The pMD Blog

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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.

POSTS BY TAG | HIPAA-Compliant



Telemedicine has been pushed into the spotlight in recent weeks in light of the COVID-19 coronavirus pandemic. Due to historically variable and restrictive reimbursement policies, many practices are not currently set up to provide virtual care. In light of the profound disruption caused by the pandemic, we are hearing from practices around the country that need to consider offering telehealth and scrambling to do so. Often, they have to consider tomorrow's appointments and wonder will we get paid for these visits? Well, here is what we know:


MEDICARE WILL COVER ALL TELEHEALTH SERVICES

CMS recently announced a major change to its telehealth reimbursement policy. During this crisis, Medicare will pay for telehealth services regardless of the originating site dating back to March 6, 2020. As long as visits are conducted via video, those visits that would normally be provided in an office, hospital, clinics or other settings, can now be done virtually, even from a patient's home. These visits are considered the same as in-person visits and are paid at the same rate as regular, in-person visits.

The codes that can be billed for what Medicare defines as “telehealth services” are typically evaluation and management (E/M) codes, such as 99213, combined with a telehealth Place of Service (POS) and potentially a modifier if required by the commercial payor.

PLACE OF SERVICE 02:

According to CMS, POS 02 is defined as “the location where health services and health-related services are provided or received, through a telecommunication system.” CMS has replaced the GT modifier with POS 02 and can be used when billing CMS claims for synchronous telemedicine visits. 

GT MODIFIER:

Although it has been widely replaced by the 02 POS location, some private payors still recognize and prefer the GT modifier to indicate a service was rendered via synchronous telecommunication.

MODIFIER 95:

Modifier 95 is a fairly new modifier and used only when billing to private payers to indicate services were rendered via synchronous telecommunication. It is important to note that Medicare and Medicaid do not recognize modifier 95. As with the GT modifier, not all payers recognize modifier 95. 

WHAT ABOUT MEDICAID AND COMMERCIAL PAYERS?

At this point, commercial and Medicaid coverage is still much less consistent. While U.S. Representatives have recommended CMS to encourage states to cover all telemedicine services and work with them to expand their capability to do so, reimbursement remains subject to state-specific requirements. In a similar vein, private health insurers, including Aetna, Cigna, Humana, United Healthcare will also cover telehealth for the next 90 days in some states, but the coverage also varies state by state. We encourage practices to always confirm local guidelines.

GET STARTED WITH pMD TELEHEALTH TODAY

pMD® Secure Messaging™ telemedicine capabilities allow practices to connect, triage, and follow up with patients through secure, HIPAA-compliant text, video, and voice calling. Easily invite patients to download the app at no cost to facilitate timely communication when it matters most:

* provide health safety guidelines and recommendations
* share important practice updates and announcements
* outreach to your most vulnerable patient population
* perform telehealth visits with patients advised not to leave their homes

No matter the specialty, pMD is highly customizable to fit your practices’ needs and workflows. View additional information, resources, and FAQs about setting up and providing telehealth services with pMD and how to get started now.   

For help setting up patient communication or to contact pMD customer support, please give us a call at 800-587-4989, x1 or email support@pmd.com.

Stay safe, 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.


Unlocking Patient Access to Specialty Care




Conventional wisdom in health care typically points to increasing access to primary care as one of the biggest drivers when it comes to lowering health care spend and improving patient quality of life. It makes intuitive sense: patients with fewer barriers between them and a Primary Care Physician (PCP) probably stay healthier. However, a recent study is challenging that assumption. Researchers found that, when comparing patients in rural settings to those in urban neighborhoods, rural patients had poorer health outcomes. Again, this might make sense when one considers the likely fewer number of primary care providers in small towns, but the underlying cause the study found was surprising. Researchers discovered that access to a specialist accounted for 55% of the difference in preventable hospitalizations.  Proximity to a PCP didn’t affect the numbers.

Kenton Johnston, lead author of the study told Modern Healthcare:  "CMS and other health policymakers are misguided if they think that expanding access to primary-care providers alone will eliminate disparities in health outcomes for chronically ill rural Americans. The specialized skills and expertise brought by specialists for treating particular chronic conditions are necessary."

This likely comes as a surprise to many readers, but at pMD we’ve had a front-row seat to the essential role that specialists play in patient care since our company was started (our very first customer was a Cardiologist!).  We’re continuing to add new ways for those practices to give their patients access to the care they need, even when those individuals might be geographically located far from the practice.

As an example, our recent release of Patient Chat Routers functionality allows practices to open up new lines of text-based communication for their patients who are enrolled in pMD® Secure Messaging™.  Based on the patient’s request, the message will then be routed to a designated group or individual in the practice. This feature gives practices a seamless and efficient way to connect with their patients about appointment scheduling, test results, and health-related questions.

In 2020, we’ll leverage that foundation and continue to build additional innovative tools for our customers to utilize in order to facilitate frictionless access to care. Soon, Patient Chat Routers will be able to dynamically route messages based on a practice’s call schedule, and we hope to also expand beyond text routing into phone calls as well - something practices often have to rely on via answering services today. Our goal is to break down the barriers that prevent patients from getting the care they need!


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.


Since the very first version of pMD on the Palm Pilot nearly twenty years ago, security has been a foundational principle in how we design and build our software. As technology has advanced, the challenges have grown but security has remained a steadfast commitment to everything we do. From how data is stored and transmitted to how we operate internally and with customers, security is as much a cultural value as it is a set of encryption algorithms or protocols.

Service Organization Controls (SOC) 2 Type 2 is one of the highest industry standards for software as a service, and is particularly relevant to health care technology. It helps potential customers to measure and assess the risk of using different services and tools, like pMD. Earlier this year, pMD successfully completed its third-party security audit, achieving SOC II Type 2 and HIPAA certifications. These reports are a validation of the things we've always done, yet it allows an easier and industry-standard medium to communicate our security commitments to our users.

Handling personal health information is a privilege. So much of health care is based on trust -  trust in your doctors, trust in your tools and their privacy protections, and trust between everyone involved in helping provide the best possible care for patients. At pMD, even though we're proud of this milestone, we never take this for granted and will continue to keep security practices a core focus of everything we do.

 

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.


Recipe for Success


In 2013, approximately 7.96 million patients discharged from an acute care facility required some type of post-acute care service, representing 22.3% of all acute care discharges. With changes in reimbursement and providers assuming more risk, it is understandable that health systems and providers are seeking to better understand and manage this patient population.

Traditionally, post-acute care has been fragmented and disjointed at every level with little investment in creating a seamless transition across the care continuum. I entered the post-acute world in late 2009 and was astonished at the accepted paths of communication between health systems, providers, and the post-acute care companies caring for these patients. In my experience, I would say that the most accurate way to describe the coordination of patient care in this environment is ‘poor.’

In the overwhelming majority, there is no efficient collaboration between the acute care and post-acute care worlds. Providers have been left to piecemeal and bootstrap their own, oftentimes clunky and cumbersome, solutions for the ongoing communication required in managing this patient population. These solutions tend not to be secure and are woefully inadequate, lending to the issue of readmissions and sentinel events that have plagued our health care system. 

The amount of information that needs to flow between providers and the companies caring for these patients can be daunting, especially when the provider has another patient population to manage that is in the acute setting. Traditional landlines and fax machines are sadly the standard in coordinating patient care and the reliability is just not there. Today’s providers are busy and often will not immediately receive that fax or voicemail seeking orders to deal with a critical lab value, evaluate a concern for a post OP infection, or make decisions regarding end of life care. The RNs in the field visiting these patients have done the best they can with the means they’ve been given but the ability to securely communicate in an organized and timely fashion has remained out of reach.

As mentioned above, the days of patients getting readmitted to the emergency room due to inefficient communication are drawing to a close, thanks to penalties in reimbursements that providers are facing. There are options that exists today with pMD® Clinical Communication™ that allow for a seamless and timely flow of communication between post-acute providers in the field and the physicians that are following their care. 

This can currently be done in real time - issues brought up and issues solved by creating a secure, direct line of communication between individuals responsible for the care of these patients. The ability for a physician to quickly shift from one population to another, review pertinent historical information, and issue orders of corrective action directly from their smartphone exists. If properly implemented, it can make a difference in the outcome of the patients we serve and avoid the readmission penalties that have hurt providers.

With just a small amount of effort, the abilities and impacts are nearly endless in bolstering the communication between the acute and post-acute worlds. For example, the ability for a physician and collaborating pharmacist to receive an automated alert to their smartphone or desktop which is tied to a specific patient, would solve a persistent and frustrating problem in that community that often requires printed or faxed documentation. Oh, and it also creates a better situation for the patient, reducing the potential negative impact on their well-being.

This is just one example, but it is a scenario that I have seen play out numerous times over. Enhancing our communities’ ability to talk and share documents, photos, and video efficiently in a HIPAA-compliant fashion can improve outcomes and save lives. That is what we are here for ... isn't it?

Find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, clinical communication, and care navigation software and services, please contact pMD.


Secure HIPAA-compliant Communication


Lately, it seems that more and more health care providers are increasingly interested in secure HIPAA compliant communication and the different platforms available to them. These providers and their support staff want to improve communication at their practices while still remaining compliant.    

As a member of our sales team, I’ve had the opportunity to speak with many of the interested practices who reach out to pMD to learn about what we have to offer in this space. pMD has two different HIPAA compliant communication products: our Free Secure Messaging and our more robust Clinical Communication option. If you just did a double take to see if you misread “free,” no, you were not mistaken!

Free or Paid: Which to Use for Your HIPAA Compliant Communication?

Are you curious about when our free option is the best fit for a user or when they might benefit more from our paid option? Continue reading to learn what I listen for when I speak with potential clients and help them decide which product will best suit their needs!

Using pMD’s Free App for Texting PHI

When I have the opportunity to speak with someone who is looking into the options they have for secure messaging, the first question I ask is, “What are your needs, and how many people do you need to message?” If the prospect tells me, “My colleague and I want to be able to message with each other about PHI (Protected Health Information) on our phones while remaining HIPAA compliant,” that is generally a cue for me that they have fairly simple needs and are most likely a good fit for our more basic Free Secure Messaging. Generally, groups with under five users that need to communicate basic information in a HIPAA-compliant and streamlined fashion are a good fit for our free product, and I suggest that they go to the App Store or the Google Play store and sign themselves up for pMD’s Free Secure Messaging. They can then get started right away!

I also often speak with groups who tell me about how much time they’re wasting trying to keep PHI out of their text messages by using cryptic symbols or hieroglyphics, and they end up having to just pick up the phone and call to find out who and what the message is even about! They recognize that they’re wasting even more precious time in their busy schedules and want a better solution that reduces inefficiencies.

When to Consider pMD’s HIPAA Compliant Clinical Communication

For larger groups who have complex workflows and more users needing to communicate about patients or securely send PHI, I suggest they evaluate our Clinical Communication product. Clinical Communication users can securely message using pMD on either their mobile device or the website, so they can stay compliant whether they’re on the go or stationed in front of a computer. pMD Clinical Communication also includes patient-centric messaging, allowing users to store a variety of information and message history. This removes the need to search through hundreds of messages to find one specific conversation with Dr. Smith about patient John Doe’s condition three weeks ago.

Texting Patients

Another great use case I often hear is the need to message with patients. This is a feature of our Clinical Communication product, which allows users to easily send messages to their patients while keeping their health information secure.

pMD Platform Update Offers Secure, HIPAA Complainant Video Chat

pMD is always innovating and working to meet the needs of our customers. We very recently released our new Video Chat function, so if you prefer a more face-to-face interaction with your colleagues, feel free to give it a try!

We hope that by allowing providers to communicate in a more streamlined and efficient fashion amongst themselves and their supporting staff, we can give them back more time to be doctors and provide care to their patients.

Contact pMD to Learn More!

If you’re interested in learning more about our Free Secure Messaging or Clinical Communication products, please submit your information here and we’re happy to help you evaluate which product would be the best fit for you! Don’t miss out on our signature text tone: the goat squeal!

Find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, clinical communication, and care navigation software and services, please contact pMD.

Related Articles:
Healthcare Communication Platform: A Picture Is Worth A Thousand... Lives?
Customizing Patient-Centric Solutions for Better Care: Clinical Communication That Improves Resident Training
Beyond the Call: Messaging with Patients in Health Care


Healthcare communication


Coordinating a patient’s care is complex. Professionals from a variety of disciplines deliver care to a single patient at various times throughout the day. Specialists may be traveling from several different locations from across a city to where this one patient is receiving care. And all of this complexity limits the chance for care teams to reliably connect with each other regarding the current plan for a patient’s care.  This is when inefficiencies and medical errors arise.

Ineffective Healthcare Communication Causes Medical Errors

The growing body of research on medical error prevention reveals that ineffective or insufficient healthcare communication among care team members is a significant contributing factor to adverse events. Ineffective communication is at the root of nearly three of every four medical errors. Industry studies have classified communication errors that led to inefficiencies and medical error into a few buckets:

1) Communication that was simply too late to be helpful for the patient.
2) Failure to include the whole care team in communication about a patient.
3) Communications that proposed an action where that action was not completed.

Thus, access to a common healthcare communication platform that can link up multiple providers and support clarity in communication during the critical seconds of need must be implemented to help stop avoidable medical errors.

Reduce Medical Errors with pMD’s Healthcare Communication Platform

At pMD, we’re passionate about reducing those avoidable medical errors and saving lives. pMD’s HIPAA-compliant clinical communication and free secure messaging platforms are one key way we’re doing just that.

1) We know that texting is a quick, easy method to connect a team and convey information that can save lives. So, we’re proud to provide a proven, secure communication platform to support healthcare teams - for free.  

2) Sending images securely, including labs, diagnostic images, skin conditions, or wounds post-surgery, can link internists to specialists, residents to attendings, and patients directly to triage nurses.

3) We know that with text alone, a message can lose the inflection, emotion, or intensity intended by the sender.  So, we’ll be adding the ability to send and receive voice memos, giving messages back the volume, pitch, rhythm, and speed that can help convey a clear message.

4) And we know that verbal and non-verbal aspects of communication can be vital in ensuring clarity. Therefore, we’ll also be adding HIPAA-compliant video communication capabilities, even to our free secure messaging platform, to execute care team huddles from anywhere, to facilitate the integration of specialists, and to even host telemedicine encounters directly with patients or medical decision-makers.

At pMD, we know a text, picture, voice memo, or video encounter can vastly improve the clarity of communication. By utilizing a common secure healthcare communication platform which includes the right individuals at the right time, we can reduce medical errors and save thousands of lives.  For more information, or to easily sign up for free pMD® Secure Messaging™, please visit us here!

Find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, clinical communication, and care navigation software and services, please contact pMD.



Secure video chat


Last year we were excited to announce the launch of our free Secure Messaging product, which is now enabling thousands of health care providers across the United States to communicate in a way that’s convenient and secure. As that offering has gained adoption, we’ve been actively soliciting feedback from our user base in order to understand how we can continue to make the product better for them. One of our biggest takeaways has been that, while secure text messaging has indeed addressed a major pain point, there are additional scenarios where a richer form of communication would be helpful.

That’s why we’re excited to announce the upcoming release of secure video chat capability.  This new feature will enable providers to utilize pMD to quickly get a second opinion from another clinician, connect with a nurse at a remote clinic, or even chat directly with a patient who may not be able to leave his or her home. Best of all, video chat will be built into our free Secure Messaging product.

Secure Video Chat Added to Free App for Bigger Impact on Health Care


We know that often, vendors dangle new features behind a paywall, or an upgrade requirement, rather than shipping them directly to their customers. However, our philosophy at pMD has always been, first and foremost, to help clinicians provide better patient care.  The cutting edge design agency, Chagency, sums up this approach well in a recent blog post, suggesting, “Help [your users] grow so you can grow together.” To accomplish this, we push down as much value into our free offering as we possibly can, knowing that the more people who benefit from pMD, the bigger the impact we’re able to have on health care in this country.

pMD Product Suite Growing to Improve Health Care Communication


We’re extremely excited about this upcoming enhancement to pMD’s product suite. We look forward to continuing to gather feedback from our customers as they leverage this new tool to improve their care delivery. Most importantly, we’re not done innovating. In fact, we’re just at the beginning of a compelling roadmap of new features to empower richer communications in health care.

 
App with secure video chat capability

Find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, clinical communication, and care navigation software and services, please contact pMD.






pMD’s culture promotes the importance of customer feedback, which we’ve discussed in previous blog posts. Through conferences, implementations, and support, we’re always looking for the best way to enhance our product so that our customers can focus on improving patients’ lives. So, it’s no surprise that since its launch in 2014, pMD’s secure messaging product has been molded by the feedback and input of our customers.

Recently, the pMD team has consistently heard that providers would like to utilize pMD® Secure Messaging™ to communicate with their patients using the same platform they already use for internal communication. As emails go unanswered and phone calls are forwarded to voicemail, messaging becomes the most effective and efficient choice when deciding how to communicate with patients.

With the number of Americans that own smartphones continuing to rise to 77% in 2018 (Pew Research Center), more patients than ever before can connect with their health care providers, so we asked ourselves: how can we make the process of communicating from both sides - patient and provider - as seamless as possible?

When engineering pMD’s system for messaging with patients, we started with everything that makes pMD’s current secure messaging system an optimal solution for health care providers: an easy-to-use interface similar to your favorite text messaging app, an architecture built around security compliance, and a system of robust and reliable notifications to ensure that time sensitive information is delivered when it matters most. We spent time improving our sign up process to remove clunky steps and make sure that new patients can be on-boarded and start messaging in seconds.

On the provider side, we added clear delineations between internal and external messages, so providers, office staff, and administrators will always be reminded when their communication is being sent outside the organization. We know how important it is for providers to maintain control of the conversation threads, so we designed a system that allows caregivers to open and close conversations, while still allowing patients to initiate conversations. Providers’ personal information is hidden from patients’ view, and messages with patients can be shared among all members of the care team so that providers can collaborate and patients receive the highest quality care. pMD® Clinical Communication™ is already helping organizations deliver better care, and this additional feature set will allow those groups to reach their community on a whole new level.

pMD is currently working with innovative health care organizations to transform the way they interact with their patients. If you’re interested in learning how we can help improve your patient care through custom workflows and communication tools, contact us!

Find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, clinical communication, care navigation, and clinically integrated network software and services, please contact pMD.









pMD’s products put the patient at the center of everything we do. When we pair innovative products with the creative, consultative approach we take for every customer inquiry and then in turn see the value to our patients, it is truly a remarkable feeling. One example below may best illustrate the impact that a pMD solution can have when care teams have a common platform to collaborate around patient care.  

A group of surgical residents caring for patients across various clinical teams needed a way to capture shared rounding notes on patients. In addition, they wanted to be able to communicate between teams using a secure messaging solution to share patient details, update care plans, and send pre- and post-operative photos.

Few technology solutions are available today to support patient care for residents. Many organizations currently use paper rounding notes that can be lost in the rush of the day, shared spreadsheets where only one resident can access the data at a time, or non-secure file-sharing programs. None of these options truly meet the residents’ needs. Since clunky workflows that are currently in place still get the job done, these old methods have continued into 2018.  

Resident groups tell us that better communication can improve patient outcomes. Residents using pMD Clinical Communication™ can send messages about patients and update each other on care plans. They have the ability to securely send images to a chief or attending physician for a second opinion. Additionally, patient data can be recorded at bedside right from their mobile phone and can include updating medications, allergies, code status, and care plans. These are all kept up-to-date, in real-time, and stored on a shared patient list visible to the whole group.

HIPAA-compliant, health care messaging that’s easy to use paired with pMD’s customizable platform for mobile data capture is exactly what these residents and administrators were looking for to bring their workflow into the twenty-first century.  

We know that each practice or group faces a unique set of challenges. That’s why we approach every opportunity as unique, invest time upfront to understand workflows that support patient care, and build solutions that account for those challenges. This is also why we here at pMD work closely with existing customers to implement new products and product features as those challenges evolve.

At pMD, we are customizing solutions to help teams deliver better patient care. To explore these solutions for your group or for more information on how pMD can support your unique practice or patient population, don’t hesitate to contact us.




 If you'd like to find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, clinical communication, care navigation, and clinically integrated network software and services, please contact pMD.



Imagine, if you can, a world where medical information crosses boundaries - safely, reliably, timely, as effortlessly as water. What is required to create such permeable boundaries? Sure, there are the base technical requirements. System B must be able to read, understand, and digest System A’s output. As convoluted as medical information standards can be, there are reliable pieces there. Reliable yet limited.

So, to achieve something more dynamic, deeper, and more useful, what is required?  I think trust plays an outsized role. I am not talking about the trust inherent in the security profiles of each system, though that is important. I'm talking about the trust of the people involved. The human element.  You need to know who you are working with, what they are about, and establish if they are on the same page.

At pMD, we actively seek out partners with whom we can achieve richer technical connections as well as dynamic personal collaborations.  A recent example is the links we are building with a regional EMR company called iMed.  iMed reached out to us last year as they were assessing partners to perform the MIPS registry role for their customers.  Their dream was to create a new module in their software allowing their customers to collect quality data as they entered clinical data into iMed. This made a lot of sense. Capturing quality data in real time would help their customers achieve their MIPS reporting goals and set them up for ongoing success as the medical market continues to reach towards measurements beyond the raw financial value of services.

We met their team, shared what pMD does and what they needed and found a compelling fit.  As they developed this new module we worked closely with their team to share what registry reporting requires so they could consider those requirements in their software.  Finally, we attended their user group meeting, spoke with their customers alongside their team to better link their customers, the module, and pMD’s MIPS registry services together.

We are currently rolling out version one of our collaboration, which allows for regular data uploads from our now mutual customers into pMD, sharing that data back with the reporting providers, and targeting gaps and opportunities for improvement.  The goal is to fully automate this process this year.

It has been a rewarding and productive collaborative effort to create real interoperability between iMed and pMD, for the benefit of those providers using both systems. This type of work is part of fulfilling our mission to make doctors happy and we hope for many years working with our friends at iMed and others who want to create more vital, dynamic, and trusting health care data ecosystems.

 If you'd like to find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, and care coordination software and services, please contact pMD.