The Plan ◦ 1. Make it simple. ◦ 2. Make it user friendly. ◦ 3. Educate the provider. ◦ 4. Integrate the process in the work flow. ◦ 5. Build relationships to all the needed providers.

 How did we do this?  We reviewed the existing process to find a lean way to complete the proposed process.  We reviewed all of the approved paperwork from CMS.  We reviewed the guidelines in its entirety for power mobility devices.

In Codeable Language a power mobility device (later to be called PMD) flow was developed to directly query the providers during documentation.

Assessment 72 y/o female here for evaluation of PMD pt has history of CHF, MI, Depression, DJD of bilateral knees.

 Diagnosis:  PARKINSON’S DISEASE  SCOLIOSIS  CORONARY ARTERY DISEASE (CAD) CONGESTIVE HEART FAILURE (CHF)  CARDIOVASCULAR ACCIDENT (CVA)  CHRONIC OBSTRUCTIVE PULMONARY Disease  OSTEOARTHRITIS (OA)  DEGENERATIVE JOINT DISEASE (DJD)  DEGENERATIVE DISC DISEASE (DDD)  OSTEOPOROSIS (OP)  SPINAL STENOSIS  FEMUR FRACTURE  PARAPLEGIA  Other: Click here to see more if you don't see your diagnosis. You will be taken to the full dictionary.

Diagnosis  Left ventricular failure (I50.1)  Systolic Heart failure (I50.2)  Diastolic Heart failure (I50.3) Combined systolic and Diastolic Heart failure (I50.4)  New Diagnosis  Click here to see more if you don't see your diagnosis. You will be taken to the full dictionary.

Symptoms: Dyspnea Orthopnea  Weight gain  Increased PCO2 Increased O2 requirements  Increased abdominal girth  Wheezing  Pursed lip breathing Low Ejection Refraction  Edema

Test Echocardiogram 6 Minute Ambulation Trial Mini Mental State Test Physical Therapy Evaluation Occupational Therapy Evaluation  Pulmonary Function Test  Arterial Blood Gas

Prior Treatments Physical Therapy Pain Management Assistive device Home O2  Other

Jane Doe, a 72 y/o female is here for evaluation of PMD. Patient has a history of CHF, MI, Depression and DJD of bilateral knees. Her CONGESTIVE HEART FAILURE (CHF) with symptoms of dyspnea, orthopnea, increased O2 requirements and a low EF of 35% (please see attached Echo) affect her ability to use a self propelled device. Jane’s MI from 2009 decreased her EF from 50-60% down to 35%. Jane has had physical therapy, home health, pain management, used a walker and has home O2 at 2L/m. Jane’s mental status is good at 25 out of 30 on her mini mental exam.

Codeable Language directly queries the providers as they document; thus allowing the provider to offer accurate information in a quick and easy faction.

Codeable Language is more than just software that directly queries the provider. It is also an education program, a documentation improvement system and a way to decrease coding errors.

We have just currently completed a syllabus to present to Medical Schools, Residency Programs and Hospitals to improve documentation. Our thought is GET IT RIGHT FROM THE START!

Collaboration of 2 DME providers: A. A large company that did not win the bid however still wanted to service their clients. B. A smaller DME company that did win the bid however did not have the buying power to decrease the cost of each PMD.

1. Finding providers, 2. Leaning out the system, 3. Establishing education time, 4. Overcoming the fears of the providers, 5. Understanding the limitations of the EMR used by the providers.

By building the forms within the EMR we were able to complete the entire forms process in one PDF. The EMR used had an eScription system that allowed the MD to write the prescription electronically. The entire chart was compiled directly from the EMR. The DME provider gave us the files in PDF form allowing us to upload them into the EMR.

The success of this trial was based upon: 1. Simplifying the process for the MD, 2. Building the CodeableLanguage flow, 3. Educating the providers, 4. Creating collaboration of DME providers, 5. Double-checking the charts for completion prior to submission.