Galen Healthcare Solutions: Allscripts Consultants Enterprise EHR

CMS released a couple of updates last month regarding Meaningful Use and the EHR incentive program. I wanted to pass this information along to our readers.

In their December 7 update, CMS indicated that “HHS announced its intention to delay the start of Stage 2 meaningful use  for the Medicare and Medicaid EHR Incentive Programs for a period of one year for those first attesting to meaningful use in 2011”.  The reason as such, according to them, is that the current schedule for compliance to Stage 2 could be a challenge for those that attested in 2011. The decision also was in consideration for vendors and practices.

 The CMS update identified some benefits from the proposal:

• The delay could provide vendors more time to develop their certified technologies for Stage 2
• The delay could also provide providers more time to implement the new software to meet Stage 2 requirements
• Expectations remain current so that providers attesting in either 2011 or 2012 begin Stage 2 in 2014
• And while 2011 has passed, CMS believed this idea would provide added incentive for providers to attest in 2011.

While I am sure there is a group of people out there that is ambitious enough to keep pace for this process, I am certain that we all can stand to benefit from the proposed delay.  The benefits from the added amount of time for both the vendors and practices/providers seem more appealing, in my opinion.

Back on December 1, CMS also announced a new tool to help Eligible Professionals (EPs) through the phases of Meaningful Use.  This tool is an eighty-five (85) page PDF file, dubbed as a “Beginner’s Guide”. This file provides a thorough, interactive walkthrough of Meaningful Use.

Among the items of information provided are:

• EHR Incentive Program basics
• How to participate (determining eligibility and registration)
• Meaningful use and choosing measures
• Attestation
• Helpful resources on the Medicare and Medicaid EHR Incentive Programs

Lastly, they also provided a link to their Educational Materials page for the EHR Incentive Program. This link offers an extensive array of files and tools regarding the EHR Incentive Program.  This is definitely a link to bookmark, as well as the guide previously mentioned.

If you haven’t already done so, visit the CMS EHR Incentive Programs webpage and register to receive their email notifications. 

Contact Galen Healthcare Solutions for any additional questions regarding Meaningful Use and Allscripts Enterprise^TM EHR.

Tags: Allscripts, Allscripts Enterprise EHR, EHR Certification, Enterprise EHR, Meaningful Use

Galen’s Interface Team had a full house in Boston yesterday, hosting twelve interface analysts from ten healthcare organizations throughout the country, for Galen’s first Results Interface Conference

The training covered the topic of building and maintaining results interfaces within the Allscripts Enteprise EHR. The group covered ImageLink, order reconciliation, Requested Performing Location identifiers, auto synching, troubleshooting errors and the underlying data model.

While I have great confidence in our Interface Team and the instruction provided given their expertise, the best part of the day was the interaction that occurred between the different healthcare organizations that attended the training. Throughout the day, I saw attendees pulling each other aside during breaks. They were discussing approaches to resolving errors they saw in their own environments, best practices for building new interfaces and trading ideas on working with microbiology results in Enterprise (a perennial issue).

The group continued conversations started on the Allscripts Interface Developers Network, which I’m sure will continue today and in coming months.

We look forward to offering similar conferences and trainings, and would love to get your thoughts on what type of training sessions and conferences we should host in the future.

In the professional world, most of us spend a varying amount of time on conference calls. This can be said of folks both in an office or remote location.  For those that can remember, meetings mainly use to be face-to-face in a meeting room. There was not a dial in number or participant code. People joined around a table or in an audience. Telecommuting was very limited not too long ago.

Technology has certainly driven a shift in how we do business now. More and more people in the workforce perform their jobs remotely. Meetings, for the most part, rely upon a toll-free number and the comforts of your desk at the office or at home. Being a remote employee myself, I wanted to contribute this week with some tips that I have learned regarding conference calls.

 Scheduling

 -          Software

• Be aware of what scheduling program others use. One example is Microsoft Outlook. External recipients may not have the same program and therefore you increase your risk of someone not receiving important invite information

-          Time Zones

• It is important to know if there are differences in the time zones that attendees currently reside. This is critical for arranging the meeting time.

-          Length

• Try to keep meetings to an appropriate length. Estimate a realistic amount of time to set aside. This is beneficial to stay efficient and make the best of everyone’s schedule.

-          Coordinate

• Actively coordinate times between standing meetings both for yourself, and attendees.  Keep in mind that it may not always be possible to accommodate 100% of the requested attendees. It is however good practice to accommodate most attendees, especially essential attendees.

-          Prepare

• For more formal meetings, or meetings that have structured purpose, create an agenda both for yourself as a host and attendees.
• An agenda helps hosts prepare for the meeting, as well as attendees prepare for relevant talking points as necessary. Share the agenda if necessary

-          Arrival

• Try to join the call at least three (3) to five (5) minutes prior to the call start time. This will allow the host to begin the meeting on time. The exception to this would be when calls are scheduled back to back.

During the call

-          Noise

• As an attendee, it is absolutely critical to not cause background noise during a call. My main rule: If I’m not talking, I’m on mute.
• Some conferencing services allow the host to mute all attendees. That feature is excellent for webinars, as this is often used during the Galen Webcast Series.
• Less formal calls don’t require this kind of mind set; therefore it is best to gauge the call to determine your actions.

-          Start

• Meetings should begin on time as best as possible. Starting a meeting on time respects the efficiency of everyone’s schedule and optimizes the time allotted to tackle an agenda. Again, a barrier to accomplishing this occurs when meetings are frequently scheduled back-to-back.

-          Stick to the point

• Meeting hosts should manage the call effectively. Stick to agenda items.
• Prevent yourself and attendees to digress or side track from the topics at hand.  Meetings will often end too early or extend past a planned time if participants speak “off topic” or ineffectively discuss agenda items.

-          Listen

• Active participation in a call is expected of attendees.
• Try at every extent to not multitask during a call. You never know when the conversation might turn to you. Calls are not efficient when a participant is not paying attention; additionally the participant’s image is reflected poorly.
• Be mindful of any language barriers. Diversity is an excellent aspect of the globalization business operations. Respect and pay closer attention to those you might not easily understand, both in dialect and grammar.

-          Parking Lot

• Keep a “parking lot” list during the call for action items. This is something best done by the host or delegated to an attendee to maintain and share after the call.
• Other participants should keep their own list as well, in case of personal action items. This way, you aren’t waiting for the list from someone else for your items.

-          Notes/Minutes

• As similar to the parking lot list, someone should actively take minutes for more formal calls to share with the meeting participants. This helps solidify any items mentioned in the call and records for future reference.
• For formal and non-formal calls, it is very effective to take notes for personal use for future reference.

-          End

• Hosts and attendees that manage the time effectively often may finish early and return some time to the day.
• Be aware of the time relative to the scheduled end time. Once it draws about five (5) minutes before the scheduled end time, determine the best next course of action. The action either could be one of three possibilities: Continue with all or a portion of the participants, reschedule the call to proceed with the conversation, or end the call as it stands. The latter being the least likely course of action.
• If the meeting needs to be rescheduled, be mindful of the scheduling tips mentioned previously. Scheduling a new call can be done after the current call.
• Clearly express any expectations prior to adjourning the call.
• Thank everyone for their time!

 After the call

-          Wrap up

• Send out any new meeting invites as soon as the prior call has ended.
• If any minutes or notes were taken, be sure to share the documentation with the attendees (as necessary) as soon as possible.
• Act upon any action items either for the parking lot list or assigned items as necessary. The sooner something is completed, the sooner it is off the list!
• For more formal calls and as a host, be sure to send a follow up thank you note to participants for their time.

-          Feedback

• For webcasts or formal calls, request feedback for continuous improvement.

Some of these tips do blend into the topic of time management. I think time management becomes more crucial before, during, and after conference calls. As we are more remote these days, more effort is needed to close any loops between meeting attendees. Some meetings are simpler and require less attention, whereas some meetings are more formal and require great effort.

The tips I shared are simply from personal experience. I know people with far greater experience have dedicated books to this topic. I thought some might benefit from a brief article regarding conference calls and some friendly advice.

I am absolutely positive there are people that agree, disagree, and have their own perspective or tips to add!  Please, share your thoughts, feedback, stories, and tips in terms of conference calls! I look forward to seeing this discussion continue and what others might have to contribute to this matter.

Tags: conference calls, Galen Webcast Series, Training

The New England Chapter of HIMSS had their Monthly Event and Social last week at Papa Razzi in Wellesley, MA.  There was a great turn out, including many first time attendees.  The topic of this month’s meeting was ICD-10.  The presenters provided a great overview of ICD-10, how it compares to ICD-9, as well as identified some of the most common and significant concerns about the historic change.

• Currently, there is a CMS mandate to be compliant with ICD-10 by 10/01/2013.
• The United States is the last industrialized nation to adopt ICD-10.  Some countries have been utilizing ICD-10 for years and are now looking down the road at ICD-11.

ICD-9 is approximately 30 years old and is running out of codes. With age, the standard has lost some of its effectiveness.  For example, ICD-9 has no code to describe H1N1 (Swine Flu), an outbreak that effected tens of millions of Americans over the past few years.

One of the perceived benefits of adopting ICD-10 is the level of specificity with which diagnoses and treatments can be described.  There are 14,000 ICD-9 codes, which are composed of 3-5 digit numbers. By comparison, ICD-10 has more than 68,000 codes, which are made up of 7 character alpha-numeric sequences. Transitioning to ICD-10 will mean a five-fold increase in the number of available diagnosis codes. 

 An example referenced during the presentation concerned an ‘open wound on finger’. Using ICD-9 there are three codes available to describe that diagnosis.  Under ICD-10 there are about 400 codes that could apply.  Again, that is directly related to the level of specificity used to describe the wound, combined with putting it into an historical context.  For example, ICD-10 can be used to specify the finger (ie ‘left ring finger’), whether or not the nail was damaged, and whether the diagnosis is being made as part of an initial or subsequent encounter. Below is a diagram from the General Equivalence Mapping (GEM) user guide, published by CMS. 

Note that the same ICD-9 code is used for all four scenarios.

The participants in the event’s panel discussion provided some interesting insight regarding how their respective organizations are working to prepare, train, and ultimately implement ICD-10.  Two common themes discussed by several presenters were that importance of both senior management and physician ‘buy-in’, as well working with the Massachusetts Health Data Consortium to help ease into the transition with providers.  In one example, provided by Lahey Clinic, coders provide feedback to doctors after audits of their computer assisted coding have been reviewed.

Ultimately, physician acceptance and adoption will mostly likely be correlated to policy of CMS to withhold Medicare and Medicaid payments from doctors that are not using ICD-10.

 In the days following the November NEHIMSS event, the American Medical Association (AMA) announced its intentions to stop the implementation of ICD-10:

“RESOLVED, That our American Medical Association vigorously work to stop the implementation of ICD-10 and to reduce its unnecessary and significant burdens on the practice of medicine (Directive to Take Action); and be it further”

“RESOLVED, That our AMA do everything possible to let the physicians of America know that our AMA is fighting to repeal the onerous ICD-10 requirements on their behalf. (Directive to Take Action); and be it further”

“RESOLVED, That our American Medical Association work with other national and state medical and informatics associations to assess an appropriate replacement for ICD-9. (Directive to Take Action)”

 Galen Healthcare Solutions offers project management, implementation, and training solutions. Contact us to find out how Galen might assist your ICD-10 transition.

Tags: Galen Healthcare, HIMSS, ICD-10, ICD-9, NEHIMSS

Have you ever found yourself asking how the heck does Imagelink work?  How is it possible to click a button in the Allscripts application and view an X-ray?  Have you ever wanted to know how a result closes an order is closed without a Touchworks Order number?  Have you ever heard someone say, did you check the requested performing location dictionary, and not know what they’re saying?  Have you ever wanted to know more about Allscripts result interfaces?

Well you are in luck! The Galen technical services team is proud to host a Free Results Interface Training hosted at it’s brand new office!

Who: Allscripts Interface Analysts

What: Free Result Interface Training

Where:  70 Federal Street, 7th Floor, Boston, MA 02110.

When:  Wednesday, December 14th, 2011 from 9AM-5PM with lunch provided.  There will also be a cocktails and networking hour from 4PM-5PM with beer, wine and light snacks.

Why: Learn about more of the intimate details, nuances, and best-practices surrounding Allscripts result interfaces

Agenda:

• Imagelink
• Reconciliation w/ and w/o eletronic order interface
• Common errors
• Requisitions
• Requested Performing Location
• Auto synching
• Much More!

Please contact us if there is a topic you would like to learn more about that isn’t in the list above.

Travel:  If you are driving into the city, there are parking garages nearby. The cheapest and most convenient is the Winthrop Square Parking Garage at $20/day.  If you are coming in from out of town, there are many hotels in the area.  Also note that we will have wireless internet and workstations with a hardwired internet connection available for those who need it.

Space is limited – Register Today! If you can’t make the training, it’s ok!  Galen offers free webcasts about every two weeks.

Tags: Allscripts, Allscripts Enterprise EHR, Allscripts Interface, ConnectR, ConnectR Training, Galen Webcast Series, Integration, Interface Training, Interoperability, Results Interface

This past Tuesday, I attended the NEHMISS Monthly Event and Social hosted at the Papa Razzi in Wellesley, MA with one of my colleagues, Patrick Zummo. It provided an invaluable opportunity to network with other healthcare IT professionals as the event had one of its best turnouts in the past two and a half years that we have attended (I would estimate about 65 attendees!) It was great catching up with folks and seeing new faces. The networking opportunity can’t be underscored enough!

The event featured a presentation on “An Approach to Meaningful Use” by Laura Leinin, Sr. Project Specialist, Clinical Information Systems at Partners Healthcare, and Jennings Aske, J.D., CISSP, CIPP, Chief Information Security Office at Partners Healthcare.

Laura started things off with an overview of the MU legislation to date:

• Original goal of MU legislation was to target full EHR adoption by 2014
• The three phase of EHR: Adoption – MU – Outcomes
• Compuer Sciences Corporation (CSC) estimated that for a hospital with 276 beds, the potential MU payout would be $4.2 million
• The major certifying entities for EHR software is Certified Commmunication for Health Information Technology (CCHIT) and the Drummond Group. The model utilized is a conformance tool where submission of data is required.
• Attestation if currently a manual process – submission of the numerator and denominator.

Jennings followed by addressing security compliance & MU:

• The main components of security compliance include access control, emergency access (“break-glass” capability), auto log-off, and audit log.
• Jennings noted that with the audit report, requirements included capture of userid, patientid, user activity and the ability to sort by time.
• An example of compliance presented was since Partners had a home-grown EHR system (longitudinal medical record – LMR), in order to comply with CCHIT & Drummond certification, the system needed to possess the capability to handle encrypted file import.
• Jennings expressed that Partners needed to exhibit compliance as described above, but in some scenarios (like the encrypted file import described above) they don’t actually intend on using the functionality. This led me to wonder what the percentage of cases were where the EHR needed to comply with security standards, but would never actually use or implement the feature in operational practice.

For the remainder of the presentation, Laura offered some statistics and updates with regard to Partners MU initiative:

• As of Thursday, September 30^th, 114,644 EPs & EHs have registered for attestation.
• As previously noted, attestation for stage 1 is currently a manual process and Laura warned of the high chance that organizations are likely to be audited post-attestation and as such they should have the records and data to back it up.
• She noted that Academic Medical Centers (AMCs) need to be self-certified in that they often have home-grown systems in the inpatient setting and noted that community hospitals often have commercial off the shelf (COTS) systems provided by the leading EMR vendors.
• She provides a project status dashboard each month to stakeholders and executives with more than 125 data points to track each month!
• Laura also mentioned the challenges of qualifying for MU in the presence of the healthcare information system mosaic at Partners that we’ve previously touched on in our blog in that of the different organizations that are affiliated with Partners (Brigham and Women’s Hospital, Massachusetts General Hospital), there are different vendor systems for ED (Electronic Discharge) systems, PM (Practice Management) systems, etc.
• In some cases, to qualify for meaningful use, workflows had to be adapted. One example was the handout of clinical summaries to patients.

Several great questions were posed by the audience including the following

• Q: Is standardization of vocabularies at Partners being handled by IT or the clinical staff? A: IT staff
• Q: What’s the headcount needed at Partners for the MU initiative? A: About 50 people across hospitals and LMR teams
• Q: How is Partners handling the case where smoking status is not captured discretely, but rather exists in a note? A: The homegrown LMR at Partners currently captures smoking status discretely. However, there are NLP (Natural Language Processing) solutions (Autonomy, Nuance come to mind) to post-process the non-discrete data for those applications which do not store it discretely. We have touched on data-mining non-discrete data in a previous blog post.
• Q: What happens if an organization decides to switch an EHR going forward? How is certification and MU qualification handled? A: No presenter or audience member had experience in switching organizations, but as we’ve witnessed with EHR vendor consolidation and an explosion of acquisitions requiring data conversions, this is likely to be a hot topic going forward.

Tags: Allscripts, Allscripts Data Mining, CCHIT Certification, Custom Reports, Drummond Group Certification, HIMSS Meaningful Use, Longitudinal Medical Record, Meaningful Use, Meaningful Use Security Compliance, NEHIMSS, New England HIMSS, Partners Healthcare Meaninful Use

I attended my first New England Healthcare Information and Management Systems Society (NEHIMSS) event.  And I must say I was impressed!  There were five wonderful presentations and opening and closing remarks by Lisa Ewing, NEHIMSS President.  I had the privileged honor to meet:

• Jim Albert CIO – Charlotte Hungerford Hospital, Connecticut
• Dan Feinburg (Director, NEU Masters in Health Informatics Program)
• Arthur Harvey (Professor, Brandeis University Masters in Health Informatics Program, Director IT Operations, Boston Medical Center)
• Sue Schade (CIO – Brigham and Women’s Hospital) and,
• Many other influential people within the healthcare IT industry.

Jim Albert’s presentation was on the topic of Skillsets required in the new world of automation in healthcare.  A few of the points he touched on were the recent rise of merger and acquisitions within the healthcare world.  According to Mark Reiboldt (VP – Coker Capital Advisors), in 2010, the number of hospital merger and acquisitions have risen 25% to 30% (for full article, http://goo.gl/JOnXk).  Jim also mentioned a very interesting, recent implementation which involved 250 IPhones.   The IPhones are used throughout the Hospital as a way to communicate silently to hospital employees and much more.  Jim also talked about creating an IT department solely of clinicians who have a deep understanding of the intricacies of a hospital workflow.  I thought all of his ideas/recent implementations are very bold and out-of-the-box thinking.  What do you think?

Dan Feinburg and Arthur Harvey talked about The Changing Face of HIT Education.  There seems to be a place for everyone in healthcare IT.  Whether you are assisting with data analysis or dissecting complex workflows; with the right training and education, you can have a happy and successful career in healthcare IT.  So where do you fit in?  One topic that was brought up was the difficulties some MBA graduates face once they re-enter the workforce or are entering the workforce for the first time.  Because Healthcare IT is such a risk averse industry MBAs are facing a competitive market.  Some strategies exposed from hiring managers are simply hiring within or stealing from competitors.  We all know this happens and it can be frustrating sometimes, especially if you are trying to get your foot in the door.  I can say there are no shortages of opportunities, so keep up the hard work!

Sue Schade talked about the Challenge of recruiting and retaining talent in today’s competitive health care IT market.  She talked about some of the strategies Partners Healthcare are using to keep their employees interested and committed.  She talked about Connected Work Space, similar to the structure of a consulting company.  This strategy allows employees to work from home a few days a week and office and desk space is shared between employees.  Another strategy she discussed was Career Growth Initiative, which is a structured mentorship.  One I was particularly fond of is the IS Innovation Program.  This program allows exceptional and hardworking employees the opportunity to pilot an idea for a four month period.  The employee is allowed to put on hold all, or majority of their regular responsibilities to try something new.  The program allows the chosen employees to dive-in head first and develop a creative and new project.  Some of the things this program accomplishes are encouraging risks and learning.  It also promotes staying curious, committed, open, and energized.

The event ended with a networking reception sponsored by Microsoft.  This gave everyone and a chance to talk in a casual setting.  Hope to see you at the next NEHIMSS event!  Did I mention the food was delicious?

This piece is the second of a two part series discussing the transition to ICD-10.

As I mentioned before, the healthcare industry is rapidly moving closer to the October 1, 2013 compliance date for ICD-10. As that date draws closer, organizations will need to actively take action to successfully be compliant.  The Centers for Medicare and Medicaid Services (CMS) is actively providing resources to assist in achieving this success.

Before I share another tool that CMS is offering as support to the transition, I wanted to reflect upon some rather humorous information regarding the new ICD-10 codes. Last week, I read a blog from EMR and HIPAA that made me aware of the fact that the ICD-10 code volume has expanded and now includes some “off-the-wall” codes.

One example the article shared was “V91.07XA, “burn due to water-skis on fire”. I would say that’s fairly specific!  After reading this, I was encouraged by curiosity to dig for more interesting codes. After browsing the ICD10 code listing, I did manage to find some more codes that amazed me.

In tribute to the Southeast United States:

• W5803XA Crushed by alligator, initial encounter
• W5803XD Crushed by alligator, subsequent encounter
• W5811XA Bitten by crocodile, initial encounter
• W5811XD Bitten by crocodile, subsequent encounter

I come away from those codes wondering what the actual number of times the code W5803XD will be used.

The fact that these codes have increased in volume and in specificity, to me, seems to have far more benefit than harm as we transition to using ICD-10 codes. But before we see the end result of this transition, we have to endure the transition and arrive to October 2013 with only success. One tool CMS is offering to assist is the Implementation Widget.

Implementation Widget

CMS offers a “timeline widget” that users can download to their desktop of mobile device.  Once downloaded by a user, that person can share the application through email, social media, or post in a website. The purpose of the widget is to “identify and take action on the benchmarks you will need to ensure smooth transitions to” the ICD-10 compliance date. HIMSS News summed it up perfect indicating that it would help organizations:

• Understand what should be done right now to prepare for the switches to 5010 and ICD-10
• Know the steps needed to take in the future and when
• Stay on top of approaching transition deadlines to help manage the implementation process

The widget first prompts for a selection among four choices: Vendors, Payers, Large Providers, or Small Providers.  Each category differs in the output of the timeline, benchmarks, and necessary actions suggested by CMS to act upon.  A full timeline can be downloaded in each category. The timeline, viewed as a PDF file, indicates the suggested immediate actions/goals, then broken down by quarter up to the deadline. However, users can step through the timeline using the widget, making the experience more visually appealing as it breaks down the timeline piece by piece.

The goals and action points are clean, concise bullet points set to guide the organization in the direction of a successful compliance. Here’s an example of the bullet points for Venders listed of Actions to take immediately:

• Identify staff to receive training and develop training materials (5 months)
• Establish organization’s implementation chart (6 months)
• Determine product requirements (8 months)
• Estimate budgets.  Budgets should include all costs associated with implementation including software, software licensing, hardware procurement, development, and staff training costs (8 months)
• Conduct product re-engineering analysis (6 months)
• Start product/solution development (9 months)

Each action point has a timeframe given. That timeframe is the estimated total duration needed for that action point.

The information presented in this tool should prove to be a valuable resource to organizations. I am interested to hear feedback from organizations whether they are using this tool or not, and if so, how the information is helping steer them successfully to compliance.

Another key ingredient to the October 2013 compliance date will be the incorporation of the ICD-10 codes to vendor systems. This will certainly affect systems such as the EHR and PM systems. Hopefully soon, the various vendors will begin (if they haven’t already started) to incorporate plans to swap the ICD-9 codes to ICD-10. Organizations will need to pay close attention to any vendor communications, as vendors will surely indicate release dates and material that correspond to the ICD-10 implementation.

As we move closer to the deadline, CMS will certainly provide more information on the ICD-10 transition. Visit their Latest News page to sign up for notifications, industry updates, attend teleconferences, and obtain other valuable resources.

One common and important theme from the CMS resources is training.  Proper and well established training inside each organization will prove to be a crucial step to ensure a smooth transition to using ICD-10 codes.  Training is the most powerful force behind deciding the level of success to using any new or updated information and procedures.  An organization that chooses to invest more in training will certainly have a higher return on that investment.

Galen Healthcare Solutions offers project management and training solutions. Contact us to find out how Galen might assist in the ICD-10 transition.

Tags: Centers for Medicare and Medicaid Services, Clinical Conversion, CMS, Compliance, Data Conversion, Galen Healthcare Solutions, Healthcare IT, ICD-10, Implementation, October 2013

This piece is the first of a two part series discussing the transition to ICD-10. The ICD-10 transition should be a high priority concern in healthcare.

Today, the healthcare industry is rapidly moving closer to the compliance date for ICD-10. That date is October 1, 2013.  As that date draws closer, organizations will need to actively take action to successfully be compliant.  The Centers for Medicare and Medicaid Services (CMS) is actively providing resources to assist in achieving this success.

FAQ Fact Sheet

CMS posted a downloadable PDF FAQ “transition basics” fact sheet indicating sixteen question and answers.  This tip sheet gives an excellent and informative overview to the transition to ICD-10.

Among these Q/A’s are:

• What does ICD-10 compliance mean?
• ICD-10 compliance means that all Health Insurance Portability and Accountability Act (HIPAA) covered entities are able to successfully conduct health care transactions on or after October 1, 2013 using the ICD-10 diagnosis and procedure codes. ICD-9 diagnosis and procedure codes can no longer be used for health care services provided on or after this date
• What is the transition to ICD-10 happening?
• The transition is occurring because ICD-9 codes have limited data about patients’ medical conditions and hospital inpatient procedures. ICD-9 is 30 years old, has outdated and obsolete terms, and is inconsistent with current medical practice.
• Also, the structure of ICD-9 limits the number of new codes that can be created, and many ICD-9 categories are full.
• A successful transition to ICD-10 will be vital to transforming our nation’s health care system.
• What type of training will providers and staff need for the ICD-10 transition?
• Training should take place in late 2012 or early 2013 for most staff. Training needs will vary for different organizations. For example, physician practice coders will need to learn ICD-10 diagnosis coding only, while hospital coders will need to learn both ICD-10 diagnosis and ICD-10 inpatient procedure coding.
• Look for specialty-specific ICD-10 training offered by societies and other professional organizations. Take into account that ICD-10 coding training will be integrated into the CEUs that certified coders must take to maintain their credentials.
• ICD-10 resources and training materials will be available through CMS, professional associations and societies, and software/system vendors. Visit http://www.cms.gov/ICD10 regularly throughout the course of the transition to access the latest information on training opportunities.

As we move closer to the deadline, CMS will certainly provide more information on the ICD-10 transition. Visit their Latest News page to sign up for notifications, industry updates, attend teleconferences, and obtain other valuable resources.

The second part of this series will discuss implementation and producing results.  Look for that piece next week!

Tags: Centers for Medicare and Medicaid Services, Clinical Conversion, CMS, Compliance, Data Conversion, Healthcare IT, ICD-10, ICD9, October 2013

Technology in healthcare is taking a huge step forward. Wellpoint, Inc has announced that they will be using a commercial version of IBM’s Watson supercomputer.

Not too long ago, a room full of computer hardware once computed at a power less than what our cell phones currently do. Now, a room full of computer hardware will equate to a computing entity with the intelligence to assist physicians with medical decisions.

You may know Watson best for its performance on the Jeopardy game show. Watson demonstrated swift decision making after indexing over 200 million pages of data. Watson would only answer if the system crossed a certain confidence threshold.  The confidence threshold was a predefined percentage set inside the system. When Watson referenced the data, it determined the percentage to which it was sure the top three answers were correct. If the percentage of the top answer crossed the confidence threshold, Watson would signal for the answer. The IBM machine proved itself successful against two humans competing in the game show by winning both rounds.

Certainly physicians and members have much to gain from the assistance of a machine that can reference millions of pages of data to ascertain a diagnosis or treatment.  While physicians may always hold the upper hand to interpret the context of the situation for a presenting patient, Watson’s assistance can certainly supplement any decision using vast amounts of data in a quicker time frame.

In an article posted by EMR and HIPAA, it noted that “One of the keys in the AP article above and was also mentioned by Dr. Nick from Nuance was that the Watson technology in healthcare would be applied differently than it was on Jeopardy.  In healthcare it wouldn’t try and make the decision and provide the correct answer for you. Instead, the Watson technology would be about providing you a number of possible answers and the likelihood of that answer possibly being the issue.” The article later went on to state:  “Saying that perhaps 25 percent of all healthcare errors are errors of diagnosis, Kohn [IBM Chief Medical Scientist Dr. Marty Kohn] noted how getting the diagnosis right can prevent all kinds of unnecessary complications and spending. “Of course, if you’ve made the wrong diagnosis, picking the right course of treatment becomes a challenge,” Kohn said.

So how might this affect the EHR world? The electronic EHR would be used as a reference for the Watson system. Previous prescriptions, orders, lab results, presented problems, among others, would all contribute to Watson ascertaining a confidence threshold.  Once a confidence threshold is reached or passed, the system would suggest a route of possible treatment, or determine a possible diagnosis.

With the advances in accuracy, these decisions can come back to the EEHR and certainly provide more efficiency and cost savings for the practice. The technology undoubtedly proves to be a win-win situation for all players in the healthcare industry.

 What do our readers think?

Tags: Business Intelligence, EHR, Healthcare IT, IBM Watson