Six Months to ICD-10

With only six months to go, many industry leaders believe another delay to the implementation date for ICD-10 to be unlikely. October 1st seems to be a lock. The only remaining obstacle is the impending congressional vote to reconfirm the date, and if that goes through without issue, as many state senators expect it will, then October 1st it indeed is. Ready or not.

Many that were preparing for ICD-10 placed their preparations on hold on April 1, 2014, when the deferment brought about by the Protecting Access to Medicare Act was signed, pushing back the ICD-10 date by a year. The mixed message sent by that act has some still thinking ICD-10 will eventually just go away. This now appears highly unlikely.

Sigmund Software Has A New Home

Sigmund Software move to Lee FarmSigmund Software is pleased to announce the new location of its corporate headquarters at Lee Farm Corporate Park in Danbury, CT. Our successful growth and market demand for our services and software solutions has facilitated the transition to a much larger office space with state of the art amenities and technological capabilities. We would like to welcome you to our new home:

Sigmund Software, LLC
Lee Farm Corporate Park
83 Wooster Heights Road, Suite 210
Danbury, CT 06810

2016 HHS Budget Highlights

The Department of Health and Human Services (HHS) budget for 2016 runs to 158 pages. Available in full as a PDF from the HHS web site it covers the entire spectrum of healthcare expense and was presented at a recent press conference by Secretary Sylvia M. Burwell. At 158 pages the entire budget is far too complex to analyze in a blog post, so here is a handy graphic, provided by the HHS, which breaks out the gross overall percentages.

Are Patient Portals Good Investments?

A core requirement for Meaningful Use Stage 2 is the provision of patient access to personal health data. This is commonly achieved using a dedicated web site, known as a patient portal. OK. We can do that. Ah. But there is a catch. Just providing such access is insufficient. Patients must be shown to be actually using the patient portal. That's a different animal.

There is no way to force anyone to visit any web site. If there were, we could all be Internet millionaires. Yet if the required percentage of patients do not Visit, Download and Transmit (there are percentage requirements for each) their personal health data, then MU incentive payments will not be issued, since the criteria has, in the eyes of the issuing authority, not been met. Tricky.

According to a recent study published in the Journal Of The American Health Information Management Association, ICD-10 implementation costs can be expected to be significantly below previously estimated figures for smaller practices.

The research behind the report was done by the Professional Association of Health Care Office Management (PAHCOM). 276 practices with fewer than six providers were polled. Although 276 is a relatively small sampling in relation to the nation as a whole, PAHCOM has Chapters and members in many US states from coast-to-coast. Across this diverse population they found that ICD-10 implementation costs per provider averaged $3,430, and the costs to the practices themselves averaged $8,167. That's a lot lower than feared by many.

Google to Provide Mayo Certified Medical Search Results

Over on their official blog recently, Google announced the launch of a pilot program developed in association with the Mayo Clinic. The collaboration will see search results for many common medical conditions and ailments featuring prominently alongside the general search results in the area of the page known as the Knowledge Graph. That's the part to the right of search results, where maps and contact information often shows.

These search results are curated and collated by Google's own in-house team of medical doctors, and cross-checked and verified with a team from the Mayo Clinic. This work flow provides highly accurate and very useful information for each entry. According to the blog article, 1 in 20 Google searches are for health-related information. This highlights the huge demand for help with common ailments like, for example, Tonsillitis.

The Benefits of Pre-implementation Workflow Analysis for EHR

It is often said that one key factor of any successful EHR implementation is a comprehensive and accurate workflow analysis. What is workflow analysis? Simply, walking through the steps that happen for a given situation and asking some questions. How do we do this? What happens next? Do we need to do that? Would it work better if...?

Workflow analysis (WFA) is always a good thing, as it can identify areas for improvement, eliminate previously hidden issues, and streamline general productivity. Some of the most successful organizations perform WFA on regular schedules, once or twice per year or even more. WFA is a continuous roadmap for organizational improvement that many agree has no down side.

But the majority of those that undertake the WFA challenge in relation to their EHR / EMR seem to perform their WFA after EHR implementation. This is, in truth, the wrong way round. To use a driving analogy, performing WFA after implementation is like sitting in a truck that just ran off the highway: Changing direction can be hard with that much momentum pushing you forward. And just like that truck, WFA after implementation is, in the worst case implementation scenarios, a crash waiting to happen.

There is a better way.

Prepare Now For ICD-10 Later

October is closer than you think. The ICD-10 implementation date is only a few months away. Though it is possible there will be a further delay, nobody now really thinks it will happen. Even if it did, it is just delaying the inevitable. So healthcare providers need to be ready. And that goes beyond software.

Most software vendors either already have or soon will transition to accommodate the ICD-10 coding system. The software will be ready. The question then becomes, will those that use the software be ready?

Research shows that dual coding (coding simultaneously in ICD-9 and ICD-10) can be a valuable training tool which significantly increases productivity by allowing coders to absorb the new coding system over time, so that when the October deadline arrives these advance-trained coders will see the change as just another day at the office.

HIPAA Compliance in Four Easy Steps

HIPAA compliance is not about the technology itself. You could use almost any computer, any software, on any platform, and still be compliant. Or not. It's more about how the technology is used, and the security of the data itself. Remember, one of the A's in HIPAA stands for Accountability.

HIPAA compliance requires many hoops to be jumped through, and while this article is not an exhaustive or definitive investigation of those hoops, in basic principal we can break HIPAA Compliance down to these four key points that the ONC are looking for.

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Practitioners Favor Revenue Cycle Management

A 2013 Black Book study, 'Top Physician Practice Management & Revenue Cycle Management: Ambulatory EHR Vendors' surveyed over 8000 CFO's, CIO's and administrative support staff from a wide range of hospitals and medical practices.

Results showed that 87 percent of those surveyed agreed their billing and collections systems needed to be upgraded, with the majority favoring the move to an integrated EMR and practice management system that includes RCM features.

42 percent were thinking of upgrading within the year, and an overwhelming 92 percent would only consider a software vendor that provided a complete solution which included EMR, RCM and practice management.

Healthcare Paperwork Wastes $375 Billion Per Year 

A research study published in the BMC Health Services Research journal claims that over $375 billion per year is wasted on bureaucratic paper work and inefficiency. The primary cause? An overly complex multi-payer healthcare financing system which multiplies paperwork exponentially.

The four-person research team behind the report carry a lot of academic weight. Among their many accomplishments, two of the authors are Harvard Medical School lecturers, one is a teaching UC San Francisco medical economist, and one a Yale Masters’ degree graduate pursuing doctoral studies at George Washington University.

The team believes that medical billing and insurance red tape are fundamental factors which inflate annual healthcare costs unnecessarily, to the tune of around $471 billion in 2012. Their analysis indicates that 80 percent of this is waste, which could be avoided with changes to the current healthcare system.

ICD-10 and Microsoft Windows

I was trying to find a suitable analogy that adequately reflects the current ICD situation. After rejecting many, it occurred to me that moving from ICD-9 to ICD-10 was much the same in many ways as upgrading a computer. Old-schoolers will remember Windows 95 and 98, Windows 2000, XP, and Vista, then more recently Windows 7 and 8. For each, we went through steep learning curves.

Nobody wanted to move up to the next release. But when we did, oh my, the wonderful increase in speed and functionality that it brought to the table was a thing of beauty. Every time.

Each time a new Windows operating system launched, there was strong resistance from those that had just become adjusted to the old one. And with many good reasons. Nobody wants the trouble of learning how to use something new, or to risk losing data, or to upgrade their other software to work with it. Just as is the case with ICD-10. But.

Breaking Down ICD-10

The full ICD-10 code set contains over 141,000 codes. That is 19 times more procedural and 5 times more diagnostic codes than the current ICD-9 code set. Even though the implementation date has been pushed back to October 2015, many practitioners still fear the change, perhaps justifiably so.

However, things may not be as bad as these numbers at first make them seem.

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



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