Electronic tools make it easy to copy and paste documentation from one record to another or pull information forward from a previous visit, someone else’s records, or other sources. Failure to build in technical or policy and procedural safeguards creates an environment in which documentation manufacturing is encouraged and fraudulent entries are possible—thereby compromising data integrity. There also are instances in which borrowed documentation cannot be tracked to the original source, creating both legal and quality of care concerns.
With CureMD, you aren’t burdened with the anxiety of communicating with a new expert every time you require professional help; we assign a dedicated account manager to each practice. Our creativity is a distinguishing factor and that’s where we have the edge over “any other EHR vendor” (See EHR Vendor Comparison Case Study ) . We provide specialty driven EHRs, tailor-made to meet the needs of your practice. Our template experts create customized templates for your practice to ensure that your clinical content is documented and accessed swiftly and accurately, and according to your style and preferences. Moreover, we offer the best role-based real time trainings to each staff member to ensure that the practice workflow proceeds optimally. The training schedule is extremely flexible as per the convenience of the practice. Both individual and group sessions are offered, and provided accordingly depending on the client’s preference. Furthermore, we don’t leave you out in the open once the implementation process is complete and we regularly follow up with our clients post-implementation.
HIM professionals are a key participant in the development of copy audits, in part because of their knowledge of essential state, federal, organization-specific, and Joint Commission documentation requirements. To that end, they can ensure that all of these standards are identified, reviewed, and met in conjunction with the proper implementation of the copy functionality. Failure to consider these key documentation requirements can result in inaccurate or erroneous information within the health record, even potentially a deficiency from an accreditation body.