Case Study: Unified PCM Delivery for Multi-Specialty Care Teams with eCareMD

Client Overview

Based in Ohio, USA, the client has a multi-specialty hospital focusing on primary care, cardiology, and pain management. Currently managing these patients throughout their Epic EHR, while seeking the Care coordination opportunity for attention required patients with one serious condition by enrolling in the PCM program, the client is actively looking for a digital care coordination platform equipped with the PCM care coordination program.

Problem Statement

1. Missing an EHR-integrated solution, causing insufficient patient information

For providing care coordination services to the required patients' clients, the current EHR system has the patient’s health data, from which the client needs EHR-integrated care coordination software to onboard patients in the PCM program with their health data, such as conditions, medications, directly from their current EHR

2. Absence of real-time patient engagement

The client’s current care delivery system has no advanced functionalities to attract more patient engagement, as care delivery requires patient engagement in health outcomes

3. Lack of a real-time logging system

While observing the current functional requirements of PCM software, the client has required logging functionalities in care coordination software, which is necessary to track PCM services for billing and revenue generation. The absence of these key functionalities makes a client’s business fail in audit reports.

4. Poor Billing management

Inconsistency in tracking revenue, missing billable service code causing inconsistency in billing reports, resulting in slow revenue growth. This is an important area where the client's business is set back in monetary terms while delivering care services.

Solution

While considering these obstacles in the current software, the client’s team had a demo call with Medarch’s business analyst team, where the care coordination software eCareMD was introduced, which has robust technology in integrating the latest EHRs along with value-based health care modules. By reviewing and adhering to the eCareMD platform, the client’s business has solved key business problems in providing care service, especially in the PCM program as below:

Solution Highlighted

1. eCareMD’s EHR import functionality

The eCareMD software integrates with different EHRs, such as Epic. By integrating with the client’s EHR, the providers can import patients directly from their EHR to eCareMD along with patients’ Clinical data, such as conditions, Medications, Vital data, and demographic information. This helps care coordinators monitor and provide necessary care services to the patients.



2. Predefined Care plans

The eCareMD platform has the Library module, which added over 160+ care plans for specifically PCM-oriented conditions, which helps care managers to assign an accurate care plan to deliver care services within a time. This functionality also gives the feasibility to assign a pre-defined care plan for each program.

3. Auto/Manual Time logging system

To qualify each CPT code under PCM program, the eCareMD has the auto/manual time logging system for each activity perform by care coordinator, also it generates the time log reports for specific provider as well as patients, by logged time CPT codes are qualifies for billing for billing and generates billing report helping clients to reimbursement.

4. Billing and Claim Module

eCareMD has a dedicated Billing and Claim module to track Monthly care services along with the qualified CPT codes. This Module detects the patients based on their time logged and fetches CPT codes accordingly. Additionally, the reports generated from that billing patient list, including provider group details, included CPT codes and time logged for each patient.

Value Delivered

1. 60% fast Streamlined patient Onboarding

The EHR patient import functionality streamlines the process of patient onboarding, helping providers to save manual entry for patient onboarding, saving valuable time for provider care for multiple patients.

2. 50% Care plan creation time saved

eCareMD has a dedicated Library module with predefined 160+ care plans for specific conditions from which the provider can quickly assign a care plan to the patient, filling the gap between manual care plan creation for the same conditions and diagnosis codes, resulting in 50% time-saving for providers.

3. Accuraccy in time logging

The auto time logged system emphasis the accuracy in time log report of each provider as well as patients, empowering the audit quality for each time log, this fuctionality has the robust features such as auto time zone capture, time log saving every, log as title and edit modify log entries giving more feasibility to provider to enter care hours.

4. Increase in reimbursement

eCareMD’s Billing and claim module has an auto code qualification system where the CPT codes get qualified for each month based on time logged. The provider can generate billing and clinical reports, including billing and clinical data for the reimbursement process.