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Technology Archives

Webinar – The Hype and the Hope: Exploring Artificial Intelligence in EMS

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Did you miss the webinar that we hosted through Pinnacle? Check out the video recording below of The Hype and the Hope: Exploring Artificial Intelligence in EMS, a panel discussion exploring the impact of artificial intelligence in emergency medical services.

In this session, we delve into early uses of AI in EMS, beginning with an overview what AI is – and what it isn’t. Panelists explore AI’s application in their areas of specialization: dispatch and communications, ePCR and RMS software, EMS education, and revenue cycle management. A lively Q&A with the expert panelists offers additional insights and takeaways on the emerging applications of AI in EMS.

You can watch the webinar here:

The Hype and the Hope: Exploring Artificial Intelligence in EMS

Or download the slides here.

Beware of Breaches: Data Security Strategies for EMS Agencies

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In the fast-paced world of EMS, efficient communication and seamless access to critical information are second only to patient care. As technology continues to revolutionize EMS, securing against data breaches becomes an essential concern. Cyberattacks can lead to damaging consequences, such as a recent ransomware attack that affected computer systems and caused the closure of emergency rooms and redirection of ambulance services in multiple locations[1]. When it comes to protecting sensitive patient data, EMS personnel have not only a legal obligation but also a responsibility to maintain trust and provide high-quality care. EMS breaches can lead to identify theft, which can be damaging to individuals who may already be experiencing the financial and emotional stress of medical emergencies.

Here we explore strategies for EMS leaders to improve data security in their organizations and ensure patient confidentiality while embracing technological advancements.

Vendors’ Security Policies and Practices

Most EMS agencies utilize third-party software or services of some kind these days – ePCR and CAD applications, billing services, hardware manufacturers, and more – and it’s crucial to assess the security measures of those vendors. Ensure that they follow stringent data security practices and comply with industry standards and regulations and have a comprehensive understanding of how vendor relationships impact the security of patient data. All the following strategies apply not just to your EMS agency but to your vendors as well.

A recent data breach that affected numerous EMS agencies was traced back to a third-party vendor’s use of MOVEit Transfer software[2]. Digitech implements stringent security policies and rigorously safeguards our clients’ data. Click here to talk to a Digitech expert to learn more.

Implement Robust Encryption

One of the foundational steps in securing EMS data is the implementation of strong encryption protocols. Encryption scrambles sensitive data, making it virtually impossible for unauthorized individuals to access or interpret. Ensure that both data at rest (stored data) and data in transit (data being sent or received) are encrypted using modern encryption algorithms. This prevents unauthorized access in case of a data breach or theft.

Access Control and Authentication

Access control is the first Technical Safeguard Standard of the HIPAA Security Rules. Implement stringent access controls to restrict data access based on roles and responsibilities. Not everyone in EMS requires access to all patient records. Utilize role-based access control to ensure that each team member can only view or edit the information they need for their specific tasks. Multi-factor authentication adds an extra layer of security by requiring users to provide multiple forms of verification before accessing any systems that house patient data.

Regular Training and Education

Human error remains a significant factor in data breaches. Conduct regular training sessions to educate EMS staff about the importance of data security, best practices for handling protected health information, and the potential risks associated with mishandling data. Make sure all employees are well-versed in recognizing phishing attempts and understand their role in maintaining data security.

Secure Mobile Devices

In EMS, mobile devices play a crucial role in accessing patient information in the field. However, these devices can also be vulnerable points of entry for cyber attackers. Ensure that all mobile devices used by EMS personnel are equipped with strong security measures, such as device encryption, remote wipe capabilities, and biometric authentication.

Regular Software Updates and Patch Management

Outdated software is a common entry point for breaches. Regularly update the operating systems, applications, and software used within EMS to ensure that security vulnerabilities are patched. Implement a systematic process for monitoring and applying updates promptly.

Data Backup and Recovery

Having a robust data backup and recovery plan is essential in case of a cyber incident or breach. Regularly back up all patient data to secure off-site locations and understand the guidance on HIPAA and cloud computing. Test the restoration process periodically to ensure that backups are functioning properly and that critical data can be quickly recovered.

Data Minimization and Retention Policies

Collect only the necessary patient data and avoid gathering excessive information. Implement data retention policies that define how long patient data should be stored and when it should be securely deleted. This reduces the amount of data that could potentially be exposed in the event of a breach.

Audit Trails and Monitoring

Implement comprehensive audit trails that log all activities related to patient data access and modification. Regularly monitor these logs to detect any unusual or unauthorized activities. Anomalies can be identified and addressed promptly, minimizing the potential impact of a security breach.

Incident Response Plan

Despite the best preventive measures, security incidents can still occur. Having a well-defined incident response plan in place is essential. This plan should follow the HIPAA Breach Notification Rule and outline the steps to be taken in the event of a data breach, including notifying affected parties, addressing the breach’s root cause, and implementing measures to prevent future incidents.

Conclusion

Technology advances bring with them the responsibility of safeguarding sensitive patient data. By implementing a robust combination of encryption, access controls, staff training, and comprehensive security practices, EMS providers can ensure the confidentiality and integrity of patient information. As the healthcare landscape continues to evolve, so too must our commitment to data security in the realm of EMS.

[1] https://www.cbsnews.com/news/prospect-medical-cyberattack-california-pennsylvania-hospital/

[2] https://www.reuters.com/technology/moveit-hack-spawned-around-600-breaches-isnt-done-yet-cyber-analysts-2023-08-08/

Webinar: Best Practices for EMS Providers Now That Mandatory Cost Reporting is Underway

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Some EMS providers remain unaware that ALL ground ambulance providers are required to provide cost data to CMS, and the first reporting period is already underway. Even if you understand the submission requirements, there are still some best practices to learn that can help the process run more smoothly. In this webinar, Digitech’s cost reporting experts as well as client guest speakers will review the current state of the mandatory cost reporting cycle, share examples and tips from EMS providers’ experiences in the field, and offer insights and resources that will help you avoid the 10% Medicare penalty that CMS will impose if data is not collected and reported accurately.

View the webinar below:

 

Download the slides here.

Check out our recent blog post if you would like to learn more: CMS Cost Reporting in 2023 and the Impact on EMS & Ambulance Medicare Reimbursement: Where Are We Now?

CMS Cost Reporting in 2023 and the Impact on EMS & Ambulance Medicare Reimbursement: Where Are We Now?

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Check out our webinar on this topic: Best Practices for EMS Providers Now That Mandatory Cost Reporting is Underway

Mandatory CMS cost reporting was announced in earnest several years ago, only to be interrupted and delayed (like many things in our lives) by the COVID Public Health Emergency. Now, ground ambulance providers are focused on reporting under the Medicare Ground Ambulance Data Collection System (GADCS), with approximately half of all EMS agencies well into or even having newly completed their mandatory data capture. The other half of EMS agencies are at the beginning stages of collecting the required data. The process of data submission to CMS has just begun, depending on the reporting period for each agency.

Now is a good time to take a look at some of the context around mandatory CMS cost reporting and examine the impacts on Medicare reimbursements in the medium-term as a result of these efforts.

GADCS Key Milestones for EMS Providers

GADCS Key Milestones for EMS Providers

First, let’s review the history of ambulance reimbursements and how the structure for ambulance reimbursements differs from the reimbursement allowables that Medicare sets for other healthcare services.

In 2002, Medicare implemented a phased-in national fee schedule for ambulance services. The goal was to address the high variability in the amounts being reimbursed depending on whether an EMS provider was hospital-based or independent. In 2005, the Government Accountability Office (GAO) conducted a cost study. Interestingly, of the responses received in the cost study, 1/3 were omitted because the responding services were Fire-based and did not have a clean carveout of only ambulance costs versus other costs. The GAO report estimated that in 2010, excluding most Fire based agencies, 39-56% of providers would receive average Medicare reimbursement payments that would exceed their costs – which means, conversely, that half or more of the providers would not be able to cover their costs with Medicare’s reimbursements (Ambulance Providers: Costs and Expected Medicare Margins Vary Greatly, 2007). Additionally, the GAO report identified super rural providers as being at the highest risk of having Medicare payments well below their costs.

In an attempt to address the perceived shortfall in Medicare reimbursement, Congress included temporary Medicare ambulance bonus payments in the Medicare Modernization Act that paid an additional 2% (urban), 3% (rural), and 22.6% (super rural), starting in 2004. Those temporary bonus payments have been extended, with much debate, every few years since then.

Elsewhere in healthcare services – hospitals, physicians, clinics, labs – Medicare payments are established via an annual collection of cost data from all providers. CMS uses the collected data to update the allowable amount continually to cover costs for the provider, plus a reasonable margin. Ambulance services have been the exception, and the industry has been vocal about the existing allowables not being sufficient to cover the costs of providing the service. Outside of the 2005 GAO study, which excluded a large number of fire-based municipal ambulance providers, there is little factual data that ties current reimbursements to current ambulance rates. The amounts set in 2002 are adjusted by an annual inflation factor. The “temporary” Medicare add-on bonus payments are a modest recognition that the current Medicare rates are insufficient.

As you likely have inferred, the ambulance cost reporting initiative by CMS is intended to put ambulance providers on par with other healthcare service providers in terms of assessing costs and delivering fair reimbursement. EMS providers have received a concession, at least initially, by not being required to submit cost data annually, but rather every four years.

The collected and reported data is going to the Medicare Payment Advisory Commission (MedPAC); MedPAC will then be required to submit a report to Congress on the adequacy of Medicare payment rates for ground ambulance services and geographic variations in the cost of furnishing such services. The timing of that report is not specified. The idea is that, at some point in the future, the data would be used for resetting the amounts Medicare will pay to ground ambulance providers.

There has been speculation by some providers that the Medicare allowable amounts will go up significantly as a result of the cost reporting submissions, while others believe the amounts could drop. This difference in perspective likely depends on what type of agency you are. Fully integrated providers under municipal structures typically have costs substantially higher than the current allowables, but private ambulance services that provide a large percentage of 911 services nationwide typically have a much lower cost structure. Also, agencies running all-ALS services have a higher cost structure than those that have a mix of ALS and BLS vehicles in their system.

No matter what, over the next several years, we expect to see changes to Medicare reimbursements in ground ambulance as a result of the cost reporting efforts. Generally the sentiment is that, at minimum, the cost of providing 24/7 911 services has increased faster than the current inflation factor accounts for. Time will tell, but there is a reasonable chance that reimbursements will be enhanced to better align with today’s costs of providing this critical service.

Digitech hopes that you find this context about the substantial Medicare GADCS cost reporting effort useful to understand the system more deeply or to explain the reasons to your key stakeholders. Please reach out to CMSDataCollection@digitechcomputer.com if you would like more information about Digitech’s data collection software, which assists agencies in organizing the required data elements, or if you would like assistance in data collection via our cost reporting consulting services.

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Check out our webinar on this topic: Best Practices for EMS Providers Now That Mandatory Cost Reporting is Underway

Why Should You Outsource EMS Billing?

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EMS billing isn’t for the faint of heart. While patient care is the core mission of any EMS organization, it’s impossible to provide adequate care without resources provided by a healthy revenue stream.

Billing Isn’t Just Paperwork

Agencies that handle their billing in-house, rather than outsourcing EMS billing to a third-party vendor, are in fact running two business. Ambulance transport and EMS billing are different enterprises with different requirements for staffing, IT infrastructure, compliance, operational costs, analytics, and more.

This leads many EMS agencies to outsource their billing. Smart decision. The fee that a billing service will charge will certainly be less than the cost of running a second internal business. Let a specialized company handle the specialized work of billing so that the EMS agency can focus on patient care and other operational priorities.

Here are five main reasons why EMS agencies have made the switch to outsourcing. 

1. Reduced Costs

An established third-party billing company has a head start on infrastructure that an in-house department may never catch up with. Staffing, workspace, IT, hardware, training, software licenses, maintenance, even office supplies and equipment – these essential elements create burdensome ongoing fixed costs. Letting the billing provider handle these costs allows the EMS organization to direct resources to other essential budget items. Meanwhile, if the billing company invests in scaling their operation, building technology, and attracting top-tier staff, those benefits will be passed along to clients.

2. Industry Expertise

Billing companies deal with hundreds of providers, payers, and facilities – far more than a single EMS organization with an in-house billing department ever will. You may transport to a few different hospitals, but a billing firm may have connections to hospitals across an entire region and access to databases of patient data that your in-house billing team will not have. Outsourcing EMS billing allows you to take advantage of these economies of scale and collect every dollar.

Billing vendors also have the benefit of a broader range of resources and staff who can engage with industry associations, attend events, and stay abreast of trends in the changing healthcare environment. A good partner will keep you informed of new developments when necessary and will make sure that changes are incorporated into technology and policy as needed.

3. Top-Tier Technology

All billing companies rely on claims processing software to manage their operations. Good billing companies develop their own claims processing software to manage their operations with efficiency, opportunities for customization, and automated processes balanced with manual oversight.

Simply put, it would be impossible for an in-house billing department to develop and scale the technological expertise needed to maximize the potential of technology for billing.

4. Customer Service for Patients

After a traumatic 911 event, the best customer service may be no customer service at all. In other words, the best thing for a patient is not to have to worry about how to pay for their emergency transport.

Often, individuals are confused about their insurance coverage for EMS services. Third-party billing companies have advanced technology solutions designed to identify patient insurance information quickly and efficiently – more so than an in-house billing department could do alone, even armed with the best software. If your billing company processes millions of claims annually, they have established manual and automated processes to uncover patients’ insurance information through clearinghouses, demographic databases, admitting hospital data access, and sheer manpower.

Patient inquiries and other sensitive customer service touchpoints will inevitably still arise, so it’s important to look for a third-party vendor with high levels of professionalism and sensitivity to your organization’s reputation.

5. Increased Collections

The results of the combination of cost reduction, industry expertise, targeted technology, and great customer service? Increased collections for your organization. A billing company has one goal: maximizing the return on every claim submitted. To keep the business viable long-term, they must do so compliantly and direct resources toward infrastructure and technological innovation. This results in increased collections for clients.

Third-party billing companies should also have the capability to perform sophisticated analysis by looking at the right metrics to measure performance. Your billing partner should help you understand the right data at the right time for the right reasons. Then, you’ll be able to monitor and assess your billing company as well as project revenues.

Deciding how to handle your agency’s EMS billing takes analysis and careful consideration, with plenty of pros and cons to weigh. We’ve provided a handful of good reasons to outsource EMS billing. What are your reasons to keep doing your own billing? 

Innovative Technology in the Face of Crisis

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As the first line of defense in our communities, EMS personnel need support now more than ever. Agencies and organizations across the country are pooling their resources to help serve and make a positive impact during this crisis. 

Sullivan County Emergency Medical Services, the primary EMS provider for Sullivan County, TN, provides aid to about 150,000 citizens and visitors, as well as those in surrounding communities. A number of ambulances and first responder agencies spread across Sullivan County are ready to respond at a moment’s notice, as their mission is to provide “the best emergency and non-emergency care to patients and their families at the worst times in their lives.” 

The progressive care provided by the service personnel of Sullivan County EMS (SCEMS) is often described as an “extension of the emergency room,” where the years of experience offered by the County’s personnel of highly-trained Medical Directors, Paramedics, and EMTs allow them to maintain a “continuity of care from the place of origin to the hospital.” Since 1970, it has been their prerogative to have as many trained personnel on scene of an emergency as soon as possible. 

In this particular line of work, “seconds count,” and Sullivan County EMS has committed to having the right systems in place in order to lower response times to medical emergencies within their growing communities. Part of their ability to provide such timely service is due to Sullivan County’s tiered response system, which allows for readily-available, localized teams to respond preemptively:

“These response teams bring manpower and multiple levels of training –from Medical Doctors to First Responders– to the crisis environments faced by our  Paramedics and EMTs quickly and efficiently. These teams are highly lauded amongst emergency medical personnel for their selfless acts.  With their short response times, they have repeatedly induced appropriate care and –most importantly– prolonged viability of life in the field prior to our arrival.” – Gary Mayes, Regional Director

Sullivan County EMS is not alone in providing care and support for their people. In this rural community, EMS is a third service for the County, acting as an extension of the Sullivan County Regional Health Department (SCRHD). The SCRHD also helps to prepare the County for public health emergencies. Their Public Health Emergency Preparedness Department, recognized by NACCHO Project Public Health Ready, uses “an all-hazards approach for emergency planning, focusing on situations that specifically affect the health of the public.” The SCRHD serves the communities of Kingsport, Bristol, Bluff City, and Piney Flats within Sullivan County. Their department’s workforce of around 90 personnel also works closely with the Northeast Tennessee Healthcare Preparedness Coalition in preparing their response to public health emergencies like the one we are experiencing today.

The collaboration between Sullivan County EMS and their Health Department combined with their support from Digitech as an EMS billing partner has inspired inventive measures to combat the COVID crisis. As technological innovation is at Digitech’s core, the evolution and design of new tools in the Ambulance Commander software system ensures that partners will have access to such timely solutions. With data gleaned from Digitech’s recent COVID-19 Symptom Map, Sullivan County has been able to identify the areas within their community in the greatest demand of care. This insight allows them to strategically place future COVID-19 testing sites, so Sullivan can continue to support their most vulnerable populations. 

“The COVID Symptom map can be a helpful tool in mitigating the virus by determining specific communities that may need testing, quarantine, or treatment. It allows EMS and Health departments to work collaboratively during the COVID Pandemic.” – Brandon Alley, Sullivan County EMS

The gears continue to turn in Sullivan County as leaders look to this new Ambulance Commander tool for even more creative solutions in the future, like tracking flu-related incidents. 

Between these partnerships and updating their Facebook page with information and guidelines on COVID-19, mental health tips, and to thank individuals making donations to support their emergency service providers, Sullivan County EMS continues to commit to their mission of looking out for every single one of their neighbors in need. 

 

Sources:

New Utilities in Ambulance Commander

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Coronavirus Incident Tracking Tools

Our ability to adapt to an ever-changing EMS landscape is a benefit to our clients. We’ve released new tools to help track Coronavirus-related incidents in your service area. 

With this latest development, Incident Mapping allows you to:

• Isolate incidents by diagnosis code
• Get a color-coded visual map of your service area’s hotspots
• Interactive maps allow you to drill down to the individual call record
• Adjustable settings to scale heat map coloring based on call volume and service area geography
• Built in integration with Triage utility to display COVID-related pickup locations regardless of provider’s impression

Reach out to your account manager for detailed training by clicking here.

Same Dashboard. Better Results.

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You asked, we delivered. 

All New Features on Digitech’s highly acclaimed  

Digitech’s development team has added some cool new features:

  • Multi-select Filtering – Drill down on multiple data points at once
  • Zooming and Scrolling – Zoom in your horizontal view to better view large numbers of data points
  • Legend Quick-Filter – Hide or show data points with a checkbox in the legend
  • Cross-hair – Show a vertical cross-hair to make reading line graphs easier

Let us know what you think! Reach out to our Account Managers if you have any questions.

The Dirty Secret Your Software Vendor Won’t Tell You

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Companies that sell billing software to the ambulance industry never fail to promise that their software will increase efficiency and profits. What they haven’t mentioned is that their software improves their efficiency and profits, not yours. To achieve that, they sell software that is inferior by design. There. We said it.

To be fair, they have no choice. Software companies can’t make money selling billing software to the ambulance industry – at least not real money as defined by the technology industry. So they have to sell low performance products to maintain their bottom line. How can this be, you ask?

Let’s say a software company somehow captures the entire New York City non-emergency medical transportation market, one of the largest non-emergency medical transportation markets, at approximately one million transports per year. Say that software company wins a killer deal by charging ambulance companies $2 per transport to use their software (about four times the current market rate). Ultimately, after snagging an impossible share of the market and charging an outrageous rate, the software company generates $2,000,000 in annual revenue – less than the annual revenue generated by the average McDonald’s franchise. Consider that for a second: a software company dedicated to the ambulance industry can’t survive by dominating the largest market on the planet and overcharging.

Given this limited revenue potential, the software companies can only afford to build mediocre, fairly generic products, and they can’t afford to market them as anything less than cutting edge. These vendors will point to their software’s well-organized process flow – but that’s exactly the flaw in the argument. In this system, claims are moved from bucket to bucket within measurable time frames. The system just has to keep track of the claim, and all the biller has to do is manually move the claim from one bucket to the next. How’s that for automation? It’s not particularly efficient, but the software provider benefits because the client needs more seat licenses to keep the volume of claims moving. The software system stays simple and cheaper to maintain, which improves the software company’s profits.

A software manufacturer will similarly avoid adding features that maximize collections because those features require additional system complexity, which increases development costs and complicates implementation, training, and maintenance. In other words, it’s a loss for them to help you collect more.

Here’s the good news: Given that the billing software sold to this industry is weak, at best, there is a significant opportunity to improve collections and efficiency with the right technology and the right partner. You need a vendor whose goals are in line with yours.

The only entity incentivized to develop the technology that will maximize efficiency and collections is a billing service that lives for the challenge of continuously evolving new solutions – because really, they’re the only ones who can afford to. They know that the more automated the process, the more code is required, which increases development and maintenance costs. But they also know that extra development expenses result in improved labor efficiencies, allowing fewer people to handle more claims, collect more dollars per claim, and collect on a higher percentage of claims.

Effective billing companies improve by analyzing exceptions, not ignoring them. When enough similar exceptions are found, the truly efficient billing company is able to build a new automated process flow to capture and properly handle those claims. This kind of company sees agencies’ problems as opportunities instead of obstacles, which creates a rewarding partnership.

So if you accept the notion that technology is the key to maximizing efficiency and collections, the answer should be clear: You need a complete billing service with proprietary software.