MaHIMA Connect
Official Newsletter of MaHIMA
July 2010
In this issue:
- Editor's Note
- President's Message
- Update on the Medical Record Retention Law
- Legislative Affairs Committee: Summary of 5th Annual MaHIMA Beacon Hill Day
- Communications Committee: Summary of e-Survey on Volunteerism
- Education Committee: Webinar Taskforce
- News and Events
- AHIMA Winter Team Talks and Capitol Hill Day
- Recap of MaHIMA's ICD-10 Summit
- Photos from the 13th Annual Conference of the NE HIM Associations
- Panel Discussion: Release of Information - From Guard to Guide
- MaHIMA Annual Awards
- Legal Briefs: Physician-Patient Emails
- Technology Forum: Patient Empowerment
- Summary of Governor's HIT Meeting: A National Conference Hosted by Governor Deval Patrick
- Education Notes - Fisher College
- Education Notes - Labourè College
- Education Notes - Bristol Community College
- Congratulations to Our Newly Credentialed
Links to previous issues: April 2010 January 2010
Editor's Note
Clare Carvel, M.Ed., RHIA, CCS
I hope everyone is enjoying the summer! A main theme of this issue of MaHIMA Connect is volunteerism.
In the arena of human life, the honors and rewards fall to those who show their good qualities in action.
- Aristotle
One of the primary goals of MaHIMA's new President, Elyse DiSciullo, is increasing member participation in volunteer activities for the association. It has been my experience that volunteering for a job in MaHIMA reaps many benefits. The organization as a Component State Association (CSA) of AHIMA benefits, individual members benefit AND the person who volunteers benefits ... from networking and demonstrating their abilities. At a minimum, you feel good about giving back to an organization that provides education and support for its members, and it also might help you pave a successful career path.
If you have any doubt about the benefits of volunteering, read on! The following focus article is about Jeanne Fernandes, RHIA, incoming Director of Communications and recipient of the MaHIMA Outstanding New Professional Award, whose volunteer work put her in a great position to network and fast track her career. A quote from Jeanne's award nomination submitted by Susan Pepple, outgoing Director of Communications, reads: "Jeanne demonstrates significant leadership, innovation, creativity, and administrative capacity. She is a great pleasure to work with and to know." Susan knew this because of the volunteer work Jeanne did for the Communications Committee.
Prior to transitioning into HIM, Jeanne was employed as Data Systems Manager for The Essex Group, a corporation that owns and operates skilled nursing facilities. During her twelve-year tenure, she led six long term care facilities through many challenging initiatives including transition from paper to electronic encoding; implementation of a company-wide intranet to provide employees access to policies, event schedules and other internal communications; migration from paper based documentation to an electronic point-of-care system and implementation of enterprise-wide electronic health records. Eventually Jeanne enrolled in the online HIM program at Stephens College, earned a post-baccalaureate certificate and went on to pass the RHIA credentialing exam.
While attending online classes and working in Long Term Care, Jeanne felt somewhat disconnected from "mainstream HIM". This changed with an opportunity to complete her nontraditional internship assisting with rejuvenation of the MaHIMA Website. Her initiative and technical skills were a huge help on the project. A new, innovative website went live in December, 2009. Jeanne has since been elected as Director of Communications and will continue in her role as Website Content Editor.
Through her volunteer work, Jeanne met Jackie Raymond and went on to complete her acute care internship at the Brigham & Women's Hospital. Jackie and her staff helped Jeanne apply knowledge learned in school to department functions and later she was hired into a new position as Acute Care Documentation Project Specialist. Jackie saw Jeanne's abilities during her internship; a classic example of win-win (HIM Directors asked to take students - please take note)! Jeanne enjoys the challenge of her new job which requires collaboration among Health Information Services, IT and clinicians to implement an inpatient Electronic Medical Record.
Through volunteering, Jeanne "showed her good qualities in action". If you are thinking about stepping up to the plate, there are lots of opportunities ... and no time like the present!
Incoming President's Message
Dear Fellow HIM Professionals,
Let's see, with so much happening in our work lives and profession where do I begin? I would first like to update you on what I have been doing since being elected President-Elect . It has been an honor and a privilege for me to have served in this capacity for MaHIMA. This year, I went to Summer Team Talks and Leadership Conference in Chicago (July 2009), attended and voted at the House of Delegates at the AHIMA Annual Meeting in Grapevine,Texas, and also went to the Winter Team Talks and Capitol Hill Day in Washington, D.C. It has been very rewarding and interesting for me to see the "inner workings" of AHIMA and our Board of Directors as they work to maintain high visibility for our profession in both the public and private sectors. It was certainly a treat to attend Capitol Hill Day and meet and shake hands with Senators and their staff and discuss with them the importance of growing and supporting the Health Information profession to meet the demands of ARRA and HITECH.
On a personal level, I have been through a tremendous amount of change; 1) I closed Westborough State Hospital where I have worked for the last 8 years and at the same time was made responsible for Health Information at Worcester State Hospital which considerably increased my commute, 2) spent both the February and April vacation weeks college hunting with my son, who is a junior in high school, and lastly, 3) I accepted a new position at the Massachusetts Hospital School as Director of Health Information and Quality Coordination which is not only closer to home, but will represent a welcome challenge! So, as you can see I have been very busy this year both personally and professionally!
I am looking forward to an exciting year as your President, as our profession continues to take front and center in the healthcare arena. During our MaHIMA strategic planning session held March 12th at New England Sinai in Stoughton, MA, my goal for this coming year is How To Grow MaHIMA. Our goal is to continue to encourage participation in MaHIMA by offering interesting and pertinent educational opportunities, partnering with other organizations that have similar interests (MAHQ, MAPAM, Health Informatics...), getting involved in social media (Facebook, Twitter, etc.), working with AHIMA to accomplish Vision 2016 goals (i.e. workforce readiness), and supporting education by providing sites and mentors for students in the HIM profession. These are just a few examples of how we plan on meeting our goal for growth this year.
I am very excited to take on the challenge as President of MaHIMA and look forward to a rewarding year. Please do not hesitate to contact me (new contact information will be forthcoming) to talk about your ideas that can help accomplish our goal of How to Grow MaHIMA. Volunteer with us to broaden your horizons and be part of a fun group of professionals! Have a great summer and I look forward to seeing you at the Fall meeting!
Update on the Medical Record Retention Law
Massachusetts Hospital Association (MHA) held a conference call for members only on Wednesday, June 23, 2010 at 1 p.m. Representatives from the Department of Public Health (DPH) were also on the call. (Anuj K. Goel, Esq., MHA Vice President, Legal and Regulatory Affairs; Lisa Noling Snellings, DPH Deputy General Counsel; and Elizabeth C. Daake, DPH Director of Policy Development and Planning)
Anuj provided an overview of the Medical Records Retention Law:
Chapter 308 of the Acts of 2008 made four important changes to the HIM process related to the retention of medical records; it:
(1) reduced the medical record retention period from 30 years to 20,
(2) updated the reference of what constitutes an official medical record to include electronic and digital records, and
(3) streamlined the process that hospitals/clinics could follow for notifying DPH when destroying records that exceed the applicable retention period.
The fourth component of the law included the requirement to notify patients of the provider's medical record destruction policy. MHA, working with DPH and the Massachusetts Health Information Management Association, developed language to address hospitals' concerns that adding hospital-specific detailed policies in the NPP will make it more difficult to read and will create more confusion for the patient.
MHA proposes hospitals consider adding the following language to your NPP, to meet the patient notice requirements of chapter 111, section 70:
"_____ hospital/clinic maintains medical records for at least 20 years after the patient's discharge or after the final treatment, as required by state law; a copy of the hospital's medical record retention policy is available upon request."
Anuj mentioned Massachusetts is the only state in the country requiring updated language in the Notice of Privacy Practice (NPP). Anuj reiterated the law was passed in August 2008 and the recommendation made was that hospitals/clinics need to update their NPP quickly.
HIM members asked a few questions pertaining to updating the NPP.
Question: If you do not plan on destroying medical records do you still have to update your privacy notice?
Comments: Does your Patient Bill of Rights or other public document reference your medical record retention policy or does your NPP state this now? Do you have a public document stating you do not destroy medical records? You are definitely safer if you don't destroy medical records from a compliance perspective. Lisa thought it was a good idea to have access and retention practices included in a public document such as the NPP or Patient Bill of Rights. Lisa and Anuj suggested talking with your Legal Council if a separate document satisfies the Statue.
Question: Do you need to re-consent patients when you update your NPP? No, this is not considered a significant change to the NPP, we are following Mass. State Law.
Comment: A member suggested new language removing the "for at least 20 years after the patient's discharge or after the final treatment" and requested adding "in accordance with State Law" with a footnote referencing the 20 years. Anuj cautioned omitting the language in the Medical Record Retention Law and felt this would open other legal liability in the future as to whether you followed State Law in notifying patients of the new medical record retention law.
Question: Would it be permissible to begin updating the NPP now with the proposed medical record retention language and wait for the upcoming HITECH NPP language provisions?
Comment: Anuj reiterated to begin updating your privacy notice now and document your efforts. If you are waiting to include the HITECH provisions do not wait too long. Six - nine months to update your privacy notice is not considered "quick" and he reminded us the Medical Record Retention law was passed in 2008.
Question: What is the liability to a facility if a patient was previously informed that records would be retained for 30 years vs. current law which is 20 years?
Comment: Anuj stated that since the change is a result of state law, there is no risk to the provider as long as the facility has met the requirements of the law.
Legislative Affairs Committee:
Summary of 5th Annual MaHIMA Beacon Hill Day
Karen Griffin, Director, Legislative Affairs & Advocacy
On May 20, 2010, the MaHIMA Legislative Committee was pleased to offer the 5th Annual MaHIMA Beacon Hill Day to the membership. Thirty-one members attended the event held at the State House in Boston. Hill Day started with a Breakfast Networking Session with visits from more than 35 legislators and aides. Next, a morning educational session was held that included an Update on Massachusetts Health Care Reform by State Senator Bruce Tarr; Update on the Massachusetts Registry of Vital Records and Statistics Bill by Jerry O'Keefe, Director of Bureau of Health Information, Statistics, Research and Evaluation for the Department of Public Health; and How to Effectively Lobby Legislators and Staff on Lobby Days by Patrick O'Connor, Legislative Director for State Senator Robert Hedlund.
After lunch, members had an opportunity to participate in group visits to their senate and house representative offices to engage in conversation regarding important issues facing the HIM profession, both on a state and national level such as, House Bill 2064, An Act Relating to the Security of the Vital Records and Verification of Identity; Proposed Legislation 114.5 CMR 21.00, All Payer Claims Data Submission and 114.5 CMR 22.00, Health Care Claims Data Release, and the HIM workforce. To view the complete list of Talking Points, click here .
Lastly, as a bonus, a State House Tour was conducted.....did you know that the painting of President Abraham Lincoln in the State House is the only portrait of him in a standing position? And did you know that the land the State House currently resides on was once owned by Massachusetts's first elected governor, John Hancock? We learned these and other interesting fun facts about our State House.
If you were unable to attend Beacon Hill Day, please consider attending the event next year. It's an experience that will remind you how you can impact the legislative process as constituents of the Commonwealth. Here are just a few of the comments shared by those in attendance:
"It was a great opportunity for me. I had never been in the State House. Great job organizing the event."
"Excellent educational content and thank you for providing a forum to visit with the legislators and promote HIM."
"Thanks to all the organizers and speakers for this informative and enjoyable day, my first time but won't be the last!"
Events such as Beacon Hill Day could not be possible without the generosity of our sponsors. Please take a moment to thank our sponsors; HealthPort, Nuance Communications, Inc, and Retrievex for supporting MaHIMA's legislative efforts.
Please take a moment to enjoy some photographs of the day's event. To view the photo album, click here.
Communications Committee:
Summary of e-Survey on Volunteerism
Sherry Palo, RHIA, CCS, e-Survey Team
Our e-Survey for May was on the topic of volunteerism in the Health Information Management field. We had 59 responses for a response rate of 3.36%.
Thirty eight percent (38%) of respondents indicated they currently volunteer for either MaHIMA, AHIMA, or another HIM related organization while sixty two percent (62%) do not volunteer.
Opportunity for growth was the number one reason given for volunteering. Giving back to the profession, meeting new people, and using one's skills and experiences were close seconds for respondents' reasons for volunteering. One individual noted that volunteering allows her "to network with potential clients".
The #1 reason (almost half) for not volunteering for MaHIMA was 'no available time'. About ¼ of the respondents noted they either 'didn't know where to begin' or 'hadn't found the right opportunity yet'. Others indicated volunteering was not endorsed by their employer. Several members mentioned they didn't realize MaHIMA needed volunteers.
When it comes to making it easier to volunteer, respondents offered some great ideas. Many mentioned the need for greater communication and publicity around volunteer opportunities with suggestions including emails, e-Alerts, and website posting. Specificity regarding the volunteer opportunity would also be helpful. One member suggested pairing a new volunteer with an experienced one in order to make a new volunteer feel more comfortable and aid in the learning process.
More than 10 members offered their contact information and want to become MaHIMA volunteers. A MaHIMA board member will contact them in the near future to match their interests with an appropriate volunteer activity. A huge thank you goes to each of them and to everyone who responded to the survey.
Education Committee:
Webinar Taskforce
Georgette Wilson, Director, Education
We realize that it is becoming more and more challenging for our members to receive funding and time off to attend an all day or even a half day educational session. One of the goals of the MaHIMA Education Committee is to explore alternative learning options for our membership.
Webinars offer a cost effective option for multiple individuals to take part for one low price. If you are interested in being part of the MaHIMA Webinar Task Force, please contact George Wilson at georgette.wilson@umassmemorial.org. Task Force meetings will be conducted via conference calls. Our role will be to identify topics, speakers and to coordinate the webinar. The Education Committee looks forward to hearing from volunteers!
News and Events
Congratulations to MaHIMA and Jackie Raymond, RHIA, Director of Health Information Services at Brigham & Women's Hospital and Outgoing President of MaHIMA, for being awarded a 2010 AHIMA Component State Association (CSA) Core Services Achievement Award for the innovative and highly successful MaHIMA Director/Manager HIM Forum.
The following is an excerpt from Jackie's description of the Forum:
"Part of my MaHIMA President-elect ballot statement in 2008 summarized my hope to share thoughts and ideas in managing health information, increase networking and revive basic HIM 101 among MaHIMA members. Following input from a MaHIMA Past President, I started the Director/Manager HIM Forum. A networking group of HIM professionals meet quarterly to discuss hot topics, share best practices and provide support for directors/managers facing new challenges within their organization."
When implementing the Forum, Jackie set out goals that included discussion of hot topics facing HIM, review of AHIMA resources, sharing policies, job descriptions, etc., networking with peers and forming business relationships with HIM Directors and Managers across the State. She notes these goals were met, many would say they were exceeded - attendance has been good and the sessions have increased member participation, networking and discussion of important topics affecting all HIM professionals. Topics were selected by vote to ensure a democratic approach and have included Red Flags Rule, ARRA/HITECH, EHR's and RAC. The MA CoP is used as a polling mechanism along with email for topics/ideas and posting materials for upcoming meetings. For resources and upcoming meetings, visit the Massachusetts CoP at http://mahima.org/communities_of_practice___cop/ .
AHIMA Winter Team Talks & Capitol Hill Day
Karen Griffin and Elyse DiSciullo, RHIA
On March 22, 2010, Karen Griffin, Heather Hedlund and Elyse Disciullo attended Winter Team Talks in Washington, D.C. At this meeting, Dr Alan Dowling was introduced as CEO of AHIMA. Dr. Dowling has more than 35 years of experience in the health industry. AHIMA leaders reviewed the HIM core model as well as the 2010 key initiatives. The AHIMA Board of Directors is developing a "Core Model" of HIM functions to describe the robust set of functions and opportunities open to current and future health information managers. The 2010 key initiatives are: 1) Grow membership and improve efficiency of servicing members, 2) Communication through the new AHIMA website and COP; 3) Professional Resources provided thru ARRA resources, ICD-10, professional workgroups, Global Office opening in Belgium, promoting CAHIM (Council on Accreditation for Health Informatics and Information Management Education) as the premier organization for program accreditation, 4) Professional Development Opportunities in areas such as confidentiality, privacy and security, EHR implementation, ICD-10, Clinical Data and Documentation Integrity and Certification Exam preparation.
At the meeting the National HIT initiatives were reviewed which covers:
- Incentives to meaningful users
- Regional extension centers
- State health information exchange
- Workforce development
- Privacy and Security
- ICD-10
Finally, the apportionment issue facing the House of Delegates was also discussed at length along with the other HOD items. We had a very long and informative Team Talks!
On Tuesday, March 23rd, it was off to Capitol Hill to attend scheduled visits with our Senate and Representative offices. The AHIMA agenda was full and included discussion topics such as the Health Information Management Workforce-Bureau of Labor Statistic Categories and Health Information Management Workforce; for those interested, documents pertaining to these topics are linked on the MaHIMA website. The group had an opportunity to engage in conversation with legislative representation from the following offices:
- Senator John Kerry
- Senator Scott Brown
- Representative James McGovern
- Representative William Delahunt
- Representative Richard Neal
We became acutely aware of the fact that legislators clearly wanted to learn more about the challenges facing the profession, as the healthcare environment quickly changes its platform. Within just the past year, it was apparent from the types of questions that we were being asked that legislators were in agreement that the HIM profession can positively impact the success of an ever changing healthcare industry.
Lots of great questions were asked and informative answers were provided. It was an honor to represent AHIMA and MaHIMA in this forum.
Recap of MaHIMA's ICD-10 Summit
On March 31, 2010, MaHIMA hosted an ICD-10 Summit at the Holiday Inn in Dedham, coordinated by Coding Committee members Bob Seger, RHIA, CCS and Shari Manning, RHIT, CCS. Presenters included Carolyn Piselli and Anne Boucher from 3M; Bernice Von Saleski, RHIA, Corporate Coding Manager, Partners Health Care; Linda Hyde, RHIA, Director, Clinical Quality Management, MedMined Services, CareFusion; and Luisa DiIeso, RHIA, CCS, Manager of Education Services, Medical Record Associates, Inc.
Below are presentation summaries from Luisa, Bernice and Linda. Bernice's write up includes information from the March Summit, the AHIMA ICD-10 Summit in April and an ICD-10 presentation given at the 6-State Annual Meeting in May. Thanks also to Denise Duhamel, RHIA, for taking photos at the Summit which are linked here: http://picasaweb.google.com/dduha987/20100331MAHIMAICD10Summit
Climbing the Mountain to ICD-10 by Bernice von Saleski, RHIA, MAS
The MaHIMA ICD-10 Summit, the second Annual AHIMA ICD-10 Summit, and the NEHIMA Meeting have started to prepare us to meet our destination to the top of the ICD-10 Mountain. Below are a few of the highlights from these meetings to assist you as you journey on your climb to the mountaintop of ICD-10.
Pat Brooks, Senior Technical Advisor for CMS
She frequently is asked whether or not the implementation date will be changed. She assured everyone that there is no plan for a push back on the implementation date of October 1, 2013.
Did you want to get something for free, and discover it is of value? Pat stated that all the information that is on the www.cms.gov/ICD10/ website can be used for free, and there are no copyrights on the materials.
You may have heard about the General Equivalence Mapping (GEM) translator. It is a tool that CMS has developed to use for their needs, and they are sharing it with anyone who needs a translator to cross walk to and from ICD-9-CM to ICD-10-CM and ICD-10-PCS. To learn more about GEM's, do a search on the www.cms.gov/ICD10 website for General Equivalence Mappings. It has most frequently asked questions to assist organizations. The translator tool is free.
Margaret A. Skurka, MS, RHIA, CCS, FAHIMA Professor and Director, HIM Programs of Indiana University, Northwest, "Road to an ICD-10 Proficient Coding Staff"
She recommends deciding what needs to be done for 2010, then 2011, 2012, and 2013. Listed below are the areas that she advocates to start NOW (2010).
- Physician involvement by specialty
- Assessment of current coders
- Overview session of both ICD-10-CM and PCS for coder comfort
There is the fear of learning ICD-10-PCS. Margaret recommended:
- Important to minimize the "fear of change" in this totally different system
- Practice is necessary for the NEW thinking - it is FUN when learned
Documentation assessments can begin NOW. An example she gave was:
- Glasgow coma scale: used with traumatic brain injury codes or sequelae of Cerebral Vascular Accidents. 3 codes needed to complete the scale.
"Catching a Ride on the 5010/ICD-10 Jet Plane! Before it's Too Late" by Bernice von Saleski, RHIA, MAS
- To start the 5010/ICD-10 process, it is important to put an infra-structure together.
- Executive sponsorship is highly recommended.
- Project Managers need to be in place to assist the teams, provide coordination and keep everyone on target. As the project continues to grow with more and more teams, the Project Managers take a large load off of everyone who has a day job to do as well.
- ICD-10 Training Planning process should be starting NOW. This will set the guidelines for the ICD-10 Training Implementation Team.
- Building blocks of training can start NOW for coders. One step at a time is easier than trying to learn a larger piece.
- Each week take a look at what is the main category for each section of ICD-10-CM.
- For ICD-10-PCS , start reviewing the Sections, Root Operations, Body Systems, Body Parts, Approaches, Devices, and Qualifiers.
- Attend AHIMA Webinars on any ICD-10 coding topic.
- System inventories should be done NOW or close to completion to set the foundation toward gap analysis and system remediation. Listed below is a frame work to consider when developing a system inventory
- Entity Name (if you are part of a health care system)
- Vendor Name
- Application Name
- Functionality
- System Type
- Does the system currently have ICD-9-CM codes?
- System Analyst Name
- Department Owner/Business Owner
- In and Out Bound interfaces
In Summary, there is a great deal of knowledge out there. Get out your computers and Google away on ICD-10 and find things on all kinds of interesting websites to make your journey easier and fun. It is great to be climbing with all of you as we endeavor to reach the top of the Mountain of ICD-10.
Summary: Planning for ICD-10/PCS: Coding Paradigm Shift Luisa DiIeso, MS, RHIA, CCS
Presentation Highlights and some examples of shifts in coding practice and data variations associated with the transition from ICD-9-CM to ICD-10/PCS:
Highlights and Categories of ICD-10-CM Differences:
- Fractures: A key axis/default for coding fractures in ICD-10-CM is whether or not the fracture is displaced (default) vs. non-displaced. In ICD-9-CM the key axis is whether the fracture is open vs. closed (default). ICD-10-CM allows for greater anatomic specificity as well as laterality when coding fractures. Seventh (7th) character extensions are available to denote the specific type of encounter for the fracture (initial, subsequent, sequelae options).
Shifts in Coding Practice/Documentation Requirements:
- Documentation considerations for greater anatomic specificity and displaced vs. non-displaced fractures (Attending M.D., Radiology)
- Source Documentation Requirements for Specific Type of Encounter
- Coding Capture of Documented Laterality
- Coding Review and Capture of Specific Type of Fracture Encounter
- Adverse Effects: Code sequence guidelines have changed for capturing adverse effects in ICD-10-CM vs. ICD-9-CM. The specific type of medication or substance causing the adverse effect is first listed in I-10 followed by the condition. Reverse sequencing occurs in ICD-9-CM. Example: Acute Tubular Necrosis secondary to Bactrim (Adverse Effect)
ICD-9-CM ICD-10-CM
Admission for ATN Secondary to Bactrim Admission for ATN Secondary to Bactrim
584.5 ATN = PDX T37.0X5A (Adverse Effect Bactrim-Initial Enc.)
E931.0 Adv. Effect of Bactrim N17.0 ATN (Secondary Dx. Code)
E849.7 Nsg. Home- Place of Occurrence Y92.122 Nursing Home - Bedroom
Shifts in Coding Practice/Documentation and Data Quality Considerations:
- Reverse Sequencing Coding Practice Change
- Data Quality Review Considerations: Cautions for Adverse Effect Data Quality Review Comparisons that Involve ICD-10 and ICD-9 Casemix
ICD-10 PCS Highlights and Examples:
- Seven Character Alphanumeric Code Structure. Note: Letters O, I are not used.
- Root Operations: There are a total of 31 Root Operations that have specific definitions, some of which are very different than the current ICD-9-CM definitions.
Examples of Root Operation Comparisons:
ICD-9-CM ICD-10-CM
Reduction (ORIF) Reposition (ORIF)
Ostomy (Colostomy) Bypass (Colostomy)
Amputation (AKA) Detachment (AKA)
Shifts in Coding Practice/Documentation Considerations:
- Mastering Root Operation Definitions - Coders
- Coders as Translators - Mapping Procedural Documentation to the Appropriate Root Operations
- Documentation Considerations: Proactive Review of High Volume Procedures and Documentation Issues or Challenges Prior to ICD-10-CM Implementation
- Mutual Training: Physician/Coder
Resources: www.ahima.org
ICD-10-CM/PCS and Quality Measures Linda Hyde, RHIA
MaHIMA held its first ICD-10 Summit in March 2010. Presentations at this meeting covered a range of topics to assist MaHIMA members in preparing for the implementation of ICD-10 in October 2013. HIM professionals who support the capture and/or use of ICD-9 data should start thinking about both the internal and external uses of this data and what tasks will need to be done to transition to ICD-10. Some suggested planning steps are:
- Develop and inventory of current uses of ICD-9-CM data for analysis and reporting. This could be accomplished in the form of a survey and then followed up with a more detailed assessment based on the survey results.
- Identify on-going analysis or reporting applications currently using ICD-9-CM that will continue beyond October 2013? For these areas, identify the data definitions describing the ICD-9 codes used and how they are maintained.
- Identify key stakeholders who use ICD-9-CM data across the organization to be included in general education about the ICD-10 implementation plans and their affect on the applications or reports that they use currently using.
- Become familiar with the work being supported by CMS to develop General Equivalence Maps (GEMs) that will help with the conversion of ICD-9-CM codes to ICD-10-CM/PCS to support transitioning software applications, reporting and quality measurement definitions. (http://www.cms.gov/ICD10/Downloads/GEMs-CrosswalksBasicFAQ.pdf)
It is not too soon to start planning and laying out timelines for general education, staff training and impact assessment on all the areas in a healthcare organization that currently use ICD-9-CM in various systems and applications especially those that focus on reporting and quality measurement.
Photos from the 13th Annual Conference of the NE HIM Associations
A successful Joint Annual Meeting of the MA, VT, RI, CT, ME and NH Health Information Management Associations was held at the Radisson Hotel in Manchester, NH, on May 2 through May 4, 2010. Below are two links to photos from the conference, provided by Denise Duhamel and Clare Carvel, and following this article is a summary of the Breakfast Panel Discussion on Release of Information held on Tuesday, May 4, 2010.
http://picasaweb.google.com/dduha987/20100503NewEnglandHIMASessionsAndVendorHall
Panel Discussion: Release of Information - From Guard to Guide: Tools and Strategies for Making Health Information Manageable
Marianne Garfi, RHIA, CCS-P, MyPHR Community Advocate
The following is a summary of a presentation given on May 4, 2010 during the 13th Annual Conference of the New England Health Information Management Associations at the Radisson Hotel in Manchester, NH.
Panelists
Marianne Garfi, RHIA, CCS-P, Coding Specialist, US Dept of Labor and MyPHR Community Advocate, MaHIMA
Mary Horan, MA, CCC/SLP Director of Family Centered Care, Windham Hospital, CT
Karen Lawler, RHIA, Director, HIM/Privacy, Stamford Hospital, CT
Panel Discussion Points were:
- Types of requests
- Timeliness and release
- Rules and regulations
- Patient and family access
- Additional audience points
Karen, Mary and Marianne discussed and pointed out that there is a real human need to many of the "personal" information requests made, and that we as health information professionals need to take the time to accommodate the request, not just live by the facility policy rules.
- The discussion to be the advocate to assist the patient, family member or caretaker in providing the most appropriate, and timely response to their information needs, while keeping to the rules and regulations that govern the transmission of health information.
The audience raised many questions and discussion points to address the different perspectives their facilities are/can be using to accommodate this idea. The audience shared it was a beneficial hour and agreed the idea is not practiced as often, and through discussion we were reminded to start with the question, how can I help in this situation, and accommodate the needs of the requestors and keepers of health information.
MaHIMA Annual Awards
In addition to swearing in a new President and Director of Communications during their annual business meeting on May 4th in Manchester, NH, the Massachusetts Health Information Management Association proudly honored members who have served the profession well in the past year. This year, there were two recipients of the Outstanding New Professional Award; both qualified and deserving!
Outstanding New Professional Award: Maxine Bennett, H.I.M. Coordinator, New England Sinai Hospital
Maxine Bennett, RHIT, received the Outstanding New Professional Award due to her many valuable contributions as H.I.M. Coordinator at New England Sinai Hospital.
Among the many valuable leadership qualities cited as a reason for Maxine's nomination were assistance with hiring new staff, coordination of activities for students doing directed practices at New England Sinai Hospital, speaking at new employee orientations, taking part in the Meditech implementation process, implementation of e-faxing of transcribed reports to physicians, coordination of a new internet-based dictation system, and positive interactions with medical staff, other clinical staff, wing secretaries, and patients.
In summation, Maxine's supervisor, Sue Marre, described Maxine as deserving the Outstanding New Professional Award because, "she exemplifies what the HIM profession and MaHIMA are all about."
Outstanding New Professional Award: Jeanne M. Fernandes, Acute Care Documentation and Project Specialist, Brigham and Women's Hospital.
Jeanne M. Fernandes, RHIA, received the Outstanding New Professional Award due to her many valuable contributions to MaHIMA as a member of the Communications Committee including redesign of the MaHIMA Website, her continuing service as Content Editor, and being newly elected as the MaHIMA Director of Communications.
Significant leadership, innovation, creativity and administrative capacity which were mentioned in describing Jeanne are valuable qualities for an Outstanding New Member to demonstrate.
Distinguished Member Award will be given to Luisa DiIeso, RHIA, CCS at the Fall Meeting on September 22, 2010.
The Distinguished Member Award is MaHIMA's highest award of honor and will recognize Luisa for her long, exceptional history of contributions to MaHIMA. It is awarded to an outstanding individual whose record of contributions to MaHIMA over many years is truly exceptional. A write up of Luisa's accomplishments will appear in the October 1 issue of Connect.
Student Achievement Awards:
MaHIMA is also proud to honor outstanding students with the Student Achievement Award. The recipients of this year's Student Achievement awards are:
Christopher Rushbrooke, Fisher College
Anjannette Waller, Laboure College
Nancy Ruth Ouellette, Bristol Community College
Congratulations to all! MaHIMA extends best wishes for future success to the award winners! Below is a link to photos from the award presentations: http://picasaweb.google.com/dduha987/20100503MAHIMABusinessMeetingAndAwards
Legal Briefs: Physician-Patient Emails
Colin J. Zick, Esq., Folley Hoag LLP
Attorney Colin Zick was recently interviewed by the Health Care Channel (HCC-TV). Colin's informative talk focused on legal considerations of physician-patient e-mails. Click below to view:
http://www.currentmedicine.tv/2010/policy/legal-considerations-to-using-emails-with-patients/
Please note: You will be prompted if you need to download a plug such as Flash Player. Just follow the directions and then click the arrow to start the video.
Colin J. Zick is a member of Foley Hoag LLP's Health Care and Litigation practice groups. He advises clients on a variety of matters, including HIPAA, patient confidentiality, patient care, fraud and abuse, OIG advisory opinions, compliance programs, reimbursement, and other health care related issues. Atty. Zick has served as a Committee Chair on the Boston Bar Association HIPAA Task Force, has participated in a variety of health care educational programs and is an advisor and frequent speaker for MaHIMA. Atty. Zick invites you to visit the Foley Hoag LLP's website blog, "Privacy, Security and the Law" at http://www.securityprivacyandthelaw.com/ for timely and informative discussion on cases impacting the HIM Profession and health care in general.
Technology Forum: Patient Empowerment
Pat Rioux, RHIT, eClinicalWorks
"The age of paternalistic medicine is ending - the age of participatory medicine has begun." http://epatient2009.com/
The earliest recognition of 'e-patients' has been attributed to the late Tom Ferguson, MD, author of the 2006 white paper, e-Patients, How They Can Help Us Heal Health Care. At that time, he said patients were empowered, engaged, equipped, and enabled. Leaders in participatory medicine take his message one step further today and say that patients are also educated, expert, and electronic.
From an e-Patient Revolution 2009 promotional video, consider these points:
- In 1930, house calls made up about 40% of the patient-physician encounters in the U.S.; today they make up less than 1%.
- The average length of a primary care visit is ten minutes.
- Patients are only able to recall 50-60% of the information given to them by doctors.
- Half of the 2 billion prescriptions filled each year are not taken correctly.
- The age of paternalistic medicine is ending - the age of participatory medicine has begun.
- More people now consult the Internet than doctors for their health information: 83% search online for health information; 57% are eager to share their new health or medical knowledge.
- There are over 1,000 Facebook communities around chronic illness.
- 30% compare and choose among physicians.
- 1 in 3 compares prescription drug options.
The American Recovery and Reinvestment Act (ARRA) requires hospitals and providers to achieve meaningful use (MU) of electronic medical records to qualify for stimulus funds. Patient engagement is one of the goals for transforming health care that includes these Stage 1 objectives for eligible professionals and hospitals:
- Send reminders to patients for preventive/ follow up care
- Provide patients with an electronic copy of their health information (within 48 hrs)
- Provide patients with timely electronic access to their health information (within 96 hrs) of the information being available to the eligible professional
- Provide a clinical summary of each office visit for patients
- Provide patients with an electronic copy of their (hospital) discharge instructions and procedures at time of discharge, upon request
Some organizations started their patient engagement efforts before it was part of ARRA. For example, Mayo Clinic uses YouTube, the CDC uses e-widgets, Johnson & Johnson tweets, and Pharma interacts with Facebooks groups.
The shift to patient-empowered health care can also be seen in the proliferation of groups and communities such as Patients Like Me, 73 Cents and e-Patient Dave. "Patients Like Me" was started by the brothers of Stephen Heywood who had ALS (Lou Gehrig's disease) with the premise "given my status, what is the best outcome I can hope to achieve, and how do I get there?" Their goal is to enable people to share information that can improve the lives of patients diagnosed with life-changing diseases with a new system of medicine: "by patients for patients."
Regina Holliday painted a mural in Washington, DC and became a national advocate for patient access to medical records when she could not get access to her husband's records when he was dying of cancer. She noted that the cost was "73 cents" a page which was highlighted in news stories on the BBC, CNN, CBS, AOL, VOA, NPR, The Washington Post and the BMJ.
The Boston Globe ran a front-page story in 2009 "Electronic health records raise doubt - Google service's inaccuracies may hold wide lesson" - which led to widespread discussion of patient's involvement in their medical data after Dave deBronkart's experience. He imported his electronic medical record data from Beth Israel's patient portal, Patient Site to Google's personal health record (PHR) and the coded billing records posted medical conditions that he was tested for as actual diagnoses on his PHR - thus creating an inaccurate record of his medical condition(s). Dave is the co-chairman of the Society for Participatory Medicine and has testified in Washington about patient's rights.
Patients demand: 'Give us our damned data' read the headline of a CNN Health story in 2010 that summarized Regina and Dave's experiences with medical records access. Other stories of patients and families encountering difficulty getting medical records were told to reinforce the need for patients to know their rights. The article provided tips on how to deal with hospitals and doctors and file a complaint with the Office for Civil Rights at the U.S. Department of Health and Human Services, if necessary.
Author Chris Dimick in AHIMA's journal article, The Empowered Patient, acknowledges that the "movement to give patients better access to and control of their health information is giving HIM a new customer: the patient. That requires a shift in both operations and culture."
He writes that "Private, state, and federal initiatives have granted patients better access and new control over their health information. Laws like HIPAA and ARRA and private initiatives like AHIMA's Health Information Bill of Rights and the national push toward personal health records will change the way HIM professionals interact with patients."
Are you ready for the new 'empowered' patient?
Pat Rioux, RHIA, is employed by Westboro-based eClinicalWorks, a market leader in ambulatory electronic medical record solutions. Their CCHIT-certified EMR and practice management system is in use by more than 30,000 providers in all 50 states. Its Patient Portal allows patients and doctors to communicate easily, safely and securely over the Internet, and eClinicalWorks Electronic Health eXchange (eEHX) is the fabric behind clinical integration systems becoming community-wide projects.
SUMMARY OF GOVERNOR'S HIT MEETING: A National Conference Hosted by Governor Deval Patrick, April 29-30, 2010
Health Information Technology: Creating Jobs, Reducing Costs and Improving Quality
I was fortunate to be able to attend this 1 ½ day conference that brought together a number of thought leaders at the national and state level to discuss the current status of health information technology (HIT) and the role of the states in supporting the changes needed to increase adoption of HIT to improve the healthcare delivery system and also the impact these changes will have on creating jobs.
Keynote speakers, panels and breakout sessions provided the opportunity to engage the speakers and the audience in a number of topics. Governor Patrick welcomed the participants and acted as moderator for one of the panels describing the role of the patient in HIT to create a 'consumer-centric' or 'patient-centric' system through personal health records while maintaining privacy and security.
Dr. David Blumenthal, National Coordinator for HIT, presented a status of all of the activities being coordinated through his office. They are currently completing their review of the numerous responses to the proposed rule for meaningful use. The regional extension centers that have recently been identified will be focusing initially on helping provider sites of 10 or less physicians and critical access hospitals with EHR implementation. Surgeon General Regina Benjamin provided a compelling story of her efforts to establish a clinic in rural Alabama and the effects of two hurricanes and a fire on her ability to provide health care and access to patient information for her patients. Donations of hardware and software to create an EHR after the second hurricane made it possible for her clinic to survive the fire that later destroyed the clinical building.
A panel of presidents and CEO's of some of Massachusetts leading HIT companies discussed the opportunities and needs for jobs in healthcare information technology. Across the board all the panelists acknowledged the need for technical expertise to develop and maintain the hardware and software needed to support HIT but all were even more emphatic of the need for more 'knowledge workers' or 'information analysts' to actually work with the data being collected and reported from EHRs. Discussion centered on how to educate people to assume these roles. Consensus seemed to be that there was no single approach but a coordinated multi-focused effort was needed that included formal education as well as on the job training and retraining of people entering the HIT workforce from other professions.
Breakout sessions provided the opportunity for attendees to meet in smaller groups and focus on specific topics such as state initiatives in healthcare reform, creating a successful health information exchange, EHR early adopters, the role of HIT in public health, Health IT and Clinical Quality Improvement. Regional collaboration meetings, organized by CMS region, were also held for neighboring states to meet and discuss potential collaboration, regional interoperability issues and current plans for Health IT.
Education Notes: Fisher College
Congratulations, New Graduates
Patricia Parkes, RHIA, Program Director, HIT & Medical Coding
Please help me in congratulating the following Fisher College Associate Degree in Heath Information Technology and Medical Coding Certificate graduates. Some of these graduates are just beginning their careers in Health Information Management, others have been working in the field and now have the opportunity to earn their RHIT credential or coding credential of their choice. The Fisher College Commencement Exercises were held on Saturday, May 15, 2010. The list of graduates below includes those students who have completed or are completing their final course work or internship in the May term and will have all requirements completed by July 3rd.
My heartfelt thanks (and theirs!) to the many MaHIMA members who have assisted these graduates in their academic and/or professional endeavors. Perhaps you gave a tour of your department to one of these graduates before they began their studies and encouraged them to join the HIM profession. Maybe you mentored one of students as a supervisor, friend, or simply because you are a true professional. Undoubtedly, many of you had a direct impact on the success of these graduates as you willingly accepted the responsibility to supervise them in their professional practice experiences. I thank you, they thank you, and I have no doubt that you will continue to support these new HIM professionals whenever you have the opportunity to do so.
Associate in Science Degree in Health Information Technology
Crystal Anson
Teresa Barnabe
Melissa Caron
Lorraine Dondero
Helen Drake
Jochim D'Sa
Suzanne Ferreira
Alexia Motley
Juliette Nunez
Marcy Rosenzweig
Christopher Rushbrooke
Nicole Scott
Bibiana Von Malder
Michelle Walden
Medical Coding Certificate
Lashonda Atkinson
Sherry Brown
Angela Burchill
Virginia Costa
Cristina Ferreira
Cheryl Hassey
Kymm Hogan
Margaret Kornegay
Jane McCarthy
Carmen Santiago
Marianne Warren
You can reach Patricia Parkes at pparkes@fisher.edu or by calling 508-699-6200. Website: www.fisher.edu
Education Notes: Labourè College
Nancy A. Entwistle, MPA, RHIT, CCS, ACE, Chairperson & Assistant Professor, Coding & HIT
You can reach Nancy Entwistle at Nancy_Entwistle@laboure.edu or by calling 617-296-8300 ext 4063. Website: www.laboure.edu
Education Notes: Bristol Community College
Joins National Consortium to Educate Healthcare
Information Workers
Joy Rose, MSA, RHIA, CCS, Director, HIT & Medical Coding Certificate Program
Press Release - June 3, 2010
BRISTOL COMMUNITY COLLEGE JOINS NATIONAL CONSORTIUM TO EDUCATE HEATHCARE INFORMATION WORKERS
Bristol Community College (Fall River, MA) is one of 23 community colleges that will participate in a $16-million Federal grant over two years to educate up to 7,500 healthcare information workers in 12 states. Bristol will provide services in Massachusetts and Rhode Island through the collaboration.
The grant, awarded to Tidewater Community College (TCC) in Virginia, was awarded by The U.S. Department of Health and Human Services (HHS) to address efforts to improve, implement and unify electronic health records (EHRs) across the nation comes under the American Recovery and Reinvestment Act of 2009. It is part of HHS activities to increase access to healthcare, protect those in greatest need, expand educational opportunities and modernize the nation's infrastructure.
Bristol joins the consortium with its Healthcare Information degree program and will address the critical need to provide skilled professionals who can modernize and manage electronic health records.
TCC will coordinate the collaboration of more than 100 community stakeholders and 22 other community colleges in 11 states and the District of Columbia to provide training on six key positions needed to establish or expand health information technology (HIT) systems.
The six key positions are:
- Practice Workflow and Information Management Redesign Specialist
- Clinician/Practitioner Consultant
- Implementation Support Specialist
- Implementation Manager
- Technical/Software Support Staff
- Trainer
Bristol Community College will offer educational programs in Practice Workflow and Information Management Redesign Specialist and Clinician/Practitioner Consultant.
The consortium's more-than-100 industry and community partners reflect a blending of the best healthcare providers, including military and veteran affairs treatment facilities, community clinics, health insurers, Workforce Investment Boards and hospitals from Virginia to Maine.
Consortium results will include an electronic repository of curriculum resources and materials for members to share, and a blueprint of practical experiences in configuring EHRs within a simulated lab environment, with approaches to assessing, selecting and configuring EHRs to meet needs of end-users.
HHS descriptions note that HIT "allows comprehensive management of medical information and its secure exchange between health care consumers and providers." With a well-prepared workforce, records would become available in all scenarios and patients would be treated with the immediacy of electronic records.
Bristol Community College offers an Associate in Science degree in Health Information Technology and a Certificate Program in Medical Coding.
For more information on the Bristol Community College programs, please contact Patricia Dent, Dean of Health Sciences, at 508-678-2811, ext. 2142; or Program Director Joy Rose, ext. 2329
Congratulations to our Newly Credentialed
The following MaHIMA members earned an AHIMA credential in the second quarter of 2010:
Jean P. Carey, CCS
Alanna Lunden, CCA
Denise Paul, CCA
Diane E. Vitagliano, CCS
MaHIMA grants Certification Scholarships to any member of MaHIMA who has taken and passed one of the AHIMA sponsored certification programs.Information on the MaHIMA Certification Scholarship is available at www.mahima.org/member_certification_scholarship/.
The following newly credentialed members have been awarded a Certification Scholarship from MaHIMA this past quarter:
Stephanie Bortelho, CCS
Jeanne Fernandes, RHIA
Cindy Marchando, RHIT
Philip Tentindo, RHIT
E-Channel Editor in Chief
Clare Carvel , MEd, RHIA, CCS
clarecarvel@comcast.net
E-Channel Staff Editor
Sherry Palo, RHIA, CCS
palo@tiac.net
E-Channel Technical Editor
Karen O'Donnell, RHIA
karen@mahima.org