RIHIMA meeting hits on many hot topics

The list of topics covered at the recent RIHIMA meeting truly ran the gamut: Medicare payment reform, Office for Civil Rights (OCR) enforcements, the 21st Century Cures Act, FY 2018 ICD-10-CM coding changes, and more. The meeting, which drew approximately 50 people, was held in Warwick on October 20.

2017 health IT updates

Jennifer L. Cox of Cox and Osowiecki, LLC kicked off the morning with an update on health IT, the future of which she said is unclear in light of unprecedented budget cuts to infrastructure. What can HIM professionals expect during the next year and beyond? Cox told attendees to keep their eyes open for the 21st Century Cures Act, which she said is one of the most significant regulations that will affect the HIM profession. The legislation, which was enacted in December 2016, includes a section on health IT interoperability that requires data sharing and prohibits data blocking. A first set of draft rules is due by March 2018.

“This is going to be bigger than HIPAA and Meaningful Use–it will be the biggest thing in our careers that will shift how we use health information,” said Cox.

Cox also touched on the federal government’s efforts to remove Social Security Numbers (SSN) from Medicare cards by 2019. Although this may reduce identity theft, she said it creates an inability for HIM professionals to verify patient identity using this unique identifier. HIM may eventually need to create consistent verification standards in lieu of having access to the SSN, she added. They may also need to retrospectively sanitize records to remove the SSN. Cox encouraged attendees to make a list of all the ways in which they currently rely on the SSN so they can work collaboratively with the legal/compliance department to develop a strategy for how they’ll handle these scenarios once the SSN is no longer available.

Cox also warned of increasing OCR activity, stating that high-dollar settlements have increased over the last year and a half. She encouraged attendees to monitor the OCR’s running list of resolution agreements because she said it’s often a roadmap for potential vulnerabilities. “Learn from your colleagues’ misfortune,” she said. “This is what [the OCR] cares about, and what they care about, we should care about.”

Risk assessments should be a top priority, she said, adding that many independent physician practices are failing Meaningful Use audits because they didn’t conduct an assessment during the year of attestation. Also remember to fix any problems discovered during the assessment, she added.

Staff education is equally as important, said Cox. For example, employees should notify their IT department when a computer is particularly slow, as this could signal an impending cyber attack. “These are very sophisticated attacks,” she added. “It takes minutes–not hours–to infect the entire system.”

FY 2018 coding updates

Mary Beth York, senior associate at Barry Libman, Inc. discussed several important ICD-10-CM coding changes that took effect October 1, 2017. She encouraged attendees to review the FY 2018 ICD-10-CM coding guidelines as well as the 2018 Addendum. When coders rely entirely on the encoder–and don’t review all of the additions, deletions, and revisions–they aren’t as aware of these oftentimes subtle changes, she said.

Third-party release of information

Amy Derlink and Laureen Rimmer, both of MRA Health Information Services, gave an informative presentation on ROI best practices.

Derlink encouraged attendees to create a third-party audit record review policy that addresses these and other questions: Will you ask to see the business associate agreement between the health plan and third-party auditor before releasing information? Will you allow the third-party auditor onsite? What access will you provide to the third-party auditor? Will it include remote access? How will you comply with HIPAA’s minimum necessary requirements? “We need to protect privacy,” she said. “That’s our number one obligation.”

Don’t let auditors bypass HIPAA to access protected health information, said Derlink. Quality audits (e.g., HEDIS) are not included in uses and disclosures for treatment, payment, and operations, she added.

Rimmer said HIM must leverage technology and tap into data analytics to identify compliance risk and prepare for audits. “Understand your data, and know what’s going on so you can be proactive with your own internal audits,” she said. “As you see themes, you need to drill down.”

Embracing leadership qualities

Karen A. Benz of Benz Strategic Group gave an interesting presentation on leading vs. managing. “Management is doing. Leadership is being,” she said. “As a leader, you set the culture and tone of your department.” She described managers as productivity-oriented implementers, and she identified leaders as open-minded agents of transformational change. Managers ask people to follow, but when you’re a leader, people will follow naturally, she explained.

She challenged attendees to embrace leadership qualities and not succumb to negativity. Doing so improves employee retention and satisfaction. And when employees are happy, they’re often willing to go the extra mile for patients as well.

 

 

 

 

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Inspiration, innovation key themes at the 2016 annual AHIMA convention

20161018_211108“Inspire big thinking to launch our future” was the theme of the 88th annual AHIMA convention held October 16-19 in Baltimore, MD. And wow, did it inspire. I imagine that most HIM professionals walked away from the event feeling incredibly energized about the role they’ll play in this new era of big data and patient engagement.

In my opinion, the most powerful presentation was that of Dr. Bennet Omalu, the first doctor to diagnose chronic brain damage in NFL athletes. He also inspired the movie “Concussion” starring Will Smith. Dr. Omalu received frequent applause as he shared his personal journey–one in which he overcame insurmountable odds in war-torn Nigeria to not only attend medical school at the age of 15 but also to ultimately make a discovery that revolutionized neuroscience and sports medicine/safety. I had goosebumps just listening to him. As I watched and listened in awe, I was reminded that with hard work, passion, and a little luck, anything is possible. This is an important lesson for everyone, including HIM professionals working tirelessly to improve compliance and data integrity within their organizations.

Retired American astronaut and U.S. Navy Captain Mark Kelly continued the theme of inspiration as he spoke about his career flying 39 combat missions over Iraq and Kuwait during the first Gulf War. He also described in vivid detail what it felt like to blast off in a rocket when he served as the commander of space shuttle “Endeavor” on its final flight. His talk then turned personal as he spoke about the day his wife, former congresswoman Gabrielle Giffords, was severely wounded after being shot in the head at near point-blank range. Giffords joined him on stage at the conclusion of the talk and received a standing ovation.

Many of the sessions throughout the duration of the conference focused on thinking ‘outside the box’ of traditional HIM roles.

For example, ONC Chief Medical Information Officer Andrew Gettinger, MD, encouraged HIM professionals to help their organizations integrate patient-generated data into the EHR–especially as medical care continues to move outside of a hospital’s four walls. He said HIM is also well-suited to help organizations “harvest digital dividends” from EHRs–that is, use the technology (and big data) to solve operational challenges and problems.

During a panel discussion about the future of healthcare, AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, CAE, FACHE, FAHIMA, encouraged attendees to imagine the HIM jobs of the future–and take steps now to prepare. Is higher education warranted? A specialty credential? She said to embrace industry changes–not simply react to them.

Panelists identified these healthcare trends that will continue to shape HIM in the years to come:

  • Push for transparency around healthcare costs
  • Integration of patient-generated data for a 360 degree holistic view of one’s health
  • Increased interoperability to meet patients’ demands and coordinate care more effectively
  • Best practices to educate patients about their health information
  • Best-of-breed strategic partnerships
  • Availability of clinical information at the point of care

Others spoke about new and emerging roles in HIM, including data scientist and healthcare data quality manager. Michelle Basco, RHIA, of Children’s Medical Center spoke about her own journey to become a personal health record coordinator. HIM professionals are uniquely qualified to engage and educate patients. “They need to learn, and they need us by the side,” she said.

Various speakers also talked about the importance of developing an HIM workforce to meet the job demands of the future. Apprenticeship programs are critical, said Bill Rudman, PhD, RHIA, executive director of the AHIMA Foundation. “We’re evolving so quickly with technology. On-the-job experience is so necessary,” he added.

Marci Wilhelm, of MedPartners, said apprentices with whom she’s worked achieved a 95% coding accuracy rate in only 90 days. Debra Boppre, MSM, RHIA, CCS, CCS-P, FAHIMA, of Trinity Health recounted a similar experience with apprentices who helped address coding backlogs at their facility.

Boppre encouraged other HIM professionals consider serving as mentors. “You owe it to these HIM professionals,” she said. “Invest the time, and you will see the return on investment over and over again.”

Information governance was also a hot topic. During a panel discussion, panelist Sally Beahan, RHIA, MHA, director of HIM at UW Medicine said to start small by identifying the ways in which HIM is already striving to enhance data integrity. Others shared their journeys toward information governance and encouraged HIM professionals to champion the effort within their organizations.

Did you attend the AHIMA convention? If so, what did you take away from it? What inspired you the most?

 

 

 

Why HIM professionals hold the keys to patient satisfaction

I started writing about medical coding and health information back in 2005. When I stop and think about how many changes HIM professionals have been through during that decade, it’s mind-boggling! First it was MS-DRGs and the dawn of clinical documentation improvement, then the Affordable Care Act and the push for electronic health records, then ICD-10, and now a transition to value-based payments.

As medical records have evolved, HIM professionals’ skills have evolved as well. With their intimate knowledge of data — particularly how data is created, modified, stored, and shared — they bring such value to the table. The sky is the limit when HIM and IT collaborate effectively. Add a hospital executive to the mix, and you’ve got a powerful trio of intelligent minds that can propel process improvement forward. What an exciting thought!

Unfortunately, it’s sometimes difficult to find common ground. And it’s easy to lose valuable ideas in translation. The good news is that everyone seems to speak the language of ‘patient satisfaction.’ Organizations nationwide  continue to focus on the patient experience — especially in light of the important role that both of these plays in CMS’ latest hospital quality star ratings.

This is an opportunity for HIM. Take it.

Meet with a C-suite executive and explain how HIM can engage patients. Here are a few examples:

  1. Portal navigation. Who is most qualified to convey the value of portals and educate patients how to use them? HIM.
  2. Health coverage education. Who is most knowledgeable of complex insurance policies (including copayments, deductibles, coinsurance, etc.) and can thus help patients understand these concepts? HIM.
  3. Digital forms. Who can help digitize forms, integrate EHR data into those forms, reduce duplication, and create opportunities for e-signatures on mobile devices? HIM.
  4. Advocacy for privacy and security. Who can help patients understand their rights to obtain copies of their own medical records? HIM.
  5. Protection against medical identity theft. Who can implement policies and procedures to thwart identity theft and protect patient information? HIM.
  6. EHR best practices. Who can help physicians integrate the EHR into the exam room so it doesn’t disrupt communication? HIM.

In what other ways do you, as an HIM professional, strive to improve the patient experience daily?