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Industry Insight

Custom Consent Forms Help Patients Better Understand Heart Procedures

Patients who received personalized, easy-to-understand consent forms before angioplasty or stent implantation better understood the procedure and the potential risks of treatment and were more engaged in shared decision making with their doctors, according to research presented at the American Heart Association’s 2011 Scientific Sessions.

In the study, patients at nine treatment centers got either a personalized patient risk information services manager (PRISM) consent form or standard consent forms before undergoing procedures to open blocked heart arteries.

The PRISM form, which is generated through a Web-based tool, allows doctors to input patients’ specific health information and execute complex prediction models that generate each patient’s individualized risks and benefits of treatment. These results were imbedded into a consent form that included educational pictures of the procedure. It was written at an eighth or ninth grade reading level, unlike typical hospital forms that are often written in legal language and above the college reading level. Standard informed consent forms are usually generic and don’t contain customized information about risks based on patients’ individual clinical characteristics.

“The current consent process is terribly flawed in that it does not educate patients effectively about their procedures, nor does it support shared medical decision making,” says John A. Spertus, MD, MPH, the study’s lead researcher, a professor and chair at the University of Missouri in Kansas City, and clinical director of outcomes research at Saint Luke’s Mid America Heart Institute.

Compared with the 590 patients receiving standard consent forms, the 527 patients who received the PRISM forms were more likely to do the following:

• read the form (72% vs. 45%) and understand it (52% vs. 31%);

• feel that treatment descriptions (49% vs. 25%) and complications (50% vs. 27%) were clear;

• feel less nervous about the procedure (77% vs. 62%);

• know there was a risk of death (66% vs. 36%) and bleeding (61% vs. 31%) from the procedure; and

• discuss stent options with their doctor (58% vs. 31%).

Those using the PRISM form were also less likely (52% vs. 72%) to feel that the doctor alone determined which type of stent—drug eluting or bare metal—was used in their procedure.

“In an era of increasing calls for personalized medicine, this is an important opportunity to advance that principle by sharing with each patient their expected risks and benefits from treatment,” says Spertus.

Importantly, the results varied by site, suggesting that some hospitals took better advantage of the forms than others, he says.

More research is needed as to whether patients who actively shared in making decisions are more likely to adhere to recommended therapies or have better long-term outcomes, he notes.

— Source: American Heart Association


G2N Hires ICD-10 Expert Zeisset to Lead Client Training for Looming Switch

Medical coding leader G2N has hired Ann Zeisset, a former AHIMA professional practice resource manager, as special consultant for ICD-10. Zeisset will lead G2N’s practice to assist healthcare providers in transitioning from the ICD-9 to ICD-10 coding system before the October 1, 2013, deadline mandated by the Centers for Medicare & Medicaid Services.

A member of the AHIMA ICD-10 national rollout team, Zeisset has coauthored more than one dozen books and instructional guides about the ICD-10-CM/PCS transition. The guides detail the process by which healthcare providers can achieve organizationwide proficiency in the additional medical codes that will be required to properly complete all medical records under ICD-10. Zeisset is also a regular speaker at national HIM conferences, raising awareness of the extensive preparation required to successfully complete the ICD-10 transition without creating a backlog of claims or losing revenue due to improper coding.

G2N training helps guide healthcare organizations through the ICD-10 implementation process. Essential support services include the following:

• organizational awareness through an overview of format and structural changes as well as introductory training for HIM staff and coders;

• implementation guidance, including providing understanding for plan development and impact assessment;

• rigorous coder training to ensure coders are thoroughly trained to meet the new demands of ICD-10; and

• coding support for both ICD-9 systems prior to October 1, 2013, and ICD-10.

— Source: G2N


HL7 and CLSI Sign Collaboration Agreement

Health Level Seven International (HL7 and the Clinical and Laboratory Standards Institute (CLSI), a nonprofit organization dedicated to developing standards and guidelines for the healthcare and medical testing community, have announced an agreement to create a complementary process to foster interoperability that will lead to improvements in patient safety.

As part of the new agreement, both organizations will create a consistent industrywide process and mechanism for pathology specimen identification and labeling that will streamline the process of reporting clinical information. The goal is to allow integrated workflows across all systems and users in specimen handling and processing.

In addition to the three HL7 work groups, this project will involve the CLSI, College of American Pathologists, GS1, and IHE Anatomic Pathology.

HL7 and CLSI have a long history of cooperation, which has yielded results such as the development of an HL7 laboratory automation chapter by CLSI for HL7’s version 2 standard. CLSI also created a table that became part of HL7’s table for abnormal flags.

— Source: Health Level Seven International


HL7 and Regenstrief Institute Sign Statement of Understanding

Health Level Seven International (HL7) and the Regenstrief Institute, Inc, a healthcare and informatics research organization, recently announced an agreement to create a complementary process to develop and extend comprehensive standards in the healthcare industry.

LOINC is a universal code system developed by the Regenstrief Institute for identifying laboratory and clinical observations. When used in conjunction with the data exchange standards developed by HL7, LOINC’s universal observation identifiers make it possible to combine test results, measurements, and other observations from many independent sources. Together, they facilitate the exchange and pooling of health data for clinical care, research, outcomes management, and other purposes.

“Regenstrief has been a long-standing contributor to the standards developed by HL7, and likewise, LOINC has been enhanced by its adoption in HL7’s standards,” says Daniel Vreeman, associate director of terminology services at the Regenstrief Institute. “With this agreement, we look forward to an even closer collaboration with HL7 that improves the semantic interoperability of health data exchange worldwide.”

— Source: Health Level Seven International