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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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Clinical Documentation Improvement Vital for Patient Care

Clinical Documentation Improvement Vital for Patient Care | EHR and Health IT Consulting | Scoop.it

Clinical documentation improvement programs lie at the heart of quality patient care and should accurately show a patient’s clinical status as well as inform which services were provided. According to the American Health Information Management Association (AHIMA), clinical documentation improvement programs transfer patient’s medical information into coded data, which is then part ofquality reporting, claims reimbursement, public health information, and disease tracking.


Health information management (HIM) professionals work as both coding experts as well as clinical documentation improvement strategists within their organizations to ensure meaningful information is captured.


In particular, clinical documentation improvement experts remain dedicated to ICD-10 implementation and the adoption of strong EHR systems across the healthcare continuum. HIM professionals work to assist physicians in remaining compliant with all patient documentation requirements.


Some policies that need to be followed when implementing clinical documentation improvement programs are hiring staff with the right education, experience, and credentials as well as ensuring ongoing education and training for such staff, according to AHIMA. The major roles that healthcare providers have in ensuring their clinical documentation is solid are reporting medical decision making, diagnostics, treatment plan, and outcomes of tests, treatments, and other procedures.


One partnership that is targeting clinical documentation improvement is Nuance Communications, Inc. and medical care predictive analytics company Jvion, according to a joint press release. The two companies are looking to better assist healthcare providers in meeting the requirements of a value-based reimbursement model.


Many medical facilities will likely experience various challenges when transitioning from a fee-for-service payment model to value-based care. Advanced Practice CDI from Nuance Communications should assist providers in this transition.


“We want to get paid for the quality of care and services we provide,” says Joann Hatton, director of Utilization Management and Clinical Documentation Management at Heritage Valley Health System, in western Pennsylvania. “It’s not about the money, it’s about improving patient care, but the positive financial impact of Nuance’s CDI program was clearly evident.”


When it comes to implementing clinical documentation improvement strategies and clinical quality metrics, Heritage Valley Health System saw a significant drop in their predicted mortality rate. This particular rate decreased by 27 percent after integrating clinical documentation improvement programs.


“Data drives our practice,” explains Jennifer Woodworth, director of Clinical Documentation Integrity Program at Swedish Health Services. “Physician and hospital compensation is tied to quality metrics, which means to prove that you are providing high quality care you need data. This real-time reporting allows us to drill down to ICD-9 and ICD-10 codes, complications and other specialized details to see how we are doing with the accuracy of physician documentation, and this enables us to create proactive initiatives that maximize our current resources.”


As more health IT tools are developed to assist providers with clinical documentation improvement programs, the healthcare industry will be ready to effectively transition to a value-based care payment model.

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Hoping for ICD-11 is “Waiting for Godot,” ICD-10 Coalition Says

Hoping for ICD-11 is “Waiting for Godot,” ICD-10 Coalition Says | EHR and Health IT Consulting | Scoop.it

Clinging on to the current outdated ICD-9 code system until ICD-11 is ready for use at some unspecified point in the future is akin to the endless idle loitering of Vladimir and Estragon in Samuel Beckett’s classic play Waiting for Godot, says the Coalition for ICD-10 in a new opinion piece.  After waiting more than twenty years for the implementation of ICD-10, the healthcare industry simply cannot afford another two or three decades for the newest code set to be finalized and ready for use.

“Based on the World Health Organization’s (WHO) current timeline, ICD-11 is expected to be finalized and released in 2017,” the commentary explains. “For the US, however, that date is the beginning, not the end.  As with every WHO version of the ICD codes, ICD-11 would need to be adapted to meet the detailed payment policy, quality assessment and other regulatory requirements of US stakeholders.”  The country could be waiting until 2041 for the entire pre-implementation process to be completed, the Coalition adds.

Meanwhile, the healthcare industry will be forced to continue to use a significantly outdated code set that cannot account for many emerging health threats or new advances in technologies, diagnoses, and procedures.  That’s just fine with representatives from the American Medical Association (AMA), whose House of Delegates voted to reject an internal report noting that implementing the changes inherent in ICD-10 would provide an important foundation for the eventual adoption of ICD-11.  The report concluded that skipping ICD-10 all together was “not recommended” as a viable course of action, yet the AMA continues its resistance to the ICD-10 codes – and the Coalition continues to fight back against their reticence.

“The US simply cannot wait decades to replace ICD-9, a code set that was developed nearly 40 years ago,” the Coalition states. “US healthcare data is deteriorating while at the same time demand is increasing for high-quality data to support healthcare initiatives such as the Meaningful Use EHR Incentive Program, value-based purchasing, and other initiatives aimed at improving quality and patient safety and decreasing costs.”

The AMA argues that the expense of ICD-10 implementation is overwhelming for smaller physicians struggling keep their doors open, pinning the costs at anywhere from $50,000 to $225,000 for a small provider.  Despite contradictions from AHIMA, the cost of the switch has been a major selling point for opponents.

However, after two one-year delays, the tide seems to be turning in support of ICD-10.  Not only is the Coalition growing, but Congress has stepped in to enforce the idea of a 2015 due date.  Will the wait for Godot be over in October?  The Coalition would certainly like to see an end to the “unending barrage of excuses” and continual delays.

“Waiting for ICD-11 is simply not a viable option,” the blog post concludes. “The absurdity of the endless waiting in Waiting for Godot culminates in frustration: “Let us not waste our time in idle discourse! Let us do something, while we have the chance!” Yes, the wait needs to be over. It’s time to stop wasting time. It’s time to get ICD-10 implemented.”

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