News 2/18/16

Top News

Complete P.T., Pool & Land Physical Therapy (CA) pays a $25,000 fine to HHS to settle HIPAA violations stemming from testimonials posted to its website without HIPAA-compliant patient permission. The practice must also adopt a corrective action plan and report on its compliance efforts for one year.

Webinars

February 23 (Tuesday) 1:00 ET. “Completing your EMR with a Medical Image Sharing Strategy.” Sponsored by LifeImage. Presenters: Don K. Dennison, consultant; Jim Forrester, director of imaging informatics, UR Medicine. Care coordination can suffer without an effective, cost-efficient way to share images across provider networks. Consolidating image management systems into a single platform such as VNA or PACS doesn’t address the need to exchange images with external organizations. This webinar will address incorporating the right image sharing methods into your health IT strategy.

February 24 (Wednesday) 1:00 ET. “Is Big Data a Big Deal … or Not?” Sponsored by Health Catalyst. Presenter: Dale Sanders, EVP of product development, Health Catalyst. Hadoop is the most powerful and popular technology platform for data analysis in the world, but healthcare adoption has been slow. This webinar will cover why healthcare leaders should care about Hadoop, why big data is a bigger deal outside of healthcare, whether we’re missing the IT boat yet again, and how the cloud reduces adoption barriers by commoditizing the skilled labor impact.

Acquisitions, Funding, Business, and Stock

Forefront Dermatology secures a $47 million second lien debt and equity investment from Penfund in support of Forefront’s acquisition by Omers Private Equity. Manitowoc, WI-based Forefront provides PM services to Dermatology Associates of Wisconsin, operating over 80 clinics across 11 states.

People

Medfusion promotes Kimberly Labow to CEO.

Gerald “Jerry” Peters (Latham & Watkins) joins Cal Index as general counsel.

Radiologic Associates of Fredericksburg (VA) promotes Chris Snyder to practice administrator for Virginia Medical Imaging and Virginia Interventional & Vascular Associates, and appoints Aatif Rahman to director of technical services for Virginia Medical Imaging.

Announcements and Implementations

M&M Chiropractic and Wellness (MI) selects EHR, PM, and RCM technology from IPatientCare.

Windward Urgent Care (HI) implements chronic care management technology from ChronicCareIQ. Matt Ethington, founder and CEO of the Atlanta-based startup, also founded SimplifyMD in 2006, which merge with Azalea Health in 2014.

GeniusDoc integrates document management technology from Updox into its EHR and PM software for hematologists and oncologists.

ITelagen adds PhoneTree’s HealthWave Connect patient-reminder system to its EHR deployment and support services for physician practices.

Telemedicine

Telemedicine-based concierge services provider Patronus Medical integrates BaseHealth’s health assessment engine into its health and wellness plan. The integration will also enable Patronus physicians to create personalized action plans for their patients, set goals, track achievements, and identify emerging trends at the individual and population level.

INeuro Headache Specialist (VA) rolls out a virtual diagnosis service for headache and nerve pain.

Chicago-based startup Opternative raises a $6 million Series A round led by Jump Capital. The company, which has developed an eye-exam and prescription delivery app for consumers between 18 and 40, operates in 33 states. It will use the venture funding to expand the app’s capabilities and age range.

Other

Valentine’s Day may have come and gone, but that doesn’t mean kisses can’t still be exchanged: A new study finds that cohabitating couples share more than gestures of affection; their immune systems become remarkably similar, too. Researchers attribute the phenomenon to the convergence of diet, alcohol intake, and exercise routines, as well as exposure to pollution and infections. Even a couple’s microbiomes become more similar. Fun fact: A 10-second kiss is a conduit for exchanging 80 million bacteria of about 300 species.

Contacts

Jennifer,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

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Readers Write: From Complacency to Compliance – How Physician Coder Training Systems Evolve in Light of ICD-10

From Complacency to Compliance: How Physician Coder Training Systems Evolve in Light of ICD-10
By Daria Bonner and Philip Miles

“You cannot escape the responsibility of tomorrow by evading it today.”

This famous quote by Abraham Lincoln is relevant in our day-to-day experiences, and it’s particularly relevant in healthcare. More specifically, you can’t make ICD-10 go away by simply refusing to learn it. The realities of medical necessity, denied claims, and OIG fines impact all practices and physicians. The days of nonchalant coding in physician practices are gone. Little by little, practices are realizing the importance of accurate and complete coding. They’re also recognizing the need for certified medical coders as part of an integrated professional practice team.

The Tides are Turning
Welcome to a new era of coding where compliance programs, established coding guidelines, and clinical coder certifications are the norm. And these demands for better coding don’t stop at ICD-10. All physician coding practices are prime for improvement, including CPT and E&M. Many practices are under an incorrect assumption that the grace period announced by CMS and the AMA in July 2015 lets them completely off the hook in terms of ICD-10 specificity. In reality, codes submitted from physician practices must still be accurate. The only flexibility is with retrospective audits, denials, and fines — for now.

Effective October 1, 2016, the grace period will end, and all providers will likely see an increase in denials for medical necessity and nonspecific codes. All sites of service, including hospitals, may be affected. Note that pre-payment audits require specificity even during the grace period. Many providers are seeing denials related to these audits now. As a result, coder training and certification within physician practices must evolve and improve. Having certified coders on staff propels coding initiatives and helps drive stronger compliance. Many medical groups have already employed certified medical coders to:

• Navigate the complexities of ICD-10.
• Establish practice-specific coding guidelines and a coding compliance program.
• Support clinical documentation improvement (CDI) efforts.
• Team-up with IT for stronger EHR data integrity and information governance.
• Fine-tune EHR documentation templates for ICD-10.

The first step is to recruit, hire, and retain a certified coder. Keeping your certified coder credentialed and continually educated in a rapidly changing medical practice is next. Quality coder training is an essential operational cost — and one that can’t be ignored.

Technology’s Role in Coder Training
Traditionally, coders travelled to coding conferences for credentialing, updates, and continuing education. However, sending coders offsite has become cost prohibitive for many medical groups and physician practices for three reasons:

• Travel costs sometimes exceed registration for the actual training event.
• Cases pile up and billing stalls when coders are out of the office.
• Backlogged coding disrupts cash flow during a time when practices are particularly vulnerable to ICD-10 denials and payment delays.

Online/virtual coder training systems are rising up to meet this need. That’s because many online learning management systems (LMS) not only offer coders a quality education, but also yield significant cost savings for practices.

A Five-Point Technology Checklist

Aside from the cost of the LMS itself, the only other ongoing cost is effective Internet virus protection. This protection allows coders to access Web browsers and online platforms without the added risk of inadvertently downloading a virus. Most practices have already invested in this software. Another benefit is the pace and format of online coder training. The sky is the limit in terms of online/virtual training developments — particularly in the physician practice market.

Educators continue to explore and enhance virtual options that mirror a live classroom environment, providing a more hands-on experience. Many of these online/virtual options are also self-paced, meaning a coder can move through certain portions of the course more quickly and spend more time focusing on content that seems unfamiliar or challenging.

If you’re going to invest in an LMS, there are key capabilities to include. Consider the following top six characteristics of an effective LMS:

1. Functional and elegant user interface.
2. Efficient and effective back-end (underlying program).
3. No additional software or systems to access the LMS.
4. Simulated “live setting” so students feel as though they’re physically in a classroom setting.
5. Constant feedback mechanisms regarding grades and/or progress.
6. Ability to provide certification.

To maximize effectiveness, practice managers or instructors using the LMS should also be able to complete these tasks:

• Import and segment groups of students.
• Interact with the entire group, a subgroup, or an individual student.
• Update and amend content in real time.
• Allow students to communicate with each other.
• Offer multiple learning modalities.

Credibility Powers Productivity

Beyond the technical and instructor-specific capabilities listed above, training options should be evaluated for their credibility. There is a whole host of online courses for clinical coding in physician practices. It’s important to ensure that each coder obtains high-quality training catered to his or her unique learning style. Use the following checklist to vet coding trainers and find the best solution for your practice:

• Does the instructor hold any credentials? If so, which ones?
• What is the instructor’s educational and professional background? What other courses has he or she taught?
• Is the course backed by an accredited organization? If so, which one?
• Are any prerequisites required?
• What experience do students need before taking the course?
• What type of access will students have to the instructor?
• How much time, on average, will students spend interacting with the LMS daily or weekly?
• What are the goals of the course, and do these goals meet coder expectations?
• Will the course be offered according to a specific schedule?
• What’s the cost of the course, and are payment plans available?

Coding Content is King
When evaluating coder training options, practices also need to focus on content. Today’s physician practice coders require training on a variety of topics, including clinical documentation improvement, coding, auditing, and compliance. Physician practice coders also want to be cross-trained in inpatient and outpatient coding, and they want to learn more about other types of specialized coding. This includes HCC coding and coding for home health and other settings that have become targets for the federal government. Ensure that any LMS you choose includes educational components for each of these areas.

Consult with your coders to ensure the LMS is worthwhile and will ultimately help staff be more productive and compliant. Remember that anyone can create an online training program. Look for a credible source, ask questions, and get references before making a final decision. Now is the time to level-up coder training systems, programs, and coder certification in physician practices — starting with your own.

Daria Bonner is CEO of Xact Healthcare Solutions in Port St. Lucie, FL. Phillip Miles is the owner of The Medical Management Institute in Alpharetta, GA.

Contacts

Jennifer,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

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News 2/17/16

Top News

Somerset, NJ-based Medical Transcription Billing Corp. acquires Houston-based Gulf Coast Billing for an undisclosed sum. GCB Founder, President, and CEO Rhonda Turner will join MTBC as director of business development.

Webinars

February 23 (Tuesday) 1:00 ET. “Completing your EMR with a Medical Image Sharing Strategy.” Sponsored by LifeImage. Presenters: Don K. Dennison, consultant; Jim Forrester, director of imaging informatics, UR Medicine. Care coordination can suffer without an effective, cost-efficient way to share images across provider networks. Consolidating image management systems into a single platform such as VNA or PACS doesn’t address the need to exchange images with external organizations. This webinar will address incorporating the right image sharing methods into your health IT strategy.

February 24 (Wednesday) 1:00 ET. “Is Big Data a Big Deal … or Not?” Sponsored by Health Catalyst. Presenter: Dale Sanders, EVP of product development, Health Catalyst. Hadoop is the most powerful and popular technology platform for data analysis in the world, but healthcare adoption has been slow. This webinar will cover why healthcare leaders should care about Hadoop, why big data is a bigger deal outside of healthcare, whether we’re missing the IT boat yet again, and how the cloud reduces adoption barriers by commoditizing the skilled labor impact.

People

Justin Zellem (Keurig Green Mountain) joins Vermont Information Technology Leader as its new systems administrator.

Announcements and Implementations

Toledo Radiological Associates (OH) extends its RCM and analytics agreement with Zotec Partners for another four years. The 34-radiologist practice has served Northwest Ohio and Southeast Michigan since 1929.

AssistRx, Cerner, DrFirst, NextGen, and Practice Fusion subscribe to the ePrescribing State Law Review from Point-of-Care Partners to proactively identify system modifications that may be needed to address ongoing state and federal regulatory changes.

Telemedicine

The ERISA Industry Committee, which represents some of the nation’s largest employers, formally endorses Michigan Senate Bill 753, which establishes a regulatory framework for telehealth services but doesn’t impose a state licensure requirement. It also “applauds the technology-neutral definition of telehealth put forth in S. 753 that will permit use of different types of technology platforms designed for delivery of health care services. With innovative technologies emerging every day, limiting the types of technology that may be used to provide telemedicine creates an unnecessary barrier to telehealth services. There are many technology platforms that may be used to provide telehealth services, and patients and providers should be allowed to use different types of technology to give and receive needed care.”

Government and Politics

ONC’s latest data brief looks at trends in individual perceptions of medical record privacy and security, and exchange of health information. The brief notes that at least 75 percent of individuals supported their physician’s use of EHRs despite any potential privacy or security concerns, while seven in 10 supported electronically exchanging their health records despite potential privacy or security concerns.

Other

The local paper highlights the efforts of Genesis Medical Associates to stay independent in the midst of an increasingly consolidating Western Pennsylvania healthcare market. Executive Director Mark Kissinger explains that the move to an EHR was bumpy at first, but that technology has ultimately helped the 20-physician practice remain competitive: “

“We moved to an electronic medical record at the end of 2007. No doubt, it’s a challenge. We are in the process of evaluating the decision to move into a new product for those services. Our patient portal is very helpful for our patients to access their medical records, but it’s not as user-friendly as I need it to be. But part of what has made us successful is continuing to look at what tools do we need. Last year, we developed an app for same-day appointment scheduling. That’s the kind of thing we have to be more proactive about.”

They feel my pain: American Airlines sues in-flight WiFi provider Gogo in an effort to switch to its rival, ViaSat, which AA has found to have “materially” improved service. Gogo’s stock fell 30 percent on the news, and the company, which has maintained an almost-monopoly on in-flight WiFi over the last several years, is now attempting to come up with an improved service agreement.

Sponsor Updates

• The local paper highlights Clockwise.md’s online check-in app in its coverage of a new Carolinas HealthCare Systems urgent care facility.

Blog Posts

• Collections by Visit Feature Enhancement (AdvancedMD)
• Patient Access, Patient-Centered Care, and Population Health – Let’s Connect the Dots … (Culbert Healthcare Solutions)
• 5 Tips for Biomeds to Convince Leadership to Invest in RTLS (Versus Technology)

Contacts

Jennifer,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

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From the Consultant’s Corner 2/16/16

Effective IT Governance: It’s a Matter of Integration

When it comes to decision-making within physician practices, historically there’s been a “great divide.” On one side is operations. Operations teams traditionally make decisions about patient access, clinical goals, and revenue cycle objectives driven by their own distinct missions, focus areas, and priorities. On the opposite side is IT. Charged with directing IT programs and setting IT priorities, IT teams frequently function under separate leadership. While both sides of the divide may work very hard to support the same organizational goals, they often overlook the importance of pulling together to advance the practice’s overall strategic goals. An integrated approach to IT governance through the alliance of IT and operations is now essential.

Setting Common Goals
Until the development of truly integrated healthcare vendor solutions, many of a practice’s IT systems were managed autonomously. From a practical perspective, this meant that IT interfaces often represented the extent of collaboration efforts.

Going forward, focus should not be on just the systems themselves, but on aligning IT programs to support dynamic goals. Today’s healthcare environment is fast-paced and interdependent, making it critical for historically insular departments and IT systems working on static goals to move toward a culture of integration and collaboration. For example, achieving quality and financial performance metrics within evolving Meaningful Use and value-based care initiatives will be difficult for practices that attempt to do so with autonomous systems.

Instead, IT ideally will be positioned to support strategic operational goals. While IT leadership should not be asked to drive strategy, it’s imperative that they understand the practice’s overarching ambitions so they can work in harmony with operations to accomplish them.

For example: Consider how a practice’s productivity objectives might be affected by its scheduling system. An IT team unaware of the productivity aims might inadvertently make decisions about scheduling templates that hinder the provider’s ability to see enough patients to achieve the targets. Conversely, an IT team that understands the productivity goals can act as an enabler of the desired change.

The role of operations within this collaborative atmosphere is to point everyone in the same direction. Although IT teams possess the expertise to manage technical infrastructure, operations teams generally are in the best position to help navigate an organization’s clinical and political landscape.

Best Practices
To develop an integrated governance structure, practices should consider taking a four-tiered approach:

1. Start at the top, with executive leadership. C-suite executives are the ones who must define both short- and long-term practice-wide objectives, complete with clearly described expectations for success. (How will a practice know, for example, if it is attaining the desired return on its investments?) Once executives define the goals, they must then communicate them and provide staff with the right resources to accomplish them.
2. Integrate governance at the practice level. IT implementations can no longer be led solely by IT leadership. Rather, integrated leadership teams should be co-chaired by IT leadership and the CMOs/CMIOs who traditionally oversee clinical quality and operations.
3. Create an integrated leadership council. All organizational aspects should be represented on a working council. Include leadership from patient access, clinical quality, and revenue cycle, for example. Together, council members should define the standards the practice wishes to accomplish: quality, financial, and patient satisfaction goals, for instance.
4. Form integrated work groups. Once an integrated leadership council has defined the standards to be met, work groups consisting of IT and operations can then be tasked with implementing them.

In today’s healthcare environment, pushing top-down IT decisions onto providers should be a thing of the past. The fact is, it isn’t just about IT anymore. It’s about implementing a decision-making process that supports practice goals. The only way that IT leaders will know if their overall strategy is aligned with organizational objectives is if an integrated governance structure enables them to work in tandem with operations.

Brad Boyd is vice president of sales and marketing for Culbert Healthcare Solutions.

Contacts

Jennifer,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

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News 2/16/16

Top News

CMS and the Core Measures Collaborative release seven sets of core clinical quality measures to streamline physician quality programs across payers. The new measures pertain to ACOs, patient-centered medical homes, and primary care; cardiology; gastroenterology; HIV and Hepatitis C; medical oncology; obstetrics and gynecology; and orthopedics. Implementation of the new measures is in the works for Medicaid and Medicare, and will be phased in by private payers. CMS notes that implementation will depend on the availability of clinical data from EHRs or registries; as such, the agency recommends that “[p]rovders and payers will need to work together to create a reporting infrastructure for such measures.”

Webinars

February 17 (Wednesday) noon ET. “Take Me To Your Leader: Catholic Health Initiatives on Executive Buy-In for Enterprise Analytics.” Sponsored by Premier. Presenters: Jim Reichert, MD, PhD, VP of analytics, Catholic Health Initiatives; Rush Shah, product manager analytics factory, Premier. Catholic Health Initiatives, the nation’s second-largest non-profit health system, knew that in order to build an enterprise analytics strategy, they needed a vision, prioritization, and most importantly buy-in from their executives. Dr. Jim Reichert will walk through their approach.

February 23 (Tuesday) 1:00 ET. “Completing your EMR with a Medical Image Sharing Strategy.” Sponsored by LifeImage. Presenters: Don K. Dennison, consultant; Jim Forrester, director of imaging informatics, UR Medicine. Care coordination can suffer without an effective, cost-efficient way to share images across provider networks. Consolidating image management systems into a single platform such as VNA or PACS doesn’t address the need to exchange images with external organizations. This webinar will address incorporating the right image sharing methods into your health IT strategy.

Telemedicine

Associates in Dermatology (KY) launches telemedicine services via a partnership with Pittsburgh-based teledermatology company Iagnosis.

The village of Vicksburg, MI offers telemedicine services via Teladoc to its 25 employees and members of the village council.

Announcements and Implementations

Jellyfish Health develops a mobile app enabling patients to find, schedule, and wait for a physician using their mobile device. Jellyfish Health President and CEO Dave Dyell founded ISirona in 2008, becoming senior vice president of product development for Nanthealth when the two companies merged in 2014.

The Jewish Board of Family and Children’s Services selects Netsmart technologies including the company’s CareRecord EHR to better provide mental and behavioral health services to its 43,000 clients in New York City. The board will also work with Netsmart to develop new technologies and demonstrate improved outcomes to Netsmart clients.

AssessURHealth releases a mental health risk assessment survey app to help physicians screen pregnant women and new mothers for postnatal depression.

People

Matthew Kremke (AMA) joins the American Osteopathic Information Association as vice president of business development.

Sara Barry (University of Vermont) joins OneCare of Vermont as director of clinical and quality improvement. 

Research and Innovation

Biomedical data analysis company Seven Bridges opens up its Cancer Genomics Cloud, including the National Cancer Institute’s Cancer Genome Atlas, to researchers across the globe. The database of over 11,000 patients and 33 types of cancer is used by oncologists, data scientists, and geneticists to better understand the disease a tool likely to be used by Vice President Joe Biden’s Cancer Moonshot Task Force.

Other

Apple officially acknowledges a bug that will render newer IPhones useless if their internal clock is set back to January 1, 1970 (a full six years before the company was founded). Rumors swirled around the notion that setting the clock back would uncover an “Easter Egg” that puts a retro Apple logo theme on the phone’s display. An impending software update will soon fix the glitch.

Contacts

Jennifer,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

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