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eHealth News and Analysis - free to your inbox The Green Report analyses the initiatives, trends and politics in e-health care in South Africa. With its finger on the pulse of developments in the industry the Report brings you timely information and analysis to assist you in your business life. You can make your thoughts and opinions heard through The Green Report by e-mailing the editor, Dr David Green (david@green.za.net) To stop receiving The Green Report e-mail report-unsubscribe@green.za.net This month's stories: A coding tool and Guide to Fees search engine Coding of claims sent to medical schemes and the coding of other healthcare information has long been problematic and difficult. Because payment for claims to medical schemes required that a code from the Guide to Fees accompany each item on the claim, doctors and the systems they use are fairly well set up to insert a valid (if not always accurate) code on these claims. The problem with the code contained in the Guide to Fees is that it yields no clinical information and the financial or claims information that it yields is poorly structured and therefore difficult to work with. For this reason many players in the healthcare sector have attempted to implement new coding systems and standards. Diagnostic coding systems including the International Coding for Primary Care (ICPC) and the International Classification of Diseases - 10th Revision (ICDC-10) have more or less been agreed on for the coding of diagnoses. The Green Report (TGR) however suspects that no one will pay adequate attention to diagnostic coding until payment by schemes is linked to adequate and accurate coding. The other side of the coding coin is procedure coding - this is the Guide to Fees. The Medical Association (SAMA) has for some time suggested that the Guide to Fees be replaced with an adaptation of the American Medical Association's Current Procedural Terminology (CPT) coding system. This implementation has been painfully slow. This is because the vested interests that fear a loss of revenue from changing coding systems are numerous and substantial. SAMA itself has been slow to take the initiative here. Some years ago its Private Practice Committee hounded a guest speaker on the subject out of its meeting. Slowly, but surely, the importance of accurate coding is dawning on all the players in the industry. A tool to help with accurate coding, called SAMA SE has now been made available by SAMA and is available from PracticeMill. The tool includes the new CPT-4 adapted for South Africa. The experience of downloading the tool from the Internet and installing it is not good. There are a number of files to download and install after an online registration process. Which files do what is not clear - you have to know in advance what you are after or you will have to download them all, install them all before you can work out what it is that you want or need. Dr Dirk Koekemoer of PracticeMill acknowledges the problems and that they are being addressed. The web site is currently for the technically minded to play with the SAMA SE. Although TGR did not test the CD version of SAMA SE, Dr Koekemoer indicated that this is easier to install and work with. An order form for the CD version is available at the web site. Have your say - click here to contact The Green Report The use of computers slows the delivery of lab results in emergency settings? The British Medical Journal published on the 5th of May an article entitled "Use of computer terminals on wards to access emergency test results: a retrospective audit" by Eric S Kilpatrick and Stephen Holding. For those in the IT industry their findings are surprising, if not startling. In essence their findings show that, in the situation which they studied, the computer system resulted in an overall delay in the viewing of the results by the attending doctor. In 3% of cases the results could have made a difference to the patient's management and were not viewed at all - amounting to an average of 1 patient per week that could have been managed better. The weakness of the study is that the implementation of the computerised system coincided with the changing of procedures in that the laboratory stopped phoning through results to the emergency ward. So the study does not compare paper based systems with computerised systems or even a "pull" system (doctor phoning in to get the result rather than having the result "pushed" i.e. phoned through to them) with the pull system required of the computer. The doctors were all used to, and relied on, being phoned with the results. When the system changed and they had to remember to log onto the PC to get results then Kilpatrick and Holding were able to demonstrate these surprising results. TGR feels that the value of this article lies in the fact that it shows that computerised systems should reflect and facilitate existing work processes and work flows rather than attempt to impose their own logic. Perhaps the hospital concerned should develop an automated system for notifying practitioners when the results are posted on the computer system Have your say - click here to contact The Green Report Help your hypertensive patients comply with prescribed medication Most people on anti-hypertensive medication don't feel sick. Remembering to take medication on a daily basis under these circumstances is difficult, if not impossible. Patients who would benefit from a daily reminder can be enrolled to receive a daily SMS message to prompt them to take their medication. Fill in this form This service is free to your patients. The service is sponsored by HealthBridge who provide a real-time patient validation and claims submission system. Healthbridge allows practitioners direct access to the processing systems of the medical aids with an immediate response, resulting in faster payment (14 days from date of service to date of payment) a reduction in bad debt, and reduced administration. Have your say - click here to contact The Green Report Health information in demand online A Harris Poll, conducted in April 2001 shows that health information has a huge online demand. The poll suggests that up to 100 million people seek healthcare information online and on average they do so three times per month. 75% of all online adults use the Internet for health information. Of particular interest is that very few go directly to health sites, they get to the health sites via search engines or through portals. "Brand" loyalty to a particular health web site seems not to be a feature of online health information seekers. Health sites wanting to build traffic would need to keep this in mind when developing marketing strategies. This huge usage of health sites is despite the fact that, according to research done by the Rand Research Corporation which suggests that "consumer-oriented health information on the Internet is often difficult to access, hard to understand and incomplete ...". TGR would add that some of it is downright dangerous. With all these people seeking health information online, no one has yet cracked the formula for turning the provision of online health information into a profitable business. Take WebMD as an example. On May the ninth it reported that its revenue for the first quarter was US$184.5 million - down by about US$15 million from its December 2000 earnings. Despite an enormous cost cutting exercise, it still reported a loss of US$32 million for the quarter. WebMD is one of the most popular health sites on the web with over 300 000 unique visitors visiting the site per month. Someone, somewhere is going to have to come up with an innovative model that makes the provision of online health information worthwhile. Hopefully the model can also address the concerns raised in the research by the Rand Research Corporation. Have your say - click here to contact The Green Report See also: Hypertension and Compliance initiatives. |
