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Will We Need Billing Codes Once We Have Nice Structured EHR Clinical Data?

Posted on July 27, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I had a really fascinating discussion recently with @AlexHBurgess where we discussed the role of billing codes in an EHR today and also the future of billing codes as EHR notes get much better and more granular. This is particularly interesting to me as I’m at the HealthPort HIM Summit the next couple days.

Here’s the question that started the conversation:

This was @AlexHBurgess’s response:

And then I replied:

The last question is something worth chewing on. I’ll have to ask it of a few HIM managers the next couple days. I think the simple answer is that we’ll still likely need billing codes. I don’t think that our payers are forward thinking enough or at least progressive enough to try and push forward a non-billing code reimbursement system. It’s pretty interesting to think about though.

The second reason I don’t think it’s likely to happen is that the data in the EHR will likely not be good enough. Although, if the data in the EHR (and not just the billing codes that were selected) were how you got paid, then you’d see a dramatic improvement in the quality of the EHR data. So, maybe it’s not a bad idea after all. I’m pretty sure my medical billing friends would scoff at this idea as they think about the number of times they’ve had to have doctors correct something in the paper chart to make sure the billing was ok.

Long story short, I think that you could theoretically get rid of medical billing codes and just use EHR data for reimbursement. However, in practice I don’t really see this ever becoming a reality. At least not in the short to medium term.

How To Respond to Data Breaches

Posted on May 19, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

A lot of people have really liked this whitepaper on the 6 Reality Checks of HIPAA compliance. It’s a good download for those concerned about their HIPAA readiness. It will wake you up to the fact that you need to be ready and compliant with HIPAA.

Mac McMillan recently did a great HIPAA compliance interview with me where he said “A little bit of prevention goes a heck of a long way to preventing a bad event.” That’s great advice and if you read this whitepaper I think you’ll be woken up to the need to do a little more than you’re doing today to be HIPAA compliant.

While prevention is better, I was intrigued by this article (annoying registration required) in Health Data Management that talks about what to do in the event of a data breach. I love this quote from Rita Bowen, Senior VP at Healthport, “Breaches are inevitable.” It’s true. Despite your best efforts, breaches happen in every organization large and small.

Rita also points out that the key to a data breach is to have a system in place to “learn what went wrong and fix it.” I’ve always found HIPAA to be pretty generous with mistakes. As the HIPAA name says, it’s more about accountability than anything else. If you’re accountable for the decisions you’re making, then it’s more lenient than a lot of laws out there.

The article also gives three insights worth considering if you experience a data breach:

  • Honesty, the best policy
  • Keep Asking, “What if?”
  • Go the Extra Mile

All of these are great advice. If you go the extra mile and are honest about what happened, then you’ll usually be able to recover from a data breach. If you try and cover it up or hide what happened, then that will often come back to haunt you and damage you much more than if you were just honest and up front about what happened.

A List of Key Insights for EHR Data Conversion

Posted on December 17, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Healthcare Scene sat down with Sean West, VP of Data Conversion at HealthPort, to discuss EHR data conversion. EHR data conversion is quickly becoming a hot topic for many organizations that rushed their initial EHR selection and implementation. In our video discussion embedded below, Sean West offers a number of key insights including the following:

  • Convert the Data Close to the EHR Conversion
  • Ensure You Have Enough Time to Make the Conversion
  • Consider How Much Data Needs to Be Converted
  • Look at the Impact on Performance of Converting All EHR Data
  • Evaluate Your Legacy EHR Vendors Willingness to Work with You on Data Conversion

Check out the following video for all the details:

We also asked Sean West about when an organization would want to consider a vendor neutral archive for their EHR. While the vendor neutral archive is incredibly popular with PACS systems, we’re just now starting to see the idea crop up with EHR data. In the following video, Sean West provides some good insight into when an organization might want to consider a vendor neutral archive for their EHR data.

Highlights from the HFMA #ANI2013 Show Floor

Posted on June 27, 2013 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

As I mentioned in last week’s post, I’ll share a few highlights from the HFMA ANI 2013 exhibit hall this time around. The show floor was fairly busy over the three days it was open to attendees. I do believe this is the first event I’ve attended where the convention center shut the lights off right at the end of exhibit hours on the last day. Talk about a clear message to vacate the premises!

I’ve captured most of my experience via pictures and captions below.

coniferband

Conifer played host to the opening night reception, welcoming attendees with some island tunes that made me want to grab the next flight to Tortola. At their booth, the company once again offered attendees a chance to donate money to select charities. I had fun playing plinko and making a donation to the Red Cross.

siemens

Siemens offered attendees a chance to help make a donation to the Wounded Warrior Project.

relayhealth

RelayHealth was of a similar, charitable mind. I lent my chips to the Giving Comfort cause this time around.

zirmed

The ZirMed team was actively tweeting during the event, so I used that as an excuse to find out more about their recent rebranding. It seems they offer a little bit of everything, “connecting providers, payers and patients to make the business of healthcare faster, clearer and more efficient for everyone,” according to the flyer I picked up.

torture

I forget the name of the company that likened going through a RAC audit to literally being on the rack. This was definitely stop-you-in-your-tracks marketing.

stilts

I just couldn’t resist capturing this conversation for posterity’s sake. Oh, the things you see at trade shows.

racecars

I’m pretty certain this was part of the MedeAnalytics booth, whose team was fitted out in some pretty snazzy racing gear/booth attire.

m2sys

The friendly folks at M2SYS

kforce

Speaking of friendly, the folks at Kforce are always ready to chat about IT staffing solutions, though when I snapped this pic they did look a bit lonesome for their colleagues @Brad_Justus and @BocaHudson.

jvion

The jvion team knows how to have a good time on the show floor. Enticing me with a wig and mic offered the perfect excuse to tell me more about their solutions that focus on “reducing the financial impact and burden of converting to ICD-10, and helping providers protect their revenues from increased financial waste associated with mandated changes and increased payor scrutiny,” according to their website.

ipadrace

I’m sad to say I didn’t take down the name of this company, but I did play the game you see above. Needless to say, I’m sure my four-year-old could probably have done a better job than I did of getting the iPad controlled ball through the maze.

healthport

You can’t go wrong with sweets, and HealthPort took things a step above the typical candy in a bowl. I had the chance to meet with Dawn Crump, HealthPort’s new Vice President of Audit Management Solutions. She seems to really know her stuff, having moved over from the provider world quite recently. She is the first super user HealthPort has ever hired, and it seems as if she has big plans for their products.

cognizant

Cognizant’s booth says it all. Many attendees were looking for ICD-10 and ACO solutions, though as I mentioned last week, value-based care seems to be the next iteration of accountable care.

allscripts

I didn’t make it to the Allscripts booth, but did make a point to visit their coffee stand. If there’s a quick way to my heart, it’s through coffee.

I did make it to the athenahealth booth, and chatted with John Lewis about the company’s ICD-10 conversion guarantee. The company has gotten a fair amount of traction with the offer, and, as Lewis explained to me, it has definitely helped start meaningful conversations with providers.

I also had the opportunity to meet with Mel Tully and Ann Joyal at the Nuance/J.A. Thomas booth. They caught me up on what the companies are doing in the areas of intelligent systems for clinical documentation.

Other exhibitors of note included Health Business Solutions, which showed me their latest patient-facing product. Revel is a mobile application that facilitates patient after-care payment via smart phone.  I would definitely have appreciated something like this right after both of my daughters were born. I was in no mood to take a phone call from the hospital wanting their balance due. I would have much rather received a call or text on my phone that I then could have handled at my convenience.

Healthcare management information systems provider Ormed had some pretty compelling customer testimonials rolling at their booth. It seemed to have a steady stream of folks sit down for their brief presentations throughout each day. Kudos to the presenter who kept each one moving along.

AMN Healthcare caught my eye with its “Use of Social Media and Mobile by Healthcare Professionals” report. Though it’s from 2011, I think many of the statistics are still relevant. I hope to see the third version of this come out in time for ANI 2014.

Challenges and Risks Associated with Disclosure of Health Information in an EHR World

Posted on October 22, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

While at AHIMA 2012, I had a chance to sit down and talk with Rita Bowen, MA, RHIA, CHPS, SSGB, Sr. VP of HIM and Privacy Officer at HealthPort to talk about some of the challenges and risks associated with the disclosure of health information in this new world of EHR software. In this video, Rita talks about some challenges with EHR software disclosures that I bet a lot of people haven’t thought about before.

Battle of the AHIMA Buzzwords: Upcoding vs. ICD-10

Posted on September 26, 2012 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

I’m heading to Chicago this weekend for the annual AHIMA show. It will be my second time attending, and last year’s experience will be hard to beat. I stayed at the Grand America hotel, which has now spoiled me for days when it comes to tradeshow accommodations (or vacation accommodations, for that matter). The show was in beautiful Salt Lake City, which literally was a breath of fresh air every time I walked from the hotel to the convention center. The show floor was bustling, attendees were friendly and chatty, and exhibitors were eager to talk about their latest offerings in the world of coding, transcription and health information management, with a dash of healthcare IT thrown in for good measure. And how can I forget the great networking off the show floor? Those HealthPort folks sure know how to karaoke!

Needless to say, AHIMA set the bar high in Utah, and I’m eager to see if my experience in Chicago will live up to it. The time definitely seems right for talking to providers and vendors about ICD-10, of course; but I believe ICD-10 has met its match in the EMR-related buzzword “upcoding.” You may have seen it mentioned in the major news outlets in recent days, read John’s post about EHR Incentive Increasing Medicare Costs, or come across this statement from the government:

“There are … reports that some hospitals may be using electronic health records to facilitate “upcoding” of the intensity of care or severity of patients’ condition as a means to profit with no commensurate improvement in the quality of care.

“False documentation of care is not just bad patient care; it’s illegal.”

The government obviously means to let providers know that inappropriate documentation will result in legal action, but there is another side to this story in that some providers claim they aren’t “upcoding,” but rather more accurately documenting care now that they have the technology to do so. For hospitals that are struggling financially, implementing new EMR/billing technology may simply allow them to clean up their documentation and billing methods. Seems to me that it’s pretty easy to immediately go from red to black if you’re used to using paper, but now have all kinds of efficient technology at your fingertips.

At any rate, the upcoding conundrum has, for me, elucidated the link between coding and documentation, the EMR and a healthcare facility’s fiscal health. Harold Gibson makes a number of good points around this relationship is his recent blog, “Medical Documentation Specialists can do Better Medical Billing:”

“The medical record is the basis for every financial transaction that follows its creation. EHRs have the advantage of being instantly accessible to a credentialed medical coder or biller at any location. The value of EHRs cannot be underestimated, nor can computer assisted coding software, but they are not a panacea for the elimination of billing errors.”

I hope to find out as I walk the show floor next week how vendors and providers alike are trying to get past this problem. If you have any insight, please share them in the comments below, or, if you’ll be at the show, grab me on the show floor for a quick chat.

Also, if you’re in Chicago and/or at AHIMA 2012, then be sure to come by the AHIMA Tweetup on Monday, 10/1 5:30-6:30. Swissotel, Friedman Marketing suite.

The Intersection of EMRs and Health Information Management

Posted on July 26, 2012 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

It was with great regret that I canceled my trip to Healthport’s first HIM Educational Summit earlier this week. (A rampant stomach bug claimed me as the last victim in our family of four, and so I thought my healthcare conference colleagues would, in fact, appreciate my absence.) I had been scheduled to moderate a discussion on the exchange of personal health information within an accountable care organization (ACO) – a topic that I thought I knew a lot about, until I began researching the subject. Turns out that to truly grasp this topic from a health information management (HIM) perspective, you need to be well versed in the current state of ACOs, Office of Civil Rights audits, HIPAA rules and regulations, privacy and security breach prevention strategies, the bring-your-own-device movement …. Needless to say, HIM professionals seem to have their hands full at the moment, as they will likely interact with a few if not all of the aforementioned areas in the coming months.

I especially had been eager to see if this cartoon from Imprivata got a few chuckles from my audience. Pretty timely, no?

Courtesy of Imprivata

I was also looking forward to attending a number of sessions, including:
“The Effects of EHR on HIM”
“Where HIM & MU Intersect, and What’s in it for You”
“Meaningful Use: Countdown to Attestation”
“Is Your PHI Protected? Security Measures you Need to Know About”
“The Brave New World of HIEs”

In prepping for the event, I came across a great list of “The Top 10 Trends Impacting HIM in 2016.” Note that EHR and related technologies top the list. I guess it’s safe to say that concerns around them aren’t going away any time soon.

Courtesy of Precyse

I’d love to have readers weigh in on what relationship HIM professionals have with their EMR counterparts in the hospital setting. How do they impact your workflow? Is Meaningful Use making your lives easier or harder? And how in the world are you going to find the time to worry about 2016, when it seems you’ve got enough on your plate in 2012?

Please share your thoughts in the comments below.