College of American Pathologists



cap today

October 2003 Newsbytes

Raymond D. Aller, MD;
Hal Weiner;
Michael Weilert, MD

Secure messaging at heart of HealthyEmail’s endeavors
Doctors need healthy e-mail—that assertion is the foundation of HealthyEmail, a nonprofit organization formed earlier this year to promote the use of secure electronic communications in the health care industry.

Dallas-based HealthyEmail offers two-year licenses for an e-mail encryption program called ZixMail, provided by ZixCorp., also of Dallas. Physicians or their staffs can download the software, as well as e-messaging educational tools, at no cost from HealthyEmail’s Web site, Once the software license expires, doctors can renew for $45 per year, per license.

ZixMail allows doctors to communicate securely with patients, insurance providers, and others, even if those on the receiving end do not have secure e-mail capabilities. Instead of using the regular “send” icon on their e-mail program, users hit a red “Z” that appears on Microsoft Outlook systems once ZixMail software has been downloaded. This feature encrypts the message. The receiver of the e-mail gets a link to HealthyEmail’s Web site, where they are given instructions on how to access the message.

Nearly 1,000 physicians had signed up for the free encryption service as of August. So far, feedback has been positive, says Jennifer Schuder, a project coordinator for HealthyEmail. Many doctors especially like using HealthyEmail to communicate with their invoicing services, she adds.

“You have to be a little more technically savvy and a little bit more advanced to really see the benefits of using e-mail,” Schuder says.

In a 2002 poll by Harris Interactive, 90 percent of adult Internet users said they would like to be able to communicate with their doctors online. Currently, however, only about 20 percent of physicians use e-mail to communicate with their patients, says Mark Bard, president of Manhattan Research, a New York city-based marketing information and services firm.

“The vast majority use personal e-mail accounts,” says Bard, “and that’s not the best way to [communicate electronically with patients].”

As technology improves and becomes safer, adds Bard, more physicians will use e-mail. The availability of organizations such as HealthyEmail, however, may lead only another five to 10 percent of physicians to communicate with patients electronically. What will drive a greater number of physicians into the system is reimbursement for e-mail consults, he says.

One secure messaging provider involved in pilot reimbursement programs with insurers is RelayHealth Corp., Emeryville, Calif. RelayHealth offers a Web-based system in which, through a series of questions, patients are “interviewed” online about their medical condition. For example, patients may be asked to briefly explain their symptoms and then answer questions, such as how long the symptoms have been appearing. That information is delivered to the physician, who can formulate a reply in an efficient and timely manner.

Insurers prefer this structured communication system over free-text messaging, which can be time consuming and costly, Bard says.

The American Medical Association issued e-mail guidelines last year that, among other suggestions, call for physicians to establish a turnaround time for messaging and to keep electronic or paper copies of e-mail communications when appropriate. Additional guidelines, issued last year by eRisk Working Group for Healthcare, a collaboration of physicians, medical societies, and malpractice carriers, mandate that e-mail take place only in pre-existing doctor/patient relationships. The guidelines also re-emphasize the need for secure online communication that is subject to authentication and encryption.

Wyndgate and McKesson launch Horizon Blood Bank
Wyndgate Technologies, a division of Global Med Technologies, has announced that it will provide McKesson Information Solutions with its SafeTrace Tx advanced transfusion management system, which will be privately labeled as Horizon Blood Bank.

The product will be marketed as an integrated module of McKesson’s Horizon Lab laboratory information system. Horizon Blood Bank will automate the management and tracking of the blood transfusion cycle.

Terms of the agreement were not disclosed.

McKesson Information Solutions is a division of McKesson Corp.
Wyndgate Technologies, Circle No. 193
McKesson Information Solutions, Circle No. 194

Getting a bang from your billing system
In response to Hal Weiner’s billing information systems article (July 2003, page 68), Steve Gowdy, national lab consultant for the outsourcing services company Electronic Data Systems, offered Weiner insights from the perspective of the payer community that can help labs improve their billing processes. Pathology groups nationwide are experiencing greater than 50 percent claim denial rates, which represent millions of dollars in added cost to the health care system. Here is Gowdy’s “Top Ten” list to boost revenues and decrease denials.

  1. Possess an up-to-date user’s manual and read it. Many payers have placed their manuals on their Web sites.
  2. Read the monthly program updates on payers’ Web sites. These should be read by your technical and billing staff and your information systems group.
  3. Know your billing staff and meet with them. All staff members should have the same understanding of the billing process.
  4. Be sure your compliance program includes a section on billing practices.
  5. Review your remittance advice notices. Run a trend analysis on denials and denial followup.
  6. Get on the Web. For example, in California, Medi-Cal providers can check eligibility denials, claims status, and other information online at
  7. Update your master billing file. Many labs are billing less than the maximum allowable.
  8. Validate all coding. Lab management and the billing department need to work closely to ensure correct coding for all lab tests.
  9. Check eligibility before submitting a claim. Eligibility is the No. 1 reason claims are denied.
  10. Challenge your biller. Get involved.

Ask payers for their suggestions on how you can do a better job of billing. They might, for example, tell you that most paper documents are scanned, and if they can’t be scanned, they are returned. Or they might mention that documents highlighted with marker scan black, causing the documents to be rejected.

Additional sound advice is to wait an appropriate period of time for multiple procedures to be reimbursed. Some payers take 90 to 120 days to pay for a second procedure. Starting a rebill process before this time can double or triple the cost of the claim.

Think, look, listen, and be patient, and profit from it.—Hal Weiner

Modulus unveils new LIS
Modulus Data Systems has introduced the Modu-LIS II Web-based laboratory information system.

Key to the product’s design is a Web-based ordering and reporting system that can be used as part of the total LIS or as a stand-alone accessory to any LIS. The Web-based server communicates with any LIS or hospital information system via an HL7 interface protocol.

Modu-LIS II includes such features as customized results reporting, real-time instrument interface monitoring, stringent quality control checks, and specimen handling.
Modulus Data Systems, Circle No. 198

FDA clears Cerner blood bank donor product
Cerner Millennium PathNet Blood Bank Donor has received FDA 510(k) premarket notification clearance and is now available to Cerner clients.

The product automates the management of the blood-donation process and helps users determine donor eligibility and blood product suitability. It also features streamlined workflow with bar coding, online donor recruitment lists, donor management to track eligibility and demographics, blood drive scheduling, and full support of ISBT 128 blood labeling.

For more information about PathNet Blood Bank Donor, see the blood bank information systems survey in this issue (page 40).
Cerner Corp., Circle No. 197

Siemens, Data Innovations enter marketing venture
Siemens Medical Solutions recently entered into a marketing agreement with Data Innovations under which it will market Data Innovations’ Instrument Manager data-management system.

Siemens will offer Instrument Manager to its Novius laboratory information system customers as an instrument and reference lab interface option.
Siemens Medical Solutions, Circle No. 195
Data Innovations, Circle No. 196

The Blood Center, a nonprofit community service organization serving more than 40 hospitals in southern Louisiana and Mississippi, has implemented Information Data Management’s Surround 3.1 open laboratory system. The Blood Center will use Surround 3.1 to sort and report donor testing results to testing clients.

Information Data Management, Circle No. 199

Contrary to what CAPTODAY reported in its September “Newsbytes” column (“Vendors delving into digital,” page 95), Cerner Corp. has not entered the construction business. Instead of building a 220-bed hospital for Legacy Health System, Cerner is serving as the information technology provider for that hospital.

CAPTODAY regrets the error.

Dr. Aller is director of bioterrorism preparedness and response for Los Angeles County Public Health Acute Communicable Diseases. Weiner is president of Weiner Consulting Services, LLC, Florence, Ore. Dr. Weilert is director of laboratories, Community Hospitals of Central California, Fresno.