- Mobile health technology is helping to make the cumbersome process of responding to physician queries easier for physicians, giving them more time to spend with their patients.
Often considered a necessary evil in the hospital-based physician’s busy workflow, queries are administrative tasks designed to make sure the physician’s notes are accurate and complete in the medical record.
The traditional process calls for CDI specialists or coders to contact the physician to clarify any uncertainties. That query often comes in the form of a note in the EMR or an e-mail, with no guarantee that the physician will respond immediately. That delays the process, leading to incomplete medical records and delays in coding and billing.
Now health systems are turning to mHealth to improve the clinical documentation query process. They’re deploying digital messaging platforms that send queries to the physician’s mobile device of choice, enabling him or her to review all the details and respond quickly.
Dr. Daniel J. Brotman, MD, an internist at Johns Hopkins Hospital in Baltimore, answers queries sent to his smartphone as quickly as he can, no matter whether he’s in the hospital, at home or at a soccer game.
“It’s good to be answering queries when the patients are still fresh in your mind,” he says.
Physician queries, Brotman says, are challenging. They fill up time between patient care duties, clutter up daily workloads and force physicians to sit down at a computer when they’d much rather be checking in on patients or doing other clinical tasks.
“This is really add-on work that doesn’t complement the workflow of taking care of the patient,” he says. “It’s administrative. It’s not really a part of doctoring, and it feels particularly burdensome to doctors.”
In fact, he says, these types of tasks often weigh down on a physician, causing stress and creating an increased risk of burnout.
mHealth companies have been working their way into the clinical documentation space for several years, offering cloud-based and mobile tools designed to speed up the process and give physicians tasks that they can do on their mobile devices at the time and place of their choosing.
Documentation queries are the perfect application for mHealth, Brotman says. They’re not so time-sensitive that they justify an interruption of the clinical workflow - yet it is best to answer them before a case can be coded and billed and while a patient is fresh in the doctor’s mind.
Marisa MacClary, co-founder and CEO of Artifact Health – one of several mHealth companies in the coding arena, and the one used by five hospitals within Johns Hopkins Medicine – says physicians often don’t realize how important the CDI process is to the health system’s financial sustainability.
“Physicians typically are documenting for the next provider of care,” she says. “They’re not thinking of coding.”
Coding drives quality metrics and scores, she says, and plays an integral part in how health systems and hospitals are ranked for clinical care. Incomplete medical records can lead to missed billing opportunities and even inadequate or wasteful care management.
“Every hospital has this problem,” says MacClary, who estimates that more than 60 percent of physician query responses have a positive financial impact on the patient record.
As a consultant during the early 2000s, MacClary says she noticed a number of claims that had been written off as bad debt because they were missing crucial data from physicians. A more effective physician query platform could have turned those claims into appropriate revenues.
An mHealth-based physician query platform can do more than pin the right codes to the right services, she adds. It can educate physicians on how they interact with the EMR, producing a more accurate and complete medical record of the patient encounter and reducing future physician queries.
“Doctors need fast and convenient technology solutions and prefer not to be tethered to the EMR,” MacClary says. “So while people may have been initially skeptical about doctors using mobile devices to answer queries, we’re finding the physicians we work with love the simplicity and convenience of it, and how quickly they can check it off their to do list and get back to taking care of patients.”
Brotman agrees. He also sees the mHealth platform helping the health system by making CDI specialists and coders more effective in reviewing information in the EMR and educating physicians on best practice documentation that aligns with coding guidelines. As physicians enhance the specificity of their documentation, the number of physician queries is reduced, and the process is improved.
“It puts work where it should go and gives physicians back valuable time for patient care,” he says.
Any mHealth solution that can simplify and streamline a back-end administrative task is a good idea, he says. If he can answer a query on his smartphone in a matter of seconds rather than minutes, perhaps while he’s grabbing lunch, sitting at home or watching the kids, it means he’s spent less time in front of a computer screen and more time taking care of his patients – and himself.