The rise of HIPAA-certified telehealth
Designed for providers to reach remote or immobile patients and expand their practice, telehealth took on new prominence in the effort to mitigate the spread of COVID-19.
CGM ELVI Telemedicine
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CGM SCHUYLAB is a modular laboratory information system. As your lab grows and your needs change, CGM SCHUYLAB can grow with you. This also helps start-up POLs and reference laboratories get off the ground with a chance to determine what their needs are over time.
Billing Module is an optional, but fully integrated feature of the CGM SCHUYLAB system. Bill directly for the procedures your lab performs, sending transactions directly to government insurance, private insurance and billing consolidators. CGM SCHUYLAB also receives remittance from insurers and consolidators and posts payments to the individual claims..
What makes the billing option special? Laboratory billing is often accomplished by using another system that is not connected to the LIS. This means that all of the information about the patient and the tests that were run must be manually re-entered. This ‘double-entry billing’ uses up a lot of time and resources. A manual entry process can also introduce errors. Since CGM SCHUYLAB offers a fully integrated billing solution, the information entered on the patient during the course of laboratory accessioning and analysis automatically becomes part of the billing record: name, patient ID, doctor’s name, and the tests and procedures performed.
Overall, CGM SCHUYLAB offers two comprehensive solutions, rather like the two hemispheres of a brain. There is the lab side, where the patient and specimen information is entered, tests are ordered, and results are generated. And, there is the billing side, where the procedures are compiled, costs are summed, and bills are printed. The two sides talk to one another: the lab side tells the billing side the patient’s demographics and the tests ordered, while the billing side can update the lab side’s patient records.
CGM SCHUYLAB handles CMS-required test bundling rules automatically, but also has the flexibility to allow custom billing panels for your clients. Add-on or cancelled tests trigger automatic re-bundling if necessary. CGM SCHUYLAB knows not to bill for tests that have QNS, Cancelled or Rejected as the result. Electronic transmissions reflect cancellations and add-ons.
CGM SCHUYLAB has unlimited fee schedules that can be applied to bill types, insurance companies, and specific clients. These fee schedules allow you to manage differential payments to various payers.
CGM SCHUYLAB offers many ways to bill your payers:
While CGM SCHUYLAB is designed to do as much as possible automatically, the Edit Claims feature does allow easy manual access to manipulate existing claims, including adding procedure charges, adjusting claims, and posting payments.
Secure, online access is the most contemporary method of providing result delivery. It does not matter where your clinician is: in his office or at home or at a conference. With CGM SCHUYNET Laboratory Outreach Solution, providers can still log on and see patient results and look up prior information. With the Ordering option, CGM SCHUYNET allows doctors to place orders for tests online, and the Medical Necessity option can be activated to advise on the payability of tests as they are ordered.
There is little that you can do to speed the transit of coolers full of specimens across town in rush hour, but once the samples arrive in the lab and analysis is complete, modern results dispersal allows healthcare providers to quickly and easily view results online.
CGM SCHUYNET is HIPAA compliant—it meets HIPAA security requirements for patient data. The laboratory controls the security setup for each of its customers, determining the visibility of results to each physician in a practice. CGM SCHUYNET allows providers to view custom graphs and .pdf reports that identical to the results they would have received on paper from the laboratory. A patient's result history and diagnoses are available with just a couple of button clicks.
With CGM SCHUYNET, healthcare providers can quickly and conveniently order diagnostic procedures online. (This is an optional feature of CGM SCHUYNET and is configured individually for each of your clients.) Customer-based order entry improves the accuracy of the orders. When coupled with Medical Necessity, CGM SCHUYNET facilitates the selection of adequate diagnoses for the laboratory tests just ordered. ABN’s are also printed as needed.
When Barcoding is also part of the system, labels are printed at the client’s practice to securely identify the patients’ samples at point of collection. With CGM SCHUYNET online ordering, laboratory accessioning turns into a check-in process, where the samples and tests ordered are validated, alterations are made as necessary (a tube broke on the way in), and the sample is activated in CGM SCHUYLAB. Barcode scanners streamline this process this into just a couple of clicks.
CGM SCHUYNET can integrate with your existing webpage or stand on its own. Either way, it advertises your laboratory. Your physicians go to a webpage with your name and logo on it to retrieve their results—and they can do this from anywhere they have web access. This provides a personalized utility that associates the increase in accessibility of results with the name of your laboratory. As a historical record of the patients accumulates on your CGM SCHUYLAB system, the doctors will have access to more and more lab information on their patients. This is data that they will not want to lose by changing to another lab. In the meantime, your lab experiences a reduction in calls for reports and patient information.
Do you already have an EHR, HIS, or billing system in place? CGM SCHUYLAB can do it your way by interfacing to the other systems and receiving orders/sending results/sending billing information to your third-party software (to the best of that software's ability to interface). CGM SCHUYLAB can filter transmissions to send specific data sets belonging to a client to their EHR, while simultaneously sending a different set of data to a different HIS or EHR.
We live in a connected world, and your physicians expect no less from your laboratory. They want to order lab tests electronically and see the test results on their own EMR. With system interfaces, CGM SCHUYLAB is able to provide direct connections between your laboratory and other software products: EHRs, HISs, and reference laboratories.
Your laboratory does quality work, but if you want to capture the attention and business of healthcare providers, you need to offer a modern, streamlined service. Physicians want to see their lab results on their clinic’s EHR, in the context of the patient’s office visit—and their business will go to a lab that can provide that service! Since clinical laboratory results constitute around 60% of the hard data in a patient record, having the laboratory results as part of that record is essential to good patient care.
A system interface uses the standard HL7 format, making it compatible with most other health systems. CompuGroup Medical has connected CGM SCHUYLAB through more than 400 system interfaces to more than 120 different systems. Each system interface has to be exactingly configured, so that the tests and patient IDs at one facility correctly match the corresponding tests and patients at the other. Our technicians are veterans at this: a dedicated technician will be assigned to carry your laboratory through the full process of connection, interfacing, and testing. Once the system interface is implemented, the medical provider at a clinic or hospital will be able to seamlessly order tests for your lab from their own EHR, and their EHR will display the results when the tests are complete.
System interface connections provide a faster and surer way to get orders into CGM SCHUYLAB without any additional personnel resources needed at your lab. If you’re an independent reference laboratory, an EHR interface to your major customers is also a way to lock in their commitment to use your laboratory. Once your lab is connected electronically to their practice management or EHR system, there’s a major incentive for the doctors to keep you as their laboratory.
CGM SCHUYLAB System Interfacing also includes interfaces to major reference laboratories. In this case, CGM SCHUYLAB will transmit orders to the reference lab for the tests you don’t perform in-house. Once the reference lab has completed those tests, the results are transmitted back to your laboratory, where CGM SCHUYLAB stores them in the appropriate patient files. Per CLIA, CGM SCHUYLAB automatically tracks which reference lab performed which tests. This keeps your both labs and inspectors happy.
Many of our laboratories have been operating for decades. While CGM SCHUYLAB is a very concise system and has no real need to archive patients, some laboratories and IT personnel prefer to have a smaller active set of patients.
Archiving allows you to better manage your active patients by placing your long-term, inactive patients in another section of your CGM SCHUYLAB database. It is important to realize that all of the test results and demographic information of the archived patients are still retained in the LIS, they are just located in a different place. These patients can still be viewed, printed, and re-activated by someone who has the right security privileges.
Archiving will improve your daily backup process. It will be faster, and you will be able to use smaller media for the backup, since you are only backing up the active patients. It will also shorten any other diagnostic functions that have to be run on the database as a whole. You will need to backup your Archived databases occasionally. We recommend doing this once a month. Your daily backups of the active database should still be done every day.
Note: If you have a CGM SCHUYLAB version 3.0, only a portion of the Archive option is available. You will be able to archive patients, but not view or retrieve any results until after you upgrade to a 3.1-or-later version.
The simplest way to improve result delivery is to have CGM SCHUYLAB automatically fax results when they are done. The CGM SCHUYLAB Fax option will fax patient reports directly from CGM SCHUYLAB to your clients’ fax machines. It can be set up to do this automatically when a report is final, whenever you print in batch, or one report at a time.
Regulatory statutes now allow results to be verified by an LIS. CGM SCHUYLAB provides rule-based options that allow the bulk of your work to be automatically accepted as soon as it is performed. Your technologists will only need to look at exceptions/abnormal results.
The Autoverification feature of CGM SCHUYLAB is intended for those laboratories where the test results don’t necessarily require human approval. CGM SCHUYLAB can be set, using Autoverification, to accept for final release all test results which fall within a normal range, or which follow certain user-defined rules.
Autoverification is frequently used in conjunction with another option called Review Results (also known as Second Level Review).
If your major analyzers can read barcodes and you have a substantial specimen load, the Barcode option will increase both your efficiency and the quality of your patient results—perhaps more than any other single option. Barcodes increase specimen integrity by improving the readability and accuracy of the labels and diminish tech time and operator error by allowing host query by the instruments.
Positive patient identification is necessary if the results obtained by the laboratory are relevant to a patient’s prognosis. Each time a sample is relabeled, aliquoted, or manually identified, there is a chance for error. Primary tube analysis of bar-coded samples provides the best system for achieving an unbroken linkage between the test results and the patient who actually provided the specimen.
In addition to the benefits for patient care, using barcodes in a laboratory can save personnel time measured in FTEs (full-time equivalents).
Lastly, many modern instruments do not function well without bar-coded tubes. Laborious workarounds are necessary if a technologist attempt to run these instruments without barcodes.
If your CGM SCHUYLAB system connects a multi-station network and your specimens tend to arrive in large batches, you will often have numerous techs entering the requisitions simultaneously. Batch Requisitions streamlines large-volume, multi-tech specimen entry.
Batch Requisitions is designed for large-volume labs with multi-station network where specimens tend to arrive in large batches, one or two times a day, and there are numerous techs entering the requisitions simultaneously.
Batch Requisitions integrates with the Barcodes and Labels option and the standard CGM SCHUYLAB tube type. This combination allows the proper number of barcode labels to be printed out.
When specimens arrive in the lab accompanied by a printed requisition, the Check-In option allows for quick, easy assignment of an accession number to incoming specimens. Check-In validates that the samples submitted to the lab are adequate in quantity and quality for the tests ordered.
When tests are ordered outside of the CGM SCHUYLAB system, for example via an EHR interface or via the CGM SCHUYNET Laboratory Outreach Solution, there are two ways that CGM SCHUYLAB can handle this. Either the LIS issues accession numbers directly when the orders are made, or it uses a temporary number (order number or requisition number) as a place-holder for the order, and issues the accession number when the samples actually arrive in the lab.
Logically speaking, an outside system that is closely associated with the lab (e.g. in the next room) should have accession numbers directly issued, while a system that is physically removed (e.g. across the city) would utilize Check-In procedures. This distinction would be based on the probability that the patient would wander in from the next room to have his blood drawn immediately, but the patient across town only might come in—and it could be tomorrow or the next day. You do not want accession numbers issued until the work is imminent.
The problem with this scenario is that the ability to issue an accession number is often not distinguished by logical need, but by the capabilities and requirements of the EHR or HIS system. These technical interfacing requirements often obscure the situation: an accession number may be issued for a site across town, while an order placed in a room down the hall could require the Check-In process.
The CGM SCHUYNET Laboratory Outreach Solution is a remote ordering system that always uses requisition numbers when orders are placed. It requires a Check-In to issue accession numbers when the samples arrive in the lab. Other HIS, EHR, and third-party billing systems each have their own specific manner of operation—some of them will require Check-In, and others will have CGM SCHUYLAB issue an accession number on its own
The purpose of the Check-In option is to:
The Cytology option offers a demographics-style report with the ability for entering the interpretative ranges based on the Bethesda system for reporting cervical cytology.
Cytology offers a report that will monitor and provide statistics for those aspects of Pap smear testing which need to be monitored for legal and technical purposes.
Limited release of this option is available. Eligibility enables the automation of the search of insurance and other qualifying files (provided by the payor) to see if an individual patient is under coverage at a given time.
CGM SCHUYLAB allows you to email a secure link to the doctors your laboratory serves. Your doctors can click on this link, and it will take them to your CGM SCHUYNET Laboratory Outreach Solution web portal. Once they sign in, the .pdf of the patient’s results is available to them to view and print from their desk.
The Export option allows you to create commonly used data platforms (e.g., fixed field, comma delimited, HL7) and select types of data (e.g., billing, results, demographics) that are going to use that format in each instance. Once the format is created, CGM SCHUYLAB remembers the configuration, and the user can export using the icon.
The CGM SCHUYLAB patient database is kept in a proprietary format, which generally wouldn’t be interpreted by other LIS or MIS systems. The Export option was devised to translate patient records (demographics and test results) into other formats and write those records to a file. The file can be on a memory stick, on your computer’s hard drive, or (if your station is networked) on the network server’s drive. If you save to a memory stick, the memory stick can then be taken to another computer, and the results read in.
Remember that with some exports, the data generated might contain patient’s data. Follow all HIPAA security rules to ensure that you always protect each individual's electronic personal health information.
Import is generally a manually triggered utility that a site can use to import patient demographics from another system on a daily or weekly basis. This is used in cases when the site decided it is not worthwhile to establish a dynamic interface.
CGM SCHUYLAB allows users to place text notes in many different locations throughout the system. The Image Import option allows users to place images into any report alongside any text note.
The images can come from any source, not just from microscopes or equipment.
The CGM SCHUYLAB Medication option is designed to correlate a patient’s lab test results with their prescribed medication. Doctors can immediately see whether or not a patient’s test results are consistent with their prescription. The Medication option tracks the patient’s current and previous prescriptions to ensure correct interpretation. This option is easy to set up and use, and CompuGroup Medical provides a full catalog of medications and dosages at no charge.
The Medication option enables CGM SCHUYLAB to automatically correlate the pharmaceuticals prescribed by the doctor with the results of the tests performed by the laboratory, producing text comments to describe that relationship. For example, if a patient has been prescribed oxycodone, a test for that drug is expected to show its presence. If the test is negative, then the patient is non-compliant with the prescription.
The Medication option includes:
As a foundation list of pharmaceuticals and their ingredients, CGM SCHUYLAB imports the RXNorm subset of the National Institute of Medicine drug database. All of the drugs imported from this database are available for prescription purposes.
Will you get paid for the work you do? It is important to know which tests the various insurance companies and government agencies will pay for and which they won’t.
Medical Necessity is designed to help prevent any mistakes, alerting you to tests and diagnoses that have nothing to do with one another, and allowing you to check if you have entered each ICD-9 code correctly. Keyword and reverse-lookup aids are also available.
CGM SCHUYLAB Lab licenses the region-specific CodeMap database for this option. It is designed to advise you of potential Medicare claim denials.
Messages allows CGM SCHUYLAB users to send messages to one another.
These text messages can be sent to all users, or to specific individuals within the CGM SCHUYLAB system, on CGM SCHUYLAB stations within your lab.
The Microbiology option has been enhanced for smoother operation and increased entry of results. It permits users to define the organisms that may be entered for any bacteriological sample. Sensitivities are custom tailored to each organism. Fully annotated in each instance, results are entered for the culture, the organism, and the antibiotics. There is no limit to the number of organisms that may be identified and reported on a single specimen.
Microbiology is one of the most challenging aspects of any medical lab. The microbiologist must be able to record—without necessarily displaying on the patient’s results report—the working notes that track the process of identifying one or more organisms: type of culture, preliminary and final results for multiple growth media, multiple organisms per medium, sensitivities, and much more. For every rule, there appears to be an exception, and sometimes the exceptions have exceptions!
The Microbiology option was designed in consultation with working microbiology lab professionals. Cultures may be ordered by the Micro department or by the data accessioning crew; but they’re officially received into the Micro department through the Microbiology option. Once a culture’s checked in, CGM SCHUYLAB can automatically order the media appropriate to that culture. The process is particularly suited for use with barcodes, especially two-dimensional barcodes that can hold a wealth of specimen information.
The Microbiology option delivers truly paperless sample processing:
CGM SCHUYLAB has long had the ability to track turnaround time on a report. Now, CGM SCHUYLAB provides the ability to monitor your lab’s turnaround times in a dynamic display, so you can track your lab’s efficiency in real-time and be notified before your turnaround time goes above the expected time.
A main laboratory that has satellite labs associated with it, or a set of associated co-equal laboratories under one organizational head, is called a multi-facility group. Each lab has their own instruments and processing but is connected to the main lab by either a VPN or LAN network.
These would not be independent labs, but two or more labs owned by the same corporation and using one database, yet run separately from one another. Most important, each lab has its own CLIA number. When CGM SCHUYLAB is configured as a Multi-Facility system, it automatically tracks which tests were done at which facility and annotates the tests in compliance with CLIA regulations.
The Multiple Languages option enables the possibility for test definitions to have synonyms for name and description in a set of non-English languages. Once the synonyms have been defined, each client in CGM SCHUYLAB can be set to report in any of those languages.
Facilities (e.g. hospitals) sometimes do not need the complete Billing option, but they do need to produce reports that reflect the prices in different fee schedules. The Pricing option provides this ability, catering to your laboratory's specific needs.
Maintaining quality control is a critical part of the work you do everyday in the lab. You need to track the set values of any given test and, on occasion, print out these values. The QC option, included as a standard feature in CGM SCHUYLAB, can do this for you and more. See the Daily Operations section of your CGM SCHUYLAB manual for more details in setting up and using QC.
Most laboratories send some portion of their testing out to other facilities for analysis. CGM SCHUYLAB can establish a system interface with many of these other reference labs and electronically send orders and receive results. Reports of the work done at other labs are correctly annotated to show the performing facility.
Remote Printing provides crisp, clear copies of patient results to a special modem-equipped printer in a doctor’s office.
Imagine your system is set up with its required printers, reports and invoices are printing nicely to the correct locations, and all is right with the world. Now, you need to print something from your computer station to the lab next door, the boss’s office across the street, or a client across town. That’s where Remote Printing comes in. Much like faxing, you can print when the patient’s report is finalized or when you batch print, or you can manually send it to the remote printer queue. Specific hardware (printers or printing attachments) is necessary, as is a dedicated phone line.
As technology has advanced, the Remote Printing option is often supplanted by the use of auto-faxing or the CGM SCHUYNET Laboratory Outreach Solution.
Review Orders allows the initial input of the requisition to be fault-tolerant. Review Orders serves as a safety net to require that a second pair of eyes confirm the demographics. Review Orders does not delay analysis of a sample (and hence increase TAT) but works in a parallel timeframe so that the demographic review is done by the time the results are ready to be released.
In the old days, when you printed a set of reports, the lab chief looked them over and signed them before the reports left the lab. The Review Results option is a new, fast, rules-based, electronic method of giving a lab
manager an overview and opportunity to sign-off on the work that has been done. This option also firewalls the faxing, remote printing, internet viewing, and transmission of results data to other systems.
Review QA works hand-in-hand with Accessioning and Review Orders to separate the requisitions that require customer contact (e.g. missing diagnosis) into a queue that can be handled by laboratory personnel authorized for that role.
Standing Orders will allow the entry of single or repeated future orders without the need to generate any accession that is contemporary with the date of order entry. Instead, CGM SCHUYLAB creates pseudo-accessions, such that some attributes of accessions (e.g. date of draw) can be used. No actual accession numbers are created.