Viewpoint

I wonder if Richard Pryor suffered neck trauma

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Since I was way too young to listen to his albums and watch his films, Richard Pryor has been my favorite comedian. Despite the fact that he spoke in the patois of the street and cursed a great deal, his humor was not scatological; in fact, his comedy insights were often anecdotal in nature, and imbued with a great deal of knowledge about the human condition. It broke my heart when he was diagnosed with multiple sclerosis (MS), and we watched helplessly as he devolved from a once-vibrant, verbose slickster to a wheelchair-bound infirm who had difficulty speaking.

Thanks to healthcare IT, new findings could help shed some light on what actually causes MS – and how it may one day be cured.

Last month in a newly published paper, medical researchers at FONAR Corporation reported a diagnostic breakthrough in MS, based on observations made possible by the company’s FONAR UPRIGHT Multi-Position MRI. The findings reveal that the cause of MS may be related to earlier trauma to the neck, which can result in obstruction of the flow of cerebrospinal fluid (CSF), produced and stored in the central anatomic structures of the brain known as the ventricles. Since the ventricles produce a large volume of CSF each day (500 cc), the obstruction can result in a build-up of pressure within the ventricles, resulting in leakage of the CSF into the surrounding brain tissue. This leakage could be responsible for generating the brain lesions of multiple sclerosis.

The paper, “The Possible Role of Cranio-Cervical Trauma and Abnormal CSF Hydrodynamics in the Genesis of Multiple Sclerosis,” appears in the journal Physiological Chemistry and Physics and Medical NMR (Sept. 20, 2011, 41: 1-17). It is co-authored by MRI researchers Raymond V. Damadian, who invented the MRI, and David Chu.

The disease results in the destruction of the coverings, or myelin sheaths, that insulate the nerve fibers of the brain. The destruction prevents the nerves from functioning normally and produces the symptoms of MS. The destruction is the origin of the lesions seen on the MRI images.

But, unlike nerve tissue, the myelin sheaths can regenerate – once the cause of their destruction is eliminated. The paper suggests that surgical or biomechanical remediation of the obstruction of the flow of CSF in the cervical spine could relieve the increased CSF pressure within the ventricles and eliminate the resultant leakage of fluid into the surrounding brain tissue and the inflammation of the myelin sheaths that it generates. Once the leakage has been stopped, the myelin sheaths could be repaired by the body’s myelogenesis process with the prospect of a return to normal nerve function.

As someone who suffers from a neck injury, these findings make me nervous; yet it’s because of incredible discoveries such as this that I remain cautiously optimistic about the future of healthcare IT.

Enjoy the issue.

 

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AHIMA spotlights global transformation of health information management

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The 83rd American Health Information Management Association (AHIMA) Convention and Exhibit is scheduled for Oct. 1-6 at the Salt Palace Convention Center in Salt Lake City, Utah. With a focus on “Reaching New Heights in Health Information,” the event will attract professionals from across the full and varied spectrum of health informatics and information management for a six-day-long focus on HIM’s global transformation.

The show will offer plenty of opportunity for networking, and more than 200 exhibitors are expected to show off their wares. Experts will discuss the latest developments in HITECH, EHRs, ICD-10 – and everything in between, providing a comprehensive overview of current and emerging HIM issues and challenges.

Additionally, the convention will mark the debut of new AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, FACHE, who took over as chief executive of the 61,000-member organization on Sept. 29. She joins AHIMA after serving as associate vice president for hospital operations and director of the Children’s Hospital at Rush University Medical Center in Chicago, IL. She also is a member of the Rush University faculty in the graduate program in health systems management.

Convention speakers include Apolo Anton Ohno, eight-time Olympic speed-skating medalist; Dr. Peter Tippett, VP of technology and innovation, CMO, Verizon Business; Gail Collins, first woman appointed editor of the New York Times’ editorial page, New York Times syndicated opinion columnist and blogger; Dr. T.B. Üstün, team coordinator of classification, terminologies and standards, Department of Health Statistics and Informatics, World Health Organization; Carolyn Clancy, M.D., director of the Agency for Healthcare Research and Quality; and Stephen M. R. Covey, bestselling author of “The Speed of Trust.”

AHIMA was founded in 1928 when the American College of Surgeons established the Association of Record Librarians of North America (ARLNA) to “elevate the standards of clinical records in hospitals and other medical institutions.”

As the industry changed, so did the organization’s name. In 1938 it became the American Association of Medical Record Librarians (AAMRL) and in 1970 the American Medical Record Association. Its current name, adopted in 1991, captures the expanded scope of clinical data beyond the single-hospital medical record to health information comprising the entire continuum of care.

AHIMA is committed to promoting and advocating for high-quality research, best practices and effective standards in health information and to actively contributing to the development and advancement of health information professionals worldwide. AHIMA’s enduring goal is “quality healthcare through quality information.”

For more information, check out www.ahima.org.

Until next time, here’s wishing you good healthcare IT.

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Taking patient advocacy to a whole new level

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I recently had the pleasure of being invited to moderate a panel at the World Congress Third Annual Leadership Summit on mHealth, held July 28-29 in Cambridge, Mass. I found the conference informative, the panelists well versed in their respective topics of expertise and the exhibitors entertaining (highlights included AT&T’s diabetes app, Humana’s wireless teddy bears and Rubbermaid Healthcare’s telemedicine solution). But what I will remember most about the event was meeting a powerfully proactive patient.

Wife and mother Natasha Gajewski was hard at work – living her busy life and staying in shape by practicing Zumba, a Latin-inspired, dance-fitness program – when she was diagnosed with a chronic, incurable disease.

Understandably, the diagnosis left her scared and feeling more than a little helpless. Her doctor suggested she keep a diary of her symptoms to help clarify her diagnosis and redefine her treatment plan. Gajewski needed an easy way to capture and log data and thought, “There must be an app for that!”

But there wasn’t.

So Gajewski decided to take matters into her own hands and build one herself.

Based upon the axiom that “participatory healthcare + evidence-based medicine = happier, healthier patients,” Symple App was born.

The intuitive interface allows users to define their own symptoms, while some elegant programming makes it possible to log symptoms with as few as a half-dozen screen touches.

The app tracks symptoms and triggers, and can even remind the user to log observations at the same time every day in order to standardize data. The tool bridges the gaps between doctor visits, allowing the patient to share only important data with their healthcare provider on a schedule that makes sense for both parties involved.

“Getting diagnosed with an incurable disease is a life-changing experience, but it’s not scary anymore,” Gajewski says. “Now, I’m a scientist of my health, not a victim of my disease.”

Symple App is currently going through its beta-testing phase.

On her Web site, www.SympleApp.com, Gajewski quotes Shannon Brownlee (from an article titled “21st Century Leeches” in the New Health Dialogue blog), which sums up her perspective perfectly: “As a patient, I want to be the driver; my physician is the GPS.”

Enjoy the magazine. If you’re in Salt Lake City for AHIMA the beginning of October, we hope to see you. And, until next time, here’s wishing you good healthcare IT.HMT-Editor-Phil-Colpas-Signature

   

Giving you what you want

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He who rejects change is the architect of decay,” said former British Prime Minister Harold Wilson. “The only human institution which rejects progress is the cemetery.”

For several years, print publications have been criticized – often rightly – for being stuck in their ways, afraid or unwilling to change or go against the grain or do something different.

Here at Health Management Technology, we look at our annual readers’ survey as an opportunity for us to change for the better in order to provide more of what our readers want.

We were gratified to see that our expert roundups are among the most popular features (the favorite of more than 70 percent of you); we recently introduced them as a regular feature based upon feedback on another reader survey. We thought the roundups were a good way for readers to get a variety of perspectives on important subjects in a short amount of time; it turns out you agree.

And that brings me to another change we’ve implemented: keeping it short and sweet.

For better or worse, most people I know are busier than they’ve ever been. Honestly, when was the last time you sat down and read an entire 3,500-word feature article in a magazine?

In our continuing effort to make sure our readers and advertisers get the most bang for their buck, we are running more short stories, editing them down to their most important points, so that you can quickly glean something positive from reading a page-long case study on one organization’s purchase and implementation of an EHR system, for example – and then get on with the rest of your busy day.

Also faring well in the readership survey: our weekly e-newsletter, bylined case studies, industry news, hospital and EHR features, Thought Leaders and product announcements. Rest assured we will continue to provide you with these popular regular items.

Some other key findings of the survey: Nearly half of readers surveyed have read or looked through all of the most recent four magazines. Our audience is varied: Readers’ IT networks range from serving less than 50 to more than 10,000 users. Nearly 80 percent of those surveyed saved an issue for future reference; 60 percent visited a vendor Web site after seeing a story or ad in this magazine; 65 percent shared HMT with a coworker or supervisor; more than 20 percent contacted a vendor after seeing them here; and nearly 10 percent of you purchased a product featured in these pages.

More than half of readers surveyed are more likely to inquire about a company featured in an HMT advertisement, and more than a third are more likely to consider that company during product evaluations.

These are encouraging numbers; they keep us motivated to continue to improve on giving our readers what they want.

Enjoy the magazine. Until next time, here’s wishing you good healthcare IT.

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They said I was sick; turns out it was just a code

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Coding.

Does that term evoke images of pristine, crisp, detailed ICD-10 code zip-zapping around the ether, leaving reduced claims and billing errors in its formidable wake? Or does the mere thought of abandoning the relatively simpler days of ICD-9 give you a bellyache?

In this issue of HMT, we’re focusing on that very issue, with a roundup of experts discussing the best ways to minimize mistakes during the conversion to ICD-10, as well as other articles on coding, claims and compliance.

I have a vested interest in this coding conversion conversation.

I recently received a bill for a few hundred dollars from the local hospital. Since I hadn’t been to the hospital, this concerned me. I contacted the billing office, and a person there gave me several other numbers to call. After discussing the situation with a number of representatives from the hospital, the company that handles the hospital’s billing and my health insurance company, I contacted the only two doctors I had seen within the past year who were connected in any way to the hospital. Both assured me I didn’t owe them anything.

Apparently, the only way to get an itemized bill was to obtain and fill out a form allowing the hospital to send such information to me.

I filled out the form and sent it in. The next week I received another bill from the hospital, this time threatening to contact a collection service if the bill wasn’t paid immediately in full.

I again filled out the form to request an itemized bill and sent it in. Weeks went by. Finally, I received in the mail a work order, coded for insurance, but nothing in English to tell me – the lowly patient – what I supposedly received for my money.

Before I could contact the hospital yet again, I received a call from a collection agency; and every day after that for a few weeks, several times a day.

I sent a letter to the collection agency, explaining the bill is in error and I am disputing it.

A co-worker gave me the name of someone to talk with at the hospital. We played phone tag. The harassing phone calls from the collection agency stopped.

Until yesterday, that is, when the calls began anew, with renewed vigor.

I guess I’ll resume my phone-tag rally with the hospital, and continue to hope for a smooth transition to ICD-10 so that billing errors like this one – all too commonplace today – might become a thing of the past.

On a separate topic, I will be moderating a panel discussion, “From the Technology and Clinical Perspectives: Enterprise Planning for a Diversity of Mobile Devices,” at the third annual World Congress Leadership Summit on mHealth, July 28-29 in Cambridge, Mass. Hope to see you there.

Enjoy the magazine. And, until next time, here’s wishing you good healthcare IT.HMT-Editor-Phil-Colpas-Signature

   

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