Hospital and Commercial Labs to Get Educated on Key Reforms to Order Processing at Executive War College
One recent study found that 52 percent of studied claims were riddled with lab testing errors, and accounted for 55 percent of indemnity paid in malpractice suits involving injury or death.1 Another persistent problem, lab specimen mislabeling, costs the lab dearly with each mistake. One 2010 study put the figure at
Patient identity mistakes also creep into the outreach lab, putting patients at risk and costing the average hospital considerable sums each year in denied claims. Further, a Black Book survey recently found that 18 percent of the average hospital's patient records are duplicates—and in the absence of master patient index solutions, hospitals achieve only a 24 percent match rate when exchanging records with other organizations.3
Given this concerning backdrop, 4medica executives, including company president
Of note, this year's
"Now we're aiming to take orders and results management to the next level, reforming the order process to reduce the great risk to patient safety that comes with improperly submitted orders. While these originate with providers, labs can be the heroes who prevent the mistakes they contain from harming patients," said Church.
He added, "It won't cost a big investment to do so, either. The perfect order has built-in measures to reduce claim denials, confirm financial clearance, and increase more payment at the point of service, which help these reforms pay for themselves."
The following core elements enable labs to process this "Perfect Order."
Electronic ordering. Many lab and imaging facilities still see over 50 percent of their orders transmitted via handwritten or EMR-printed requisitions. That's out of step with today's expectations for expediency, but even more seriously, increases the likelihood of error. For those facilities that want to modernize without a major technology overhaul, 4medica offers several options to capture orders electronically from each physician's practice—including EMR interfaces, web-based ordering/resulting portals, and paper-to-digital conversion services.
Patient identity matching. Accurate patient data and zero duplicate records is the lab's formula for making sure the right test is ordered for the right patient--and the right results are delivered to the right patient, too. With the 4medica Big Data MPI tightly integrated into the lab ordering process, patient records are scanned and matched in milliseconds. The end goal is to prevent overlays, one of the most serious clinical risks among hospital and commercial labs today. 4medica's core mission with all of its clients is to provide 4medica MPI-enhanced orders and results—assuring there is "one patient, one record" for every patient identity.
Revenue cycle management. Given today's declining reimbursement environment, labs can no longer take a passive approach to billing and depend on the provider or other hospital department to protect revenue. Instead, labs can maximize revenue with 4medica's proprietary workflow that delivers electronic orders fully verified for medical necessity, correct patient identity, insurance eligibility and pre-authorization. With the addition of accurate patient cost estimates, labs can collect payment at the point of service.
Members of the media and others interested in meeting with 4medica at
About 4medica
4medica provides the industry's leading SaaS (Software-as-a-Service) Big Data MPI and clinical data exchange platform to help healthcare organizations of diverse types create a seamless view of the patient care experience and further drive better health outcomes. The 4medica Big Data MPI and ClinXdata Clinical Data Exchange platform integrate with and build upon disparate systems to facilitate patient identity management and interoperable data exchange across various care settings to promote care continuity. The cloud computing model is scalable, lower cost, maintenance-free, easy to use and deployable in a few months or less, eliminating large capital outlays or resource utilization. 4medica connects hundreds of organizations including ACOS, HIEs, hospitals, health systems, physicians, laboratories, and radiology imaging centers. Learn more at www.4medica.com and www.bigdatampi.com.
1 https://coverys.com/PDFs/Coverys_Diagnostic_Accuracy_Report.aspx
2 http://www.cap.org/apps/portlets/contentViewer/show.do?printFriendly=true&contentReference=practice_management%2Fdirectips%2Fmislabeled_specimens.html
3 https://www.fiercehealthcare.com/finance/patient-matching-technology-costs-1-5-million
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