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?

 

 

 

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OCR audits, risk-adjustment coding discussed at RIHIMA

OCR audits, FY2017 coding updates, and risk-adjustment coding were among the many topics covered during the most recent RIHIMA meeting on October 7 in Warwick, RI. These meetings provide an affordable opportunity to stay abreast of industry changes and network with peers. Another perk: Free coffee and donuts. 🙂

HIPAA branding, OCR audits

Norma Chitvanni, RHIT, CHPS, privacy officer and director of privacy and confidentiality at Beth Israel Deaconess Medical Center, spoke about her efforts to lead an awareness campaign to help employees understand the importance of HIPAA. She reminded attendees that employees are an organization’s biggest vulnerability, and she urged others to consider creative ways to brand an internal privacy and security program.

For example, Chitvanni worked with the hospital’s communications department to create an educational video in which members of a patient/family advisory group spoke about the importance of keeping information private (KIP). She and her team also:

  • Created a padlock logo for the program
  • Identified internal KIP coaches to help educate staff
  • Put KIP labels on salad contains and food wrappers in the cafeteria
  • Created a staff portal with resources about how to secure laptops
  • Handed out promotional materials about KIP (e.g., pens, phone wipes)

Chitvanni also urged attendees to prepare for upcoming OCR audits. She provided these tips:

  • Provide HIPAA education to all staff. Ensure that you have some way to monitor and assess staff member’s understanding along the way (e.g., test-your-knowledge questions or a final exam).
  • Use the OCR audit tool as a foundation for compliance. Do your policies and educational materials support each of the 109 elements included in the tool?
  • Compile information for your business associates in advance. HHS provides a complete list of necessary information.
  • Use technology to monitor and mitigate risk. For example, some applications can identify and flag unencrypted emails that include medical record numbers, patient information, or medical codes.

FY 2017 coding updates

Mary Beth York, CCS, CCS-P, CIC, senior associate at Barry Libman Inc., provided a helpful overview of important coding changes that took effect October 1. She encouraged attendees to review the updated ICD-10-CM guidelines and also pointed out several surprises, including:

  • 1.A.19: The assignment of a diagnosis code is based on the provider’s diagnostic statement that the condition exists.  The provider’s statement that the patient has a particular condition is sufficient. Code assignment is not based on clinical criteria used by the provider to establish the diagnosis.

“I think we have to see how this is going to play out,” she said, adding that it remains unclear as to how insurance companies and Recovery Auditors will handle this guideline when a condition doesn’t meet clinical criteria.

  • 1.C.12.a(6): If a patient is admitted with a pressure ulcer at one stage and it progresses to a higher stage, two separate codes should be assigned: one code for the site and stage of the ulcer on admission and a second code for the same ulcer site and the highest stage reported during the stay.

She urged HIM professionals to work with members of the quality team to raise awareness of this new guideline.

Risk-adjustment coding

Gerry Petratos, MD, MS, CEO of Hiteks Solutions, Inc. said HCC coding is becoming the “gold standard” in healthcare because of its ability to capture clinical complexity and predict costs.

Many organizations are already using HCC modeling in the outpatient arena, necessitating the need for documentation improvement, he said. “Ambulatory CDI will be the biggest growth area in which there are the fewest people to do the work,” he added.

Accountable Care Organizations can also use HCC data to segment populations and target preventive care.

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?

 

 

 

Information governance, cybersecurity discussed at RIHIMA

Last week, I attended the annual meeting of the Rhode Island chapter of AHIMA. The event, held in Warwick, drew 70+ people as well as several vendors. It was a day filled with a wide variety of presentations, a delicious breakfast and lunch, and many opportunities for networking. The best part was that I only needed to travel 10 minutes from my home!

The day began with an overview of AHIMA’s strategic goals and initiatives. Tim J. Keough, MPA, RHIA, FAHIMA, of the AHIMA board of directors, spoke about the importance of data in healthcare — and why HIM is well-suited for the role of data analyst. He urged HIM professionals to lead the charge in the current data revolution — that is, to look for ways in which their organizations can turn data into health intelligence that can mitigate risk and improve outcomes.

Keough also talked about information governance through data transparency, data protection, and data integrity. As the industry continues to tap into big data for precision medicine, he said HIM should be at the forefront managing, using, and improving this data.

Cybersecurity expert, John H. Rogers, CISSP, gave a great presentation on the growing risk that hackers pose to health information privacy and security. “Healthcare information is more valuable than any other information on the market,” he said.

HIM professionals must make cybersecurity a core mission of the organization. This requires ongoing staff education, virus protection/patch updates, and social engineering testing. “It’s not just about the technology. Situational awareness is your power,” he said.

On the coding side, Barry Libman, MS, RHIA, CDIP, CCS, CCS-P, CIC, provided a helpful overview of important ICD-10-CM/PCS changes that will go into effect for FY 2017 on October 1, 2016. In particular, there are 3,651 new PCS codes (many of which are cardio-related) and 1,943 new CM codes, including a new code for the Zika virus (A92.5).

Attorney Jennifer Cox, JD gave an update on the ever-evolving Meaningful Use (MU) program, urging attendees to perform a security risk analysis if they haven’t done so already. Cox said this analysis is the number one reason providers fail to meet MU criteria.

David L. Rousseau, director of cancer information systems at the Hospital Association of Rhode Island, talked about the importance of cancer registries and why this is a good fit for HIM.

Perhaps the most riveting presentation was given by Michael G. Cooley, executive director of Nalari Health. Cooley shared his personal journey to overcome many challenges and hardships to ultimately find success both personally and professionally. His story, which also serves as the basis for his memoir “Rock Bottom: From the Streets To Success,” was extremely inspirational and unexpected. It also serves as a reminder of the strength of the human spirit — a good lesson for all of us.