Wendi Klein, Director of Marketing & Communication, North America, A2iA
Since reform and regulation have stirred the industry, it has become an even more complex environment, though the goal is to streamline processes. In the wake of healthcare reform, healthcare IT has been forced to comply with new regulations, and healthcare IT needs have shifted. The U.S. government has set forth dates and deadlines by which providers and payors must meet certain milestones, placing emphasis on obtaining meaningful use of patient data, the availability and recovery of data to increase productivity and enhance patient care, as well as the industry’s transition from ICD-9 to ICD-10.
Given this complex and changing environment, healthcare IT providers must focus on implementing solutions that will meet users’ needs today and in the future, while maximizing existing spending to deliver an ROI. But with so many vendors trying to make a name for themselves, how can one stand out from the competition yet still deliver technology that meets government mandates?
CCHIT certified solutions, for example, are becoming more and more common since this is how the Department of Health and Human Services deems a system a "qualified EMR." However, many CCHIT solutions today still require manual document sorting and data entry because of the complex nature of healthcare documents. Hospitals and clinics alike are looking for ways around this, as it is no secret that manual document handling is a time consuming and expensive task, and even allows for breaches in privacy with the involvement of third-parties.
By partnering with technology companies that provide advanced indexing and data lifting capabilities, CCHIT certified solutions can address these pain points by removing the human interaction and allowing for higher levels of productivity, consequently differentiating themselves from the competition. By allowing complex and even handwritten documents such as provider notes, clinical documentation, lab results or prescriptions to enter the workflow, automatic routing to EHR, EMR or PM solutions can occur, and the data can be automatically located and lifted. Tangible results are seen almost immediately, and the CCHIT solution stands out from seemingly similar applications by providing a greater level of automation for all documents, regardless of their type or complexity.
Once these complex documents are incorporated into the EHR, EMR or PM solution, the next steps, like coding and billing, can occur. According to a recent study, between 5 and 15 percent of a coder’s time is spent reading health information, and 50 percent of a record clerk’s time is spent looking for information. ICD-9 is currently an accepted set of codes to be used for reporting diagnoses and procedures on healthcare transactions, although it must be replaced by ICD-10 no later than October 2013.
Because ICD-10 contains nearly 5 times as many codes and sub-codes, the conversion from ICD-9 to ICD-10 is predicted to decrease productivity by a minimum of 25 percent for three to six months after the transition as coders adjust to new methodology, and become a more costly endeavor than Y2K in terms of both time and money.
Although the deadline to transition to ICD-10 is not until 2013, many have already started to look for solutions to counteract the predicted loss of efficiency. Computer Assisted Coding, or CAC solutions, can help, but many are still asking, “How will coders remain productive as they learn the new codes and sub-codes so that providers can submit and receive payments, and payors can process claims, at the same level of accuracy and speed that they are today?”
Because of these fears and the anticipated decrease in efficiency, there is a large opportunity for technology that can aid in the transition process. Newer, advanced solutions can bring greater levels of automation, help to increase processing times and accuracy, and even save money. By enhancing CAC solutions with capabilities that can automatically locate and lift medical terms and diagnoses from both printed and handwritten documents, such as providers notes and clinical documentation, the research process is sped up and manual labor decreased as codes are automatically assigned. All coded documents can then be indexed and routed with virtually no human interaction to the appropriate EHR, EMR or PM solution, speeding productivity, guaranteeing automation, and aiding in the research and coding process.
Healthcare data management is a complex world, and no one knows what changes are on the horizon. Current solutions can certainly aid in productivity, but combining them with the capabilities of newer, advanced technology, today’s pain points can be lessened, automation improved, and tomorrow’s fears calmed.
What do you think?
Showing posts with label ICD-10. Show all posts
Showing posts with label ICD-10. Show all posts
Monday, April 18, 2011
Friday, October 1, 2010
ICD-10, EHRs Take Center Stage at AHIMA
Posted by Mark Brousseau
AHIMA's 82nd Annual Conference and Exhibit, held this week at the Gaylord Palms Hotel and Convention Center in Orlando, Florida, may not have featured "Earth-shattering new products" or "game-changing players," but it did have something that made exhibitors smile: better booth traffic.
"I can't say that I saw any new products at AHIMA," says exhibitor Greg Lusch (glusch@ibml.com), ibml's (www.ibml.com) business development manager for healthcare. But attendance at the event -- which draws coders, transcriptionists and other medical records professionals -- was noticeably higher than in recent years, Lusch adds, resulting in a steady stream of potential buyers visiting the Birmingham, Alabama-based company's booth. He attributes the increased buying interest to the "loosening economy" and strong demand for ICD-10 and electronic health records (EHR) solutions.
"There was a sense among the exhibitors that attendees had a little more money to spend," he says.
If the AHIMA conference is any indication, healthcare providers will spend a lot of that money on ICD-10 initiatives. In 2013, the U.S. healthcare system will transition from ICD-9 to ICD-10 as the HIPAA mandated code set for medical symptoms and procedures. This code set is used for billing and health insurance reimbursement, as well as statistical analysis, clinical, epidemiological and quality reporting. As a result of this transition, Lusch notes that the number of diagnosis codes will swell from 13,000 to 68,000, while the number of procedure codes will soar from 3,000 to 87,000.
"ICD-10 was by far the hottest topic at AHIMA," Lusch says. "Many attendees were there to better understand how to deal with ICD-10; how to make the transition from ICD-9 to ICD-10, what tools and updates were available to help streamline the process, and, in many cases, to find third-party services to help them figure it all out. Clearly, this was a major area of focus for AHIMA attendees."
The other area of focus for many AHIMA attendees was the conversion to EHRs. Lusch notes that in addition to hospitals and large practices -- which have been showing increasing interest in EHR solutions at conferences throughout the year -- a number of service bureaus were at AHIMA sizing up the potential opportunity, looking for EHR solutions of their own, or offering conversion services. "There is no question that more service bureaus are jumping on the EHR bandwagon, offering to scan medical records on behalf of healthcare providers. They clearly believe there is a lot of scanning business out there."
Interestingly, Lusch noted that many of the large EHR solutions vendors did not exhibit at AHIMA.
Noticeably absent from most of the exhibit hall banter was any talk of health reform. That's not to say that it didn't come up during some sessions. But Lusch thinks AHIMA attendees were "too consumed" with the major tasks of ICD-10 and EHRs to focus on the uncertainties of reform.
AHIMA's 82nd Annual Conference and Exhibit, held this week at the Gaylord Palms Hotel and Convention Center in Orlando, Florida, may not have featured "Earth-shattering new products" or "game-changing players," but it did have something that made exhibitors smile: better booth traffic.
"I can't say that I saw any new products at AHIMA," says exhibitor Greg Lusch (glusch@ibml.com), ibml's (www.ibml.com) business development manager for healthcare. But attendance at the event -- which draws coders, transcriptionists and other medical records professionals -- was noticeably higher than in recent years, Lusch adds, resulting in a steady stream of potential buyers visiting the Birmingham, Alabama-based company's booth. He attributes the increased buying interest to the "loosening economy" and strong demand for ICD-10 and electronic health records (EHR) solutions.
"There was a sense among the exhibitors that attendees had a little more money to spend," he says.
If the AHIMA conference is any indication, healthcare providers will spend a lot of that money on ICD-10 initiatives. In 2013, the U.S. healthcare system will transition from ICD-9 to ICD-10 as the HIPAA mandated code set for medical symptoms and procedures. This code set is used for billing and health insurance reimbursement, as well as statistical analysis, clinical, epidemiological and quality reporting. As a result of this transition, Lusch notes that the number of diagnosis codes will swell from 13,000 to 68,000, while the number of procedure codes will soar from 3,000 to 87,000.
"ICD-10 was by far the hottest topic at AHIMA," Lusch says. "Many attendees were there to better understand how to deal with ICD-10; how to make the transition from ICD-9 to ICD-10, what tools and updates were available to help streamline the process, and, in many cases, to find third-party services to help them figure it all out. Clearly, this was a major area of focus for AHIMA attendees."
The other area of focus for many AHIMA attendees was the conversion to EHRs. Lusch notes that in addition to hospitals and large practices -- which have been showing increasing interest in EHR solutions at conferences throughout the year -- a number of service bureaus were at AHIMA sizing up the potential opportunity, looking for EHR solutions of their own, or offering conversion services. "There is no question that more service bureaus are jumping on the EHR bandwagon, offering to scan medical records on behalf of healthcare providers. They clearly believe there is a lot of scanning business out there."
Interestingly, Lusch noted that many of the large EHR solutions vendors did not exhibit at AHIMA.
Noticeably absent from most of the exhibit hall banter was any talk of health reform. That's not to say that it didn't come up during some sessions. But Lusch thinks AHIMA attendees were "too consumed" with the major tasks of ICD-10 and EHRs to focus on the uncertainties of reform.
Thursday, September 30, 2010
Healthcare Payables: From Bad to Worse?
By Amer Khan (akhan@egisticsinc.com) of eGistics (www.egisticsinc.com)
Effectively managing the payables process is a big job for most companies, but for healthcare organizations, it is a particularly tall order -- and it's about to get a lot more challenging.
The problem in managing healthcare payables stems from the byzantine network of buyer and seller relationships employed by most healthcare organizations, combined with the increasingly complex procurement processes and contracts that healthcare organizations use to purchase goods and services. Every day, the typical healthcare organization receives a mountain of invoices from many different suppliers, most under different contracts with potentially different payment arrangements.
When you mix in the unusually high number of suppliers that most healthcare organizations use -- a hospital might have thousands of suppliers compared to a few dozen for a big law firm -- you can see how the payables process can quickly become complicated. For instance, on a given day, a hospital might receive invoices for everything from Band-Aids to the pricey cardiology equipment it leases.
The healthcare industry's attempts to address the inefficiencies of the payables continuum have delivered mixed results. Several years ago, group purchasing organizations (GPOs) started sprouting up, allowing healthcare organizations to buy a range of goods and services from a single entity, rather than dealing with multiple vendors. While GPOs have enabled their customers to maximize discounts and reduce the number of vendors they do business with, there are still many cases where healthcare providers must source goods and services directly (such as buying from local suppliers), meaning they still must maintain a high number of supplier relationships.
Here's the scary part: the problem is likely to get worse. Every innovation in the healthcare industry -- whether it's new technologies, new devices or new drugs -- may create more suppliers, generating more invoices, contracts, payment arrangements, and, in some cases, acquisition channels. With our nation focusing like never before on innovations in healthcare, providers have no time to waste.
And while healthcare organizations are focusing tremendous amounts of time and resources on "big issues" such as meeting new requirements for electronic health records (EHRs) and ICD-10, driving down the costs associated with payables can deliver significant benefits as well, and in short order.
So, how can healthcare organizations accomplish this?
Since manual processes don't scale, the healthcare industry will need to rethink its approach to payables. The answer starts with eliminating paper at the earliest point possible in the process.
Whether it's converting paper invoices to electronic images, or convincing business partners to provide electronic invoices in the first place, eliminating paper simplifies and automates the payables process. It allows healthcare providers to apply automated rules for processing, and to initiate an electronic payment with detailed remittance information so the supplier can automatically post the receivables. With these types of solutions, providers can solve their current business challenges and lay a solid foundation to manage the increasingly complex payable environment that is sure to come.
What do you think?
Effectively managing the payables process is a big job for most companies, but for healthcare organizations, it is a particularly tall order -- and it's about to get a lot more challenging.
The problem in managing healthcare payables stems from the byzantine network of buyer and seller relationships employed by most healthcare organizations, combined with the increasingly complex procurement processes and contracts that healthcare organizations use to purchase goods and services. Every day, the typical healthcare organization receives a mountain of invoices from many different suppliers, most under different contracts with potentially different payment arrangements.
When you mix in the unusually high number of suppliers that most healthcare organizations use -- a hospital might have thousands of suppliers compared to a few dozen for a big law firm -- you can see how the payables process can quickly become complicated. For instance, on a given day, a hospital might receive invoices for everything from Band-Aids to the pricey cardiology equipment it leases.
The healthcare industry's attempts to address the inefficiencies of the payables continuum have delivered mixed results. Several years ago, group purchasing organizations (GPOs) started sprouting up, allowing healthcare organizations to buy a range of goods and services from a single entity, rather than dealing with multiple vendors. While GPOs have enabled their customers to maximize discounts and reduce the number of vendors they do business with, there are still many cases where healthcare providers must source goods and services directly (such as buying from local suppliers), meaning they still must maintain a high number of supplier relationships.
Here's the scary part: the problem is likely to get worse. Every innovation in the healthcare industry -- whether it's new technologies, new devices or new drugs -- may create more suppliers, generating more invoices, contracts, payment arrangements, and, in some cases, acquisition channels. With our nation focusing like never before on innovations in healthcare, providers have no time to waste.
And while healthcare organizations are focusing tremendous amounts of time and resources on "big issues" such as meeting new requirements for electronic health records (EHRs) and ICD-10, driving down the costs associated with payables can deliver significant benefits as well, and in short order.
So, how can healthcare organizations accomplish this?
Since manual processes don't scale, the healthcare industry will need to rethink its approach to payables. The answer starts with eliminating paper at the earliest point possible in the process.
Whether it's converting paper invoices to electronic images, or convincing business partners to provide electronic invoices in the first place, eliminating paper simplifies and automates the payables process. It allows healthcare providers to apply automated rules for processing, and to initiate an electronic payment with detailed remittance information so the supplier can automatically post the receivables. With these types of solutions, providers can solve their current business challenges and lay a solid foundation to manage the increasingly complex payable environment that is sure to come.
What do you think?
Sunday, February 28, 2010
The ICD-10 Challenge
By Mark Brousseau
“ICD-10 is probably one of the biggest changes to occur in health IT in 30 years,” Dr. Joe Nichols, Edifecs medical director, told attendees at the Medical Banking Project Boot Camp this afternoon at HIMSS10 in Atlanta. “It is massive.”
ICD codes, which were developed for coding institutionally related procedures, are maintained by the World Health Organization (WHO). Most developed countries other than the United States use ICD-10, Nichols noted. The United States still uses ICD-9 codes. The international version of ICD-10 contains approximately 12,400 diagnostic codes. WHO approved the U.S. version of ICD-10, which contains approximately 69,000 codes.
As of October 1, 2013, all claims in the United States must use ICD-10.
Why is this so important? Because ICD-10 is a cornerstone of healthcare information, Nichols said. “It is the standard for defining the health state of the patient, and the institutional procedures that patients may receive to maintain or improve their health state,” he explained. “This is a big change in the coding system.” What was 14,300 codes under ICD-9 will rise to 69,000 codes under ICD-10, Nichols noted, with the number of procedure codes increasing from 3,800 to 72,000 under ICD-10.
With ICD codes pervasive throughout most health systems, and many business functions impacted by the codes, it is important that healthcare organizations have plan for supporting ICD-10 codes.
“ICD-10 codes are used for a lot of things,” Nichols said. As examples, he mentioned: actuarial and financial risk; adjudication; outcomes; population health analysis; benefits design; fraud, waste and abuse analysis; quality and efficiency assessment; medical policies and clinical guidelines; payment rules; clinical history; utilization; and regulatory reporting. “We based a lot of our national policies on this,” Nichols said. “The implications are far-reaching. Imperfect mapping from ICD-9 to ICD-10 will affect processing and analytics in a way that impacts revenue, costs, risk and relationships.”
So how do you deal with this?
“If you haven’t started now, you’re going to be behind the gun,” Nichols said. But organizations need to look at their short-term goals with a long-term vision, to determine what solutions they need today, and whether those solutions will meet future needs. Organizations also need to be aware of ICD-10’s touch points with other initiatives, and the potential downstream impacts of the change. And they should collaborate with business and trading partners as they develop their ICD-10 plans. Finally, organizations should use ICD-10 to try to position themselves for competitive advantage. “There are huge competitive advantages to using ICD-10 better than your competitors,” Nichols explained.
“ICD-10 is probably one of the biggest changes to occur in health IT in 30 years,” Dr. Joe Nichols, Edifecs medical director, told attendees at the Medical Banking Project Boot Camp this afternoon at HIMSS10 in Atlanta. “It is massive.”
ICD codes, which were developed for coding institutionally related procedures, are maintained by the World Health Organization (WHO). Most developed countries other than the United States use ICD-10, Nichols noted. The United States still uses ICD-9 codes. The international version of ICD-10 contains approximately 12,400 diagnostic codes. WHO approved the U.S. version of ICD-10, which contains approximately 69,000 codes.
As of October 1, 2013, all claims in the United States must use ICD-10.
Why is this so important? Because ICD-10 is a cornerstone of healthcare information, Nichols said. “It is the standard for defining the health state of the patient, and the institutional procedures that patients may receive to maintain or improve their health state,” he explained. “This is a big change in the coding system.” What was 14,300 codes under ICD-9 will rise to 69,000 codes under ICD-10, Nichols noted, with the number of procedure codes increasing from 3,800 to 72,000 under ICD-10.
With ICD codes pervasive throughout most health systems, and many business functions impacted by the codes, it is important that healthcare organizations have plan for supporting ICD-10 codes.
“ICD-10 codes are used for a lot of things,” Nichols said. As examples, he mentioned: actuarial and financial risk; adjudication; outcomes; population health analysis; benefits design; fraud, waste and abuse analysis; quality and efficiency assessment; medical policies and clinical guidelines; payment rules; clinical history; utilization; and regulatory reporting. “We based a lot of our national policies on this,” Nichols said. “The implications are far-reaching. Imperfect mapping from ICD-9 to ICD-10 will affect processing and analytics in a way that impacts revenue, costs, risk and relationships.”
So how do you deal with this?
“If you haven’t started now, you’re going to be behind the gun,” Nichols said. But organizations need to look at their short-term goals with a long-term vision, to determine what solutions they need today, and whether those solutions will meet future needs. Organizations also need to be aware of ICD-10’s touch points with other initiatives, and the potential downstream impacts of the change. And they should collaborate with business and trading partners as they develop their ICD-10 plans. Finally, organizations should use ICD-10 to try to position themselves for competitive advantage. “There are huge competitive advantages to using ICD-10 better than your competitors,” Nichols explained.
Unifying Information Channels
By Mark Brousseau
Healthcare organizations should look at new ANSI 5010 standard as an opportunity to modernize their entire information processing infrastructure, Edifecs CEO Sunny Singh told attendees this afternoon at the Medical Banking Project Boot Camp at HIMSS10 in Atlanta.
By January 1, 2012, all covered entities must be able to send and receive all HIPAA transactions in the 5010 format. With more than 1,300 changes in 5010, compared to 4010A1, organizations must understand the new information contained in 5010 and how best to use this data. Combined with all of the other corporate strategies that healthcare organizations face, 5010 is a complex challenge – and its deadline is fast approaching. “Deadlines make everybody nervous,” Singh said, adding that organizations that haven’t started implementing a 5010 solution need to do it now.
But the new 5010 standard provides healthcare organizations with the chance to finally unify their information channels, to ensure that they process all of their information – incoming and outgoing – in a consistent way. This will help organizations achieve operational efficiencies and remain competitive, while easing their path to compliance with inevitable future regulations, Singh said.
“Healthcare organizations are getting information from various channels,” Singh explained. “When you make sure that every channel is unified, initiatives like 5010 become much easier to implement.”
Faced with meeting the new 5010 standard, healthcare organizations face three options, Singh said: complete replacement of all systems (“rip and replace”); remediation of core processing systems; and step-up/step-down. Singh noted that the complete replacement of core systems is a very expensive proposition for which there doesn’t seem to be a lot of takers. Remediation takes less time, Singh said, but organizations must have a sizeable team working on the project, and, depending on the existing systems involved, may still require considerable time, money and resource investments.
The option that is gaining the most traction, he said, is the step-up/step-down approach. In this scenario, organizations would convert 5010 information to 4010 and pass it throughout their systems; they also can convert the 4010 information to 5010 format and pass that throughout their systems.
“This is the most pragmatic option if 5010 planning and implementation has not yet commenced,” Singh said. “It has the least impact on core processing systems and other ongoing projects.”
But most importantly, it helps to unify a healthcare organization’s information channels.
Healthcare organizations should look at new ANSI 5010 standard as an opportunity to modernize their entire information processing infrastructure, Edifecs CEO Sunny Singh told attendees this afternoon at the Medical Banking Project Boot Camp at HIMSS10 in Atlanta.
By January 1, 2012, all covered entities must be able to send and receive all HIPAA transactions in the 5010 format. With more than 1,300 changes in 5010, compared to 4010A1, organizations must understand the new information contained in 5010 and how best to use this data. Combined with all of the other corporate strategies that healthcare organizations face, 5010 is a complex challenge – and its deadline is fast approaching. “Deadlines make everybody nervous,” Singh said, adding that organizations that haven’t started implementing a 5010 solution need to do it now.
But the new 5010 standard provides healthcare organizations with the chance to finally unify their information channels, to ensure that they process all of their information – incoming and outgoing – in a consistent way. This will help organizations achieve operational efficiencies and remain competitive, while easing their path to compliance with inevitable future regulations, Singh said.
“Healthcare organizations are getting information from various channels,” Singh explained. “When you make sure that every channel is unified, initiatives like 5010 become much easier to implement.”
Faced with meeting the new 5010 standard, healthcare organizations face three options, Singh said: complete replacement of all systems (“rip and replace”); remediation of core processing systems; and step-up/step-down. Singh noted that the complete replacement of core systems is a very expensive proposition for which there doesn’t seem to be a lot of takers. Remediation takes less time, Singh said, but organizations must have a sizeable team working on the project, and, depending on the existing systems involved, may still require considerable time, money and resource investments.
The option that is gaining the most traction, he said, is the step-up/step-down approach. In this scenario, organizations would convert 5010 information to 4010 and pass it throughout their systems; they also can convert the 4010 information to 5010 format and pass that throughout their systems.
“This is the most pragmatic option if 5010 planning and implementation has not yet commenced,” Singh said. “It has the least impact on core processing systems and other ongoing projects.”
But most importantly, it helps to unify a healthcare organization’s information channels.
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