|  | Vicky Wolf, Editor
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Happy Autumn!
A great time was had by those in attendance at the Fall Conference in La Crosse and we could not have asked for a more perfect evening aboard the Island Girl. It was a conference filled with networking, interesting discussions, learning and laughter.
It is an exciting time to be part of HIM with so many hot topics. In this issue we decided to feature “Core Measure Abstraction”. If you are not sure what that is, you will need to read on. Also, in this issue Sally Hensel shares with you our graduate scholarship winner and a few things she and Sandy Bissen found in the archives at the WHIMA office.
The national convention in Texas was a blast and the House of Delegates turned out to be very interesting. A decision was made to send the Delegate Apportionment resolution back to committee. A vote on that item is planned for the coming year. Check out Sandy Stevens-Berens’ message for more news from the convention.
Enjoy!
Vicky Wolf, RHIT, CPHQ
Editor
We need YOU…to HELP us…VOLUNTEER today!
In This Issue:
 From the WHIMA President
Core Measure Data
Plan Now for HI&T Week
Clinical Documentation Improvement
Found in the Archives
Webinars on Demand
2009 Legal Resource Manual Update
WHIMA Presents ICD-10
Legislative News
All Aboard from the Fall Conference
Ruth Heraver 2009 Scholarship Winner
New HIT Programs in WI
President's Message
Sandy Stevens-Berens, RHIT
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| | Sandy Stevens-Berens
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“Health Information Management (HIM), front and center!”
As I mentioned in my previous president’s message, there are a multitude of initiatives that will be calling on our skills and HIM body of knowledge in the near future. Recovery Audit Contractors (RAC’s) are making their way into Wisconsin, facilities are gearing up to take advantage of the stimulus dollars for implementation of electronic health records (EHR), and ICD-10 is soon to place educational demands on our workforce and educators.
Listening to Linda Kloss, CEO of AHIMA and David Blumenthal, National Coordinator for Health Information Technology at AHIMA’s national convention, it became readily apparent that HIM professionals will be promoted for our expertise and widely sought after for our knowledge in the pursuit of electronic record documentation. Without a doubt, this is our chance to shine and we must be prepared to step up and most importantly, to deliver on our promise of expertise and knowledge.
Frequently, a common theme in many discussion groups, is the sense that HIM is not invited to the table until the decisions have been made and implementation is about to commence. My challenge to our profession is to start asking to be invited to these discussions rather than wait for an invitation. Some may have already tried and feel it was unsuccessful...try again. Continue to put it “out there” what you have to offer and use whatever leverage you have at your disposal to find an inroad. This does not have to be an aggressive maneuver, but certainly a persistent one. If asking does not work, try demonstrating the expertise and knowledge in other venues. Sooner or later, the dots will get connected. Steven Covey, renowned author, believes in starting with the end in mind. The end, to be a recognized part of the health care team. In whatever way possible, work towards that end.
Of note, the WHIMA Board is in the process of formulating a Leadership Conference to provide leaders with the required skill set needed to propel us forward. The board is also investigating the best methods for delivery of the advanced skill sets for the workforce as we prepare for ICD-10 and the electronic health record. Educational tracks in upcoming workshops and conferences will continue to focus on these new and advanced talents to meet the job requirements in the future. The board will also continue to evaluate how we can be more effective in meeting the needs of our members going forward.
To be successful as a profession and an organization, we also need help from you, the membership, to participate as volunteers. The networking opportunities afforded to volunteers is invaluable especially as the workplace changes and today’s jobs transform into new and challenging work. Join us today!! Again, if you have not been asked to volunteer, ask how you can become a volunteer.
I’d love to hear from you.....To send me an e-mail click here Sandy Stevens-Berens
Sandy Stevens-Berens, RHIT
WHIMA President
Using Core Measure Data to Improve Quality of Health Care
by Loretta Herfel, RN, CCS, CPHQ; Kristine Hoffman, RN, CPHQ and Orest Kostelyna, MD
In the past several years, initiatives have emerged to assure quality health care through accountability and public disclosure. One initiative, the Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU), involves submission of data for specific quality measures for health conditions common among the Medicare population that typically result in hospitalization. The RHQDAPU program was initially developed as a result of the Medicare Prescription Drug, Improvement and Modernization Act (MMA) of 2003. New requirements to the program built upon the ongoing voluntary Hospital Quality Initiate were seen in Section 5001(a) of Pub. 109-171 of the Deficit Reduction Act (DRA) of 2005.
The RHQDAPU quality measures, often referred to as CMS core
measures, are intended to provide consumers with quality-of-care information that can help them make more informed decisions about their health care, along with encouraging hospitals and clinicians to improve the quality of inpatient care provided to designated patient populations. The hospital quality-of-care information gathered through this initiative is available on the Hospital Compare website at: Hospital Compare Website
Core Measures are used to track performance on a variety of evidence-based and scientifically researched standards of care with a goal of improving clinical outcomes and care in specific disease processes. Evidence-based medical care requires physicians to focus on problem specific literature to help direct decisions in clinical situations. Thus decisions are based on “strong” evidence along with incorporating clinical experience and expertise in the process. Although evidence-based medicine is sometimes criticized as “cook book medicine,” sound clinical judgment, patient preference, or unique circumstances or situations are never downplayed. Standardized quality measures can help identify gaps in practice and lead to process improvements. Effective results can be seen in lower mortality and morbidity rates, reduced length of stays, reduced readmissions, and overall better patient outcomes.
Read on for more concerning core measures, evidence-based medicine and examples...
How Much Are You Willing to Invest in a Clinical Documentation Program?
Brandi Rogers, RHIA
How much are you willing to invest in a Clinical Documentation Improvement (CDI) program? A successful CDI program allows a facility to capture complete and accurate documentation by all sources within the medical record providing greater specificity and medical necessity to code assignments, higher outcome severity scoring, and justification for continued stay and direction for the plan of care. With the Medicare audits and ICD-10 around the corner, there is a wave of interest in facilities looking to develop a strong CDI program. Those programs that are already in place will need to grow, expand and mature.
The CDI Specialist(s) designated at each facility, will play a significant role in the success of the program and will be essential in utilizing good communication skills to promote accurate clinical documentation and coding knowledge. The work of a CDI Specialist is meant to improve clinical documentation in real time, which will allow coders to assign more specific DRGs and better portray a hospital’s severity and case-mix index. The CDI Specialist is vital to the CDI program and will be key in fostering strong relationships between coders, HIM professionals and nurses. Some key tasks that a CDI Specialists may perform include but are not limited to the following:
• Reviewing new admission charts daily (specifically CMS fee-for service and any other identified payers)
• Looking for inadequate or incomplete documentation in chart
• Clarifying conflicting or contrasting documentation in chart
• Selecting ICD-9 codes, compare them with the coders’ selection, and address discrepancies
• Entering or tracking case review detailed data and those of the CDI program
• Speaking with physicians daily about documentation in their patients’ charts
• Following up on previous cases every few days until the patient is discharged
• Offering provider education, when necessary
Some resources that a CDI Specialist can tap into include a wide array of CDI articles, blogs, websites and associations, such as:
Medical Records Briefing
Briefings on Coding Compliance Strategies
CDI Strategies
For the Record
Advance
Journal of AHIMA (www.ahima.org)
In October of 2007, hcPro developed an organization specifically for Clinical Documentation Specialists called the Association of Clinical Documentation Improvement Specialists ACDIS. There are many opportunities for networking, continuing education, and even a credential for those CDI Specialists that possess the knowledge and experience to attain the Certified Clinical Documentation Specialist (CCDS) credential within this unique profession.
The benefits of a strong CDI program are never ending. Clinical documentation improvement leads to improved patient care and higher reimbursement. Facilities with CDI programs have also experienced a drop in length of stay, an increased Medicare Case Mix Index, and team ownership of process and change. There has even been speculation that a CDI program can even boost job satisfaction for coders due to improved turnaround times, reduced query rates, and more accurate coding at the time of discharge, which gives a better sense of a job well done. The success of your program depends on how much time, resources and dedication you and your facility are willing to invest. Good luck!
Facts from 1935
Celebrating WHIMA's Diamond Jubilee
1935 Historical Snippets:
• Unemployment was running at 20%
• Persia was renamed Iran
• Amelia Earhart flew solo across the Pacific
• President Roosevelt signed the US Social Security Act providing unemployment compensation and pensions for the elderly.
• Toyota cars were launched in Japan.
• The predecessor to WHIMA was founded.
Costs:
• Average Cost of new house $3,450.00
• Average wages per year $1,600.00
• Cost of a gallon of Gas 10 cents
• Average Cost for house rent $22.00 per month
• A loaf of Bread 8 cents
• A LB of Hamburger Meat 11 cents
• Average New Car Price $625.00
• First Treasurer's Report WHIMA income of $19 and $12.15 expenses
Fall Conference Highlights
All Aboard!!
Linda Kloss, RHIA, CEO AHIMA, opened the conference by tossing
out life lines to the HIM professionals in the audience as she delivered her presentation on the exciting time it is for our profession and the challenges ahead. She stressed that we, the HIM professionals, are the key in reforming health care as health IT emerges as an important piece of ARRA and health care reform. She challenged everyone to grab a line and come aboard to successfully help move health IT forward.
Cathy Hansen further emphasized the need to engage HIM professionals in the process and to take the lead on these initiatives. She shared with the group that at this time the Department of Health & Human Services, as part of ARRA, received funding which the department used for Phase I of the State-level Health Information Exchange (HIE) Planning and Design Project. This money was used for planning activities for state –level HIE governance, functions and services. The
| | Kay Dockendorff, Jean Krause, and Kris Schneider
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services of Deloitte Consulting were obtained and input gathered from stakeholders across the state this past summer. Additional funding will be sought for Phase II, of the state-level HIE Planning and Design Project.
A consortium has been formed to plan, apply for and implement a Regional Extension Center (REC) in Wisconsin. Members of the consortium include the Wisconsin Medical Society, MetaStar, the Wisconsin Primary Health Care Association, the Wisconsin Hospital Association and the Rural Wisconsin Health Cooperative. The Wisconsin (DHS) intends to support the consortium. The eHealth Program will also be participating in the consortium’s activities and provide guidance. At this time, MetaStar intends to apply for funding on behalf of the multi-stakeholder consortium to create and operate the REC and to serve as the lead organization. DHS also intends to apply for additional funding to be used for the competitive grant process for other HIT projects. DHS will not be the governing entity, but will supply support and be responsible for distribution of the funding under ARRA for the Medicaid incentive program for EHR implementation for physicians and hospitals. Cathy stressed that HIM professionals need to watch for more to come, reach out, grab a life line and come aboard to take part in this initiative.
Life lines were also tossed out on other hot topics,to include coding, team buoyancy, strategic thinking, EMR privacy and security, data analysis and RAC to name a few. After soaking up the knowledge it was time for rest, relaxation and networking. Attendees boarded the Island Girl and spent a beautiful and enjoyable evening cruising down the Mississippi River.
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| | Chris Young, Vicki Peshek, Jean Lippert
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Fall conference attendees bid “bon voyage” to La Crosse with a lot of joy and laughter as Deb Olson and Nancy Martinson led the group in “HEEEE-Heeeing” and “HAAAA-Haaaing”, a laughter yoga exercise. They expressed how important it is for us to “laugh for the Well of it!” Because, as you know… “Laughter is the best medicine”. Some members asked for more information on using "laughter yoga" to relieve stress. So here is a web site for you to order Laughter Yoga CDs: Laughter Yoga
Kudos go out to the Fall Conference team for planning a great conference.
This e-mail was sent to you by www.whima.org. WHIMA respects its members' Internet privacy. Update your Membership Profile or E-mail Address. If you prefer not to receive informational e-mails regarding WHIMA and the Link newsletter, send an e-mail with the subject line Remove to Sandy Bissen and include your full name and member ID number (if applicable) in the text. Please allow a few days for processing of your request.
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Mark your calendars to celebrate Health Information and Technology week. Take some pictures of your celebration and we will publish them in the next issue of the Link. Send your photos to Vicky Wolf.
For Webinars on Demand, just click here ...Webinars on Demand
to order the "Never Events" session or "Demystify Infusion" or "Pressure Ulcer Coding" session.
Take this opportunity to update your Legal Resource Manual now. The Legal Resource Manual Team, led by Debbie Case, RHIT, have completed the 2009 Update to the Legal Resource Manual.
Revisions were made to the Mental Health (51.30), Long Term Care Records, Redisclosure of Proteted Health Information and several other chapters. New chapters for 2009 include Documentation Requirements for Acute Care and the Physician Office.
Order your copy of the 2009 Update now. For an order form, just go to 2009 Publications Order Form
WHIMA, represented by members of the Ambassador Team, exhibited at the 10th Annual Midwest Coding & Practice Management
| | Angela Espinosa and Julie Andrews From Ambassador Team, 2009 Coding Symposium Booth
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Symposium, held October 18-20, 2009 at the Kalahari Resort, Wisconsin Dells. WHIMA provided a handout with steps for successful implementation to ICD-10-CM/PCS and a listing of web sites for more information on ICD-10. Did you know that the number of codes increased from about 13,000 to 68,000? All ICD-10-CM codes are alphanumeric. WHIMA is gearing up with a task force composed of opinion leaders, experts and pracitioners with insight and knowledge to plan the training needed to prepare coding staff for the transition. Watch for more information in the WI Community of Practice and in upcoming issues of the Link newsletter.
Have you implemented ARRA? Here are some tips to help you get started.
In the American Recovery and Reinvestment Act (ARRA), new regulations expanding HIPAA 45 CFR were released in the August 24, 2009 Federal Register. Breach notification regulations were effective September 23, 2009. The regulations require health care organizations to notify an individual, the media, and the Department of Health and Human Services (HHS) if protected health information (PHI) has been misused or disclosed inappropriately. The HIPAA Collaborative of Wisconsin (HIPAA COW) website, www.hipaacow.org, has a breach notification policy available for organizations as a reference to assist in the implementation of the breach notification requirements. WHIMA members contributed their expertise in the creation of this valuable document.
In ARRA, health care organizations are required to modify their business associate agreements by February 2010. Business associates are now subject to the HIPAA privacy and security rules including the criminal and civil penalties for violating those standards. The regulations require business associates to report breaches to the health care organization. An updated template of a business associate agreement will be available this fall on the HIPAA COW website addressing the new requirements.
ARRA defines civil monetary penalties which may be imposed to the health care organization, business associate of the organization, and an individual of the organization for a breach of PHI. The penalties are tiered based on the entity’s perceived responsibility for the HIPAA violation. The penalties range from $100 for those violations unknown to the entity to $50,000 for those violations due to willful neglect but not corrected.
The workforce needs to be trained regarding policies and procedures pertaining to the above provisions.
Throughout 2010, regulations and guidance pertaining to provisions of ARRA will be released by HHS. AHIMA has a Web page devoted to ARRA: ARRA.
Ruth Heraver, RHIA is this years Karen Kohler Past President Graduate Scholarship winner. She moved to Wisconsin in 2004 to accept a position is an instructor at Chippewa Valley Technical College. This December she graduates from UW – Stout with a Masters degree in career and technical education.
When asked why she thought she may have been awarded the graduate scholarship, she immediately responded, “probably because I’ve been active in the HIT club and WHIMA”. When she first moved to Wisconsin, in order to meet fellow professionals in the HIM arena, she became the Secretary for the Western Association. She also volunteered on the Scholarship Team as well as the Logo Wear team. Last spring, facing lower attendance resulting from the downturn in the economy, she recruited five CVTC students to assist in the Logo Wear booth at the conference.
In a slight segue, the conversation changed to transitioning to ICD-10 at the technical colleges. CVTC’s HIT program has up to eighteen students starting in both spring and fall semesters. She said that either in the fall 2010 semester or spring 2011 CVTC would start teaching both ICD-9 and ICD-10 coding classes. All students starting in 2011 with graduation in 2013 will have ICD-10 coding experience.
Her closing remarks were, “be involved, don’t be afraid to volunteer!” Congratulations to Ruth Heraver on being the Graduate Scholarship winner and on her upcoming graduation.
Rasmussen College in Green Bay and Waukesha County Technical College in Pewaukee both recently received their accreditations from the Commission on Accreditation for Health Informatics and Information Management (CAHIIM).
Rasmussen College has over 100 years of history as a private career-oriented educational institution based in the Twin Cities and is pleased to announce the accreditation of the Health Information Technician associate degree program on the Green Bay campus in August 2009. According to Susan Johnson, RHIA, CCS, HIT Program Director, “Rasmussen offers another opportunity for students throughout Wisconsin to enter the health information profession. Rasmussen plans to open a second Wisconsin campus in Wausau in January 2010.”
For a list of the Wisconsin educational programs go to: Wisconsin HIT Programs
Check out these quick links.
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| Celebrate WHIMA's 75th Jubilee. Plan to come to Elkhart Lake, May 5-7, 2010.
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