Whodunnit? Let’s be honest!

At the start of the New Year, I can’t help but reflect on how much patient care has changed in my 25+ years. Many things that were common practice back then were either not necessary or even sometimes harmful. An example would be Foley catheter placements. Foleys for “everyone” whether they needed them or not!

However, the advent of superbugs with increasing antibiotic resistance has also meant an increase in catheter-related UTIs. Organizations became focused on prevention, using different catheter materials thought to prevent colonization, and by evaluating the need for insertion and/or continued placement. It certainly didn’t hurt that catheter-associated UTIs (CAUTIs) were determined to be hospital-acquired preventable conditions that CMS would not reimburse, and were also factored into quality outcomes metrics by quality assessment programs or organizations. Continue reading

Resolution 2015: Time to Audit

Like many, the end of the year is a time of reflection and planning for me. Where did I succeed in 2014 and where do I need to focus in 2015?

One of my plans for 2015 is cleaning the basement. I know, I hate doing it too – that’s why I had to make it a resolution – give it more emotional power.

My daughter graduated from college in 2006 and wanted to “leave some of my stuff here temporarily.” It’s now 2015 and that stuff is still in my basement. Does she need it? Likely not, since it hasn’t seen the light of day in nine years. But before it’s moved, we’re going to go through it and throw out what’s no longer needed. I’ve learned that it makes more sense both from a time and cost perspective, to clean up before a move than to pack, move, unpack and then throw out the same stuff. Continue reading

Those three little words…

As we wrap up another year of blogging at 3M Health Information Systems, we want to thank our readers and share an inspiring blog post from blogger Rebecca Caux-Harry.

Those three little words……that you NEVER want to hear: “You have cancer.” By the time I got that call my mind had already explored all of the possibilities from worst to best, and I was tired. You just can’t imagine how many “worst” things the mind can conceive of, especially if you’re in the healthcare industry and have a rich family history of cancer. But the call did come. I had been expecting it. I had been going through tests after finding a breast lump for about a month and a half. That’s a long time to fear the worst. At least for me it was a long time, having enjoyed exceptional health for my 50 years. Yep, turned 50 and was diagnosed with cancer in the same year. Lovely! Continue reading

AMIA 2014: RxNorm

Guest blog by Michael Totzke, 3M data analyst.

At the AMIA 2014 convention in Washington D.C., we showcased some of our processes for mapping and maintaining RxNorm drugs into the Healthcare Data Dictionary (HDD). Our poster and podium presentations emphasized the fact that with clinical data, accurate and consistent mapping of terminology standards over successive versions is critical. With the selection of RxNorm as the drug terminology standard required to meet Meaningful Use criteria, it has become necessary for the HDD to maintain RxNorm’s drug data from a longitudinal perspective. Our former process for maintaining RxNorm dealt solely with the mapping of the current version, with limited regard to managing changes in RxNorm’s data over time. However, it’s not just the initial mapping that is important; having a long term strategy for maintaining that terminology within a larger terminology server is crucial for ensuring data quality. Medical terminologies change over time, and there is no algorithm yet that can alone guarantee the level of accuracy required for exchange of clinical data. Continue reading

Himagine That! A New Year, a New Coding System

Sue: Donna, you look reflective?

Donna: I guess I am. You know how you kind of take stock of everything as the year winds to a close?

Sue: Yes, I know what you mean.

Donna: Well, I was thinking about ICD-10 . . .

Sue: It was a roller coaster ride! Continue reading

Why I Wouldn’t Want to Be a Hospital CFO

More than 60 percent of CFOs at struggling hospitals expect to lose their jobs by 2016, according to a Black Book report. Not surprising amid news that at least 20 hospitals will go bankrupt this year. Moody’s predicts declining operating margins for all but large health systems. These are difficult days for healthcare finance.

The Black Book report said CFOs point to health IT—investment in EHR systems, HIE, and patient portals—as the main source of their revenue cycle woes. But I suspect the pain is symptomatic of a dysfunctional revenue model that is strained to a breaking point. Continue reading

Study Validates the Value and Utility of Risk-Adjustment for Stratifying Complex Patients

Introduction by Norbert Goldfield, MD, and Richard Fuller

Increasing value, or more precisely, improving outcomes from health care spending, a recurring theme of the C&ER blog, is intrinsically linked with risk-adjustment. If we can’t accurately compare patients, then we can’t determine if we are paying too much for their care. We cannot be certain if their health outcomes deviate from what we should expect. As governmental and private payers increasingly employ both managed care and prospective payment programs with more complex patient populations, the need for accurate risk-adjustment grows exponentially since cost variation across patients is greater. This variation is often greatest in pediatric populations, which range from healthy kids to some of the sickest individuals insured by government programs. Continue reading

Palliative Care: Payers and Providers Collaborate to Improve Quality of Life, Care and Experience

A study published by the Institute of Medicine (IOM) this fall, Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life, concluded that improving the quality and availability of medical and social services for patients and their families could not only enhance quality of life through the end of life, but may also contribute to a more sustainable care system. Among the calls to action from the IOM committee are strengthening palliative care and the reorientation of policies and payment systems to support high-quality, end-of-life care.

What is palliative care? Continue reading

Tinted Moisturizer and Medical Necessity Data

I know what you are thinking – the woman has finally lost her mind. Or, this is the most ridiculous post I have ever seen – and I’m not going to waste my time reading it. Wait! I promise it will make sense.

Everyone has a favorite something – right? It’s a common enough story; in addition to holiday shopping this past weekend, I spent over an hour searching for a new tinted moisturizer to no avail. If you are a woman, you know what it’s like to have a favorite fragrance or lip gloss or nail color. Then, for some unknown and misguided reason, the manufacturer changes the formulation and it loses the je ne sais quoi that made it so special. Well, this just happened to my favorite aforementioned tinted moisturizer with sun screen! I want it back at any price – it has irreplaceable value to me. It was lightweight and matched my skin tone. Not too shiny or oily and just the SPF I need. I’ve searched but I can’t find a replacement I like. I trusted the product; it provided the ROI I was seeking. Continue reading

Taking a Closer Look at the November ICD-10 Coding Challenge


A 49-year old female arrived in the trauma ED via helicopter in cardiac arrest after sustaining a stab wound to her upper torso. The patient was attacked by an unknown assailant with a knife (found at the scene) as she was walking to her car in a parking lot. The patient was unable to be resuscitated and expired. The Emergency Department physician documented the following diagnoses:

1. Penetrating laceration of anterior left thorax with near complete laceration of thoracic aorta
2. Hemopneumothorax

Assign diagnosis codes for this Emergency Department encounter. Continue reading