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“The Impossible Day” Issue with EMR Software

Posted on November 11, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In continuation of my posts about RAC auditors and other audit issues that EMR software can help or hurt, the following comment was sent to me by an EMR and HIPAA reader. Maybe all of you have heard of “The Impossible Day” but I found the concept interesting and it seems like EMR software could be well positioned to control this issue. Is this a major problem or only a problem for a few people that like to code too high?

The RAC audits are an interesting and mindful subject. Some practices have been getting into trouble with the “impossible day” which their EMR’s seem to help perpetuate. Some seem to end up with more documentation in files, but when RAC auditors do the math on how long the docs are supposed to be legitemately spending, its not adding up… Thereby “The Impossible Day” emerges.

I’ve asked some EMR vendors if there is some sort of a control feature with a warning on the total time based on visits/notes for a day. Most are not familiar with this. Just like anything else, if we hear more about it from the RAC audits, more will pay attention.

Medicare RAC Auditors and EMR

Posted on November 2, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Yesterday I addressed the possible caustic demeanor of insurance companies towards template based EMR documentation methods. Definitely something worth considering when you choose an EMR. How they document and the type of note that it creates matters to the insurance company, matters to you reading the note later, and to some extent the doctors who receive your notes on a referral.

Today let’s look at another possible problem with the ugly template note that many EMR systems like to employ (Note: The Jabba the Hut EMR vendors LOVE this type of note). This was sent to me by another reader (Yes, I have the best readers).

I know that Medicare RAC auditors apparently love the EMR systems as practices seem to be hanging themselves with poorly maintained patient notes; (ie. “sutures healing nicely “ in a current note for a surgery that is 2 years old). I guess some insurance payers are jumping on that same wagon of EMR note distrust as the RAC auditors.

Now I’m sure that none of those reading this blog would have poorly maintained patient notes. At least not intentionally. The problem with many of the template approaches to EMR documentation is that the above scenario easily happens in a busy clinical practice. Luckily there are a number of EMR software which don’t use this poorly designed template note systems.

As they say, Buyer Beware. It’s never been more true than when selecting and purchasing an EMR.