The Multi-Faceted Realities of Present Day Medicine

by Marlin W. Schul MD, MBA, RVT, FAcPh

How many years have you used a computer in your home? When you had your first mobile phone, was it in a bag? Did you dream it could get any better? Do you remember when the internet was so slow you could complete your paper medical documentation while a web page was loading? Over the years in your medical practice, did you ever believe that communi-cation, documentation, and billing would prove so dependent on an interlaced electronic network? Welcome to present day medicine.

The reality is that many productive practices rely on com-puters and the internet to not only assist with day to day billing and documentation purposes, but to promote their respective practice. Electronic billing software enhances efficiency in getting charges submitted. When coupled with an integrated electronic medical records system that guides effective documentation, revenues may appropriately be enhanced. Though nearly all practices have websites, do they truly optimize the material at their finger tips when market-ing? Whether webpage enhancements, electronic posts on Facebook, Twitter, email blasts with an educational message, the utility of electronic media in a phlebology practice is truly far reaching, and typically far less expensive.

Add the certainty of National Healthcare initiatives under the Obama administration, the extent of dependence if not mandated integration to electronic media causes anxiety and potential concern if one has ever implemented a new billing or electronic medical records system. The administration is seeking universal access and transparency for medical records for the sake of efficiency, without sacrificing privacy. Optimistically speaking, one could easily argue that transpar-ency could potentially help identify best practices, establish outcome measures for phlebology, and across specialties identify compliance with DVT prevention efforts. What this likely means is that to be competitive, a practice may find it crucial to become formally affiliated with a hospital system. The private practice/hospital model takes many forms, but the relationship may prove necessary to simply get paid for the work performed vs. mere convenience.

Enter the new United Healthcare coverage guidelines issued August 1, 2010. Electronic media now becomes the only means possible to acquire a pre-service approval with this publicly traded company. In a means to curb utilization of thermal ablation procedures, the current documentation guidelines and submission process is manageable, yet fails to represent anything resembling efficiency for the phlebology practice. The guidelines, found only on the Worldwide Web, raise questions about their validity as is shared elsewhere in this issue, but at least the rules are known. The fact remains that digital imaging of gross photos and duplex images are now required for all pre-service reviews, and the only way to submit these under the current UHc mandated system is through a secure encrypted portal. given the fastest T1 line in an office, it still takes time to compress the images, load them, and submit electronically into the abyss. In a day of enhancing efficiency of day to day practices through electronic media, this example fails to offer anymore than an onerous documentation challenge for the office/billing staff submitting the pre-service request.

Given the challenging times in medicine today, one cannot refute the reliance on the electronic age to support a vein practice. The articles sharing the present day implementa-tion of electronic media in phlebology may prove enlight-ening in offering new opportunities for efficiency for the vein practice. As always, if you have an interesting topic or medical case you believe would be of interest to the readers of VEIN Magazine, please share your thoughts. We would like to hear from you.