The pMD Blog

Welcome to the
pMD Blog...

where we cover interesting and relevant news, insights, events, and more related to the health care industry and pMD. Most importantly, this blog is a fun, engaging way to learn about developments in an ever-changing field that is heavily influenced by technology.


Source: Getty Images

Here's The Latest in Health Care:


Chili peppers aren’t for the faint of heart, but maybe they should be. According to a recent study, those who consumed the spice at least four times per week reduced their risk of dying from a heart attack by a staggering 44 percent and from cerebrovascular disease by 61 percent.  Read More

•  Nearly 1.5 million people in the U.S. develop sepsis each year, with a mortality rate of 17 percent. For sepsis, it’s all about early detection, and now one hospital system is using AI to analyze EHR data to deliver real-time warnings to clinicians.  Read More

The U.S. is already behind the curve when it comes to primary care, and now it looks as if we’re moving in the wrong direction. A new study found a two percent drop in people with primary care physicians in the last decade, a decrease that represents millions of Americans.  Read More

Experts are predicting gene editing and data privacy will be among the top issues which determine the future of health in the next ten years. Will the first CRISPR-based medication be approved within the next decade? At least one expert says yes.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, secure messaging, clinical communication, and care navigation software.
/AT Blog Integrations3.jpg – Health data sharing is caring



Health Data Sharing is Caring: Overcoming Integration Hurdles


Over the last decade or two, we’ve seen much of the medical industry transition onto some kind of electronic health system as a result of government requirements. However, until recently, there’s been little emphasis on requiring these systems to be able to share health data with each other. At pMD, we endeavor to connect the world (in a HIPAA-happy way of course) in our mission to save patient lives. We strive to reduce manual data entry, saving users time while preventing avoidable medical errors. I have worked in the medical industry for almost a decade now, connecting hospitals and practices, and here's my brief view of the world from my corner of the office.



Keep it standard: HL7, that is


HL7, or Health Level 7, has been around for decades and still seems to be the most popular data format of choice. This agreed-upon format gives software systems a way to package health data relating to a patient (demographics, appointments, encounters, etc) in a structured way, so everyone can understand the shared data easily. This standard format allows for easier setup and quick go-lives of integration projects. I’ve worked on projects before where we were able to connect, format test, and go-live in a matter of days, as opposed to the usual weeks or months! The main challenge I usually come across is with connectivity or bizarre user workflows, rather than the interface itself. If your system supports this format, odds are you can integrate with a majority of the system players in the health industry. With that said, you may come across hurdles where some software companies cannot process data that seems basic. For example, a handful of big-name practice management systems cannot receive admission or hospitalization dates. Ask any biller or coder out there and this would boggle their minds! I theorize that these companies originally developed their interfaces for one specific scenario, which is fine to start with, but have not updated their systems since. It frustrates many a customer.



Consider VPN-less solutions


Packaging data in a standard HL7 format simplifies the way the systems read data, but it doesn’t address how to get data from A to B. This question can usually eat up a lot of time on a project, which I personally find can be the most painful hurdle of integration. While the internet offers many solutions, VPNs (virtual private networks) are still unfortunately the popular choice. This technology was made popular in the 1980s due to its security, but it can get very complicated to set up, and just becomes a maintenance nightmare if the connection breaks. The internet has come a long way since then, and with it cybersecurity. pMD certainly supports VPNs, but we prefer the other VPN-less solutions, such as web services. If only the health world would catch up to the banking industry when it comes to modern technology. Security officers out there, listen up! We all access our bank accounts online through the web, and not a VPN. They’re not needed anymore. Let’s stop living in the dark ages!



Facing hurdles with APIs


While VPNs are still a hospital’s best friend, it’s encouraging to see a shift to the development of Application Program Interfaces, or APIs, for integration. This is where a software system provides a standard way to integrate with their software - essentially saying, “here you go! If you follow these rules, we’ll connect with you without needing much work from us”. This really sounds great from a development perspective. It cuts downtime from having connectivity discussions, the data format is fixed and clear, and the main work is left to the vendor who wants to hook up to your system. In practice, however, it can actually be very challenging if this is designed poorly for the outside vendor. For example, I encountered an API that required 20+ individual message calls in order to submit a single financial transaction. This was quite messy as there were way too many pieces to line up and was just gearing up for mistakes. Ultimately, APIs are great, but since everyone seems to be developing their own right now, there’s really no standard, which is a bit of a burden on other vendors. While your own development team might need to do little after developing an API, asking other vendors to adhere to your private API is a potential hurdle that will slow the project down. At times, it can even be a show-stopper because not everyone will have the resources to work with every separate format. 


We take great pride at pMD in our ability to connect physicians, hospitals, and patients. We’ve integrated countless systems which transmit millions of messages daily. It’s fun to think back at how many keystrokes saved, typos avoided, and/or medical errors averted because of our integrations. Let’s connect everyone!


To find out more about pMD's suite of products, which includes our charge capture and MIPS registrysecure messagingclinical communication, and care navigation software and services, please contact pMD.




Source: Getty Images

Here's The Latest in Health Care:


Everyone has a go-to family soup recipe that seems to magically cure any illness; but how about one of the world’s most deadly diseases? What started as an elementary school science experiment could have significant impacts on the fight against malaria.  Read More

•  This year’s flu season is off to an early start, spreading like wildfire. Even after seeing one co-worker or classmate fall victim after another, still, more than one-third of people refuse to get a flu shot. Widespread vaccination remains our best defense against this sometimes-deadly virus.  Read More

We may be on the verge of a major breakthrough in treating advanced breast cancer. Doctors recently released test results of two experimental drugs, one of which can deliver chemotherapy directly to the cancer cell.  Read More

CVS launched a new program aimed at boosting access to genetic testing for people with advanced cancers. A partnership with the precision medicine company Tempus will make it easier for doctors to pinpoint the best treatment option.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, secure messaging, clinical communication, and care navigation software.


PATIENT COMMUNICATION TOOLS FOR BETTER PATIENT CARE


These days, being a patient comes with a slew of responsibilities: staying on top of your medical history, knowing which medications to take and when, calling in to make an appointment and actually remembering said appointment, following post-op or post-discharge instructions, and the list goes on.

Even with the help of supportive medical staff and a patient portal, patients still struggle to navigate through what is often a confusing health care environment. Why is that?

Patient Portals Can Slow Communication


Sometimes patient portals can introduce barriers that often slow the communication process. For instance, a majority aren’t mobile, forcing patients and doctors to log in from a computer. Then, once a message is sent, there’s usually a delay in response because let’s be honest, what medical professional is at their computer 24/7 to receive and subsequently reply to messages?

Advanced Mobile Patient Communication Tools Supplement Portal


Of course, we here at pMD understand the need for patient portals and the robust information they house. With pMD’s updates to its secure messaging platform, we give care teams more advanced messaging functionality that supports a variety of patient communication scenarios while supplementing your practice’s patient portal. These communication tools also empower patients to overcome barriers that prevent them from being involved in their own health care.

Patients can reach out to their practice on their mobile device via pMD® Secure Messaging™, saving them from several failed login attempts in the portal or being forced to listen to smooth jazz on loop while on hold. Let’s say a patient is experiencing headaches and insomnia that may be related to their newly prescribed medication. The patient sends a message to the practice in pMD, the message gets routed to the Medical Assistant (MA), who then promptly discusses with the doctor. The MA responds back immediately in a group message that includes the doctor and the patient letting the patient know they can stop taking the medication. After the patient says thanks and bye, the MA is able to then end the conversation and close the message thread. The patient can still reach back out in the future by starting the process again. This feature gives practices and patients a seamless and efficient way to connect about important and time-sensitive matters such as appointment scheduling, test results, and urgent health-related questions without the hold music or delayed emails.

Group Chat Connects Care Team & Patient in Unified Message Thread


With the ability to send group chats, multiple users in a practice are able to communicate with a patient in a single, secure conversation. Everyone involved in the patient’s care, such as schedulers, nurses, and specialists, including the patient, can connect on one unified message thread for complete transparency. 

Compliant, Real-Time Face-To-Face Video Calling & In-App Voice Calls


In addition to messaging, providers can also securely communicate with patients and colleagues through face-to-face video calling or in-app voice calling. By giving users a mobile option for video calling and also a way to call through the app, health care professionals are able to foster real-time communication with patients, keeping their care coordinated and compliant. 

Physician Says Using pMD Secure Messaging App a "Great Decision"


“We started using pMD® Secure Messaging™ because we needed a HIPAA-compliant way to communicate with our patients,” said Dr. Stacey Marquee. “It’s been a great decision so far! We’re able to message with our patients about clinical information, medications, appointment cancellations, and for general check-in. Adoption across our staff and patients is high because the app is simple to download and very easy to use.”

Let’s face it; life happens. Patients are real people who try to balance busy work schedules and their personal lives while figuring out the health care landscape all at once. With pMD’s communication tools, patients have a convenient way of engaging with their care teams and reducing miscommunication and confusion. For practices, being able to fast-track communication with their patients saves support staff more time and reduces phone volume by 12%.

Patients Prefer Practices using pMD App, a “Real Anxiety Reducer”


“Using the pMD app was a real anxiety reducer,” says one patient. “If you have a question and something’s not right, you can get an answer through the pMD app. It’s immediate. You feel closer to the doctor and staff. It’s more personal. I would prefer practices that use this type of technology!”

Improving patient engagement and continuity of care is the first step in promoting positive patient outcomes. Better communication tools mean patients are more involved in their care, making them happier and, more importantly, healthier.


To find out more about pMD's suite of products, which includes our charge capture and MIPS registrysecure messagingclinical communication, and care navigation software and services, please contact pMD.


Here's The Latest in Health Care:


Roughly half of the new 133 grants announced by the US Department of Agriculture, totaling $42.5 million, will help bankroll the deployment of telemedicine programs in rural areas. These grants are the latest push from the federal government to improve education and healthcare access in rural areas across the country.  Read More

Often times patients are unaware of the costs of health care services until it is too late and they are on the hook for expensive medical bills. University Health is now offering a price estimator on its website to give patients a head start in planning.  Read More

Researchers say that artificial intelligence (AI) can be used to predict future heart risks and even death by examining electrocardiogram (ECG) test results. The studies are among the first to use AI to predict future events from ECG results rather than to detect current health problems.  Read More

Amazon is attempting to make clinical documentation more efficient with its new medical transcription service. Cerner is already using the platform to develop a digital voice scribe that can "listen" in the background during a patient's visit and transcribe physician-patient conversations into text.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, secure messaging, clinical communication, and care navigation software.

Source: Getty Images

Here's The Latest in Health Care:


• It’s Black Friday today, which means deals, deals, and more deals. And TVs and sweaters are not the only things on sale. Some health care organizations are getting into the spending frenzy, offering discounts on items such as medical supplies or healthcare services. One hospital is even offering a 50 percent discount on balances paid in full.  Read More

In this day and age, social media represents the biggest outlet for those seeking support. Behavioral health and social media have a long-standing and complicated relationship, but Pinterest is making an effort to address a big issue by removing posts related to self-harm.  Read More

Amazon’s Alexa has a new skill; managing your medications and reminding you to take them. This is another big step for the tech giant into health care, adding fuel to the conversation of convenience versus privacy, especially when it comes to confidential information like medical details.  Read More

• As we close out the year, it is once again time to consult the crystal ball for what 2020 holds in store for the health care industry. Will the balance of power begin to shift from hospital systems back to physician groups? Amid revelations about data privacy, will companies that are transparent and ethical come out ahead?  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, secure messaging, clinical communication, and care navigation software.
ICD 10 Codes Thanksgiving


THANKSGIVING CORNUCOPIA: TURKEY, STUFFING, AND ICD-10S


With Thanksgiving right around the corner, we often associate this special holiday with giving thanks, being with family, and eating far past what's considered comfortable. For many hospitals and providers across the country, this day represents a smorgasbord of possible turkey-related hazards that can ultimately result in one of the following bizarre ICD-10 codes. Let's have a look!

Fancy yourself the deep-frying kind? Take caution when submerging that hefty turkey or you'll end up in the emergency department with one of the following codes:

X10.2 contacts with fats and cooking oils
Codes T20-T25 burns and corrosions of external body surface, specified by site

The overindulging type? Gravy piled on top of mashed potatoes piled on top of turkey piled on top of stuffing with 5 dinner rolls and 3 pieces of pie can likely result in:

R14.0 abdominal distension
R14.2 eructation (belch)
R14.3 flatulence
K30 functional dyspepsia (indigestion)
R12 heartburn
Z72.820 sleep deprivation

You've been given the distinct honor of carving the turkey this year! Just be sure to lay off the wine, lest you desire an injury relating to:

W26.0XXA contact with knife
W29.1 contact with electric knife

You've opted for a vegetarian Thanksgiving and have the opportunity to visit with the turkey whose life you've spared. While your efforts are noble, the turkey, who you've dubbed Liberty Gobblestein, is none-the-wiser and without hesitation, turns on you. The following ICD-10s would likely be reported:

W61.43 pecked by a turkey
W61.49 (other contact with a turkey)

The non-billable turkey codes mentioned above are required to be reported alongside the place of occurrence:

Y92.7 farm as the place of occurrence
Y92.71 barn as the place of occurrence
Y92.72 chicken coup as the place of occurrence
Y92.74 orchard as the place of occurrence

So this year, remember to enjoy the festivities with some level of caution. When in doubt, steer clear of hot oils, sharp objects, and live turkeys. Happy Thanksgiving, from all of us here at pMD!

 

Related Articles:
A Collection of Holiday Icd-10 Mishaps
ICD-10 Halloween Edition: The Mysterious, The Spooky, and The Bizarre

To find out more about pMD's suite of products, which includes our charge capture and MIPS registrysecure messagingclinical communication, and care navigation software and services, please contact pMD.

Source: Getty Images

Here's The Latest in Health Care:


What will health care look like in 2040? According to Deloitte, we can expect monumental changes in the next 20 years, including almost zero diseases with no cure and affordable cell and gene therapies for the masses. What else should we expect?  Read More

The rise of out-of-pocket costs has created an expectation for physicians to better understand the cost of care and how to reduce spending. This is why the American Medical Association (AMA) is calling on medical schools and residency programs to add medical economics courses to their curriculums.  Read More

Just a week after reports of Google’s controversial project involving patient data, the tech giant showed off its new integrated charting system. In an attempt to reduce documentation and EHR burden for physicians, doctors can access a unified view of data normally spread across multiple systems.  Read More

In a landmark trial, doctors are reporting the first evidence that genetically edited cells could offer a safe way to treat sickle cell disease. The cells modified using CRISPR seem to already be limiting the agonizing attacks of pain the disease is known for.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, secure messaging, clinical communication, and care navigation software.
Healthcare Interface Integration, a three-way tango


IT TAKES TWO TO TANGO BUT THREE TO INTERFACE


While dance shoes are not required, implementing a health care interface, especially one that can smoothly share data between two systems, can be as intricate as a three-way tango. The partners you choose to dance with can make all the difference. Who will lead? What special talents does each dancer have?  How do we put together a winning routine?

Small & Mid-Sized Practice Management System Vendors More Responsive

Here at pMD, we have worked with every imaginable type of system vendor from small mom-and-pop shops to huge national organizations. There is no hard and fast rule, but in many cases, the benefit of working with small and mid-sized organizations is that more often than not, they’re more responsive and eager to satisfy the customer.

While it seems like everyone may get overloaded, in my experience, working with a smaller vendor actually often means you have access to the people who can make decisions and get them implemented.  Want to add a more complicated dance move to your routine?  With a small-to-midsize dance partner, often you can just easily ask for help with that and it gets done. 

Delays Common When Working Alone with Large Vendors

With a larger one, a request for a new feature may get taken by your account manager, then relayed to a technical analyst who in turn has to get approval from a committee. Then, if it gets approved, you may find out that the dance partner does not even know how to carry out that complicated dance move. Too many dancers on the dance floor can lead to a spotty routine!

pMD has a long-established, reliable interface with a very large and major vendor, making it easy to implement for new practices joining pMD. Groups that are new to pMD and that request this interface can often get it implemented in a matter of days. Which is great, right?

Recently, a few practices with this interface asked about leveraging a new feature in their practice management system. The other vendor was unwilling to enhance the existing interface and insisted on making it a brand new project. On our end, we were able to make the requested enhancements in just a few days but somehow ended up spending months trying to get a new connection up and running in order for us to send that additional data over to the vendor's system correctly. While this isn’t always the case for all large vendors we work with, this tango, unfortunately, fell short. 

Working With Responsive Vendors Results in Faster Implementation

In working with many small and mid-sized vendors, we’ve found that the person we are dealing with is the actual interface designer and developer. Projects like these can often go very smoothly due to that close proximity. In a recent project with a mid-sized systems vendor, the interface engineer was reliably on every status call, creative about addressing special requests from the practice, and prompt in following up. The customer was able to go live in about a month with a customized interface that addressed their needs. Here, the tango routine wowed. 

Charge Capture Interface Implementation a More Challenging Project

If you’re unfamiliar with interfaces, just know that different types of interface projects have different degrees of difficulty. For example, there is very little variation in setting up patient demographics interfaces from one vendor to the next.  However, when it comes to charge interfaces, or sending charges from one system to another, they prove to be a little more challenging, take more time, and require more testing. In other words, the dance routine takes more practice and finesse. 

Interface Implementation with Vendors & Customer Working Together

While we at pMD and your practice management system vendor or hospital IT department are the dancers that have to agree on the moves, the dance routine cannot go anywhere without that third partner, the customer. The customer helps keep the tempo and encourages us vendors onto our feet, pushing us to dance through the routine without stopping. Keep us on-beat and you’ll find the dance slowly unfolding as a thing of beauty - an interface that will wow the crowd.

To find out more about pMD's suite of products, which includes our MIPS registrycharge capturesecure messagingclinical communication, and care navigation software and services, please contact pMD.

Source: Getty Images

Here's The Latest in Health Care:


Google is continuing to push its way into health care, but its most recent partnership with Ascension has triggered a federal inquiry. The Department of Health and Human Services' Office for Civil Rights will investigate Google's efforts to collect health data on millions of Americans.  Read More

If sometimes it seems like the health care industry is stuck in the 1970’s, you are not imagining it. According to a new survey, 89 percent of health care organizations are still heavily reliant on a piece of technology that many consider obsolete, the fax machine. How can we expect these organizations to communicate effectively when they are stuck faxing important information back and forth?  Read More

It may be up to the big-box retailers to revitalize rural health care. For the millions of Americans who struggle to get affordable, timely medical care these retailers can offer a convenient place to turn to. Adding telehealth capabilities to our existing retail infrastructure could significantly expand access to top-notch care—and reduce costs for patients and the health care system.  Read More

While there is no doubt that machine learning (ML) applications will dramatically improve health care, we have a tendency to get a little overzealous with predictions. CEOs from across health care have identified three common myths surrounding the future of ML in health care.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, secure messaging, clinical communication, and care navigation software.