SLIDE 1 THE HE SL SLEEPI PING D DRA RAGON
POCT and the Bottom Line: Negotiate your DRG w ith POCT Are you doing all you can?
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SLIDE 2 DISCLAIMER
This material is general in nature. It is made available on the understanding that the presenter is not engaged in rendering professional advice. Before relying on material in any important matter, users should carefully evaluate completeness and relevance for their purposes, and should obtain any appropriate professional advice relevant to their particular circumstances. In some cases the material may incorporate or summarize views, guidelines
- r recommendations of third parties. Such material is assembled in good
faith and the opinion of the author. The intention heretofore is for intellectual pursuit and the expansion of knowledge of POCT systems. It is not for the endorsement of any one entity or vendor.
SLIDE 3 POCT EXPANSION
POCT Expansion
Test menu Test frequency Migration of tests Patient satisfaction
SLIDE 4 THE BUZZ
- Growth acknowledged in trade publications.
- CAP has dedicated chapter for POCT
- TJC has dedicated chapter, Waived Testing
- Fisher Scientific POCT catalog
SLIDE 5 POLLING QUESTION
How much of an increase in test frequency have you seen in the past few years?
- 0%
- 10%
- 20%
- 30%
- More
- Our test frequency has decreased
SLIDE 6
HOW THINGS HAVE CHANGED
Diabetic crisis Tight Glycemic Control Nanotechnology development Increased test availability Increase in testing per hospital stay
SLIDE 7 TEST GROWTH
Increase in Diabetes Tight Glycemic Index Consciousness APA algorithm AACE/ADA algorithms
SLIDE 8 GRO ROWING S STRO RONG
- Bedside Glucose tests
- Increase growth per year
- 40% increase in past 5 years
1000 2000 3000 4000 5000 6000 7000 8000 9000 10000 total month
Glucometer Use
Total 2008 Total 2009 Total 2010 Total 2011 Total 2012
SLIDE 9
NEW GUIDELINES
American Pediatrics Association algorithm AACE/ADA algorithm
SLIDE 10
AVERAGE LENGTH OF STAY
ICU to post surgical avg 7 days. 4 x 7 x patient population
SLIDE 11 TEST FREQUENCY
tests per day
- Newborns
- Post surgical
- ICU
SLIDE 12
DO THE MATH
ICD 9 codes Reimbursement schedules Frequency
SLIDE 13 CUMULATIVE G GROWTH TH BY Y MONTH THLY RE Y REPORTS TS
32% % Growth s since ce 2 2010
2000 4000 6000 8000 10000 12000 14000 16000
POCT Cumulative Growth
2010 2011 2012
SLIDE 14
REASONS FOR GROWTH
Immediate results Saved time Impact on patient care
SLIDE 15 2 TYPES OF TEST SYSTEMS
Integrated Non integrated
SLIDE 16 INTEGRATED VS MANUAL TESTING
PAITENT ID Operator ID QC lockout Results Date & Time Reports Written on Customized
form
Written in Nurses notes Not written at all Reports??
SLIDE 17 POLLING QUESTION
Integrated systems and growth
How many integrated systems have been added to your hospital in the past 5 years?
SLIDE 18 THE EL E ELEP EPHANT IN IN THE E ROOM 2016 F Federal G Govern rnment d dire rective All t ll tests i in ele lectronic c cha hart
SLIDE 19 WHAT IS IMPORTANT??
Name MRN Date and time of test Test result
SLIDE 20 WHAT ELSE?
Pathology Concerns
Name or ID of test performer Lot # Expiration date Address of facility
SLIDE 21 QC AND ITS PLACE
QC result types
Imbedded Outside LQC
SLIDE 22 MANUAL TESTING CONCERNS
No
Not all da data i is s captured
QC C logs
Electronic
nic docum ument ntat atio ion n and d repor
devel eloped ed
miss ssing e exa xact t time me o
st
QC
C is is no not trac aceable t to pat atie ient r resul ult in in buil uilt in in ki kits
ach p pat atie ient do does n not have t the Q QC C do documented.
SLIDE 23 HOW TO MAKE A INTERACTIVE FORM
IT department assist List your important items
Build an Excel Form with bullets for results
- easiest to extract data from
SLIDE 24 HOW TO BUILD IT
George Washington MRN 000 000 000 Date Time Patient Result ⃝ Positive ⃝ Negative Normal Reference Range: xxxxxxx Positive Control ⃝ Positive ⃝ Negative Negative Control ⃝ Positive ⃝ Negative Comments: Operator John Doe Facility ↓ Lot#
SLIDE 25
WHY EXCEL??
Report can be built Easily customized Reports sent to POCT Test totals can be traced
SLIDE 26 TYPICAL REPORT
Unit Patient Name MRN DOB Date/ Time Result Postive QC Negative QC Operator Lot number Expiration Facility Rose Garden Suzy Que 222111222 1/1/2020 4/1/1920 0111 Elvis Presley 210111 1/1/1991 Hospital General Herb Garden John Doe 333555333 2/2/2022 04/1/1920 0111 Jon Winters 210111 1/1/1991 Hospital General Play Yard Elmer Fudd 1010101010 3/3/2033 04/1/1920 0020 Greta Garbo 210111 1/1/1991 Hospital General Tea Room Bugs Bunny 4151415141 4/4/2044 4/1/1920 1000 John Smith 210111 1/1/1911 Hospital General
SLIDE 27 HOW TO PRESENT INFO
Excel month by month growth
By unit Whole facility
Graph Column year to year Line for growth measurement
SLIDE 28
HOW IS QUANTITATIVE INFO VALUED?
Good monitor for growth is needed Budget management Reimbursement
SLIDE 29
WHAT IS CHANGED?
Historically billed item by item Now DRG Negotiated per contract or review Frequency
SLIDE 30 POLLING QUESTION
Do you know your facility’s last insurance
contract negotiation?
- 1 year
- 2 year
- +2 year
- I don’t know
SLIDE 31
DRG
CDM CPT ICD9
All tests have a reimbursement schedule.
SLIDE 32 POCT AND NEW CONTRACT
New standards of care
ADA and AACE and APA
General use of POCT
quicker turnaround
Exponential growth in just 5 years.
What if last contract negotiation was 2+ years ago?
SLIDE 33 ARE YOU DOING ALL YOU CAN?
Electronic result forms
Can improve QA
By monitoring required fields
Can be quantitated
Sum of tests in Excel
Results can be migrated to patient chart
With correct date and time With traceable QC
SLIDE 34
SUMMARY
Traceable customized forms DRG negotiation and POCT affect on the
bottom line
