Copy-paste in the EHR

Should physicians use the “copy-paste” function to document in the EHR?  In his latest blog post, 3M HIS blogger Jeremy Zasowski uses a whiteboard to sketch out the pros and cons, and offers two case studies that get to the heart of the copy-paste issue.

Watch the video here.

Copy-paste in the EHR title screen

 

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Taking flight: How the right metrics can improve computer-assisted coding

Recently, I boarded a Delta Boeing 757 plane. The plane held 180 passengers with a cruising speed of 517 mph. My flight to Portland, Oregon lasted just under two hours, of which I slept for more than an hour. By contrast, Wilbur Wright covered 852 feet in 59 seconds on that day in 1903 when the Wright brothers completed the first four sustained flights with a powered, controlled airplane.

It’s hard for the modern day traveler to imagine that the airplane and way of life we understand today wasn’t always the case. What enabled the evolution of the aviation industry from the first recognized flight of the Wright brothers to the kind of aviation travel we have today? Continue reading

Our response to the 2016 ONC Interoperability Standards Advisory

The Office of the National Coordinator (ONC) recently published the draft version of the 2016 Interoperability Standards Advisory (2016 Advisory). The 2016 Advisory is the ONC’s “identification, assessment and determination of the ‘best available’ interoperability standards and implementation specification for health IT.”¹ This article asks and answers, the following questions:

  • What are the most important clinical interoperability needs?
  • What are the best available vocabulary, structural and service standards that support clinical interoperability needs?

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Some thoughts on risk measurement

One reader of my latest blog on segmenting health care consumers asked me if I knew of any tools to calculate a person’s chance of developing a particular disease. That question got me thinking again about the topic of risk in health and disease. I pulled a copy of John Last’s Dictionary of Epidemiology from my office bookshelf for a proper epidemiologist’s definition of risk:

“The probability that an event will occur, e.g., that an individual will become ill or die within a stated period of time or age. Also, a nontechnical term encompassing a variety of measures of the probability of a (generally) unfavorable outcome.”1 Continue reading

CMS releases clarifications regarding NCDs and LCDs

I feel a bit like January, 2000 – much ado about little. Looks like (so far) ICD-10 is a go. I’m not saying there haven’t been bumps in the road, or that there are no obstacles we have yet to recognize, but I think I can say, “so-far-so good.” Something I have spent the last few years deeply involved with is the translation of the National Coverage Determinations (NCDs) to ICD-10. On November 20, 2015, CMS released information regarding feedback on some of the NCD translations and issues discovered in some of the LCD policy translations prepared by the MACs. Continue reading

Lifestyle improvement: An untapped resource in population health management

The recent report describing a decline in new cases of diabetes is good news. An article about it in The New York Times does a nice job describing the lifestyle changes individuals have made to reduce their personal risk. The article is informative on several levels: Continue reading

Prescribing exercise to achieve the Triple Aim

It’s a fact: Americans have become more sedentary. This not only leads to greater susceptibility to obesity and chronic diseases, but also contributes to increased symptom severity for those with chronic conditions. Getting the entire nation off the couch and on their feet is a laudable goal for promoting overall health and quality of life. Given resource limitations, however, it would be best to focus on patient subgroups, particularly those that would experience the greatest benefit from physical activity while meeting the goals of the Triple Aim – better outcomes, improved patient satisfaction, and lower cost. Continue reading

They just don’t get it: Who is to blame for increased complication rates?

Let me start by saying Happy Holidays to everyone. However, I am feeling a bit like Mr. Scrooge. I have heard from many clients lately regarding their struggles with obtaining accurate complications rates. In almost every instance, there is finger-pointing (with coding and CDI taking the hit) and even software gets blamed for the increased capture of complications rates.

So let me explain a few things: Continue reading

Will the first technology choices in design of population health be the most important?

As the healthcare industry strives to converge all the data sources required to manage population health, the mass of data needed to do it well, and to both clinically and analytically inform, will require something of a science project. Let’s call it gravity. Continue reading

Coast to coast with ICD-10

We’re now almost two months into ICD-10. I’ve been, literally, coast to coast during that time and have asked everyone how their transition is going. To my surprise, regardless of where physician practices were in their preparation when ICD-10 was delayed last year, everyone that I’ve visited with was well prepared for this year’s Oct. 1 implementation.

Many practices used the extra time to work on dual coding, testing of clearinghouses, reviewing new LCD policies, etc. Some groups were glad the implementation date was pushed back, but equally as many were not, having to retrain coders and providers on the new code set. As mentioned last month, there have been a few bumps, but the only consistent comment I hear is about coder productivity and documentation. Continue reading