Archive for December, 2011

CMS Delays Version 5010 Compliance Enforcement

30 Dec

The Centers for Medicare & Medicaid Services announced last month that it will delay its requirement for the adoption of a more-robust set of claims transmission standards.

Originally, the switch the ASC X12 Version 5010 standards required of hospitals, physician practices, health plans and claims clearinghouses was set for January 1, 2012. But the CMS announced it would push it back to March 31, 2012.

The announcement came after a significant amount of protest within the medical industry and their inability to be ready to make the upgrade from the Version 4010 standards currently in use. The CMS respond accordingly.

According to the CMS, its decision to push back their enforcement deadline was “based on industry feedback revealing that, with only about 45 days remaining before the January 1, 2012 compliance date, testing between some covered entities and their trading partners has not yet reached a threshold whereby a majority of covered entities would be able to be in compliance by January 1.”

The switch to the Version 5010 standards is consider a necessary precursor to adoption of ICD-10. Those who do not comply by the deadline face hefty penalties. According to the CMS website, “The HIPAA legislation permits civil monetary penalties of not more than $1.5 million per calendar year for a violation of an identical provision.”

According to a Medical Group Management Association member survey, only one in 50 physician group practices has completely implemented the software changes  that are necessary to make the switch to Version 5010.


More Doctors Using Telehealth Solutions

28 Dec

In these challenging times in healthcare, physicians and policymakers alike are looking for ways to streamline the way they deliver care. So-called “telehealth” is having a major impact on multiple fronts: health outcomes in patients, financial health of medical practices, and even potentially the environment when considering less travel time to doctors’ offices.

One way virtual doctor visits can save lives and improve care is with the growing elderly population who often have difficulty going to and from appointments.

“We do a lot of chronic disease management in primary care, which is where telehealth is the most valuable to me,” said Ronald Dixon, a practicing general internist and director of the Center for Integration of Medicine and Innovative Technology in Boston.

A 2010 survey by Intel found that an overwhelming majority of health care decision makers – 89 percent – believe telehealth will transform health care over the next decade. The survey found that about two-thirds of all physicians currently use telehealth solutions, with 87 percent of those being happy with results. Among those healthcare providers not currently using telehealth solutions, 50 percent say they will by next year.

Many third party payers, including Medicare and private health insurance plans, are starting to pay providers for online visits, usually at a lower rate than with traditional office visits.

London-based market research firm Datamonitor estimates the market for telehealth services in the U.S. and Europe will grow to $8 billion by next year, up from $3 billion in 2009.


AMA Fights Against ICD-10

27 Dec

Medical professionals already have their hands full with healthcare reform, they don’t have ample time or resources to comply to changes that come with ICD-10. That’s, in essence, what The American Medical Association’s House of Delegates is saying in their opposition to the demands associated with the mandatory switchover to the International Classification of Diseases 10th Revision family of diagnostic and procedural codes.

The association voted to “work vigorously to stop implementation” of ICD-10, not only due to healthcare reform, but also the federal push for doctors to adopt electronic health-record systems.

“The implementation of ICD-10 will create significant burdens on the practice of medicine with no direct benefit to individual patients’ care,” said AMA President Dr. Peter W. Carmel in a written statement from the association’s nearly week-long policy meeting in New Orleans.

“At a time when we are working to get the best value possible for our healthcare dollar, this massive and expensive undertaking will add administrative expense and create unnecessary workflow disruptions,” said Mr.Carmel. “The timing could not be worse as many physicians are working to implement electronic health records into their practices. We will continue working to help physicians keep their focus where it should be – on their patients.”

Without giving a name, the AMA cited a study from 2008 that found that a three-physician practice would spend $83,290 to implement ICD-10, and a 10-physician practice would spend $285,195.

With the Medicare and Medicaid electronic health record initiative, there are incentive payment programs under the American Reinvestment and Recovery Act of 2009 for doctors. However, with the transfer from ICD-9 to ICD-10 there are no funds made available to offset costs.

The deadline for the switch to ICD-10 is October 1, 2013. That date has already been pushed back once. The CMS continues to stand by its stance that they have given healthcare providers enough time to make the transition to ICD-10.

“Implementation of this new coding system will mean better information to improve the quality of healthcare and more accurate payments to providers,” said a CMS spokesman. “We will continue to work with the healthcare community to ensure successful compliance.”


Anesthesia Residents See Benefits of Tablet Devices

07 Dec

Technology is a wonderful thing. It creates all kinds of conveniences in our daily lives. When it can be integrated into such important aspects of our society such as the medical industry, it’s truly a marvel.

Last July, 100 anesthesiology residents and fellows at Mount Sinai School of Medicine  went from traditional textbooks to the use of Apple iPads. The idea was suggested by Adam Levine, MD, director of the anesthesiology residency training program at Mount Sinai. As he says, “it took exactly two seconds” to win the approval of the anesthesiology department chair.

While the department paid $700 per iPad, which included a protective cover and warranty, residents now are able to access electronic medical records and a library of e-textbooks, medical journals and guidelines at the point of care.

“This one device has multiple functions at every stage of the perioperative process, and it’s something residents can use both for their education and for patient care,” said Levine.

Here are some of the benefits they have reported:

– Anesthesiology resident Daniel Katz, MD says he uses the iPad to not only read through textbooks and guidelines, but also as a reference tool in the operating room. He also said the iPad has helped him make more informed decisions at the patient’s bedside and that accessing electronic medical records at the point of care is an improvement over paper records, due in part to potentially missing information or bad handwriting.

– Dr. Levin reports better information flow in the hospital after iPads began to be used.

– Residents can conduct video conferences anywhere in the hospital.

– With an iPad or iPhone, faculty can look into an operating room remotely.

– The University of Chicago Medical Center has also distributed iPads to its residents. Dr. Bhakti Patel, a fellow in the Section of Pulmonary Critical Care, says being able to access medical records, radiology reports and images, and placing electronic orders from the patient’s bedside significantly increase the residents’ efficiency.

– Dr. Katz and his fellow residents are putting together a video library of anesthesia procedures, along with a procedure simulator designed for the unique attributes and features of the iPad.

The use of iPads or other tablets is a growing trend in the medical industry. According to C. Peter Waegemann, president of mHealth Initiative, which examines how technology is adopted in the health care industry, there are as many as 7,000 health care iPad applications with hundreds being released every month.