Half of Primary Care Physicians Think Quality Metrics Have a Negative Impact on Quality

In a Commonwealth Fund/Kaiser Family Foundation survey, 50 percent of PCPs report that quality metrics have a negative impact on their ability to provide quality care to their patients.i

Quality Metrics Chart

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If you spend any time in a primary care office practice this should come as no surprise. PCPs tend to be deeply dedicated to their patients and want very much to do the right thing. Continue reading

Twenty Years of Transcription

Twenty years ago, I began my journey in healthcare documentation technology. I’ve been traveling up and down memory lane for the past few days, thinking about how the healthcare industry has changed, and healthcare documentation tools and processes along with it.

Back in the mid-90s, healthcare documentation was almost entirely created for paper, whether it be handwritten notes and forms or transcribed documentation. Many of the hospital medical transcription departments I visited at that time were transitioning from typewriters and fancier word processing units to networked workstations running our DOS-based ChartScript application. I remember transcriptionists being concerned because a computer-based transcription system could measure productivity more consistently and precisely than the manual methods employed with typewriters and word processors. Continue reading

ICD-10 Cheat Sheet, Part 2: DIY for Physicians

This blog assumes you have read part 1, so if you haven’t, see you back here in a few minutes. Part 2 is for those of you in specialties where the number of codes has gone up significantly—orthopedists, OB/GYN docs and oncologists—it takes a bit more work to build a cheat sheet of reasonable size. I called it an “interesting challenge” in Part 1 of this blog, but it’s doable.

After accessing the Tabular.pdf (see instructions in part 1), I would recommend you first take half an hour and do an eyeball review of your specialty’s home base chapter without copying or pasting any codes (you might have to review sections of multiple chapters if your specialty doesn’t have a single home base). This will help you see what you are up against, and help you apply the two principles I introduce below. Continue reading

ICD-10 Cheat Sheet: DIY for Physicians

Did you end up here because you haven’t done squat about ICD-10, and you googled “ICD-10 cheat sheet?” Fantastic. Come on in, there’s plenty of room. I could get all high and mighty about cheat sheets, but by temperament I am practically allergic to telling people what to do. So, if you want to stick with the cheat sheet for coding in ICD-10, I will not try to talk you out of it. Continue reading

The Internet of Things in Health Care

A few weeks ago, my wife and I were watching an interview with Dr. Michael Roizen, who leads the Department of Preventive Medicine at the Cleveland Clinic. Dr. Roizen was describing his “7 Action Steps to a Healthier You,” one of which is “Walk 10k a Day,” where one tries to take 10,000 steps each day. Dr. Roizen explained that this 10K threshold seems to impart important health benefits, although the mechanisms aren’t fully understood. While my wife and I try to get out most mornings and walk for 30-60 minutes—at least that’s our intention—we had no idea how many steps we were taking. Continue reading

HCCs: Don’t Underestimate Their Importance

So there are PPCs and HACs, PPRs and PPAs, PSIs and VBP just to name a few. But please don’t forget or underestimate the importance of HCCs. Why should you care about HCCs? HCCs are Hierarchical Condition Categories (there’s a mouthful). In simpler terms, HCCs are diagnoses/conditions that are present in the patient that complicate their care and management and require more resources to treat. Sounds easy enough right? Continue reading

Why I get excited about APCDs (hint: also a memoir and album by Herbie Hancock)

I love hearing about multi-source or all-payer claims databases (APCDs). I’m not a data scientist, but I know enough about analytics to appreciate the possibilities within an APCD. Each announcement of a new state APCD (or private data alliance) feeds the expectation that someone will discover something new and useful and that maybe, sometime soon, the information will change the healthcare system for better.

I get excited about the possibilities. (Jazz musician Herbie Hancock chose “Possibilities” as the title for his memoir. It’s a tribute to those who aren’t afraid to explore in music and in life.) Continue reading

CMS Clarifies “ICD-10 Families” and Offers Guidance on ICD-10 Flexibilities

The latest from CMS and AMA on July 6, 2015 is a bit confusing – I agree. But a clarification was released yesterday.

In case you missed the July 6, 2015 release, CMS and the AMA announced an effort to work together to help Part B providers under the Physician Fee Schedule prepare for ICD-10. CMS recognized some physician and other professional providers need additional help. To assist in the transition, CMS announced “Medicare review contractors will not deny physician or other practitioner claims billed under Part B physician fee schedule through either automated medical review or complex medical record review based solely on the specificity of the ICD-10 diagnosis code as long as the physician/practitioner used a valid code from the right family. Continue reading

ICD-10: After the Thaw

If you have the slightest inclination to freak out about ICD-10 because change makes you nervous, please ignore this blog.

Okay, now for the rest of you: the code sets have been frozen for more years than is good for them, and once we get to “thaw” the code sets, they need to be updated. How can that be, you say? ICD-10-CM/PCS is brand spanking new. No, not exactly—not new, unused. New and unused are not the same thing. Putting meat in the freezer does not make it fresh—it lets you put off cooking it for a while. Continue reading

HIMagine That! Queries for ICD-10

Donna: You know Sue, I think that people are really stepping up their ICD-10 game as we enter the home stretch.

Sue: The way I look at it, they’ve been stepping up their game for the last five years!

Donna: So true. Still, I’ve received a lot of emails lately from coding and CDI professional requesting assistance with ICD-10 queries that they can use to ensure they have ICD-10 ready documentation.

Sue: So what kinds of queries are they asking about? Continue reading