Laughter is the best medicine – ICD10 Illustrated

You know those things you didn’t know you need until you see them? I found one today when the Internet directed me to ICD-10 Illustrated.

Tara Courtland

Communications Director Tara Courtland

I’m not sure how I’ve been living in the healthcare documentation field without this — it’s a series of paintings, drawings and photographs by various artists that illustrates some of the more amusing ICD-10 codes, such as:

  • T63.442S Toxic effect of venom of bees, intentional self-harm, sequela
  • Z73.1 Type A behavior pattern
  • W56.22xA Struck by orca, initial encounter

By now, we’ve probably all heard about some of the bizarre codes in ICD-10. (“V91.07xD Burn due to water-skis on fire, subsequent encounter” is one of my personal favorites.) But seeing them in illustrated form makes the entire system all the more … palatable.

I thought this was the best thing I’d ever seen and I was planning on getting a deck of illustrated playing cards (labeled “ICD-10 The Gathering”) until I discovered another product: “MU2 Illustrated” — a guide to Meaningful Use Stage 2 with humorous artistic posters for providers and hospitals. And my office wall.

If laughter is the best medicine, illustrated guides to government regulations may be the answer to what ails us all.

To see more, visit www.icd10illustrated.com

 

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The most dreaded word: ‘breach’

NEMT President Linda Allard

So, what is a breach according to HIPAA? A breach is, generally, an impermissible use or disclosure under the Privacy Rule that compromises the security or privacy of protected health information (PHI) such that the use or disclosure poses a significant risk of financial, reputational, or other harm to the affected individual. [45 C.F.R. §164.402.7]

One of the things I have learned through all my reading, webinars and seminars is that not only do we need to know when to report a breach but we must investigate any security incident, whether it warrants reporting or not. How a security incident is investigated and handled is looked at with great interest during an audit. The way in which we handle security incidents and breaches can greatly impact the fines imposed, and fines tend to be much greater when they are not handled properly.

We need to look at the investigation of a security incident as a way of making sure we don’t repeat an issue. If we have an incident that didn’t cause us an issue and we don’t thoroughly investigate how it happened, what will prevent it from happening again and possibly causing an actual breach?

It stands to reason that repeated incidents and breaches are not looked upon well. They are also not good for the patients we are trying to protect. Now is a great time to take a look at how you handle investigations and to make sure that everyone is following your policies.

 

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David and Goliath — how Cerner beat out Epic

I think it makes a huge statement that the DoD (United States Department of Defense) chose Cerner as its EHR vendor.

NEMT CEO Linda Sullivan

As we all know, Epic has been the Goliath in the industry for the last five years, snapping up nearly every major hospital system seeking the best electronic health record solution possible. We also know they are not the least expensive. And what we have also have come to know is that they appear to have adopted not just the size of Goliath but also the mindset: “We’re the biggest and the best and you’re darn lucky to be working with us.”

Now I’m not sure I would call Cerner “David” in this scenario but it does feel a bit that way.

In Malcolm Gladwell’s book “David and Goliath: Underdogs, Misfits, and the Art of Battling Giants,”

a large part of the message to the business-owner readership is to find the vulnerabilities of the behemoth and look to your strengths.

Assuming a level playing field in terms of functionality, in this case I believe Cerner’s strength is being good team players – approaching client relationships with the attitude that it’s a partnership. Along with that approach comes openness and willingness to share information and work with others in the sandbox.

Tom Sullivan writes recently in “Healthcare IT News” that “… the thinking was to pick the team that best demonstrated an ability to work with modular capabilities from other vendors …”

Cerner is setting itself apart by being a real team player in a contentious landscape. And given that the next frontier is interoperability they have positioned themselves well.

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Windows 10 is here!

Windows 10 is here! It was just released and, as I have said before, my suggestion is that you to wait to upgrade. You want to aim to be on the leading edge, not the bleeding edge.

Andrew Clarke

You don’t need to be the first to upgrade unless you absolutely hate the version of Windows you’re running now, and you know that you will still be able to work if you upgrade. If the version of Windows you have is working, you should wait until the first adopters work out the bugs, and there will be bugs. Remember: the early bird gets the worm, but the second mouse gets the cheese.

I have not completed my evaluation of Windows 10, but one very important thing jumped out at me. Microsoft reported that Windows Media Player would not be included in this version of the OS. What appears to be the case for those who upgrade, however, is that you will still have your current version of Windows Media Player when the upgrade completes. Microsoft might change that at some point, so some of you may need a replacement program. Anyone who buys a new computer that comes with Windows 10 will definitely need a media player in order to play music or videos.

I recommend a program called VLC [http://www.videolan.org/vlc/index.html] as a wonderful replacement. Here is a partial list of the features they boast :

  • Simple, fast and powerful media player.
  • Plays everything: Files, Discs, Webcams, Devices and Streams.
  • Plays most codecs with no codec packs needed: MPEG-2, DivX, H.264, MKV, WebM, WMV, MP3…
  • Runs on all platforms: Windows, Linux, Mac OS X, Unix…
  • Completely Free, no spyware, no ads and no user tracking.
  • Can do media conversion and streaming.

For additional feature information, visit http://www.videolan.org/vlc/features.html or click the link on the page above labeled Discover all features.

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‘Skype on steroids:’ iPads battle healthcare costs

I recently attended a healthcare summit near Washington, D.C. that included a segment on telehealth. The use of iPads and other tablets in healthcare has been a growing trend and all over the country, hospitals and agencies have been experimenting with this technology to solve problems.

Tara Courtland

Communications Director Tara Courtland

Dr. Katherine Wibberly, director of the Mid-Atlantic Telehealth Resource Center, recently explained the use of tablets in taking healthcare on the road.

Wibberly referred to telehealth as “Skype on steroids” and said the technology will allow all types of medical equipment and tests to be performed remotely, from heart monitoring to diabetes testing to weight monitoring.

It also has promising implications for stroke patients. An ambulance crew equipped with tablets can start processing the patient while en route to the hospital, saving minutes that are vital when a patient has had a stroke.

But it’s not all lifesaving moments. The most widespread use of telehealth will be in saving time and money on routine matters.

Wibberly gave the example of a child at school who goes to the nurse’s office with an earache. Currently, the nurse calls the child’s parent, who leaves work, drives to the school, picks the child up and takes him to the doctor’s office. The doctor looks in the child’s ear, diagnoses an ear infection, calls in a prescription and tells the parent that the child can return to school.

But by that time, both the parent and child have missed most of the day.

Instead, a telehealth-enabled tablet would allow the nurse to check the child’s ear and send the images directly to the doctor. The doctor would then make the diagnosis remotely and call in the prescription. The parent could pick up the prescription on the way home and no one need miss school or work.

That same kind of remote diagnosis is already being used by ambulance crews to keep non-critical cases out of the emergency room.

Earlier this year, a story on NPR detailed a program in Houston where ambulance crews are using telehealth and taxis to help patients who are ill but not critical to avoid the ER. Ambulance crews there are equipped with tablets and when someone calls 9-1-1 for a medical issue that doesn’t seem to require the emergency room, the EMTs call in a doctor via video chat, just to be sure. The doctor can then talk to the patient and make a preliminary diagnosis remotely. But it doesn’t stop there — the doctor also sets the caller up with a clinic appointment for the next morning. And sends a taxi over to pick them up and return them home — for free.

Houston’s pilot program costs more than $1 million a year to run and it’s being paid for with city money plus grants, including one from the Medicaid program.

But the city spends far more than that each year in ER visits that could have been handled by a primary care physician. Officials estimate using video chat plus free taxis and clinic visits will save more than $2 million a year.

We’ve spent years talking about the growing cost of healthcare and the seemingly insurmountable political obstacles that prevent a solution. How ironic that Apple may end up solving the problem using the same platform we use for playing Candy Crush.

For more information on the Mid-Atlantic Telehealth Resource Center and a list of telehealth providers in the region, visit www.matrc.org.

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