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Editor's e-Note
In an age when the specter of artificial intelligence looms large, it’s hard to believe the seemingly archaic idea of faxing still has its place in the health care space. In fact, it does—if that “faxing” has nothing to do with paper.

Organizations that adopt Direct message protocols are enjoying rousing success exchanging data with like-minded colleagues. This month’s E-News Exclusive details how this approach is making interoperability a reality for many providers.

Also, be sure to check out our coverage of the happenings at the recent HFMA ANI conference.

Lee DeOrio, editor
e-News Exclusive
The Journey to AI Begins with These Steps Toward Interoperability
By Jon Elwell

For many of us in health care, artificial intelligence (AI), or machine learning, as it’s also known, is the bright, shiny object we have our eyes on right now.

There are good reasons to be excited about the technology, not the least of which is its potential to transform the vast amounts of big data we are accumulating into intelligent insights that weren’t possible even a few years ago. The promise of AI is that it can identify patterns and trends hidden within the data that can tell us what we should be looking at—and even what we should be doing about it.

There’s only one problem with this focus on all of the wonderful things that AI can do: It ignores the current realities of the state of health care data—even at some of the most forward-thinking health care organizations in the United States.

Full Story »
Recently in For The Record
Discover the Auditor Within
More organizations are looking to take control of the auditing process by developing auditors from their pool of coders. Read more »

NLP: An Evolving Dictation Opportunity
A formative study looks into natural language processing’s role in solving the documentation quagmire. Read more »

Improve Security Through Information Governance
Take these seemingly disconnected elements and form a hand-in-hand partnership to better protect your organization. Read more »

External Cause Codes in the Courtroom
How a shooting incident was coded led attorneys to request a new trial in a high-profile case. Read more »
HFMA News
Three Essential Takeaways From HFMA ANI: Keep a Diligent Eye on Value
By James P. Fee, MD, CCS, CCDS

The Healthcare Financial Management Association (HFMA) recently hosted its Annual National Institute (ANI) at Orlando, Florida’s Orange County Convention Center. Thousands of health care professionals flooded meeting rooms and exhibit halls to discuss the transition from fee-for-service to value-based care.

However, with reimbursements down and denials on the rise, attendees also remained firmly entrenched in the current diagnosis-related group (DRG)-based reimbursement system. Dozens of sessions focused on the need to continually assess, improve, and monitor revenue cycle operations including clinical documentation integrity, medical record coding, financial compliance, and denial management.

During HFMA ANI, three essential themes emerged: enterprisewide collaboration, physician engagement, and ambulatory care partnerships. Getting involved in these revenue cycle initiatives will be a key success factor for HIM professionals in the years ahead.

Read more »
 
In this e-Newsletter
Other News
Groups Surmount Barriers to Help Patients Access EHRs
SHARE For Cures and other organizations are working to overcome interoperability hurdles and improve patients’ ability to access their health records, according to MedCityNews.

EHR Vendors, Providers Struggle to Incorporate Gender Identity Information Into Patient Records
Integrating gender identity data into EHRs is an ongoing challenge for both developers and users, according to FierceHealthcare.
AHDI Preview
AHDI Conference to Bring Health Care Documentation Specialists Together in San Antonio
By Heather Hogstrom

The Association for Healthcare Documentation Integrity (AHDI) Annual Conference will be July 13–15, in San Antonio. The conference’s location is along the River Walk, allowing attendees to board a riverboat right outside the hotel to tour the city. While in San Antonio, visitors will want to make the five-minute walk to see the Alamo, Texas’ most visited historic landmark.

The AHDI conference, featuring the theme “Onward! Together Toward Tomorrow,” brings together health care professionals such as health care documentation specialists, HIM and HIT professionals, medical transcriptionists and scribes, clinical documentation improvement specialists, and more. The Welcome Reception on Thursday night offers the opportunity to network with fellow attendees. AHDI members can also get together with others from their district during the District Meet & Greets on Friday night.

Read more »
Industry Insight
AMIA Launches “Why Informatics?” Campaign

AMIA recently launched a new public education campaign entitled Why Informatics? to meet the increased demand for knowledge in health care. With the explosion of data available in health and health care, informaticians have been critical to discovering the insights that are accelerating the transformation of health care.

The campaign, which features informatics professionals discussing the impact of their research, is vital to helping define the field at a time of rapid change in health care. “Informatics has reached a tipping point in its growth,” says Douglas B. Fridsma, MD, PhD, FACP, FACMI, president and CEO of AMIA. “Using insights obtained from data throughout health and health care is the driving force of informatics and its ability to innovate critical advancements that directly benefit people. We need to share this story widely to continue transforming health care.”

Since the founding of AMIA nearly 30 years ago, informaticians have played important roles in many of the major health discoveries, treatment advances, and public health improvements defining today’s health and health care. “Informatics is more than collecting and managing data; it is the profession that encompasses the scientific analysis and use of data that helps patients, increases effectiveness, improves safety, and reduces care costs,” Fridsma adds.

Read more »
Ask the Expert
Have a coding or transcription question? Get an expert answer by sending an email to edit@gvpub.com.

This month’s selection:
Do you have any clear advice on how to use the new Anesthesia codes 99151–99157? Our office uses qualified nursing staff when performing moderate (conscious) sedation. We were coding the drug administration codes for the nursing staff as they were administering the medications when the procedures are being performed on an outpatient basis prior to the new codes for 2017.

Now, with the new codes added, my take is that we can eliminate the administration codes and now use the new CPT codes provided for moderate conscious sedation. These codes could now be used by the qualified nursing staff when they’re in attendance during the procedure for monitoring the anesthesia care, which would start at the administration of the sedation and end when the procedure has been completed.

Read the response »
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Tech & Tools
Partnership Brings Genetic Tools to the Physician Office
Aprima Medical Software, a provider of EHR, practice management, and revenue cycle management solutions for medical practices, plans to integrate the ActX Genomic Decision Support platform within the Aprima EHR. The addition of the ActX platform provides Aprima clients with access to genomics in everyday patient care and delivers clinically actionable insights that facilitate personalized medication and screening choices based on a patient’s unique genetic profile. The integration of ActX real-time genomic decision support into the Aprima EHR means providers will get drug genomic interaction alerts as part of their normal prescription workflow and be informed of possible issues regarding medication efficacy, adverse reactions, or dosing. The combined solution will help providers personalize therapies and manage actionable hereditary risks. The ActX Genomic Decision Support platform will be available through the Aprima EHR beginning in late summer 2017. Learn more about Aprima and ActX.

Availity Launches Digital Authorization Platform
Availity, a real-time health information network, announced the launch of its automated prior authorization platform, which eliminates the cost, time, and administrative burdens associated with manual authorization processes. Availity Authorizations utilizes a HIPAA-compliant, secure cloud platform to automatically check whether a prior authorization is required or has been obtained. The platform also helps provider organizations avoid costly denials by ensuring that services are rendered only when an authorization has been approved. Availity Authorizations automatically checks CPT eligibility and benefits, payer edits, and client history, ensuring users don’t waste time when an authorization isn’t required. Availity Authorizations also streamlines front-office workflow and reduces the prior authorization process from weeks to minutes. If an authorization cannot be obtained automatically, the solution helps the provider team members answer clinical questions by automating the remaining steps required to obtain an authorization. Other key functionality includes e-mail alerts based on defined parameters; integrated, intuitive dashboards for managers to monitor and control flow cases; and a ‘touchless’ experience for many authorizations, allowing users to work only those that require manual intervention. Availity Authorizations will initially be launched for radiology and imaging units. Learn more »

EHR Platform for Telehealth Introduced
PlushCare, a direct-to-consumer online urgent care provider, announces the launch of Lemur, the first EMR for the telehealth industry. Lemur, a cloud-based and HIPAA-compliant EMR platform, allows PlushCare doctors to diagnose, treat, prescribe, and provide ongoing treatment throughout the course of a medical issue directly from the platform itself. Lemur requires the fewest clicks in the industry to complete tasks such as writing a note, sending a prescription (eRx), ordering labs with full price transparency, and reviewing lab results. PlushCare has collaborated with Surescripts, Eligible, and Elsevier, among others, whose capabilities are integrated into Lemur. Lemur revolutionizes virtual health through its physician-driven design that enables smarter, more meaningful interactions between physicians and patients. It streamlines cumbersome physician tasks and consolidates data across a siloed health care landscape. Learn more »