
Dr. Scott Munsterman is an expert on the transforming model of health care delivery and compliance with a commitment to the promotion and advancement of the chiropractic profession. Dr. Scott Munsterman is the founder and CEO of Best Practices Academy, a clinical improvement organization providing focused leadership to bring practices into compliance with regulatory standards, equip them to improve clinical outcomes, and integrate into the transformed care delivery system.
In this episode of TechTalk Podcast, Brad Cost, Dr. Jay Greenstein, and Dr. Scott Munsterman sit down to discuss:
The significance of digital health in today's day and age.
Promoting telehealth and digital health for all who will listen!
Using technology and partaking in the practice of the present to stay ahead.
SHOW NOTES:
6:55 – The meaning of digital health. “Well, to me, it means how we communicate with patients and how we carry out services, which, many times, we don't think about the clinical advice that we give to patients. We're always thinking about adjusting or modalities or in office exams. We're in the digital world, so we're actually able to perform evaluation and management types of services in that type of a media, whether it's voice only or synchronous/asynchronous. The other side of it has to do with being able to collect information from devices that we have patients utilize. How do we take that information and apply it to the patient's treatment plan? It is a whole new world. It causes us to step outside of the boundaries of our brick and mortar to be able to extend this knowledge base that we have in our head further.”
9:42 – Determine your vulnerabilities. “That really stems around having good policy in place, understanding what the requirements are under the Privacy Rule and the Security Rule, and figuring out how we determine our vulnerabilities. If we are utilizing different types of systems within the practice, whether it's a cloud-based backup or a backup to our EHR system to move that offline or offsite, it’s considering it all because that's PHI. That is data that’s moving from one place to another. Making sure we've got all those bases covered is anyone’s HIPAA program. It really begins with understanding the policy and procedures and having those customized to your practice. You have to know what you're doing and understand your systems to determine what vulnerabilities you have in your practice.”
20:31 – Broadcasting telehealth! “A big part of it is just helping educate providers that it's an option, whether it’s a synchronous type, where you actually have face-to-face time with patients, or if it’s just strictly voice. In addition to that, you have portal communication or virtual check-ins as other forms of telehealth, where you have back-and-forth secure communication with a patient in a text format. There's just a number of different options we can go about to have a digital and coded form of clinical communication with patients, just like we did during COVID.”
23:57 – E/M Coding. “We always have to be mindful that each state has its own telehealth rules. I want to get that out there right away! Synchronous is like Zoom, where you have audio and visual and feel like you're in the office. You are utilizing your evaluation and management coding for that. Typically, it's regarding an established patient. E/M coding can be coded based on medical decision making or time. Medical decision making is the complexity of the diagnosis or the amount of information that you're taking in (the table of risk). Time is how long you are spending on that date of the encounter, both the face-to-face and non-face-to-face. Whether you're in the clinic or in a synchronous environment, you're doing E/M coding.”
25:47 - Non-face-to-face communication examples. “Information you reviewed on that day, either before or after you had a face-to-face patient visit. Maybe the patient brought in x-ray reports or MRI scan reports. Maybe you reviewed the intake paperwork prior to walking in to see the patient. That could take two or three minutes, if they've got a very complex history. When you get into seeing the patient, we're including talking about the history of the patient and your actual exam. If you refer them out for x-ray, the time it takes for you to do a report of findings with the patient when they come back. If you pick up the phone and you call Dr. Jay to ask a question about their case. All of that is time. The final part of the timeframe is the time you spent documenting in your EHR on that date of the encounter. When we talk about total time, face-to-face or non-face-to-face, all of a sudden, you begin to see how providers can now recoup a lot of their time. It makes it much fairer.”
34:12 - The future of healthcare and digital health. “Two things. Number one is the last two cars I've owned have had adaptive cruise. I love it. I use it, but I don't throw caution in the wind. I'm still driving, but it's nice that I have that assistance. As a doctor, the old-fashioned part of me says that I love the idea that somebody else is listening in the clinical room. There is a whole list of things that I've been taught as my clinical skills, but having backup would be nice. Number two is that I want to make sure that we continue to have clinicians that are refining their skills or diagnostic abilities and don’t have a sole reliance on that. How are we going to harness that? How are we going to use it? It may not matter what I think, but it will matter what the federal agencies, like the Department of Justice, think. What is their big thing? They don't want to see false claims out there. You're going to see a balanced approach. There's going to be organizations running out, making AI and technology do this, this, this and this. There will also be government agencies coming around that, disapproving of them as a good thing. We have a way to go and it all boils down to is that patient going to get clinical intuition from AI? I have a hard time believing that.”
39:42 – AI vs. human. “Will it be an issue if a note is AI-documented versus human-documented? I'm not saying it should be one way or the other. This is just so new. We've got things that are moving along, but how will that be viewed for authenticity of a record? You've got to make sure you meet elements within a note to make sure it’s coded correctly and authentically. Does it accurately describe what the patient said or what happened during the visit? Was it human-generated or AI-generated? I think it could be a debate!”
47:02 – Practice of the present. “It is the practice of the present. It's all right at our disposal. This has been great getting into this venue to talk at this level. The key is just for our providers to be able to understand and harness that knowledge of what's around them to leverage what they know. Not only what they can do in providing services in their office, but what they know and how they can extend beyond that and just open up their mind. They just need to step outside and gain more knowledge, then they'll become more comfortable and build out their infrastructure within their clinic system. I would encourage everybody to come up with opinions. I came up with my opinions up to this point and I hope I'm wrong on some of them. I just have reservations on different things that I've seen and experienced in life. It's a very exciting time in health care.”
CONTACT SCOTT
Comments