It amazes me the amount of apps or (applications) that are available for phones these days. I recently heard on the news that only 40 % of Americans still use a land line. So the use of a cell phone as a standard means of communication is in full swing for most of us. So with that many people using cell phones it is no wonder that more people are demanding apps for tracking things that are important to them. If you are dieting, there is an app to track your progress, if you want to track your exercise routine there is an app for that. Too bad there is not one app that does it all for tracking health care information or personal health information. I would like to see an app that tracks all my medical information and stores it all in one place. There are many barriers to this project but slowly the barriers of capturing, storing and sharing health care information are deminishing as new technology becomes available.
I think all patients should monitor their own health care. Do you keep track of your medical records and what is inside them? I do. Why because I feel I know myself better than anyone. It is not that I do not trust but I feel that I need to know what is going on with regards to my medicine, treatment and options. I would go as far as to say that if you have a chronic problem or serious disease you need to be 100% involved in your healthcare.
I went to the doctor the other day for a check up. The doctors visit went great it was just the confusion with scheduling and getting the appointment that was a hassle. The doctor that I see is a specialist. I told her of the scheduling issue when she was examining me. I told her that I had to cancel the last appointment due to the snow/ice but I had a terrible time getting back into see her. She told me she knew of the problem and wondered if I took names and notes of who I spoke with and I told her I did. She wants the names of the people who are in her scheduling office. The weird part was that when I left the doctor she told me she wanted to see me back in two months and if I had trouble with scheduling let her know. She is booked out for a year in advance. She told her assistant to go with me to scheduling to make sure I got back in within two months. The lady went with me and the lady at the front receptionist counter in scheduling was busy. The doctors assistant told her to make sure that I got an appointment in two months. The lady finally got to me and told me the doctor was booked and I reminded her that I needed an appointment in two months. One lady went to go ask why??? and the other lady at the counter acted like she did not want to get involved. She kept saying we are booked and I will put you on the wait list. The one lady tried to make a few phone calls to someone who could override the appointment but she could not get an answer. The one lady came back and said I cannot find anyone to help me. I will put you on the wait list and someone will call you. She told me, “You can go now and we will call you”. Well do you think I will get an appointment in two months. No one has called me yet.
I see every day the barriers of the electronic health record (EHR) that face the health care community. Tablets are fancy gadgets but I am so concerned that the text is so small and so hard to read. Errors are made. Implementation is slow going and a daunted task. The conversion of the workflow and the training are so critical and yet it is easily misunderstood to how important it is. Proper training is needed and yet we rely on salespeople to guide the process, a train the trainer approach. The colleges of today and our educational system is failing us since there is not enough grants to offset offering new and upcoming programs for technicians to be trained on the electronic health record. Our backs are against the wall, so many of my friends have lost jobs since the government is regulating everything and the physicians are not coming on board like they anticipated. Let’s face it the real reason for the loss of jobs is the grant money ended. We are all waiting on the next funded project. Yes, the electronic health record is here to stay but the barriers are bigger now than ever.
I just can’t believe we are so close to changing to a new coding system with so many providers not getting their claims out the door and paid. I can only imagine the mess it is going to be unless your health care organization or office is starting to plan now for ICD-10. As an educator/consultant I really do not see that many small practices even concerned about ICD-10 yet. Are you conducting an office assessment of your internal needs? Do you know what training is required before you can submit a clean claim? What is your staff going to do to get the training they need? Are you going to send them to a webinar, full day conference or back to school to the formal classroom. What is your approach?
Wow, it doesn’t seem that long ago that I was learning all about Diagnostic Related Groups (DRG’s) and now it is time to learn a new way of coding. I am so glad that I have a pre-nursing background and that I continue to teach and work with allied health students today. It keeps me young. I try to always keep one hand in full grip of the basics of medicine and one hand always ready to reach for the new concepts that come along. We really needed to be life long learners if we are going to really understand and embrace ICD-10.
I hope that the new coders that are just coming into the career field do not have to go through what I went through to learn coding and to transition to DRG’s. I know now that I was hired because of all my pre-nursing education and my on the job training in respiratory therapy. I can still remember when they offered me the job as a coder. I was so excited to be offered a job in the medical field that was full time days. The administrator told me upon hiring me that they did not have a medical records director in place. After working for about two weeks, they sent me to a workshop in another city to learn everything I needed to know about coding and DRG’s. I really relied upon my medical background to grasp everything that I needed to know. I kept all kinds of medical books, surgical books, dictionaries open in front of me as I coded the diagnosis and the procedures. If there was something I didn’t understand I would try to ask a question of the physician on the case. The physicians came to the medical records department on a regular basis to complete their records. It was acceptable for coders and physicians to discuss cases in the dictating room. I can still remember the other people in the department and how they related to me as a new person and in my new role. They were like, Oh she is the one that works with and talks to the doctors, ooooh. Most of my coworkers acted like they were all scared to even say hello to the physicians when they came into the department. I became very comfortable with working with physicians early on in my career. Before I knew it I was asked to join them in their committee meetings and take notes
Finally the day came when I was introduced to my new boss. She was young and pretty and single.
She was fresh out of college. After working with my new boss after about three months and DRG’s was coming closer to being fully implemented in our state, I can remember asking her a question about a particular case that I was working on. I was having a challenging time trying to really grasp the concepts of all the DRG’s and how to map them. I approached my director with a question. She tried to explain it the best she could. I still did not get how she arrived at her choice. I sat the record to the side and thought I would try again tomorrow. I approached her again the next day and she explained to me again what the DRG should be. I asked her why that particular DRG and she got very upset with me.. I got upset when she changed her tone of voice and she ended up saying to me, do I need to draw you a picture? I was so hurt by that comment. I shouted back to her, “I guess you do and left her office”. I finally assigned the DRG that she suggested and submitted the claim but I realized that I had a lot of work to do to really understand the concepts behind how to select the best code and the best DRG’s.
In reflection, I think about how hard it was to learn and apply new concepts and I think about how hard it is going to be for some of these hospitals when they need to train their staff on coding for ICD-10 and really start implementing the system. I think about the coders themselves and the countless hours of sleep they are going to lose when they try to implement this new mandate. Are hospitals going to hire a pretty little thing, right out of college and think that she can do the job of implementation by herself? Are administrators and Health Information Managers (HIM) going to send people to a one day workshop and think they can learn it all there? What about productivity rates? Are hospitals going to only hire people with years of experience? There is definitely going to be a learning curve? Who is going to pay the price?
I am now on board with a network whereby I can communicate with my physicians and access my medical information. The portal is called My Mercy. I am finding the website easy to navigate and very informative. My physician answers his emails timely and answers me thoroughly when I have a question. I would like for this network to consider a few up grades to their system. I would like to access my diagnosis and treatment. I think that would be helpful. I cannot remember the date of when I was in for a sore throat last and what he prescribed that worked so for me to have that information would be helpful. I have a few more suggesstions but this is one that sticks out the most. I know they do not realize that I have alot of experience in this sort of thing (Selecting and Implementing EHR’s) Other than that good job. I would rate them a B-
Just this week the Office of the National Coordinator for Health Information Technology (ONC) announced their selection of the final two regional extension centers (RECs). This brings the total count to 62 and completes a national network of RECs. The last two RECs will provide support for providers in Orange County California and the state of New Hampshire.
RECs are funded by the Economic Stimulus Bill of 2009, or more specifically, the HITECH Act. This program has received funds of $677 million so far. Their mission is to help 100,000 providers become “meaningful users” of electronic health records in 24 months. Each individual REC is required to help at least 1,000 providers achieve “meaningful use” status. Will RECs deliver on their mission?
Their poll also ties in with a blog post titled, “5 Reasons RECs are RECkless.” One of their main concerns with RECs is the short timeline. RECs funded in February of this year have just 17 months to reach their goal; the others funded in April have 19 more months. So, if their goal is to help 1,000 providers in this short time frame, they will need to work with 50 to 60 providers a month. Do they really have enough time and reosurces to support this demand? Where are they going to find enough staff?
To participate in their poll and read more from their article, visit: http://www.softwareadvice.com/articles/medical/five-reasons-we-think-recs-are-reckless-1092310/