The date for compliance with ICD-10 has been pushed back to October 13, 2014, from October 2013, but this doesn’t mean delaying implementation is in your best interest.
The move to ICD-10 is a dramatic change that should not be taken lightly because this change permeates many layers of a hospital, clinic, or practice. This extends to vendors’ ability to support ICD-10 and payers’ ability to process claims accurately and on time. The ICD-10 pilot identified end-to-end testing as the most challenging area of the conversion.
To use the extra time proactively, the following questions should be considered to help you successfully complete the migration to ICD-10.
Create a basic checklist. According to a HIMSS Whitepaper on ICD-10, a basic checklist for the implementation of ICD-10 should include a complete list of interfaces that are associated with ICD-9 and/or ICD-10 codes. This also includes reports that may be generated from primary and secondary systems which use ICD-9/ICD-10 as a data element, or reports created and sent to external agencies or organizations.
Once pertinent information is compiled, the next step is to determine what needs to be tested. The following questions should be considered:
After testing, potential scenarios need to be reviewed, including:
Part of the challenge includes competing organization priorities, which restricts many organizations from participating. Some recommendations from the ICD-10 pilot include creating a test plan in which multiple clinical scenarios can be checked during end-to-end testing as a collaboration across the healthcare groups.
Now is the time to assess, test, implement, and evaluate all systems and determine whether contingency plans are needed in preparation of the ICD-10 Big Bang. Are you ready?
More assistance and information on the conversion to ICD-10 is available in the ICD-10 playbook on the HIMSS website.
Just announced today from the Centers for Medicare & Medicaid Services (CMS) is a new timeline for Meaningful Use Stage 2 and Stage 3. Although there has been speculation about delays in these two stages, this is the first real step to implement a new timeline. Highlighted below are some key points from the CMS announcement.
In fall of 2014:
“…CMS will release of proposed rulemaking (NPRM) for Stage 3 and corresponding ONC NPRM for the 2017 Edition of the ONC Standards and Certification Criteria will be released in the fall of 2014, which will outline further details for this proposed new timeline. The final rule with all requirements for Stage 3 would follow in the first half of 2015.”
With these proposed changes, many providers and vendors may welcome the added time to meet the criteria and continue implement the supporting technologies to make health care work in a more efficient and effective way.
What are your thoughts on the new timelines? Given the challenges with Healthcare.gov, will more time raise the opportunity for success? Join the conversation.
I had the pleasure of meeting John Traeger in October at Corepoint Connect 13. John works with a number of hospitals and health systems in the Northwest to set up private HIEs and to connect to various forms of external HIE organizations. His keynote presentation on private HIEs had some interesting information I thought readers of this blog would appreciate. Feel free to leave any HIE questions for John in the comments.
The context in which we provide interfaces outside of hospital organizations is changing rapidly. There are many new regulatory and business requirements. The government and market pressures to form ACOs and HIEs have generated a high number of new participants and connections. These factors and others are creating a tsunami of interface work that is coming in at a rapid pace.
While there has been a considerable amount of work done on public, state and local HIEs, the private HIEs still outnumber them. Private HIEs are experiencing a considerable growth in demand for interfaces being driven by Integrated Healthcare Delivery organizations that want to capture physician “mindshare” and the patients that go along with the new care coordination model.
The integration of formerly independent organizations also frequently involves sharing new HIS system builds to make extending patient information and physician teamwork easier. These system conversions drive a considerable amount of interface work.
Frequently, the nature of the business relationships force the provider organizations to share only the minimum amount of patient data. Centralized data repositories have turned off some provider organizations from participating for this reason. HIEs that utilize this model are also experiencing high costs to manage an ever-growing data store and often have to charge high fees that put their business model at risk.
Private HIE data connections tend to be more comprehensive than public ones, with tighter integration between systems than just sharing CCD documents on a query/response model. This often involves standing up the “traditional” set of ADT, clinical results, lab and rad interfaces, depending on the nature of the relationship and entities involved (for example, specialty clinics vs. ambulatory care vs. rural hospitals, etc.).
Also, technology matters. One private HIE implementation I worked with had this long chain of handoffs making troubleshooting particularly difficult, especially when three of the components in the data flow are opaque to the participating organizations.
ACOs, public and private HIEs, and regulatory or market requirements are driving a massive growth in demand for community data sharing. Selecting the right strategy to keep pace with the demand and being agile enough to handle the evolving requirements is critical. A key technology strategy for success is to select a robust interface solution that makes interfaces quicker to deploy, easier to support, has less skilled resource risk, and delivers community connectivity quicker and more cost effectively. (See John’s white paper “13 Steps to Select the Right HL7 Interface Engine“)
“Happy dreams, Mama.”
That’s the last thing my daughter says to me before bedtime. I like it because it seems more tangible and emotional than the standard, “Sweet dreams.” Also, it ensures I’m not kept awake because I have this classic Eurythmics song stuck in my head.
Eighties music aside, it seems many Americans aren’t dreaming much these days. According to the Centers for Disease Control and Prevention, 50 to 70 million Americans have a sleep or wakefulness disorder.
Factors that contribute to sleep disturbances include medication, illness, and stress. So do two things common to the health care industry – shift work (particularly night shift) and technology. Both are messing with our circadian rhythms.
Circadian rhythms are basically a human being’s internal clock. They run on a 24-hour cycle and tell us when it’s time to wake, sleep and release particular hormones like cortisol and melatonin.
The circadian biological clock is controlled by a group of cells in the hypothalamus that respond to light and dark signals. When light travels to this group of cells, it’s signalling the body that it’s time to be awake. The other parts of the brain that control hormones, body temperature and other functions that play a role in making us feel sleepy or awake also kick in.
This is the perfect set-up for the day shift. When they get up in the morning to go to work, they are exposed to light and the brain sends signals to raise body temperature and produce hormones like cortisol. Unfortunately, the bright sunshiny day also greets the soon-to-be clocking out night shift. Even though they’ve been up all night, their body is jolted by the same shot of sunshine as the day shift. But here it is detrimental to their sleep habits. It’s telling them, “Get up! Get moving! It’s time to start the day,” when what they really need is sleep.
Light from technology is affecting users in the same way natural light affects night shift workers. The blue light emitted from your tablet as you play Angry Birds before bed is particularly powerful in suppressing melatonin production — the hormone needed to induce sleep. The blue light that most of our devices emit works on melatonin in the same way. Again our bodies are being told, “Get up! Get moving! It’s time to start the day!” even though it’s 11pm.
Sleep disturbances and sleep disorders can have serious impact on people’s health. According to research, working the night shift is going to kill us. A 2003 review lists peptic ulcers, cardiovascular disease, cancer, and diabetes as hazards of working nights. Shift work has also been linked to obesity and depression.
Some suggestions to help mitigate sleep disturbances are:
Installing blackout curtains and wearing amber colored glasses when the sun sets can also help night shift workers.
There’s also some technology out there that claims to help with sleep disruption.
If none of that technology works for you, you can always try the old fashioned remedies eliminating screen time two hours before bed, restorative yoga poses such as legs up on the wall, and meditation or relaxation.
What are your tips for working the night shift and/or breaking through insomnia?
The Nov. 15 #HITsm Chat kicked things off with the following question I thought was worth preserving via blog post:
“The most overused term in #healthIT is ______?”
It’s a fun question and so as you might expect, we got a few answers, but before you jump the gun and check out our list, take a crack at it yourself – what do you think the most used terms are?
According to fellow #HITsm’ers, the most overused buzzwords are…
— georgemargelis (@georgemargelis) November 15, 2013
— Julie Maas (@JulieWMaas) November 15, 2013
— Ryan Lucas (@dz45tr) November 15, 2013
— Bob Green (@HealthcareNovel) November 15, 2013
— Charles Webster, MD (@wareFLO) November 15, 2013