Staying on top of recordkeeping during a pandemic

Most veterinary hospitals are overwhelmed these days. A major consequence for many: their recordkeeping is taking a hit. Sometimes it’s just a matter of little things slipping between the cracks. Other times it can be a ton of missed charges that really add up.

NEWStat spoke with Kathy Kirk, practice manager at AAHA-accredited Pikes Peak Veterinary Clinic in Colorado Springs, Colorado, to see how her practice was keeping up.

She says it’s been tough, as transferring and updating records can be time consuming right when time is at a premium. Her hospital doesn’t use a cloud-based recordkeeping system, which makes things even more challenging. “We do a lot of scanning and attaching at the end of the day,” she laughs.

Pikes Peak didn’t have someone continually checking and updating records before COVID but realized pretty quickly after going to curbside that they needed a full-time staffer in that role. Kirk says it worked out well having someone working remotely assigned to the task: “It gave us an opportunity to retain staff who were unable to come into work,” due to personal circumstances such as pregnancy, illness, or lack of childcare, but who were still able to work from home. “We have one person who literally sits at home all day attaching forms to patient records as they come in.”

Some hospitals have been having problems getting records for new patients from their previous hospital, and Kirk says they’ve run into some of that: “Other hospitals are busy, so trying to get records the same day can be very challenging.”

Kirk says many clients mean well when they offer to email or bring records, “But then they forget.”

That’s why Pikes Peak has a policy of always calling the client’s old hospital to ask for records, although that doesn’t always work.

She says it’s not uncommon to have clients sitting in the parking lot while staff is still scrambling to get hold of their old patient records, “even though it’s been a week since they made their appointment. We’ve reached out to their old hospital multiple times, but everyone’s so busy. Or they’re just closed.”

It’s also been tough simply to keep all the patients’ information in one place. “Right now, we’re seeing clients coming back and forth between multiple hospitals.” Many go wherever they can get an appointment, and a client who took their business to another hospital last month may be back at your hospital next month.

One change she’s noticed that can slow patient-record transfer: “More and more hospitals—especially corporate hospitals—are requiring a signed client release” before they’ll share their pets’ records. “So the sooner we can start that process, the better.”

Worst-case scenario if she can’t get hold of patient records? “We’ve had to revaccinate with at least the core vaccines. Clients have been very understanding.” Fortunately, Kirk says, “those cases are few and far between.”

“Record sharing is a challenge,” concedes Debbie Boone, CVPM. Boone owns 2 Manage Vets, a veterinary consulting firm in Myrtle Beach, South Carolina, and she told NEWStat there are ways to overcome that challenge.

“Apps like VitusVet allow the client to have access to their pet’s chart as long as their regular veterinarian is participating and their computer is online.” So check to see whether your new client uses such an app. Using a pet app that stores basic health information means they have at least some information about past visits available. And if a client’s old hospital is closed for good, or dragging its feet on record transfer, reporting them to their state veterinary board may be a last-ditch option. “Depending on the state, practices that have gone out of business are required to arrange for owners to have access to their pets’ records,” Boone said.

She also suggests using alternate forms of requests such as email instead of—or in addition to—phone calls. Hospitals’ front desks have been overwhelmed by skyrocketing call volume during COVID, “so trying other routes may get [you] a faster response.”

As for general recordkeeping, Boone recommends that practices having trouble keeping up use an app like Talkatoo to speed things up. Dictation software developed specifically for the veterinary profession, Talkatoo can help reduce charting time. “It types at 200 words per minute, compared to most humans, who type at 40,” she says.

Reducing charting time and charting immediately after the patient visit increases accuracy and efficiency.

Another way to increase efficiency is to have nonveterinary staff perform record audits, as they’re doing at Pikes Peak. Boone also recommends checking the appointment log for the presenting issues, then comparing it to the patient chart to confirm that all appropriate notes, services, and invoice items are recorded. If your hospital uses check-in sheets, use them as an additional reference to double-check that the chart is correct.

And because most hospitals doing curbside are communicating with clients via text, those texts are another avenue for record review, Boone says: “Review your conversation with the client and then confirm all the notes are in the history.”

Above all, Boone stresses awareness.

If a hospital is auditing charts and finding gaps or missed charges, Boone says it’s imperative that management make the entire team aware of the problem so they can all work to solve it together. “Just like the cash drawer should have a system of checks and balances, our charts and invoices should, too.”

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