The clinical burden of documentation

KevinMD

The purpose of clinical documentation is to efficiently communicate critical data to peers in a readable fashion while meeting compliance and billing requirements. This documentation should not represent a data dump.

FHIR Documents (and other stuff)

HAY on FHIR

We’d likely think of a clinical note as a Document – a summary at a point in time that should be persisted in the clinical notes, and that leads us to the Composition resource. There’s a lot more to say about documents in FHIR – but hopefully this describes the basics.

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Telehealth Documentation

Telebehavioral Health Institute

How to Stay Out of Hot Water: Telehealth Documentation! Easy 3-Part TBHI Online Webinar Series) 6 CE Hours Available Have you updated your telehealth documentation to address recent state and association specific requirements? Reviewing your documents has never been easier.

Creating documents in clinFHIR 

HAY on FHIR

I did a demo of clinFHIR for the Clinicians on FHIR group that will be meeting at the Working Group Meeting next week, and completely forgot to talk about creating/viewing documents in clinFHIR using the scenario builder. Note the Document tab in the middle pane (next to the Graph).

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Medical documentation AI system Sopris Health raises $3.4M

Mobi Health News

The Denver-based startup designed an AI system that lets doctors capture their conversations with patients and transfer those notes to EHRs.

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Optimizing Process and Document Automation in Healthcare

Electronic Health Reporter

The article Optimizing Process and Document Automation in Healthcare appeared first on electronichealthreporter.com. Editorial Document Automation in Healthcare healthcare automation Nintex patient admissions Physician contract management

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Study: Examining the Clinical Documentation Improvement Landscape

Electronic Health Reporter

When hiring professionals for clinical documentation improvement (CDI) programs, managers seek candidates with a background in both clinical and health information management (HIM) knowledge—challenging a common perception that a clinical background alone is sufficient, according to a recent survey by the American Health Information Management Association (AHIMA). The article Study: Examining the Clinical Documentation Improvement Landscape appeared first on electronichealthreporter.com.

CMS's 2019 proposal makes broad strides in telehealth, interoperability, documentation

Mobi Health News

The Centers for Medicare and Medicaid Services released its new proposed Physician Fee Schedule and Qualified Payment Program updates for 2019, and the announcement includes some big strides forward in promoting digital health technology, including widened telemedicine coverage, an overhaul of documentation requirements, and a new focus on interoperability

Clinical Documentation Improvement Top Priority for Hospitals

BHM Healthcare Solutions

Editor’s Note: BHM watches health trends and understands the importance of improving clinical documentation and improving the industry. Hospitals are increasingly implementing clinical documentation improvement technologies, according to a Black Book survey.

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Documents, anonymous source describe Amazon's wearable, app for voice-based emotion detection

Mobi Health News

Codenamed Dylan, the system could be used to help an individual better communicate with others

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FHIR documents in XDS

Healthcare Exchange Standards

How does one put a FHIR Document into XDS? How does one find a FHIR Document in XDS? XDS, more broadly the whole Document Sharing family, including XDS , XCA , XDR , XDM , and MHD. Initially Document Sharing was about 'historic' documents. FHIR has a Document model.

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Study: Provider Experience Affects EHR Documentation Time

hea!thcare innovation - Clinical IT

It’s been widely-referenced that physicians spend large chunks of their days documenting patient encounters using electronic health records (EHRs), and now a new study has pointed to provider experience being a key factor in just how much time

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IHE Document Sharing (XDS) Metadata management Handbook

Healthcare Exchange Standards

The IHE IT Infrastructure Technical Committee has published a new Handbook as of August 20, 2018: Document Sharing Metadata The above document is available for download at [link] or at User Handbooks. Each document shared is described by metadata.

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Through AI text chats, Sopris Health's new app saves time on clinical documentation

Mobi Health News

Launched today, Sopris Health uses voice tech and simple Q&As to wrap up notes in less than a minute

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Basics of doing Document Sharing Query right

Healthcare Exchange Standards

Mostly they keep trying because the most basic query is just asking for all documents available for a given Patient. These are useful, just not very primary for a general purpose Document Consumer. Where these classifications are useful to a Document Consumer.

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House Dems demand documents on DOJ’s position in ACA case 

FierceHealthIT

The political back-and-forth about the legal fight over the legality of the ACA continued this week, as top Democrats demanded documents on the Trump administration’s position in the matter.

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Coffey Health's $250K settlement highlights meaningful use documentation risks

FierceHealthIT

Coffey Health System will repay $250,000 of the $2.2 million it received in incentive payments as part of a settlement with the Department of Justice over alleged False Claims Act violations

CMS new rule: Experts weigh in on big changes to clinical documentation, EHRs and interoperability

Mobi Health News

The "historic changes" announced late yesterday by the Centers for Medicare & Medicaid Services, promising big adjustments to its policies around the Physician Fee Schedule and the Quality Payment Program, already have the healthcare industry talking

Variation in physician EHR documentation can put patient safety at risk: study

FierceHealthIT

This variation—which leads to physicians searching different places in the chart for information or documenting the same information multiple times—is impeding safe and effective use of EHRs, according to a study published in the Journal of General Internal Medicine

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Medicare made $23B in improper payments in 2017 due to documentation errors, GAO finds

FierceHealthIT

Medicare made more than $23 billion in improper payments in 2017 due to insufficient documentation, according to a new Government Accountability Office (GAO) report. The GAO also found that Medicaid paid out more than $4 billion for services that were not fully or properly documented

CAQH CORE Outlines Five Areas to Improve Medical Documentation Attachments

hea!thcare innovation - Clinical IT

About 84 percent of attachments are currently being sent manually, leading to misinformation and delays

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CMS new rule: Industry reacts to big changes to telehealth, clinical documentation, and interoperability

Mobi Health News

The "historic changes" announced late yesterday by the Centers for Medicare & Medicaid Services, promising big adjustments to its policies around the Physician Fee Schedule and the Quality Payment Program, already have the healthcare industry talking

Improving Document Exchange Response with Asynchronous FHIR API

Healthcare Exchange Standards

This is just one step in the overall interaction that one does with a Cross-Community Document Exchange (XCA). Thus this Patient Discovery can take minutes before the second step of Query for Documents can happen. Thus the Query for Documents can be limited to just those 10.

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Multiple formats of the same Document content

Healthcare Exchange Standards

I propose that “The most technically advanced” document format be considered the Prime, with all of the other formats considered Transforms (XFRM) from that prime document. Thus if the Document Source can create a C-CDA 2.1; As proof, FHIR Documents will re-open this discussion.

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Telehealth Risk Management Checklist

Telebehavioral Health Institute

Blog Telepractice Documentation Guidelines checklist documentation How to Stay Out of Hot Water: Telehealth Documentation! Easy 3-Part TBHI Online Webinar Series) risk management Tarasoff Law Telehealth Documentation & Administrative Compliance

IHE ITI Document Sharing Metadata Handbook Published for Public Comment

Healthcare Exchange Standards

IHE IT Infrastructure Handbook Published for Public Comment The IHE IT Infrastructure Technical Committee has published the following new handbook for public comment in the period from June 13 through July 13, 2018: Document Sharing Metadata - Rev. The document is available for download at [link]. Those implementing or improving their XDS or XCA community are the intended audience of this Handbook. As a Handbook, it strives to inform on critical aspects of Metadata management.

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How Technology will transform the Future of Clinical Documentation

Lloyd Price

Dr Simon Wallace looks at how technology will transform the future of clinical documentation. As the NHS turns 70, it’s time we considered how Britain’s world-leading health service has transformed clinical documentation since its inauguration back in 1948.

IHE Document Digital Signature (DSG) Profile approved for Final Text

Healthcare Exchange Standards

Today the IHE ITI Technical and Planning committees approved the Document Digital Signature (DSG) Profile be moved into Final Text. This Document Profile defines a way to support Digital Signatures, including when those Documents are managed in a Document Sharing infrastructure.

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HIE future bright -- FHIR API to Document Sharing

Healthcare Exchange Standards

Initially I would focus on Document sized objects, Later moving to more element level. Likely move to publishing Documents before element level access For targeted Apps, that is the most highly vetted and trusted, they will be Reading and Writing at the Organization level.

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Travelers' online workplace injury claims tool brings document upload, telemedicine capabilities

Mobi Health News

The Travelers Companies announced yesterday that it would be adding new digital resources to improve healthcare and claims access for employee customers who have experienced a workplace injury

Aetna suspends whistleblower in CVS fraud case after she refused to destroy documents

FierceHealthIT

Behnke's attorney told FierceHealthcare Aetna placed her on leave requesting she destroy documents Sarah Behnke, an Aetna actuary that accused CVS Caremark of engaging in a massive fraud scheme, was placed on paid administrative leave days after her suit was unsealed.

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Epic, Nuance team up on voice assistance technology to help lighten doctor documentation burden

FierceHealthIT

Two major companies, Epic and Nuance Communications, have teamed up, hoping voice assistance technology in electronic health records is an answer to reducing the documentation burden for doctors

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Data Security: How eVisit protects your booty

eVisit

Telemedicine is easy, right?

Aetna asks court to force CVS whistleblower to turn over documents in fraud case

FierceHealthIT

Weeks after an Aetna actuary was placed on leave for refusing to turn over documents tied to a CVS fraud case, court filings show that the insurer requested a Pennsylvania court force her to turn over the documents protected under attorney-client privilege, vaguely referencing a "corporate investigation

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House lawmaker seeks to force release of documents on proposed Title X changes

FierceHealthIT

The ranking Democrat on the House Oversight committee is seeking a subpoena of documents regarding the drafting of the Trump administration's proposal for the Title X National Family Planning Program

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2nd Qtr Release Notes

Health Portal Solutions

Release Notes census report document management enrollment live chat mobile online enrollment screen sharingMobile Employer Portal, Screen Sharing, and More! Featured Enhancement: Mobile Employer Portal The first release of the Mobile Employer Portal is now available!

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House lawmaker requests documents about HHS scrubbing ACA information from websites

FierceHealthIT

He asked Secretary Alex Azar and CMS Administrator Seema Verma for documents related to the removal of ACA references on government-run websites, noting that it could be a violation of federal law Elijah Cummings, D-Md., who has requested information from HHS on several occasions, took another stab on Tuesday.

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Securing legacy medical devices is daunting – but not optional

Mobi Health News

Skipping out on comprehensive device documentation and risk assessment will cripple an organization's cybersecurity program, experts say

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Telehealth Informed Consent, Licensing & Other Telehealth Legalities

Telebehavioral Health Institute

Blog Uncategorized Consent Document ethical practice guidelines Informed Consent online therapy informed consent telebehavioral informed consent telemental health informed consentTelehealth legal issues are complicated, fraught with exceptions and in telecommunications, still unfolding. Also, many practitioners either fear them or do not understand telehealth legalities.

FDA's new draft guidance could hinder applications for digital combination products

Mobi Health News

Released yesterday, the document outlines FDA's preference toward single applications for combination products

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