Dr. Corazon Oca, MD, pediatrician from Huntington Beach, passed away March 11, 2014

http://www.legacy.com/obituaries/orangecounty/obituary.aspx?n=corazon-iniguez-oca&pid=170237093&fhid=20239

The staff at e2o Health are saddened to learn about the passing of Corazon Oca, MD. Dr. Oca was one of our first providers to meet Meaningful Use and is featured in our Doctors’ Hall of Fame.

Dr. Oca was one of the kindest doctors with whom we had the pleasure to work. e2o Health would like to express our deep condolences to her family, friends, and staff.

Sincerely,

the rest of e2o Health Staff

ICD-10 Impact Assessment - 2

 ICD-10 Impact Assessment

An Impact assessment is a major effort made early in the ICD-10 Transition Process and can take two to three months. The results drive the action items that become part of the project plan and estimate the budget.

The following table shows business processes that must be analyzed and the appropriate actions determined for the ICD-10 transition:

Business Processes and ICD-10 Effects

Business Process	Next Steps to Address ICD-10 Effects
Referrals	Update referral processes and forms for ICD-10 codes
Authorization / pre-certification	Update authorization forms to show the proper ICD-10 codes and to allow for medical necessity review
Patient Practice Intake	Update registration forms for add'l documentation of patient's health state to support ICD-10 codes.
	Update decision support system business rules for ICD-10
	Update existing business policies to determine coverage
	Update business policies to determine eligibility for dual insurance / SS Income, and coordination of benefits for special clinical programs
Patient clinic encounter	Verify service benefits and eligibility using ICD-10 codes
	Update clinical documentation to support ICD-10 coding
	Update existing billing systems, processes, and forms to accomodate ICD-10
Physician Orders	Update any coding on the physician order to capture ICD-10 specifics
Medical Records	Update medical record system including supporting forms, templates, interfaces and decision support.
Analytics	Update existing reports containing ICD-10 codes
	Modify report business rules to support ICD-10
Contracting	Identify which contracts and service level agreements refer to ICD-10
Public Health Reporting	Update ICD codes used to report diseases and conditions as well as immunizations
Financial Operations	Update existing processes to identify and forecast reimbursement payment
Value	Update logic for quality reporting under ICD-10. Identify actions aimed at improving quality measures
Clearinghouse relationship management	Update HIPAA transactions affected. Look for opportunities for Clearinghouses to provide translation / crosswalk ICD-9 to ICD-10 accountability
Payer relationship management	Contracts/reimbursement models: Modify pricing and reimbursement structures, fee schedules for greater diagnosis-specificity

(This Business Process table was taken from the CMS Road to 10: The Small Physician Practice's Route to ICD-10,​)

ICD-10 Impact Assessment

An Impact assessment is a major effort made early in the ICD-10 Transition Process and can take up to three months, depending on the number of areas that must be assessed and the level of preparedness of the practice. The results drive the action items that become part of the project plan and estimate the budget.

The impact of ICD-10 transition must be evaluated for all organizational operations.

1. Conduct survey of all business areas to determine level of impact of the transition.
2. Determine how long dual code sets will need to be maintained.
3. Inventory all systems applications and databases using ICD-9 CM codes.
4. Determine the types of system changes that will be made.
5. Audit the software vendors and contracts to see which changes they will be making and when.
6. Are there system interfaces that use ICD-9 CM codes such as lab interfaces and e-prescribing?
7. Identify new or upgraded hardware / software requirements.
8. Do chart audits of charts with common diagnoses in ICD-9 to assess the quality of the current medical record documentation.
9. Identify ways that processes and work flows could be improved.
10. Determine the education needs of doctors, medical staff, billing staff and medical coders.
11. Identify all ICD-10 transition expenses and estimate associated costs:  software modifications, Education, hardware / software upgrades,  testing related costs, Consulting services to help with the transition, staff time, data conversion, maintenance of dual code sets, and additional software or other tools / resources to facilitate the ICD-10 transition.*

(*excerpt from ICD-10-CM/PCS Transition: Planning and Preparation Checklist | 2012 American Health Information Manangement Assoc.)

(previous March 24th newsletter - Business Processes and ICD-10 Effects table taken from CMS Road to 10:The Small Physician Practice's Route to ICD-10)

ICD-10 FAQs

When must doctors only submit diagnoses in ICD-10?

Beginning October 1st, 2014, doctors must only submit claims with ICD-10 diagnoses. The diagnostic code used must show medical necessity and be the most specific code available.

For more FAQs regarding ICD-10, go to ICD-10 FAQs on the Meaningful Use Experts website.

Planning for ICD-10

Planning for ICD-10

Planning for ICD-10 is a five phase process. To fully implement and test ICD-10 in your clinic or organization could take up to six months. It is best to start planning now. Here is an overview of the five phases:

Phase 1: Create awareness throughout your organization

This is the phase where you educate the providers,  medical staff and billing staff about the impacts associated with the change to ICD-10.

Phase 2: Organize the implementation effort

This phase includes:

• an organizational readiness survey sent to the various departments and payers associated with the clinic.
• A chart review done to assess the current documentation shortfalls that will effect ICD-10 coding documentation, and
• an Impact assessment 

The Impact Assessment can take two to three months. The results drive the action items that become part of the project plan.

Phase 3: Create a project plan

In this phase you create live estimates for budgets for specific areas of the project. Being able to estimate the budget for ICD-10 is one of the biggest challenges.

Phase 4: Project Implementation

This is where you review the budget in real-time and print and distribute the plan.

Phase 5: Monitor ICD-10 Submissions and Receipt

In this phase you monitor key benchmarks for trending in ICD-10. Problem areas are identified by monitoring payer decreases and delays. Action items are then created and acted on.

This project plan can be created automatically using the Ready-10 project management tool offered as part of Meaningful Use Experts ICD-10 Implementation services.

Planning for Patient Portals

How to Optimize Patient Portals 

Effective implementation of a patient portal will help you attest to several patient and family engagement requirements of Stage 2 Meaningful Use: Clinical summaries Patient-specific education resources Secure electronic messaging Timely access to health information Reminders for preventive and follow-up care 

The patient portal also has great potential for meeting emerging requirements in Stage 3 Meaningful Use that are expected to focus on self-management and shared management of health care. A patient portal can be used to assist in self-management tasks through tools for interactive monitoring and coaching. A portal also can enable patients to collect data about their health and treatment, and to share that data with their providers. 

Implement Portal Features that Support Engagement 

A patient portal that mostly provides administrative functions, such as scheduling appointments and getting lab results, will not be interesting or useful to patients. Patients will more likely use a portal that is designed and configured to address their personal interests and needs. A portal that includes interactive and personalized tools and information will be more relevant to patients’ needs. 

Patients are more likely to register and continue using a portal that has a problem-solving orientation, interactive decision tools, and the ability to communicate securely with their doctors. Key questions to answer during planning include: 

• What are the goals for the portal in terms of potential benefits for patients and the practice? Which features and services should be offered? 
• Should they be offered all at once, or phased in? Will the portal be open initially to all interested patients, or to a select group during early deployment? 
• How will you handle marketing, enrollment, training, and support for patients’ use of the portal?  

Aim to establish efficient workflows and policies, and avoid burdening providers with troubleshooting during initial rollout.

Why the Change to ICD-10? What does it mean to Providers?

Are you Ready?

ICD-10 codes came from the National Center for Health Statistics (NCHS). They serve to:

• Describe the patient's current health status 
• Explain why medical services were performed 
• Provide data for public health and disease surveillance efforts 
• Use same codes as global mortality. 

The periodic revisions of ICD-9-CM mirror changes in the medical and health care field. The U.S. has been using ICD-9-CM since 1979, and it is not sufficiently robust to serve the health care needs of the future. The content is no longer clinically accurate and has limited data about patients’ medical conditions and hospital inpatient procedures, the number of available codes is limited, and the coding structure is too restrictive.

The U.S. cannot directly compare morbidity diagnosis data to state and national mortality data, because mortality data have already transitioned to ICD-10 code sets and internationally, most developed countries transitioned to ICD-10 code sets decades ago. The value of ICD-10 makes it clear that the main purpose of using ICD codes is not for billing.

Biggest Challenge for Providers

For physicians, the biggest challenge in the change to ICD-10 is the need for high quality documentation that includes more detail for diagnoses than was previously required.

ICD-10 is comprised on seven alpha-numeric codes. Some codes map directly to ICD-9 codes; many map to many different codes. ICD-10 uses combined codes for conditions and their associated symptoms. Two of the main differences from ICD-9 codes are Laterality and Expanded classifications. Laterality is the specific code for left or right ear, arm or other body part. Expanded classifications record status of disease and associate it with related combinations of disease characteristics.

Adjectives bring greater specificity to the ICD-10 code. Examples of adjectives include: acute or subacute; chronic, intermittant, mild, moderate, severe; primary vs secondary; major. The new coding also includes laterality and 

Meaningful Use Experts ICD-10 Conversion Package

Meaningful Use Experts offers an ICD-10 Conversion Project Management package. Includes:

An ICD-10 Comparison Utility for all clients to easily upload and generate test 837 claim files and analyze 835 remittance data in an effort to:

• Create a valid 837 EDI file to send to Clearinghouse or Payer for testing purposes to prepare for coding and reimbursement change.
• Help providers better understand which codes are being utilized more frequently than others and improve efficiency. 
• Allow coders to drill down further with ICD codes to assist with better reporting

An ICD-10 Conversion Package that helps providers with the workflow changes and training required to transition to ICD-10.

Begin now, to make sure that your EHR and staff are ready for October 1st, 2014 when all billable claims must be submitted in ICD-10-CM to be reimbursed. Please call (800) 409-0096 to arrange for a free ICD-10 assessment now.

Provider Education

Doctors can go to the 4Med Online Education courses  on this site to sign-up for an online course on ICD-10. 

Simplify Diagnostic Lab Ordering and Test Results Delivery with Informedika

e2o Health Inc. to provide EHR-hosted providers the ability to electronically fulfill any transaction more quickly and at less cost.

Providers looking to incorporate Lab and Radiology ordering into their EHRs can now utilize Informedika to electronically order diagnostic lab tests, radiology studies, physical therapy and home health services among others, while reducing costs, accelerating order requests, and improving patient relations overall. Here is how Informedika works:

To subscribe to Informedika please click here:

 https://portal.informedika.com/register/e2ohealth

Informedika’s recently integrated technologies including DocuSign and Box, satisfy physicians' need to remain compliant while providing them with the latest technologies to create a more efficient and paperless workspace. Within the Informedika platform, DocuSign automates important, yet historically inefficient, paper-based healthcare processes, allowing for lab orders and diagnostics tests to be securely ordered, delivered, and signed-off on by doctors and patients 100 percent digitally. Additionally, users will have the ability to access their Box account to securely share and file test results and other medical documents.

“We’re excited to help bring NextGen-hosted doctors and their offices the ability to connect to a wide-range of services, including diagnostics, equipment vendors, and referrals, using the secure Informedika platform, all while staying compliant,” points out Steven Yaskin, CEO of Informedika. “Doctors deserve a modern solution that doesn’t slow down their practice, and can be used within minutes of signing up.”

For more information about e2o Health and their new business ventures with Informedika, visit our Informedika portal.

https://portal.informedika.com/register/e2ohealth

About e2o Health 

e2o Health is an innovative Healthcare Solutions services company that specializes in providing Electronic Health Record (EHR) solutions and HIPAA Secure Cloud hosting services. e2o Health is a Value Added Reseller of NextGen electronic health record and practice management software. e2o Health works with small practices, independent practice associations, healthcare clinics and hospitals. Our services include Practice Assessment, Project Management, Workflow Re-Design, Configuration, Technical Infrastructure, Application Interfaces, Training, Functional Interoperability, On-going IT Support and Health Information Exchange (HIE) Services. We also help your practice to establish HIPPA Privacy and Security Risk Assessments and to attain Meaningful Use Attestation, leading to your practice receiving incentive payments.

http://www.e2ohealth.com and http://www.meaningfuluseexperts.com.