Every healthcare provider and institution is unique. Yet no matter what services you offer or who your constituents are, you and your peer institutions share at least two common goals:

A. Provide the best quality of care possible.

B. Get paid quickly and appropriately so you can continue offering care.

If only it were that easy.

The art of getting paid

Tom Brokaw once wisely said, "It’s easy to make a buck. It’s a lot tougher to make a difference." For healthcare institutions and providers, however, the opposite is often true: all hands are on deck in the effort to help people, but afterward, getting paid is challenging. It all boils down to accountability: having each piece of a patient’s information puzzle in place so you can prove the right services were provided and (finally) get the monies you deserve. Information must be gathered from multiple sources – including third parties – and fully reconciled. Chart deficiencies must be rectified. Unless paperwork is 100% complete and timely, payment may not follow.

Deciphering the requirements

Rulings such as the CMS July 13 "Medicare and Medicaid EHR Incentive Payment Program Final Rule on Meaningful Use" raise the bar for patient care as well as professional and institutional accountability. Standards and criteria for achieving meaningful use (of electronic information) have been set, along with mandated timelines. Whether the requirements are for clinical, research, or reimbursement purposes, each depends on something few manage well: the efficient exchange of patient information.

To get paid, patient information must be complete and correct. Few incentives are more effective for getting things right.

Coordinating the efficient, secure, electronic exchange of information – often scattered and on diverse paper and electronic media – is a vital step toward electronic health records (EHRs). Yet as practitioners work toward compliance, they fight another battle: protecting confidentiality of patients’ health information (and proving it).

So what does all of this have to do with enterprise content management (ECM)? Everything.

Satisfying mounting expectations

A powerful integration and information management tool, ECM bolts onto existing information systems, giving pre-authorized persons access to interact appropriately with clinical and administrative documents and systems. From doctors’ orders through lab tests, radiology reports, admissions, surgeries, prescriptions, billing, and more, a thoroughly integrated ECM system arches over clinical, HR, accounting, and other systems, providing a holistic view of patients’ treatments and transactions.

Make "exchange" happen

Workflow connects the dots, recycling meaningful information that’s available through ECM, wherever it’s needed. Patient information that is otherwise manually collected and replicated is extracted, then pushed or pulled to its intended destination via institutional rules – minimizing human involvement, increasing security, eliminating mistakes, and saving time.

Let’s examine how it works in three critical areas.

1. Deficiency Chart Tracking

Before requests for reimbursement can be made, all required forms must be on file. Missing signatures, insufficient documentation, and other deficiencies must be tagged; someone must be assigned to address them; issues must be resolved.

Workflow simplifies and expedites the process, letting you:

• Dictate which documents and transactions are required for documentation to be complete;

• Prioritize work based on deadlines, patient discharge, and other pertinent information;

• Electronically pull all relevant documents on demand or at a pre-specified point in the process;

• Ensure ECM’s security authorizations are respected;

• Automatically tag what’s missing;

• Route deficient files to pre-assigned persons for follow-up;

• Create prioritized work lists for each doctor so s/he can see what must be addressed;

• Compile completed documentation.

By capturing, storing , routing, and handling everything electronically, you also lay the path to meet a future requirement under meaningful use: electronic claims submission.

2. Invoice Processing

ECM and workflow bridge the gap between information stored in your clinical applications and the administrative files that accompany and support patient services. Together, they make invoicing easier, faster, and ensure accuracy by:

• Prioritizing invoices for timely payment;

• Matching purchase orders with requisitions and receipts;

• Gathering and packaging all pertinent backup documentation for invoice review;

• Routing invoices for approval;

• Answering vendor inquiries about payment status;

• Creating a clear audit trail of transactional activity every step of the way.

3. Keeping patients informed

New legislation acknowledges that patients need timely access to summary care records that they can understand. Information needs to follow each patient so s/he can make informed decisions. Getting information into clinical, ERP, and administrative systems typically isn’t difficult. However, extracting it on demand and into meaningful formats can be cumbersome, challenging, and frustrating for providers and institutions.

Underlying all of your electronic information systems, ECM becomes a pointer to scattered information, letting authorized persons access, view, annotate, report, and manage files according to their permissions. Complete, accurate, timely reporting – another benchmark in the process of enabling meaningful use – is a task designed for ECM.

Prepare for Success

Whether or not meaningful use rules directly affect you now, they are a big step toward EHRs, and EHRs are the future. ECM advances your readiness. By taking steps to embrace electronic recordkeeping now, your staff will transition gradually into a digital healthcare environment, and you’ll be positioned for EHR success. Not only will you offer better services and be compliant; you’ll meet your other main objective: to be paid for the quality care you deliver…so you can continue delivering it.