The Healthcare Insider

Behind the scenes of the health care industry

July 28, 2014

ICD-10: How to Avoid Déjà Vu All Over Again

ICD10 Delays

This is a guest post by Jim Hennessy, CEO of e4 Services and a regular guest of the ICD-10 Roundtable

Let me start with a prediction – if CMS’ Proposed Rule simply mandates an industry-wide compliance with ICD-10 as of October 2015, ICD-10 will eventually be delayed again.

As CEO of a consulting firm that has been assisting dozens of hospitals and health systems responsibly prepare for ICD-10 readiness, this is an incredibly frustrating and unfortunate prediction to offer.  The majority of the healthcare industry was fully committed heading into this past spring to complete the transition this year – there obviously would have been problems and challenges that would have been worked through, but the momentum and collective commitment towards a single objective had never been higher than it was prior to the legislative delay.

While we wait for CMS to publish their Proposed Rule that is anticipated to just re-establish the new compliance date of October 2015, the majority of industry discussions have been centered around – “keep the momentum going,” “continue testing,” and “educate physicians on why this is good.”  These are all worthwhile tactical discussions, but are increasingly being evaluated against the more pressing and strategic needs of each organization.  Focus on ICD-10 continues to get pushed down on the already long lists.  More importantly, none of these discussions will reduce the likelihood of yet another delay being lobbied for and implemented, since they do not address the underlying concerns of those who lobbied for delay.

At the core of the most effective lobbying is a subset of the physician community that was not sufficiently motivated by the incentives associated with HITECH and Meaningful Use to implement compliant EMR systems within their practice operations.  Without trying to understand and address this community’s concerns, the government and industry have no chance of getting them to support a mandated regulatory change, like ICD-10.

The only way that the industry has a chance to avoid the crippling impact of annual resets on the compliance date is to push CMS and the payers to support a creative implementation approach that is incentive-based, and allows those who choose to “be left behind” on ICD-9 – at least for some transitional period of time.  For example, make October 2015 the start of when providers can choose to begin to send claims and reporting data in ICD-10 format.  Will there be complexity and issues with a hybrid model?  Absolutely.  However, is the alternative of never advancing off ICD-9 better?  The calls for “let’s wait for ICD-11” ring hollow, since the same mandated implementation issues will exist and need to be addressed then.  The industry was so close this year before having its collective legs chopped out from under them.  It would be a complete reset sometime in the next decade or longer before ICD-11 would realistically be ready and be considered.

How do the influencers and thought leaders within the industry elevate the dialogue to start looking at changing strategies for transitioning to ICD-10, rather than just on the current preparation tactics?

The fear is that unless that dialogue can get started quickly in a meaningful way, we should expect more of the same – CMS announcing a mandated date in 3Q, and then lobbyists succeeding in 1Q next year to get another ICD-10 delay added to the 18th annual Medicare SGR fix.  We can and need to do better.

Jim will be joining us soon for a podcast on the ICD-10 Roundtable for further discussion.  Please be on the lookout for that episode in the near future.

July 23, 2014

Chris Powell + Teresa Michael: CDI and the future of ICD-10


Teresa Michael + Chris Powell

Today’s Guests:
Teresa Michael, Director, Health Information Management, Sarasota Memorial Hospital
Chris Powell, CEO, Precyse

Teresa Michael, BA, RHIT has enjoyed a long career in Health Information Management. She has been the Director of Health Information Management at Sarasota Memorial Health Care System since December 2010. Prior to returning to her HIM roots, she spent 5 years as a Clinical Systems Analyst at SMHCS implementing and supporting document imaging, coding, and other HIM systems. Teresa came to SMHCS from Streamline Health where she worked in sales, marketing, implementation, and product management for the HIM and Revenue Cycle Suite of Products. She went to Streamline Health from Mercy Regional Health Systems in Cincinnati, Ohio where she was the Director of HIM for Mercy Hospitals Anderson and Clermont. Teresa is a graduate of the University of Cincinnati and Eckerd College in St Petersburg, FL. Teresa was also the Team Manager of the US Archery Team for the 1996 and 2000 Olympic Games.”

In April 2014, Chris Powell was promoted to Chief Executive Officer and elected to the Board of Directors of Precyse. In this role, he is responsible for the overall day-to-day operational performance and leadership of Precyse, including implementing strategic operational plans to advance the company’s mission and financial and non-financial objectives. Mr. Powell leads the efforts to evolve the company along the path to a sophisticated technology-enhanced services model, including focus on product development and commercialization, and engagement in merger and acquisition and channel partnership opportunities as they arise. He is also responsible for operations, service delivery, sales, marketing, finance and information technology and is a member of the organization’s Executive Council. For the three years leading up to this promotion, Mr. Powell served as President of Precyse.

Today’s discussion guide:

1. What kind of impact is the ICD-10 transition having on the healthcare marketplace?
2. Will we still be ready for October 2015?
3. How will we deal with further delays?
4. Teresa presented at this year’s ANI on “Advancing Clinical Documentation Quality and Accuracy While Preparing for ICD-10.” What were the key takeaways from the presentation?
5. How is Sarasota Memorial dealing with the delay? They were prepared for the 2014 deadline, but do they process the delay? It will be dealt with in three phases….
6. How does the delay impact momentum?
7. How does this impact CDI, and where do we go from here?
8. Despite the delay, what are the opportunities as a result of the delay?
9. For those providers who were NOT ready for the 2014 deadline, what do they do now?


jvionOur LIVE, on location coverage from HFMA’s ANI2014, is brought to you by JVION, transforming healthcare compliance!

To follow all of our On Location coverage from ANI and jvion, you can subscribe by CLICKING HERE!

July 23, 2014

Lee Aase: The burgeoning role of social media in healthcare

This interview was originally published by Dodge Communications.

leeaaseIf you want a glimpse into an organization that is genuinely leading edge in terms of social media, listening to this conversation is a must.  Lee Aase, Director of the Mayo Clinic Center for Social Media describes a set of creative initiatives that are having a positive impact on doctor/patient communication and education, but also on research and a host of other healthcare issues.


  • The Mayo Clinic’s social media journey
  • How to get physicians actively engaged in social media.  What’s the hook?
  • Is there proven ROI for investment in social media for healthcare organizations?
  • Not just creating and curating content, but also educating the health consuming public and healthcare professionals/communicators on using social media for healthcare.  (The Social Media Health Network)
  • Social media’s role in the larger mHealth context
  • The future of healthcare social media


Catch the latest episode of The Healthcare Insider in your INBOX, or through iTunes!

July 21, 2014

Ed Daihl of Surgical Information Systems: The perioperative surgical home


Ed Daihl SISWHO: Ed Daihl
WHERE: Surgical Information Systems

Built to meet the demands of anesthesia and surgery, Surgical Information Systems (“SIS”) provides software solutions that are uniquely designed to add value at every point of the perioperative process. Developed specifically for the complex surgical environment, all SIS solutions are architected on a single database and integrate easily with other hospital systems. SIS’ complete perioperative solution is proven to support hospitals’ goals of helping increase operational efficiencies, improve financial performance, and deliver better patient outcomes throughout the continuum of care.

Today’s discussion topics:

How have today’s perioperative services eveolved these past few years?

Industry leaders are quite knowledgeable about PCMH, or patient-centered medical home, but perioperative surgical home is a newer term. Please define…

Why is the perioperative surgical home an advantageous model for today’s OR?

What metrics or standards can help providers determine if their perioperative surgical home is working?

How can technology help drive the perioperative surgical home model?

Are there any barriers to provider adoption of the perioperative home model? How do you overcome those barriers?

What do you see as the next frontier for perioperative services – how will it continue to evolve?


Catch the latest episode of The Healthcare Insider in your INBOX, or through iTunes!

July 19, 2014

Steve Jourdan: Increasing efficiency and providing transparency in your throughput processes

Steve JourdanSteve Jourdan is a recognized leader and entrepreneur with a passion for developing technology solutions that empower people. As an IT leader for a national contract service company, Steve drove innovation across all areasand managed the implementation of a cultural shift in the way the organization utilized technology, with a company-wide move to cloud computing.

Steve’s ability to identify cultural and technological shifts in the industry and to determine how these new innovations can be applied directly to real-world business problems has lead to the evolution of the core business, as well as the creation of healthcare technology start-up, BedWatch®. Steve is a Microsoft Certified Systems Engineer (MCSE), and has several patents pending for technology inventions around Patient Flow technology designed and developed for BedWatch®. He excels at developing and empowering teams to achieve high levels of success, and is adept at building business strategies designed to realize a specific vision.

BedWatch® was recognized as the most innovative technology product in Austin, Texas, by the Greater Austin Chamber of Commerce in 2011, beating competitors like Dell and National Instruments. Prior to founding BedWatch® in 2010, Steve had started and operated several businesses in the areas of consulting, retail, and landscaping. He graduated from the University of Texas at Austin with a B.S. in Communications. He currently resides in Austin, Texas, with his wife and son.

Discussion guide from today’s show:

Why is mobile so interesting for Healthcare? (Because it forces innovation and rethinking of what’s important)

Responsive Web Design (web vs. native apps, what’s important?)

Security – Is information secure on mobile?

Technology exists to deliver better Healthcare.

Healthcare Landscape (Baby Boomers, ACA, HIPAA / Privacy)

Barriers to Entry (Long Sales Cycle, Difficult Vendor Vetting, IT Agenda)

IT Agenda – Focus on Risk Mitigation, Not Innovation

What is the risk of not innovating?

How can vendors approach the market? (independent hospitals, innovative, early adopters)

How can hospitals innovate? (infrastructure, innovation group, empower patients and staff)


Catch the latest episode of The Healthcare Insider in your INBOX, or through iTunes!

July 19, 2014

Jay Kelley: Peer-to-peer engagement and wellness

SpireJay Kelley currently serves as President and CEO of Spire, a social/mobile platform that leverages group dynamics and peer support to help keep populations happy and healthy.

Previously, Jay was a founding executive of Documentary Channel, a national cable and satellite network that reached around 27 million households until its sale to Participant Media. Jay raised much of the initial seed capital for the channel and served in a variety of top executive positions during his nine-year tenure with the company, overseeing marketing and PR, commercial operations, digital platforms, advertising sales, strategic partnerships and branded entertainment. Jay was instrumental in growing the network from idea to profitability, and developed partnerships with Fortune 500 brands including P&G, ExxonMobil and Red Bull.

Prior to his involvement with Documentary Channel, Jay worked in advertising, developing campaigns across all media and a variety of categories for clients like Cricket Wireless, Litespeed Bicycles, Brach’s Candy, Five Star Stoves, Bull Frog and Krystal Restaurants. Before starting his career in media and entertainment, Jay taught at international schools in Latin America and the Middle East, and at Johns Hopkins University. Kelley has a master’s degree from Johns Hopkins and a bachelor’s degree from Sewanee. He currently lives in Nashville, Tennessee with his wife and two sons.

Some highlights from the conversation:

Social media and the way we build culture, today.

The lonely quantified self and moving beyond just you and your data (peer-to-peer engagement and wellness).

The plight of modern healthcare employees: unhealthy, stressed-out, and expensive.

The importance of mobile apps for mobile populations.

Building a tech startup outside of a major hub: Why Tennessee makes sense.

Now accepting requests for Spire Innovation Partnerships!


Catch the latest episode of The Healthcare Insider in your INBOX, or through iTunes!

July 17, 2014

Hippert + Troutman: Banks and healthcare?


PNC BankJeffrey Troutman is Executive Vice President of PNC Healthcare Group. Troutman has been a key player in developing PNC’s direction for serving the healthcare industry. He has been involved in HIPAA strategies and tactics from both industry and PNC perspectives, since 1996.

Mr. Troutman brings to this role previous PNC experience, including business development for national corporate finance, where he is credited with expanding the array of products and financial services offered by PNC. Prior to joining PNC in 1992, he served as an associate with Interstate Hotels Corporation where he spent time working within the real estate M&A group.

Mr. Troutman is a member of the Association for Financial Professionals. He currently chairs PNC’s Healthcare Advisory Board and co-chairs PNC’s Healthcare Foundation Board.

Jean Hippert is senior vice president PNC Healthcare. As senior managing director for PNC’s healthcare business, Jean is responsible for increasing the presence and awareness of PNC Healthcare nationally, especially as a thought leader in subjects integral to the healthcare revenue cycle. As a member of the division leadership team, she helps develop and implement division strategy and tactics. She is co-sponsor of the PNC Healthcare Advisory Board, executive sponsor for the Revenue Cycle Advisory Services group, and works closely with the Healthcare Innovations and product teams, as well as with regional sales teams. In addition, for four years she was region director for the Southeastern US, and her responsibilities include regional business development activities, sales team and client management.

Prior to joining PNC Healthcare, Jean spent nearly 10 years at Premier Inc., a strategic alliance of not-for-profit hospitals and healthcare systems. At Premier, she was responsible for relationship management with shareholder organizations, specializing in integrated delivery networks, academic medical institutions and faith-based healthcare systems. She also helped manage national business development and participated in the corporate Baldrige team. Before joining Premier, she was a healthcare consultant at Hyatt, Imler, Ott & Blount specializing in clinical resource management and operational productivity.

Prior to her healthcare experience, she spent fourteen years in information technology sales management with Hewlett Packard and Xerox Corporation, focusing on defense manufacturers and cross-border manufacturing.

Hippert holds a Bachelor of Arts degree from Mary Washington University and is a participating member of Health Care Financial Management Association and Women Business Leaders of Healthcare Foundation.

Todays discussion topics:

Providers and payers are developing their responses to new models of patient engagement. How can a bank like PNC help in this transition?

As patients assume more responsibility for the cost of their own care, how can an organization like yours help?

We hear a lot about the “consumerism” and “retailization” of healthcare, but banks went through that a long time ago. What lessons have banks learned in this process, and how can they be applied to what is happening in healthcare today to assist providers in making the transition from a third party payment model?

In the past, awareness about banks was largely developed through the presence of retail branches. You’ve said that PNC is moving away from less efficient service models like branches to more electronic options for the consumer. But without “brick and mortar” How does PNC expand its brand awareness?

You’ve talked about the healthcare revenue cycle. From your vantage point, how is that evolving for your customers? What’s next?


jvionOur LIVE, on location coverage from HFMA’s ANI2014, is brought to you by JVION, transforming healthcare compliance!

To follow all of our On Location coverage from ANI and jvion, you can subscribe by CLICKING HERE!

July 10, 2014

Travis Mendenhall: The future of patient portals!


Travis Mendenhall

Travis Mendenhall

Who: Travis Mendenhall, FHFMA
What: Manager, Patient Accounts
Where: Gwinnett Hospital System

Today’s discussion topics:

Can you tell us a little bit about Gwinnett Hospital System and your role within the organization?

You are speaking at this year’s ANI conference on the topic of “Best Practices for Simultaneously Increasing Patient Collections and Satisfaction”. Can you talk about what you are doing within the Gwinnett Hospital System to increase collections and patient satisfaction?

What is a POS collection strategy?

How can you drive adoption of a patient portal?

As you look to the future of healthcare, how do you see providers leveraging patient portals?

What do you hope attendees take away from your session?


jvionOur LIVE, on location coverage from HFMA’s ANI2014, is brought to you by JVION, transforming healthcare compliance!

To follow all of our On Location coverage from ANI and jvion, you can subscribe by CLICKING HERE!

July 9, 2014

Charles Meadows: Revenue cycle challenges, and opportunities!


Charles Meadows

Charles Meadows

Who: Charles B. Meadows
What: Network Vice President Revenue Cycle
Where: Community Health Network

Ranked among the nation’s most integrated healthcare systems, Community Health Network is Central Indiana’s leader in providing convenient access to exceptional healthcare services, where and when patients need them—in hospitals, health pavilions and doctor’s offices, as well as workplaces, schools and homes.

As a non-profit health system with more than 200 sites of care and affiliates throughout Central Indiana, Community’s full continuum of care integrates hundreds of physicians, specialty and acute care hospitals, surgery centers, home care services, MedChecks, behavioral health and employer health services.

Today’s discussion topics:

Can you tell us about Community Health Network and your role within the organization?

What are the biggest revenue cycle challenges you face?

As you think about changes to the US healthcare system, what keeps you up at night? What are you most excited about?

How is technology changing the way you manage the revenue cycle?

Let’s talk about emerging predictive analytic solutions, how do you think they will impact the way hospitals think about the revenue cycle?


jvionOur LIVE, on location coverage from HFMA’s ANI2014, is brought to you by JVION, transforming healthcare compliance!

To follow all of our On Location coverage from ANI and jvion, you can subscribe by CLICKING HERE!

July 7, 2014

Dr. Neil Rawlins: How big data solutions can identify root causes of disorders like MTHFR


rawlins_neil_clinicforweb3Who: Dr. Neil Rawlins
What: CMIO
Where: Kadlec Medical Center and expert on MTHFR

Dr. Rawlins graduated from the University of Utah School of Medicine and completed his residency at Madigan Army Medical Center. He is board certified in obstetrics and gynecology.

Discussion topics on today’s show:

Can you tell us a little bit about the Kadlec Clinic and your role within the organization?

You’ve done a lot of work around MTHFR (Methylenetetrahydrofolate Reductas), what spurred your interest in the disorder?

What are the symptoms of MTHFR?

What potential do you see in big data solutions to identify the root cause of disorders like MTHFR?

What role do you think predictive solutions will play in personalizing medicine?

When you think about healthcare 10 years from now, what are you most excited about?


jvionOur LIVE, on location coverage from HFMA’s ANI2014, is brought to you by JVION, transforming healthcare compliance!

To follow all of our On Location coverage from ANI and jvion, you can subscribe by CLICKING HERE!

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