Here is a snapshot of recent and upcoming activities.

The annual AHIMA meeting was held back in October.  The House of Delegates had a few items to vote on, the results are as follows:

• Revision to AHIMA Bylaws - Approved
• MPI - TABLED for clarification.
• Resolution on Diversity & Inclusion - Approved
• Resolution on HIM Management of Quality of Health Data  - Approved
• Revision of Code of Ethics - Approved

A successful Dott Wag Memorial Seminar was held this past November.  The seminar was well attended with 91 registered attendees.  Topics included HIM’s role in Meeting Meaningful Use, Improving your Legal Knowledge, Submitting your Information Electronically to Mass Rehab Commission and a General Update for Release of Information.  The participant survey is a very important part of the daily program.  It provides the Legislative Affairs Committee with an opportunity to improve upon future offerings.  It also provides a list of topics that YOU the members want to hear in the future.  Thank you all for attending this annual event.  We look forward to planning next year’s event.

The Committee is in the beginning stages of planning our Annual Visit to Beacon Hill.  This year we are collaborating with New England HIMSS.  We expect to increase the attendance and enriching the topics by joining efforts with them.  The date of this event will be May 22, 2012.  Stay connected for more information.

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 It seems like 2011 just started and yet it’s time to wrap up the year and look ahead to 2012.  What can you expect?  The single best place to look for clues is the “Work Plan” of the federal Department of Health and Human Services, Office of Inspector General.  In that Work Plan, all the issues of enforcement that HHS is concerned about for 2012 are listed out for everyone to see.  For HIM, the primary subjects in the Work Plan are those overseen by the HHS Office of Civil Rights (OCR), which have been charged with the enforcement HIPAA:

• OCR Oversight of the HIPAA Privacy Rule

“We will review Office for Civil Rights (OCR) oversight of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule.   The Privacy Rule establishes Federal minimum standards for safeguarding individually identifiable health information referred to as PHI. The Recovery Act requires that OCR investigate all privacy complaints filed against covered entities if a preliminary investigation indicates willful neglect of the Privacy Rule.”
What does this mean? In short, if someone makes a privacy complaint against your institution, you may get a call from HHS OCR.  And there will be more privacy complaints made to HHS OCR in 2012 than in prior years, as patient awareness of their rights grows. 
In addition, we know that HHS OCR will be conducting HIPAA audits in 2012.  We don’t know the precise form or possible penalties related to these audits, but if you look a little further down in the Work Plan, you can see that OCR is focused on the imposition of penalties for HIPAA privacy violations:
“The Recovery Act also strengthened OCR’s enforcement of the HIPAA Privacy Rule by increasing the civil monetary penalties for covered entities’ noncompliance. (74 Fed. Reg. 56123.) We will review OCR’s investigation policies and assess OCR’s oversight to ensure that covered entities are complying with the Privacy Rule.”
A Work Plan item such as this usually leads OCR to ratchet up its own efforts at enforcement, in order to make a good impression.

• OCR Oversight of the HITECH Breach Notification Rule

Breach Notification also is going to be a significant focus of OCR in 2012:
“We will review OCR’s oversight of the Heath Information Technology for Economic and Clinical Health Act (HITECH) Breach Notification Rule, which requires that covered entities, as defined by HIPAA, notify affected individuals; the Secretary of HHS; and when required, the media, following the discovery of a breach in unsecured PHI. . . .  We will review OCR’s policies for investigating breaches reported by covered entities and determine whether Medicare Part B-covered entities have policies or plans in place to mitigate breaches. “ 
As you know, if you have a breach (and you have to assume you will), there are new HIPAA/HITECH reporting rules.  One of the biggest questions that institutions face (and that I receive from clients) is whether to disclose a breach.  Part of the OCR audit process is likely to focus on whether you reported breaches that needed to be reported and whether “entities have policies or plans in place to mitigate breaches.” 

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The Institute of Medicine (IOM), best known for their landmark 1999 report on medical errors (To Err is Human) recently reported on the use of health information technology (HIT) and its impact on patient safety. In this report, Health IT and Patient Safety:  Building Safer Systems for Better Care, they make ten recommendations that include the creation of a council to evaluate criteria for assessing the safety of IT systems and reporting requirements for electronic health record vendors.

The HHS Office of the National Coordinator for Health Information Technology (ONC) commissioned the study and called for the HIT industry to improve the safety of its software products or have the software products regulated by a federal agency.  The IOM is an independent, nonprofit, non-governmental organization that provides unbiased advice to the public, government and decision makers.  
The IOM report recommends that the Secretary of Health and Human Services (HHS) ensures that the HIT vendors support a free exchange of information and establish a mechanism for users and vendors to report on HIT related deaths, injuries or other safety issues.  HIT is recognized for its importance to a continuous improvement of health care quality and safety through rapid and reliable flagging of potential safety risks and prevention of adverse events.

ONC has reported that they have undertaken a planning initiative to “develop a comprehensive EHR safety action and surveillance plan well within the 12-month period recommended by IOM” according to National Coordinator Farzad Mostashari, M.D.  ONC will work with the “FDA, AHRQ, NIH, and CMS as well as the broader health care community and industry.” 

Several Affordable Care Act initiatives including the Partnership for Patients and the accountable care organizations include safety programs that address medical errors, hospital acquired conditions, and readmissions.

http://www.iom.edu/Reports/2011/Health-IT-and-Patient-Safety-Building-Safer-Systems-for-Better-Care.aspx

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So what’s happening in the ICD-10 world in Massachusetts? The MaHIMA ICD-10 Forum held its second meeting November 29th at New England Sinai Hospital. Minutes from that meeting are posted on the Massachusetts CoP but the primary topics of discussion centered on what MaHIMA can do to support members for education and training. Several ideas came out of the discussion that will be taken to the board and respective committees for implementation. The next meeting will be in February. Anyone who is interested in participating in this forum can contact Sue Marre at smarre@nesinai.org.

As mentioned in the last ICD-10 update, the Massachusetts Health Data Consortium (MHDC) has also convened an ICD-10 forum.  One of the activities coordinated by this forum was an ICD-10 Provider Readiness Survey conducted by the Massachusetts health plans and MassHealth. HealthCare Administrative Solutions (HCAS) administered the survey and summarized the results. Survey results came from physician offices, other health care providers and hospitals and showed that 37% of respondents have started ICD-10 planning and 28% of providers have dedicated resources for ICD-10 compliance and implementation efforts. The entire survey results can be found at www.hcasma.org. Plans are to use this information to determine what resources and materials will be useful to facilitated ICD-10 preparations.  Anyone who works for an MHDC member organization interested in participating in the ICD-10 forum or the Coding and Operations Workgroup can contact Stacy McKenna, Office Manager, at smckenna@mahealthdata.org to be added to the participant list.

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Medicare and Medicaid EHR Incentive Program Update

Both the Medicare and Medicaid programs are fully underway,with eligible providers and hospitals successfully attesting to Stage 1 Meaningful Use and receiving their first incentive payments.  As of October 31, 138,570 national providers and hospitals had registered for the incentive program.  This resulted in $1,239,106,258 in EHR incentive payments.

First Massachusetts Meaningful Use Attesters

140 Eligible Professionals who are enrolled with the Regional Extension Center have successfully attested to Stage 1 Meaningful Use.  To celebrate this achievement, an event was held at the State House on November 2.  Congratulations to these and all of Massachusetts’ early Meaningful Use attesters!

Heather Hedlund can be reached at 617-371-3999 x234 or Hedlund@masstech.org.

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As a first-time attendee and relative newcomer to the Health Information profession, the 2011 AHIMA Annual Convention in Salt Lake City was an amazing experience.  My first thought when I walked into the cavernous room hosting the general sessions filled with people from around the country and the world, was how impressed I am with the strength and knowledge of the representatives of our profession.  Seeing and hearing speakers with whom I am "virtually" familiar with through publications and webinars, including Nelly Leon-Chisen, RHIA and Sue Bowman, RHIA, CCS, was a wonderful motivator.  There is a very impressive amount of diverse knowledge from truly dedicated and talented professionals in our field and I am pleased to have had the opportunity to hear their ideas in person.

The general session also presented terrific and thought provoking speakers outside of our profession with important messages for all of us.  One in particular was Stephen M.R. Covey, a nationally renowned advisor in the business world on topics such as leadership, ethics and trust in the work-place.  His presentation encouraged thought about how one works within and outside his or her organization in order to foster trust.  This idea requires personal reflection and most importantly action because even with intent we can fall well short of our goal without a plan for change.  Another important message is that there is always room for improvement and that trust grows from integrity and consistency on an individual level which then may transfer to groups and the organization as a whole. 

Like other conferences, there are an overwhelming number of education tracks and pre-conference workshops to expand one’s knowledge of current issues in HIM.  I attended those primarily related to my interests:  the transition to ICD-10 and Clinical Documentation Improvement (CDI).  The emphasis was on how to implement successful programs, incorporate ICD-10 guidelines into existing programs and who should lead the effort.  My impression from the discussions is that a collaborative effort is the key to success, especially in presenting the true Severity of Illness (SOI) and Risk of Mortality (ROM) of patients. 

One presentation in particular was very good at illustrating the success of a CDI program.  Loma Linda in California turned around their actual vs. expected mortality rates and increased their case-mix index by 12% within 2 years of implementing a CDI program.  This was focused on Medicare cases only and emphasized the data quality derived from accurate documentation rather than focusing solely on financial benefits.  The program encompasses many disciplines in the medical center and provides a great deal of education to entering residents regarding documentation.

This is only a small sample of the things that impressed me during my stay in Salt Lake City.  I encourage everyone, especially those new to the profession, along with HIM/HIT students, to attend the next convention in Chicago.  You won’t regret it.

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Joy P. Rose, MSA, RHIA, CCS
Assistant Professor/ HITECH Grant Program Coordinator
Bristol Community College
777 Elsbree Street, Fall River, MA  02720
Voice: 508-678-2811, ext. 2329 Fax: 508-730-3262
Joy.rose@bristolcc.edu

Bristol Community College would like to take this opportunity to thank all the healthcare organizations who are participating in Professional Practice Experiences for BCC HIT and medical coding certificate students.  BCC continues to have very strong interest and enrollment in both programs and enrollment is full for this current semester.

What is the HITECH Grant Program?  The HITECH Grant program at BCC is an ARRA funded grant that provides FREE training on how to implement and install an electronic health record.  The BCC HITECH Grant program is also enrolling qualified persons at a very robust rate.   BCC has currently enrolled and trained 150 individuals for the roles of Practitioner Consultant and Workflow Redesign Specialist.  These individuals have a backgrounds ranging from IT to clinician and associates degrees through PhDs.  The program is a very rigorous program that provides education to qualified people who will assist physician practices in making the transition from paper to electronic.  BCC is hoping to enroll more qualified personnel by mid November.  If you are interested in participating in this no-cost opportunity, email HITECH@bristolcc.edu or contact Bonnie Warner at 508 678 2811, ext 3665.

Newly Credentialed Students:
Elizabeth Dozois, RHIT
Elizabeth Torres, RHIT
Jessica Simas, RHIT

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Valerie McCleary, MS, RHIA

Valerie McCleary, MS, RHIA
Director of HIM Programs
Fisher College
Voice: 727-433-2816
vmccleary@fisher.edu
www.fisher.edu

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Programs offered:

• Coding Certificate Program
• Health Information Professional Certificate Program (open to students interested in the health information field who hold an associate degree or higher)
• Health Information Associate Degree Program

Application and program information can be found at the College’s website:  www.laboure.edu

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President
Mary Radley, RHIA
617-355-5502
mary.radley@childrens.harvard.edu

President-elect
Linda Young, JD, RHIA
978-725-5200
younglaw@prospeed.net

Director – Education
Diane Lindo, RHIT, CCS
857-218-4514
diana.lindo@childrens.harvard.edu

Director– Legislation/Advocacy
Ellen MacMullen, RHIA
781-756-7229
emacmullin@winhosp.org

Director – Communications
Jeanne Fernandes, RHIA
617-582-5223
jfernandes7@partners.org

Past President
Elyse DiSciullo, RHIA
781-830-8764
Elyse.Disciullo@massmail.state.ma.us

Adminstrative Director
Karen O'Donnell, RHIA
978-649-7517
info@mahima.org