Health Information Defined

Health Information Defined

Health information sounds like a vague and ambiguous term. It means different things to different people. In this article, Nitin Chhoda ‘breaks it down’ and defines health information in a manner that makes it meaningful for a private practice owner.

Nitin also highlights the implications of health information (and its privacy) for your practice.

health informationAs a general term, health information can be any information that relates to health. However, in a medical information management context, health information has a more specific meaning.

Health information refers to medical records, health records, and communication regarding patients that is sent between hospitals, doctor’s offices, health insurance companies, and anyone else in the health care industry, physical therapy management practice included.

Health Information and Technology

As technology improves, health information that must be transferred between clinics, or even between a clinician and nurses in the same practice, is traveling faster.

That means that we now can send sensitive and personal information with a single keystroke.

The technological improvements that are coming to all medical clinics are making communication simpler, faster, and more efficient, but some worry that health information will not be managed as well as before. A paper document is somewhat cumbersome when compared to electronic medical records or electronic health records.

Due to concerns about security and privacy, an entire industry has grown up around health care information management. But the management of health information didn’t start as a technological career – health information management has been around in the United States since the late 1920s. It is now possible to earn a degree or certificate in health information management.

The Skilled Professionals

Naturally, with improvements in technology there has been an increase in the need for skilled health information professionals who are also technologically savvy. In fact, many information health professionals are in favor of moving to entirely electronic systems to manage medical records and health records.

Medical records are used internally, within a single clinic or practice, but often must be accessed by more than one person. Nurses and clinicians, as well as receptionists, may need to know what is going on with a patient so that the proper tests are scheduled and performed.

Having an electronic medical records system allows for quick and easy access for everyone charged with caring for a patient. The same can be said for electronic health records, and many health information managers will say this is an area where electronic records are even more beneficial.

Electronic Health Records

Health records that must be passed from a surgeon to a primary care provider, or from a doctor to a physical therapist, can be more easily, efficiently, and securely transported using electronic health records.

health information definedHealth information can also refer to the various forms and paperwork that is passed back and forth between a healthcare provider and a health insurance company.

For every insurance claim, healthcare providers must fill out certain paperwork and ensure that there are no mistakes.

This form of health record can cause problems when it is not filled out correctly, as an insurance company can reject a claim even if a small mistake is made.

Health information professionals often encourage healthcare providers to use electronic systems because electronic health records tend to be more accurate and are less likely to be filled out incorrectly than paper records.

HITECH Act Explained

HITECH Act Explained

HITECT Act was created aside from the pre-existing HIPAA laws to strictly implement the patients’ security of information. Nitin Chhoda explains the difference between the two, and how they are connected to each other.

HITECH act explainedHITECH Act Protections for Patients

HITECH Act or the Health Information Technology for Economic and Clinical Health Act expands on the already existing HIPAA regulations protecting patient health information.

The result is that healthcare practice management providers must take certain steps when privacy issues arise.

If sensitive and personal health information has been stolen or possibly viewed, HIPAA covered hospitals or medical facilities must notify their patients within 60 days.

Within the HITECH Act, the term breach is used to mean

“unauthorized acquisition, access, use or disclosure of protected health information which compromises the security or privacy of such information, except where an unauthorized person to whom such information is disclosed would not reasonably have been able to retain such information.”

A breach of patient health information not only requires the medical clinic to report to the patients, but also to a major media outlet and to the Secretary of the Dept of Health and Human Services.

The HITECH Act even outlines what must be included in the notice, including the date of the breach as well as the date of discovery of the breach along with a description of what happened. Other information that must be included:

  • Steps that patients can take to avoid potential harm.
  • Description of what was stolen or viewed.
  • Description of what is being done by the medical clinic to minimize damage, investigate what happened, and avoid a similar incident in the future.
  • Contact information so patients can call, email, review, or write to the company for more information or if they have questions.

HITECH Act explainedWhile some of the information in the HITECH Act may be familiar because it relates to pre-existing regulations from HIPAA, the major difference will be enforcement.

HIPAA is thought to provide these protections, but it is also considered to be very poorly enforced.

The HITECH Act puts enforcement as a top priority and includes hefty fines for what has been termed “willful neglect”, a very imprecise term that will be defined by cases in the future.

Additionally, the HITECH Act puts more pressure on “business associates” of healthcare providers. HIPAA allows these business associates to have access to information via contracts.

But now they will be held responsible for breaches in a more comprehensive way. Providers of EMR or EHR systems are considered business associates and will have to consider HIPAA security and privacy rules when designing EHR or EMR systems.

Incentives for Healthcare Providers

The HITECH Act isn’t all focused on procedure, however, and as it is part of the American Recovery and Reinvestment Act (ARRA), there are also some incentives for healthcare providers.

Most of the incentives focus on promoting the use of electronic medical records and electronic health records. Because electronic records cut down on long term costs, but require an initial investment that many clinics don’t want to make, ARRA and the HITECH Act offer financial benefits if you make the switch.

HITECH Act : Economic Stimulus for EMR Adoption

HITECH Act : Economic Stimulus for EMR Adoption

Nitin Chhoda reveals a few ways that the HITECH Act can help a private practice switch to an electronic medical records system using a limited budget.  He also shares the requirements needed so that the practice can qualify with the HITECH Act incentives.

HITECT Act While the HITECH Act may help improve the safety and security of electronic medical records keeping systems, the aspects that clinicians and healthcare providers are excited about is the incentives.

The HITECH Act provides financial encouragement to clinicians, hospitals, and medical practitioners for the “meaningful use” of electronic medical records. A total of $19 billion has been allocated for incentives.

Financial Benefits

There are some great financial benefits to switching to electronic medical records anyway, but the HITECH Act makes things even easier. Physicians could qualify for as much as $44,000 for electronic health record implementation and use over the five years that the Act is funded.

The incentives only apply to the Medicare and Medicaid programs, but they can only get incentives through one program at a time. This means that they can also accrue incentives through one program and then when that runs out, they can accrue the same amount through the other program.

The incentives were also meant to encourage providers to adopt EMR systems for HITECH Act as soon as possible. One deadline was for 2012, and next year the incentives will be lower than they are this year.

And after 2015, medical practices will start to incur penalties if they have not switched to an EMR, starting with a 1% Medicare fee reduction. After 2017, that fee reduction is increased to 3%, an after 2019 the fee reduction will be increased to 5%.

Regional Extension Centers

In addition to financial incentives for adoption of EMR, the HITECH Act also funded 70 regional extension centers that can provide administrative help and guidance for health care providers attempting to make the switch to EMR.

Specifically, these regional extension centers will help “providers select the highest-value option, defined as that which offers the most favorable cost of ownership and operation, including both the initial acquisition of technology, cost and implementation, and ongoing maintenance and predictable needed upgrades over time.”

However, there is no requirement that health care providers use the regional extension centers unless they need help implementing an EMR.

HITECH Act stimulusQualifying for HITECT Act Incentives

The most important requirements for qualifying for HITECH Act incentives for EMR adoption are the proper selection of an EMR system and understanding “meaningful use”.

There are a total of 25 meaningful use criteria, and health care providers must demonstrate 20 out of those 25. Fifteen criteria are pre-determined by the HITECH Act, and out of the final ten, you must choose five. The criteria are measured in three stages over five years.

The first stage of HITECH Act requires that you use a certified EMR system and document set percentages of criteria electronically.

You will also be required to use the reminders and warnings systems that certified EMR systems have, share patient information, and report public health information and quality measures.

The second state of HITECH Act requires that you also send and receive lab results and other information using the EMR.

The third stage of HITECH Act requires that you also enroll patients using public health records, access patient data, improve population health, and report on national high priority conditions. Other criteria may be added in the future.

Medical Management: Defined

Medical Management: Defined

Medical management in today’s world is not as simple as it was decades ago. Many practitioners believe they need to extend their education in order to properly manage their clinic. Nitin Chhoda defines medical management practice in the 21st century.

medical management definitionClinicians and other healthcare practice management professionals spend a lot of time getting a thorough education. Unfortunately, their medical knowledge is not supplemented with quite enough business and medical management study.

Private Practice Trends

Some clinicians opt to get an additional degree in business or medical management so they can comfortably run a private practice. However, that is the exception and not the rule.

There has been a recent trend in private practices where clinicians are finding themselves in financial trouble due to mismanagement of expenses, billing, and health insurance companies refusing to pay for the provided care.

In some ways, the problems of private practice physicians in medical management are not their own fault at all. Insurance companies change their policies frequently, and what was billable one week may not be billable the next.

Additional Education

In response, new degrees and a new career path have been forged so clinicians or their staff can be educated about dealing with the particular challenges of running a medical practice. A medical manager is also often called the healthcare administrator, health services manager, or healthcare executive.

For those interested in medical management careers, you must complete at least a bachelor’s degree in business or a related field, and a master’s degree is highly recommended. The Bureau of Labor Statistics estimates that medical management is growing more rapidly than many other fields due to projections of an increase in demand for medical services over the next decade.

Medical management combines strategy, information management, and leadership for building and managing a successful health care practice.

Components

One of the major components of being able to manage a medical practice is having an understanding of the laws and requirements that health care providers must adhere to, such as HIPAA and the HITECH Act.

medical management definedClinicians are usually concerned with being able to do their job and take care of their patients as best they can.

What a medical management professional can bring to a private practice should include everything else, from understanding how to implement an EMR and EHR system to reporting to government agencies and ensuring that the practice is eligible for tax breaks and HITECH Act incentives.

The health care industry is changing rapidly and clinicians who run a private practice are starting to pay for inattention to administrative and management duties which they do not really have the time to handle.

There are medical management systems that attempt to streamline the way that medical clinics handle administrative tasks, such as billing, scheduling, and health insurance filing.

In fact, most EMR systems are equipped to handle medical management tasks as well as medical records. EMR and EHR systems will include scheduling and billing organization and reminders so that the clinic can be more efficient.

They can also ensure that the proper paperwork is filed for Medicare, Medicaid, and health insurance companies. Claims are often rejected due to illegibility or errors in the paperwork, and EMRs attempt to do away with those kinds of mistakes and rejections.

Health Care Management Overview

Health Care Management Overview

EMR reports can help assist management on deciding whether or not to add more staff. Nitin Chhoda shows managers how EMR can help uncover issues by providing reports based on the needs of the physical therapy practice.

health care management overviewWe don’t tend to think of health care practice management as all that different from any other kind of management.

But it turns out that health care management has to adapt and change policies more quickly than almost any other field.

The business side of running a practice involves a complex billing structure, high regulation, and constant updates.

Health Care Management at its Most Basic 

The most basic definition of health care management can be summed up as the role an office manager plays in a health care practice. An office manager must be aware of the tasks of every staff member; they should be able to re-assign tasks or jobs as necessary.

Often it is the health care management that keeps a practice running smoothly. A health care manager may simply be the person in the office who does not see patients or handle a easy-to-define work load, simply so that when problems arise, there is someone to take care of things.

Today, the health care management role has changed to include monitoring efficiency and making administrative changes. With the introduction of electronic medical records, electronic health records, and technology that can track financial indicators, improving efficiency is not only possible, it has been made much more simple.

Health care management is often in charge of deciding what kind of technology to invest in. Increasingly, this means conducting analysis on current systems and workflows.

The Future of Health Care Management

Health care management is not only changing in the way tasks are delegated, but it is also experiencing the same growth as every other aspect of health care. The health care industry is rapidly approaching a level of demand that has never been seen before, thanks to the baby boomers.

This means demand for skilled employees is going up, too. This is true of certified positions such as x-ray technicians and ultrasound tech, but it is also true for management positions.

As the industry becomes more and more streamlined and efficient due to technology, each added employee turns into a significant benefit to the practice. If demand for services is overwhelming, then the only way to increase capacity is to hire more staff. Health care managers have to analyze the benefit of added staff and then manage the integration of new team members.

health care management outline

Technology is Changing Everything

For health care management programs, technology improvements are both a blessing and a curse.

On the one hand, office managers have to be adaptive, tech savvy, and they have to know how to implement software improvements. On the other hand, the job is changing so fast that it can be hard to know what it means to be hired as the office manager.

With EMRs tracking the number of cancelled appointments that never get rescheduled as well as statistics on referrals and number of visits per patient, health care management is turning into a more technical job. Drawing up reports on efficiency can show health care management how much work needs to be done to reach the goals of the practice.

Health Care Practice Management Present and Future

Health Care Practice Management Present and Future

Nitin Chhoda shares the state of health care practice management from the past and how it will affect the future. He shows how the role of management and its staff are evolving as technology enters the physical therapy business.

health care practice management futureEven though the tasks assigned to health care practice management staff have been around for as long as hospitals have existed, the job of health care administrators is relatively new and is constantly changing.

Handling medical records and medical billing is a big job. For very small practices, these jobs used to be the tasks of the health care practice management, usually in the form of an office manager.

But today, health care practice management involves so much more, and tasks like medical billing and coding are handled by specialists.

The current role of the health care practice management staff involves a lot more analysis and efficiency management than ever before, largely due to changes and improvements in technology.

The role of electronic medical records (EMR) in this change cannot be emphasized enough. Electronic health care practice management technology has allowed health care management to take advantage of data that was previously too time consuming to extract.

Health Care Management Focuses on Patients

Of course, all these technological improvements might lead health care practice management consulting professionals to spend more time with charts and graphs than dealing with patient concerns. But that is not entirely the case. In fact, analyzing performance of the clinic will serve two purposes.

Firstly, identifying problems with efficiency will provide many advantages to the doctors, nurses, clinicians, and entire staff of a hospital or practice. Many health care practice management professionals will be quick to look for ways to save money, which is another advantage of EMRs and using the technology that is available today. But most of the changes that help the practice’s bottom line have other benefits, too.

The second purpose of looking for inefficiencies by using data on outcomes, re-scheduling rates, and visits per patient is to identify where patients can be better served. This is the tangible benefit that technology can bring when used the right way.

Number of Patient Visits

As an example, imagine that some clinicians only see a patient three times before the patient can go back to life as usual but other clinicians spend at least five visits with each patient.

healthcare practice management presentUsually, in a busy office, you would never even notice a pattern of health care practice management like that.

Clinicians tend to know just how often they need to see patients, based on past experiences and what they were taught.

But if you could see that patients with the same complaint were given a more effective treatment or series of treatments, you could find out what it is that efficient clinician is doing.

Health Care Practice Management, a Delicate Balance

It’s easy enough to see how this kind of information could be misused. And it is likely that we’ll see plenty of cases of disgruntled staff members who are frustrated by statistical analysis and being treated as if they aren’t doing a good job.

Health care practice management in the future is going to be more and more a job focused on efficiency. But there are important human elements that must always be kept in mind so a practice is really running the best it can. Unhappy staff are not the way to make things better.