Upload
doreen-wilson
View
216
Download
1
Tags:
Embed Size (px)
Citation preview
Making the Difference
in Referral &
Communication
SystemsSeptember 2012
Emerald Health Exchange
STATE OF CURRENT COMMUNICATIONS
PEDRO FALLA, M.D.
www.emeraldhealthllc.com88 Faunce Corner Mall Road, Suite 230 | North Dartmouth, MA 02747 |
855.650.9906
Confidential and Proprietary
Typical PCP Office
Medical Office PCP
Phone Calls
Faxes
Fax Bac
k
Scan
Files
Sort Faxes
Sort Mai
l
Triage
Phone
Calls
Return
Phone
Calls
Back
Confidential and Proprietary
Current Referral System
Medical Office
PCP
Hospital
Specialist
Medical Group/Network
Patients sent to other MDs outside of the network
• Consult is faxed• Consult is mailed• No Consult at all• No confirmation of appointment• No Show
Results:• faxed• mailed• phoned
• Ancillary Services
• Faxes not received
• Fax• Phone• Forms• Reason for consult
• No Shows
Discharged patient:• No notification• No comments• D/C summary sentby mail or fax
Referral outside of the network
Ancillary Services outside of the network
Confidential and Proprietary
Impact of EHE on PCP Office
Medical Office PCP
Employees
EMR
EHE Communication
Fax, phone, and mail
usage decreases
Smooth flow of electronic
information increases
Confidential and Proprietary
Impact of EHE on Referral System
Medical Office
PCP
Hospital
Specialist• Ancillary Services• Confirmation is received• Decrease no shows
Results sent by
EHE
Confirmation sent to hospital
• Confirmation is received
• Consults are received
• No show info is sent
Referral sent by EHE
Patient is sent back with discharge info and comments through EHE
Ancillary Services out of
network decrease
Referrals outside of the
network decrease
Referrals outside of the
network decrease
Medical Group/Network
Confidential and Proprietary
Current Network Communications
HospitalMedical
Group/Network
ERPT
NH
Provider
Medical
Group
PCP
VNASpeciali
st
Confidential and Proprietary
Impact of EHE on Communication Within the Network
PT
NH
Provider
Medical
Group
PCP
VNASpeciali
st
HospitalMedical
Group/Network
ER
Confidential and Proprietary
Summary of Benefits for Referring Physicians
Cut costs/expenses.Improve work flow efficiency.Better documentation in EMR
after consultant reports are received.
Decrease liability.Improve access to consultants.Reduce or eliminate
overwhelming paperwork load.
Confidential and Proprietary
Summary of Benefits for Consultant Physicians
Increase referral base.Enhanced communication
with referring physicians.Excellent platform to
project growth.Less administrative/labor
work by receiving referrals via EHE.
Confidential and Proprietary
Summary of Benefits for Medical Groups/NetworksCreate a cohesive and strong
relationship with all physicians by improving communication among them.
Track referral pattern inside/outside network.
Control of network leakage.
Improvement of communication with other health care providers (VNA services, home services, hospice care, nursing homes, physical therapy..Etc).
Integration of all physicians within the network despite use of different EMRs.
Confidential and Proprietary
Summary of Benefits from EHE
Cut cost/expensesIncrease referral baseEnhanced communication
within the networkTracking referral within
the system
Confidential and Proprietary
Cost Savings PotentialThe cost savings illustrated are typical of what a FT physician can expect based on workflow improvements
60-70% of referrals go unscheduled25% of scheduled appointments aremissed68% of specialists receive noinformation from PCPs prior to referralvisits25% of PCPs do not receive timelyinformation from specialists post referral
Paperwork costs a national average of over $23,000/year per physician
EMERALD REFERRAL &
COMMUNICATION SYSTEM
ARUN B. RAJAN, M.D
Confidential and Proprietary
EMERALD REFERRAL &COMMUNICATION SYSTEM FEATURES
Hosted System-SaaS Model
HIPPA CompliantComprehensive Referral
SystemDocument ManagementCommunication Tool For
Physicians & Users
Confidential and Proprietary
EMERALD REFERRAL &COMMUNICATION SYSTEM
FEATURESDesigned For Quick
ImplementationMinimal Learning CurveCustomizable FeaturesAny Size NetworkNo Paper No Faxing
Documents/Phone Calls
Confidential and Proprietary
REFERRAL MODULE
Send referralsReceive referralsRequest reports- automated
and manual requestsTrack the life history of
referrals Capture key data pointsGenerate report based on
predefined data points
Confidential and Proprietary
COMMUNICATIONS MODULE
Communicate securely within the portal
Send secure emails to recipients out of portal
Receive emails (may not be secure)
SMS to recipients
Confidential and Proprietary
DOCUMENT MANAGEMENT
Customization of documents in HTML or XML to track data
Send documents attached to referrals
Receive reports within portal
Manage documents that require receiver responses more efficiently
Capture electronic signature or image signature
Analyze, create reports of customized documents
Store documents
Confidential and Proprietary
SECURITYAccess Control. Technical policies and
procedures that allow only authorized persons to access electronic protected health information (e-PHI).
Audit Controls. Software and procedural mechanisms to record and examine access and other activity in information systems that contain or use e-PHI.
Integrity Controls. Electronic measures in place to confirm that e-PHI has not been improperly altered or destroyed.
Transmission Security. Technical security measures that guard against unauthorized access to e-PHI that is being transmitted over an electronic network.
Confidential and Proprietary
SECURITY (cont’d)Facility Access and Control.
Limit physical access to facilities while ensuring that authorized access is allowed.
Workstation and Device Security. Implement policies and procedures to specify proper use of and access to workstations and electronic media.
* Above security measures to be defined by applications and end users