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.

E&M Coding: The Final Level of Care

In keeping with the theme of previous blog posts–the professional realm of E&M coding–I’d like to discuss medical necessity as it relates to the final level of care. CMS has stated that medical necessity is the over-arching criterion for payment of E&M services, which, in pure CMS fashion, gives us a goal, but not guidelines as to how to get there. We have no medical necessity policies for the differing E&M codes.

I think we all understand the intent of that statement, which I interpret as “don’t game the system”. But how do I, as a coder, teach a provider how to do that? And, how does the provider document a record to reflect the medical necessity clearly? So, let’s put a pin in that and talk about the calculation of the E&M codes, then circle back.

Report from AMDIS: Top CMIO Issues

Last week we attended the 2014 Physician-Computer Connection Symposium sponsored by AMDIS, the Association of Medical Directors of Information Systems. It was our first time attending the event, held this year in Ojai, California. The conference is geared toward the needs and concerns of Chief Medical Information/Informatics Officers (CMIOs), and we learned a great deal about the issues that are top of mind for today’s CMIOs. This is a relatively new role within hospitals, health systems, and corporations. In the past, the CMIO was primarily seen as a liaison or bridge between providers and IT; more recently, however, the role has transformed into a leadership position that plays a key role in IT decision making, managing people, and even managing its own budget.