Though many find it fulfilling, working as an IT professional in the physician practice side of healthcare is quite a challenge. There are numerous responsibilities and a shortage of the necessary resources to do the job—including budget.
So, how can healthcare IT professionals employed by physician practices, billing agencies and coding vendors overcome these challenges? And what steps can their organizations take to mitigate the risk of IT failures that negatively impact the professional fee revenue cycle? It all starts with a look into the network’s overall infrastructure.
Here are the top three IT challenges faced by private medical practices and their billing partners:
- System integration within physician practices
Larger practices and medical groups manage myriad IT applications, each requiring manual transfer of data from system to system. This practice of siloed systems—also known as technology stovepipes—often leads to delays and increased expenses due to duplicate efforts when systems are not working together. The ideal solution is to eliminate the need for manual work by integrating these systems wherever possible and enabling interoperability. Enter the HL7 Interface.
HL7 is one of the best interoperability tools for healthcare. Within physician practices, siloed systems should be able to communicate about scheduling, nursing, etc. HL7 enables this capability in real time. Three ways for IT professionals working in the physician practice setting to improve success with system integrations include the following:
- Ensure the EMR is customized specifically for the physician practice and all of its moving systems
- Properly train and educate clinical staff to use the system correctly
- Insist that all IT service providers and third-party vendors use the HL7 interface to support and collaborate on the integration
- IT security, privacy and data integrity
The technology landscape is ever evolving, along with IT security, privacy and data integrity challenges for physician practices.
To protect both sides of the IT environment—technology and operational processes—practices must go beyond generic security guidelines to produce detailed proof of their systems’ capability to follow HIPAA’s security rules. It is also imperative to uphold patient confidentiality through solid record management policies, operations, and staff training according to the HIPAA Privacy Rule. Finally, healthcare data accuracy is essential to ensure dependable patient care, efficient clinical communication and compliant billing processes.
Due to budget restraints, many practices find it difficult to meet these high standards. However, there are several obtainable solutions to overcome those challenges:
- Contract with a third-party firm to perform privacy and security assessments and staff training
- Designate a multi-skilled staff member to focus on privacy, security and data integrity—perhaps offering an incentive for the added effort
- Task your BAs and third-party vendors with overseeing the systems and services they provide, through documented HIPAA compliance and staff training as part of their Business Associate Agreement (BAA)
- Use online resources for physician practices—including those provided by healthcare associations such as HBMA, MGMA and others
- Coding and billing technology workflow
The third technology challenge physician practices and their billing partners face is the management of the professional fee revenue, especially coding and billing processes. Most critical is when hospital patient data incorrectly flows into physician practice EMR systems. In this case, coding and billing can be severely interrupted.
Attention to detail is vital when using a third-party agency for medical billing and coding. Workflow and data “handshakes” are critical. One hiccup can lead to subsequent complications, unraveling the entire process.
The solution to this IT challenge: Invest in a verifiable chain of custody for each chart and piece of data.
- A verifiable chain of custody guarantees that each data element is tracked through the entire process.
- Chain of custody is protected and quickly moves through the billing workflow.
- Inconsistencies are identified and addressed early in the coding and billing workflow to prevent claim denials.
Building the right technology team
Managing healthcare IT in physician practice environments is a challenging maze to navigate. Therefore, it is important to have a strong technology team in place to address the complexity of your technology needs.
When building your team, assess the attributes required, ensuring candidates have experience working with limited technology budgets within small to medium-sized organizations. Further, team members must understand the specific requirements of your practice.
Building the right technology team helps ensure your practice or coding and billing organization can efficiently and effectively combat even the most common IT challenges, while protecting patient information and providing the best care in this technology-driven time.