As with any physician-patient encounter, telemedicine needs to include proper documentation and use of electronic medical records. In Part V of our series, Physician Focus: Telemedicine, we talk with Dr. Jonathan Terry, an award-winning osteopathic physician and surgeon and psychiatrist who uses telemedicine extensively in his practice. Dr. Terry explains that, in addition to documenting all of the usual aspects of the provider-patient encounter, physicians and practices using telemedicine should document that the patient was seen using telemedicine and why telemedicine was used. Also, when using ICD-10 diagnoses and CPT codes to fully document all aspects of the encounter, including the physical locations of the provider and patient during the encounter.
Telemedicine can act as a ‘shortcut’ in many ways, allowing physicians and patients to interact in ways that have not been possible in the past. However, physicians cannot take shortcuts when it comes to documentation and electronic medical records. If anything, physicians should be even more aware of these procedures when using new and less common technologies. To learn more, watch Part V of our series below. To watch the full interview, click here.
A community hospital in Boulder Colorado is facing a major challenge this week because it’s computer system has failed. The IT professionals handling the outage have not been able to determine what caused the issue, or if it is related to hacking. These types of warning signs should grab the attention of hospital and medical practice administrators around the country.
Boulder Community Hospital uses the EHR system called Meditech. This outage has not only effected the hospital, but also eight laboratories and six imaging centers. This is why we always stress to our clients that you need to have a backup situation in place if you choose to go with an EHR system. Please don’t misunderstand, we do think EHR is a good idea for healthcare. We have seen how technology has helped so many other industries, but since this is still fairly new to our sector, we need to ensure there are real backup plans in place.
One idea that all systems should deploy is redundancy. This increases the cost of the EHR system you select, but it can avoid long outages like the one the Boulder hospital is dealing with. What you can do is pretty much mirror your system using a RAID technology. This allows you to bring your backup system online when the primary one goes down. If you have worked in the IT industry, you know that it’s not “if” a system will go down…..but “when” it will go down. Deploying this type of system is not simple, but when there is a critical emergency, you will be happy it was setup.
So what are the physicians dealing with exactly during this outage? Well…..everything was entered into the EHR system, including surgery scheduling, test results, and routine appointments to name just a few. Everyone is scrambling to find paper records to get background on patients, and they are writing down what they are currently doing so they can be entered into the system when it’s back online.
There are a ton of IT companies that specialize in EHR implementation, make sure you choose one that at least touches upon the need for a real backup plan. We do think EHR is here to stay……but lets make sure we don’t take any shortcuts….because there are literally lives on the line.
Side note: Since its recent introduction, medical malpractice insurance companies have been promoting electronic medical records, or EMRs, as a “miracle innovation” that would help to lower medical malpractice rates. As of November, 2010, when the Conning Research and Consulting Company released their findings, the promised savings from EMRs have not materialized. The study also shows that the initial “break-in” period for the EMRs may actually cause an increase in medical malpractice litigation.
By Leigh Page
Beckers Hospital Review
Expected malpractice insurance discounts to practices for installing electronic medical records have not yet materialized, according to a report by American Medical News.
Malpractice insurers had been promising that EMRs would lower rates by improving patient safety, but insurers now believe claims will initially rise as practices work through kinks in the new systems.