Template trouble: Change worries stakeholders

Friday, July 13, 2012

BALTIMORE – Industry stakeholders aren't pleased with one aspect of the newest version of the proposed electronic clinical template for power mobility devices (PMDs): the removal of anything referencing use outside the home.

"For Medicare to pay for that equipment, it must be used within the home, so we removed those types of questions from the template," said Doris Jackson, a health insurance specialist at CMS, during an Open Door Forum to discuss the template last week.

That may be true, but stakeholders worry that the physicians who use the template for Medicare will also use it for other payers, which don’t necessarily have the same payment policies.

Laura Cohen, executive director of The Clinician Task Force, suggested to CMS officials that they keep the references in the template and rely on reviewers to apply Medicare payment policies to documentation.

"Standard medical practice considers all of a person's needs and the environments they encounter," she said. "If we create a template that is adopted by electronic health record vendors and implemented across the board in medical practice, you are changing medical practice forever."

CMS officials told Cohen that when they send the template to the Office of the National Coordinator for Health Information Technology (ONC), which will prepare it be part of the electronic health record, other payers and policies will be taken into consideration.

"Right now, it is a CMS document but when we turn it over to the ONC, there will be other payers and electronic health record vendors at the table," said Melanie Combs-Dyer, deputy director of CMS's Provider Compliance Group. "I think you should rest assured, it will not, in the end, be a Medicare-only document."

Providers have until Sept. 25, the date of the next Open Door Forum, to submit comments to eclinicaltemplate@cms.hhs.gov. Soon after, CMS will turn over the template to the ONC, which will then host its own series of calls.


The fact of the matter is, an Electronic Clinical Template for Power Mobility Devices already exists and has been successfully utilized by Physicians and other Prescribing Practitioners for almost 2 years. 

PMDRX (Power Mobility Doctor RX, LLC) introduced the first and only Electronic Clinical Template for PMD evaluation and documentation after it became apparent to the PMDRX development team over 3 years ago, that existing Physician's EHR Systems did not have a PMD EHR component, or capabidlity,  within their systems to address whether or not there was true identifiable patient need for the power mobility devices being prescribed.

The PMDRX EHR technology incorporates all current Medicare required assessment criteria and also includes the entirety of the proposed CMS Electronic Template recommendations.  It's important for Suppliers to understand that the CMS Electronic Template recommendations are guidelines for EHR Vendors to use in their development and incorporation into EHR technologies.  While those recommendations have not been finalized, the PMDRX team continues to update and enhance the PMDRX PMD evaluation and documentation technology to incorporate the latest CMS proposed recommendations.

Whether or not CMS will construct an actual template or not remains to be seen.  It's very possible that CMS will simply produce final recommendations that EHR Vendors will utilize to make sure their EHR templates meet those standards.

Suppliers currently utilizing  documentation created as the result of face-to-face evaluations performed by Physician's via the PMDRX electronic clinical template, are reporting that documentation to be the most comprehensive and complete documentation they have seen. More information regarding the PMDRX PMD Electronic Clinical Template is available at www.pmdrx.com


I couldnt agree more with Gary.  I use PMDRx everyday and it is working great.  Its seems too often its Government trying to reinvent the wheel.  We don't need to spend anytime on a templet it is here!  There is a viable templet already available to the industry that cost very little to access as a supplier and its free to the physician.  Once most physicians see how easy this is and how much time it will save them they love it!  And it is comprhensive and thourough!  It absolutely covers every element Medicare wants documented in the medical record and does in the standard formats that physician document their records in.   I have also had these claims audited and have passed 100%.  The best part about it is when you have an idea to improve the templet the folks at PMDRx actually listen to what you say and make those changes.  Folks this thing for me is it.  I wish I thought of this...... and even though I didn't I am glad someone did because its made my life as a provider so,so much better.  I encourage you to check it out for yourselves!