During the implementation of ICD-10 almost a year ago, ICD-10 coders poked fun at the many new diagnosis codes.  Did the World Health Organization (WHO), the producers of ICD-10, really think we would experience an influx of patients walking into lamp posts again and again?  Now, it seems ICD-10 is already prepared to capture injuries of the latest craze, Pokémon Go. 

Pokémon Go, a smart phone game, has acquired more than 30 million daily users since its launch less than two months ago.  Players are really getting into catching Pokémon characters in real-world locations.  But like your mama said, “it’s all fun and games until somebody gets hurt.”  Players are so enthralled in capturing more Pokémon characters to get to the next level, they end up losing focus of their surroundings.  Even though the application displays warnings to pay attention, players are not heeding to the warnings during their Pokémon hunt, and unfortunately, some end up injured. 

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Medical data of all shapes and forms add additional contours to the existing IT Healthcare landscape, but what does it mean in layman’s terms? 

To simplify, one analogy is fairly clear, “You can throw the paper at the printer and hope some of it makes it into the feed or you can put the stack in the tray.”  Like everything else in life, wondrous variety exists in types of data and integrated systems from differing vendors to data fields and similar data sets.  Like the printer, if the formats are “groomed,” it eases complexity and adds efficiency to migrations.

Why does it matter? 

Not all data structures are created equal or contains equal languages and values.  To better suit both integration and data standards, it often helps to develop a template to corral the data into a clear and useful format.  System “A” may contain a date of birth in “month/day/year” format while System “B” may define the same value under a different field and carry with it a Julian calendar format (3 numeric digits 001-365 for the day of the year and 2 or 4 digits for the year.)  Though it is a rare occurrence, this type of difference provides illustration of the challenges involved in making one system’s data useful by the new system’s operational conventions.  Health Information Exchanges had the right idea of making data fit specific criteria for interoperability, but many vendors and homegrown/custom EMR systems maintain and use formats that do not match.  Due to the mismatch, transformation and validation become the keys to successfully migrating data to new systems.

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When I first started coding in 1990, working from home was not an option. In 2007 I was given the option to work from home, and I jumped at the chance, not knowing what I was getting into. Many people think working from home would be an ideal situation. What I have discovered over the past nine years of working from home is it takes a lot of discipline. As an educator, one statement I hear more than any is, ‘I want to work from home, so I don’t have to pay for daycare.’ Coders and auditors, along with many other professionals, require a lot of concentration whether working onsite or at home. 

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"Just fill those open CDI positions."

Sound familiar? Through the years the Clinical Documentation Improvement (CDI) program has worked very hard to demonstrate the value of their program. After numerous meetings and long hours of data analysis, executive leadership has approved new positions to support the goal of reviewing 80% of inpatient admissions, for example. Now, low and behold, top leadership gets it! But, do they?

Hospital leaders seem to now understand that a CDI program can improve data quality and outcomes, provide accurate reimbursement that may otherwise have been left on the table, improve quality scores, decrease denials, enhance coder productivity, engage physicians, and improve patient care. But do hospital leaders understand that experienced CDI professionals are hard to find? Do hospital leaders understand that the salary and benefits need to attract the experienced CDI professionals to apply for the open positions? Hospital leaders may say, “just hire any RN’s or credentialed coders to do the job”. 

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Have you ever heard:

• “We are changing this unit to an observation unit.”
• “Medicare has just released new requirements.”
• “We need more specialty content.”
•  “We are acquiring a new ambulatory practice.”
• “We are marketing a new service line to our diabetes patients.”
• “It is time for our yearly audit.”

All of these are often followed by, “There is no need to worry, this requires no IT Involvement.”  For a CIO, this is a phrase they dread hearing.  Usually, this means there will be an immense amount of work with tight timelines and seemingly unrealistic expectations. Many times, they will need to ask their teams to lay aside other priorities to focus on this new request. For a CIO and their application team, there are never enough hours in the day to keep up with new regulatory requirements, maintain system health, and manage all of the daily requests.  What is the solution? It really comes down to 3 things: capacity planning, an empowered governance structure, and transparency. Read More

Everyone has been in the hot seat of interviewing for the big position or the next position on your career path.  It can be high stress for all parties involved.  We’ve all seen advice on interviewing - what to do, what not to do, and what are considered red flags.  But, it ultimately comes down to two questions: 1. Is the employee right for your business and 2. Is your business right for the employee?  All subtleties aside, the hard-sell from the interviewer or interviewee may mean that there are other questions begging to be asked.  Within the hiring process there are many key points for interviewing where we can all reach common ground.

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As consultants, many times we are posed with a myriad of problems, solutions, and challenges.  Of the foremost is how to get the most from our relationships with clients - even though we may be set on resolving issues and implementing or building solutions.  A key point of any successful engagement is the relationship built between consultants, clients, and staff.

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How many times have we heard the phrase “We have always done it this way?”  We may cringe at the notion and sometimes more so when we catch ourselves repeating the credo of our predecessors, but there are still lessons to be learned. It is easy to fall back into the concept of business as usual, but small changes can make the difference in great products/services and world class offerings.  Let’s step back and examine the structure of everyday business processes. 

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In the modern age of Healthcare IT, we are becoming accustomed to IT services requiring more robust skillsets to bring implementation and integration projects to fruition.  With skillsets including application management, systems integration, database administration, user education, change/project management, and documentation, we have all seen our share of specialized consultants through the years since adoption of new EHR/EMR and service delivery systems.  Common observation leads us to believe that there is high demand and higher pay for these individually specialized skillsets. 

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Your EMR users have experienced performance issues on and off again for some time now. Individually, the database, network, hardware, and end device folks, along with your EMR vendor have thoroughly investigated this issue and have conclusively determined that their piece of this puzzle could not possibly be the cause of the problems. But, the end users remain Plagued by Performance Problems.

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