From the National Conference - Day 1

On the first day of the 2014 National Conference the highlight speaker for us here at Sigmund was Hillary Rodham Clinton.

Speaking on the subject of Behavioral Health to a packed audience, former Secretary of State Clinton veered on to the loaded (pun intended) subject of gun control, citing as examples the recent shootings of one man for just sending a text message in a movie theatre, and of two teens for playing loud music and chewing gum.

However annoying those activities may be to many of us, I think it can be agreed that murder by bullet is quite an overreaction, indicative perhaps of mental health issues suffered by the shooters, which convoluted thread keeps us neatly within the topics that might be expected at a National conference on behavioral health.

The Human Factor

In the pages of this blog we have discussed many aspects of IT security, almost to the point of paranoia. One reason is simple: Some people are just not very nice.

Yesterday, New York Attorney General Eric T. Schneiderman sentenced Raheel Pervez to a prison term of 1 to 3 years for being the public face of a Medicaid scam which netted the perpetrators an estimated $16,000,000.

The Medicaid Fraud Control Unit determined that Mr. Pervez, one of six arrested, was guilty of felony Enterprise Corruption for his part in a coordinated and systematic fraud involving more than a dozen different pharmacies across the New York districts of Long Island, Bronx, Manhattan and Queens. Prior to this conviction, three of the thirteen pharmacies in the syndicate of crime had already been ordered to make restitution to Medicaid, to the order of $16.7 Million.

Sigmund Software at the National Council Conference 2014

May 5-7, in Washington DC, at the Gaylord National Resort and Convention Center. Come see us at Booth#239

"But I can't leave the practice, not even for a day!" What? Your practice has you so tied down to daily operations that you just can't break free? Shame. Then you won't see or hear Hillary Rhodam Clinton, Patrick Kennedy or Mariel Hemmingway! Featuring 300 speakers over three days, you'll also miss several Senators, Bruce Perry, Arthur Evans, Pamela Hyde and a host of other industry leaders. Including, dare we say it, us.

With Sigmund Software as a Service (SaaS) cloud based EHR your data is accessible 24/7 from any Internet connected device. So you wouldn't have to miss out on Hill Day 2014. Your voice could be heard loud on Capitol Hill and your practice would still be at your fingertips. Interested? Give us a call.

If you are going to attend, float on by booth #239 and we'll show you how you won't need to miss any more events, because with Sigmund SaaS, the Cloud truly is in your hand.

Apart from engaging conversation with our EHR experts, you can also enter our prize contest for the chance to win a brand new Windows tablet.

Our contest has a difference: You win the prize, then you give it away. Here's how it works.

New genetic disorder found. So...which ICD code covers this?

Today in the Baylor College of Medicine News an article announces the discovery of a neurological disorder affecting both peripheral and central nervous systems. The discovery centres on the CLP1 gene.

This find is the result of a joint effort between scientists from the Baylor College of Medicine and a team in Vienna, and is said to represent a significant step toward a clearer understanding of brain development. CLP1, which plays a part in RNA processing, may hold the key to the genomic treatments of several Mendelian diseases. There are many implications here.

The science behind the research is of great interest - to geneticists. Others may be less fascinated to learn how this research indicates that tRNA biogenesis is affected by CLP1 mutations, causing associated neural progenitor (brain stem) cells to become statistically more apoptotic (self-destructive), resulting in overall cumulative loss of brain cells and, long story short, that an affected human is likely to have a small head. Quite literally. One disease mentioned specifically in the article is ALS, commonly known as Lou Gehrig's. Researchers think that insights from their new research may ultimately bring hope to sufferers of this and many other genetic disorders. We really hope it does, and really soon.

What this article really highlights to me, though, is that the field of medicine continues to grow apace, and that research along many diverse frontiers is constantly revealing new and exciting fields of study. Growing exponentially, these new fields of study may bloom into new fields of specialty. That is the way of medicine, after all.

Our 30-second Survey On ICD-10 Delay

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.

HIPAA and Data Encryption

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.

Devil's Advocate: Against ICD-10 Delay

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.

Devil's Advocate: In favor of ICD-10 Delay

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.

Third Strike for ICD10

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.

Client Focus: Retreat at Lancaster County

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.

Retreat at Lancaster County video

Windows XP, Office 2003, and HIPAA compliance

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.

MU Stage 3 Required Measures May Be Cut

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.

EHR Incentives - Just The Numbers, from CMS

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.

Patient Assessment and Progress Notes with AURA EHR from Sigmund Software


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Custom User Interfaces with Administrative Dashboards in the AURA EHR from Sigmund Software



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