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Subject:
From:
Lauren Majors <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 30 Oct 2014 23:37:25 -0400
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Hello,

I’m a long time reader and first time contributor to LactNet.  You all have been a wealth of wisdom for me throughout the past couple of years—so thank you!!

I work in the electronic medical record healthcare consulting space (vendor-neutral working with most of the well-known EMRs out there on the market).  I see a huge need for electronic documentation optimized for IBCLCs that is easily accessible and affordable, especially to those in private practice.  Most of the major vendors auto-populate E&M/CPT codes based on your assessment and plan during an encounter and allow you to electronically file a claim, as well a send & receive referrals, perform eligibility checks, and customize assessments and plans.  I understand the complexities that our profession faces when it comes to billing and the need is great to have the ability to electronically document our encounters in a meaningful, efficient way.  I’d like to advocate change in this area and I’m in my own assessment and planning phase.  Who better to ask than the ones doing this work every day?  Any feedback is helpful, but what I’d like to know is:

Private Practice-based LC's:

What are you using? Paper, semi-electronic (ex, Microsoft applications), or fully electronic software?  For both assessment and billing or just for one?
What are some characteristics of your assessment documentation?  
Do you have an electronic system for populating E&M/CPT codes?  
Do you electronically file claims?  Are you reimbursed in a timely manner?  Do you have a way of getting notified that claims will be accepted before you submit?
Have you been able to get licensure recognition from insurance companies and feel those codes are adequate to the level of services you are providing?
If you are not affiliated with a provider, what are the top office visit codes you use routinely?

Hospital-based LC’s:

Are you using an EMR?
Were you apart of the build for your consults during implementation & is it optimized for a LC consult or is it sorely lacking?
If it’s a fit, why?  If it’s lacking, what do you need that you don’t have?
Do you document in the room with the patient?
Are you you able to do specialty-specific functions like calculate feeding requirements or print outpatient ID labels/bar codes for milk storage (NICU’s)?
Do you document on mother’s chart, baby’s chart, or have flowsheets built to populate data on both?

Both:

Does your electronic documentation allow you to quickly do detailed HPI’s, ROS’s, save templates, or send electronic referrals to other practices?
Do you have education handouts saved as templates that you can easily print or electronically send to patient or other provider that auto-populates with your encounter assessments?
Are you able to use tablets and/or a jotter to draw images for electronic documentation tied to your encounter?
Do you have any clinical decision support tools tied to your EMR that appear as alerts?
What are your reporting capabilities?  Can you document and measure statistical data relevant to our field to identify trends?
Basically, as LC’s, what are your TRUE needs in this area?

I realize there are a LOT of questions here, however, there is a lot to consider.  I’m willing to hear what you have to say in regard to any of the questions above.  I look forward to hearing your thoughts and seeing things from your perspective.  I'm hoping for some change and improved resources in this area!
Thank you,

Lauren Majors, BS, IBCLC, RLC, LLLL, IGP

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