Monthly Archives: May 2014

WEDI Emergency ICD-10 Summit Highlights

After the ICD-10 compliance date was officially moved back at the beginning of April, WEDI organized an emergency ICD-10 Summit in Reston, VA on April 30 to bring folks from different sectors of the industry together and formulate a roadmap of where all as a whole should go next w/this change in date.  Several of us from Consulting Services attended this session.  Many thanks to Peggy Honts for writing up a summary of what transpired at this meeting.  -GP

WEDI ICD-10 Summit: Developing an Industry Action Plan for ICD-10 Implementation

AXIOM attended the WEDI emergency ICD-10 Summit focused on the announced delay and how the industry can moved forward.  Approximately 200 people participated with 100 in the room and the others on-line.  The summit was divided into four sections:

  • What are the real underlying issues?
  • Impact & Unintended Consequences of the delay to all industry stakeholders
  • Building the industry roadmap forward
  • Next steps for WEDI and the industry

A great deal of the discussion centered on getting CMS to announce the new compliance date.  The day after the meeting did in fact announce that October 1, 2015 would be proposed new date Public display copy of the 2015 IPPS NPRM may be found at https://s3.amazonaws.com/public-inspection.federalregister.gov/2014-10067.pdf.  The statement on page 648 of the proposed rule speaks to the new date.

Since the above announcement the issue of CMS announcing the date is off the table.  Below is a summary of the key points with a link to the full summit minutes.

The key underlying issue was the credibility of the new date. It has been changed several times before and in light of the fact the last delay was a result of Congress and not CMS there is a high level of uncertainly and credibility in the new date.  The only way to build credibility is gain endorsement from the people opposing ICD-10 and find ways to get the industry prepared for the new date.  If the industry believes and is prepared, there should not be a reason for a further delay.

The foundation of an industry roadmap forward was discussed and needs to be discussed further to assure the industry is committed to common objectives, approaches and the compliance date.  The roadmap will include defining ways to remove or mitigate barriers and identifying a value proposition to gain buy-in.  If these root cause issues are not addressed we will be faced with the same problem next October.

In addition to the roadmap, the summit recognized the consequences and impacts for those organizations that were ready or would be ready this year.  20 plus States have passed legislation to mandate the use of ICD-10 codes for Workers Compensation carriers.  (These are currently non-HIPAA covered entities and not being mandated by CMS to use ICD-10).  Most organizations need to re-evaluate their plans and roll-back some of their function or processes.  This effort will come at a cost and perhaps a large cost to many organizations.

Ideas to move the industry forward include:

  • Clarify Terminology.  There is much confusion between the differences between dual processing versus dual coding and run-off claims.
  • Outreach and Messaging.  There is a real need to develop and deliver more positive communication regarding ICD-10 versus the negative and funny jokes that have been  communicated in the media and the internet, e.g. ICD-10 diagnosis codes for running into a lamp post.  Otherwise, in a year we could still be in the same position we are today.  We have to do a better job engaging those that are resistant to ICD-10 today.
  • Testing.  It was acknowledged that all entities in healthcare will not be able to test with everyone.  It was agreed that a more effective approach to testing needs to be determined.
  • Vendor Readiness.  One of the underlying issues was the lack of some vendors not being ready in time to support testing.
  • Milestones to Implementation.  One idea was to develop a new milestone plan for each type of stakeholder with criteria in order to determine if you had met the milestone.

A report is to be published on the summit but below is the link to the WEDI site that contains notes captured during the session.   http://www.wedi.org/knowledge-center/resource-view/resources/2014/05/06/notes-from-icd-10-summit-developing-an-industry-action-plan-for-icd-10-implementation

Boston Marathon Bombing Aftermath: How an Area Hospital’s Workflow and EMR Handled It

Most of us at Axiom have limited experiences w/the provider side of the industry.  I know that was the case for me before I went to work at a major hospital in the Atlanta area implementing Epic a few years ago.  Here’s an interesting article about how Brigham and Women’s Hospital in Boston handled the influx of the Boston Marathon bombing victims and how they are using this to better refine their workflow and supporting technologies (including their EMR) to better handle these mass casualty incidents.

Patient-Centered Medical Homes: Success Story?

Patient-Centered Medical Homes (PCMH) are increasingly being looked at to coordinate care between disparate providers all for the purpose of better quality of care for the patient at a reduced cost.  Think of it as having a central person (usually a nurse practitioner or a PCP) acting as the quarterback coordinating the patient’s healthcare needs.  An article published in the Journal of the American Medical Association (JAMA) showed it was hard to show a direct connection to improved quality measures and controlling of costs.  In this article, it goes into further detail in this controlled study published in JAMA as well as results from another PCMH where they have seen improved measures and controlling of costs in their participants.

Cover Oregon to be Run on Healthcare.gov, State Panel Recommends

As mentioned in previous blog postings, Oregon’s state-run exchange, Cover Oregon, had a disastrous rollout and is still not running as of date.  The board of the exchange has recommended using healthcare.gov instead of completely overhauling the state-run site.  This has support from the Obama administration.

 

ACA 2.0: What’s Next?

From previous articles, we know the last enrollment numbers posted after the first open enrollment period that ended in March was a little north of 7.1 million.  Now that the ACA is officially live and in living color, what is next for it?  Typically, an implementation will have a deployment period where any bugs or fixes are made in a production environment.  Anything outside of go-live issues are considered enhancements and done as an optimization.  Here are some thoughts for what could be in store for the ACA in the coming months.