Bill Spooner comments on cash flow needs during the ICD-10 transition | HIM pros play key role in population health management, expert says | Technology for calculating hospital-error surcharges is introduced
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August 1, 2013
CHiME Healthcare CIO SmartBrief
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Cash reserves are crucial during ICD-10 changeover, experts say
Physicians should plan to have cash reserves to cover three to six months of operating expenses or a line of credit to handle reimbursement delays brought about by next year's transition to ICD-10 codes, billing experts said. MediGain's April Arzate said that despite advance planning and testing, physicians, especially those in smaller practices, should plan on some delays. Clint Hughes, also of MediGain, recommends approaching banks for loans now, if one is needed. "The bank will be more open now than if you come to them desperate because you're two months behind," he said. Healthcare IT News (7/30), PhysBizTech (7/30)
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Bill Spooner comments on cash flow needs during the ICD-10 transition
While the article emphasizes the cash flow risk facing the independent physician practice as we transition to ICD-10, it is no less applicable to the hospital or integrated delivery network. Any provider organization performing rigorous enterprise risk management should conclude that ICD-10 is on the "top 10" list for the next 18 months. Optimists that we like to be, we might assign the change a low to moderate failure ranking. The mammoth impact of delayed cash flow, however, requires that we identify the potential failure points and establish contingency plans for the most impactful elements.

Those given to considering such things instead of counting sheep at 3 a.m. have the short list already:
  • What if the computer-assisted coding engine I just paid megabucks for misses most of the documentation my physicians were trained and cajoled into recording?
  • What if my competitor hires away several of my coders?
  • What if my software upgrades complete perfectly but my largest payer isn't ready to receive the codes, despite all the testing?
Readers can add their own concerns to this list. In my organization, a large multidisciplinary team is working to ensure that every controllable element is addressed effectively. My role is to offer leadership, encouragement and resources to the team. In addition to the contingency planning of any large project, I ask my organization to consider:
  • What projects are we willing to delay if resources need to be diverted to ICD-10 during those last few months before October 2014?
  • How much spending are we willing to defer to accumulate a cash buffer that will get us through the first few months until the ICD-10 gremlins are eliminated?
Work closely with your executive team. Partner with finance like never before. Encourage the auditors to bring on their questions. This is the time to shine!
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HIM pros play key role in population health management, expert says
Population health management programs will increasingly rely on data stewards to maintain the integrity of clinical data at the point of care, a trend that could create new career opportunities for health information management professionals, Bonnie Cassidy of Nuance Communications wrote in the Journal of AHIMA. Cassidy offered four ways that HIM experts may take advantage of those opportunities, starting with developing advanced analytics technology and methods for PHM. Government Health IT online (7/30)
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Technology Spotlight
Technology for calculating hospital-error surcharges is introduced
A Web-based tool called the Hidden Surcharge Calculator was released by the Leapfrog Group to enable purchasers and employers to determine the amount they pay due to medical errors at general acute-care hospitals. The tool leverages claims information from an employer along with the Hospital Safety Scores of the hospitals being used to come up with the estimated surcharge. Healthcare Informatics online (7/29)
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Big Data used in new method to predict patients' disease risks
Nitesh Chawla, an associate professor of computer science at the University of Notre Dame, and his doctoral student Darcy Davis have developed the Collaborative Assessment and Recommendation Engine computer-aided method that leverages EHRs to come up with personalized disease risk profiles for individuals. To examine disease risk and well-being, the system uses a novel filtering method that looks at Big Data from similar patients. Healthcare Informatics online (7/29)
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Extension center in N.H. hits milestone in provider MU attestation
The Regional Extension Center of New Hampshire said that 85% of critical access hospitals and 65% of primary care providers in the state have been successful in attesting to EHR meaningful use. According to the center, New Hampshire ranked second among the 62 regional extension centers in the U.S. in terms of EHR attestation. "These milestones are a testament to the work we're doing collectively to improve health care delivery across the U.S. and to encourage an overall healthier population," said Micky Tripathi of the Massachusetts eHealth Collaborative, which launched the Regional Extension Center of New Hampshire in 2010. Healthcare Informatics online (7/30)
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Fourth data breach at Ore. university is reported
Oregon Health & Science University announced its fourth data breach, in which resident doctors posted information on more than 3,000 patients on Gmail or Drive, two cloud-based information-sharing services from Google. Compromised data included patients' names, medical-record numbers and diagnoses. Modern Healthcare (free registration) (7/29)
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Regulatory & Legislative
CMS reports $15.5B in EHR incentive payments in June
The federal government has released $15.5 billion in EHR incentive payments as of the end of June, CMS data show. According to the agency, all but 11% of the nation's 5,011 eligible hospitals have registered with the program, while 24% of some 527,200 eligible physicians and other professionals have yet to register. Modern Healthcare (free registration)/Vital Signs blog (7/29), (7/30)
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Market Focus
Telemedicine gives patients in outlying areas access to pregnancy experts
The number of telehealth consultations offered by Midwest Maternal-Fetal Medicine in the first six months of the year tripled, allowing it to serve a greater population of patients at its offices in Washington and O'Fallon, Mo., and Maryville, Ill. Participating doctors use telemedicine tools, as well as ultrasound machines provided by Mercy Hospital St. Louis, to perform real-time ultrasound examinations of patients and give them immediate feedback and guidance from specialists. Healthcare Informatics online (7/30)
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More health groups use mHealth to reach out to underserved populations
Health groups increasingly are turning to mobile health to better connect with underserved patient populations, according to this article. For instance, the Center for Connected Health in Boston is using text messaging to provide medical interventions to underserved addiction and prenatal patients, while Dignity Health in California is using an inhaler and mHealth application to monitor medication adherence among asthma patients. Healthcare Informatics online (7/29)
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Learn from your CIO colleagues at CHIME13
The CHIME13 Fall CIO Forum features 16 peer-presented and peer-reviewed education sessions across four tracks. Hear from your health IT colleagues on the topics of strategy and leadership; organizational performance improvement; business and care transformation; and emerging issues in health care and health IT. The CHIME13 Fall CIO Forum will be held Oct. 8 to 11 at the Westin Kierland Resort and Spa in Scottsdale, Ariz. - register today!
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Nominations due for public policy award for CIO leadership
Nominations are due by Aug. 2 for CHIME’s State Public Policy Award for CIO Leadership, awarded to a CHIME member CIO with demonstrated leadership in state-level public policy activities. This award recognizes the contributions of a CHIME member who is active in educating policy makers at the state level on the value of health IT and its role in patient care. Read the nomination criteria or nominate someone for this award.
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We choose our joys and sorrows long before we experience them."
-- Khalil Gibran,
Lebanese-American artist, poet and writer
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