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Health IT Pulse

October 1, 2015  8:19 PM

ICD-10 conquers AHIMA

Posted by: ShaunSutner
AHIMA, health information management, ICD-10, ICD-10 conversion, ICD-10 implementation

Don’t take this the wrong way.

The 2015 AHIMA Convention & Exhibition, held earlier this week in sultry New Orleans, was a productive conference. 

A few thousand health information management (HIM) and health IT professionals and dozens of vendors had a great time, educated themselves, did business and celebrated the coming of ICD-10 a day after the American Health Information Management Association conference ended.

But attendance was down from last year, with fewer attendees and fewer vendors on the floor (though nobody seems to have a precise count, which in itself kind of shows how slow things were).

Ironically, it’s pretty apparent that the ICD-10 conversion on Oct. 1, the very milestone that the great majority of those present were celebrating, was the culprit.

While the official line from countless pro-ICD-10 AHIMA members in NOLA was “if you’re not ready for ICD-10 by now you’re not going to be ready by staying home,” it became increasingly clear over the three days I was there that many did, indeed, stay behind at their jobs at healthcare organizations, payers and health IT and HIM companies.

They were undoubtedly hustling to do last-minute preparations for ICD-10.

On the brighter side, the show also saw a lot of warped humor about ICD-10. I glimpsed one T-shirt with a bunch of jagged lines saying: “This is your brain on ICD-10.” An AHIMA official joked from the stage that she hoped everyone would enjoy New Orleans “both pre- and post-apocalyptic.”

And most people, while slightly amused by the Twitter accounts, Web sites  and jokes making fun of some of ICD-10’s nuttier codes — such as being injured by an Orca whale, to cite just one well-known example — actually tended to poke fun at the naysayers and critics in the anti-ICD-10 camp. Certainly they had little patience for them.

In any event, one sure sign that this AHIMA confab, the venerable organization’s 87th, wasn’t quite as hoppin’ as usual was the absence of high-octane luminaries from the health IT and entertainment worlds.

Last year, movie star heartthrob Rob Lowe drew throngs of AHIMA-ites to San Diego’s PETCO Park stadium and ONC chief Karen DeSalvo, M.D., roamed the halls and attracted rapt audiences.

This time around, no ONC people were on hand in any official capacity. And among the invited guest speakers were a deputy assistant secretary for manufacturing from the U.S. Department of Commerce, futurist Joe Flowers, and Robin Roberts, co-anchor of ABC’s Good Morning America.  

Next year, the first post-ICD-10 AHIMA conference will be in Baltimore.

September 30, 2015  3:44 PM

Survey: Technology in healthcare not yet meeting patients’ expectations

Posted by: klee34
Electronic Medical Record, personal health records

A recent survey by Surescripts — a health information network provider — found that 29% of Americans, close to 70 million individuals, still fax or physically transport their test results, X-rays or health records from one doctor’s office to another — and it’s because of the lack of electronic communication between doctors and patients.

In such cases, ultimately patients have to connect the medical records dots themselves, making it challenging for Americans to manage their health, according to the survey. While millions of people across the United States are open to using technology for a variety of healthcare needs, that survey found that the health system is not yet living up to their expectations.

And Regina Holliday, patient rights advocate and founding artist at the Walking Gallery, has experienced this first hand when her 39-year-old husband died of metastatic kidney cancer in 2009, which she recently spoke about in a keynote at the annual Allscripts Healthcare Solutions, Inc., user conference. Holliday believes that the combination of a late diagnosis, unresponsive and impersonal healthcare providers, and the cumbersome system of printed health records contributed to her husband’s death.

Holliday said in her keynote: “There are computers all over the hospital and you can’t show us the medical record?”

“Dangerous voids in health information sharing can easily be solved through the use of digital communications and technology. This survey proves patients take notice and are ready for a change,” Tom Skelton, CEO at Surescripts, said in a press release. “As an industry, we need to come together to connect the nation’s healthcare system — to enhance the patient experience while improving quality and lowering the cost of care.”

September 29, 2015  1:55 PM

Blue Cross and Blue Shield to make cost and quality info available in huge new database

Posted by: adelvecchio
healthcare costs, patient data, population health management, price transparency

Consumers eager to review cost and healthcare quality data before making a care decision are in luck. If they are covered under the Blue Cross and Blue Shield (BCBS) umbrella, that is.

All 36 BCBS companies pledged to pool their cost and healthcare quality data to the BCBS Axis, the Blue Cross Blue Shield Association announced. The BCBS Axis is a database of healthcare information containing data from 96% of U.S. hospitals, covering 2.3 billion yearly procedures. BCBS companies can distribute this data, which is derived from every U.S. zip code, to its affiliated physicians and patients.

The cost aspect of this announcement shouldn’t be overlooked, especially now that the U.S. healthcare industry is moving towards a value-based care model. SearchHealthIT contributor Evan Albright looked into this development at this year’s Healthcare Financial Management Association conference. He learned that providers that adopted population health care models learned they need to be more precise is their pricing estimations when formulating their budgets. They might find that easier if they had access to a database such as the BCBS Axis.

The BCBS Axis should allow BCBS companies to provide patients with even more information to help them locate the best physician to treat them and make more personalized care decisions, though it doesn’t appear patients will have direct access to the data they desire. The BCBS Association’s announcement stated that by using BCBS Axis data, “BCBS companies also help consumers gain access to reliable and accurate information on more doctors, hospitals and procedures.”

The BCBS network — which covers one in three Americans, contains data from 92% of U.S. physicians and hosts more than 700,000 patient reviews — is the “largest aggregated data resource” in the American healthcare industry, the association said. “Through our actionable data, and the speed at which it is available, we are leading a transformation of the healthcare system to improve the quality and affordability of care,” Scott Serota, president and CEO of BCBSA, said in a release.

September 24, 2015  3:06 PM

AHIMA conference attendees stand at brink of ICD-10 transition

Posted by: ShaunSutner
AHIMA, IBM Watson, ICD-10, ICD-10 conversion, ICD-10 readiness

It seems almost uncanny how the health IT conference most associated with ICD-10 and all things medical coding is being held this year literally on the eve of the historic transition from ICD-9 to ICD-10.

Indeed, when the 2015 AHIMA Convention & Exhibit ends in New Orleans the afternoon of Sept. 30, the ICD-10 deadline will be only about eight hours away at midnight on Oct. 1.

While some worry about the changeover, the ICD-10 milestone is one that leadership of the American Health Information Management Association, and the majority of AHIMA’s members, overwhelmingly support, considering that AHIMA has been one of the strongest advocates for ICD-10.

“There’s going to be a celebratory atmosphere,” Sue Bowman, AHIMA’s senior director for coding policy and compliance, told SearchHealthIT. “I think the vast majority of the industry is ready.”

Even so, there is simmering unease in some quarters about the advent of the new and exponentially more complex coding system, particularly among physicians and physician practices.

For an up-to-the-minute expression of this ICD-9 to ICD-10 angst, check out this blog post from Merge Healthcare Incorporated, the VNA vendor recently acquired by IBM Watson Health.

A Merge poll of its medical enterprise imaging clients found that about half felt they were 80% ready for ICD-10, and another 40% felt they were 50% to 80% ready., Many of those polled were worried not so much about the switch itself, “but rather the interim period following the switch where they will likely have to use both code sets for billing,” the blog says.

All that said, the AHIMA conference — expected to draw several thousand health information management professionals and a few hundred vendors — will deal with more than just ICD-10, though there will be panels devoted to last-minute conversion tips and vendors selling ICD-10 accessory software.

High on the agenda is information governance, a field that has been prominent for years in information management in other industries, but only made its first real splash in health IT last year at the AHIMA conference in San Diego.

This year, AHIMA is rolling out a host of information governance resources, including consulting services, Bowman noted.

In the meantime, Bowman said she feels confident that individual practitioners and others who see adopting ICD-10 as daunting will ultimately come around to the coding system’s benefits: more than six times as many codes as ICD-9 and the resulting richer trove of health data for analysis and mining and clinical knowledge.

“I think even physicians will see that it’s not too hard to use and will give them better health data,” she said.



September 23, 2015  10:11 AM

Health IT figures into NIH’s plan for national precision medicine research group

Posted by: klee34

The National Institutes of Health’s Advisory Committee to the Director (ACD) recently detailed a framework in a report for building a national research group of one million or more Americans to expand the knowledge and practice of precision medicine by utilizing genomics and big data analytics.

The opportunities this initiative presents, according to the agency, include the following technology-related aspects:

  • Using mHealth technologies to correlate activity, physiological measures and environmental exposures with health outcomes.
  • Empowering study participants with data and information to improve their own health.

NIH said it hopes to be able to build the infrastructure for this plan soon so that participants can begin enrolling in 2016, and the agency hopes to enroll at least one million people in three to four years.

President Obama proposed the Precision Medicine Initiative in order to advance the development of individualized care.

Francis S. Collins, M.D., the director of NIH, established the Precision Medicine Initiative Working Group with the goal of creating and managing a large group of research participants with data and specimens that can be accessed by all researchers, who would draw on this information to understand the variables that contribute to health and disease. The ultimate goal: Development of more effective treatments tailored to individuals.

The report also includes a strategy to allow any person living in the United States to voluntarily enroll in the study directly or through a participating healthcare provider.

Participants would volunteer to share core data such as EHRs, health survey information and mobile health data on lifestyle habits and environmental exposures. In return, they would have access to their study results and aggregated results from all study participants, and they would receive tools to make sense of the results, the NIH said. The agency would ensure participant privacy and security safeguards.

“Many factors have converged to make now the right time to begin this ambitious project,” Collins said in a press release. “Americans are engaging in improving their health and participating in health research more than ever before, electronic health records have been widely adopted, genomic analysis costs have dropped significantly, data science has become increasingly sophisticated and health technologies have become mobile. We have to seize this moment to invest in these promising scientific opportunities to help Americans live healthier lives.”

September 22, 2015  1:05 PM

A fraction of mobile health apps control download market

Posted by: adelvecchio
Healthcare apps, mHealth, mHealth applications, mobile apps, mobile health, mobile health technologies

New mobile health apps face a challenge in gaining recognition and adoption in the mHealth app market, where a miniscule fraction of the apps have nearly 50% of the market.

There are more than 165,000 consumer mobile health apps, according to research from healthcare technology service provider IMS Health, and 36 of those apps account for almost half of app downloads. Greater than 90% of downloads come from a mere 12% of the available mHealth apps. The vastness of the mHealth app market makes it unsurprising that so few applications are established as consumers’ favorites. People may download an app based on suggestions from friends or medical professionals, but they’re unlikely to take the time to thoroughly evaluate which app works best for them — especially when there are more than 100,000 possibilities.

Users are more likely to stick with an mHealth app if it was recommended to them by healthcare professional, at least for a limited time. The IMS report noted that 30-day retention rates for apps were 10% higher among patients that were “prescribed” to download and operate a specific app by a healthcare employee. Under that same directive, the retention rate for fitness apps was 30%.

IMS Health found 34% of mHealth apps can connect to social networks, up from 26% in 2013. While social connectivity improved, not as much progress was made concerning mobile health apps hooking into providers’ electronic healthcare systems, such as EHRs. Murray Aitken, executive director of the IMS Institute for Healthcare Informatics, addressed what’s preventing app and provider collaboration and said, “Healthcare providers are actively addressing the remaining barriers. These include… creating practical reimbursement models and ensuring true interoperability within and across healthcare systems.”

Mobile health apps could communicate with more healthcare systems and become a larger part of patient care if the recent increase in clinical trials on mHealth apps gives providers conclusive proof that apps are worth their time. There are 300 clinical trials underway using mobile apps, more than twice the 135 trials conducted two years ago.

September 17, 2015  3:36 PM

$750,000 settlement points to the need for strong HIPAA policies

Posted by: klee34
HIPAA, HIPAA audits, HIPAA compliance, HIPAA data breach, HIPAA enforcement, HIPAA healthcare data

Many have talked about how HIPAA audits have yet to materialize. But for some providers, HIPAA-related investigations are very much a reality. Take the story of Cancer Care Group, Inc., located in Indiana, which provides a cautionary tale of what could happen if a covered entity does not do everything in its power to ensure HIPAA compliance.

On September 2, the U.S. Department of Health and Human Service’s Office for Civil Rights (OCR) reported that it agreed to settle potential violations of HIPAA with the Cancer Care Group for a sizeable $750,000. Not only will the Cancer Care Group have to pay up, but it also had to agree to a three-year corrective action plan that OCR will monitor.

Here’s what happened (and it’s something that is, unfortunately, a fairly common occurrence and easy mistake to make): On August 29, 2012, the OCR was notified by the Cancer Care Group that there was a breach of unsecured electronic PHI due to a laptop bag being stolen from an employee’s car. The bag contained the employee’s computer and unencrypted back-up media that contained the names, addresses, dates of birth, Social Security numbers, insurance information and clinical information of approximately 55,000 current and former Cancer Care patients, according to the government. OCR said the Cancer Care Group did not have a written policy to routinely remove back-up media from devices that left the clinics, which contributed to the breach.

Although the HIPAA audits have been delayed several times — and at the beginning of this year OCR Director Jocelyn Samuels couldn’t give a definitive timeline for the audits — the government can still investigate alleged violations, even if they’re self-reported by an organization. However, a 2014 survey by NueMD — a seller of cloud-based medical practice software — of more than 1,000 healthcare providers and administrators found that most doctors are unprepared, with only 32% of respondents indicating they knew about the HIPAA audits at all.

In an article about the Cancer Care Group settlement, the National Law Review urges covered entities and business associates “to ensure that risk assessments and policies are up to date, are well documented, and provide for adequate safeguards for the nature and scope of the business involved.”

September 17, 2015  12:54 PM

CHIME announces changes at corporate and board levels

Posted by: ShaunSutner
Cerner, CHIME

The College of Healthcare Information Management Executives (CHIME), the leading organization for health IT CIOs, has been going through changes.

First some background.

Jeff Smith, former vice president of public policy, left CHIME in June for a job with the same title at the American Medical Informatics Association. At about the same time, Stephanie Fraser, CHIME’s former director of communications and corporate relations, departed for the PR agency world, where she is now senior media and social media director for Amendola Communications.

Also in June, CHIME co-founder and former president and CEO Richard Correll retired after serving as the organization’s COO and senior strategic advisor since April 2013, after current CHIME president and CEO Russell Branzell was appointed.

Since then, Leslie Krigstein, who had been acting as vice president of public policy, has become vice president of congressional relations, focused solely on Capitol Hill lobbying for CHIME.

Meanwhile, CHIME has split its policy and congressional relations functions and earlier in September hired. With a background that includes federal affairs work for the American Medical Association and stints at CMS and the Office of the National Coordinator for Health IT, she will guide CHIME’s relations with federal regulators.

To replace Fraser, CHIME has tapped veteran healthcare journalist Matthew Weinstock, an editor for the last 12 years with trade publication Hospitals & Health Networks. Weinstock’s title is director of communications.

Change is also afoot at the Board of Trustees and CHIME Foundation board levels, with three new members elected to the board, and a new board chairman, Marc Probst, vice president and CIO of Utah’s Intermountain Healthcare, set to take over in January from current chairman Chuck Christian, vice president and CIO of St. Francis Hospital in Columbus, Ga.

The new trustees are Cletis Earle, CIO at St. Luke’s Cornwall Hospital in Newburgh, N.Y.; Theresa Meadows, senior vice president and CIO, Cook Children’s Healthcare System in Fort Worth, Tex.; and Donna Roach, CIO at Via Christi Health-Ascension Information Services in Wichita, Kan.

In other CHIME news, Zane Burke, president of EHR giant Cerner Corp., was elected to the CHIME Foundation board in a move that puts one of the most influential executives in the industry in the CHIME camp and makes him the only EHR vendor representative on the board.


September 15, 2015  1:42 PM

Providers can pass problems with health IT products, information blocking to ONC

Posted by: adelvecchio
EHR usability, health IT usability, HIE, information blocking, ONC, ONC-ACTB

If customer satisfaction and retention weren’t reasons enough, health IT vendors now have more motivation to quickly and thoroughly respond to complaints about their health IT products. Healthcare providers can appeal to ONC if they feel vendors don’t acknowledge and assist them with system dilemmas or questions.

A blog post written by Jon White, M.D., deputy national coordinator at ONC, stated the agency will work with CMS to record and respond to health IT product concerns filed at the ONC’s complaint webpage. The post advises providers to first contact their vendors, and if that effort isn’t fruitful, to contact an ONC-Authorized Certification Body if they think the issue relates to something a product is certified to do. ONC-Authorized Certification Bodies comprise a group of vendors and testing labs that certify EHRs for the government. Only if those two steps fail should a grievance be formally made to ONC.

ONC said it will assign each issue to the appropriate ONC staff member or pass the problem to another group within the federal government. If someone at ONC can’t fix the problem, the agency may send providers back to where they started: communicating with their vendors.

Information blocking — which occurs when providers or vendors meddle with the exchange of health information without reason for doing so — appears to be stuck on ONC’s radar. It is mentioned as the first issue on a list of causes for which providers should contact ONC. White’s blog also mentioned poor information exchange, EHR usability and general product performance and safety as reasons providers should file complaints through ONC.

Information blocking was the subject of a 39-page report released by ONC earlier this year, preceding the HIMSS 2015 conference. That report made it clear ONC was aware that some health IT product vendors and providers were deliberately engaging in information blocking and the agency would take action to deter it. The establishment of the health IT complaints outlet is one step in that anti-information blocking plan, as the blog said one of the website’s goals is to help ONC follow and reduce instances of information blocking, as well as enhancing the usability and safety of health IT products.

September 11, 2015  11:23 AM

HIMSS asks Congress to push HIE standards, cybersecurity and telemedicine

Posted by: adelvecchio
health IT standards, HIE, HIE implementation, HIMSS, Interoperability, ONC, telemedicine, telemedicine reimbursement

Count the Health Information Management Systems Society (HIMSS) among the groups that say federal healthcare agencies can do more to promote the use of health IT. Specifically, HIMSS is asking Congress to consider its recommendations for strengthening interoperability, healthcare cybersecurity and telemedicine reimbursement.

Interoperability testing must be introduced into the ONC Health IT Certification Program, according to HIMSS, and Congress must order HHS to make that happen so HIE standards will be met by all certified products. HIMSS also asked that the prohibition on using federal funds to create a patient identifier standard be abolished. Those two requests indicate HIMSS sees a strong tie between increased interoperability and the establishment of a national patient identifier, which echoes what was said by members of the College of Healthcare Information Management Executives at HIMSS 2015.

HIMSS doesn’t need to remind the Office of the National Coordinator for Health IT (ONC) that interoperability should be a priority for health IT regulators. Earlier this year, ONC released its interoperability roadmap, seemingly shifting the agency’s focus from the meaningful use program to HIE standards. A recent blog written by two ONC employees noted a 23% increase from 2013 to 2014 in the number of hospitals that electronically passed health information to outside providers.

HIMSS’ second directive is for HHS to cooperate with the National Institute of Standards in creating a national health IT data security framework, consisting of a group of security standards that would be regularly refreshed. HIMSS proposes the framework should be voluntary. Due to the different sizes and workflows of separate healthcare organizations, some people — such as former ONC chief scientist Doug Fridsma, M.D. — don’t think a single health IT standard can fit every organization’s unique needs.

The third request made by HIMSS was that Congress should force CMS to eliminate some of the obstacles facing providers eager to practice telemedicine. Current law restricts CMS from offering reimbursement payments for remote patient monitoring or telemedicine services. If telemedicine reimbursements are increased, it’s likely more providers will offer remote care. Variations in telemedicine licensure for physicians in different states complicate the treatment of patients across state borders. HIMSS asked that states consult with each other to address this issue.

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