency department notes, through the history and physical and start building a story from a clinical standpoint.
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An emergency physician is managing an acute myocardial infarction, arranging for a patient transfer, sewing up a laceration, and putting in a chest tube, with 20 people still waiting to be seen in the waiting room.
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When the home health nurses at Little Rock, AR-based Baptist Health Home Health Network began observing that many of their patients had poorly managed chronic diseases and were not receiving evidence-based care, the network designed a new approach to delivering care for patients with chronic diseases.
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A photonovela became a master's project for Laura Nimmon, MA, a doctoral fellow with the Social Sciences and Humanities Research Council of Canada and the Michael Smith Foundation for Health Research in Victoria, British Columbia.
