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Home / News & IndustryManaged Care Insight and Analysis
Updated: June 10, 2008
National Survey Queries Ambulatory Surgery Centers On Electronic Documentation

Ambulatory Surgery Centers (ASCs) appear to face challenges yet see promise in the adoption of electronic health records (EHRs).

According to an independent national survey of ASC administrators, 82 percent of ASCs do not use an EHR, 85 percent use paper perioperative notes, and 74 percent use dictation and transcription for the generation of physician procedure notes.

The study was commissioned by Wolters Kluwer Health, a leading global provider of information for healthcare professionals and students.

Wolters Kluwer Health provides electronic procedure documentation and patient charting solutions for hospitals and ASCs through its ProVation Medical brand.

Forty-three percent of the administrators cite the following obstacles to electronically streamliningdocumentation:

  • Lack of interface with scheduling software and other existing systems;
  • Lack of capital investment;
  • Lack of software that will capture their patient mix; and
  • Lack of personnel to implement a new system.

In addition, 49 percent have concerns revenue may be lost in the implementation process.

Nearly one-fourth of the ASC administrators do not know their current per chart document management costs. Among those who are aware, 69 percent place this cost between $3.00 and $9.00.

"Relying on paper in an era of electronic documentation and communication is inefficient and expensive. Our goal is to help ASCs streamline processes and cut administrative costs by integrating electronic documentation with their workflow and current IT systems," said Arvind Subramanian, president and CEO, Wolters Kluwer Health Clinical Solutions and ProVation Medical.

Subramanian cites changes to ASC reimbursement that will call for careful cost management and accurate billing.

"In 2008 Centers for Medicare and Medicaid Services (CMS) begins a four-year phase-in of a new ASC reimbursement schedule. In 2008 CMS also added approximately 800 surgical procedures that qualify for reimbursement when performed in the ASC setting. These changes present both opportunities and challenges for ASCs and compel them to examine best documentation and billing practices, which directly impact revenue and reimbursement," said Subramanian.

In the survey, 175 administrators considered these combined changes and estimated future revenue at their ASCs, making predictions based on full phase-in of the new reimbursement schedule. Forty-two percent of ASC administrators expect decreased revenue at their sites; of these administrators, 50 percent believe gastroenterology services will negatively impact revenue. Of those who anticipate increased revenue at their sites, 36 percent believe orthopedic services will have a positive effect on revenue.

Address: Wolters Kluwer Health, 161 West Washington St., Suite 1100, Conshohocken, PA 19428; (610) 234-4345,

  This article was taken from:
Pay-For-Performance Reporter

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