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Don't miss at AHIMA 2011 conference: Meaningful use, coding, documentation

Computer-assisted coding and natural language processing, and their promise to enable meaningful use and ACO compliance, will be the hottest technology at this year's AHIMA event.

This year, the American Health Information Managers Association (AHIMA) 2011 conference comes at a very busy time for its members -- they're gearing up for the International Classification of Diseases, Tenth Edition (ICD-10) transition in 2013, meaningful use stage 2 will drop, supposedly in December, and hospital leadership is pressuring them to gather new patient data metrics for accountable care organization reporting. Through it all, they need to convince physicians to learn how to document care and diagnoses in more detail to support the paperwork those three compliance initiatives require.

The convention leadership hopes its keynote speakers will help equip AHIMA's rank and file with the knowledge and motivation to accomplish these new initiatives -- and to roll with the changes they're bringing to the health information manager's role.

The job will include a lot more than working with payers to resolve claims. New responsibilities revolve around being able to provide accurate and timely data for these new reporting mandates, sometimes surveying an organization's entire patient base in order to get a quality- or performance-based payment.

"The keynote speakers were selected in response for the need to help the HIM professional take on the mantle of leadership within the healthcare community," Bill Rudman, executive director of the AHIMA Foundation and AHIMA vice president of education, wrote in an email to "From the Stephen Covey presentation to the leadership speaker to Gail Collins, the message is clear: in order for quality care to occur, the provider must have information they can trust. For this to happen, the HIM professional must take the lead and drive change in both process and technology."

Surveying the vendor offerings on the AHIMA 2011 conference exhibition floor, Rudman noted that the hottest technologies are two that will help ease the coding department's transition to ICD-10. Computer-aided coding systems and natural-language processing can both help match physician documentation to the new diagnosis and treatment codes -- of which there are many more in ICD-10 compared to the current ICD-9 set.

With the advent of ICD-10 and meaningful use standards, providers and vendors will be most interested in how technology can address those issues in the cost effective and timely manner.
Bill Rudmanexecutive director, AHIMA Foundation

"With the advent of ICD-10 and meaningful use standards," Rudman wrote, "providers and vendors will be most interested in how technology can address those issues in the cost effective and timely manner."

Meaningful use and preparation for the accountable care organization (ACO) model will profoundly affect AHIMA members, said Dan Rode, AHIMA vice president of advocacy and policy. Although they won't be quite as big as the coming transition to ICD-10, they will be numbers two and three on the "hot issues" list for this year's annual meeting.

Believe it or not, ICD-10 codes are tied closely to meaningful use. Standardized problem lists, driven by the Systematized Nomenclature of Medicine -- Clinical Terms (SNOMED CT), will help enable hospitals meet meaningful use criteria for stages 2 and 3 and ICD-10's more rigorous documentation needs, he said.

"Using terminology in electronic health record software, especially SNOMED, has the potential of both automating the coding process as well as being mapped to the ICD-10 classifications so that it can be part of either meaningful use stage 2 or meaningful use stage 3," Rode said. "It was discussed as going into stage 2, but until we see the final rule in December, we really won't [know for sure]."

Hospital information managers also need to be ready to interact with their counterparts at other hospitals in what looks to be ACO or ACO-like groups, as payers move to value-based reimbursement models. Hospitals that today are competing with one another may see themselves banding together to form these entities as ACOs, tasking their respective HIMs with comingling patient data for reporting-- and, ultimately, better reimbursement.

"That gets into some very interesting situations," Rode said. It starts with putting the data interoperability problems of multiple hospitals' different health IT systems -- EHRs, pharmacy, radiology and so on -- on the information manager's plate. It also means understanding how to combine multiple data sets into a single report. "That's a role that our members play in, but this is going to accelerate that."

With all these new needs for patient data -- not forgetting federal mandates for hospitals to give patients access to their own data in meaningful use, too -- Rode said information managers will also have to work with IT staffs to understand new documentation needs and give clinicians the tools to do it. While the capability of collecting more documentation has been in health IT systems for a long time, he hasn't seen "major innovations" for years.

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To achieve new documentation goals set by ACO reporting, ICD-10 and meaningful use, Rode thinks speech recognition systems will come to the fore at the AHIMA 2011 conference -- as well as figuring out how to help physicians make better use of the technology.

Piled on top of all this is privacy and security. While meaningful use is forcing open access to the growing documentation and proliferating patient data in digital form, the Office for Civil Rights within the U.S. Department of Health & Human Services is developing stronger HIPAA enforcement policies.

Even the HHS rule announced last month that patients now must be able to access test results directly from the lab poses a new problem. Lab systems are designed to give access to pathology results to care providers and allied health personnel to render care and provide treatment, Rode said. Hardwiring that into EHR and rolling it into personal health record systems so that patients can make sense of it is another IT-intensive data puzzle for information managers to solve. They'll be at the AHIMA 2011 conference looking for solutions.

Let us know what you think about the story; email Don Fluckinger, Features Writer.

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