Will ICD-10 ever be implemented? And if so, when?

Two new bills have recently been introduced to either delay or entirely eliminate the implementation of ICD-10.

NEMT CEO Linda Sullivan

Congresswoman Diane Black, a Tennessee Republican, introduced a House bill last week calling for an ICD-10 transition period. The gist of the bill, as explained by Black, is “to require the Secretary of Health and Human Services to provide for transparent testing to assess the transition under the Medicare fee-for-service claims processing system from the ICD-9 to the ICD-10 standard, and for other purposes.” The suggested transition period is defined as 18 months.

Texas Republican Ted Poe has introduced H.R. 2126: Cutting Costly Codes Act of 2015. This bill is more draconian. It “prohibits the Secretary of Health and Human Services from replacing ICD-9 with ICD-10.”

Driving this point home, there is no new implementation deadline. The bill also requires the Government Accountability Office to “conduct a study to identify steps that can be taken to mitigate the disruption on healthcare providers resulting from a replacement of ICD-9.”

Millions, more likely billions, of dollars have been invested in ICD-10 preparedness on the part of out healthcare institutions and they are largely ready. ICD-10’s time has come.

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Share and share alike

Have you ever wanted to share videos, pictures or other files with friends or coworkers just to find out that they were too big to attach to email? Or have you tried to send a file only to find out that the receiver’s email program wouldn’t allow that type of attachment? Well, there’s a solution, and it’s free. It’s called Dropbox (dropbox.com), and if you use this link to sign up, you will get an extra 500 Mb of disk space. If you would rather go to the site manually, that’s ok, too. Either way, your life will never be the same.

Andrew Clarke

Once you install Dropbox on your computer, any files you place in the Dropbox folder created during installation are automatically available on all your computers and devices where you install Dropbox. If you save your documents from Word or other programs to your Dropbox folder, they are instantly syncronized to your Dropbox account in the cloud. That means that you can access your documents from any computer anytime using the username and password you create when you sign up.

A few other benefits of Dropbox are:

• Multiple versions of your documents are saved – Have you ever accidentally saved changes to a document and wished you could go back in time? With Dropbox, you can.

• Sharing a document with anyone is as easy as right-clicking on the document and choosing Share Dropbox link. When you do, a secure link to the file is created and placed on your clipboard. You can then create an email to the person you want to receive the file and Paste the link in the email. The best part is that the person receiving the file does not need to have Dropbox.

• If your phone or tablet doesn’t have enough memory to hold all your pictures and videos, save them to your computer and install the Dropbox app so that you can view them on your phone or tablet easily.

• View your files on any computer through the browser (Internet Explorer, Firefox, Chrome, etc). There’s no need to install the software. All you need to do is login on Dropbox.com. You can also download files this way.

• Share folders with other Dropbox users. This is a great way to share vacation photos if multiple people are vacationing together, or collaborate with coworkers. Everyone uploads / downloads using the shared folder, and anything placed in that folder is automatically downloaded to each computer that shares it. The best part is that you can share different folders with different people.

The free version has a limited amount of storage space. To get more space, you can either pay to upgrade or invite people to enjoy Dropbox using a special link (like the one I placed above). When your special link it used, both you and the person signing up receive an additional 500 Mb of storage space.

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Outside-the-box thinking cures health costs

I’ve been hearing a lot recently about the rising use of tablets in healthcare. You’ve probably heard of this concept too – instead of driving to your doctor’s office, you set up a Skype call where you can describe your symptoms and show your provider that itchy rash or swollen tonsils. In many cases, a provider can make a diagnosis over video chat and can call in a prescription without far less administrative costs than an in-office visit.

Tara Courtland

Communications Director Tara Courtland

I already loved that idea — I’ve got a serious aversion to doctors’ offices, not because of the doctors (or more often, nurse practitioners), but because of the time spent hanging out in the waiting room. If I could do the waiting in my living room, I’d be a lot more likely to get medical attention from time to time.

Then I heard a story on NPR that takes it one step further. The city of Houston is undertaking a pilot program that uses video chat to hook up doctors with people who call 9-1-1. Ambulance crews carry tablets and if a caller’s medical issue doesn’t seem to require the emergency room, they call in a doctor via video chat, just to be sure. The doctor can talk to the patient and make a preliminary diagnosis remotely.

Houston isn’t the only place trying out video chats through ambulance crews. But here’s where Houston goes everyone else one better: the doctor sets the caller up with a clinic appointment 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 all know the rising cost of healthcare is nearing crisis level. Houston’s got it right – new technology plus outside-the-box thinking is exactly what we need to start knocking it back.

Read the whole NPR story by clicking here.

 

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What’s in your email?

These days we use email for everything. We use it to communicate with our staff, our bosses and our vendors.  The problem for those of us who work with patient documentation is the proper handling of PHI.

NEMT President Linda Allard

Many facilities now have encrypted email systems where they can encrypt a particular email that contains PHI.  This allows them to send what they need to send securely.  The receiver has to use a password or pass phrase to read the email.  This is an excellent option, but what if it isn’t available to you?

If you don’t have a way to encrypt an email that contains PHI, you should not send it over regular email. Depending on the information you need to send, you can remove parts of the name and replace them with an “X” or other character.  For example, Allard, Linda would become AXXXXX, LXXXX.  The same is true of any information you are sending that is considered PHI.

Something many people forget about is replies and forwards of emails they receive.  If someone sends you an email that contains PHI and you reply to it, you have now caused PHI to be transmitted insecurely twice.  The reason is that most email systems automatically include the original text of an email in the reply.  If there was more than one person on the original email and you used reply all, it is an even bigger problem.

So what do you do if you receive an email where the PHI in it has not been removed and no encryption has been used?  First you should check to see if your facility has a policy concerning how this situation should be handled.  The key thing is to make sure that you remove the PHI from the email before you either reply to or forward it.  You can use the same simple steps suggested above.  Make sure you handle all PHI contained in the email (names, account numbers, dates of birth, phone numbers, etc).  Replace the information that needs to be hidden with other letters or characters.  The idea is to ensure that the patient cannot be identified.  I also suggest that you note within the email that PHI has been removed. That way, if others were on the original email thread they won’t accidently resend the PHI.

If you deal with PHI regularly, you should make it a point to re-read your emails and look closely at everything you are sending or resending to make sure PHI has been removed correctly.  Be especially careful where long email threads are involved.  We are all busy and have multiple responsibilities, but protecting our patients’ data should be in our thoughts at all times.

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Don’t get snippy with me!

There are times when you need to capture the information on your screen.  The print screen function is nice, but sometimes you only want to capture a portion of the screen or you want to point out a specific part of the screen once you capture it.

Andrew Clarke

These functions can be performed with print screen … and one or more other products.  Wouldn’t it be nice if there were a single program to help you get the job done at an economical price (free)?

Well, you’re in luck!  That program exists, and it’s built into your windows operating system (Windows Vista, Windows 7, Windows 8, Windows 8.1).  It’s called the snipping tool.

To find it in Windows 8, you will need to use the search feature.  If you move your mouse to the lower-right corner of the screen some icons will appear.  You can then move your mouse up to Search and click.  Type Snipping Tool in the search box then click Snipping Tool.  Once you do, the following program will appear on your screen:

 

 The snipping tool allows you to capture:

  • Free-form Snip – Draw any shape around an object using your finger, mouse or tablet pen.
  • Rectangular Snip – Drag the cursor around a rectangular portion of the screen.
  • Window Snip – Choose a window and click.  By default, the screen about to be captured will stand out.
  • Full-screen Snip – Capture the entire screen.

Once you complete a capture, the snipping tool will show what you captured on the screen.  You can then add notes or mark areas that need to be emphasized, highlight portions of your capture, save or email the results, and more.  Additional instructions on using the snipping tool can be obtained from Microsoft at:

http://windows.microsoft.com/en-us/windows/use-snipping-tool-capture-screen-shots

Make sure you use the dropdown arrow on the right to select your Windows version to ensure you get the proper instructions.  Have fun, and feel free to share the results of your captures.

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