Press Releases

Picis Redefines the ED as the Heart of the Hospital with ED PulseCheck 5.0

Industry’s first EDIS to address the five elements most critical to creating a healthy hospital including potential to increase revenue by millions of dollars annually

WAKEFIELD, Mass. — Feb. 16, 2010 — Pressures from regulatory audits. Bottlenecks of patients in nearly all departments. Revenue reimbursement struggles and leakage. Interoperability of multiple systems. Meaningful use. What do all of these have in common? They are the five greatest challenges hospitals face today — and they can all be addressed in the emergency department (ED) with Picis ED PulseCheck^® 5.0.

Nearly one-third of all hospital revenue — approximately $350 billion in the U.S. — comes from patient admissions through the ED. Having licensed its software solutions to more than 1,800 community, non-profit and academic hospitals and integrated delivery networks (IDNs) worldwide, Picis has long recognized the ED as the gateway to the most critical operational, clinical and financial functions within the hospital.

Dr. Michael Westcott, Chief Medical Information Officer at Alegent Health, recently highlighted as a center of excellence by U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius commented, “The ED feeds patients into all other care areas, and accounts for so much of the hospital’s revenue, that clinicians and executives should view the ED as both the clinical and financial hub of the hospital. Picis ED PulseCheck has helped our clinicians deliver the highest-quality patient care, streamline the flow of patients throughout our hospital, and provide complete, defensible medical documentation required for reimbursement.”

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Medical Necessity: The Multi-Million Dollar Decision
Providing accurate documentation to support physicians’ patient care decisions — particularly around whether a patient should be admitted to the hospital from the ED, or kept in observation status for up to 24 hours — is a major area of concern to hospitals. Hospitals often place patients into observation who might otherwise be admitted, because intensity of service and medical necessity for these patients are not clearly defined or documented. The difference in reimbursements resulting from this decision averages $6500 per patient, and is often the cause of increased scrutiny by recovery audit contractors (RAC).

With LYNX CareBridge^® integrated into PulseCheck 5.0, Picis is delivering the industry’s first software solution designed to address this medical necessity dilemma. Accurate and appropriate billing and documentation regarding medical necessity determinations have the potential to help hospital customers that have seen a recent increase in observation stays realize a projected average increase in revenue of nearly $5 million per year.¹

CareBridge allows hospitals to apply specific hospital policies around determining appropriate admissions and observation practices, then captures medical necessity documentation to support the disposition decision and assignment of the appropriate level of care — leading to defensible and accurate reimbursement for the care provided.

“Because a majority of admission decisions begin in the ED, CFOs in every hospital need to view ED systems as the most important investments they will make — and they should look closer at the revenue they are likely leaving on the table around the admission vs. observation decision,” said Dr. Jim Fox, emergency physician at St. John Health System in Detroit, MI and member of the American College of Emergency Physicians (ACEP) reimbursement committee since 1995. “By collecting the necessary documentation to defend treatment decisions — right at the point of care from when a patient enters in the ED — CareBridge has the potential to change the way hospitals do business by avoiding costly audits and recouping millions in revenue they weren’t even aware they could be saving.”

A Better Window to Eliminate Patient Bottlenecks
While traditional resource management tools have been utilized for some time, our nation’s hospitals still suffer from overcrowding. ED overcrowding is often the result of a scarcity of other hospital resources, not the conditions of the ED itself. Conversely, ED bottlenecks can adversely affect the hospital as a whole.

Picis ResourceView™, integrated into ED PulseCheck 5.0, is the first to offer a two-way view and communication between the ED — where the overcrowding issue begins — and the rest of the hospital. It is also the first tool to provide a comprehensive view into key resources that directly impact the ED’s throughput, including available beds, rooms, staff and equipment in various departments.

ResourceView is a communication tool that allows inpatient units to indicate resource utilization and bed usage on a regular interval. It displays the current status of each unit so that ED and hospital administration can take quick action, allows a unit to request resources, allows the ED and administration to see the bottlenecks when they occur and take action, delivers notifications via pager and email, and collects data for reporting and analysis.

“It is critical for the staff in the ED to have access to an accurate view of how the rest of the hospital is operating every day,” said Marian Moran, CIO at St. Mary’s Medical Center in Langhorne, Pennsylvania and an ED PulseCheck user since 2004. “Coupled with hospital process improvements, ResourceView within ED PulseCheck can open that window of visibility between the ED and the rest of the hospital to help eliminate bottlenecks and improve patient flow and throughput.”

Integrated ED Charge Capture Tools Increase Revenue
Hospital charging for intravenous (IV) infusion and injection services in the ED can account for up to 15 percent of hospital revenue for ED services, but these charges are routinely lost or under-reported because ED clinicians often cannot meet the increasing demands of complex documentation and charging rules within their clinical workflows.

With Picis LYNX E/Point integrated into ED PulseCheck 5.0, clinical staff can spend more time on patient care and less time trying to capture complex codes by collecting these in the background during the normal course of clinical documentation. This drives increased accuracy of hospital reimbursements for these costly IV infusion and injection services — estimated at approximately $10 per ED patient visit. This is incremental to an increase of approximately $30 per ED visit derived from accurate facility visit level charges in earlier releases of E/Point — and for an ED that sees 50,000 patients a year, that can mean an increase in revenue of $2 million a year.

Have Your Favorite HIS and ED Solution Too
Picis ED PulseCheck 5.0 is the first high-performance EDIS, and is designed to easily fit into a hospital’s existing or future IT strategy. Picis is making available new interoperability packages designed for a range of hospital information systems, including those offered by Eclipsys Corporation, GE Healthcare, McKesson Corporation, Siemens Medical Solutions, Medical Information Technology, Inc. (Meditech), Cerner and Epic Systems Corporation.

“Hospital CIOs today are all facing a similar challenge — they know their hospital or IDN needs a specialized tool to meet the needs of the ED, but are afraid of what it will cost in time, money and resources to integrate it with a house-wide system. For us, Picis ED PulseCheck took much of the fear and pain out of making that decision,” said Geoff Brown, CIO of Inova Health System, who drove the implementation of ED PulseCheck in November of 2007. “The new interfaces in PulseCheck 5.0 will make it even easier for hospitals to integrate ED data with other systems and enable CIOs to drive efforts to share information across all types of care settings, help meet quality and patient safety requirements, reduce risk, and ultimately improve coordination of care.”

Become a Meaningful User to Secure ARRA Funds
With built-in support for Health Information Exchanges (HIE), Picis ED PulseCheck 5.0 is now fully compliant with meaningful use guidelines under the American Recovery and Reinvestment Act (ARRA) HITECH of 2009. ED PulseCheck 5.0 delivers standards-based HIE documentation to support specific requirements, produces documents with standard data elements, enables users to view documents from others with the same standard elements, and protects patient privacy.

“With health reform hanging in the balance, we’re proud to be providing the industry with the solutions it needs now to help overcome the five most critical challenges facing hospitals today: medical necessity, patient bottlenecks, reimbursement/revenue capture, interoperability and meaningful use,” said Todd Cozzens, CEO and Vice Chairman of Picis.

Availability
Picis is scheduled to demonstrate ED PulseCheck 5.0 at the Emergency Nurses Association (ENA) Leadership Conference, February 17-21 in Chicago, Illinois in booth #1212, as well as at the HIMSS 2010 Conference & Exhibition, March 1-4 in Atlanta, Georgia in Picis booth #941. Picis is also participating in the HIMSS Interoperability Showcase scheduled March 1-3, an event designed to show real world scenarios and workflow of interoperability between healthcare information systems. For more information on Picis, please visit www.picis.com/solutions or to join a discussion on how cost containment and RAC impact emergency physicians or other issues, visit healthcare-exchange.com, Picis’ new blog.

About ED PulseCheck
ED PulseCheck, part of the CareSuite^® family of high-acuity solutions, was designed by ED physicians and nurses to be the most comprehensive and user-friendly emergency department software available. ED PulseCheck delivers tangible results to hospitals by helping them to improve operations, drive advanced quality initiatives, improve patient satisfaction and recover revenue in the ED. Automating more than 30 million patient visits annually in more than 700 hospitals throughout North America, Picis ED solutions help improve hospital operations and increase patient satisfaction in the ED. When integrated seamlessly with Picis LYNX E/Point point-of-care charge capture system, hospitals can be more confident in facility charging and billing accuracy.

About Picis
Picis is a global provider of innovative information solutions that enable rapid and sustained delivery of clinical, financial and operational results in the acute care areas of the hospital. These high-acuity areas include the emergency department, operating and recovery rooms, and intensive care units. Picis offers the most advanced suite of integrated products focused on these life-critical areas of the hospital where the patients are the most vulnerable, the care process is the most complex and an increasing majority of hospital costs and potential revenue are concentrated. Headquartered in Wakefield, Massachusetts, Picis has licensed systems for use in more than 1,800 hospitals in 19 countries. More information is available at www.picis.com.

© 2010 Picis, Inc. All rights reserved. Picis, LYNX, E/Point, ResourceView, CareBridge and ED PulseCheck may be trademarks or registered trademarks of Picis, Inc. in the United States and/or other countries. All other trademarks mentioned herein are the properties of their respective owners. This press release contains express or implied forward-looking statements relating to, among other things, Picis’ expectations concerning the functionality and market acceptance of its products, and management’s plans, objectives and strategies. These statements are neither promises nor guarantees, but are subject to a variety of risks and uncertainties, many of which are beyond Picis’ control, which could cause actual results to differ materially from those contemplated in these forward-looking statements.

¹The Formula: Hospitals are reimbursed approximately $1,000 for billing related to the care of a patient put under observation in the ED, while admission – even less than two-day inpatient stay – yields the hospital approximately $7,500. Hospitals frequently lack sufficient medical necessity documentation to support reimbursement for admission. Using LYNX CareBridge to provide more accurate medical necessity documentation, a hospital ED can potentially reduce its rate of observation stays as compared to admissions. Assuming a 10 percent reduction in the ratio of observation stays to admissions, with 50,000 ED visits a year, a hospital could realize an increase in lost revenue of $4.8 million.