Message from
Senior Management
Frank Fortner
Sr.
Vice President
Applications
Series
Senior Management
'Twas the Year Before
HITECH
Frank Fortner, Sr. Vice President - Applications
'Twas
the year before HITECH and all through IT
Not an EMR was in use (not meaningfully).
The incentives were dangled by old Medicare
In hopes that providers would all want their share.
The
checkbooks were tightened and watched in '09
IT spending was light as we waited and pined,
For the final position of Doc Blumenthal
And the certification of health systems for all...
I could certainly go on here, but this is a very long poem, so I'll exercise
mercy and (hopefully) keep my day job. The real point is that 2009 is
swiftly coming to a close and it is with great anticipation that the
industry waits (somewhat) patiently on the eve of HITECH for the stimulus
ball to begin rolling in early 2010.
December should prove to be a very busy month in the mad march toward
HITECH. HHS Secretary Kathleen Sebelius has until December 31 of this year
to issue an interim rule on the definition of meaningful use, which is the
key to unlocking federal funding for hospitals and providers. While most of
us shop for gifts and prepare for time with family and friends, David
Blumenthal, the National Coordinator for Health Information Technology, is
working hard to deliver his position to the HHS Secretary. After the interim
rule is issued and a period for public comment, we should expect to see the
final definition by the end of the first quarter in 2010.
In addition, we will soon be hearing about the first Regional Extension Centers (REC) established by the government to help providers select, deploy and meaningfully use EHR technology. These centers will be U.S.-based non-profit organizations that will also be connected to a national Health Information Technology Research Center (HITRC) that will serve as a centralized collaborative for the various RECs. Each REC will support up to 100,000 primary care providers in a particular geographic area. The plan calls for the establishment of approximately 70 RECs to be established and functional by the end of 2010.
Finally,
2010 will also mark an exciting milestone for Iatric Systems – 20 years in
the healthcare IT business! We believe our experience is particularly
meaningful to our customers, because many of the components found in the
meaningful use matrix are current areas of expertise for Iatric Systems.
From HIPAA privacy and security to medication reconciliation, discharge
instructions, patient and physician portals and health information exchange,
Iatric Systems has the tools and talent to help your hospital meet its
specific care goals and objectives.
As we say goodbye to this year, we look forward to helping you meet the
challenges of the next. Happy HITECH and Merry Meaningful Use!
According to HITECH Act requirements hospitals must:
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Maintain user audit trails
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Monitor user access to patient data
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Report breaches to the Department of Health & Human Services
Learn how Delnor Community Hospital's automated process achieved compliance and saved staff time. Download the Delnor Community Hospital Success Story and learn more about our Security Audit Manager solution.
For more information, please contact us at info@iatric.com.
Security Planning: Security Risk Assessment Part 1
Learn how to build a comprehensive security risk assessment into your hospital’s overall security plan. The Healthcare Information and Management Systems Society (HIMSS) recently published its
2009 Security Survey Results. The results indicate that 75% of organizations that conduct security risk assessments found patient data at risk, proving this type of analysis is a critical step in a comprehensive security plan.The American Recovery and Reinvestment Act (ARRA) and Health Information Technology for Economic and Clinical Health Act (HITECH) set forth heightened regulations and significant monetary penalties for violations, making it more important than ever for hospitals to perform thorough security risk assessments.
During this education session, presenters Johan Lidros and Richard Sands of Transcendent Group will:
- Discuss why a security risk assessment is necessary and who should be involved
Johan Lidros
CISA, CISM, CGEIT, ITIL-FPresident - Transcendent Group
Johan is the co-founder and President of Transcendent Group. He has provided IT governance and information security services in the healthcare industry for 18 years in Europe and in the US. Johan is well versed in accepted information security standards/frameworks (ISO27000, HITRUST, etc.) and has participated in several related committees during the years.
Richard Sands
CISA, CISM, ITIL-FDirector IT Risk Assurance Services - Transcendent Group
Richard is the Director of IT Risk Assurance Services at Transcendent Group. He has spent approximately 18 years in various IT risk management positions in the healthcare and financial industries. Richard has performed numerous security risk assessments in the healthcare industry.
To register to attend, select the date below and follow the instructions.
|
Webcast Date |
Day |
Time |
|
Tuesday |
2:00pm Eastern |
For more information please contact
Sandy Barbieri at
Sandy.Barbieri@iatric.com or
978-805-3196.
Interoperability - Are You Ready?
Does your facility have an interoperability strategic plan? Attend our 30-minute complimentary webinar to learn more about what interoperability means to you.
During this webinar, presenters Mary Moewe - Associate Vice
President and Bonnie
McAllister - Project Manager/Certified HL7 CDA Specialist will discuss:
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HITECH Act/American Recovery and Reinvestment Act (ARRA)
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Codification/Standards/HL7/Clinical Document Architecture (CDA)/Continuity of Care Document (CCD)
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The U.S. Electronic Medical Record (EMR) Adoption Model (Stages 1-7)
-
Electronic Master Patient Index (EMPI)/Health Information Exchange (HIE)/Personal Health Records (PHR) and Insuring Privacy/Security Protection
To register to attend, select the date below and follow the instructions.
|
Webcast Date |
Day |
Time |
|
Tuesday |
2:00pm Eastern |
|
| 01-27-2010 | Wednesday | 2:00pm Eastern |
For more information please contact
Sandy Barbieri at
Sandy.Barbieri@iatric.com or
978-805-3196.
Kay Jackson, Marketing Manager - Financial
One more for the Alphabet Audit Soup (RADV)
On July 17, 2008, Centers for Medicare and Medicaid Services (CMS) announced a 60 day Risk Adjustment Data Validation
(RADV) pilot program that targeted a select group of Medicare Advantage
(MA) health plans. CMS has now begun conducting further RADV audits to
determine whether differences in coding between MA plans and
Fee-For-Service providers are the result of coding patterns or of
underlying beneficiary health status. Additionally, CMS expanded its
RADV audits to randomly selected plans to generate statistically valid
plan level payment error estimates based on 2007 payments.
So what does that mean to your hospital? Many of our IatriTRAC (our audit tracking tool) customers have reported receiving several record requests for managed care Medicare patients' audits, adding one more level of audit tracking and possible recoupment. What does it mean to the health plan? A health plan with $10 million in Hierarchal Condition Code (HCC) reimbursements for the audit year faces the prospect of writing a $3 million "failed audit penalty" check back to CMS (based on a 30 percent audit failure rate) because the risk is extrapolated across the plan.
Recovery Audit Contractor (RAC) will expand to Part C and Part D by December 31, 2010. Effective tracking of all RAC audited services, all other Medicare audit types, MIP, commercial as well as RADV audits is more important than ever before. Please join me at one of our IatriTRAC webcasts below.
To register to attend, select the date below and follow the instructions.
|
Webcast Date |
Day |
Time |
|
Thursday |
2:00pm Eastern |
|
| 01-26-2010 | Tuesday | 2:00pm Eastern |
For more information please contact
Sandy Barbieri at
Sandy.Barbieri@iatric.com or
978-805-3196.
Client/Server Report Efficiency: BUF does not mean in exceptional physical shape.
This month's tip applies to Client/Server only. The MAGIC NPR Report Writer does not do the kind of temp file buffering discussed in this tip.
Recently one of my staff called to ask me to look at a report she had written out of C/S 5.5 NPR.PC.WORK that was designed to select some query responses for two interventions for a documentation date range.
Although we had picked the best index available to run through a list of interventions for a date range, the report was taking several hours to process just a few weeks worth of data.
Review of the object code of the report showed why it was so slow:
The offending line is the M($(N1)NPCW[aa],/(.TR)NPCW[aa]. As the report loops thru each day in the @date.doc.x, it moves all the documentation to the temp file for each patient who had any documentation during that day. Then it proceeds to check the other select criteria against the massive file it has moved to /.
M is the "Move" command, and it makes a copy of an entire structure (regardless of how many subscripts it has).
In a typical NPR data file, moving the entire record to temp before doing selection might make a report faster, and it would be unlikely to involve moving lots of data. In NUR, however, the main record for a patient has hundreds of interventions and thousands of queries. It is just wrong to move such a huge structure over and over while trying to select records.
The fix in 5.5 or 5.6 is to add a BUF NONE footnote:
This eliminates all buffering of records, both in the selection loop and in the printing loop.
Do you see what is different about the object code with the BUF NONE footnote?
Alternatively, you can add:
BUF NONE removes ALL buffering from your report, meaning data is never moved into the memory based temp file. BUF @interventions moves the data at the intervention level into a temp file when the report has selected its records and is printing. The second method might provide some very slight improvement in efficiency.
At the hospital in question, running for a seven day documentation date range had been taking two or three hours. Adding BUF NONE or BUF @interventions reduced the run time to less than one minute.
In some experimentation at another (5.6) site, I found that BUF NONE and BUF @interventions were equally efficient.
In 5.6 (only), there is a prompt on the sort/select page "Buffer Sort Temp" that defaults to N and if it is set to N, the buffering in the selection loop will not happen.
Be careful, however; if you skip this field, the default behavior when it is left nil is to include the buffering and your report will be a dog.
You can find additional NPR Tips on our website at http://www.iatric.com/information/npr-tips.asp, as well as information about our on-site NPR Report Writer Training and NPR Report Writing Services.
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