Flannigan Matthew J, Adhikari Srikar
Department of Emergency Medicine, Michigan State University, College of Human Medicine, and Spectrum Health, Grand Rapids, Michigan, USA.
Department of Emergency Medicine, University of Arizona, College of Medicine, Tucson, Arizona, USA.
J Ultrasound Med. 2017 Dec;36(12):2467-2474. doi: 10.1002/jum.14284. Epub 2017 Jun 24.
To evaluate the impact that an innovative automated ultrasound (US) work flow, which allows for bedside performance of examination documentation and order placement, has on point-of-care US billing compared to ordering US examinations through an electronic medical record.
We conducted a retrospective review of point-of-care US billing data (March 2014-February 2016) for adult and pediatric emergency departments with an emergency medicine residency and a US fellowship. An innovative work flow with the ability to automate US billing and selectively transfer the images and reports for patient care examinations to an electronic medical record and picture archiving and communication system using the QPath US work flow solution (Telexy Healthcare, Maple Ridge, British Columbia, Canada) was implemented. The total number of examinations billed and percent increase in technical and professional revenue, excluding examinations performed by US fellows, before and after implementation of the automated work flow innovation were determined.
After implementation of our automated US work flow process, the number of patient care US examinations billed increased significantly due to completing documentation and immediate billing determination at the bedside. The increase in percent billing relative to total examinations was noted in both technical (32% to 61%; P < .0001) and professional (37% to 65%; P < .0001) billing components. In addition, there was a net increase in technical and professional fee revenue to 96% and 78%, respectively.
The implementation of an innovative automated work flow to include bedside point-of-care US documentation, order placement, and the automated transfer of images and reports led to a significant increase in US billing revenue, documentation, and compliance.
评估一种创新的自动化超声（US）工作流程对即时超声计费的影响，该流程允许在床边进行检查记录和订单下达，与通过电子病历订购超声检查相比。
我们对设有急诊医学住院医师培训项目和超声 fellowship 的成人及儿科急诊科的即时超声计费数据（2014 年 3 月至 2016 年 2 月）进行了回顾性研究。实施了一种创新的工作流程，该流程能够自动进行超声计费，并使用 QPath 超声工作流程解决方案（加拿大不列颠哥伦比亚省枫树岭市的 Telexy Healthcare）将患者护理检查的图像和报告选择性地传输到电子病历和图像存档与通信系统。确定了自动化工作流程创新实施前后计费的检查总数以及技术和专业收入的百分比增长，不包括超声 fellowship 人员进行的检查。
在实施我们的自动化超声工作流程后，由于在床边完成记录和即时计费确定，患者护理超声检查的计费数量显著增加。技术计费（32%至 61%；P <.0001）和专业计费（37%至 65%；P <.0001）组件相对于总检查的计费百分比均有所增加。此外，技术和专业费用收入分别净增加到 96%和 78%。
实施创新的自动化工作流程，包括床边即时超声记录、订单下达以及图像和报告的自动传输，导致超声计费收入、记录和合规性显著增加。
