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HEDIS Chart Abstraction: Paper vs Electronic Medical Records

The many clinical and non-clinical professionals I have spoken with often have the same questions about the HEDIS opportunities I present to them. Obviously, we cover the basic facts essential to any contract job assignment, such as Pay, Location, Duration, Benefits, etc. The inquiries for HEDIS chart abstraction opportunities are unique to the challenges common to the assignment, and informed by their past experiences: “Is there travel to provider offices? If so, how much?” “Can I work remotely from home or will I be working in the Managed Care Organizations corporate offices?” “What equipment will be provided?” All of these excellent questions are directly related to one of the most important questions: “Will the format of the medical record be Paper or Electronic?”

Written by Derek Dunbar, Associate Search Consultant.
Contact him at 1.800.974.4828 ext 123, or derek@carenational.com

With H.E.D.I.S. (Healthcare Effectiveness Data and Information Set) work already started for some and quickly approaching for others, CareNational has been on a quest to find qualified nurses and clerical support staff to fill assignments for our clients related to this critically important Quality Improvement survey. Since we are experts in providing top-tier talent, but not in actually doing Quality Improvement or HEDIS functions, we are tapping into the extensive knowledge of our candidates using an ‘Ask the Expert’ format. This week we wanted to highlight a continuing challenge encountered every year during HEDIS, and a topic near-and dear to the hearts of every Chart Abstractor: Electronic vs Paper medical records.

The many clinical and non-clinical professionals I have spoken with often have the same questions about the HEDIS opportunities I present to them. Obviously, we cover the basic facts essential to any contract job assignment, such as Pay, Location, Duration, Benefits, etc. The inquiries for HEDIS chart abstraction opportunities are unique to the challenges common to the assignment, and informed by their past experiences: “Is there travel to provider offices? If so, how much?” “Can I work remotely from home or will I be working in the Managed Care Organizations corporate offices?” “What equipment will be provided?” All of these excellent questions are directly related to one of the most important questions: “Will the format of the medical record be Paper or Electronic?”

Every aspect of providing and paying for professional health care services requires diligent record keeping. Without maintaining accurate and reliable medical records, a health plan cannot measure how efficient or utilitarian its programs are to its members. Poorly kept records can lead to a wide variety of problems in any organization, and can result from a multitude of reasons. Many of the smaller, independent provider offices still rely on paper health-record systems to maintain vital patient information. This is despite seemingly glaring setbacks, such as relying on the recorder to have clean penmanship for one. Paper is easily destroyed, difficult to disseminate, and over time takes up lots of space, while electronic medical records (EMRs) can be recovered if lost, easily passed on to other offices, and take up no space at all.

While physical drawbacks are obvious, what is of greater note is the financial stress that paper systems place on the health organizations that use them. Time could be utilized much more effectively if much of it was not spent filing, copying, faxing, and mailing records. With an EMR / EHR system, medical records can be recorded on standard templates that make analyzing data simpler. It also allows one to retrieve, copy, or deliver necessary information with only a few clicks of a mouse. Paper systems are susceptible to offering misinformation resulting from illegible or missing records and can result in glaring errors throughout the coding and billing process, ultimately costing the healthcare industry millions of dollars. Through the use of an EMR system, however, medical records can be more easily read and are less prone to have errors go unnoticed.

Large health systems and their partnered Managed Care Organizations will often incentivize affiliated providers offices to make the switch to EMRs, if by nothing else than by excluding them from their delegated provider network. Additionally the Centers for Medicaid and Medicare (CMS) have begun penalizing those still using paper systems, by reimbursing them at a gradually declining rate. For physicians who either have not adopted certified EHR / EMR systems or cannot demonstrate “meaningful use” by the EMR deadline in 2015, Medicare reimbursements will be reduced by 1%. The deduction rate increases in subsequent years by 2% in 2016, 3% in 2017, 4% in 2018, and up to 95% depending on future adjustments.

So how does this all relate to clinical and non-clinical HEDIS workers? Those unique questions about HEDIS involving amount of travel and work setting are directly influenced by the extent the provider network is maintaining EMRs. When all health records are electronic it is a simple matter to gather the chart review nurses into a central office space, or even allow them to work from a home-office with high-speed internet connectivity. These are great perks that help to attract the best HEDIS staff. On the other hand, if all or even some of those records only exist in the printed form, health plans and HEDIS production vendors must send workers out to provider offices. It might be an administrative clerk to scan the documents for upload, or a Certified Medical Assistant to locate missing information, or they may even have to send a Registered Nurse (RN) to set up shop in the doctor’s office and conduct Chart Abstraction on the spot. As you can imagine, this work-around creates additional financial and personnel costs to health plans, which can trickle back down to their provider network. As any HEDIS professional will tell you, Electronic Medical Records are just the easier way to go.

As stated initially, CareNational specializes in HEDIS staffing and career search consultation in these specialized areas, but we do not perform the functions ourselves. So how did we do? Did you find this information useful? We love feedback!

If you would like to speak with the author about these topics, or to discuss our current job opportunities, contact Derek Dunbar, Associate Search Consultant. Call him at 1.800.974.4828 ext 123, or email him at derek@carenational.com