5 Takeaways From AHIMA 2012

By Ken Congdon, Editor In Chief, ken.congdon@jamesonpublishing.com
Follow Me On Twitter @KenOnHIT

The 84^th annual AHIMA (American Health Information Management Association) convention and exhibition was held at McCormick Place in Chicago October 1-3. This was my fourth time attending AHIMA, and while I haven’t seen a final attendance tally, my impression was that overall traffic was down at this year’s event. Those HIM professionals that did make the trip to the Windy City, however, were treated to three days of stimulating educational sessions and an exhibit hall showcasing some of the latest technology solutions available. The following are the messages that resonated most with me at AHIMA 2012:

1. Privacy & Security Paramount — During the AHIMA General Session on Monday, October 1, Joy Pritts, the chief privacy officer in the Office of the National Coordinator for Health Information Technology, emphasized the importance of creating a healthcare culture where a patient’s health information is shared responsibly in the electronic age. Pritts explained how the explosive growth of EHRs introduces new data security challenges to providers. She urged healthcare facilities to put privacy and security at the forefront when implementing EHR systems, and to make ongoing security training an ongoing part of their EHR strategies. Pritts also referenced the impact of mobile devices on health data security. While the use of tablets and other mobile devices are on the rise across the board for clinical applications, Pritts stressed that 49% of healthcare facilities do nothing to secure these devices. Ensuring mobile assets are properly managed and secured should be a top initiative for healthcare IT leaders heading into 2013.
    

2. ICD-10: A Priority Again — When the ICD-10 deadline was extended to 2014, many healthcare providers took pause to reassess their ICD-10 plans. However, according to several technology and service vendors at AHIMA, this reprieve was short lived and providers are once again very serious about the ICD-10 transition. Surprisingly, many vendors also applauded the deadline extension, saying it was necessary given all of the other technology initiatives healthcare providers are currently bombarded with. Now that ICD-10 once again tops the IT priority list for many healthcare organizations, the vendor community is focusing on addressing the challenges this market is likely to face.
   
   “With a move from 13,000 codes in ICD-9 to more than 68,000 codes in ICD-10, the biggest challenge healthcare providers are likely to face during the transition is the learning curve involved in speaking this vastly expanded language,” says Torrey Barnhouse, president of TrustHCS, an ICD-10 training provider and consultant. “Healthcare providers need to develop a culture where continuous education is encouraged and invest in the technology to aide in the transition. To accomplish this goal, the C-suite needs to take the leadership role in the ICD-10 initiative.”
    

3. Audits: Appeal, Appeal, Appeal — With Medicare and Medicaid cracking down on fraud and reimbursement errors, audits have become a huge pain point for HIM and finance departments. Ensuring you get to keep the money payers have already awarded is a labor-intensive process that consumes countless man hours. And, as evidence shows, some healthcare facilities aren’t doing a very good job of keeping this money, resulting in millions of dollars in lost revenue annually.
   
   “On average, 75% of audits that are appealed by providers are overturned,” says Karen Bowden, senior VP of Craneware InSight, a revenue cycle management technology and service vendor. “The problem is only 40% of audits are being appealed. Huge amounts of money are being given back to payers that don’t have to be. Providers need to ensure they not only appeal, but continue to push the appeal through the process. For example, payers will often deny an appeal without even reviewing it the first two times it is submitted. The key is to get to “Level 3” of this process. This is the first time you will actually get to state your case in front of a judge, and this is where most appeals are won or lost. Many providers stop the appeal process after they receive that first ‘no’ from the payer. They need to push the appeal forward to Level 3.”
    

4. A Transcription Evolution — Dictation and transcription has long been a cornerstone of the clinical record. However, with the rise of EHRs and voice recognition technologies, it is feared that transcription may soon go the way of the dinosaur. AHIMA exhibitors such as Nuance and M*Modal were quick to dispel this myth. They stressed the ongoing importance of the clinical narrative as part of the patient record, saying it helps fill gaps in documentation and provide a clearer picture into patient conditions. They also emphasized the need to provide a combination of technology and services that address any physician’s desired workflow.
   
   “Transcription isn’t going away — it is simply evolving,” says Randy Drawas, chief marketing officer at M*Modal. “The information captured in the clinical narrative is still critical to patient care. There are just a variety of ways to capture this information these days. Physicians can choose to dictate a patient narrative the same way they always have and get the note transcribed locally or overseas, or they can eliminate transcription altogether using front-end speech recognition. Offering a combination of technology and transcription services is crucial. Equally as vital to the patient record is the ability for speech recognition technologies to not only transform speech to text, but to understand context and deliver discrete data that can be leveraged by business intelligence and analytics tools.”
    

5. It’s All About Data Quality — I had the pleasure of attending a Clinical Documentation Panel Discussion hosted by Nuance that featured HIM leaders from five notable healthcare facilities (MultiCare Health System, University of Wisconsin Medical Foundation, Childrens Medical Center/Dallas, Lahey Clinic, and University of Utah Health Care). A central topic during this discussion was the quality of data recorded in today’s EHRs. Most of the panelists stressed weaknesses in this area and outlined key ways to improve it.
   
   “When our clinicians transitioned to an EHR, we quickly realized that the quality of the data they were entering into the system wasn’t very good,” says Katherine Lusk, senior director of health information and exchanges at Childrens Medical Center/Dallas. “We developed a ‘record hygiene task force’ that provides feedback to physicians on their data and establishes best practices for what a good progress note should look like in the system.”
   
   “EHR systems will come and go, but your data won’t,” says Scott Bennett, senior enterprise medical imaging analyst at MultiCare. “Your data is all that counts. It must be solid so that you can use predictive tools for analysis and push actionable information to your clinicians.”