Paper, Paper Everywhere but Not a Drop of Ink Commentary 

Paper, Paper Everywhere but Not a Drop of Ink

A recent article on titled “UCSF Nurses Want Someone To Build These Products” By Fiahna Cabana, Desiree Matloob, and Priyanka Agarwal includes the following: ‘Frontline nurses attend to almost all of a patient’s basic needs. In doing so, they often juggle up to 25 pieces of paper with critical information. Ideally, nurses could use charting software that would help... Read More
VA Ready to Junk Vista Commentary 

VA Ready to Junk Vista

For as long as anyone can remember, the US Dept. of Veterans Affairs (VA) has managed patient data on VistA, their EHR system that was started in the 1970s. VistA consists of 180 different applications for clinical, financial, administrative and infrastructure functions in the VA. The Computerized Patient Record System (CPRS) represents the common clinical graphical user interface started in the... Read More
Garbage in Ratings Out Commentary 

Garbage in Ratings Out

As CMS continues to evolve quality reporting requirements for hospitals and nursing homes, the law of unintended consequences can come into play as administrators struggle to raise their ratings. In a recent article on Bloomberg News titled New CMS Nursing Home Ratings Don’t Solve Accuracy Issues, Senator Michael Williamson reports the following: “Increasing the number of measures on which nursing homes must... Read More
Goldilocks and the Three Bears Commentary 

Goldilocks and the Three Bears

In a recent article on titled “EHR Re-evaluation and Replacement is on the Rise”, Stephen Campbell reports that the replacement market for EHR systems is being driven by ‘systems that are too complex (in form and function)’ and the trend to cloud-hosted systems that run on mobile devices. He defines the ‘Goldilocks’ Principle as finding the right application for... Read More
A Picture is Worth 1,000 Words Commentary 

A Picture is Worth 1,000 Words

Many patient conditions are difficult to describe accurately but can easily be captured by a digital photo. While most hospital EMRs will accept photo files, the process can be very cumbersome. A digital camera has to be found, the picture taken, then uploaded to the hospital EMR system through a PC. This not only takes time and multiple devices but... Read More
Medical Necessity in the ER Commentary 

Medical Necessity in the ER

Of all the criteria for a receiving a payment by Medicare, MACRA requirement to establish medical necessity seems to generate the most questions and discussion. With the introduction of ICD10 and the added complexity of coding for medical conditions, the debate over what constitutes medical necessity and how it should be documented runs high. Discussions with ER physicians indicate that... Read More