Sigmund Software, LLC is part of the VSS Medical Group
There are many arguments in favor of and against the recent delay to ICD-10. We covered several in recent articles. Now we want to know what you think.
Our 30-second survey will take a straw poll of professional opinion. Statistics can be viewed on completion, allowing instant feedback on the opinions of your colleagues within the medical community.Those results should make for interesting reading.
We encourage you to share this survey with all your colleagues! The more that participate, the more representative and accurate the results become.
The most interesting comments may appear in future articles. Whether we use your comments or not, you can be assured that, as always, we will strive to present a balanced viewpoint both on the survey and the results.
All comments are anonymous and no personally identifiable data is gathered. We are HIPAA compliant. But you knew that.
In Los Angeles, eight computers were physically stolen from the premises of Sutherland Healthcare Solutions (SHS), a medical billing contractor for LA County. The personally identifiable PHI contained on those eight computers numbered 338,700 medical records. That's a lot of ID theft and a whole heap of HIPAA fines.
Technically, HIPAA does not require data encryption on those actual computers, if the initial risk assessment showed that other measures were in place to protect patient data. Except, when computers are physically marched out of the door, those measures are clearly bypassed and are not going to work. So this provider is looking at loss of data, loss of clients, loss of reputation and trust, severe HIPAA fines and whatever other ongoing difficulties become associated with this incident. All this, every piece, could have been avoided.
Our last article showcased some of the arguments in favor of the recent ICD-10 deferment. As promised, this one focusses on some of those against. Let's see where it takes us.
ICD-9 was implemented way back in 1979 when flared trousers were still cool and cutting-edge technology was an LED wristwatch that showed the time in little red numbers when you pressed a button. Well, where I grew up, at least. Clearly, technology has moved on, and so has the practice and complexity of Healthcare. Significantly.
A primary argument against further delay is simply that ICD-9 is hopelessly outdated. Many providers feel ICD-9 just cannot cope with current healthcare practices, some of which did not even exist when ICD-9 was born. Therefore, there are no codes to cover them and billing is made more difficult. Some feel that coding for new technology using old coding systems is a challenge they would rather move away from and that ICD-10, precisely because it does have so many new diagnostic codes, offers the future-proof flexibility needed to move healthcare out of the stone-age.
After all, they argue, ICD-9 is, literally, so last century.
In this second article on the recent deferment of ICD-10 until 2015 we take the time to examine the situation in a measured manner and discuss both sides of the argument, in an attempt to make sense of this complex issue. First, the arguments in favor of the delay. For balance, our next article will discuss the arguments against. Let's begin.
Cost is the primary concern for the majority of healthcare providers. Costs take various forms. Third-party costs can take the form of new software, or upgrades to existing EHR systems. That can involve a simple one-time payment, commonly in the case of Cloud based systems which simply change seamlessly the next time you log in. Being faced with new screens and added functionality brings additional considerations. To get up to speed with these changes may require staff training, which incurs even more costs. For traditional self-hosted implementations, costs can be more complex, with extensive initial consultancy fees and software customizations involving expensive programming teams. To update your software to suit your organizational ICD-10 requirements may not come cheap, and in this latter scenario staff training will definitely be required.
And that's just the first argument.
Is there anyone in the healthcare industry that does not yet know about this?
Waiting until the afternoon to ensure it was not recorded as the biggest April 1st prank in history, President Obama officially signed in to law the bill which delayed implementation of ICD-10 until 2015.
The $21 billion bill was passed 64-35 by the Senate the preceding day, allowing the President time to get this in under the wire and extinguish the burning fuse on the automatic 24 percent reimbursement cut due to be applied to Medicare practitioners. Close call.
CMS will now have to wait until October 1st 2015 before being able to enforce the ICD-10 transition, which has had many vendors and providers scrambling to meet the original deadline of October 2014. For the record Sigmund Software is ready and so are our clients.
Many millions have been spent by providers in their run up and preparations for ICD-10 implementation this year. Many more providers have proverbially hidden their heads in the sand and hoped ICD-10 would just go away. Well, they got lucky. It did.
The Retreat at Lancaster County is a 120 bed drug and alcohol rehabilitation center based in Ephrata, PA. The 24 acre facility offers peace and tranquility and individual one-on-one treatments. Retreat implemented Sigmund Software right from the start. With no preconceptions, their paperless environment made an ideal test case for the effectiveness and usefulness of electronic health record systems.
Retreat are already looking forward to opening additional centers and plan to implement Sigmund at those locations, too. They find our specialized EHR software, designed specifically for behavioral health and addiction treatment, fits naturally into their way of working and does not slow them down. Rather, it speeds them up and frees staff to concentrate on treatments, not paperwork.
Sigmund Software has been featured on Fox News (see top right). As part of their research for their article, Fox went on site with Sigmund to see how our EHR worked in the real world. Shot during that visit, this 1:37 minute video features the CEO and Founder of Retreat at Lancaster County, Peter Shorr, explaining how the partnership with Sigmund is helping to take things to the next level.
We are proud to work so closely with Retreat at Lancaster County and look forward to continuing this partnership for many years to come, in all their facilities.
Our recent blog article about Microsoft ending support for Windows XP and Office 2003 discussed some ways that users could handle the situation. But we did not mention HIPAA. Let's address that.
HIPAA requirements dictate that medical data, particularly personally identifiable health records, be protected and secured at all times. Given that as of April 8th this year the twelve year old operating system will stop receiving security updates and bug fixes, this is a serious problem for those wishing to stay with XP while remaining HIPAA compliant. From April 9th, any internet connected XP computer will be wide open to all kinds of everything. Office 2003, ditto. The best antivirus and anti-malware software may not by themselves be sufficient to maintain security. If the operating system and software itself is flawed any organization could be facing a breach.
In a nutshell, XP and Office 2003 just won't cut it.
The Health IT Policy committee recently proposed reductions to Stage 3 requirements, which if passed will take the required measures down from twenty-six to nineteen.
The policy committee recommendations will be sent to the Secretary of Health and Human Services for review and consideration. As the go-to committee for all things MU, these recommendations will form the focal point for some very high-level decision making processes. It should be noted that while this is a step along the way, recommendations are only recommendations and do not represent any change to current or future laws. However, this is a strong indication of possible future amendments which may be coming down the pipe when Stage three arrives in 2017.
These numbers come direct from the CMS January 2014 Summary report and detail incentive payments made for Medicare and Medicaid since 2011.
Without further ado, let's take a look.
Active registrations are low for 2014, but then the numbers provided are only for January. Registrations overall are higher. 296,528 Medicare Eligible Professionals, 147,520 Medicaid Eligible Professionals and 4,702 hospitals have registered with the programs since their inception.
To a clinician ICD may mean Implantable Cardioverter Defibrillator, but to an administrator? ICD means trouble.
Providers, consumers and payors alike will be affected when ICD-10 kicks in this October. What is needed is a game plan which addresses all stakeholders and provides each with a clear way forward. Enter vendor, stage left.
OK, it could be said that EHR software vendors have their own agendas, with different priorities to those of the organizations they serve. Even so, they have a vested interest in ensuring ICD-10 coding is implemented smoothly and efficiently: No vendor gains from a poor or failed implementation.
Vendors know that long-term relationships and reputations are not built overnight, but that they can be lost overnight. In the field of behavioral health software, like many others, you are only as good as the support you provide. All vendors realize that, too, and most will jump through hoops to make things work the way their clients need.
An industry source close to Apple says that the fabled Healthbook app is finally nearing completion: The mobile hospital may be just around the corner.
When and if released, the app, designed to incorporate both mobile healthcare and fitness-tracking, will spearhead the next wave of mobile innovation. It should run on any iOS device. That degree of flexibility will appeal to those wanting to record personal medical data through their phone while on the move for later review on their larger screen iPads.
Unofficial screenshots show the app has sections for activity, nutrition, heart rate, blood pressure, blood sugar, respiratory rates, oxygen saturation, weight and hydration. Blood work is given a separate tab. Given the connectivity of the iPhone, it is not hard to visualize that this section may both pull and push results direct to health providers and hospitals.
In a Google Hangout by Cosmopolitan magazine, Senior Presidential advisor Valerie Jarrett gave a Q&A session during which she encouraged viewers to sign up for health insurance through the troubled healthcare.gov web site, before the registration deadline of March 31, 2014.
Being from Cosmo, this was a lightweight affair with real world questions from real people. The direction and content of the hangout reflected that, and was aimed squarely at non-professionals with personal concerns. Jarret was at pains to inform viewers they can explore healthcare options and price-shop health insurance plans through the web site, noting that affordable healthcare (sic) would be available for around the same cost as a regular cell phone plan. Which is of course only useful to those that can afford two cell phone plans. Or even one, though you would then have to choose between a cell phone and a health plan. Anyway, Jarrett tells us that plans average out at either 1 percent of annual income or $95 per month (Affordable Cellcare - I'm copyrighting that).
Many healthcare providers still use their beloved XP operating systems and Office 2003 because they are reliable, run all the software required, and upgrading could be a painful process. It took several years to get the software set up and these venerable systems are not quite ready for retirement yet. Are they?
Unfortunately, Microsoft will cease support for these time-served workhorses in 27 days. It is a logical business decision dictated by simple economics and market forces. Many have criticized Microsoft for dropping this beloved combination of OS and software but hey, even a new car warranty runs out eventually. Why should Microsoft expend resources on outmoded technology? If they did, we would all still be using Windows 95 and that would not be fun for anyone. But I digress...