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Interesting and Funny Insights Into EHR and Health Information Management

Posted on October 20, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Last week I had the chance to attend the Craneware Summit in Las Vegas. It was a really interesting event where I had the chance to meet and talk with a wide variety of people from across the spectrum of healthcare. I love getting these added perspectives.

One of the sessions I attended was an E&M session which provided some really interesting insights into the life of an E&M coder and how they look at things. There’s a lot more to their job, but I tweeted these comments because they made me laugh and illustrated part of the challenge they face in a new EMR world.


I thought these immediate responses to the question were interesting. They came from a crowd of HIM and coding professionals. Overall, they were quite supportive of EMR it seemed.


Many doctors don’t understand this. That’s why so many coders still have jobs.


Too funny.


Said like a true coder.

300 Automatic E&M Coders in EMRs

Posted on May 30, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Automated coding has been a popular topic ever since I first started blogging about EMR software 7.5 years ago. In fact, back then the discussion was usually around how great automated E&M coding was going to be for a doctor. Everything from increased coding levels to firing your billing person were talked about. However, I think the reality is that we’ve seen something much different happen.

Many people hate the automatic E&M coding in EMR because it is wrong so often. If they can’t trust it to do the right coding, then what savings are they really getting from the automation? To put it in the words above, they still need their billing person. Plus, the idea of coding higher is great because it can mean more revenue. However, it also can be seen as upcoding and give you plenty of grief as well. “My EMR told me to do it” isn’t a great defense for over coding a visit.

As I think about these automatic E&M coding engines, it makes me wonder why we don’t have someone who’s created a really great coding engine like we have with drug databases. Since there isn’t that means that every one of the 300+ EMR vendors has their own coding engine. That means we have 300 different E&M coding engines all with different ways to approach coding.

I imagine many would argue the reason the E&M coding engine needs to be part of the EMR is because it needs deep integration with the EMR data. This is true, but the same is going to be true as we enter the world of smart EMR software with deep CDS applications. EMRs aren’t going to build all of these pieces. They’re going to have to enable entrepreneurs to build some really cool stuff on top of their EMR. Why not do the same with E&M coding?

Although, it’s also worth consider, is medical billing one area where human touch is better than automated coding?

What could replace E&M coding to improve healthcare (and EMR)?

Posted on January 21, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

A comment on my somewhat controversial thought post about imagining an EMR without billing reminded me that I wanted to ask the question of my readers about what could replace E&M coding. Seriously, I can’t think of anyone I know that actually likes E&M coding. I know some people that are good at it and so they like that they have a skill in that area. However, I don’t remember anyone being a proponent of E&M coding because it provides better patient care or makes life easier for doctors. Am I just missing these reports? So, this leads to the important question…

What could replace E&M coding that would improve healthcare and still handle billing?

Plus, after you read the comment below, you’ll understand why improving billing could also improve many of the billing machines EMR software that’s out there as well. Let’s hear your thoughts.

Here’s the comment that prompted this thought:

The broader problem is that the billing aspects have many more insidiously negative effects than simply sending a charge transaction across an interface.

They actually degrade the quality of the documentation by requiring certain elements to support specific levels of billing. The whole issue of needing to have a certain number of elements done and documented to bill a particular E&M code is one example. A particular visit may have extremely complex history/assessment/decision-making but to get “credit” one also has to document a certain number of irrelevant review of systems items.

It is no surprise that the places that have used EHRs most effectively such as Kaiser and the VA are incentivized to give care that will produce better outcomes. They are less beholden to bureaucratic insurer-driven documentation demands that do not aid in patient care or communication.

Eliminating all of these items (and similar demands for information to fulfill PQRI and other measures that are irrelevant to a particular patient or that fragment thought processes) would improve workflow and efficiency in any system, paper or electronic. It would certainly make it easier to develop an EMR that would support patient care needs.

But just having distinct EMR and billing software isn’t going to do the trick in our current dysfunctional health care system. It is only if an EMR can be designed (and insurer/payor/regulatory demands can be synchronized) so that the health care system looks like a single payer system to the EHR user and clinicians can go about the business of treating patients.

It’s a little bit pie in the sky thinking, but sometimes that’s beneficial.