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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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CMS Administrator Welcomes Providers to ICD-10 Compliance

CMS Administrator Welcomes Providers to ICD-10 Compliance | EHR and Health IT Consulting | Scoop.it

On October 1, the healthcare industry began ICD-10 compliance after countless months of preparation. In a CMS post, Deputy Administrator and Director of the Centers for Medicare & Medicaid Services (CMS) welcomed providers to ICD-10 and provided words of guidance to industry stakeholders on the transition day.

According to Cavanaugh, it may take a little while before CMS is able to assess how the transition to ICD-10 is proceeding. The reasons for this are twofold: first, most providers do not file claims on the same day as a service has been provided, and second, it takes a few weeks for CMS to process Medicare and Medicaid claims.


“Even after submission, Medicare claims take several days to be processed, and Medicare -- by law -- must wait two weeks before issuing  payment. Medicaid claims can take up to 30 days to be submitted and processed by states,” Cavanaugh wrote.


It is most likely that CMS will be able to assess ICD-10 progress following the first complete billing cycle. This is consistent with other CMS claims. In aconference call with industry stakeholders which took place a week before the October 1 deadline, CMS Principal Deputy Administrator Patrick H. Conway, MD, MSc, confirmed the same timeline for checking ICD-10 progress.

Until then, Cavanaugh explained, CMS plans to closely monitor the transition. Furthermore, CMS will be managing problems and questions that are submitted to the ICD-10 Coordination Center, which is staffed by several Medicare, Medicaid, billing, coding, and health IT experts to assist during the transition. In addition to the ICD-10 Coordination Center, Cavanaugh points providers toward other ICD-10 assistance resources, including William Rogers, MD, the ICD-10 ombudsman, and Medicare Administrative Contractors (MACs).


Cavanaugh also discussed the potential benefits of the ICD-10 transition, including the promise of more detailed health data reporting and and better healthcare delivery. By increasing the detail with which medical care is reported, policy changes can be more specific to the needs of populations.


“The change to ICD-10 allows you to capture more details about the health status of  your patients and sets the stage for improved patient care and public health surveillance across our country,” he wrote. “ICD-10 will help move the nation’s health care system to better, smarter care.”


These hopes for ICD-10 have been mirrored by many industry stakeholders, including AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, CAE, FACHE, FAHIMA. Thomas Gordon recently stated howICD-10 will be of great benefit for patients because it will allow for better healthcare innovation due to the extensive detail of health records.

“As an active leader, supporter and advocate for ICD-10, AHIMA is pleased that the greater detail inherent in the code set will reverse the trend of deteriorating health data and tell a more complete and accurate patient story,” she said.


As providers continue with their transition to ICD-10, CMS is expected to report any major issues and provide guidance in fostering the smoothest transition possible.

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Is ‘Safe Harbor’ Needed After ICD-10 Implementation Deadline?

Is ‘Safe Harbor’ Needed After ICD-10 Implementation Deadline? | EHR and Health IT Consulting | Scoop.it

As the ICD-10 implementation deadline drew closer, more lawmakers began attempting to develop a different type of transition period in which healthcare providers would not be penalized for reporting inaccurate ICD-10 codes. For example, HR 2247, the ICD-TEN Act, would create a “safe harbor” for providers in which they wouldn’t be denied reimbursement “due solely to the use of an unspecified or inaccurate sub-code.” 


The Coalition for ICD-10 states that the Centers for Medicare & Medicaid Services (CMS) has often accepted less specific codes under ICD-9 and, when the ICD-10 implementation deadline hits, the new reporting requirements will have no difference in level of specificity.


“CMS has reiterated numerous times that their acceptance of unspecified codes will not change as a result of the ICD-10 transition,” the Coalition for ICD-10 explains. “Furthermore, it would be inappropriate and a violation of coding rules to require a level of specificity that is not documented in the medical record. Indeed, CMS has made it abundantly clear that it would be inappropriate to select a specific code that is not supported by the medical record documentation or to conduct medically unnecessary diagnostic testing in order to determine a more specific code.”


Essentially, the ICD-TEN Act was proposed due to physician fears that there may be a significant increase in the number of claim denials once the ICD-10 implementation deadline takes effect.

However, the latest CMS end-to-end testing results show that there is only a 2 percent denial rate of claims due to ICD-10 errors. This shows that the physician fears may be unfounded.


According to the Coalition for ICD-10, a “safe harbor” transition period is not necessary and the current status of the ICD-10 implementation deadline should take effect on October 1 as is.


Additionally, CMS released its acknowledgement testing results taking place between June 1 and June 5. CMS accepted a total of 90 percent of claims submitted across the nation during this time period.

While a 10 percent denial rate is significant, CMS holds that the majority of claim rejections were due to submission errors within the testing environment that won’t affect the processing of claims when real claims are submitted after the ICD-10 implementation deadline.


It is time for providers to be ready for the ICD-10 implementation deadline or else risk having their claims rejected once October 1 hits. Any provider who submits ICD-9 codes after the deadline risks having the claims returned to their facility, returned as unprocessable, or rejected, according to apamphlet from CMS.


“As we look ahead to the implementation date of ICD-10 on October 1, 2015, we will continue our close communication with the Centers for Medicare and Medicaid Services to ensure that the deadline can successfully be met by stakeholders,” House Energy and Commerce Committee Chairman Fred Upton (R-MI) and House Rules Committee Chairman Pete Sessions (R-TX) stated at the end of 2014. ““This is an important milestone in the future of health care technologies, and it is essential that we understand the state of preparedness at CMS.”

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Bracing for ICD-10 Implementation Deadline amid ICD-9 Shortfalls

Bracing for ICD-10 Implementation Deadline amid ICD-9 Shortfalls | EHR and Health IT Consulting | Scoop.it

With the ICD-10 implementation deadline only three and a half months away, it is beneficial for healthcare providers to continue their last-minute preparations for the coming ICD-10 transition. The Centers for Medicare & Medicaid Services (CMS) includes a variety of tools and resources for providers to utilize when getting ready for the ICD-10 implementation deadline.


From the Road to 10 website to videos and expert columns, CMS is working toward preparing healthcare providers for the coming ICD-10 implementation deadline on October 1, 2015. In a video called “ICD-10: Getting from Here to There – Navigating the Road Ahead,” Dr. Ricardo Martinez, Fellow of the American College of American Physicians, discussed how the International Classification of Diseases (ICD) version 10 is a significant improvement over the more outdated ICD-9 codes being utilized across healthcare facilities today.


The video also went over key steps that small medical practices should incorporate when preparing for the ICD-10 implementation deadline. In particular, providers will need to understand how the new codes will differ from the older ICD-9 codes.


“As a practicing physician, I see the limitations of ICD-9 every day and why input from the medical community into the development of ICD-10 has been so valuable,” Martinez explained. “ICD-9 is outdated – even antiquated by today’s practice standards – and it limits the speed and accuracy with which I can gather information, gain insights, and, more importantly, care for my patients.”


“Today, ICD-9 doesn’t even address laterality, which signifies if a condition affects the left or the right limb,” continued Martinez. “On a professional note, when recently faced with a complex patient who had an acute stroke in history of a previous stroke, we had to search through many old records to determine whether that old stroke was left or right side, wasting valuable time that could have been dedicated to patient treatment. With a single code, ICD-10 will provide us with more detail. Better data makes better care possible.”


“To help small provider practices and other healthcare professionals with the transition to ICD-10, the Centers for Medicare & Medicaid Services is actively working with physicians, industry leaders, and others,” Martinez mentioned. “Healthcare has been using the international classification of diseases for over a century to identify and track diseases and help us improve our care for our patients.”


“Although most of the world transitioned to ICD-10 years ago, the currently used version of ICD-9 is fundamentally unchanged since its implementation in the United States in 1979,” Martinez stated. “One major limitation of ICD-9 is that it predates many modern technological advances and clinical terminology reflecting the use of CT scans, for example, which were also invented in 1979. Therefore, an update was necessary to account for these innovations in medicine.”


“For years, practitioners noted the need for increased specificity within clinical terminology, documentation, and coding to accurately represent the care provided to their patients,” Martinez clarified. “Under sponsorship of the World Health Organization (WHO), a group of physicians developed the basic structure for ICD-10. Then, each specialty provided input on the subset of procedure or diagnosis code needed. Addressing both the changes in medicine and the need for increased specificity, ICD-10 will capture greater detail in the clinical encounter for each patient.”

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Does Healthcare Fraud Impact Meaningful Use Audits?

Does Healthcare Fraud Impact Meaningful Use Audits? | EHR and Health IT Consulting | Scoop.it

While the majority of medical providers are preparing for the ICD-10 transition deadline and are utilizing diagnostic coding accurately, there are certainly outliers who have attempted to defraud the healthcare system and the Centers for Medicare & Medicaid Services (CMS). These outliers may even affect the CMS’ stance on meaningful use audits. Former Central Texas Hospital owner Tariq Mahmood is one such individual that has been sentenced to 135 months in federal prison last Monday for submitting false and fraudulent claims to healthcare payers including CMS.

The Cameron Herald reported that Mahmood was ordered to pay $599,128.02 to CMS and Blue Cross Blue Shield of Texas due to the violations of identity theft and fraudulent medical care claims. Mahmood had owned and operated a handful of hospitals across the state of Texas including Lake Whitney Medical Center, Central Texas Hospital in Cameron, Renaissance Terrell Hospital, Cozby Germany Hospital in Grand Saline, and Community General Hospital in Dilley.Meaningful Use Audits

Prosecutors Assistant U.S. Attorneys Nathaniel C. Kummerfeld, Frank Coan and Special Assistant U.S. Attorney Ken McGurk claimed during the trial that Mahmood and other individuals defrauded Medicare and Medicaid from January 2010 to April 2013 by submitting false identities and inexistent diagnoses and treatments.

Currently, ICD-9 diagnostic codes are being utilized by healthcare providers while the ICD-10 coding set will be required to use by October 1, 2015, which is the ICD-10 transition deadline. Mahmood, however, modified and incorrectly sequenced diagnostic codes to reflect the wrong medical conditions and diagnoses of his patients without checking their healthcare records. The names of Medicare beneficiaries and their associated numbers were also incorrectly and fraudulently used.

“Americans enjoy the best health care in the world and the cost for this care is expensive,” U.S. Attorney John M. Bales said in a statement.“What we do not need is providers like Tariq Mahmood who masquerade as physicians who pretend to care about American health care but actually are determined to loot the Medicare Trust Fund. He is now being held to account, and I congratulate the prosecution team for a job very well done.”

Former chief financial officer of the Cameron hospital and the Shelby Regional Medical Center Joe White will also be sentenced for defrauding the government and healthcare payers on Monday, April 27.

White had made a false statement regarding the meaningful use achievements of the Shelby Regional Medical Center and claimed the hospital met relevant meaningful use requirements under the Medicare and Medicaid EHR Incentive Programs. This false statement led to the hospital being awarded $785,655 from Medicare.

Healthcare professionals that defraud the medical payer system along with federal agencies lead to difficulties among honest providers who have successfully met meaningful use requirements and are preparing to accurately and authentically send ICD-10 coding claims to CMS by the ICD-10 transition deadline. For example, current meaningful use audits are burdening a variety of healthcare professionals who have received financial incentives from CMS for meeting relevant meaningful use requirements.

The American Academy of Family Physicians has asked CMS to offer a report that outlines the reasons why some providers have failed the meaningful use audits. Since healthcare fraud is a serious issue across the nation, federal agencies are likely to continue pursuing claims under the EHR Incentive Programs and filing additional meaningful use audits.Since healthcare fraud is a serious issue across the nation, federal agencies are likely to continue filing additional meaningful use audits.

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AMA Urges CMS to Provide Backup Plans for ICD-10 Transition

AMA Urges CMS to Provide Backup Plans for ICD-10 Transition | EHR and Health IT Consulting | Scoop.it

What would happen to a medical practice that has one in five of its Medicare claims not properly processed by the Centers for Medicare & Medicaid Services (CMS)? It could lead to a serious financial disruption and strain the budgets of most medical facilities. However, this is just the scenario that could occur on Oct. 1, 2015 when the country carries out the ICD-10 transition if CMS does not develop suitable contingency plans.

The American Medical Association (AMA) and 99 other specialty groups from around the country called for CMS to develop contingency plans for the anticipated failures once the nation transitions to the ICD-10 code set, according to an AMA press release.

The impact to the healthcare sector upon ICD-10 implementation could be severe, leading to a multi-billion dollar disruption and significant access to care problems for Medicare patients. The latest end-to-end testing results show that the Medicare claims acceptance rate would decline from 97 percent to just above 80 percent if ICD-10 implementation occurred today.

Even this percentage on its own could lead to an accumulation of millions of unpaid Medicare claims, which would severely damage the financial outlook of the healthcare industry. However, since the end-to-end ICD-10 testing only speaks for about 1 percent of all Medicare providers, the acceptance rate in actuality may be lower, depending upon how prepared the country is for the ICD-10 transition by October 1.

“The likelihood that Medicare will reject nearly one in five of the millions of claims that go through our complex health care system each day represents an intolerable and unnecessary disruption to physician practices,” AMA President Robert M. Wah, M.D., said in a public statement. “Robust contingency plans must be ready on day one of the ICD-10 switchover to save precious health care dollars and reduce unnecessary administrative tasks that take valuable time and resources away from patient care.”

Along with creating contingency plans, the AMA and other groups are asking CMS to consider how the ICD-10 transition will impact the Physician Quality Reporting System (PQRS) and meaningful use requirements.

The reporting periods for both meaningful use and PQRS will take place more than three-quarters into the calendar year, which means the 2015 reporting data will use both ICD-9 and ICD-10 codes. This will be especially confusing for providers that are treating patients for the same condition right before and right after the October 1 deadline.

The AMA President Dr. Wah continued by explaining that the federal government may be “underestimating the impact” of ICD-10 implementation on providers that are already being encumbered by the many healthcare regulations currently in place. The AMA is focused on reducing burden on physicians and ensuring enough information is given regarding the effects of the ICD-10 transition. A major goal of the AMA is to confirm physicians are able to avoid Medicare payment penalties.

A total of 100 physician groups are asking CMS to provide contingency plans for the anticipated issues of the ICD-10 transition. Having plans in place can help avoid the potential backlog of millions of unpaid Medicare claims once ICD-10 implementation occurs.


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CMS Confirms Readiness to Assist During ICD-10 Transition

CMS Confirms Readiness to Assist During ICD-10 Transition | EHR and Health IT Consulting | Scoop.it

The ICD-10 compliance deadline of October 1 is less than a week away, creating a frenzy of preparation amongst coders, billers, and providers. The Centers for Medicare & Medicaid Services (CMS) senior officials recently held a conference call to answer questions regarding implementation, and specifically addressed the issue of CMS as a resource come October 1.


The September 24 call included CMS Principal Deputy Administrator Patrick H. Conway, MD, MSc, and ICD-10’s recently appointed ombudsman William Rogers, MD.


The bulk of the call consisted of a question and answer session which generally revolved around the roll of CMS as a resource for clinician practices experiencing issues with transition. Specifically, many callers were concerned with the potential government shutdown that could occur on October 1 if Congress cannot reach an agreement on the federal budget.


“In the event of a shutdown, we will continue -- and I want to be clear on this -- to pay claims,” Conway said. “We will continue to implement the ICD transition.”


Rogers made it clear that the Medicare administrative contractors (MACs) would still be working in the event of a shutdown, so claims will be accepted and paid during that time.


Conway elaborated on that point during another question, stating that payment systems are an essential part of the Medicare program and would still function in the event of a shutdown.


“In terms of staffing, we do have the flexibility to ensure core operations are operational and in effect,” Conway stated. “And obviously, our payment systems are a core piece of the Medicare program that will continue to be fully operational.”


Conway also addressed the issue of claims processing timelines and how that will affect real-time assessments of the transition. Although it would be ideal for CMS to have a clear idea of the state of the transition as soon as it occurs, Conway explains that due to the typical billing timeline, it will in reality take about one billing cycle.


“The Medicaid claims can take up to 30 days to be submitted and processed,” he said. “This end can take approximately two weeks. The Medicaid claims can take up to 30 days to be submitted and processed. For this reason, we expect to have more detailed information after a full billing cycle is complete.”


The questions on the call revolved around the cost of ICD-10 implementation, especially considering systems upgrades. According to Conway, the cost greatly relied on the specific circumstance of the practice or facility. Rogers shed light on the costs for smaller practices.

“[M]ost smaller practices just use a super bill,” Rogers explained. “t requires a little bit of an expansion of the number of diagnoses on the superbill. But they can easily cross walk their ICD-9 based super bill to an ICD-10 super bill.”


Rogers also assured callers that CMS has ample resources to ensure a smooth transition, and that they themselves will be able to serve as a resource for clinician practices. He explained that he, along with all of CMS, can serve as a major resource for providers who have questions regarding the transition process, and encourages providers to contact the ombudsman email address when in need of assistance.

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ICD-10: CMS won't deny claims for first year

ICD-10: CMS won't deny claims for first year | EHR and Health IT Consulting | Scoop.it

In a surprise concession, the Centers for Medicare & Medicaid Services announced Monday that it would work with the American Medical Association on four steps designed to ease the transition to ICD-10.


Despite longtime disagreements on the topic, CMS will now adopt suggestions made by none other than the AMA with regard to the code set conversion. Those changes concern:


1. Claims denials. "While diagnosis coding to the correct level of specificity is the goal for all claims, for 12 months after ICD-10 implementation, Medicare review contractors will not deny physician or other practitioner claims billed under the Part B physician fee schedule through either automated medical review or complex medical record review based solely on the specificity of the ICD-10 diagnosis code as long as the physician/practitioner used a valid code from the right family," CMS officials wrote in a guidance document.


2. Quality reporting and other penalties. "For all quality reporting completed for program year 2015 Medicare clinical quality data review contractors will not subject physicians or other Eligible Professionals (EP) to the Physician Quality Reporting System (PQRS), Value Based Modifier (VBM), or Meaningful Use 2 (MU) penalty during primary source verification or auditing related to the additional specificity of the ICD-10 diagnosis code, as long as the physician/EP used a code from the correct family of codes," CMS explained. "Furthermore, an EP will not be subjected to a penalty if CMS experiences difficulty calculating the quality scores for PQRS, VBM, or MU due to the transition to ICD-10 codes."


3. Payment disruptions. “If Medicare contractors are unable to process claims as a result of problems with ICD-10, CMS will authorize advance payments to physicians,” AMA president Steven Stack, MD, noted in a viewpoint piece on the group’s website.


4. Navigating transition problems. CMS intends to create a communication center of sorts, including an ICD-10 Ombudsman, "to help receive and triage physician and provider issues." The center will also "identify and initiate"resolution of issues caused by the new code sets, officials added. 


"These provisions are a culmination of vigorous efforts to convince the agency of the need for a transition period to avoid financial disruptions during this time of tremendous change," wrote Stack.


While AMA played a pivotal role in bringing about these CMS concessions, it was not the only party calling for a smoother conversion to the new code set.


Some members of the U.S. Congress have publicly suggested a dual-coding conversion period wherein CMS would accept and process claims in both ICD-9 and ICD-10. Instead of dual coding, CMS indicated that "a valid ICD-10 code will be required on all claims starting Oct. 1, 2015."


So as things stand today, providers have to use ICD-10 come October – but CMS will be more flexible about denials and payments than it has previously suggested it would be.

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Three Steps to Follow Before ICD-10 Conversion Deadline

Three Steps to Follow Before ICD-10 Conversion Deadline | EHR and Health IT Consulting | Scoop.it

If any providers still think there will be another ICD-10 delay, they may be mistaken. The ICD-10 conversion is moving forward and a full implementation will take place on October 1, 2015. The Healthcare Information and Management Systems Society (HIMSS) reports that this major diagnosis coding change is coming in less than five months and providers need to be prepared for the ICD-10 conversion.


Providers will need to be ready to use ICD-10 codes on claims and other transactions with health insurers in order to be adequately reimbursed. The Centers for Medicare & Medicaid Services (CMS) will not be accepting any claims that used ICD-9 coding after October 1, which means providers that utilize old codes will not be paid.


While there are many healthcare providers that have taken the necessary steps to prepare for the ICD-10 conversion deadline, a WEDI survey and other reports illustrate that a significant number of healthcare organizations have not gone forward with preparing for the ICD-10 implementation.


HIMSS states that providers who haven’t taken the necessary steps need to devote as much time as possible over the next few months to prepare for the ICD-10 conversion and conduct testing, upgrading and training in the limited time before October. There are three steps that HIMSS suggests providers follow in order to prevent any major issues with their revenue cycle after the deadline passes.


Identify the Top Medical Conditions


Every healthcare organization has several common conditions that their patients are afflicted with. To prepare for the ICD-10 conversion, it’s vital to identify these diseases and find the corresponding coding set of each. The most common conditions are associated with the largest net of revenue for medical facilities, which is why understanding the documentation of these health problems is so vital.


Hospital coders and claim submitters need to know the key documentation information to ensure they select the right ICD-10 code. Processes surrounding data capture, documentation, and recording will need to be updated to correspond with the new coding set.


Upgrade Health IT Systems


In preparations for the ICD-10 conversion, one of the most important tasks to complete is to update all health IT systems within an organization for ICD-10 capability. If a vendor handles IT updates, be sure they have come to install and test the latest versions of their software, HIMSS explains.


If an internal team handles health IT updates, be sure they have gone forward with all relevant installations especially with coding, documentation, and billing systems. All staff affected by the ICD-10 conversion will also need to be trained before the deadline.


Conduct Internal and External Partner Testing


After all systems are upgraded to the new coding set, it’s vital to conduct ICD-10 testing procedures both on the internal side and with external partners. Dual coding of incoming patients could be very useful information. Additionally, “dummy claims” in which false patient scenarios are incorporated can help test updated systems before the ICD-10 deadline. Any issues that may come up during testing should also be adjusted before October 1. It’s vital to follow these steps and prepare for the ICD-10 conversion before time runs out.


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State Hospitals Go Digital for ICD-10 Compliance Deadline

State Hospitals Go Digital for ICD-10 Compliance Deadline | EHR and Health IT Consulting | Scoop.it
In order to prepare for the ICD-10 compliance deadline by October 1, medical facilities will need to integrate revenue cycle and EHR systems that follow the new coding set. The State of Washington Department of Social and Health Services (DSHS) recently announced their association with health IT supplier Cerner Corporation to revolutionize their revenue cycle systems and EHR technology in order to better align with ICD-10.

Recently Victoria Roberts, Deputy Assistant Secretary at DSHS, and Justin Dickey, Consulting Practice Director at Cerner, spoke with EHRIntelligence.com to discuss their collaboration further and better prepare providers for the ICD-10 compliance deadline. The two individuals began by discussing how the collaboration will lead to better preparedness for the ICD-10 transition.147504495

“In Washington state, we have two state hospitals that are each about 100 years old and a much newer child study and treatment center. Within those 100 years, these facilities have all worked very independently. They are still very dependent on paper systems,” Roberts explained. “This project is allowing us to really look at how to work with continuity between hospitals, develop more consistent policy and practice, and bring the hospitals into the current century.”

Justin Dickey added: “Our teams are coming together to focus on standardizing workflow and developing a standardized tool set with the Cerner Millennium clinical and revenue cycle platform. More than technology, this is a lot about organizational change management and making sure we have the training programs in place to facilitate the use of the tool set we’re delivering.”

The integration of these health IT tools such as the revenue cycle system will play a key role in improving patient safety and quality of care. Victoria Roberts expanded on this goal.

“The biggest [part of this] is how we share information across shifts and across wards about individual patients,” Roberts said. “One of the things that I’ve been pushing forward is finding a way [to help] nurses and mental health technicians immediately see through the Cerner system the alerts they need to pay attention to.”

“Right now in our facilities, we continue to use white boards and white boards aren’t always updated as they should be. Sometimes things happen at 10 o’clock in the morning that don’t get communicated to the shift that comes at 3 o’clock in the afternoon. The hope is that through the Cerner system that information can be entered into the EHR and then communicated out through the alert board.”

Roberts went on to explain how allergy and medication alerts play a role in helping physicians provide safe care. Cerner representative Justin Dickey mentioned that “a task-driven clinical workflow allows [Cerner] to ensure they’re leading clinicians down the right path and also to have a mechanism that measures the quality of documentation as care is progressing through the organization.”

While the health IT tools are used in collaboration to increase the quality of care, they are also impacting the revenue cycle and ensuring that the document quality of claims are up to high standards. The two individuals went on to speak about solutions they’re incorporating to prevent any issues once the ICD-10 compliance deadline takes hold.

“One of the [solutions] we’re dependent on is the dashboard report,” Roberts said. “This allows us to understand the workflow and how well different staff are adopting to the model.”

“Our toolset has a physician dashboard that allows us to zero in on clinicians’ usability experience,” said Justin Dickey. “It identifies the areas where we may need to increase training and assist [promoting] workflow. The dashboard helps track problem areas and gives a tool set that shows what to focus on and issue remediation.”

While incorporating new health IT systems is necessary for the ICD-10 transition, providers are also concerned about other areas with regard to the upcoming ICD-10 compliance deadline. Many fear delayed payments and claim rejections from the Centers for Medicare & Medicaid Services (CMS). Victoria Roberts and Justin Dickey spoke about best practices to follow in order to avoid these issues during the ICD-10 compliance deadline.

“From the state perspective, it’s really anticipating and planning for the training curve that will take for the staff to support the implementation. We’re going from a primarily paper system to an electronic system with staff who rarely have need to even check e-mail,” Roberts explained. “It’s figuring out how to invest and support the staff during the transition.”

Justin Dickey added that Cerner is “helping define those workflows and giving the tools necessary to manage denials and throughput [as well as] giving a visual of what’s happening through the care process and payment process.”

The new EHR systems that DSHS will be using include a diagnostic assistance tool that includes natural language clinicians can easily understand. It provides a simple way to find the right diagnostic coding at the needed specificity instead of forcing physicians to search through a large variety of codes.

“The natural language helps clinicians choose and navigate down to the appropriate level of specificity within the ICD-10 code set,” Justin Dickey mentioned.
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