ICD-10 Coding Issues

Organized medicine has had some recent success with CMS.  CMS has agreed to not penalize providers who do not use ICD-10 coding accurately.  This was in the face of their previous refusal to postpone implementation of it's implementation this October 2015.  Despite their reticence, organized medicine mounted an offensive to convince CMS otherwise.  CMS relented somewhat to accomodate organized medicine's advice to  slow down the process so that   providers can learn the new system.

Many large groups and hospitals have in place their ICD-10 EMRs.  Larger institutions have IT support staff dedicated to these issues. The steady mounting requirements for meaningful us also placed a burden on smaller to medium sized medical practices.

For those of  you  who wish to learn more about ICD-10 conversion, attend this webinar

64 East Main Street, Freehold NJ 07728             Phone: (732) 817 9475 or (800) 479 4875

July 7, 2015

TOWN HALL MEETING - CODING ICD-10 WITH IMEDICWARE

Join Dr. Gerald Meltzer, our medical director for a demonstration of iMedicWare’s implementation of 

ICD10 coding.  He will be discussing:

1. Fundamentals of ICD-10 Coding

2. Tips on how you can prepare for ICD-10 conversion

3. New CMS flexibility rules concerning ICD-10 coding

4. iMedicWare’s ICD-9 to 10 Crosswalk

5. Converting ICD-9 codes to ICD-10 codes

6. Using IMW for ICD-10 coding.

The presentation will take approximately 45 minutes with approximately 15 minutes for questions.  For those of you who can’t make the presentation - it will be recorded for you to review at a later time.

For your convenience, there will be two presentations on Thursday July 16, 2015, one at noon the other at 7 pm (all times are Eastern Time Zone).

Date	Time	Registration Link
Thursday July 16th	12:00 Noon -1:00 PM EDT	https://attendee.gotowebinar.com/register/8327954324136169985
Thursday July 16th	7:00 P - 8:00 PM EDT	https://attendee.gotowebinar.com/register/2578145128100186113

Audio

Participants can use their computer’s microphone and speakers (VoIP) or telephone.

View System Requirements

Notes

Infographic: Physician Telehealth Use July 1st, 2015 by Melanie Matthews

Infographic: Physician Telehealth

Some 57 percent of primary care physicians are willing to conduct a video visit with a patient, according to a new infographic (click to enlarge) by American Well.

The infographic examines why physicians want to conduct video visits, potential use of telehealth by physicians and the type of video consults physicians find most valuable.

The world of digitally enabled care is exploding: the number of patients using telehealth services will rise to 7 million in 2018, according to IHS Technology; healthcare apps and 'wearables' are trending in technology circles and healthcare providers' offices; and CMS's new 'Next Generation ACO' model is expected to favor expanded telehealth coverage.

2015 Healthcare Benchmarks: Telehealth & Telemedicine delivers actionable new telehealth metrics on technologies, program components, successes and ROI from 115 healthcare organizations. This 60-page report, now in its fourth year, documents benchmarks on current and planned telehealth and telemedicine initiatives, with historical perspective from 2009 to present.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

 Click here to download our eBook “American Well’s Telehealth Index: 2015 Physician Survey.”

Patients are interested in telemedicine. It offers much in time efficiency and can at times eliminate the need for an office visit, and can be more cost effective if the fee is less than a typical office visit. Some are willing to pay an office visit fee for a telehealth consultation. For the patient it saves time, travel time, and decreases daily disruptions for busy parents. Adding on travel time, and wait time it can save several hours in a day.

Some physicians also indicate an interest in telehealth for distant patients and in rural areas. However efficiencies may not work in the same manner for doctors. Staff time is a consideration. Most practices have full appointment schedules, leaving little time for telehealth, unless a F/T equivalent is added to the clinical staff.  Fees generated must support the service as a profit center if it is to survive market economics. This model may function best in a clnic or group with shared services. Outsourcing telehealth may work well, however adding another intermediary can lead to errors and/or medical-legal liability.

There remain two major obstacles for telehealth to flourish.

         1. Governmental regulation by state medical boards

         2. Reimbursement

Governmental regulation is lagging. Some state boards do not allow telehealth except in specific insances There are ingrained practice patterns and ethical issues as well as adequate examination practices via telehealth. Video telehealth would seem to assuage some of these concerns.

Insurers do not want to cover telehealth and few insureres have procedure codes to bill for telehealth. Some insurers are concerned about additional cost.  MEDICARE is on the cusp of allowing telehealth. Medicare is  the most conservative payor since it 'guards tax payer dollars'

Fraud and abuse are possibilities. It would be more difficult to audit and track  telehealth, however there are means to integrate billing, diagnostic and procedure codes directly into a billing system.

It is time for health care to catch up with Health Information Technology. not only to store data, analytics, but to facilitate patient care.

Habits of Physicians Posting for Professional Purposes

The following information is gleaned from

Kantar Media Healthcare Research Insights

Kantar Media is a pharma research company offering insights to drug manufacturers. The information also reflects directly back to MD usage of social media. 

Many physicians still are reticent to use social media. If you have not looked at social media in the past two years you would not know about the uptick for #hcsm. Users in all fields of medicine and health businesses, including device manufacturers, pharma, laboratories, and government. (FDA,HHS,CMS,WHO and more use social media for marketing and information purposes.

While most use Google to search for subjects you may notice that significant number of replies yield twitter, facebook, or Google + pages.  It is not at all unusual to see twitter handles and facebook page links on professional web sites.  If you want to remain strictly professional Linkedin has grown explosively in the last 12 months.  Building a profile on any of those sites or opening an about.me page will yield results.  About.me  is an eye catching site with creative graphics. It is much more interesting to read than a curriculum vita.

Kantar Media Healthcare Research Insights  

Uncovered some some specific insights about physicians and their professional social network usage. When it comes to posting on social media in a professional capacity, there are certain trends we can notice. We know that a doctor sharing an article is much more likely to be embracing new medical technology or drugs.

One of the trends we're noticing is that professional social networks are surpassing other platforms in terms of popularity and content shared. Our study results show that 58% of physicians that write/post on social networks for professional purposes choose to write/post on professional social networks vs. consumer or medical association social networks. What does this mean for advertisers? Well, potentially you as an advertiser should establish more of a presence on professional networks.

If you sell new pharmaceuticals to doctors, there's definitely some good news from the March 2015 edition of the Sources & Interactions™ Study. Physicians that write/post on social networks for professional purposes are more likely to be new drug adopters. Is social media advertising part of your media plan? It should be: 67% of respondents are saying they prefer to adopt drugs as soon as they are released or after a few others have tried it successfully. The fact is that medical professionals using professional social media are among the most receptive to new pharmaceuticals and you don't want to miss out on that group.

Sales teams should embrace these findings as well. Among this demographic using social media, 83% of them say they see sales reps—10 percentage points higher than the total physician population that see sales reps. It's clearly evident that social media needs to be a tool you utilize to reach the newest drug adopters. 

The Sources & Interactions™ Source is a detailed examination of doctors’ online and mobile activities, e-detailing experience, and exposure to (and evaluation of) information sources including traditional and emerging media, pharma reps, CME, convention and more. The study is conducted every six months and targets more than 3,000 physicians annually across 22 specialties, exploring their media preferences and habits. Sources & Interactions was designed to help marketers and their agencies cost-effectively allocate resources to their overall promotional mix, and provide publishers with specific insight about where their offerings fit into physicians (and other healthcare professionals’) information inventory.tudy

Sources & Interactions, March 2015: Medical/Surgical Edition

Kantar Media’s Sources & Interactions™ Studies offer detailed research on healthcare professionals’ online and mobile activities, e-detailing experience, and exposure to (and evaluation of) information sources including traditional and emerging media, pharma reps, CME, conventions and more. Sources & Interactions helps marketers and their agencies cost-effectively allocate resources to their overall promotional mix, and provide publishers with specific insight about where their offerings fit into physicians’ (and other healthcare professionals’) information inventory.

The Medical/Surgical edition is conducted every six months,with brand new data available now!

10 Reasons Why Doctors Don't Think They Are Entrepreneurs

post courtesy of Arlen Meyers, M.D. President Society of Physician Entrepeneurs

Arlen Meyers, M.D.

The conventional wisdom about doctors is filled with myths. My favorites are 1) doctors are lousy with money, and 2) doctors are by their very nature and training risk averse, and 3) doctors don't have what it takes to be an entrepreneur or a business person, and 4) if you are not taking care of patients face to face then you are not a "real doctor". What do they do, tear your epaulettes off of the shoulders of your white coat when you stop and move on to something else?

But, perhaps the worse part of all this mythology is that, in many instances, doctors believe it . Yes, there are notable exceptions.

 There are other reasons too why doctors don't think they are entrepreneurs:

1. They think entrepreneurship is only about starting a business. 
2. They are afraid of what they don't understand 
3. The culture discourages adopting an entrepreneurial mindset 
4. They think money is dirty in medicine 
5. They think it erodes medical professionalism 
6. They are just too busy 
7. They have had a bad experience before or working with "business people" 
8. They actually believe doctors are bad business people 
9. They assume the costs exceed the benefits 
10. They are satisfied with what they are doing now and think switching to something else is too risky, particularly when they are, on average, $170,000 in debt when they graduate medical school. 

Part of the equation has to do with doctors taking risk and how that impacts entrepreneurship. I agree the conventional wisdom is that doctors are risk averse. But, certainly in not all instances, both clinically and non-clinically. In my view:

1. Most entrepreneurs are risk managers, not risk takers

2. Most investors are looking for proposals where the risk has been eliminated, managed or mitigated. The goal of early design and development is to derisk the market, technology and execution risk as much as possible

3. While most doctors will do well and many go into medicine for the job security and money, the high profile few who have declared bankruptcy would disagree

4. Different specialists have been shown to have different risk profiles under different clinical circumstances. Of course they are not dealing with their own skin in the game.

5. The risk-return spectrum runs from low to outrageous. Most play in the lower left. Those rock star entrepreneurs that the media loves to hype live in the upper right and probably represent a small segment of all entrepreneurs. As far as clinical risk I have expected some risky maneuvers in the OR when, in my clinical judgement, the circumstances warranted it and I was up against it. Sometimes , when faced with a dire emergency or impending complication, taking risk is justified.

Doctors are not lousy business people. There are many reasons why they have the potential to make great entrepreneurs as has already been demonstrated by many. And, no, in many instances, doctors are not risk averse. They just believe they are and it's one of the reasons why it is so hard to get doctors involved in biomedical and health innovation and entrepreneurship.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs at www.sopenet.org