June 26, 2012
We are continuously piling new requirements on existing systems, often in conceptual isolation. It has occurred to everyone working in our industry that Medication Reconciliation overlaps CPOE, which overlaps maintaining up-to-date problem lists, which in turn overlap exchanging interoperable documents to facilitate safe hand-offs. These things are explicitly essential to reduce unnecessary readmissions, provide care in coordinated medical facilities and pharmacies, and promote self-care. What worries us all...
May 24, 2012
When the diagnoses are incomplete or non-specific, bad things happen from documentation subject to interpretation. Competent doctors may appear to have higher mortality than their actual level because imprecise documentation has made the risk adjustment blind to their truly sicker patients.
May 20, 2012
I was trained to think of coding as a downstream process to care that is of little clinical significance. But, as I learned during the course of the week; I was dead wrong. Rather than simply polishing the chart, those downstream processes are intended to strengthen it. And, with the rapid evolution of MU and value care, the focus on clinical documentation integrity is moving upstream, directly to the provider.
I also found that getting the diagnosis correct, whether for coding, clinical care, quality improvement, or value-based payment is straight-forward but not at all simple.
April 30, 2012 Joe Bormel, M.D.
Of late, there has been a loud resurgence of the collective physician voice on the topic of healthcare IT mandates.
In effect it is saying, “too much, too fast, with insufficient regard to sustainability, incentives and penalties.” The recent CMS announcement to delay ICD-10 by one year adds credence to this position. Let's break that down into further detail.
March 9, 2012 Joe Bormel, M.D.
One of our most important considerations in acceptance and usability is to provide the flexibility users need to customize the system to meet their unique demands and organizational policies. To accomplish this goal, we often depend on those users to guide us in creating the functionality they feel is important to derive the greatest benefit for their hospitals and patients.
February 27, 2012
During the past 18 months or so, I have talked with many hospital CIOs and HIM professionals. I’ve been impressed with how so many organizations have accepted the transition to ICD-10, and have had plans to do so in place for some time. My impression is that hospitals are moving right along toward meeting the transition’s October 2013 deadline. And according to the surveys I’ve read, most feel they will make it. But now, CMS may move that deadline out, which has the potential to severely complicate training and implementation cycles. There was a lot of buzz about a delay at HIMSS last week, and that is the topic of my blog.
January 24, 2012 Joe Bormel MD, MPH
The final installment of this three-part series examines the provider organizational process issues of medication reconciliation. By incorporating elements from a presentation by Vickie Kamataris, this post gives providers a path to maximize their use of technology.
December 29, 2011 Joe Bormel, M.D.
Truly advanced computers will be needed in order to help patient care organizations advance to the next levels in physician documentation and management of the ICD-10 coding system.
November 10, 2011
My conclusions, based on what I learned at AMIA and captured in the list of assumptions, are there exist several concrete and useful ways to approach medication reconciliation that are not in common practice today:
November 4, 2011
Last week, I attended the American Medical Informatics Association (AMIA) conference in Washington, DC. This conference is the largest U.S. gathering of practitioners, researchers, academics, and government/policy professionals working in informatics.
