Patient Management System
Patient management is a broad term, with two categories of definitions. One definition refers to a software tool that streamlines processes within a medical practice or hospital, and the other refers to an entire system of care involving both patient and practice.
Previously, the Food and Drug Administration (FDA) regulated some types of patient management software (PMS): Those used as medical devices (such as a wearable technology) to collect personal data, or those that used data or performed analysis to help a physician diagnose or treat a patient.
Instead of handling tasks like booking appointments, checking in patients at an office, or billing, the goal of these systems is to increase patient engagement and help them take an active role in their own health care.
Resource and patient management systems (RPMS) combine the medical data and analysis aspects of other software with administrative tools to help make a practice or hospital more efficient. This system combines patient management and health with the medical practice or hospital management.
Ease Overburdened Staff
Administrative staffing is one of the big drivers of high healthcare costs. Automating routine processes like patient flow management helps medical clinics and hospitals minimize their administrative expenses. It helps to reduce the amount of data entry tasks your front desk staff needs to perform, which lets them make the most of their working hours. It also helps maintain efficiency by easing workloads to the staff members perform better, more meaningful work.
Medical practice management systems allow physicians and office staff to quickly book and confirm appointments and manage schedules across multiple providers, locations and days of the week. Many systems also allow patients to book their own appointments online.
One of the biggest clinic staff faces when it comes to scheduling is the need to simultaneously ensure each physician’s time is appropriately allocated for patient visits as well as conference calls and other miscellaneous meetings.
Medical practice management systems give staff members real-time insight into each provider’s availability, allowing them to instantly identify potential scheduling conflicts. The software also helps clinic staff avoid (or reduce) double-bookings.
Additionally, most systems can send text or email appointment reminders to patients, helping to reduce no-shows.
The ability to track, store and access patients’ electronic medical records is vital to any healthcare provider. Some patient tracking software offers its own charting module and others integrate seamlessly with independent EHR/EMR solutions. Find out which you need before choosing a patient record management software solution.
Whichever you choose, charting features should record, update and archive crucial patient data within the system for access at future encounters. It produces flow sheets for each patient which list immunizations, previous diagnoses, surgeries, test results, chronic issues and other important data.
Some MPMs integrate with other medical software, allowing easy transfer of electronic health records between care providers. Not all solutions offer this, so keep that in mind when choosing software.
Medical billing and coding translate a patient encounter into the languages used for claims submission and reimbursement.
Billing and coding are separate processes, but both are crucial to receiving payment for healthcare services.
Medical coding involves extracting billable information from the medical record and clinical documentation, while medical billing uses those codes to create insurance claims and bills for patients. Creating claims is where medical billing and coding intersect to form the backbone of the healthcare revenue cycle.
The process starts with patient registration and ends when the provider receives full payment for all services delivered to patients.
The medical billing and coding cycle can take anywhere from a few days to several months, depending on the complexity of services rendered, management of any claim denials, and how organizations collect a patient’s financial responsibility.
Medical practice management concerns physicians and specialists throughout all disciplines in medicine as well as those staff members that support their practice of care. Running a professional medical practice is not an easy task, and there are constant challenges that professionals need to be prepared for and overcome to maintain a great reputation of quality and care for their patients.While larger organizations may purchase a software solution for each of these individual needs, small offices can get everything they need in a convenient package. With MPM, providers get instant access to patient information and a reliable method for updating charts, noting medications and other important data.
Timely Patient Care
Larger clinics and hospitals can enjoy similar benefits to smaller ones but have the added bonus of making patient-related processes more efficient. Because large practices have a heavy patient flow, the scheduling features of MPM is crucial to operations. Having an organized patient intake flow can mean the difference between a calm, orderly waiting room and a packed hotbed of irritation and frustration. A comprehensive management program enables immediate record transfers, enhances patient workflow and eliminates treatment errors that result from inaccurate or incomplete paper records. The best patient management software allows providers to deliver timely, accurate and better-quality patient care.
A medical practice management system lets physicians and their staff quickly enter and access not only basic patient information for example, the patient’s name, address, telephone number, birthdate, employer and insurance provider but also extensive clinical data, such as medical history, medications and reasons for past visits.
Medical practice management systems can also automatically verify a patient’s insurance coverage prior to the patient’s visit.
Handling insurance claims
The software has a feature of editing a patient's data according to the standards of the insurance claim handler. The software can be used to submit claims electronically, check claim status and verify benefits information. In most cases, electronic claims are submitted using an automated software process, but some practitioners take help of an electronic claim clearinghouse for submitting their claims.
Of course, Patient Management Software contains features like keeping a track on the inventory of the medical facility, monitoring stock and distribution, supply levels and preparing a list of items dispensed to a patient, thus eliminating the requirement of manual data entry.
Automated process management streamlines and standardizes many administrative tasks, freeing medical staff to focus on what they do best: patient care. As a result, staff members may see improvements that help them find their jobs more fulfilling. A happy staff shows when those providing care are happy and healthy, patients enjoy a higher standard of value-based medical care.
Efficiency, accuracy and fewer errors directly benefit the facility’s bottom line. Patients who receive quality care from a professional and focused medical team will remain with the practice and tell their friends. With management software in place, clinics and hospitals have the ability to increase their patient capacity while still providing quality care. More patients mean more profit.
Patient Encounter and Care Planning
Before the patient visit, the student team should review the medical records and work with the patient’s care team and/or preceptors to determine the team’s goals of the patient encounter.
The care team, including preceptor(s), will determine what type of patient and/or family/caregiver encounter is appropriate. This decision will take into account existing visit options, team size and composition, and patient/family/caregiver characteristics. The patient visit may be a home visit, which can be conducted with a social worker or nurse, with overall supervision by the practice preceptor. The visit may also take place in the office setting, long term care facility, hospital, correctional institution, homeless shelter, and/or other appropriate setting.
CMS defines a care plan as, “The structure used to define the management actions for the various conditions, problems, or issues. A care plan must include at a minimum the following components: problem (the focus of the care plan), goal (the target outcome) and any instructions that the provider has given to the patient. A goal is a defined target or measure to be achieved in the process of patient care (an expected outcome).”
Although much of the process of active care planning can be carried out at this student visit, finalizing the plan may not take place until the students meet with the practice team to review and/or revise the preliminary plan presented by the students.
Security and Facility Requirements
Part of being a healthcare provider is ensuring your patients’ data is secure. All medical practice and patient information systems should be HIPAA compliant in order to meet federal security standards. ICD-10 code implementation is also crucial to make sure diagnoses input into your system can be read and understood universally by other providers.
Many MPMs offer an internal direct messaging system where patients can directly send messages to their doctors. While this system is incredibly convenient and saves both patients and doctors time, it transmits sensitive information. It’s vital to make sure there is ample security for your system, and this includes any software it integrates with.