Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States.
UPMC (University of Pittsburgh Medical Center) Center for Assistive Technology, Pittsburgh, Pennsylvania, United States.
Appl Clin Inform. 2021 Mar;12(2):348-354. doi: 10.1055/s-0041-1729166. Epub 2021 Apr 28.
Power mobility devices (PMDs) such as power wheelchairs and scooters are crucial for mobility, self-care, employment, and leisure activities. The documentation process for insurance coverage is complex and requires communication and document delivery among multiple stakeholders. The objective of this project was to develop an electronic submission process for medical documentation of PMDs submitted for prior authorization to a Medicare Administrative Contractor (MAC) and implement a standardized means of communication between providers and payers.
A protocol was developed to create and securely transmit an electronic prescription and several documents that outline medical necessity from a clinical team using EpicCare to a MAC via a Health Information Handler. A Rehabilitation Technology Supplier (RTS) added detailed product information and specifications to the electronic package during transmission.
The setting involved in the study was University-based outpatient assistive technology clinic.
The protocol demonstrated successful transmission of an order, medical documentation, and request for signature. Results were transcribed to a readable format for the clinical team and RTS. A set of quality metrics for use in future projects was also identified.
This pilot project demonstrated successful electronic exchange and transmission of medical documentation for durable medical equipment from the electronic health record to a MAC.
动力移动设备(PMD),如动力轮椅和 scooters,对于移动、自理、就业和休闲活动至关重要。保险覆盖范围的文件处理过程复杂,需要多个利益相关者之间进行沟通和文件传递。该项目的目的是为提交给医疗保险行政承包商(MAC)进行事先授权的 PMD 的医疗文件开发电子提交流程,并在提供者和付款人之间实施标准化的沟通方式。
开发了一个协议,使用 EpicCare 从临床团队创建并安全地向 MAC 传输电子处方和几份概述医疗必要性的文件,通过健康信息处理程序进行传输。康复技术供应商(RTS)在传输过程中向电子套件中添加了详细的产品信息和规格。
研究中涉及的设置是基于大学的门诊辅助技术诊所。
该协议成功传输了订单、医疗文件和签名请求。结果被转录为临床团队和 RTS 的可读格式。还确定了一组用于未来项目的质量指标。
该试点项目成功展示了从电子健康记录到 MAC 的耐用医疗设备医疗文件的电子交换和传输。