Just for fun!!!! Who needs a break from the news? I know I do. Some of the headlines are just way too depressing and all the talk about repealing health care reform just makes me tired. So here's a little diversion that I hope will bring you a smile. These lyrics should be sung to the melody, Friends in Low Places - so get your Garth on folks and sing along!
Friends In Home Office Places
I stay home and work, not because of the perks
It's the job that I chose from the start
The money's not great, barely puts food on the plate
But in healthcare I'm doing my part
You think that it's grand, what I do with my hands
But it comes with superior skills
I know I belong, you can tell from this song
While I keep trying to juggle my bills
Cause I've got friends in home office places
Where the internet sings and they keyboard races
To the goal of the day, and I'll be okay
Oh I'm not hooked on financial status
Think I'll slip on down to my Facebook pages
Oh I've got friends in home office places
Things happen so fast, my IM's a blast
And now I have new SRT
Before you can say, social media's the way
I've got to Tweet my trip to DC!
Today's EHR
Is demanding so far
To keep up with Obamacare
Docs need us today, to help them relay
That important O2 sat on room air
I've got friends in home office places
Where the internet sings and the keyboard races
To the goal of the day, and I'll be okay
Oh I'm not hooked on financial status
Think I'll slip on down to my Facebook pages
Oh I've got friends in home office places
Friday, January 7, 2011
Wednesday, December 29, 2010
Challenges in 2011
As we start a brand new year, it is going to be particularly important to take notice of all that is happening in healthcare documentation. The sense of urgency for hospitals and providers to adopt EHR technology is on the rise and shows no signs of slowing down, despite the challenges, expenses and the myriad of complexities also known as meaningful use.
So what is an MT to do? Do we just go through our normal day and hope that our job is not the one eliminated? Or should we look at credentials, education and find new roles that we can do? Personally, I think it is a mistake if we don't get active in taking a long, hard look at this head-on instead of hoping that we can ride the wave to the shore.
We have heard for years that medical transcription and coding are similar (from the standpoint of clinical knowledge) and yet they remain, for the most part, very separate processes. It seems prudent to revisit these 2 tasks and see how we might bring them closer together in an effort to gain efficiencies and speed up the billing process. Having worked as both a coder and a transcriptionist, I know the skill sets are very similar. We must know and understand the language of medicine, A&P, pharmacology, disease process and so much more.
Even aside from the obvious coding option, there are others that come to mind. For those who aren't necessarily resigned by geographics or other requirements to working at home, becoming a scribe may be an option. There are probably individuals working as scribes who will tell you it isn't the same job and I completely acknowledge that it's not the same, however, it still comes back to all the medical knowledge and then training to perform the tasks that the physician needs for entry into the EHR. It can be learned, and you clearly have a huge head start.
Then what about analytics, quality reporting and a host of other tasks that we can learn? There are many options, and AHDI is exploring these with several current initiatives, but there is one step first. We need to understand that much of what will take place when the nation's healthcare goes electronic hasn't quite yet been fully determined. The roles are still being discovered. So the potential is there -- and it won't come without additional training, possible college preparation and credentials. This is just simply a call to keep eyes and possibilities wide open.
What can you do today? Start learning all you can about these new systems and keep your networks strong. Be informed and don't be afraid to consider going back to school. At a time when I thought I wouldn't need to go back to school, I find myself today enrolled at the University of Cincinnati in their BS HIM program to convert my RHIT to RHIA. Funny thing is that I looked into this program back in 2006 and decided not to do it, because I didn't think I needed to. Of course the enrollment advisor reminded me that had I done it then, I would already have gradutated. I guess the moral of this story is never say never - you might be surprised by the necessities in an evolving career!
Tuesday, May 18, 2010
EHR Process: Speak Your Preference
EHRs and meaningful use (MU) are getting so much publicity. There is the carrot (financial incentive) and stick (reduced reimbursement) approach to get them in place by 2014 with the promise of reducing costs, improving patient outcomes and patient safety. Through all of this publicity, seems we haven't heard enough from the chief care giver - the physician.
Many of the EHRs that have been approved by CCHIT don't include a dictation/transcription option. CCHIT may not ultimately be the approval body. Interestingly enough, MU definitions haven't been finalized. So there are goals to meet that haven't been fully defined and timelines that associations like the AMA and AHA along with a host of other national groups that have spoken clearly about how the all or nothing MU criteria plan is ill-advised. They agree that the timeline is not realistic.
We probably all can agree that EHR implementation without meaningful use doesn't get us to the goals promised. And we understand that it is a given to migrate away from paper records. However, the rush to get it done seems to put physicians and a practical improved approach to healthcare delivery in the system that we have, in the backseat.
Let's look at this from an objective perspective. Now we have healthcare reform. That's great news for so many who don't have healthcare today. It means that an additional 32 million (estimated) Americans will have access to healthcare who previously did not or did if their conditions became critical enough for them to present to the ER. What will healthcare reform do to physician case loads? To hospital census? Let us not forget that we have an aging population with baby-boomers approaching retirement. Do we have enough physicians for all this increased volume?
Now let's look at how many EHR systems approach healthcare documentation. They are designed for the physician to become the data entry clerk - and in truth, many are operating this way today. VA's VISTA system, Kaiser Permanente, and there are a host of EHRs designed for ambulatory settings and physician office practice that utilize the same approach.
Here's a thought. Do you see the president of a bank entering deposits and counting out cash at his bank? No, so why would we ask our most highly educated member of the healthcare delivery team to become a data entry clerk?
Currently 1.2 billion patient reports are created by expert medical transcriptionists who have trained and many have become credentialed in their field. Narrative dictation captures the unique circumstances of each individual patient. No two patients are alike in their history and even presenting symptoms. And to leave out important details of the patient's additional illnesses can most certainly impact hospital and physician revenue. So why would we A. slow physicians down entering the detail and B. risk lower reimbursements?
The purpose of this blog post is just simply this. Consider: The physicians who are mostly going to be time and resource-impacted by EHR implementation need to speak out in favor of the ability to continue to document patient encounters in the most efficient and complete way. Physicians' voices must be heard in this evolution to electronic records. What EHR systems must do is provide an avenue for physician choice in documentation practices.
If physicians want to self-enter - then that should be an option. However, for those physicians with a patient case-mix that is complex and those with multiple medical problems, their option to continue to dictate will mean the difference in their ability to increase the demand on their time as patient loads increase.
Physicians - please speak up - be sure that you have options in how you document patient encounters. You are the CEO of the healthcare delivery team and the process needs to provide better patient safety and ensure that your time is optimized while ensuring appropriate reimbursements for all you do.
Many of the EHRs that have been approved by CCHIT don't include a dictation/transcription option. CCHIT may not ultimately be the approval body. Interestingly enough, MU definitions haven't been finalized. So there are goals to meet that haven't been fully defined and timelines that associations like the AMA and AHA along with a host of other national groups that have spoken clearly about how the all or nothing MU criteria plan is ill-advised. They agree that the timeline is not realistic.
We probably all can agree that EHR implementation without meaningful use doesn't get us to the goals promised. And we understand that it is a given to migrate away from paper records. However, the rush to get it done seems to put physicians and a practical improved approach to healthcare delivery in the system that we have, in the backseat.
Let's look at this from an objective perspective. Now we have healthcare reform. That's great news for so many who don't have healthcare today. It means that an additional 32 million (estimated) Americans will have access to healthcare who previously did not or did if their conditions became critical enough for them to present to the ER. What will healthcare reform do to physician case loads? To hospital census? Let us not forget that we have an aging population with baby-boomers approaching retirement. Do we have enough physicians for all this increased volume?
Now let's look at how many EHR systems approach healthcare documentation. They are designed for the physician to become the data entry clerk - and in truth, many are operating this way today. VA's VISTA system, Kaiser Permanente, and there are a host of EHRs designed for ambulatory settings and physician office practice that utilize the same approach.
Here's a thought. Do you see the president of a bank entering deposits and counting out cash at his bank? No, so why would we ask our most highly educated member of the healthcare delivery team to become a data entry clerk?
Currently 1.2 billion patient reports are created by expert medical transcriptionists who have trained and many have become credentialed in their field. Narrative dictation captures the unique circumstances of each individual patient. No two patients are alike in their history and even presenting symptoms. And to leave out important details of the patient's additional illnesses can most certainly impact hospital and physician revenue. So why would we A. slow physicians down entering the detail and B. risk lower reimbursements?
The purpose of this blog post is just simply this. Consider: The physicians who are mostly going to be time and resource-impacted by EHR implementation need to speak out in favor of the ability to continue to document patient encounters in the most efficient and complete way. Physicians' voices must be heard in this evolution to electronic records. What EHR systems must do is provide an avenue for physician choice in documentation practices.
If physicians want to self-enter - then that should be an option. However, for those physicians with a patient case-mix that is complex and those with multiple medical problems, their option to continue to dictate will mean the difference in their ability to increase the demand on their time as patient loads increase.
Physicians - please speak up - be sure that you have options in how you document patient encounters. You are the CEO of the healthcare delivery team and the process needs to provide better patient safety and ensure that your time is optimized while ensuring appropriate reimbursements for all you do.
Sunday, November 29, 2009
Happy Holidays!
The holidays are here. Can you believe it? It's time to consider what you are thankful for, to enjoy some quality time with family and friends and to cherish what is meaningful in your life. It is also time to plan for the year ahead and think about what you want to achieve. Not so much like the New Year's resolutions we make with good intentions because they don't always last, but think more long-term and make plans to get there with a list that has dates and interval checks along the way.
Been putting off finishing that college degree? Get on track to complete it. Been thinking about your first or a new credential? Begin to study and prepare so that you can celebrate when you successfully get that achieved! Thought about running for a leadership office? Maybe this is the year to throw your hat in the ring. Whatever it is, make a serious to-do list that has something special in it - something that allows you to check it off the list, but you end up way better off once it is done! This is a way to get energized!
This year, I am incredibly thankful for the amazing friendship and support from MTs everywhere as I have traveled across the US serving as president of AHDI. I am so inspired by all those who have attended meetings and participated on committees and work groups to provide a strong future for us in this profession. There is so much to do, and the way everyone is pulling together to get us there, I have every confidence we will prevail.
So this holiday when you are contemplating your future, ask yourself, have I reached my full potential? Is there more I could do? Should do? If _______ happens, what will I do next? Prepare for the unexpected, continually improve yourself, plan for success, and decide to be great! How will you make 2010 your best year yet?
Monday, September 14, 2009
The EHR in Prime Time
Did you happen to catch CBS Sunday Morning yesterday, 9/13/09? Well if you didn't here's a link but the lead story was the EHR and all its benefits. David Blumenthal, MD, National Coordinator, spoke and others who are leading the charge. The move to the EHR is part of President Obama's healthcare reform initiative, Title XIII of ARRA that was signed into law in February. And we need to get this done.
There is little doubt that the improvements that a fully integrated and nationally linked healthcare system can bring to us as a country. Improved outcomes, less waste, faster information available when every minute counts - all of these are crystal clear, valid and important to achieve. My only concern is that we don't want to fail to capture the critical details of the patient's unique set of circumstances at the risk of getting it done faster.
There have been plenty of articles written about some of the shortcomings of new systems as well as the merits of others. This is a decision that cannot be lightly made nor should it be made hastily without all the considerations a decision of that magnitude should receive.
I am confident that these decisions will be well-made and that meaningful use will help ensure that these goals are optimally met. We do need to utilize enabling technologies like Health Story project to preserve the details of every patient's story and include this through technological solutions so that no critical issues are overlooked or left out. Physicians have so many pressures on their time with increasing patient loads. Allowing them to continue to document in this manner will help them continue to focus on the work they do best - and that is diagnose and treat their patients. You can have transcribed reports that are fullyl minable in an EHR.
Check out the story on CBS Sunday Morning and tell me what you think.
There is little doubt that the improvements that a fully integrated and nationally linked healthcare system can bring to us as a country. Improved outcomes, less waste, faster information available when every minute counts - all of these are crystal clear, valid and important to achieve. My only concern is that we don't want to fail to capture the critical details of the patient's unique set of circumstances at the risk of getting it done faster.
There have been plenty of articles written about some of the shortcomings of new systems as well as the merits of others. This is a decision that cannot be lightly made nor should it be made hastily without all the considerations a decision of that magnitude should receive.
I am confident that these decisions will be well-made and that meaningful use will help ensure that these goals are optimally met. We do need to utilize enabling technologies like Health Story project to preserve the details of every patient's story and include this through technological solutions so that no critical issues are overlooked or left out. Physicians have so many pressures on their time with increasing patient loads. Allowing them to continue to document in this manner will help them continue to focus on the work they do best - and that is diagnose and treat their patients. You can have transcribed reports that are fullyl minable in an EHR.
Check out the story on CBS Sunday Morning and tell me what you think.
Thursday, August 6, 2009
ACE Summary!
Gaylord Opryland, Nashville, TN – Music City USA was the scene for the 31st annual AHDI Annual Convention and Expo. And what an event it was. We kicked the event off with a Wednesday night welcome reception and everyone showed up in their jeans and boots to learn a few line dances from 3 very talented instructors. Later (once we had a few steps figured out), we were entertained by Les Richardson and County Line. What an awesome event and everyone was there!
Thursday morning we heard from our opening keynote, Donna Hartley who shared her incredible story with the message being that you can be more than a survivor, you can really thrive even in tough situations. She shared 9 tips you can do to get the most out of your career and your life.
At 10:00 AM the exhibit hall opened and our exhibitors were there with new offerings and great solutions for our members. Next followed the afternoon educational sessions with 3 tracks, medical, industry and MT practice. There were so many wonderful sessions to attend that it was really difficult to choose. What I did was buy the CD so I wouldn’t miss a thing.
Thursday afternoon was the continuation of the QA Summit (first launched in Louisville, KY at the MTIA meeting) and the summit leaders spent time in lively discussion on blanks and how best to address that segment of what is often a dissatisfaction indicator. Our next steps are clear and we will continue on towards a white paper on quality for our industry standard.
Friday morning early Nick van Terheyden, MD spoke on the Health Story Project (www.healthstory.com). This is the solution that uses CDA language to deliver narrative text in a format that is searchable data in the EHR. This is one of the single most important developments for our sector and every one in our profession should know about and begin to talk about how this will get implemented at every MTSO and every hospital across the nation. This is what builds the bridge from dictation and allows physicians to continue to be efficient (dictate, their preferred method of documentation by over 80%) and still allow the information to be formatted for EHR systems.
Next, we had the opportunity to hear from Bruce Mast, our Thursday morning keynote on the evolution of our role. That was a powerful, eye-opening session that proposed many possibilities based on the knowledge of our professionals – not the method of how we do it.
Then on Saturday morning, we were incredibly fortunate to have Jonathan Perlin, MD, PhD speak to us about what’s happening in healthcare and the opportunities that will abound with healthcare reform. His background and experience with both the VA and currently as the Chief Medical Officer for HCA puts him in a key position to share his insight with our members. He has also been named one of the top 10 physicians in America.
Then with an afternoon filled with outstanding educational sessions, it was time to wrap it all up with our first ever, Integrity Awards Red Carpet event and after party. The paparazzi was there snapping photos of our members who were dressed to the nines and everyone looked fabulous! The awards were presented then everyone moved over to the Gaylord’s Fuse nightclub for music, food and beverages. There was more dancing and fun for all there and as the main part of the conference concluded, we all agreed that this was one of the best events ever. The Gaylord facility was filled with greenery, waterfalls and blooms from all over the world. And speaking of the “world” their waterway complete with boat rides shares water from 17 countries worldwide.
For those who just didn’t get enough of the conference, Sunday morning the Managers and Supervisors special interest group conducted their annual event (8:00 – 11:30 AM) with great attendance and content-rich topics about how they are working and evolving in this new generation of EHR systems with SRT technologies and it was an excellent event with panel discussions and idea sharing.
When it was time to leave, I anticipated a feeling a sadness that it was over, but surprisingly, most of what I was thinking was how great the event was and how much more there is to look forward to. Our sector is evolving and as we prepare for this future, gaining knowledge and being involved in these changes at this level is something I treasure. For those who could not attend, I encourage you to get as much information as you can. If you aren’t a member, consider joining your professional association because there’s never been a more important time to be connected. The next few years are going to be amazing and we all need to be involved in securing our place as the knowledge worker for the future. Our roles will evolve, and the more visibility we have, the more opportunities we’ll have to stake our claim and say, “Yes I can do that – I have the expertise.”
Thursday morning we heard from our opening keynote, Donna Hartley who shared her incredible story with the message being that you can be more than a survivor, you can really thrive even in tough situations. She shared 9 tips you can do to get the most out of your career and your life.
At 10:00 AM the exhibit hall opened and our exhibitors were there with new offerings and great solutions for our members. Next followed the afternoon educational sessions with 3 tracks, medical, industry and MT practice. There were so many wonderful sessions to attend that it was really difficult to choose. What I did was buy the CD so I wouldn’t miss a thing.
Thursday afternoon was the continuation of the QA Summit (first launched in Louisville, KY at the MTIA meeting) and the summit leaders spent time in lively discussion on blanks and how best to address that segment of what is often a dissatisfaction indicator. Our next steps are clear and we will continue on towards a white paper on quality for our industry standard.
Friday morning early Nick van Terheyden, MD spoke on the Health Story Project (www.healthstory.com). This is the solution that uses CDA language to deliver narrative text in a format that is searchable data in the EHR. This is one of the single most important developments for our sector and every one in our profession should know about and begin to talk about how this will get implemented at every MTSO and every hospital across the nation. This is what builds the bridge from dictation and allows physicians to continue to be efficient (dictate, their preferred method of documentation by over 80%) and still allow the information to be formatted for EHR systems.
Next, we had the opportunity to hear from Bruce Mast, our Thursday morning keynote on the evolution of our role. That was a powerful, eye-opening session that proposed many possibilities based on the knowledge of our professionals – not the method of how we do it.
Then on Saturday morning, we were incredibly fortunate to have Jonathan Perlin, MD, PhD speak to us about what’s happening in healthcare and the opportunities that will abound with healthcare reform. His background and experience with both the VA and currently as the Chief Medical Officer for HCA puts him in a key position to share his insight with our members. He has also been named one of the top 10 physicians in America.
Then with an afternoon filled with outstanding educational sessions, it was time to wrap it all up with our first ever, Integrity Awards Red Carpet event and after party. The paparazzi was there snapping photos of our members who were dressed to the nines and everyone looked fabulous! The awards were presented then everyone moved over to the Gaylord’s Fuse nightclub for music, food and beverages. There was more dancing and fun for all there and as the main part of the conference concluded, we all agreed that this was one of the best events ever. The Gaylord facility was filled with greenery, waterfalls and blooms from all over the world. And speaking of the “world” their waterway complete with boat rides shares water from 17 countries worldwide.
For those who just didn’t get enough of the conference, Sunday morning the Managers and Supervisors special interest group conducted their annual event (8:00 – 11:30 AM) with great attendance and content-rich topics about how they are working and evolving in this new generation of EHR systems with SRT technologies and it was an excellent event with panel discussions and idea sharing.
When it was time to leave, I anticipated a feeling a sadness that it was over, but surprisingly, most of what I was thinking was how great the event was and how much more there is to look forward to. Our sector is evolving and as we prepare for this future, gaining knowledge and being involved in these changes at this level is something I treasure. For those who could not attend, I encourage you to get as much information as you can. If you aren’t a member, consider joining your professional association because there’s never been a more important time to be connected. The next few years are going to be amazing and we all need to be involved in securing our place as the knowledge worker for the future. Our roles will evolve, and the more visibility we have, the more opportunities we’ll have to stake our claim and say, “Yes I can do that – I have the expertise.”
Saturday, July 25, 2009
Nashville, Here I Come!
As the song goes..."Well my bags are packed and I'm ready to go"... And I couldn't be more excited about annual conference this year. ACE at the beautiful Gaylord Opryland is going to be one of the most amazing conventions we have ever had. We are doing so many new things this year. AHDI is always looking for more ways to share the latest information with attendees and this year there are many events with a new flair.
We are for the first time, doing a simulcast of a panel discussion with our closing keynote, Bruce Mast, Linda Yanisiewski, MTIA president, Peter Preziosi, CEO of AHDI and MTIA and me. One of the reasons we thought this was important is because we understand that times are tough and not everyone can travel to a convention. But we thought it would be innovative to take some of the convention to you.
This year our initiatives have been clear from January 1, 2009! We must produce an SRT curriculum and it is ready. We must update the QA standards for our industry - that collaborative work is well underway to be complete this year and we are having a face-to-face meeting in Nashville to continue to advance the work. We must continue to be visible in Capitol Hill. This work continues not only at our summit, but meetings have continued all year long and we have retained a lobbying firm, Dewey Square Group to ensure our voices are heard. We must develop our future roles that will evolve with the EHR and that work is well underway. We need to draft an open letter to all MTs to unite for the purpose of a louder, stronger voice in showing tremendous value we bring to healthcare and that has been drafted. And we must do all of these things and more for every person working in this sector and help support them in getting credentialed because it is high-time for us to join the rest of the healthcare field in doing that and having better tools/resources such as the Interfix Knowledge Base (KB).
We know that these are challenging times. We also know that if we sit quietly on the sidelines, that change will take place without our input or consideration. As the saying goes, out of sight, out of mind and it does happen when we are silent and invisible regardless of our many contributions. We can let change happen to us, or we can actively participate in ensuring that healthcare reform includes healthcare documentation professionals.
We are for the first time, doing a simulcast of a panel discussion with our closing keynote, Bruce Mast, Linda Yanisiewski, MTIA president, Peter Preziosi, CEO of AHDI and MTIA and me. One of the reasons we thought this was important is because we understand that times are tough and not everyone can travel to a convention. But we thought it would be innovative to take some of the convention to you.
This year our initiatives have been clear from January 1, 2009! We must produce an SRT curriculum and it is ready. We must update the QA standards for our industry - that collaborative work is well underway to be complete this year and we are having a face-to-face meeting in Nashville to continue to advance the work. We must continue to be visible in Capitol Hill. This work continues not only at our summit, but meetings have continued all year long and we have retained a lobbying firm, Dewey Square Group to ensure our voices are heard. We must develop our future roles that will evolve with the EHR and that work is well underway. We need to draft an open letter to all MTs to unite for the purpose of a louder, stronger voice in showing tremendous value we bring to healthcare and that has been drafted. And we must do all of these things and more for every person working in this sector and help support them in getting credentialed because it is high-time for us to join the rest of the healthcare field in doing that and having better tools/resources such as the Interfix Knowledge Base (KB).
We know that these are challenging times. We also know that if we sit quietly on the sidelines, that change will take place without our input or consideration. As the saying goes, out of sight, out of mind and it does happen when we are silent and invisible regardless of our many contributions. We can let change happen to us, or we can actively participate in ensuring that healthcare reform includes healthcare documentation professionals.
So as many of us gather in Nashville, (making this our first ever green conference in keeping with that socially responsible initiative) for those of you who can't make it this year, I wanted to be sure you know that AHDI is working for all of you who are working at home, in offices and in hospitals and clinics and we will continue to work on your behalf to secure a great future.
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