March 8, 2013

Leveraging Investments in Technology to Manage Data and Launch ICD-10

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Despite concerns from the healthcare industry, the Centers for Medicare & Medicaid Services (CMS) confirmed that they are fully behind the October 2014 deadline for implementation of the ICD-10 system, which is “good news,” said Stanley Nachimson, principal of Nachimson Advisors, on Talk-Ten Tuesday’s Thursday broadcast from the HIMSS convention in New Orleans.

 

Nachimson views the statement made on Wednesday at HIMSS by Acting Administrator for the Centers for Medicare & Medicaid Services (CMS) Marilyn Tavenner as another sign to “get moving” and urges those in the healthcare industry to participate in The HIMSS/WEDI ICD-10 National Pilot Program (http://www.himss.org/library/icd-10/national-pilot-program?navItemNumber=13477).

The pilot, he explains, is a collaborative “opportunity [for the industry] to participate in end-to-end testing without having to develop their own process or test data and determine which partners to send it to. The pilot will present actual test data, and we’ll manage all of the connections. All participants have to do is test their own systems, and we’ll take care of the rest.”

Leveraging Investments

 

Taking care of data management was a topic that Bonnie Cassidy, the senior director of HIMS innovation for Nuance Communications and former president of the American Health Information Management Association (AHIMA), addressed in her HIMSS presentation. She focused on the need for an information governance structure, explaining that this is an “overall framework for policies on how you really want to manage the [electronic health record] data within your organization.”

As she explained, “There is a real focus on leveraging investments in the electronic health record from the health information management perspective.” Focus points include the automation of coding and clinical language as well as “a tremendous interest in compliance and doing it the right way.”

 

Joan Topper, vice president of IT optimization for Geisinger Health System, agreed with Cassidy, saying that HIMSS participants were “absolutely interested in new technology to leverage the impact of I-10 and the other changes upon us.” One particular area that Topper finds exciting is mobile technology, which she says “is only beginning to be a game changer, surpassing PCs, and there’s a lot of potential that’s beginning to emerge.”

A lot of people at HIMSS were talking about “big data” but didn’t seem to understand, Topper says, that “it’s not just about a lot of data but how you use it. The opportunity to leverage data near-real time or real-time is only beginning to be understood in healthcare.”

 

Big Data and CMS’s eHealth Initiative

 

If any agency knows about, and knows how to manage, “big data” it is, of course, CMS, which launched its “eHealth initiative” at the HIMSS conference. This initiative unites the following health information technology programs:

  • ICD-10
  • Medicare and Medicaid EHR incentive programs
  • Quality measurement
  • Physician Quality Reporting System (PQRS)
  • Hospital Inpatient Quality Reporting (IQR) Program
  • eRx Incentive Program
  • Health plan identifier (HPID)
  • Electronic funds transfer (EFT)
  • Electronic remittance advice (ERA)
  • Administrative simplification

On Thursday’s broadcast, Matthew Albright, CMS’s lead health-insurance specialist in the administrative simplification group, Office of E-health Standards and Services, put some of these pieces together, beginning with defining “administrative simplification” as a group of federal laws that relate to efficiency.

“ICD-10 is a key component of administrative simplification,” Albright said. “To help providers reduce their administrative burdens, healthcare data must be standardized at the lowest levels so it can be shared. I-10 provides that method, equitable provider reimbursement, fewer denials and underpayments, more efficiency overall.”

Part of CMS’s eHealth initiative is to align health information technology with electronic standards. Together they will help deliver better care and standardized data operations, improved quality of care and health outcomes, and reduced costs without compromising quality.

Other goals are to achieve consistency across all healthcare providers and to “use electronic technology to conduct, automate, and simplify billing and payment, which will make it easier for patients, insurers, and providers,” Albright said.

(More on CMS’s eHealth initiative can be found at http://www.cms.gov/eHealth/.)

 

EDITOR’S NOTE:

Listeners to Thursday’s broadcast answered this “Ten Ready” poll question: What part of testing preparedness is your biggest concern? The majority of responders (55 percent to be exact) found the following areas to be of concern: budget, technology, partner readiness, and internal knowledge. The percentages for each of the other four areas go like this: internal knowledge concerns 23 percent, partner readiness concerns 15 percent, technology concerns 5 percent, and budget concerns 3 percent.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.
Janis Oppelt

Janis keeps the wheel of words rolling for Panacea®'s publishing division. Her roles include researching, writing, and editing newsletters, special reports, and articles for RACMonitor.com and ICD10Monitor.com; coordinating the compliance question of the week; and contributing to the annual book-update process. She has 20 years of experience in topics related to Medicare regulations and compliance.