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It’s hard to argue that leaning on data analytics to improve patient care is a bad thing. But can it be done better? Yes, of course, especially if it can account for socioeconomic factors and incorporate real-time physiological data.
This month’s E-News Exclusive dives into how this can become a reality as the industry continues its quest to pinpoint those patients most in need of care management programs.
— Lee DeOrio, editor |
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How Predictive Analytics Helps Providers Identify Patients for Care Management
By Michael Simon, PhD
Care management programs are becoming an increasingly essential means for provider groups to maintain a high quality of care while also controlling costs and utilization under value-based agreements.
The problem many providers face in launching care management programs, however, is the heavy use of resources that they require. For example, each nurse care manager typically manages a panel of between 50 and 200 patients, while each enrolled patient generally spends between three and six months in a program.
For health care organizations (HCOs), the challenge lies in determining how to most efficiently allocate care managers’ limited time toward the needs of each individual patient. Generally, HCOs have employed algorithmic models to identify the patients who are the top candidates for care management programs based on future likelihood of high utilization. However, these algorithms are sometimes one-dimensional and fail to take into account whether patients are likely to respond well to care management. As a result, care management programs sometimes do not enroll the patients who would stand to benefit from them the most.
Now, with more fully developed machine-learning techniques and more comprehensive data sets, provider organizations can use predictive analytics to pinpoint the patients who are likely to respond best to care management programs.
Full story » |
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AHDI Conference Goes Virtual
The Association for Healthcare Documentation Integrity held its first Virtual Conference August 14–17. Featuring the theme “Tradition Meets Innovation,” the conference provided virtual speaker presentations and other offerings such as a desk yoga session video, created to break up the routine of sitting at a computer.
During the conference the following were announced as the winners of the 2019 Integrity Awards:
- Educator of the Year: Deb Palmer, CHDS, of Summerside, Prince Edward Island;
- Employer of the Year: Tucson Medical Center in Tucson, Arizona;
- Excellence in Credentialing Award: Laura Osborne, CHDS, CHP, CHTS-IM, AHDI-F, of Morgantown, West Virginia;
- Membership Impact Award: AHDI-West Regional, President Kat King, ASHI, AHDI-F;
- Rising Star Award: Andrea Khan of Kelowna, British Columbia;
- Distinguished Service Award: Laura Bryan, MS, MT(ASCP), CHDS, AHDI-F, of Mesquite, Texas; and
- Lifetime Achievement: Sherry Doggett of Silver Spring, Maryland.
A photo slideshow of conference highlights is available at https://vimeo.com/355185953.
— Source: Association for Healthcare Documentation Integrity |
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Connect With the Health Information Community at AHIMA19
By Heather Hogstrom
During September 14–18, AHIMA will welcome attendees to its hometown of Chicago for the AHIMA19: Health Data and Information Conference (formerly known as the AHIMA Convention and Exhibit).
AHIMA19 conference topics include career development, clinical documentation improvement, coding, continuum of care, disruption in health care, HIM case studies, innovation, leadership, performance improvement, physician practice, privacy and security, quality measure, revenue cycle, and third-party audits.
The general session theater will feature presentations by Carey Lohrenz, the first female F-14 Tomcat fighter pilot in the US Navy; Patrice A. Harris, MD, MA, and David O. Barbe, MD, MHA, the current and past presidents of the American Medical Association, respectively; and John Quinones, the creator and host of What Would You Do?
Alternatively, attendees can head to the Innovation Theater in the exhibit hall for general sessions by Alexandra Mugge, deputy chief health informatics officer at the Centers for Medicare and Medicaid Services, and Doug Lindsay, a speaker on patient advocacy and problem solving.
Read more » |
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Zipnosis Launches Customizable Offering to Accelerate Personalized Virtual Care
Zipnosis, a virtual care software company, recently launched ZipPlus, a services and tech enablement program that creates a multiyear, integrated virtual care roadmap for health systems using Zipnosis’ virtual care chassis. ZipPlus breaks down barriers to virtual care deployment in two ways. The first barrier is technology. Within the ZipPlus program, the patient and provider experience can be fully integrated into Epic, Cerner, and Athena. The second barrier is an aligned strategy for virtualizing care. With ZipPlus, Zipnosis and its partners create a multiyear roadmap for clinical business lines, such as behavioral health, postsurgical follow-up, travel medicine, and hypertension, using the virtual care technology platform as the foundation. Learn more »
Partnership Provides CDI Templates for Provider Queries
Artifact Health, which provides a mobile platform that streamlines the physician query process, has partnered with HCPro to provide and maintain a comprehensive library of compliant clinical documentation improvement (CDI) physician query templates. The template library will provide both compliance and process guidance so health care facilities can better capture the true complexity of their patient population. It will address critical areas of query practice, including ICD-10-CM/PCS coding classifications, hierarchical condition categories, severity of illness/risk of mortality, and more. With Artifact Health’s mobile platform, physicians respond to a query compliantly in seconds, often with as few as three taps on their smartphone. Query activity is automatically tracked and reported, rather than manually recorded by CDI specialists and coders, and available in real-time dashboards and reports. This partnership extends HCPro’s CDI knowledge and expertise to physicians in a way that ensures high-quality, accurate clinical documentation of patient care. With Artifact, hospitals and health systems can immediately integrate HCPro’s standardized, compliant query templates and educational guidance into their physician query workflow to improve quality measure capture and reimbursement accuracy. Learn more »
Transcription Platform Brings Entire Workflow to Mobile
WebChartMD has released a new mobile version of its dictation and transcription platform software. Transcription organizations and health care professionals can now use their mobile device to perform all the workflow management tasks previously done from their desktop computer. The new mobile application utilizes progressive web app (PWA) technology, which seamlessly integrates the mobile and desktop versions of WebChartMD. The hybrid PWA approach simplifies the user experience, creating one familiar environment for users regardless of the device they use to access their online account. Learn more » |
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Coming up in our November/December 2019 issue is our Annual Resource Guide. Contact sales for more information.
Jobs.AlliedHealthCareers.com is the premier online resource to recruit HIM professionals. Post
your open positions, view résumés and showcase your facility's
offerings all at Jobs.AlliedHealthCareers.com! |
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Mergers, MPIs, Oh My!
Things can become complicated real fast when separate entities become one, most notably when it comes to patient identification. Read more »
EHRs and Patient Safety: Where Do We Stand?
Ubiquitous and polarizing, the technology’s achievements are sometimes overshadowed by its propensity to stick in the craw of disgruntled users, a situation that can put patients in jeopardy. Read more »
CAC: Temper Expectations With Reality
While computer-assisted coding may not revolutionize the department, it is capable of adding value to any coding operation. Read more »
The Devil Is in the Details
Knowing the ins and outs of payer contracts may seem like tedious work, but the payoff is undeniable. Read more » |
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EHRs Continue to Lead to Medical Malpractice Suits
Claims in which the use of EHRs contributed to patient injury have been on the rise, growing from seven cases in 2010 to an average of 22.5 cases per year in 2017 and 2018, according to The Doctors Company.
Baby’s Photo Posted by Hospital Worker Without Permission
An employee at South Carolina–based MUSC Health violated patient privacy rules by posting a photograph on social media, reports Live 5. |
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Have a coding or documentation question? Get an expert answer by sending an email to edit@gvpub.com.
This month’s selection:
What is the correct code for multifocal pneumonia that is consistent with bilateral pneumonia? The pneumonia is not specific to an organism or a lobe.
Anonymous
Response:
Multifocal pneumonia refers to a diffuse pneumonia affecting several areas of the lung. If it is not specified with regard to a bacteria or location, it would be a simple unspecified pneumonia, J18.9. If a radiological study provides a specific location or a sputum culture reveals a bacteria, you may want to query for more specificity.
— Laudine A. Markovchick, RHIT, CCS, is director of coding, data quality, and education at Pena4, Inc. |
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Iowa Researchers Receive Grant to Study EHR Information Sharing Patterns
A research team led by faculty in the University of Iowa College of Public Health recently received a new grant to study patterns of information sharing among health care professionals in EHR systems.
The project, led by Xi Zhu, PhD, an associate professor of health management and policy, will examine EHR-based communication in virtual care teams and the relationship between EHR communication networks and quality of care. The research is funded by the Agency for Healthcare Research and Quality.
“Electronic health records systems have been widely adopted throughout the US health care system, and they are changing the way health care professionals deliver care and communicate with each other,” Zhu says. “Today’s health care professionals often work as virtual care teams—a variety of practitioners providing care to the same patients, but working at different times and locations—all connected through the EHR. Yet, it’s not clear how the EHR is impacting communication and teamwork among them and how those factors might affect the quality of care that patients receive.”
This new project will seek to develop methods for measuring the communication that takes place within EHR networks, and then examine associations between EHR communication and patient outcomes, such as hospital readmissions, emergency department visits, and mortality.
Read more » |
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