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To ICD-10 Delay or Not To ICD-10 Delay

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UPDATE: It looks like this bill has passed the house with a voice vote. I believe it still needs to be passed by Congress and not be vetoed by the President.

UPDATE 2: Late on 3/31/14, the Senate passed the bill which delays ICD-10 by a vote of 64 – 35. Barring a veto from the President, the bill will go forth and the ICD-10 implementation date will be moved to October 1, 2015. All of the discussion for the bill was around the SGR fix with no conversation around the ICD-10 delay. It’s unlikely that the President would even consider a veto of this bill.

We’d already stoked the ICD-10 delay fires in Kyle Samani’s post on “Why ICD-10?” before the news came out yesterday that a one year ICD-10 delay was put in an SGR bill. Word on the street was that the bill would be put up for a vote today. However, I hear now that the vote on the bill is going to be delayed at least until tomorrow.

The reports are saying that this bill was developed by John Boehner and Harry Reid which likely means they have enough votes to make it a reality. I read that Nancy Pelosi said on CSPAN that the bill wasn’t perfect, but needed to be passed. My only question is whether the delay in voting is because they’re still trying to cull votes for the bill or something else.

As I suggested in my post linked above, my guess is that congress is hearing from both those for delaying ICD-10 and those who oppose delaying ICD-10. I bet they consider the response a wash and so it won’t sway them either way. Plus, I bet that most in Congress are only talking about the SGR portion of the bill without much discussion on the ICD-10 delay.

This decision is going to cut many people. Let me share a few of the comments I’ve read.

First, from the LinkedIn AHIMA group, here’s a coder perspective on the delay:

I think of the coder who is a single mom struggling from pay check to pay check who had to spent $500 (or more) to take a course and another $60 on the proficiency exam, spent time away from caring for her family to prepare for the implementation only to have the rug pulled right from under her. The $560 is likely her discretionary income for the month. Who is thinking or her?

Don’t tell us there will absolutely be NO delays, allow us to spend our hard earned money to prepare, and then say “just kidding– we are going to tease you with another year — make you spend more money — promise no delays — then change our mind again!” “Oh, and the check is in the mail.” Yes ladies and gentleman, this is our government working “for the people.” And I ask, why does Congress even care about ICD-10? Do they even have a clue what they are voting for or against? They are trying to quietly slip it into a bill so that no one notices. I could be wrong, but it sounds like the work of a single lobbyist and Senator/Congressman. I would like to know the name of the person who put that language into the bill. Democracy at its finest!

Now a perspective that is likely shared by the thousands of ill-prepared practices and hospitals (although, my guess is that it was their larger organizations that lobbied for it, not the individual practices and hospitals that aren’t prepared):

As bad an idea as it is, a majority of practices, and a significant number of hospitals, health systems and other providers are, or feel, very un-prepared for the transition, and so have lobbied for delay. D.C. insiders say it’s a done deal.

On the other side is the prepared health IT vendors that think that a delay is letting the ill prepared off the hook. One EHR vendor sent me an email with this message:

This really is a pain to a vendor like us that is all ready to launch and take good care of our clients with ICD-10. Everything we programmed came out great and we are ready to go.

This feeling doesn’t just apply to health IT vendors that have procrastinated, but to all the procrastinators:

Why prolong the inevitable, again? The procrastinators should be penalized, not the rest of us who’ve been preparing for it.

What we all want most is certainty. HHS came out with certainty during HIMSS when they said that there would be no more delays with ICD-10. Unfortunately, HHS doesn’t control congress.

I’ve been reading a lot of reports that a delay in ICD-10 would cost billions of dollars. I’m not sure I trust those numbers, but it’s no surprise that those numbers don’t take into account the impact and cost of ICD-10 being implemented. Personally, I see costs in ICD-10 going forward and costs in ICD-10 being delayed. I’m not sure we can quantify either number accurately.

Obviously, this is a fast moving story, so I’ll update this post with any updates as I get them. Feel free to leave comments with updates as well.

March 27, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

3 Suggestions for Dealing with Healthcare Audits

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While at AHIMA 2013, one of the big topics people were discussing was all of the audits that the HIM staff are having to deal with on an ongoing basis. Everyone that I talked to said that there is no end in sight when it comes to the various audits. In fact, most were predicting even more audits to come.

I sat down with Dawn Crump, VP of Audit Management Solutions from HealthPort, to find out some suggestions for organizations trying to deal with this wave of audits in healthcare. Check out the video below to hear those suggestions (plus, she throws in a fourth and fifth bonus suggestion):

How is your organization dealing with all of these audits? Have you formalized and streamlined the process in your organization? Do you have an easy way to track all of your audits? Do you know the financial impact of these audits on your organization?

November 14, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Timeline for Healthcare Organizations to Train for ICD-10 – ICD-10 Tuesdays

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Right as the AHIMA exhibit hall was closing (literally they turned out the lights on us), I pulled out my video camera and got the following interview with Garry Huff, MD, CEO and President of Huff DRG Review Services. In the video, Dr. Huff addresses the challenge of training doctors on ICD-10. As a doctor, he offers a unique perspective on what works and what doesn’t work when training doctors on ICD-10. Plus, he looks at the timeline organizations should plan for training doctors on ICD-10.

I really love Dr. Huff’s approach to teaching doctors ICD-10. They realize that doctors have limited time and attention span. They have doctors from a specific specialty training that specialty. They do a gap analysis on the training needs so they can focus that training on what each specific provider needs to learn.

Dr. Huff also suggested that a doctor can be trained on ICD-10 with this type of specialty and provider specific training in 30 minutes to an hour. Is this enough time to train doctors on ICD-10?

November 12, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Prediction: AHIMA 2013 Will Be ICD-10 All Day All the Time

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This will be my third year in a row attending the AHIMA Annual Conference (I think they call it the AHIMA Convention) which starts on Monday in Atlanta. I’m particularly excited for this year’s event because I have so many healthcare IT friends in Atlanta. Plus, I always have a great time at the event and learn a lot.

This year we’ll actually have three different Healthcare Scene bloggers (Jennifer Dennar, Mandi Bishop, and myself). So you can be sure to get some really varied coverage from the event from a number of different perspectives.

As I consider all the pitches I’ve gotten and think about the work of AHIMA, I can already tell that AHIMA 2013 is going to be dominated by one topic: ICD-10.

I honestly don’t think it’s even going to be close. I believe this is a very good thing. Hopefully the focus of attention on ICD-10 a little less than a year out from the ICD-10 implementation date is a good thing for the industry. You can be sure I’ll be doing what I can to help people better understand how they can prepare for ICD-10 and some of the tools out there.

Assuming I’m not too overwhelmed with all the AHIMA ICD-10 talk, next week I’d like to start a weekly series of posts on ICD-10. It feels right to call it ICD-10 Tuesdays. So, look forward to that series in the future.

Also, Agency Ten22 is holding the third annual tweet up at AHIMA on Tuesday evening. You can find more details and RSVP here. I’m reminded of the first tweetup. Beth from Agency Ten22 told me she had a nice suite. I told her I’d bring some Twitter friends and the AHIMA tweetup was born. Big thanks to Beth and her team for carrying on the tradition.

Finally, the rest of my travel for this year is booked. I’ll be at the Digital Health Conference (20% discount if you use the code HCS) in NYC in November and at the mHealth Summit in Washington DC in December. I hope to see many of you at one of these events.

October 25, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Digital Health Conference in NYC

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As most of you know, I’ve been working with the New York eHealth Collaborative (NYeC) for the past couple years on their Digital Health Conference. They buy some advertising on my websites, and I get the chance to attend an amazing event. I love this event, because NYeC has a great connection with the local community of doctors and hospitals and so the event is chalk full of those working in the trenches of healthcare. I expect this year to be no different.

The good news is that once again they’ve given readers of my websites a 20% registration discount. Just use the code HCS when registering at www.DigitalHealthConference.com.

They’ve lined up two keynote speakers for the event: George C. Halvorson, Chairman, Kaiser Permanente and Jim Messina, National Director, Organizing for Action; Campaign Manager, 2012 Obama Re-Election Campaign; Deputy Chief of Staff to President Obama. I like the mix of someone deeply rooted in healthcare and also someone who likely understands healthcare politics really well.

Along with the keynotes, I’m told they are looking at about 1200 attendees at the event. They’ve also published the full agenda of speakers. I look forward to seeing many of my readers at the event.

Along with the Digital Health Conference, I’ll be attending a number of other Healthcare IT conferences this year. Influential Networks has created a calendar of Fall health IT events where you’ll find myself and other influencers. Right now I have MGMA, CHIME, Healthcare Payments Processing & Compliance Summit, AHIMA, and the Digital Health Conference on my dance card. I may add mHealth Summit as well. Should make for an exciting fall conference season.

Let me know if you’ll be at any of these conferences. I always love to connect with readers in person.

September 5, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

EHR and Malpractice Lawsuits

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Long time reader Carl recently pointed me to this excellent AHIMA article on EHR and Malpractice Lawsuits. It’s first section sums up the current state of EHR and lawsuits quite well:

Medical records are a vital part of any healthcare lawsuit because they document what happened during treatment. Paper medical records are relatively simple aspects of litigation. HIM staff pull the requested chart, track down additional information as necessary, and sometimes provide a deposition on the record’s accuracy.

The process is far more complex with an EHR. The record of a patient’s care that a clinician views on screen may not exist in that form anywhere else. When the information is taken out of the system and submitted into legal proceedings, the court has a very different view—one that often confuses the proceedings and, in the worst instances, raises suspicions about the record’s validity.

The challenges stem from the design of the systems, which were built for care—not court. If the provider struggles in providing documentation, a trial involving malpractice can easily shift its focus from an examination of care to a fault-finding mission with the recordkeeping system. At other times, the provider’s inability to put forward the information in a comprehensible format may raise suspicions that it is missing, withholding, or obscuring information.

I’d probably modify the sentence that says that EHR’s were “built for care-not court” to say that EHR’s were “built for billing-not court”, but the idea is still the same. The big issues for EHR in lawsuits is that there’s no really good precedent for how an EHR will be treated in court. We’re so early in the process of legal cases that use EHR documentation, that we just don’t know how the courts are going to deal with EHR documentation.

Plus, when you consider that there are 300+ EHR companies out there, I’m not sure that a legal case with one EHR software is going to be applied the same way to the other EHR software. Each EHR displays data differently. Each EHR audits users differently. Each EHR stores data differently. So, I expect that each EHR will be looked at in a different way.

The AHIMA article linked above is a good read for those interested in this topic and points out a lot of other issues that could face an HIM staff that’s dealing with a case involving documentation in an EHR. Although, one of the overriding messages is that HIM staff and healthcare organizations are going to need an expert of their EHR involved in the process. In fact, I can see many HIM departments getting trained up on EHR in order to fulfill this need.

What I also see coming is a new group of EHR expert witnesses. Again, I think that these expert witnesses will have to have specific knowledge of a particular EHR to be really effective. I’m sure they’ll come from the ranks of EHR consultants, former EHR employees, and some EHR users. Considering the millions of dollars on the line in these malpractice cases, these EHR expert witnesses stand to make a lot of money.

I don’t want to make it all sound doom and gloom. I expect that there will be many cases involving EHR where a doctor or institution is covered better by an EHR than they were in the paper world. This will be even more true as EHR vendors continue to shore up their EHR audit logs and processes. There’s new legal risks with EHR, but there are also old risks that are removed by using an EHR. We just need to make sure we’re ready for the new risks.

January 23, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Are Physicians Ready for ICD-10?

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While at AHIMA, I asked Dr. Jon Elion, Founder and CEO of ChartWise Medical Systems, the million dollar question, “Are Physicians Ready for ICD-10?” I love his comparison of the fear mongering we saw with Y2K with the move to ICD-10. Here’s his video answer:

What do you think? Are most physicians ready for ICD-10?

November 15, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Retina Scanning vs. Iris Recognition in Healthcare – Best Technology Seen at AHIMA

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While at AHIMA, I was lucky enough to meet John Trader from RightPatient (A part of M2SYS Healthcare Solutions). During our meeting he showed me the coolest technology I’ve seen in quite a while. Ever since I first started this blog, I had a serious interest in seeing how biometric solutions could benefit an EHR implementation. I’ve tried fingerprint, facial (and this review), voice, typing, etc and been amazed by the technology. Facial recognition was probably my favorite despite its weaknesses.

The funny thing is that I always shot down anyone that suggested the use of some sort of eye related biometric identification. Thinking to my only reference for retina scanning biometrics (movies like Mission Impossible), I didn’t see how that was going to integrate well with healthcare.

Turns out that I was wrong, and my big mistake was that I was looking at the technology from a doctor, nurse, front desk staff identification perspective as opposed to a patient identification perspective. Plus, I didn’t get the difference between retina scanning and iris recognition.

With this background, you can imagine my surprise when I fell in love with the RightPatient iris recognition technology that John Trader demoed to me at AHIMA. I shot this short video embedded below where John discusses the differences between retina scanning (the laser scan you see in the movies) and iris recognition. Then, John demos their iris recognition technology.


Much more could be said about how the iris technology works, but I think it’s best deployed at a hospital front desk during registration. Imagine the number of duplicates that could be avoided with good biometric iris recognition. Imagine the insurance abuse that could be avoided with iris recognition.

In the video I only showed one of the model’s that RightPatient deploys. They have another model that automatically swivels until it locates your iris. It’s hard to explain on the blog, but when you try it first hand it’s like magic.

November 1, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

ICD-10 Benefits to Patients

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In March I asked why we haven’t seen stories of all the benefits of ICD-10 to patients. Considering many other countries around the world have been using ICD-10 for years and years, I wondered why we hadn’t heard more stories of the benefits of ICD-10 to patients.

In the following video I asked Doris Gemmell, BSc, MBA, CHIM, Director of Coding Services at Accentus Inc. this same question and she provided a simple but thoughtful example of how ICD-10 could benefit the patient.

I’m also a big fan of Doris because she blogs about ICD-10 on her blog. I always love when smart people share their knowledge on a blog.

October 23, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

A Video Tour Around AHIMA’s Exhibit Floor

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AHIMA 2012 has been quite the whirlwind for me. I’ve met with some fantastic people and I’ll soon be sharing many of the things I learn with you in future blog posts. Plus, I’ve been taking the time to capture a lot of videos of people talking about some of the hot topics at AHIMA and other topics that I think you will find interesting. You’ll see many of those videos coming out across all of the Healthcare Scene blogs over the next month.

One video that I did today was me just walking through the AHIMA show floor getting some video of the various exhibitors at AHIMA. My video camera didn’t like me walking and shooting the video that much, but I think many of you will find it interesting to see some of the companies exhibiting at AHIMA and the types of booths they have.

Enjoy your virtual visit to the AHIMA 2012 exhibit floor:

October 3, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.