Basics on PhyScore Physician Assessment System, Part 1

Tuesday, April 28, 2020

The theme of big data has impacted numerous important industries, and the world of emergency department medical billing and coding is no exception. ER billing and various other medical billing areas have been enormously impacted by big data in a variety of ways. 

At PhyCon Incorporated, we recognize the challenges that often come with organizing everything within emergency medical billing and other needs, and we offer our practice management and ER billing services as a solution. In particular, over the last few years we’ve developed a patent-pending system for comprehensive evaluation of physician care, patient outcomes and costs, one we’ve dubbed PhyScore. This multi-part blog series will dig into everything you need to know about PhyScore, including the important elements behind its formation and what it helps ED physicians and staff with on a daily basis. 

PhyScore Formulation and Themes

Understanding the impact of big data on numerous industries, we entered the formation of PhyScore with two basic hypotheses: That there are no performance grading or evaluation methods for physicians that are conducted in a truly scientific manner, and that the Physician Order Entry is the foundation of all healthcare spending. 

From here, we worked to find ways to make big data translatable in ways that physicians and others in this field without corporate or administrator experience can understand. This was the early phase of the development of PhyScore. 

ED Physicians and Processes

The more information physicians have, the better they are able to perform their tasks effectively. However, many current processes undertaken by hospitals and emergency departments involve physicians receiving very little information in important areas like patient outcomes, exact dollar amounts for medical decision-making, resources consumed during treatment, and how to compare to other physician groups both inside and outside one’s specialty area. 

This is why we developed PhyScore. Through it, physicians and other emergency room staff have access to real-time data on numerous areas, from patient records to many other inputs. This allows information flow to be improved in a number of ways, which in turn improves patient care and the dollar amounts spent on it. 

Our next several sections will dig into the six categories that make up physician assessments and the scoring method for PhyScore. 

Critical Thinking Scoring

One unique element of emergency departments is the way the physician is often required to make immediate decisions without much information available. They must rely only on their training and experience. This is broadly viewed as a form of critical thinking, which is scored by the physician assessment system in the following ways:

  • Differential diagnoses: After the physician formulates different diagnoses, the system applies algorithms that properly weight the presenting difficulty and final diagnosis based on hundreds of thousands of other cases.
  • Emergent decision making: There are also criteria for overall critical thinking, such as immediate interventions or trauma admissions.
  • Consultations with attending physicians: A highly important area that signals physicians are willing to take input from others during critical thinking.
  • Critical care time: Finally, the score will document the time that’s taken to deliver forms of emergent care, helping confirm that the physician is using training and experience in optimal ways. 

For more on our PhyScore or other emergency department billing and coding services, speak to the staff at PhyCon Incorporated today.