Privacy Officer Services

A new day and a new adventure begins. In working with MTSOs for a number of years, and with the requirements of HITECH making the headlines, I have decided to start something new and provide a number of services and solutions for business associates and covered entities in efficiently achieving compliance in the area of privacy and security. Privacy Officer Services officially begins today.

This new business is designed to support business associates and covered entities in the development of their customized policies and procedures for privacy and security, to assist with completing their required security risk analysis and a number of other services like employee training, education, monthly updates, quarterly updates for the business website, and weekly updates in news in and around privacy and security as well as technical developments. There are many more and there is a unique solution for every healthcare organization.

My goal is to help these business associates achieve the HITECH requirements in a cost-effective manner so that their current staff can continue on with the business at hand in delivering on-time services and provide the customer experience their clients expect.

By outsourcing their privacy officer reponsibilities to me, they will gain efficiencies in a number of ways like having a knowledgeable resource available every day without having to add to their employee count. Having someone who can attend meetings, and present to potential and existing clients on their privacy solutions can be a huge advantage in the world where we see and hear about costly security breaches nearly every day.

It's a new world filled with legal requirements and challenges for business associates and covered entities - this is a way to check a very important responsibility off the "must-do" list and put this into the hands of someone they know and can trust to provide the right solution today.

Medical Transcription - The Gold Mine

While EHRs are going in rapidly across the country, it's important to remember that the demand for value in reducing costs, improving patient safety and providing access to more Americans still leads the charge when it comes to why we move to electronic systems in health care. One of the best ways to enhance the value in EHR systems data mining and research is to keep a robust, detailed record of each individual patient who has a unique history unlike any other. Medical transcription/editing captures details provided by clinicians that are crisp and precise filled with data and information that can get us to the goal of improved patient outcomes through the application of secondary healthcare data. There are a number of reporting agencies that are making results available to anyone who is interested in taking a look. Organizations like the Leapfrog Group, Health Grades, Bridges to Excellence along with a score of others, provide information on various diseases and outcomes. Some secondary data use reporting is required such as core measures reporting. And when I say required, I mean that there is a 2% penalty in market-basket outcomes if you choose not to report. It is probably reasonable to anticipate that the number of hospitals reporting outcomes and the agencies to which they report will also increase. This is why it is a key fundamental and logical approach that the use of dictation and medical transcription or medical editing with speech recognition tools will be the best way to capture these necessary details and be able to produce content-rich results when reporting outcomes to continuously improve care. Nine of 10 Healthcare executives agree in a survey conducted by Pricewaterhouse Coopers (PWC) that secondary use of health information will significantly improve the quality of care and that those benefits will improve in the future. A clear two/thirds anticipate a huge increase within the coming two years. (1) Consider the AMIA findings of the gains that can be made from the expansion of knowledge about diseases, treatments and make strides in public health along with advances in privacy and security. (2) There is much to be gained as we move into this era of using secondary data to advance healthcare and this can best be achieved if we continue to capture the details provided by clinicians through the dictation and interpretation process. The outcomes, however, will only be as good as the content from which the information comes - that's why dictated/transcribed reports are a gold mine of information. To in any way short-cut details will severely limit the wide-range of benefits.

Medical Transcription - In Home Offices

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

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!

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.

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?

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.