This webinar covers Health Information Technology (HIT) topics that are very much on everyone's mind today. From ICD-10 and SNOMED coding to MU and PQRS regs, this webinar will fill you in on the background and details you need to know. And if you're currently using an older version of NextGen/KBM, you'll find the upgrade info on those systems especially useful. Take advantage of this free information from Quirk Healthcare Solutions.
Ben Quirk spoke to the South Florida medical group community about the impact of ICD-10 on the healthcare industry. It was a very informative talk that covered a lot of need-to-know details, including how ICD-10 relates to Meaningful Use and SNOMED.
eHealth as a tool to support health practitioners November 2013Rajeev Rao Eashwari
“Telemedicine begins with a vision of connecting people to people, connecting resources to needs, and connecting healthcare problems to health care solutions”
Ben Quirk spoke to the South Florida medical group community about the impact of ICD-10 on the healthcare industry. It was a very informative talk that covered a lot of need-to-know details, including how ICD-10 relates to Meaningful Use and SNOMED.
eHealth as a tool to support health practitioners November 2013Rajeev Rao Eashwari
“Telemedicine begins with a vision of connecting people to people, connecting resources to needs, and connecting healthcare problems to health care solutions”
With patient responsibility becoming an increasing part of clinics AR, you need to make sure you have an effective strategy in place. Learn how to maximize your collections without negatively impacting your relationships with your patients.
Overcoming the Struggles of Small PracticesBen Quirk
Small practices face many struggles on the road to success. This webinar overviews the top obstacles they face, addresses the reasons behind the decline in numbers of independent practices, and provides solutions for them to remain successful despite the challenges.
In its January 2014 Issue Brief, the ONC announced its vision that, by 2020: The power of each individual is developed and unleashed to be active in managing their health and partnering in their health care, enabled by information and technology. And it began seeking feedback on new goals and strategies for health IT-enabled, patient centered care. With this vision in mind, this session will explore current and emerging technologies supporting person centered care in the ambulatory care setting.
For a change of pace, this latest Insights webinar covers the HIMSS (Healthcare Information and Management Systems Society) convention recently held in Orlando, Florida. Our CEO Ben Quirk attended the event and reports his observations, focusing on how convention activities reflect the state of the healthcare industry in 2014.
Medicare Advantage is a well-known program, but perhaps not so well-known in its details. In this webinar, we get into the nuts and bolts of how the program works, including a case study with practical examples. If you’d like to offer or improve a Medicare Advantage plan at your facility, this is a good place to start.
Our Insights webinar this week tackles a little-known program that will have a big impact on fee-for-service Medicare providers. The Value-Based Payment Modifier (or Value Modifier for short) is something every Medicare provider should know about as soon as possible. One way or another, providers will wind up on either the incentive or penalty side of this legislation. Take advantage of our webinar for in-depth information on this complex and far-reaching topic.
Data Conversions - Convert with ConfidenceBen Quirk
Data Conversions (DC) are necessary to ensure availability of Meaningful Use (MU) data, increased quality of care, and overall improved performance. Transferring data from an old system to a new or current one requires care and a knowledgeable project team to meet all standards of the organization for their go-live.
The recent extension of the ICD-10 deadline was greeted with mixed reactions throughout the healthcare industry. Some favored an extension, while others preferred to move ahead with the change. In this webinar, we look at the pros and cons of the delay and how it will affect providers and patients. Reactions from other vendors are also presented.
In the age of core system replacements, there are a lot of tough decisions that have to be made. Quirk Healthcare lends its expertise of this difficult topic in this weeks Insight.
Medicare Advantage is one of the few areas your clinic can generate risk scores. Learn the basics of the program, strategies to increase your reimbursement processes to monitor compliance with 5 star and tools available on the market to help your physicians.
End of Life Planning - Directives by DesignBen Quirk
Learn about Directives by Design, a culturally sensitive tool to guide patients through end of life choices and create a living will as required for hospitals in MU2.
In some ways, 2014 turned out to be not quite as cataclysmic as expected. However, maintaining a strong road map for the future remains critical especially with the ever shifting regulatory landscape. Learn four simple things to focus on for the remainder of 2014.
In this webinar, we explore the topic of Meaningful Use (MU) hardship exceptions. This should be of great interest to practices who are unable to attest for MU Stage 2 through no fault of their own. Here you'll find background on the exceptions, the categories CMS uses to determine valid hardships, and basic instructions on how to apply.
The transition to ICD-10 will affect several areas within your hospital, which means changes for most of your staff.
Areas include:
IT Systems Changes
Staff Education and Training
Business Process and Documentation Changes
Changes in Super-Bills Charges
Increased Documentation Costs
Cash Flow Disruptions
Reporting Changes
The ICD-10 Impacts presentation describes these changes and what they mean for your organization.
Use this presentation to educate and prepare your staff for the impacts of the new coding system so they are ready for the transition and the changes they will experience when the October 1, 2014 deadline hits.
Download the presentation here: http://bit.ly/13JjgG9
With patient responsibility becoming an increasing part of clinics AR, you need to make sure you have an effective strategy in place. Learn how to maximize your collections without negatively impacting your relationships with your patients.
Overcoming the Struggles of Small PracticesBen Quirk
Small practices face many struggles on the road to success. This webinar overviews the top obstacles they face, addresses the reasons behind the decline in numbers of independent practices, and provides solutions for them to remain successful despite the challenges.
In its January 2014 Issue Brief, the ONC announced its vision that, by 2020: The power of each individual is developed and unleashed to be active in managing their health and partnering in their health care, enabled by information and technology. And it began seeking feedback on new goals and strategies for health IT-enabled, patient centered care. With this vision in mind, this session will explore current and emerging technologies supporting person centered care in the ambulatory care setting.
For a change of pace, this latest Insights webinar covers the HIMSS (Healthcare Information and Management Systems Society) convention recently held in Orlando, Florida. Our CEO Ben Quirk attended the event and reports his observations, focusing on how convention activities reflect the state of the healthcare industry in 2014.
Medicare Advantage is a well-known program, but perhaps not so well-known in its details. In this webinar, we get into the nuts and bolts of how the program works, including a case study with practical examples. If you’d like to offer or improve a Medicare Advantage plan at your facility, this is a good place to start.
Our Insights webinar this week tackles a little-known program that will have a big impact on fee-for-service Medicare providers. The Value-Based Payment Modifier (or Value Modifier for short) is something every Medicare provider should know about as soon as possible. One way or another, providers will wind up on either the incentive or penalty side of this legislation. Take advantage of our webinar for in-depth information on this complex and far-reaching topic.
Data Conversions - Convert with ConfidenceBen Quirk
Data Conversions (DC) are necessary to ensure availability of Meaningful Use (MU) data, increased quality of care, and overall improved performance. Transferring data from an old system to a new or current one requires care and a knowledgeable project team to meet all standards of the organization for their go-live.
The recent extension of the ICD-10 deadline was greeted with mixed reactions throughout the healthcare industry. Some favored an extension, while others preferred to move ahead with the change. In this webinar, we look at the pros and cons of the delay and how it will affect providers and patients. Reactions from other vendors are also presented.
In the age of core system replacements, there are a lot of tough decisions that have to be made. Quirk Healthcare lends its expertise of this difficult topic in this weeks Insight.
Medicare Advantage is one of the few areas your clinic can generate risk scores. Learn the basics of the program, strategies to increase your reimbursement processes to monitor compliance with 5 star and tools available on the market to help your physicians.
End of Life Planning - Directives by DesignBen Quirk
Learn about Directives by Design, a culturally sensitive tool to guide patients through end of life choices and create a living will as required for hospitals in MU2.
In some ways, 2014 turned out to be not quite as cataclysmic as expected. However, maintaining a strong road map for the future remains critical especially with the ever shifting regulatory landscape. Learn four simple things to focus on for the remainder of 2014.
In this webinar, we explore the topic of Meaningful Use (MU) hardship exceptions. This should be of great interest to practices who are unable to attest for MU Stage 2 through no fault of their own. Here you'll find background on the exceptions, the categories CMS uses to determine valid hardships, and basic instructions on how to apply.
The transition to ICD-10 will affect several areas within your hospital, which means changes for most of your staff.
Areas include:
IT Systems Changes
Staff Education and Training
Business Process and Documentation Changes
Changes in Super-Bills Charges
Increased Documentation Costs
Cash Flow Disruptions
Reporting Changes
The ICD-10 Impacts presentation describes these changes and what they mean for your organization.
Use this presentation to educate and prepare your staff for the impacts of the new coding system so they are ready for the transition and the changes they will experience when the October 1, 2014 deadline hits.
Download the presentation here: http://bit.ly/13JjgG9
ICD-10 Transition Presentation: What Health Lawyers Need to KnowPYA, P.C.
PYA Consulting Principal Denise Hall, along with co-presenter Julie Chicoine, recently updated health lawyers about ICD-10 transition readiness at the American Health Lawyers Association Institute on Medicare and Medicaid Payment Issues, held March 26-27, 2014.
ICD-10 is an unknown terrain that the country is going toward. No one knows what to expect. Some expect productivity to decrease by as much as 50% due to its implementation. Some predict this new system will result in a shortage of coders. Is any of this true? This presentation will investigate the impacts – both foreseen and unforeseen – that ICD-10 implementation will have on radiology billing companies and radiology groups.
EMR ICD Coding and training for staff of medical recordsSrishti Bhardwaj
Computerization of medical Record;
Electronic medical record (EMR),
advantages of EMR,
ICD coding system :
application of ICD,
Minimum recording standards – training for staff and caregivers
Overview of the popHealth® open source population health and CQM Reporting system. Includes information on eHealthConnecticut FQHC implementation of popHealth®. Description of CCDs and QRDAs as well as pros and cons of using each. Includes popHealth® screen shots. Presented by Jackie Mulhall, eHCT, at Connecting Michigan for Health Conference June 2014.
Discuss challenges of EMR content awareness and analysis, and current disconnected documentation clarification processes;
Explain methodologies to engage physicians in the CDI process
Describe how technology can assist with documentation improvement and acceptance
Identify status of current advanced CDI programs and the opportunity for integration of evolving technological innovations
QualiTest offers a holistic testing approach which provides an end-to-end test at a fraction of the cost compared to current market approaches.
QualiTest understands the challenges and risks involved in ICD-10 transformation across the healthcare spectrum: providers, payers, clearinghouses, and vendors. As the world’s second-largest independent pure play QA and testing solution partner, QualiTest provides comprehensive end-to-end services for ICD-10 testing to all entities in the healthcare industry.
http://www.qualitestgroup.com
Similar to Quirk Healthcare: 2014 HIT Road Map (20)
CPT E/M codes are changing January 1, 2021. This webinar unpacks those changes for you, outlining everything you need to know including:
How to navigate all the changes
What these mean for reimbursement
What you need to know to make sure your providers and coders are ready.
Telemedicine has moved to the forefront of healthcare, opening up opportunities for both practices and their patients. To help unpack some of the enormous amounts of new information, This presentation focuses on:
- Relaxing of Regulatory Issues
- How Telemedicine Can Help Your Practice
- Challenges
- The Future of Telemedicine
This episode continues our COVID-19 COVID-19 Insights Webinar discussing CMS changes, available grants and loans, existing opportunities in telehealth, and more state openings for elective surgeries.
The COVID-19 pandemic continues to present challenges to healthcare practices. This presentation covers the reinstatement of elective surgeries in a few states, the greater adoption of remote tracking, and new developments with the FCC’s Telehealth Program.
It also goes over the technology CareOptimize has developed to help streamline COVID-19 monitoring and reporting, its genesis, and how this utility can help your practice post-pandemic.
This webinar continues the COVID-19 Insights webinar series. Topics include the loans and grants being offered by the government, how they differ, and how they may benefit your practice, including SBA Loans and Grants, HHS Grants, Medicare Advance/Accelerated Payments, and Telehealth Funding. The webinar also goes over the CareOptimize technology developed to assist with streamlining COVID-19 monitoring and reporting.
Does it feel like you’re falling behind on the latest CMS regulatory updates? You’re not alone. The CareOptimize COVID-19 Insights webinar is designed to keep you informed of everything going on with CMS as healthcare practices continue to adjust. Along with CMS updates, this webinar goes over SBA loans and Fee-for-service Advance/Accelerated Medicare payments.
CareOptimize COVID-19 Webinar series episode 2 continues with the most up-to-date news from CMS along with other regulatory changes affecting the healthcare industry. The primary focus is on a trio of distinct provider models and how each of them is managing their practices while adapting to the challenges of the pandemic. We also go over the technology CareOptimize has developed aimed at streamlining COVID-19 monitoring and reporting.
MIPS continues to be a major risk, with practices who do not participate subject to a 5% penalty. This webinar covers:
Rule clarification and changes that have occured since January 1st.
Measure clarification and changes that have occured since January 1st. Your measure calculations may be changing as a result.
Where your practice should be at this point in the year.
How we can help support unique workflows and provider documentation.
In the day and age of value based medicine, it is critical to optimize your reimbursements with more accurate coding.This webinar uses specific examples to demonstrate the intricacies of accurate coding and how you can actually benefit. Questions answered include:
• How is global service reporting changing?
• What procedures require reporting?
• Who is required to report?
• When do new requirements take effect?
MACRA is quickly approaching year 2. CMS recently released their 2018 Proposed Rule, and there are some significant changes everyone should be aware of.
Rather than wading through the 1,058 pages of the Proposed Rule, join CareOptimize for a look at the most important takeaways.
In less than 30 minutes, you'll learn:
Are any of your clinicians now exempt?
What is a Virtual Group, and will it save you money?
Are your practice's priorities aligned with the newly weighted categories?
How can the Proposed Rule increase your 2018 bonus?
Accountable Care Organizations (ACOs) have been part of the healthcare landscape for a while and remain an integral part of the move toward value-based medicine. CMS recently introduced a new model in the MSSP (Medicare Shared Savings Program), ACO Track 1+.
This presentation gives a broad overview of ACOs and explains the basics of the new Track 1+ model. Topics include:
- ACOs and their role in MACRA/MIPS
- Meeting or exceeding the standards
- Why the risk might be worth it
MIPS is here. Are You Ready? CareOptimize Is.
See how the MIPS Management Solution empowers practices like yours to:
1. Know provider scores in real-time and compare those to your peers across the country
2. Provide scorecards for each MIPS category
3. Model different scenarios to determine your highest MIPS score
4. Automatically submit to CMS
5. Choose which level of assistance is best for your organization
... And More!
Let's face it, changes are coming. Healthcare is about to undergo another big shift once the new administration comes in. Between the sure things and the big questions, CareOptimize has found a bit of clarity. Join us to learn what our experts advise you to do to stay on top of it all.
Are you:
Keeping up to date with your risk scoring?
Missing out on reimbursement premiums?
Ensuring accurate health profiles for your patients?
Proper risk adjustment is important, not only to ensure your patients' quality of care, but also to improve your bottom line. This CareOptimize presentation will take you from the basic tenets of risk adjustment to specific ways you can increase your risk scores and get the highest premium payments.
Meaningful Use: Programs, Penalities, and PaymentsBen Quirk
Meaningful Use is not dead!
MIPS may be just around the corner, but MU is still very much in the picture. There is enough time, however, for your practice to optimize 2016 reporting and increase 2018 payments and avoid penalties.
This presentation takes you through the steps needed to successfully attest for 2016 and be prepared for upcoming changes.
CMS has stopped being nice about ICD10. As of October 1, 2016, the grace period for not using specific codes for certain diagnoses is gone. If you are not precise with these codes, your denial rates will go up.
This presentatio helps you learn how you can avoid high denial rates and also explains:
- Key changes and revisions
- Written guidance from CMS and OIG that may negate a new guideline
- Chapter specific changes
- How to tell when you need documentation and when you don’t
2016 MIPS Final Rule: What you need to know NOWBen Quirk
Find out why you need to pay attention to this Final Rule and what adjustments you need to make to ensure you end up on the winning side of MIPS. It's a complicated program, and results from the Final Rule don't make it any easier.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
1. 2014
HIT
Road
Map
Wednesday,
February
12,
2014
Disclaimer:
Nothing
that
we
are
sharing
is
intended
as
legally
binding
or
prescrip7ve
advice.
This
presenta7on
is
a
synthesis
of
publically
available
informa7on
and
best
prac7ces.
2. 2014
–
An
Overview
•
•
•
•
•
•
•
NextGen
5.8
and
KBM
8.3
upgrades
ICD-‐10
Meaningful
Use
Stage
1
(MU1)
Meaningful
Use
Stage
2
(MU2)
Physician
Quality
ReporQng
System
(PQRS)
PaQent-‐Centered
Medical
Home
(PCMH)
Accountable
Care
OrganizaQons
(ACOs)
4. NextGen
5.8
Upgrade
•
•
•
•
•
•
•
•
•
•
•
Prerequisite
for
KBM
8.3
upgrade
ICD-‐10,
SNOMED,
and
MU2-‐ready
Log-‐in
Advanced
Audit
Race,
ethnicity,
and
language
PaQent
status
designaQon
Syndromic
surveillance
measure
Diagnosis
module
PaQent
educaQon
ePrescribing
PaQent
informaQon
bar
5. KBM
8.3Upgrade
• Non-‐KBM/KBM
8.1
or
earlier
• ICD-‐10
and
MU-‐compliant
• Upgrade
cost
and
effort
predicated
on
current
KBM
version
• Scope
of
conversion
based
on
customizaQon,
data
mapping,
and
workflow
changes
• Upgrade
opQons
– In-‐house
– Outsource
6. Do
You
Have
The
Right
Hardware?
•
•
•
•
•
•
Windows
OperaQng
System
Windows
workstaQons
Server
size
Development
environment
SQL
Server
Separate
SQL
server
for
reports,
HQM,
and
Advanced
Audit
7. ICD-‐10
October
1,
2014
All
enQQes
covered
by
HIPAA
affected
14,000
ICD-‐9
codes
grow
to
68,000
ICD-‐10
codes
No
impact
on
CPT
codes
Version
5010
standards
Significant
changes
to
clinical
and
revenue
cycle
systems
• Complex
conversion
to
updated
codes
• System
upgrades
to
expand
data
fields
for
longer
codes
• Staff
retraining
on
new
versions
and
codes
•
•
•
•
•
•
8. What
Are
ICD-‐10
Codes?
• Granular
code
set
developed
by
WHO
for:
– Increased
clinical
accuracy
– Improved
disease
tracking
– Disease
trending
• More
ICD-‐10
codes
compared
to
ICD-‐9
ICD-‐9
14,000
diagnosis
codes
4,000
procedure
codes
5
digit
numeric
codes
ICD-‐10
68,000
diagnosis
codes
87,000
procedure
codes
7
digit
alphanumeric
codes
9. Anatomy
of
ICD-‐10
Diagnosis
Codes
•
•
•
•
•
•
3–7
digits
Digit
1
is
alpha,
including
O
and
I
but
no
U
Digit
2
is
numeric
Digits
3–7
are
alpha
(not
case
sensiQve)
or
numeric
Decimal
is
aher
third
digit
Examples:
– A78
–
Q
fever
– A69.21
–
MeningiQs
due
to
Lyme
disease;
and
– S52.131a
–
Displaced
fracture
of
neck
of
right
radius,
iniQal
encounter
for
closed
fracture
10. Anatomy
of
ICD-‐10
Procedure
Codes
• 7
digits
• Alpha
(not
case
sensiQve)
or
numeric
digits
– O
and
I
not
used
to
avoid
confusion
with
0
and
1
• No
decimal
• Examples:
– 0FB03ZX
–
Excision
of
liver
percutaneous
approach,
diagnosQc;
and
– 0DQ10ZZ
–
Repair
upper
esophagus,
open
approach
11. What
is
SNOMED?
• SystemaQzed
Nomenclature
of
Medicine
–
Clinical
Terminology
• InternaQonal
standard
for
clinical
terminology
• Available
through
the
NaQonal
Library
of
Medicine
• Enables
communicaQon
in
common
language
– Increased
quality
of
paQent
care
across
specialQes
– Improved
accuracy
of
paQent
data
analysis
•
•
•
•
19
“hierarchies”
define
the
clinical
concept
Increasing
granularity
Very
specific
clinical
concepts
to
define
paQent
condiQon
More
complex
than
ICD-‐10
hierarchy
12. The
ICD-‐10-‐SNOMED
RelaQonship
• SNOMED
CT
has
beoer
clinical
coverage
than
ICD
• Number
of
codes:
– SNOMED
CT
(Clinical
findings):
100,000
– ICD-‐9-‐CM:
14,000
– ICD-‐10-‐CM:
68,000
• ICD
focus
is
staQsQcal
– Less
common
diseases
subsumed
under
general
categories
– Aher-‐the-‐fact
codes
• SNOMED
CT
is
clinically-‐oriented
– Used
during
care
– Clinical
relevance
and
user-‐friendliness
• Clinically
coded
data
generates
ICD-‐10
code
for
billing
13. EffecQve
ImplementaQon
Strategy
Impact
Analysis
Needs
Assessment
Project
Plan
Budget
Conversion
• IdenQfy
current
systems
and
work
processes
that
use
ICD-‐9
codes
• Talk
with
payers
about
effect
of
ICD-‐10
implementaQon
on
provider
contracts
• Workflow
and
business
process
changes
• Staff
training
• PracQce
management
vendor
accommodaQons
• ImplementaQon
plan
with
clearing
houses,
billing
services,
and
payers
• Inventory
systems
and
workflows
• ConQngency
plan
for
failed
go-‐live
• Time
and
costs
related
to
implementaQon
• Training
• IT/IS
upgrade
• Assistance
from
outside
vendor/consultant
• PotenQal
producQvity
loss
• TransacQon
tesQng
using
ICD-‐10
codes
• Historic
data
conversion
• Review
coded
data
for
claims
reimbursement
consistent
with
ICD-‐9
rates
14. Training
• AHIMA
recommendaQon:
no
more
than
six
months
before
compliance
deadline
• Approximately
16
hours
for
ambulatory
coders
and
50
hours
for
hospital
coders
– Physician
pracQce
coders
learn
ICD-‐10
diagnosis
coding
only
– Hospital
coders
learn
both
ICD-‐10
diagnosis
and
ICD-‐10
inpaQent
procedure
coding
• Specialty-‐specific
ICD-‐10
training
• ICD-‐10
coding
training
integrated
into
credenQal
maintaining
CEUs
• ICD-‐10
resources
and
training
materials
available
through
CMS,
professional
associaQons
and
socieQes
15. Meaningful
Use
• Set
of
standards
defined
by
the
Centers
for
Medicare
&
Medicaid
Services
(CMS)
• Financial
incenQves
for
using
cerQfied
EHR
technology
(CEHRT):
– In
a
meaningful
manner
– For
electronic
exchange
of
health
informaQon
– Submit
Clinical
Quality
Measures
(CQM)
• Three
stages
– CreaQng
informaQon
– Exchanging
informaQon
– Focusing
on
improved
outcomes
17. MU1
• InformaQon
gathering
• Two
years
– 90
days
(Year
1)
– Full
year
(Year
2)
• Different
schedules
for
hospitals/CAHs
and
Eligible
Providers
(EPs)
– Federal
fiscal
calendar
(Hospitals/CAHs)
– Calendar
year
(EPs)
18. MU2
• All
EPs
must
meet
MU1
– Two
or
three
years
• Focus
on
advanced
clinical
procedures
– Rigorous
health
informaQon
exchange
– Enhanced
ePrescribing
and
lab
results
requirements
– ConQnuity
of
care
across
mulQple
sesngs
– Increased
paQent
and
family
engagement
• Improved
paQent
care
19. MU
Structure
MU1
• 13
Core
• 5/10
Menu
• Total:
18
MU2
• 17
Core
• 3/6
Menu
• Total:
20
20. MU
Requirements
• Adopt
or
upgrade
newly
cerQfied
EHR
• ReporQng
– Medicare
• First
year:
Any
90
day
reporQng
period
• Beyond
first
year:
Calendar
quarter
– Medicaid
• Any
90
day
reporQng
period
• PaQent
Portal
21. MU
CalculaQons
• Denominator
– All
unique
paQents
– Subset
of
unique
paQents
• Numerator
– Number
of
unique
paQents
for
whom
required
informaQon
was
recorded
Threshold
=
Numerator
Denominator
22. MU
ReporQng
• ReporQng
through
aoestaQon
– ObjecQves
– Clinical
Quality
Measures
• ReporQng
may
be:
– yes/no
answers
– numerator/denominator
aoestaQon
• Exclusions
– Menu
objecQves
not
applicable
to
every
pracQce
• Certain
objecQves/measures
require
80%
of
paQents
with
records
in
CEHRT
23. AoestaQon
Checklist
•
•
•
•
•
•
•
Ensure
all
EPs
are
properly
registered
Run
reports
Validate
data
Complete
aoestaQon
worksheet
Collect
all
supporQng
documents
Aoest
before
3/31/2014
(MAO
–
3/1/2014)
Be
prepared
for
audit
24. What
is
PQRS?
• Voluntary,
individual
reporQng
program
– Quality
measures
for
services
provided
to
Medicare
beneficiaries
• Started
in
2007
– Tax
Relief
and
Health
Care
Act
• IncenQve
payments
for
parQcipaQon
through
2014
• Financial
penalty
for
non-‐parQcipaQon
aher
2014
• Measures
based
on
combinaQons
of
CPT,
ICD
and
paQent
age
at
the
Qme
of
the
encounter
25. Provider
ReporQng
Methods
• Individual
–
–
–
–
–
EHR
Direct
Product
that
is
CerQfied
EHR
Technology
(CEHRT)
EHR
data
submission
vendor
that
is
CEHRT
Qualified
PQRS
Registry
ParQcipaQon
through
a
Qualified
Clinical
Data
Registry
(QCDR)
Medicare
Part
B
claims
submioed
to
CMS
• Group
PracQce
ReporQng
–
–
–
–
–
GPRO
Web
Interface
Qualified
PQRS
Registry
EHR
Direct
Product
that
is
CEHRT
EHR
data
submission
vendor
that
is
CERT
CMS-‐cerQfied
survey
vendor
*Group
prac*ces
repor*ng
via
GPRO
must
register
for
their
selected
repor*ng
method
by
September
30,
2014.
26. Measure
SelecQon
• Individual
Measures
– 110
Claims
Based
Measures
– 201
Registry
Based
Measures
– 64
EHR
Measures
• Group
Measures
– 25
Measures
Groups
• Domains
–
–
–
–
–
–
Clinical
Process
/
EffecQveness
PaQent
Safety
PopulaQon
/
Public
Health
Efficient
Use
of
Healthcare
Resources
Care
CoordinaQon
PaQent
and
Family
Engagement
27. Measure
SelecQon
• Which
measures
should
you
choose?
– Difficulty
– Relevance
• Clinical
condiQons
usually
treated
–
Cardiac,
HTN,
Diabetes,
etc.
• Types
of
care
typically
provided
–
e.g.,
prevenQve,
chronic,
acute
– Best
performance
• 200
standardized
quality
measures
• Meet
50%
threshold
requirement
– Choose
a
PQRS
quality
measure
for
services
that
are
performed
frequently.
(This
is
the
minimum
required
to
prevent
penalty)
• IncenQve
Payment
or
Avoid
Penalty
28. PCMH
-‐
Overview
• TransformaQve
model
for
delivery
of
care
• Espouses
team-‐based
approach
– Comprehensive
and
conQnuous
paQent-‐driven
care
– Evidence
based
healthcare
and
best
pracQces
– Consistent
high
quality
care
• RelaQonship-‐based
• Whole
person
• Team-‐based
29. What
TransformaQon
Looks
Like
• Constant
innovaQon
• Key
data
measurement
and
improvement
targets
• Capitalizing
the
benefits
of
EHRs
• Regular
paQent
communicaQon
• ProacQvely
scheduled
paQent
follow
up
• Expanded
access
to
care
• PaQent
care
plan
coordinaQon
30. NCQA
RecogniQon
Process
• Complete
self-‐assessment
to
idenQfy
gaps
• Ensure
all
P&Ps
were
in
effect
for
at
least
90
days
• Run
reports
• Collate
all
supporQng
documents
• Submit
applicaQon
31. Accountable
Care
OrganizaQons
(ACOs)
• Builds
off
PaQent-‐Centered
Medical
Home
– Coordinated
care
to
ensure
seamless
transiQon
between
services
and
levels
of
care
• Formalizes
PaQent-‐Centered
Medical
Neighborhoods
– Brings
together
primary
care
physicians,
specialists,
and
hospitals
• Reimbursement
amount
linked
to
quality
• Launched
in
2012
32. ACO
Technology
Infrastructure
Enterprise
Revenue
Cycle
Management
Electronic
Health
Record
PaQent Engagement
InformaQcs
Health
InformaQon
Exchange
33. Technology
ConsideraQons
PaQent
Engagement
Data
AggregaQon
PopulaQon
Health
Management
Privacy
and
Security
Clinical
and
AdministraQve
Date
Exchange
Performance
Management
ReporQng
Infrastructure
Finances