Friday, October 22, 2010

Allergies Know No Vacations

Many allergy sufferers are plagued with year-round symptoms. Avoidance of most allergens is nearly impossible. What works?

Topical nasal steroids (like Flonase, Nasacort, Rhinocort, Omnaris) work the best. They are very effective anti-inflammatory agents. However, to achieve the maximal effect they take several days of application. The down side to intranasal steroids is that they can be drying to the nasal mucosa, making nose bleeds more likely. Intranasal steroids also increase susceptibility to viral and bacterial upper respiratory infections, which have the potential to lead to lower respiratory infections.

Topical antihistamines (like Astelin) work within 10-30 minutes of application, and are very effective. They too can be drying, making nose bleeds more likely, and they can also predispose to infections.

Leukotriene inhibitors (another type of anti-inflammatory agent, like Singulair) are tablets that work very effectively. Inflammation is caused by multiple pathways, and leukotriene inhibitors block pathways that are not affected by steroids or antihistamines. They are a great addition to an allergy sufferer's regimen if their allergy symptoms are not under control with other agents. They are not usually used as a first line agent because they are expensive, and because more symptoms can be effectively treated with steroids and antihistamines.

Oral antihistamines work great. They are nearly as effective as topical antihistamines, but take a few hours to feel the effect. The main advantage of oral antihistamines is cost. There is a generic version of loratadine (sold originally as Claritin) available at a cost of only pennies per day, compared to $2-5 per day for intranasal steroids or antihistamines. Easy to take pill form is another advantage.

First line treatment for severe allergy sufferers is intranasal steroids. Topical antihistamines and oral antihistamines can be added as needed.

The most affordable option is generic oral antihistamines followed by the addition of intranasal steroids as needed.

Whatever you and your doctor choose, take the medication as directed. If you are a year-round allergy sufferer, you must take precautions every day of the year.

Tuesday, October 19, 2010

iRVU Is Here

e-MedTools, the people who make MedicalTemplates and E/M Code Check, have created a new smartphone app - iRVU.

iRVU tracks the wRVUs a health care provider generates. Not only will iRVU tally the wRVUs, it will also generate a wRVU/Encounter number.

The total number of wRVUs generated and the number of wRVUs/Encounter are benchmarks used to determine individual productivity, estimate revenue generated, and compare one health care provider's productivity with another.

Virtually every medical practice uses these benchmarks to assess physician productivity and relative value to the practice.

e-MedTools have some awesome products.

Monday, October 18, 2010

Allergy Season and Flu Vaccines

Allergy season is winding down, thank goodness, but flu season is right around the corner!

If you have not already received your influenza vaccine this year, now is a great time to get one. Many drug stores and discount department stores are providing affordable flu vaccines in places where you likely already shop! Convenience, too!

Who can benefit from a flu vaccine? Everyone!

Any person with a chronic medical condition, not just a disease affecting the lungs, needs a flu vaccine. "Comorbid conditions" as it is called, increase a person's susceptibility to worse side effects from an influenza infection.

Others at risk of worse side effects include young children. They have smaller airways and they can succumb very quickly to infections.

Adults caring for children are at higher risk of catching the flu because they are more likely exposed to greater numbers of infected people, AND they can readily spread the flu to other small children.

Residents of a facility that house multiple unrelated people (i.e., nursing homes, apartment buildings, mental health facilities, prisons, etc.) also pose risks due to the increased chance that one or more of the residents will have the flu. In addition, the closer quarters increase the likelihood of being close enough to someone to catch the flu who has already been infected.

Even otherwise healthy people benefit from vaccination. Who does not have family members in school, loved ones with a chronic health condition, or family members in nursing homes? No one wants to be the reason another person gets sick.

Finally, the flu vaccine can not only decrease the likelihood of getting the flu, it can decrease the severity of illness should you get the flu. This can decrease the number of days missed from school or work (or play).

Do yourself and your family and friends a favor. Get the flu vaccine. You'll be glad you did!

Friday, October 15, 2010

Medical Documentation, Billing and Coding

Medical documentation, billing and coding requires knowledge of complex, changing rules. Thank goodness for medical documentation, billing and coding experts who can be so darn helpful!

Thank goodness, too, for point of care tools that make medical documentation and coding much easier to understand and implement, and save time and money!

A couple of these tools deserve mentioning again.

E/M Code Check is such an exciting smartphone application! It has a concise, easy to follow format. Each page is really information packed, and the buttons to transition to the next page are very easy to use, unlike some other smartphone apps.

E/M Code Check incorporates great graphics, providing a great deal of information (pictures are worth a thousand words!) on personal documentation and coding habits. The feedback this tool provides is terrific, and it will help most anyone to learn where they need to improve.

Like some other companies, E/M Code Check provides a free version, making money by inserting ads, but the $34.99 version is worth every cent!

E/M Code Check provides Medicare reimbursement rates (based on national averages), tallies them based on the encounter types entered, and graphs personal coding distribution levels!

E/M Code Check also reinforces the use of MedicalTemplates for documentation of patient encounters. MedicalTemplates are terrific tools for prompting health care providers to document a complete history and physical exam. Sometimes the situation or conversations in patient encounters can derail a train of thought. Who hasn't had to return to a patient room to ask about some missing piece of the social history? With MedicalTemplates a physician can be confident that they are consistently documenting a thorough patient encounter note. Best of all, thorough documentation using MedicalTemplates saves time. Most aspects of the patient encounter can be documented with a simple check mark, but there is ample space to write personal notes.

If you haven't checked out these products, go to

Tuesday, October 12, 2010

10 Reasons To Own E/M Code Check

The folks at e-MedTools have created another terrific medical documentation tool!

E/M Code Check is an application for smart phones (iPhone, Android, etc.) that contains important financial data for physicians. This tool not only provides benchmark data from Medicare, such as coding distribution curves and average reimbursement rates, it provides succinct summaries of documentation requirements for coding levels for many types of clinical encounters. E/M Code Check even includes encounter information not found in other medical documentation tools.

The most exciting feature of E/M Code Check is the Personal Productivity Log that tallies all patient encounter codes, then reports the data in a graph format that includes a personalized coding distribution graph, reimbursement, average number work RVUs per encounter, etc.

In today's economy, and with Medicare dropping the reimbursement rates twice in 2010 for sub-specialist physicians, and more cuts to Medicare reimbursement rates planned for December 2010 and January 2011, this tool is indispensable!

10 Reasons to Own EM Code Check