CMS and UPMC Address Quality of Care and Medicare Reimbursement Changes Via TheraDoc®-Healthcare Informatics Webinar

SALT LAKE CITY, October 9, 2007 – A free Webinar presented to help hospitals understand the impact of the latest Medicare changes and the role IT can play in helping to reduce and prevent hospital-acquired infections (HAIs) and other medical errors is available through September 2008 at www.theradoc.com. The panel presentation, titled "New Medicare Medical Error Reimbursement Exclusions: Tracking and Preventing Errors with IT," features speakers from the Centers for Medicare and Medicaid Services (CMS) and University of Pittsburgh Medical Center (UPMC).

The program is hosted by Healthcare Informatics and sponsored by TheraDoc®. During the original live broadcast, September 18, nearly 1,000 healthcare professionals from a variety of hospital departments, including hospital CIO's, risk managers, quality improvement staff, IT managers, CFO's, infection control practitioners, Medicare/Medicaid compliance staff, chief medical officers, and other C-level executives, were educated about the recent Medicare hospital reimbursement reforms.

Effective October 2008, Medicare will no longer pay the extra costs of treating a specific group of preventable errors, injuries and infections that occur in hospitals, a decision that will significantly impact hospital revenue. Beginning with discharges that occur on or after October 1, 2007, hospitals are required to document and report a Present on Admission (POA) code for all billed diagnoses. If a condition was not present on admission, reimbursement will be reduced accordingly for costs associated with that condition beginning October 1, 2008.

With these new rules, Medicare hopes to motivate hospitals to increase the quality of care and reduce preventable medical errors. In order for clinicians to make better decisions that will enhance patient safety and eliminate errors, they need tools that will provide them with the ability to see pertinent patient information in the context of best practice guidelines. Without technologies that perform surveillance and push information to caregivers in real-time, alerting them to emerging changes in patient condition and other issues needing intervention, it will be difficult to make better clinical decisions and significant strides in quality improvement.

"We understand that a lot of systems changes will need to be undertaken," says Patricia E. Brooks, RHIA, senior technical advisor, Hospital and Ambulatory Policy Group, CMS, "We will be working with and educating hospitals to make this transition smooth."

Brooks participated in an interagency workgroup, which included the Centers for Disease Control and Prevention (CDC) and the injury prevention and disease control community, to identify the proposed list of conditions non-present on admission that will no longer qualify for extra reimbursement under the Medicare Severity diagnosis related-groups (MS-DRGs) as of October 1, 2008.

"While hospitals are required to submit POA codes beginning October 1, 2007, we want to allow time for systems changes to take place," says Stuart J. Barranco, senior technical analyst, Division of Institutional Claims Processing, CMS, who was responsible for drafting the present-on-admission billing requirements used by CMS' standard systems. "We will not immediately issue penalties for missing codes, but we will begin sending alerts effective January 1, 2008. After April 1, 2008, claims with missing POA codes will be returned."

Tamra E. Merryman, UPMC's vice president of quality improvement and innovation, addresses ways in which hospitals can better monitor, track, manage and reduce HAIs and other medical errors to improve patient safety. "The healthcare system of the future will provide the right care at the right time in the right way... every time," says Merryman. "Our goal is to achieve perfect care and we can do this by focusing on quality outcomes."

A leader in patient care and safety, and one of the leading academic medical centers in the United States, UPMC maintains its high standards of care by utilizing multiple technologies to significantly improve patient safety, decrease HAIs and other medical errors and reduce associated costs. To meet these high standards and increasing federal and state reporting requirements, UPMC selected technology by TheraDoc, a Salt Lake City-based clinical informatics company that develops and implements real-time electronic surveillance and expert clinical decision support technologies.

"We have found TheraDoc solutions to be absolutely stunning and exceptional," says Merryman. "TheraDoc automates the work of an infection control nurse by providing real-time surveillance and presenting information in a decision-supported manner, thereby allowing us to identify, treat and report more effectively and efficiently."

UPMC has implemented TheraDoc technology in six of its 19 hospitals with future plans to install TheraDoc solutions in its remaining facilities. UPMC has also made a significant investment in TheraDoc and will work with the company to add new capabilities to its products.

TheraDoc representatives Scott Walker, MBA, JD, vice president, strategic development, and Aldo Tinoco, MD, clinical solutions executive director, provide additional information on how TheraDoc's patented expert systems can be utilized by hospitals to help prevent HAIs and other medical errors through enhanced clinical decision making.

"We are thrilled to bring this important presentation to hospitals facing more stringent reinforcement policies," notes Stan Pestotnik, TheraDoc president and CEO. "TheraDoc technology truly provides a solution that is uniquely positioned to help hospitals reduce occurrences of issues related to quality of care and patient safety, therefore reducing the number of non-reimbursable conditions outlined by the newly mandated Medicare reimbursement exclusions."

TheraDoc's real-time surveillance, identification, guidance, measurement and reporting technologies help hospitals to prevent and control infections, alert clinicians to adverse events and changes in patient condition, select evidence-based treatments and meet mandated reporting requirements. These technologies provide clinicians the needed support to increase the quality, efficiency and safety of patient care, which improves both clinical and financial outcomes for those hospitals using them.

As of August 31, 2007,152 hospitals representing over 37,000 beds had licensed TheraDoc technology to provide continuous patient-safety surveillance for their patients and real-time, patient-specific clinical decision support for 1.6+ million inpatient admissions and 26+ million outpatient visits. Clients using TheraDoc technology platforms include academic medical centers, community hospitals, VA Hospitals and integrated delivery networks in 29 states and the District of Columbia.

About TheraDoc
TheraDoc is a clinical informatics company dedicated to improving the quality, efficiency and safety of patient care through enhanced clinical decision making. It provides innovative, best-in-class solutions that improve clinical and financial outcomes at a range of provider and payer organizations, including some of the most-respected healthcare institutions in the country. With clinical transparency, TheraDoc's technologies seamlessly place mission-critical knowledge at the clinician's fingertips, helping them to confidently manage multiple processes of care across multiple conditions and diseases. The company's strict adherence to medical informatics standards enables connectivity and interoperability with any hospital's disparate health information systems.

Founded in 1999, TheraDoc designs, develops and supports a suite of clinical decisions support technologies utilizing inference engines that enable its real-time solutions. TheraDoc's founders and core medical informatics team are internationally recognized for their pioneering and continuing work in medical expert systems. Their experience in clinical decision support design and development spans two decades. On the Net: www.theradoc.com.