Designing, opening, managing, and maintaining an outpatient wound care department take time, dedication, and ongoing focus. Managing volume and supporting your clinical, operational, and financial outcomes are key areas for success. Utilizing a comprehensive, interoperable specialty electronic health record (EHR) with smart workflow synchronization is key to driving compliance with the ever-changing rules, regulations, and findings performed within your department.
Documentation that supports regulations needs to be mapped within the specialty EHR itself. Specific wound care elements and medical necessity requirements are essential for compliant patient records. Clinical and operational wound care triggers, outlier management, and coding and billing requirements are also necessary to drive your facility’s standards, enhance outcomes, and optimize reimbursement.
The most critical step to a successful specialty EHR implementation is conducting a workflow analysis. This analysis maps current clinical processes and data flows, identifies gaps with industry best practices, and produces recommendations for improvement through collaboration with clinical team members. It is paramount that the clinic’s workflow is implemented correctly and the software is customized to suit your facility’s expectations of staff and providers. These steps will also drive a higher adoption rate of the EHR.
We are reminded of the importance of accurate workflows and documentation through the recent findings from the Office of the Inspector General.1 Read the findings and recommendations below and ask yourself: Does the documentation in my EHR support the full scope of wound care performed? If not, why? Do I need to update my workflows or processes to capture additional information to meet medical necessity? Does my EHR solution allow more details about wound care documentation and services? A specialty wound care EHR is an important step in the compliance process.
“For this review, we focused on one Medicare administrative contractor, Wisconsin Physicians Service Government Health Administrators (WPS), because of the high volume of paid outpatient claims that contained hyperbaric oxygen (HBO) therapy services.
Our objective was to determine whether WPS paid providers in 2013 and 2014 for HBO therapy services that complied with Medicare requirements.
To read the full article in “Advances in Skin & Wound Care” by Cathy Thomas Hess, click here.
Read previous articles in “Advances in Skin & Wound Care” by Cathy Thomas Hess in the link.
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Cathy is Chief Clinical Officer for WoundExpert® and Vice President at Net Health, and in addition to being the MIPS Clinical Consultant for WoundExpert. She gained over 30 years of expertise in various acute care, long-term care, sub-acute care facilities, home-health agencies, and outpatient wound care department settings. Cathy is the author of Clinical Guide to Skin and Wound Care (also translated into Italian and Portuguese) – Eighth Edition published in September of 2018.
