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HIT Jobs Survey, Part 2

stephanie — Thu, 20 May 2010 18:07:15 +0000

This second installment of the 2010 ASHIM’s Health IT Jobs survey explores workforce training and demand.

What do you really think about Health IT and Jobs? This 5 question survey takes less than 2 minutes to complete. Your Vote Counts! Take this short ASHIM survey –and we will send you the final results.

Advantages and Pitfalls of Electronic Health Records from a Billing Perspective

stephanie — Fri, 16 Apr 2010 19:34:22 +0000

Michael Stearns, MD, CPC, CFPC™

by Michael Stearns, MD, CPC, CFPC™

President & CEO e-MDs

Electronic health record (EHR) software applications feature tools that assist providers with improved charge capture and more accurate evaluation and management (E&M) coding. These systems record the type of visit and the relevant information documented in the history, physical examination, assessment, plan, and other sections of the clinical record. When a procedure is selected, the supporting billing codes (e.g., ICD-9-CM, HCPCS, and CPT©) are recorded and made available to a practice management system, greatly reducing the potential for the provider to neglect to enter this code on a paper super bill. The systems also automate the calculation of a suggested E&M code that is then presented to the provider for review and approval. In general, improved charge capture leads to somewhat higher coding levels, with annual per provider reimbursements increasing in some cases by $30,000 or more. Currently less than 20% of physicians are using EHRs, but as this number increases, payers are likely to see an increase in average physician billing levels. This in turn may prompt more rigorous assessments of how providers are using EHRs and their E&M coding tools.

This article will explore how EHR coding tools, if used correctly, can improve charge capture and the accuracy of E&M coding. It will also examine how some features unique to EHR documentation and E&M code determination, if improperly used, could put providers at risk for submitting inaccurate codes or even committing fraud.

EHRs provide a great deal of structure to the documentation process by presenting context-specific information that can be used for optimal clinical care, guideline compliance, medicolegal defense, and accurate coding. EHRs recognize charges that should be captured during clinical care and when information related to evaluation and management coding is documented in the history, physical examination, assessment, and plan. However, these coding tools are not perfect and require the user to carefully review the documentation and codes presented before authorizing it to be submitted for the specified encounter. A significant benefit of this process is that feedback on coding rules presented to the provider during the documentation process can improve provider understanding of E&M coding and improve their coding accuracy. Users must also carefully screen for charges that may have been generated through the EHR but that were not actually provided.

Providers need to be aware of certain nuances of EHRs that could lead to inaccurate documentation and coding. Several examples are detailed below:

Templated documentation EHR products typically use some type of stored text in the form of templates or macros to improve documentation efficiency. This may include procedures that are checked by default (e.g., ordering a urinalysis when using a template for a urinary tract infection). Templates may contain extensive levels of detail for each section of the note that are “pre-populated” with information that may or may not be accurate for the visit at hand. On the positive side, templates can improve care by increasing compliance with quality of care measures and by providing clinicians with information related to history taking, the examination, diagnosis and management, and compliance with guidelines. However, templated information represents defaults that need to be carefully modified and reviewed by providers. Templated defaults in the review of systems (ROS) section of a note are a common example of information that may contain a number of default values (e.g., denies fever, chills, chest pain, cough, etc.). Accepting defaults that do not precisely match the information that was obtained during the encounter may be considered fraud, particularly if the default information is used to support the E&M code submitted via a claim or reflects procedures that were not actually performed during that encounter.

Pulling forward information from previous notes Many EHRs allow providers to reuse some or all components of an old progress note as a template for a new visit. This can improve the efficiency of documentation. But information that is pulled forward must be modified so that it accurately represents the information that was obtained during that visit. This process may also lead to orders being automatically pulled forward from a previous encounter that were not indicated during the current visit. Using information that was not actually obtained during the visit to justify an E&M code or billing for a procedure that was not actually performed, may also be considered fraudulent behavior.

Automated settings that lead to documentation that is not medically necessary from a coding perspective This may occur when the EHR has automated settings that add, for example, the patient’s social and family history to each visit, even for frequent minor visits (e.g., blood pressure checks). For some encounters, this may not be medically necessary and should not be used in the calculation of the level of service for that visit.

Documentation of complexity of medical decision making in the assessment Detailed discussions related to the thought process surrounding how diagnoses are rendered are often unique to each clinical situation. This type of information is difficult to capture via templates or macros, making this an area that may require additional effort on the part of providers. EHR products vary significantly in how they manage the documentation in this section. In general providers should avoid bulleted lists of diagnoses without supporting documentation.

Another concern is that the approaches taken by different EHR vendors vary considerably as to how they calculate the suggested E&M code and how information on what charges are being forwarded to a billing application or service is presented. The nuances of calculating the complexity of medical decision making, which include number of diagnoses or management options considered, amount and/or complexity of data to be reviewed, and risk of significant complications, morbidity and/or mortality, often require some degree of direct input from a provider. Some EHR vendors walk a fine line when their tools encourage users to add additional documentation to support higher levels of coding; a process that is viewed by many coding professionals as encouragement for providers to add documentation that may not be medically necessary solely for the purpose of increasing reimbursement.

In summary, the use of E&M coding tools in EHRs has the potential to improve charge capture and the accuracy of coding, although this generally leads to higher coding levels per encounter. This will in turn lead to greater scrutiny of how the coding related aspects of EHRs are used by providers, who remain responsible for the accuracy of the codes they submit via claims.

Providers will need to carefully review the generated claims from each encounter and expand their knowledge of the E&M coding rules. EHR users are encouraged to participate in continuing education specifically related to how their EHR calculates E&M codes and how to avoid committing what might be viewed as fraudulent behavior. A key component of this should include the need to remain vigilant in ensuring that any machine generated documentation contains information that was actually performed, medically necessary, and free of any material (e.g., template defaulted findings) that does not accurately reflect procedures performed or findings obtained during the visit. Lastly, given the variances between EHR systems, a federally recognized certification process for EHR E&M coding tools would help to standardize the process by which the E&M coding levels are determined in EHRs. However, even with this tool in place, providers will still need to have a detailed understanding of the benefits and pitfalls of using EHRs from a coding perspective.

Reprinted with permission from Parses, Inc

President and CEO of e-MDs Dr. Stearns is a board certified neurologist and one of the more experienced physician health care informaticists in the nation. e-MDs Solution is a Texas-based electronic health record and practice management software company. Dr. Stearns is a member of the ASHIM’s Health IT Industry Advisory Panel, the Health Information Technology Standards Panel, and the AAPC’s Family Practice Steering Committee.

Health IT Guru Sweepstakes

stephanie — Wed, 31 Mar 2010 17:35:53 +0000

Enter TODAY for your chance to WIN the Health IT Guru Sweepstakes sponsored by the American Society of Health Informatics Managers. Sweepstakes prize will be drawn on April 28, 2010 @ 09:58 am (PDT). No purchase necessary. Must be 18 to enter.

CLICK HERE TO ENTER THE SWEEPSTAKES – expired

2010 Chapter President Nominations

stephanie — Wed, 24 Mar 2010 18:00:35 +0000

2010 Chapter President Nominations are currently being accepted for the following locations:

Los Angeles,

San Fran,

Phoenix,

Miami,

Raleigh,

Seattle,

Twin Falls,

Elmhurst, and

Lexington.

CHECK US OUT ON MEETUP.COM

Please send your resume/bio to jjohnson@ashim.org to be considered

Health IT Consultants: EHR Vendor Directory – There’s an App for That

stephanie — Thu, 18 Mar 2010 18:07:43 +0000

ACCESS EHRBook APPLICATION HERE: Click here http://ashim.org/ehrbook/

Free smartphone application for Health IT consultants helps physicians select an Electronic Health Record (EHR)

Salt Lake City, UT (PRWEB) March 18, 2010 — The American Society of Health Informatics Managers, Inc. (ASHIM) today announced the release and immediate availability of a mobile application for smartphones. The free application enables Health IT Consultants to help physicians select an Electronic Health Record (EHR).

“In today’s rapidly expanding sea of EHR products, most Health IT experts develop a personal preference,” said Susan Nagel, ASHIM’s National HIT Member Services Director, “but having familiarity with only one or two EHRs is about as useful to most physicians as a mechanic who only knows one automotive maker.”

The web-enabled application, called EHRBook, lists products by keywords to narrow the EHR search based on the preferences of the physician. It’s designed for use with the Blackberry, Android, Palm Pre and iPhone mobile platforms. “This puts an entire searchable EHR vendor directory at the consultant’s fingertips,” says Nagel, “they can quickly produce an unbiased product list while they are sitting with the physician.”

To access the EHRBook application and for more information about ASHIM visit the organization’s Web site, www.ashim.org under the “Featured News” page.

TO ACCESS the APPLICATION: Click here http://ashim.org/ehrbook/

About the American Society of Health Informatics Managers (ASHIM, www.ashim.org)

The American Society of Health Informatics Managers (ASHIM) is a professional member association for IT professionals who specialize in Health IT. ASHIM is a non-profit, non-governmental organization that sponsors a credentialing exam to certify the healthcare industry knowledge of working level IT professionals, known as the Certified Health Informatics Systems Professional (CHISP) exam.

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ACCESS EHRBook APPLICATION HERE: Click here http://ashim.org/ehrbook/

Survey Takes Pulse on New Jobs in Health IT

stephanie — Tue, 09 Feb 2010 23:13:24 +0000

CLICK HERE for Survey Results

FOR IMMEDIATE RELEASE:

The American Society of Health Informatics Managers (ASHIM) collects public opinion on new Health IT Jobs to better survey the growing needs of the healthcare industry, the health information technology profession and interests of the engaged American public.

Salt Lake City, UT (PRWEB) February 10, 2010 — The American Society of Health Informatics Managers (ASHIM) today published results of it survey on Health IT Jobs. ASHIM conducted this survey in response to data from the United States Bureau of Labor Statistics, which indicated a national deficit of qualified Health IT (HIT) workers. Its purpose was to provide an early stage snapshot of the jobs activities taking place around HIT in the United States.

“While employers are ramping up to adopt Electronic Health Records (EHR), IT workers are looking to augment their skills to meet those needs and to effectively communicate their qualifications,” said ASHIM Senior Vice President Stephanie L. Jones. “ASHIM believes it is important to understand and support the evolving needs of the health care community and will continue conducting this survey, adjusting questions, to inquire about them.”

Survey results show that the hiring public is most interested in HIT professionals with both health care industry and IT experience. Participants of the survey believe Consultants and IT Application Trainers will fill most new positions; followed closely by new sales and technical IT positions. Responders also believe IT professionals will seek additional skills to work in HIT and that specialized HIT certification by working level IT professionals is valuable in the hiring process.

For a complete copy of the ASHIM HIT Jobs survey results and for more information about ASHIM visit the organization’s Web site, www.ashim.org under the “Featured News” page.

About the American Society of Health Informatics Managers (ASHIM, www.ashim.org)

The American Society of Health Informatics Managers (ASHIM) is a professional member association for IT professionals who specialize in Health IT. ASHIM is non-profit, non-governmental organization that sponsors a credentialing exam to certify the healthcare industry knowledge of working level IT professionals, known as the Certified Health Informatics Systems Professional (CHISP) exam.

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CLICK HERE for Survey Results

Health IT and Jobs – Survey

stephanie — Fri, 29 Jan 2010 18:26:31 +0000

What do you think about Health IT and Jobs? Your Vote Counts!

Take this short ASHIM survey –and we will send you the final results.

ASHIM members SAVE $1200 on Winter Health IT Summit!

stephanie — Wed, 30 Dec 2009 18:33:29 +0000

ASHIM members SAVE $1200 on Winter Health IT Summit!

February 9-10, 2010

Sheraton Wild Horse Pass Resort & Spa, Phoenix
To help serve our members, ASHIM has negotiated a special rate for the Winter Health IT Summit by the Institute for Health Technology Transformation.

The Institute for Health Technology Transformation has agreed to offer a special scholarship price of $195 to attend this high level, informative, health information technology conference. In order to take advantage of this ASHIM member offe,r registrants must confirm no later than January 29th, 2010 (as space is limited.) After January 29th the pass will resume to be priced at its standard price of $1395.

Email Snagel@ashim.org for the ASHIM member promotion code that lets you save $1200 off the conference list price and then Click Here to Register.

The Winter Health IT Summit is designed to bring together C-level, physician, practice management and IT decision-makers from North America’s leading provider organizations and physician practices. For two full days, executives interact with a national audience of peers, national leaders, and solution providers featuring the latest solutions for practice management, mobility, telemedicine, outsourcing, IT infrastructure, next-generation electronic medical records, disease management, and more. http://www.ihealthtran.com/hitwintersummit.html

The Winter Health IT Summit brings together the nation’s leading experts and innovators impacting change on our country’s healthcare system. Some of this year’s participants include: RelayHealth, Kaiser Permanente, Arrowhead Regional Medical Center, Wellpoint Health, Dossia, Healthcare Partners, El Centro Regional Medical Center, WebMD, Wellspan, Intermountain Healthcare, St. Luke’s Health System, Google Health, Pfizer, California Dept. of Veterans Affairs, Cedars Sinai, Avera Health, Florida Hospice of the Suncoast, VeriSign, JaxCare, Visiting Nurse Service of New York, Pacific Business Group on Health, GE Healthcare, Welch Allyn, Indian Health Service, Inland Northwest Health Service, Alcatel-Lucent, Wellspan Health, Blue Cross Blue Shield Florida, Carespark, University Hospitals and many more.

New ASHIM Association Bridges Certification Gap in Healthcare Informatics

stephanie — Tue, 10 Nov 2009 19:44:15 +0000

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New ASHIM Association Bridges Certification Gap in Healthcare Informatics

Posted : Tue, 10 Nov 2009 18:01:51 GMT, Author : PRWeb, Category : Press Release

SALT LAKE CITY—Nov. 11, 2009—A new association has formed to bridge a gap in Healthcare Information Technology (HIT) by providing a nationally recognized credential that certifies the healthcare industry knowledge of working-level IT professionals. The American Society of Health Informatics Managers (ASHIM, www.ashim.org) comes at a time when HIT is more important than ever, with billions in stimulus funding allotted for the HITECH Act and healthcare organizations putting increased emphasis on EHRs. ASHIM’s industry advisory board is comprised of leaders and influential individuals from all sectors of HIT.

ASHIM’s brand new certification, the Certified Health Informatics Systems Professional (CHISP™) credential, was developed in response to a national need for a capable Health IT workforce able to support the adoption of various Health IT tools and resources. The CHISP™ credential provides the hiring public with a means to differentiate the skills of IT professionals by validating their current healthcare industry knowledge. The credential also provides a means for job applicants to inform prospective employers of their qualifications with respect to the healthcare industry. It serves to validate the superior knowledge and skill of IT professionals already serving the healthcare community.

“We are thrilled about the launch of ASHIM—ASHIM provides our healthcare community with the means to ensure a skilled Health IT workforce,” said ASHIM Senior Vice President Stephanie L. Jones. “We believe that IT professionals who are knowledgeable in healthcare are what make it easier for physicians to use HIT in a manner that improves patient outcomes and overall efficiencies. It is this enhanced ability to communicate that makes a CHISP™-certified IT professional the best supporter of HIT.”

The certification exam, which begins beta testing in December, gives examinees the opportunity to demonstrate their understanding of healthcare as a business and an industry, as well as their ability to interact on a clinical level with physicians and other healthcare professionals. The CHISP™ exam does not require a test taker to go to a testing facility; instead it is delivered using online secured testing technologies that allow for a “green” exam, which is both fully proctored and high-stakes secured. The CHISP™ certification indicates that an individual of high professional integrity has achieved a measurable level of knowledge and expertise in the healthcare industry.

More information about ASHIM, the CHISP™ certification and membership is available on the organization’s Web site, www.ashim.org. About the American Society of Health Informatics Managers (ASHIM, www.ashim.org) The American Society of Health Informatics Managers, Inc. (ASHIM) is a professional member association for IT professionals who specialize in Health IT (HIT). ASHIM is a nonprofit, non-governmental organization that conducts a nationally recognized credentialing exam to certify the healthcare industry knowledge of working level IT professionals, known as the Certified Health Informatics Systems Professional (CHISP™). The CHISP™ credential certifies the healthcare industry knowledge of individuals who have working experience that is hardware related, software related, data related, or clinical IT training related.

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Interview with Joel White, Executive Director, Health IT Now! Coalition

Admin — Thu, 17 Sep 2009 13:12:25 +0000

Joel White, Executive Director, Health IT Now! Coalition

Mr. White runs Washington, D.C. based consulting firm, JC White Consulting, and provides clients with strategic, political and policy advice to help navigate the Congressional and Regulatory processes. His focus is primarily on health and tax issues. In addition, he is a Visiting Senior Fellow at the Galen Institute, a non-profit research organization devoted to health and tax policy. Mr. White is on ASHIM’s Health IT Industry Advisory Panel (HIT-IAP).

Interview

ASHIM: The availability of funds through the ARRA (American Recovery and Reinvestment Act of 2009) is on a one year timeline for hospitals and 18 months for individually practicing physicians. Do you believe these funds (total $63,750 over 5 years) will entice enough practitioners to take advantage of the program?

Joel White: That is a fundamental business profit and loss issue. Most physicians have a $400,000 to $500,000 revenue stream… so a ten percent incentive may not be enough. Also, the expenditure for new hardware and software is around $45,000 to $70,000. The question a doctor will ask…is my change in procedure and operation going to decrease productivity and show up in my bottom line in the short term. The answer has to be yes.

This funding of HIT will succeed if it leverages behavior! By that I mean, the funding is a tool to deliver more active and better service to patients. Through computerization of healthcare will become more proactive instead of its current reactive process.

Additionally, the financial aspect is really secondary to the benefits of HIT in the long run. Physicians have always decried the fact they spend less time with patients then with administrative tasks. IT has changed every industry (finance, auto, manufacturing, etc) to a more productive and efficient operation and now it’s time for healthcare to do the same.

The increase in efficiency in this case will be an overall improved healthcare system for a patient’s medical and lifestyle needs.

ASHIM: How do you see HIT being more proactive?

JW: Certainly more data will be available instantly providing the doctor resources to make quicker decisions. As an example, rapid weight gain for a congestive heart failure patient can be a significant warning sign. Today the patient is instructed to call the doctors office to report any changes.

However, with HIT the weight scale the patient uses could send a signal instantly to their Electronic Health Records (EHR). The office is alerted and provides the physician with the data. In this way the doctor’s office can be proactive in monitoring the patient and setting up an office visit. Time is lost when a patient is requested to take action, sometimes causing significant consequences.

AHSIM: What do you see on the horizon from Washington that will help HIT reach its goal of 40% participation by 2012?

JW: Many things are still unclear as to how all this ARRA funding will get into the hands of the practitioners. One issue circulating in the halls of congress, since the funding currently only includes practices that accept Medicare and Medicaid, is how the remainder of the healthcare industry (60%) can be enticed to make the changes.

The benefits of HIT are really not difficult to sell. Younger physicians who have grown up with current technology will readily adapt and set up their practices with technology in mind. It is the seasoned physicians who basically have to reeducate themselves. The time factor is a major deterrent, because they see it as just another thing they have to do away from their primary goal of serving patients.

We’re hoping as these changes are implemented and software becomes more user friendly, those who are resistant to change will see the incredible advantages and embrace it. Remember, the goal in the end is to increase the time with a patient, decrease the administrative workload, reduce patient errors, and hopefully improve the bottom line. Over the last ten years, practitioners have seen a significant erosion of their net income. With HIT, I see everyone benefiting!

ASHIM: Any suggestions for physicians or IT professionals that may make this entire process easier?

JW: Without a doubt, this is a great time for IT people in healthcare; a field which has a really bright future. It is projected the major stumbling block to meet the time lines will be the lack of IT savvy individuals in medicine. Those industries in a recession may provide the resources to solve that issue.

For physicians? I would say get into the “know” as quickly as you can. If the changes are approached over the next two years in a constructive and positive manner, I see the transition to be much easier and cost effective then waiting until the end and doing it all at once.

Also, physicians should use their associations to work toward what they want and need, not have it come from the top down. I think working from the bottom up with Washington will certify results benefiting patients and physicians. Everyone needs to remember, third party payers are well organized and intend to protect their interests, other participants in healthcare should do the same.

Physicians are intelligent business people who will easily see all the benefits of EHR and HIT and will join once there is clarity in how all this will work. The true challenge is for regulators to provide all the tools needed to convert an outdated system into a model of efficiency.