'Improved documentation' key to healthcare's future

In a roundtable discussion on Tuesday focusing on the results of a nationwide emergency department study conducted by the Health Management Academy [1], one of the primary points talked about was improved documentation and its role in the future of healthcare. 

According to the study, the top three best practices for successful hospitals are: 

* Stronger strategic planning to solve the root causes of key ED issues, such as throughput, patient satisfaction and capacity;

* A corporate executive designated to oversee ED management and performance system-wide, considering it a core business area; and

* Greater utilization of information technology solutions. 

In light of that third point, Drew Swiss--the Vice President of Finance for Montefiore Medical Center in New York--spoke adamantly about how improved documentation helped his facilities. Montefiore's three hospitals, according to Swiss, make up the third busiest emergency department in the nation, with more than 290,000 visits at the three EDs each year. Yet, Montefiore was able to save $3 million after implementing products to facilitate documentation for doctors. 

"All roads lead to documentation," Swiss said. He believes that improved documentation eventually leads to better collections, which, in turn, leads to more accurate reimbursements. He also said that he thinks underbilling has "dwarfed" overbilling in recent years (even though, let's face it, overbilling tends to get the lion's share of news headlines [2]). 

"If you didn't document it, it didn't happen," he said. 

Dr. Douglas Rose, the ED medical director for Stormont-Vail Healthcare based in Kansas, agreed. He said that at his facilities, volume was increased, but wait times were decreased by 50 percent and $7 million was added in revenue, all due to documentation improvements. 

"[As doctors] our priority is always first the patient," Rose said. "And the last thing that we get to is making sure that our documentation supports a certain amount of billables." 

Rose feels strongly, though, that in order for healthcare technology across the board to be successful, doctors must buy into the belief that it's actually serving a purpose. 

"If [doctors] are told to do something simply because Joint Commission or CMS has decided that that's what has to be done, that's always a difficult way to get buy-in," Rose said. "But if they can agree that, theoretically, it's a good idea, and you incentivize it with money, they'll work like any other group of people." 

The HMA study consisted of 90 hospitals and health systems within the U.S., which accounts for more than half of the net patient revenue in the country. Among those participating were NewYork-Presbyterian Hospital, Vanderbilt University Medical Center, Partners Healthcare and Johns Hopkins Hospital.