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An Article on ICD-10 We Wanted to Share

Posted by Allison on Wed, Sep 02, 2015 @ 05:01 PM

Have insurers established ICD-10 accommodation periods?

Most are mum about plans as deadline draws near

As the Oct. 1 ICD-10 deadline inches closer, many insurers haven't announced whether they have implemented accommodation periods--when they will pay claims that aren't coded correctly as long as they're in the right family of codes, reports Health Data Management.

After Health Data Management contacted seven national insurers, as well as the Blue Cross and Blue Shield Association and America's Health Insurance Plans to learn about their ICD-10 contingency plans, only Humana, Aetna and AHIP responded and none actually addressed whether they had accommodation periods prepared.

Medicare said in July that it reached an agreement with the American Medical Association that it won't deny or audit claims based solely on the specificity of diagnosis codes for the first year after ICD-10 useFierceHealthIT previously reported.

Although private insurers aren't announcing their ICD-10 contingency plans, they're likely still planning to offer some similar concessions to providers. But they don't want make these plans public so providers and vendors continue working to prepare for the ICD-10 compliance date, Pat Kennedy, president of PJ Consulting Inc., which specializes in electronic data interchange and insurers, told HDM.

Kennedy said he expects insurers to announce their accommodation periods within the next month. Part of the concessions they will offer will likely include extra staff to help make the transition to ICD-10 smooth.

He added that large insurers will probably be working hard to accommodate providers for at least six months.

"This is a tough one, tougher than anything we've ever had to do, and the payers and vendors know that," Kennedy said.

To learn more:
- read the Health Data Management article

 

Tags: healthcare, ICD10, healthIT, Scribe, Medical Scribes

An Article We Wanted to Share

Posted by Allison on Tue, Jun 30, 2015 @ 07:26 PM

Repeat emergency room visits more common than previously thought

New research suggests that ailing people should be more pushy about getting follow-up care.

Dr. Reena Duseja, lead author of a study on emergency room visits, stands in San Francisco General Hospital's emergency room. No one wants to make a repeat visit to the emergency room for the same complaint. But new research suggests it's more common than previously thought.
The Associated Press
Dr. Reena Duseja, lead author of a study on emergency room visits, stands in San Francisco General Hospital's emergency room. No one wants to make a repeat visit to the emergency room for the same complaint. But new research suggests it's more common than previously thought. The Associated Press

WASHINGTON — No one wants to make a repeat visit to the emergency room for the same complaint, but new research suggests it’s more common than previously thought and, surprisingly, people frequently wind up at a different ER the second time around.

Already some ERs are taking steps to find out why and try to prevent unnecessary returns. A Philadelphia hospital, for example, is beginning to test video calls and other steps to link discharged patients to primary care.

The new research, based on records in six states, suggests patients should be pushy about getting follow-up care so they don’t have to return to crowded emergency departments.

“You need to make sure the next day, you connect the dots,” said study co-author Dr. R. Adams Dudley of the University of California, San Francisco. “You cannot count on the health system to connect the dots.”

It’s also a reminder of how disconnected our health care system is. Chances are, your primary care doctor won’t know you made an ER visit unless you call about what to do next.

And if your second visit was to a different ER, often doctors can’t see your earlier X-rays or other tests and have to repeat them. While more hospitals and doctors’ offices are trying to share electronic medical records, it’s still far from common.

“It’s frustrating. We’re open 24 hours a day and we don’t necessarily have access to those records,” said UCSF assistant professor Dr. Reena Duseja.

Duseja’s team analyzed records from Arizona, California, Florida, Nebraska, Utah and Hawaii, among the first states to link records so patients can be tracked from one health facility to another. Researchers checked more than 53 million ER visits in which the patient was treated and sent home between 2006 and 2010.

About 8 percent of patients returned within three days, and 1 in 5 made a repeat visit over the next month, Duseja reported this month in Annals of Internal Medicine.

A third of revisits within three days, and 28 percent over a month, occurred at a different ER. Duseja couldn’t tell why – if patients were dissatisfied the first time, or traveling, or for some other reason.

Patients with skin infections were most likely to return, followed by those with abdominal pain.

State rates varied a bit, with 6.2 percent of Arizona patients returning within three days compared with 9.3 percent in Utah.

Revisits may be appropriate, Duseja said. Nearly 30 percent of revisits involved hospitalization, suggesting either patients got worse or emergency physicians felt more scrutiny or testing was warranted.

Also, sometimes ERs tell patients to return. In the ER at San Francisco General Hospital, Duseja sees many Medicaid or uninsured patients who have trouble finding a primary care doctor or specialist.

 

Tags: healthcare, emergency

New Center for Healthcare Transparency Can Transform The Industry

Posted by Allison on Sat, May 02, 2015 @ 04:29 PM

There is a newly formed Center for Healthcare Transparency (CHT) that is part of Centers for Medicare & Medicaid Services (CMS).

This new center aims to strengthen quality and cost information when it comes to healthcare. The program has ambitious goals, including, wanting half of the U.S. population to have access to reliable cost and quality information by 2020. Many healthcare leaders have been looking for something like this, because now is the time for changes that can improve efficiency. Without a doubt, the healthcare system is going through a transformation. According to the chief data officer for CMS now is the time for this new program and the new changes. He states, "A few years ago, you could've put everyone interested in transparency in a closet, and there would've been room left over." 

Recently, CMS took a major step in the direction of transparency in healthcare processes. It released data on Medicare Part D that indicated that the program spent $103 billion on prescriptions in 2013. The AMA criticized this, stating, "troubled by the lack of context provided with that could help explain physician prescribing practices and pharmacy filling practices before conclusions are drawn." So, there are clearly some issues with transparency, and in particular price transparency; this issue of price transparency is gaining some importance due to the rise in medical options and increase in consumerist healthcare trends. It is clear that this industry is changing at a rapid rate. Anytime there is change, in any situation, transparency can help aid any new challenges and can provide good insight into just how effective the changes have been. The CHT will be a good step in the right direction.

CHT can help tackle the issue of accountability in this ever-changing healthcare industry, and this is vital now especially, because of new technologies and new ways of practicing medicine that are different than they have been historically. Value-based payment models are a hot topic related to this, and there will be more information and more programs rising out of these new models. David Lansky, CEO of Pacific Business Group on Health, summed up the importance of transparency, saying, "if we're going to pay everybody based on value, we better be measuring it in a sensible way." 

What does this mean for medical scribes and EMR? Having a medical scribe in the picture helps track patient data more effectively and accurately. This goes to together with transparency, because accuracy and transparency are linked. It seems that more transparency is inevitable, and scribes already contribute to transparency, because of their documentation expertise. EMR use has been shown in many instances to increase productivity and efficiency by keep more accurate records of patients medical visits and history. 

Information gathered from FierceHealthcare article, "Center for Healthcare Transparency aims to strengthen qualilty, cost information" 

Tags: healthcare, Improve Efficiency, healthIT, EMR

The Hot Growth Area That is EMR and Scribes

Posted by Allison on Tue, Apr 14, 2015 @ 08:30 PM

A few years ago, one of the first big whitepapers on EMR as a hot growth area for staffing came out, titled "The Electronic Paper Trail: Why EMR is Staffing's Hot Growth Area", and this piece identified the EMR growth in healthcare. But, with this "hot growth area" that is EMR staffing for implementation comes another piece to the puzzle, one that our team at Scribe Solutions is very familiar with: the medical scribe. The article says, "healthcare information technology is the new big thing in staffing, thanks to the growing need for healthcare organizations to implement electronic medical record (EMR) systems. While this article is correct in saying that there is/was a growing need for healthcare organizations to implement EMR systems, since this article was written in 2011 some of that has changed and the new need is for data entry. There was an initial wave of EMR systems implementations following the Affordable Care Act becoming effective in 2010.

While some organizations still have a need for EMR systems implementation, there is a new need tied to Health IT, as mentioned above, and that need is for data entry into these EMR systems. Patient records need to be properly documented online, especially with meaningful use requirements in place, and often times this documentation  adds extra hours of work to doctors' already busy work schedules. Here is where scribes come in: scribes take away this burden, and as the meaningful use deadline approaches, hiring scribes is more important than ever for these busy physicians. 

More literature has come out on the need for scribes, and the benefits of hiring scribes are becoming more evident. The American Academy of Orthopaedic Surgeons boldly highlights these benefits in its published paper on the benefits of using scribes. On the top of the AAOS paper it is clearly stated in the header:Physicians can spend more time with patients; charting accuracy is increased. 

The AAOS paper's author, a physician himself, makes a strong case for hiring scribes, and who better to hear this news from than a practitioner himself. G. Klaud Miller, MD, the author of the paper, is a member of the AAOS Practice Management Committee who is in private practice in Chicago. Miller highlights the reasons why scribes are key to success in the age of required documentation using EMR, advocating:"...using a scribe saves time. The physician never has to do after-hours dictation in the office or bring charts home to dictate. The chart is completed when the physician leaves the examination room. A physician who sees 20 patients a day and spends 5 minutes per chart dictating or writing the notes saves more than an hour and a half of time by using a scribe. Independent of any of the other benefits, how much would you pay to get an extra hour and a half or more per day?"

He says it best when it comes to summing up just how helpful hiring scribes is and how using scribes is the way of the future, stating, "Although using a scribe may sound like a luxury to some, I have found that scribes more than pay for themselves in numerous ways, and I would never practice without one."

 

Tags: healthcare, meaningful use, healthIT, Scribe, EMR

ICD-10 On the Radar: It's Time to Get Ready

Posted by Allison on Sun, Mar 15, 2015 @ 11:50 PM

ICD-10 is really here. Yes, for real. After three delays and much discussion and deliberation, ICD-10 is near. 

This October ICD-10 will really happen. Here's the deal: 

  1. The ICD-10 deadline was first set for October 2011, then for October 2013, then for October 2014. 
  2. But, it seems that the fourth time just might be the charm. 
  3. Recent proceedings in the House Energy and Commerce Health Subcommittee hearing on ICD-10 featured seven witnesses, with only one of these witnesses opposing the transition to the new code set. 
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This hearing was preceded by the publication of a Government Accountability Report that determined that the Centers for Medicare and Medicaid Services (CMS) has taken positive steps to help the healthcare industry prepare for the switch to ICD-10. Despite delays and opposition, the switch to ICD-10 is on its way due to government activity this time around. ICD-10 has been included i another doc-fix bill, and lawmakers will be on record this time around as having discussed ICD-10. But, why do some people still raise concerns and oppose the switch to ICD-10? Some concerns, which are valid, center around encountering obstacles following the transition to ICD-10, especially barriers related to practice management since medical practices are not one-size-fits-all. Related to these concerns are questions related to scope and size of medical practices and new requirements mandated by government legislation.
 
ICD-10Watch author Carl Natale had some key comments on this topic, explaining that if Congress were to find a way to fund implementation costs for small medical practices and independent physicians, than the transition wouldn't be nearly as much of an issue. 

Tags: healthcare, ICD10, EMRs, healthIT, Medical Scribes

Healthcare Woes? Hospital Inefficiencies and Possible Solutions

Posted by Allison on Fri, Feb 27, 2015 @ 11:08 AM

Workflow and organization management are important concepts to healthcare as a whole, but specifically these concepts are key to hospital management. Not only can flaws in workflow hinder the activities of hospitals, but also it can cost a great deal of money to correct flaws. 

A recent survey by the Ponemon Institute of 400 plus healthcare providers discovered that poor communication on its own has an estimated economic impact of $1.75 million per U.S. hospital. Also, the survey found that this inadequate communication alone has an estimated annual economic impact of more than $11 billion industry-wide.  

It is clear that many of these costly issues are complex in nature, but some quick fixes can be implemented to decrease inefficiencies. 

  • In addressing lack of effective communication methods: the use of secure text messaging could increase productivity and minimize economic loss by about 50 %
  • Looking at duplicate documentation requirements: eliminating inefficiency here can allow for more patient time and higher quality patient care and management can fix this by surveying the system to find duplicates and then can address EHR issues with the vendor; next the duplicates can be reconciled with the EHR provider
  • Dealing with patient flow: address processes and review occupancy and manage ORs and facilities by providing a process for scheduling date and time of patient discharge at least one day in advance
  • Ensure appropriate hospital admission: provide practitioners with resources, for example options such as social workers, nursing homes, behavioral health centers, skilled nursing centers and rehab services to eliminate inappropriate hospital stays
  • Avoid incomplete medication reconciliation: try to obtain adequate information from patient, but also use EHR effectively to ensure accuracy 

 

Tags: healthcare, healthIT, patient satisfaction, employee engagement, Scribe, EMR

Flu Prevention and Practice Management

Posted by Allison on Mon, Feb 09, 2015 @ 12:43 AM

As you may have noticed in the news, flu season is taking its toll on communities across the country. 

With issues like Ebola facing physicians recently, and with flu season here for the time being, it is key to ensure that practices guard themselves from gaining more illnessness and spreading flu germs. 

We all know that germs are difficult to contain, this is is not something new. 

flu virus

But, with new technology comes new advances. Because germs are hard to control, practices are now trying out telemedicine to help contain the spread of illnesses like the flu. Telemedicine can help control the spread of the flu because patients can been seen virtually and not face-to-face. By seeing patients via telemedicine, fewer germs are coming into practices. 

But, telemedicine is only being used in a limited number of practices. There are other ways to help block the spread of flu germs.

Here are some tips to prevent the spread of germs:

  1. Incorporate hand-sanitizer gel in busy areas of practices and enforce hand washing and good hygiene 
  2. Offer face masks in practices; offer masks to both patients and workers
  3. Ensure countertops and surfaces are constantly sanitized
  4. Separate sick patients from well patients to the best ability

Tags: healthcare, wellness, healthIT, patient satisfaction, employee engagement

Reporting Periods for Meaningful Use: CMS Changes

Posted by Allison on Mon, Feb 02, 2015 @ 12:39 AM

Centers for Medicare and Medicaid Services recently announced that it is considering proposals to shorten the meaningful-use reporting period to 90 days in 2015. Providers have been requesting this change.

What does this mean? 

This change would mean that providers could meet the meaningful-use requirements and in turn could avoid financial penalties with software in place for less time than what is currently required.

It is clear the providers are faced with the modernization of healthcare and improving efficiency in healthcare today. Many have turned to EMR and medical scribes to adapt to meaningful use as a whole, but extensions in the reporting period among other changes could help physicians transition smoothy and without hassles and headaches. 

Stethoscope By Computer Keyboard4

Experts and researchers have weighed in on this potential change.

President and CEO of The College of Healthcare Information Management Executives, an organization that is an advocate for the changes in reporting period length, stated, "Meaningful use has the potential to be a transformative program for the nation's healthcare delivery system and we commend CMS for recognizing the need for a course-correction." Other groups have also praised CMS for looking into/and most likely changing the reporting window. The Medical Group Management Association and The American Medical Association praised the CMS for agreeing to modify the window, and they are pushing for CMS to issue the new rule quickly. 

In addition, according to the Modern Healthcare article, CMS also is considering changing reporting periods to the calendar year to "allow eligible hospitals more time to incorporate 2014 Edition software into their workflows...and will modify other aspects of the program that may lessen providers' reporting burdens.

Also, CMS explained that the rulemaking on reporting period flexibilty will be separate from the upcoming third-stage meaningful-use rule, which is expected to come out in March. 

Meaningful use takes some navigating by these physician groups. While CMS is doing its best to work with practices and hospitals to come out with the best-fit programs for healthcare as a whole, this space can be tough to handle in a busy healthcare environment. Medical scribes can lead to increased efficiency, and this has been proven in many practices and organizations. Scribes may be the answer to some of the problems physicians are facing in the switch to EMR. With supportive legislation from CMS and useful and beneficial programs by CMS, together with scribes, healthcare as a whole is on the path to becoming a more organized, high-tech sector. 

Tags: healthcare, meaningful use, Scribe, EMR

Healthcare & Privacy: Study Finds EMR Benefits Outweigh Risks

Posted by Allison on Wed, Jan 28, 2015 @ 10:52 AM

According to a new study by global consulting firm Accenture, consumers with chronic illnesses are less bothered by privacy concerns tied to EMR. Instead, the chronically ill are more concerned about the privacy of shopping and banking transactions than EMR and healthcare records. 

The study's research shows that more than half (51 percent) of the U.S. chronically ill (consumers who have chronic conditions) feel that the benefits of accessing medical records electronically outweigh any risks of privacy invasion. In this study, titled the Accenture 2014 Patient Engagement Survey, more than 2,000 U.S. consumers were polled. A unique fact was uncovered in the study, that when it comes to perceived risks in terms of privacy and EMR, the opinions on the matter varied based on specific chronic illnesses of each type of patient in the survey. 

The highest percentage of patients believing that EMR benefits outweigh the risks were those with cancer (57 percent). Other patients that were surveyed had smaller percentages of belief on the risks versus benefits of EMR; asthma and arthritis patients weighed in at a 48 percent belief that benefits of electronic health record sharing outweigh perceived risks. Another key finding in this study is that patients expressed their desire for access to EMRs, revealing their belief in the right to access their EMR, with 69 percent saying that having access to their health data is a human right. 

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Additionally, Accenture's findings indicate that it is clear that people, especially those with chronic conditions, want access to their health records. But, as fedeal legislation supports the shift to EMR, it will be interesting to discover just how many patients will shift to accessing their records via EMR technology. While the switch to EMR may seem daunting to many practitioners and patients alike, medical scribes can ease the transition to EMR. Meaningful Use Stage 2 is here, so this topic is pertinent. Scribes can help improve efficiency in healthcare practices and organizations. Combining new technology with the added resource of a scribe can increase efficiency and aid in the better documentation of patient health records. 

Tags: healthcare, meaningful use, Improve Efficiency, healthIT, Scribe, EMR

ICD-10 & Meaningful Use: 2015 and Healthcare Efficiency in EMR Use

Posted by Allison on Thu, Jan 15, 2015 @ 09:32 AM

ICD-10 has been in the news...alot. Whether you like it or not, ICD-10 is going to be shaking things up. So, it is better to get on board now, before it is complicated and costly to do so at a later date.

The American Medical Association published a list of the top 10 issues for physicians to watch in 2015, and ICD-10 implementation and meaningful use are part of this list. 

The AMA list examines the large amount of regulatory requirements, and this list explains that these regulatory requirements can take away from what is most important to most physicians...treating the patient. According to the AMA research, in order to advance health IT, many are asking for some relief when it comes to government mandates. While improving efficiency can be a result of switching to electronic medical records (EMR), the heachaches and hassles that many physicians are facing relate to government regulation and lack of time in effectively treating the patient while also switching to EMR. On the AMA list, meaningful use is focused on and the need for improvement is highlighted, according to FierceHealthcareIT.  

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Meaningful Use has been criticized as being too broad and its one-size-fits-all nature has been called incomplete. Sustainability of practices is of great concern to physicians today, so these issues and complaints noted in the AMA list need to be addressed in order to allow for the efficency that improved documentation can provide. Medical scribes can assist in the shift to electronic medical records (EMR) and can stay on as continued providers of efficient documentation of patient records. Using a medical scribe can take away the obstacles that many physicians face in treating the patient while also using EMR technology. Healthcare efficiency is an important topic in today's world, and while the technology can be helpful in documenting patient records and staying organized, using the technology can be time consuming without the assistance of scribes. 

According to the article, the AMA has pushed for end-to-end ICD-10 testing, which the Centers for Medicare & Medicaid Services announced would take place from Jan. 26-30, April 26-May 1, and July 20-24. Also, the article notes that many are starting to make the shift to ICD-10, citing figures by CMS, which revealed that acceptance rates during the November ICD-10 acknowledgement testing week improved to 87 percent. 

Tags: healthcare, ICD10, meaningful use, Scribe, EMR