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Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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Four Ways Vendors Should Help the ICD-10 Transition

Four Ways Vendors Should Help the ICD-10 Transition | EHR and Health IT Consulting | Scoop.it

ICD-10 is a lightning rod for many of the slow-to-launch initiatives promising to modernize health technology. In recent weeks, I've read wearily about 10-year interoperability roadmaps from the Office of the National Coordinator for Health IT and belabored testimony over the Medical Electronic Data Technology Enhancement for Consumers' Health (MEDTECH) Act, which, if it succeeds, would end years of regulatory uncertainty from the FDA over medical devices. So I was disheartened—though not entirely surprised—to hear that ICD-10 may be deferred yet again if powerful physician lobbies like the AMA have their way in Washington, D.C.


Policy delays are yet another variable in an already unstable landscape of rising costs, declining reimbursements, and clinical consolidation threatening the viability of many practices. As a nurse and practice manager for a small pediatric practice, ICD-10 is a policy mandate I simply can't afford to ignore. Yes, it's true that many providers are struggling with technology that isn't equipped for an Oct. 1, 2015, transition date. I feel for those providers and don't want to see them punished for the shortcomings of their laggard vendors. But rather than willfully kicking the ICD-10 can down the road, I believe that providers must prepare for the inevitable by shopping now for services that can accommodate them.


Certainly, providers have their fair share of ICD-10 preparatory work to do on their own. It's in their best interest, however, to take a long, hard look at what their vendors are offering to make the ICD-10 shift easier. Here are a few areas to think about:


Your EHR Should Know You


ICD-10 is roundly forecast to be an administrative nightmare, but it doesn't have to be. When CMS implements ICD-10, the codes which all U.S. healthcare providers use to describe diagnoses and treatment will increase overnight by from 14,000 to over 68,000. Based on your current, most commonly documented diagnoses, your EHR should know which codes you're most likely to need on come October and surface them directly into your work flow. Scrolling through a full menu of thousands of possible codes is simply untenable. EHRs which are compatible with SNOMED — a physician-friendly classification system which maps to ICD-10 — will and should provide a shorthand "crosswalk" between ICD-9 and ICD-10 codes. These product updates should be available now, so that you and your staff can begin practicing.


Your Vendor Should Curate Knowledge Just for You


Is there a resource hub full of the information you need about ICD-10? Do you have best practice configurations, which will ensure that your EHR is configured with the right clinical content based on your needs? While your vendor can't code for you, it should provide training and practice exercises to teach best practices, identify potential hot spots in your work flow, and fix problem areas before they happen.

Your EHR Should Be Prepared For a Range of Payer Compliance

Your vendor should be well underway testing payers' and clearinghouses' system flexibility and readiness to manage both ICD-9 and ICD-10 codes, given that some will linger in a bilingual ICD-9/ICD-10 environment. Vendors should have the knowledge and payer roadmap to ensure that, whatever a payer's readiness or ICD-10 compliance status is, claims are being coded in a way that will not delay payment.


Your Vendor Should Guarantee Your Success


Unlike like meaningful use certification, government mandated for all EHRs, there is no comparable test for ICD-10. It's imperative that vendors guarantee their ability to create ICD-10-compliant claims and orders to HIPAA-covered entities. If it can't, it should pledge to waive your fee. Those vendors which recommend taking out a line of credit to ease revenue cycle hiccups aren't true partners.

In the ICD-10 echo chamber, providers shouldn't be paying attention to policymakers or pundits, but to their vendors. Good technology should insulate them from the revenue cycle disruption, delayed reimbursements, incorrect documentation, and clinical work flow issues ICD-10 threatens. EHRs, practice management services, analytics tools, clinical data exchange services, clearinghouses, and payers all need to be held to account for providers' success, failure, or pain along the way.


Vendors should be taking measure, and even competing with one another, to be among the most stalwart partners for physicians as they prepare for the seismic shift about to occur in clinical documentation. ICD-10 was never meant to be the province of the provider alone. The administrative burden is potentially mammoth. Does your vendor make the cut?


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Hospital Stage 2 Meaningful Use Attestations Near 77 Percent

Hospital Stage 2 Meaningful Use Attestations Near 77 Percent | EHR and Health IT Consulting | Scoop.it

The most recent update from the Centers for Medicare & Medicaid Services (CMS) puts the percentage of hospitals eligible having successfully attested to Stage 2 Meaningful Use at 77 percent.

In latest monthly meeting of the Health IT Policy Committee, Elisabeth Holland of the CMS Office of E-Health Standards and Services (OESS) reported that 1814 of 2115 eligible hospitals (EHs) had attested to Stage 2 Meaningful Use during the 2014 period as of the first of the year.

In late November, the federal agency extended the 2014 meaningful reporting deadline until December 31, giving these eligible providers an additional month to complete their 2014 meaningful use attestation.

Over that one-month period, the number of EHs successfully attesting for meaningful use reporting year 2014 rose from 3696 to 4093, with the EHs successfully attesting to Stage 2 Meaningful Use increasing from 1681 to 1814.

The total number of hospital attestations is slightly less than last year’s mark of 4112 total attestations for this portion of eligible providers.

During December’s meeting, the federal agency reported that number of EHs having successfully attested to Stage 2 Meaningful Use as of December 1 doubled from 840 to 1681.

The update comes one day after a group of industry associations voiced their support of a reintroduced bill to modify 2015 meaningful use reporting requirements, the Flexibility in Health IT Reporting (Flex-IT) Act of 2015 that would require a 90-day, quarter-based reporting period rather than a full year of reporting this year.

Support for the bill was bolstered by CMS data indicating that one-third of hospitals expected to demonstrate Stage 2 Meaningful Use in 2014 had to file for a hardship exception or meet Stage 1 requirements again, yet these figures and those provided yesterday by CMS do not add up.

Speaking of bad math, there is CMS data on eligible professionals over the same timeframe that raises questions. As of January 1, a total of 76,730 EPs demonstrated meaningful use in 2014, up from 60,561 EPs as of December 1. As for Stage 2, CMS data from the Health IT Policy Committee meeting incorrectly shows a decrease in successful 2014 Stage 2 Meaningful Use attestations — 16,455 to 16,359. (CMS is currently correcting those figures which will be made available shortly.)

The meaningful use attestation deadline for these eligible providers is set for the end of February. The number of EPs attesting to Stage 2 Meaningful Use has ample time to increase.


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