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Health Management Technology News
  February 18, 2014
In this issue:

 11 ways to improve your IT team's productivity

 More firms buying insurance for data breaches

 Expect More Tech Acquisitions in 2014

 DRGs and ICD-10 Testing

11 ways to improve your IT team's productivity

1. Set goals -- and be "Agile." "Be Agile in your goal setting," says Zubin Irani, cofounder & CEO, cPrime, a project management consulting company. "Have the team set goals for the quarter -- and break the work into smaller chunks that they can then self-assign and manage."

2. Communicate goals, expectations and roles from the get-go. "Provide your team with background information and the strategic vision behind [each] project, activity, task, etc.," says Hussein Yahfoufi vice president, Technology & Corporate Services, OneRoof Energy, a solar finance provider. "Not only does providing more background and information motivate employees more, [it makes them] feel more engaged."

"Everyone on the team should know what the target is that they are shooting for and what success looks like at the end of their journey," adds Tony McClain, executive partner and client advisor, Geneca, a custom software developer.

"They must be crystal clear on the part they play in [the project] and how they will help the team get to the finish line," McClain says. "It is critically important that every member of the team know and understand what they are a part of and why they exist as it relates to your organization."

3. Provide tools and and infrastructure that promote collaboration and efficiency. "This is basically the cardinal rule for any IT manager," says Wes Wright, CIO, Seattle Children's Hospital. "Even the best team is only as effective as its resources and systems that they use day to day," he says. "If you want to get the most out of your IT team, invest in the proper tools. Deploy incredibly secure, yet user-intuitive solutions that will cut down on manual hours and improve accuracy in identifying network problems."

"Implement a structure that gives shared visibility and metrics to development and IT teams, so the health of an application [or project] is easily viewed by both teams once operational, and issues can be resolved more rapidly," says Andi Gutmans, CEO, Zend, which helps companies develop and deliver mobile and Web apps rapidly.

"Having technology resources that allow communication across branch offices/locations when working on a cross-office project is a must," adds Aaron Weiss, director of Marketing, HP LaserJet and Enterprise Solutions. "IT managers and CIOs [should be able to easily] share project status reports or information updates ... via cloud document management systems that allow teams to easily provide updates to the status

Read the full CIO article here

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More firms buying insurance for data breaches

The threat of cyber hacking, underscored by the credit card breach at Target, is now so great that US businesses are rushing to buy insurance coverage against the expense of being hacked, or losing sensitive customer information.

One in three companies now has insurance to specifically protect against such losses. Last year, cyber insurance polices sold to retailers, hospitals, banks, and other businesses jumped 20 percent, according to Marsh LLC, a New York insurance brokerage firm that tracks the market.

Ultimately, the costs of these policies are picked up by consumers.

A decade since it was first introduced, cyber insurance has graduated from a splurge to a necessity propelled by a series of high-profile data breaches that have cost companies many millions of dollars.

South Shore Hospital purchased its first cyber insurance policy shortly after a data breach put the names, Social Security numbers, and health histories of its 800,000 patients at risk in 2010. The policy didn’t cover South Shore’s costs in that incident — including a $750,000 state settlement for privacy violations — but the Weymouth hospital’s executives decided they needed to be better prepared for the next one.

“Who would have thought about cyber insurance?” said Sarah Darcy, a spokeswoman for the hospital. “It’s such a new coverage to have to have.”

Target’s disclosure recently that hackers had stolen the debit and credit cards of 40 million customers and the PIN numbers, e-mails, and addresses of 70 million people has prompted even greater interest in cyber insurance, industry specialists said. These policies cover the costs of a data loss, from hiring investigators to find the source of the breach to providing credit monitoring for customers to enlisting public relations experts to help salvage the company’s reputation.

The Boston insurer Liberty Mutual, which has been selling primary policies for data breaches since 2011, said the Target data theft prompted executives who were debating whether to buy coverage to make the commitment and sign policies, said Oliver Brew, vice president of privacy and technology underwriting.

Read the full Boston Globe article here

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Expect More Tech Acquisitions in 2014

We'll see more acquisitions over the next five years than we have over the past 10.

I believe we are heading into an extremely aggressive period for mergers and acquisitions. The news of Google buying Nest and Lenovo buying Motorola is just the beginning. The environment is right for more deals of this nature.

If we’re to expect a period of intense mergers, the first thing history tells us as an indicator is that we’re coming off a very deep recession. One of the first things many companies cut during rough times is research and development. The other is marketing. When both these budgets get cut, it tends to put companies behind when it comes to investing for the future. Once times start to get better, as is happening right now in many economies, companies need to catch up on innovation after research and development cuts. The other thing they have to do is spend more time getting their brand and products back into the public mind-share. Acquisitions are a way to do both these things. Strategic and targeted acquisitions help companies get back some of the time they lost due to budget cuts during tough times.

In Lenovo’s case, it acquired Motorola to help gain a clear presence in the U.S. market. Lenovo would have had to spend quite a bit of money developing its U.S. brand with huge marketing spends in order to compete. By acquiring Motorola, Lenovo now has carrier deals in place and a well-known U.S. brand to help get it jump-started in the market.

The other thing that sticks out when you look at the picture of the global technology industry is that many companies have more than a little catching up to do. In certain markets like the the western ones, you see a picture that tells the story of Apple and Samsung dominating. Globally, you see that Apple and Google have both won the platform wars, as they are the only two relevant mobile platforms for tablets and smartphones in markets all over the world. The other thing you see: many companies struggling in markets like PCs. There are a good number of global companies looking to get an edge and catch up to some of the dominant players, and one of the primary strategies for doing this is to acquire companies.

Whether they are looking to compete in their current markets or looking to compete in new markets, I expect large global companies to start spending aggressively.

Read the full Time Tech article here

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DRGs and ICD-10 Testing

As we approach Oct. 1, 2014 – the ICD-10 compliance deadline – we need to know now how the specificity in coding translations will have an impact on the DRGs. CMS has indicated that the DRG payment calculation under ICD-10 will be almost similar to the current ICD-9 system – i.e. revenue neutral. The CMS findings show that 99% of the cases did not show changes in DRGs (when comparing ICD-9 to ICD-10). These being the statistics, is your hospital on the 99% (no changes in DRG revenue amount) or the 1% (changes in the DRG revenue amount) of the normal curve?  The best way to know – and prepare – is to conduct DRG testing within your own organization.

The DRG testing plan should start from the assessment phase. As hospitals prepare for ICD-10 testing, the revenue implications can be minor to major based on the testing scenarios used and implemented at their institutions.

The DRGs are calculated by each hospital in different ways:

  • Coding the medical record in ICD-9 and ICD-10 and then compare the result.
  • Estimate the total claims data by translating ICD-9 to ICD-10 codes and then calculate the DRG.
  • Use permutation technique – all ICD-10 codes that translate to ICD-9 then group each option.

Depending on how the DRGs are calculated, the DRG testing is divided into provider specialty or the maximum/minimum payment variances:

1. There are medical records/cases where there is no permutation feasible – where the codes can return the claim to initial ICD-9 DRG. For these claims, the testing involves:

-Prepare V5010 claims –> submit claims –> payer adjudicates –> receive payment. The amount of time allocated for testing should be minimal.

2. There are other medical records/claims where the DRG shifts occur. Based on the case mix, the cases/medical records can be grouped into clusters (low to high impact or underpayment to overpayment). For each cluster, the following needs to be tested:

  • Evaluating the EMRs structured documents/template and the method used at your hospital.
  • Physician’s clinical documentation (amount of training provided; amount of training needed).
  • Medical coding (ability for the coders to code in ICD-10). This is an iterative process, and needs to be tested repeatedly until the appropriate DRG mix is matched (to the expected value) or if there is a shift.

3. You may have a case mix/medical record where the DRG shift occurs after the claim is submitted to the payers. This scenario occurs when the payers take the ICD-10 claim and then use mapping to their ICD-9 coding system. Based on the results, the payers contract needs to be revisited.

Read the full HiMSS article here

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   February  2014  HMT digital book

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