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Spotlight

Saint Thomas Health

Saint Thomas Health (STH) is a faith-based ministry with more than 6,500 associates serving Middle Tennessee. Saint Thomas Health's regional health system consists of five hospitals - Saint Thomas West, Saint Thomas Midtown and the Saint Thomas Hospital for Spinal Surgery in Nashville, Saint Thomas Rutherford in Murfreesboro and Saint Thomas Hickman Hospital in Centerville - and a comprehensive network of affiliated joint ventures in diagnostics, cardiac services and ambulatory surgery as well as medical practices, clinics and rehabilitation facilities. STH is a member of Ascension Health, a Catholic organization that is the largest not-for-profit health system in the United States. For more information, visit http://www.sths.com.

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Digital Healthcare

Top 10 Best Practices for EHR Ethical Issues

Article | November 29, 2023

Discover the potential of EHR implementation in revolutionizing clinical processes. Uncover strategies for addressing EHR ethical issues, ensuring integration that prioritizes patient-centered care. Amidst the fusion of healthcare and technology, integrating electronic health records (EHRs) has emerged as a transformative element in modern medical practice. As a digital repository for a patient's medical journey, EHRs present unprecedented prospects for elevated care quality, improved data accessibility, and cost-effectiveness. Nevertheless, these advancements bring forth an array of EHR ethical issues that demand meticulous attention. In this context, establishing and adhering to the best practices for the ethical training of EHRs assumes paramount importance and a moral obligation. By skillfully navigating the intricate convergence of technology, patient confidentiality, and conscientious healthcare, these ethical EHR best practices illuminate the path toward a future where innovation and ethical principles harmoniously coexist. 1. Upholding Privacy and Confidentiality Revealing a patient's information to external parties should strictly happen with the patient's explicit consent or within the parameters defined by legal regulations. Data stemming from clinical interactions is confidential and requires rigorous protection. The effective operation of EHRs requires authorized access by healthcare institutions, insurers, and related entities. Access by users is contingent upon predefined role-based privileges. The administrator identifies users, specifies the extent of information accessibility, and allocates exclusive usernames and passwords. Users must be conscientious about responsibly utilizing the information they access within their designated roles. Therefore, assigning user privileges plays a pivotal role in securing medical records. However, while regulating data access remains crucial, it doesn’t completely ensure confidentiality. Strengthening security through comprehensive privacy and security protocols remains essential for reinforcing patient data's inviolabilit. 2. Safeguarding Against Data Breaches Ensuring patient privacy and safeguarding sensitive medical data is paramount in EHR ethical training. The imperatives of inadequate data security, encompassing compromised medical information, unauthorized access due to weak password safeguards, and the lack of encryption, accentuate the immediate need for a holistic approach. Employing strategies such as secure cloud storage, robust password protocols, two-factor authentication, and encryption is pivotal in enhancing data security, preventing the mishandling of patient records, and abiding by ethical standards. The potential legal and financial consequences of breaches underscore the criticality of these practices in maintaining patient trust and confidentiality within the digital healthcare domain. 3. EHR System Implementation The integration of EHRs within healthcare organizations poses significant challenges, including resource waste, provider dissatisfaction, diminished patient trust, and potential safety risks. Successful EHR development, implementation, and upkeep demand substantial investment and collaboration among stakeholders, including clinicians, IT experts, educators, and consultants. Clinicians' active engagement is often underestimated, leading to the failure of EHR projects; therefore, clinician-led guidance is crucial in tasks such as EHR selection, workflow design, and quality improvement. Thoroughly mapping workflows before selecting an EHR is crucial, while maintaining user-friendly interfaces remains essential for success. Neglecting these aspects can reduce efficiency, compromise care, and increase safety threats. By prioritizing comprehensive planning, engaging clinicians, and optimizing user interfaces, healthcare institutions can ensure ethical and efficient EHR integration, ultimately enhancing patient care and safety. 4. Maintaining Data Accuracy Upholding data accuracy stands as a fundamental principle in the ethical EHR domain. The integrity of information guarantees its unaltered and precise nature, contributing significantly to the enhancement of patient safety, reduction of healthcare errors, mitigation of health disparities, and betterment of public health. Nevertheless, concerns have been voiced regarding the reliability of data input into electronic records. The improper utilization of functionalities such as 'cut and paste' can lead to misleading portrayals of a patient's condition and treatment, breaching ethical standards. This practice poses elevated risks to patients and increases the liability of clinicians and institutions. Challenges also arise from drop-down menus that limit a clinician's choices, potentially giving rise to substantial errors, especially under time constraints. The collaborative efforts of clinicians and vendors can address software concerns, promoting user-friendly, reliable EHRs while tackling EHR ethical issues. Furthermore, data loss during transfers raises pertinent concerns about the accuracy of the database, a critical aspect as patient care decisions hinge on this data. 5. Guaranteeing Data Authenticity The assurance of documentation integrity pertains to the accurate and precise nature of the comprehensive health record. This includes principles of information governance, identifying patients, validating authorship, handling amendments and corrections in records, and auditing documentation validity while submitting reimbursement claims. EHR tools offer flexible documentation options through the utilization of templates and smart phrases, assisting in precise record-keeping. However, if these tools are misused, doubts about data integrity can arise, making information unreliable and possibly raising concerns about fraudulent activity. Established policies and procedures, including audit functions, must be in place to ensure proper billing. With adequate safeguards, records may accurately represent the patient's condition at admission and over time. Providers must understand the importance of reviewing and refining default data to ensure that only patient-specific information for that visit is recorded. In contrast, irrelevant data from default templates is removed. 6. Validating Dictation to Prevent Errors Voice recognition systems lacking a validation step pose considerable challenges in maintaining data accuracy and preventing documentation errors within organizations, particularly when it comes to ethical issues with electronic health records. EHR companies need to implement a protocol requiring providers to promptly assess, modify, and validate dictated information. Given these documents' frequent use and sharing, precise and high-quality documentation in EHR systems is of utmost significance. The adoption of EHRs has led to substantial shifts in provider workflows and documentation processes. However, providers still need to clearly outline or fully understand comprehensive best practices for maintaining high-quality documentation in EHRs. Advancements are necessary to enhance documentation tools and methods, with a renewed emphasis on the essential aspects of data accuracy and quality. This should precede the widespread implementation of interoperable health information exchange initiatives. 7. Ensuring Accurate Documentation Maintaining the integrity of documentation is compromised when incorrect information finds its way onto the wrong patient's health record. Patient identification errors can influence clinical decisions, endanger patient safety, violate privacy and security, and lead to redundant testing and escalated expenses for patients as well as providers. The propagation of patient identification mistakes can rapidly expand within EHR, personal health records, and Health Information Exchange (HIE) networks as information disseminates. Failing to implement advanced front-end solutions that incorporate robust matching algorithms or innovative techniques like biometrics or fingerprinting can expose organizations to risk. EHRs can incorporate targeted alerts to anticipate safety problems, like blood type inconsistencies or allergies, during treatment, addressing EHR issues. Organizations must institute a patient identity integrity program, integrating performance improvement metrics to monitor error rates and duplicate records in their electronic master patient index. Policies and procedures must ensure the accuracy of critical demographic data, facilitating the linkage of records within and across systems. Addressing the initial point of data capture as a primary front-end verification is also vital within policies. 8. Preserving the Authenticity of Audit Trails Effective audits are crucial to ensuring that the health record documentation aligns with the reported level of service, fulfills reimbursement requirements set by payers, and guarantees that only authorized personnel access patient medical records and make entries. The audit trail must encompass the user's name, the triggering application, workstation details, the specific document, a description of the audited event (such as amendments, corrections, or deletions), and the timestamp. This audit trail outlines modifications (including deletions) within the health record and provides auditors with a foundation for compliance audits. Inadequate audit trail functionality within EHRs raises concerns about the integrity of health record documentation, potentially exposing organizations to legal liabilities and inadvertently fostering or shielding criminal activities. It may become challenging to ascertain if corrections or amendments were executed, who authorized the changes, or the nature of the modifications. In addition to the inherent unintentional errors that documentation might encounter, audit trail functionality can aid in detecting instances where records are altered to obstruct the disclosure of detrimental information. Organizations can utilize EHR trends to leverage audit trail features for identifying and analyzing patterns in health record usage. Typically, users can generate reports over specific time frames categorized by provider or provider type, with results directed to a compliance committee or the organization's governing body. 9. Fostering Compliance Awareness Enhancing ethical EHR training involves a strategic focus on ensuring providers are well-versed in compliance and legal risks, starting from the EHR training phase. To address EHR problems, organizations should implement educational initiatives aimed at mitigating compliance issues. Staff education must emphasize the integrity of health record documentation, with a continuous program monitored and provided quarterly or annually. Addressing the 'who, what, why, and how' ensures a solid grasp of organizational practices that uphold individual best practices, encompassing identifying potential fraud, universal and administrative security measures, data validity, authorship, continual education's significance, and strategies for daily fraud prevention. 10. Conducting Feedback Sessions Contrary to common assumptions, ongoing training is essential post-EHR implementation. After installing the EHR and initiating patient interactions, challenges inevitably emerge—be it staff unfamiliarity with functions or the need to revamp workflow processes. Promptly identifying these concerns to prevent errors and swiftly resolving them involves collecting feedback from EHR users among the staff, particularly in relation to EHR ethical issues. During the weeks after the system's launch, contemplate arranging routine meetings to gather insights. Ensuring diverse representation, including clinical staff, physicians, administrators, billing, and front desk personnel, is crucial. Seek input on their adaptation to changes and areas requiring improvement. Determine if specific training concepts need reinforcement. Surveys can be used in place of frequent meetings. Subsequently, prioritizing problem areas aids focused resolution by promptly addressing critical matters. The introduction of incremental changes helps staff adapt to the EHR seamlessly, safeguarding patient care continuity during the transition. The Path Ahead Following these ethical EHR training best practices ensures the accuracy and reliability of patient data, leading to improved clinical decision-making and patient safety. By maintaining documentation integrity, professionals can confidently provide quality care and reduce the risk of errors. Ethical EHR training further strengthens compliance with legal regulations, safeguarding both the organization as well as the healthcare provider from potential legal liabilities. Moreover, adhering to best practices promotes efficient workflows, enhancing productivity, and streamlining operations. Patient trust and confidence are strengthened as professionals demonstrate their commitment to data security, confidentiality, and ethical conduct. Ultimately, by upholding ethical EHR training standards, professionals contribute to a robust healthcare system by fostering positive patient outcomes, maintaining trust, and supporting the principles of ethical healthcare delivery.

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Health Technology, Digital Healthcare

How Telehealth is Changing the Nursing Industry

Article | August 16, 2023

Before we discuss the importance of telehealth and how it is changing the nursing industry in general, it is important to understand what telehealth is all about. With the advent of new-age technologies and their impact on the fast-paced, growing population, medical health is an essential department that requires special attention. One’s health is of utmost importance, and to enhance the medical facilities, we as responsible citizens and experts in this particular field must come up with novel and quick solutions to provide optimum precaution and cure. Hence, one of such technological achievements is telecommunication,s and by utilizing such a useful resource, health-related services too can be offered. Telehealth promotes the distribution of various services related to medical health through electronic devices and telecommunication technologies. What can one possibly do if he or she lives in a different country and is pushed to an emergency situation where he requires medical advice from a physician who lives in another corner of the world? Of course, through telecommunication devices, the whole process of exchanging information becomes smoother and easier. Several health-related services such as medical advice, medical care, monitoring, education, remote admissions, and intervention can be extended to a long-distance patient with the help of telehealth facilities. Hence, the contemporary picture of health and medicine has been radically improved with the introduction of these electronic telecommunication systems.

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Health Technology, Digital Healthcare

Modernizing Caregiving: How a Robotic Emotional Support Animal Can Help Caregivers

Article | August 21, 2023

A wealth of evidence supports the health benefits of keeping pets: increased life span, exercise, improved mental health, and a sense of purpose. But for older adults and those with disabilities, the responsibilities and expense of owning an animal can be overwhelming, and caregivers are often forced to take on those burdens themselves. To make matters worse, dementia patients can pose a physical threat to live animals. What alternate solutions exist for those who cannot safely or practically keep a live pet? Fortunately, information technology and robotics have advanced to the point that realistic, robotic emotional support pets are becoming a legitimate option. As research in this area advances, experts have found that robotic emotional support animals can offer a myriad of benefits similar to those associated with live pets. Robotic companions can also help caregivers. Robotic Emotional Support Animals in Practice Imagine the following scenario: An elderly woman with dementia suffering from Sundowner’s Syndrome relies on a strict daily regimen established by her caregiver. This routine is a delicate dance, balancing the patient’s meals, medication, and personal care, all designed to keep her as relaxed as possible. One afternoon, as the caregiver prepares dinner, the caregiver realizes that the patient’s beloved dog is nowhere to be found. She runs outside to look for the dog, leaving the patient to fend for herself. The patient is agitated over her missing dog and suddenly alone in a kitchen with pots and pans boiling. Fortunately, the caregiver finds the dog outside, but the patient is now too overwhelmed to eat or take her medication. Despite the caregiver’s best efforts at redirection, it’s a rough evening for everyone. How a Robotic Emotional Support Animal Can Ease the Role as Caregiver As any experienced caregiver knows, consistent emotional support for patients is critical. A robotic emotional support animal can significantly ease a caregiver’s role in this respect. Robotic companions replicate many benefits traditional pets provide – affection, responsiveness, and companionship – without the associated caregiving demands, such as feeding walking, or veterinarian visits. The Benefits of Robotic Emotional Support Animals The owners of pets are known to enjoy Reduced impact of depression Lower blood pressure Reduced triglycerides and cholesterol Longer survival rates after a heart attack 30% fewer doctor visits after age 65 Longer life spans Robotic companion animals provide genuine comfort, mirroring the emotional connection that living pets provide while lightening the caregiver load. Uplifting conversations about the robot companion elevate the moods of both patient and caregiver, potentially reducing feelings of burnout. In embracing such technology, senior care and assisted living facilities can foster an environment that makes staff and residents all smile a little more.

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Health Technology

Six Ways Technology Can Help Dialysis Centers Strengthen Their Revenue Cycle

Article | February 19, 2022

Dialysis providers face many of the same financial and operational pressures that affect other provider organizations, including flat or reduced reimbursements, chronic staffing shortages, and increasingly complex insurance requirements. Dialysis centers, nephrologists, and renal pharmacies also grapple with the impact of a growing shift in dialysis care to the home setting. End-to-End Automation Can Reduce Denials, Improve Cash Flow The good news is that despite these challenges, dialysis providers can sustain strong cash flow, reduce costs, and mitigate denials by applying advanced technology to the revenue cycle. Here are six ways technology can help strengthen the dialysis center revenue cycle in the today’s difficult operating environment: Identify undisclosed insurance coverage Because patients often present as self-pay even though coverage exists, determining their true insurance status can be challenging. Yet failure to identify existing insurance can result in significant write-offs. That’s why renal providers need technology solutions that can uncover patient coverage information before care is provided. Change Healthcare’s Coverage InsightTMsolution provides an expansive network and search-and-matching capabilities necessary to identify and confirm patient coverages at the outset of care. The solution uses machine learning algorithms—coupled with access to vast stores of available third-party-data—to develop robust patient profiles, which can then be linked to potential funding sources. Notably, it identifies a variety of indicators, including high probability of disability, income levels and financial status, insurance sources, and other actionable information to help you verify coverage and recover revenue. We can help identify undisclosed coverage for end-stage renal disease (ESRD) patients through Medicare/Medicaid, Disability/SSI, third-party liability, commercial insurance, state and county programs, social programs, and charity. Expedite seamless prior authorizations Streamlining the prior authorization process is essential to help ensure optimal reimbursement for renal care rendered, particularly with commercial insurance and Medicare. But traditional prior authorization processes are frequently time-consuming and labor-intensive and can delay necessary care. Our Clearance Authorization software addresses the chronic problem of prior authorizations with automated functionality that can determine if prior authorization is required and on file with the payer. The solution also will automatically check medical necessity requirements at the time of registration and electronically submit requests to integrated payers. Change Healthcare’s Connected Authorization Services go a step further by deploying pre-authorization experts to handle routine authorizations quickly using intelligent technology while working complex cases by exception to improve authorization efficiency and accuracy. Speed adjudication with electronic attachments As claims management processes have grown more numerous and complex, providers have struggled to ensure that the correct information is provided to the payer at the appropriate time. The result can be delayed, denied, or rejected claims. Assurance Attach AssistTMcontributes to faster reimbursement and reductions in denials, organizational expense, and administrative burden by automating the attachments process to meet payers’ increased demands for additional documentation. Attachments are automatically delivered and matched to the appropriate claim, and once the claim is released, claim and attachment status can be easily tracked. Expedite claims workflow for recurring services Creating claims for ongoing ESRD care requires repeatedly documenting the same details on each claim. Revenue Performance Advisor, an end-to-end medical billing platform, provides automation that allows dialysis staff to save time by quickly replicating unchanged data from prior visits while updating date-of-service and other information to expedite claims processing. Revenue Performance Advisor also includes eligibility and benefits verification and automated claims scrubbing that flags incomplete or incorrect claims prior to submission, resulting in a first-pass clean claim rate of 98%. Accelerate your Medicare claim cash flow Medicare is one of the largest payers of dialysis services, so ensuring a problem-free and expedited Medicare claims submission process is essential to strong cash flow. Our Assurance Medicare Direct EntryTMsolution provides a single system for the real-time submission and processing of Medicare claims. It can help expedite reimbursement, reduce AR days, and speed your Medicare primary claim cash flow by at least one full business day. Assurance Medicare Direct Entry also checks your Medicare claims for eligibility errors using the CMS eligibility transaction system (HETS). Claims needing attention are flagged and posted in Assurance Reimbursement Management for editing. You can quickly correct errors within the system before transmitting the claim directly to Medicare for validation and payment processing. Optimize patient liability Making it easy for patients to receive, understand, and pay their portion of the medical bill is key to ensuring a healthy revenue cycle, mitigating the need for collection services, and improving patient goodwill. With our Patient Billing and Statements solution, Change Healthcare serves as your strategic communications partner, delivering multi-channel, personalized print and digital statements to help expedite patient payment collection. The solution is designed to provide fast, effective statement and invoice processing, printing, and mailing—cutting your costs and getting you paid sooner. Our advanced statement printing allows you to bypass conventional and time-consuming folding, stuffing, and stamping. SmartPayTMconsolidates each step of the billing and payment process into one place, enabling you to collect more patient payments, get paid faster, reduce your collection costs, and lower patient write-offs. With multiple payment channels, including online, mobile, telephone and via mail, SmartPay helps expedite patient payments before, during, and after the encounter. A single, trusted partner Change Healthcare’s deep knowledge of the renal care landscape and our development of disruptive technologies to overcome traditional revenue cycle barriers can help dialysis centers achieve unprecedented revenue cycle excellence. And unlike many point solutions that only address a specific revenue cycle issue, Change Healthcare’s technologies are part of a comprehensive approach delivered through a single, trusted vendor. That translates into improved process integration and continuity, as well as simpler overall accountability.

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Spotlight

Saint Thomas Health

Saint Thomas Health (STH) is a faith-based ministry with more than 6,500 associates serving Middle Tennessee. Saint Thomas Health's regional health system consists of five hospitals - Saint Thomas West, Saint Thomas Midtown and the Saint Thomas Hospital for Spinal Surgery in Nashville, Saint Thomas Rutherford in Murfreesboro and Saint Thomas Hickman Hospital in Centerville - and a comprehensive network of affiliated joint ventures in diagnostics, cardiac services and ambulatory surgery as well as medical practices, clinics and rehabilitation facilities. STH is a member of Ascension Health, a Catholic organization that is the largest not-for-profit health system in the United States. For more information, visit http://www.sths.com.

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