Viewpoint

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

 

Welcome to the healthcare industry’s IT purchasing guide

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Congratulations are in order: We’ve made it halfway through another year. And as we do every June, it’s time for us at Health Management Technology magazine to unveil our healthcare IT resource guide for 2011-2012.

Regardless of whether your political ideologies swing left or right, it must be acknowledged that the $19 billion worth of federal incentive programs offered through the HITECH (Health Information Technology for Economic and Clinical Health) Act have provided an impetus for change within the healthcare industry, motivating practices both small and large to jump into the electronic fray sooner rather than later.

With incentive payments beginning this year for electronic health records systems and in 2013 for ICD-10 conversions, it’s no wonder there are literally thousands of healthcare IT vendors – and more cropping up all the time – willing to help providers achieve meaningful use.

And in order to meet meaningful use, the current Stage 1 proposal states that a minimum of 40 percent of prescriptions must be sent electronically; this increases to 50 percent in Stage 2 and 80 percent in Stage 3. It’s a safe bet that everywhere along the meaningful-use timeline, there will be a veritable plethora of vendors vying for your attention.

This resource guide is our attempt to make some sense of the wide and wild landscape that is healthcare IT, to identify companies based upon their strengths and, hopefully, to provide a source of valuable information to our readers. At the very least, it provides a starting point for those seeking the right healthcare IT vendor and solution for their particular situation and circumstance.

The resource guide is set up as follows: Companies are listed under one or more of about 80 topic-specific categories – for example, CPOE (computerized physician order entry) – so that vendors can be located based upon need. The index in the back of the book lists companies alphabetically, so that if you have a particular vendor in mind, you can immediately find information about that company, the services it provides, a description, its Web site address and physical address.

I’d like to thank every member of the team here at NP Communications for going above and beyond again this year to put this resource guide together. It was a daunting task; but, happily, no one balked and ran for the hills!

Enjoy the magazine. If you’re in Orlando for HFMA the end of June, we hope to see you. And, until next time, here’s wishing you good healthcare IT.

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A Dear John letter to technology

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Back in October of last year, I wrote an editorial titled “Technology is here to help us … right?” It was inspired by a server move that left us – how do I put this? – technologically … um … unsatisfied.

Since then, I’ve kept my feelings bottled up inside. Being a musician, I typically take frustrations out on my guitar. But for this gig, it’s more important that I write a letter:

Dear technology,
We need to talk.
I’d love to say that all the wrongs have been righted, that you’ve apologized and that we’ve reunited in a torrid love affair that is making all the other trade magazines jealous.
But I’d be lying.
It’s time we cleared the air.
It’s time for you to stop pretending, technology. Stop pretending you’re there for us when sometimes you’re not even available to host the Web site or share industry news with our friends.
You didn’t think I’d notice when your increased bandwidth allowed you to perform more tasks in the background. But it also gave you more excuses to not be available.
Stop acting like it didn’t hurt when you started allowing e-mails from those Russian “brides” into my in box when they clearly had nothing but SPAM on their minds. What about us? I thought you were supposed to make our lives easier.
I wish you all the best, technology, but this just isn’t working out.

Fact is, we all have a love-hate relationship with technology. And with all of the aggravation it brings on a daily basis, it’s easy to forget that technology allows us to regularly perform feats that just a few decades ago would have been called miraculous; indeed, the stuff dreams were made of.

As advancing technology allows interfaces to simplify, the back-end, often-behind-the-scenes processes are growing more and more complex. And if relatively elementary server and e-mail systems can break down (as in the above, mostly tongue-in-cheek missive), the myriad ways complex healthcare IT solutions can malfunction boggles the mind.

All this underscores the need for the ongoing exchange of information between vendor and end-user that Health Management Technology can provide.

To that end, this month we present a special issue focusing on cutting-edge technology; specifically, handheld devices and how they are changing the healthcare IT landscape.

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

   

Exhibition hall speed walking

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For a few days every year, at least, my fitness plan is set. No, I didn’t join a gym; nor did I purchase a treadmill or one of Tony Little’s Gazelles. I simply go to HIMSS.

In fact, I recently returned from Orlando, where HMT attended the aforementioned annual HIMSS conference, the Big Kahuna of healthcare IT trade shows.

I spent three days walking many, many miles around the mammoth exhibition hall. Just about every half-hour, I had a meeting with a different vendor – usually at their booth. It was a great deal of work, especially when my best-laid plans to keep meetings all within a few hundred yards of each other fell through, and I found myself moving at top speed from one end of the hall to the other to make my next appointment. As it turns out, it was well worth it, though, as I had sit-down (or stand-up; sometimes they didn’t provide chairs) dialogue with about 40 companies and some of their end users.

As I’ve stated here previously, HIMSS is big. It’s really big. To say that it’s a huge undertaking would be an understatement.

I heard that the exhibition area alone was the length of seven football fields. (I was unable to corroborate this, but my aching feet believe this to be true.)
During my three days at HIMSS, I picked up on a few things:

Trend: proactive care management. (I hear you laughing, Europe, Canada, New Zealand, Australia and parts of Asia. So we’re a little slow.)

Trend: “Vendor neutral,” which was everywhere at last year’s show, has morphed into “vendor agnostic.” I’m not sure why, but “vendor neutral” is now, apparently, verboten. This evoked a memory remnant from a past HIMSS, where one vendor told me “there is no such thing as vendor neutral.” Perhaps that has something to do with the term’s downfall. Funny thing is some people are already raising a stink about “vendor agnostic,” saying that it has “negative religious implications.”

One area that seemed to be on the back burner at last year’s HIMSS that was omnipresent at this year’s conference: security. In fact, after HIMSS10, we mentioned right in this very column we thought it was a mistake that security was not a more top-of-mind issue, and it’s even more important now with the explosion of mobile devices and apps.

A record-breaking 31,225 attendees were present, almost all of them armed with smart phones; many attempted – unsuccessfully – to navigate the crowd while paying all of their attention to their phones and none to what was in front of them.

All in all, HIMSS was a great success. I met many people, learned many things. And I got some exercise.

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When will healthcare IT actually improve the patient experience?

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Did you ever get the feeling that no one even looks at the reams of paperwork we’re forced to fill out each and every time we visit a medical facility?

See if this scenario sounds familiar:

You enter your doctor’s office, approach the glass window, greet the people behind the counter, sign in and receive a clipboard filled with several sheets for you to fill out and a pen that works intermittently, at best.

Among the questions asked are the same things you filled out the last time you visited your doctor’s office, and every time before that. These include: address, phone number, emergency contact, current medications, allergies and the reason you are there.

You dutifully fill out all the paperwork – again – and take your place in the crowded waiting room, competing with the other patrons for a four-year-old Mademoiselle magazine that you normally wouldn’t be caught dead reading.
You wait for a good hour past your appointment time – your blood pressure rising with each minute you are made to wait – and finally receive the call you’ve been waiting for.

In my case, I hear, “Phillup Call-pass?” Close enough.

The nurse asks how you’re doing. You try to be nice, but you’re thinking to yourself, “How do you think I’m doing!? My appointment was an hour ago!” (In no other industry would this inability to keep appointments be deemed acceptable, let alone the rule.)

You are weighed. Your blood pressure is taken. (“It’s a little high.” “Really? I wonder why that could be.”) Then the nurse proceeds to ask all of the questions you just answered while filling out the reams of paperwork in the waiting room; she ends with, “Why are you here today?” You dutifully and patiently answer all queries. Again.

You then are left alone in the examination room to wait some more. It is at this point you realize that you have merely graduated to a private waiting room without even four-year-old magazines to entertain you as you wait for the elusive doctor, who clearly isn’t very good at keeping appointments.

When the doctor finally does grace you with his presence, he looks through a plethora of handwritten notes and asks, “Why are you here today?”

This evoked a memory remnant of an editorial from several years ago by a former editor of HMT, who was bemoaning the archaic state of medical records when she went with a friend to a veterinarian’s office. For Fido, everything was state of the art, fully computerized and smooth as silk. Appointment times were kept, all data was completely electronic and paperless and Fido’s owner was given an itemized bill at the time of services.

I think the next time I need medical attention, I may try the canine hospital down the street …

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

 

   

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