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Managed Care in the Age of Accountability

Author: Tercero, Wendy

Source: Journal of AHIMA

Publication Date: April 1999


Additionally, as managed care grows, quality and cost will reach equilibrium, and today's economically driven model will have stabilized, turning into one that truly balances cost and quality. Healthcare organizations of the future will need to implement information systems that support decisi....

AHIMA Census Results: Focus on Compliance

Author: Lorence, Daniel P.

Source: Journal of AHIMA

Publication Date: April 1999



The Office of the Inspector General (OIG) has instituted compliance guidelines for medical laboratories, hospitals, and home healthcare agencies. Within this framework, these guidelines provide at least some compliance direction for individual providers and group practices ....

IT Angle

Author: Quinsey, Carol Ann

Source: Journal of AHIMA

Publication Date: April 1999


Since my first years managing health information, it has been my goal to deliver information to clinicians in a format that is timely and useful. My current job is practically made to order to meet my personal goals as well as contribute to the vision that Kaiser Permanente, my employer....

Reaching Operational Goals

Author: Green-Shook, Sheila

Source: Journal of AHIMA

Publication Date: April 1999


An HIM career in managed care opens doors not only in healthcare but in our evolving electronic age. This is an exciting time to pursue such a career choice because of the seemingly infinite number of opportunities and challenges this environment presents and will continue to present.....

Teamwork and Compliance Go Hand in Hand

Author: Ruppersburg, Patricia L.

Source: Journal of AHIMA

Publication Date: April 1999



Compliance is an issue that has earned much respect from healthcare professionals. It has become imperative to all HIM professionals to focus on providing the best possible solution for compliance. The ultimate goal: to create a scenario in which compliance supports the existing heal....

Clear Focus on Coding

Author: Moses, Rhona

Source: Journal of AHIMA

Publication Date: April 1999


For the past three years I have been manager of coding education and billing guidelines at Group Health Cooperative, a 600,000-member HMO. Group Health has 25 primary care clinics, four specialty centers, an ambulatory surgical center, and two hospitals. We have about 700 staff physic....

Alternative Medicine: Growing Trend for the New Millennium

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: April 1999


Please note that the information contained in this article concerning alternative medicine treatments and their underlying principles and theories is provided for educational purposes only. It does not represent a position of either AHIMA or the author regarding the efficacy or scientific val....

What Is Diversity?

Author: Shepard-Jackson, Karen

Source: Journal of AHIMA

Publication Date: April 1999



Many organizations around the world are struggling to figure out how to reinvent themselves to gain and maintain their competitive advantage. Businesses and healthcare organizations are putting long- and short-term strategies into place to ensure that their research and development o....

Elements of Provider Credentialing

Author: Nelson, Patricia

Source: Journal of AHIMA

Publication Date: April 1999


HIM professionals manage patient information. But in the provider credentialing process, another kind of information management is necessary -- handling the varied and important information compiled on doctors throughout the country. Here's how the credentialing process works.

Trad....

Benchmarking For a Burst of Creative Thinking

Author: Kloss, Linda L

Source: Journal of AHIMA

Publication Date: May 1999


It is precisely when an old paradigm crumbles and the new one is not yet in place that we get great bursts of creative thinking."1 I'm convinced that this is such a moment for HIM.

The old paradigm of a static, facility-bound record is, unfortunately, still the norm,....

Home Health Balancing Act

Author: Sourapas, Joan

Source: Journal of AHIMA

Publication Date: May 1999



What does a home health agency have in common with a typical Fortune 500 company? Though their activities and goals may differ, both organizations can benefit from the use of the balanced scorecard approach to measuring and enhancing performance.

Since Harvard professo....

Influence: Making Things Happen

Author: Pavoni, Mary Mike

Source: Journal of AHIMA

Publication Date: May 1999


Scenario: You are an HIM professional who is working on a project with a room full of colleagues. Suddenly, one of the team members is asked to attend another meeting. Upon returning, this person announces that he was selected to lead a reengineering design team and needs to select h....

Desperately Seeking Smart Cards

Author:

Source: Journal of AHIMA

Publication Date: May 1999


The Department of Defense issued a request for proposals (RFP) for a personal identification card that can be used in conjunction with systemwide computer-based patient records system. Currently, most chip-based smart cards hold eight to 16 kilobytes, but the department is looking for a ....

Productivity: How Do You Measure Up?

Author: Lorence, Daniel P.

Source: Journal of AHIMA

Publication Date: May 1999



Previous issues of the Journal of AHIMA, along with other health information publications, have featured examples of benchmarking and best practices, describing how healthcare organizations use the process of benchmarking to identify the "best in class" achievements for a given organ....

OASIS Cracks Down on Home Care

Author: Carpenter, Jennifer E.

Source: Journal of AHIMA

Publication Date: May 1999



January 25, 1999, brought the publication of the final rule on the assessment and use of the Outcomes and Assessment Information Set (OASIS) in the Federal Register. This rule requires that each patient receive a patient-specific, comprehensive assessment that identifies the patient'....

Decimating Duplicates

Author: Gentry, Lynne; Harnish, Patricia A.

Source: Journal of AHIMA

Publication Date: June 1999


After approximately 150,000 (out of 787,000) medical record numbers in a master patient index (MPI) were identified as possible duplicates, MultiCare Health System in Tacoma, WA, decided to address the problem through a multidisciplinary approach. An MPI conversion to a new hospital in....

Leading through Empowerment

Author: Bradt, Gary

Source: Journal of AHIMA

Publication Date: June 1999


What got you to the top will not keep you there. This is a difficult lesson to learn. Many leaders earn success by getting involved and accomplishing things. They are tireless workers willing to do whatever is necessary to complete the task. Their diligent efforts lead to rewards, reco....

Sign of the Changing Times: CPT 1999

Author: Mallett, Sherri; Smith, Gail I.

Source: Journal of AHIMA

Publication Date: June 1999


This year brought with it 686 changes to CPT. While this is a moderate number in comparison to previous years, several of the changes have significant impact on code assignment. The purpose of this article is to highlight some of the areas of significant change. (See "1999 CPT Revisions" in t....

Medical Dictation: A New Generation

Author: Groner, Gabriel F.

Source: Journal of AHIMA

Publication Date: June 1999


As the term implies, automatic speech recognition is a computer's recognition of speech, automatically converting it into readable text and interpretable commands. To fully understand automatic speech recognition, one must first be aware of the distinction between speech recognition an....

EMR Education for a Student Health Center

Author: Burgess, Barbara

Source: Journal of AHIMA

Publication Date: June 1999


How does a busy student health center on a state university campus implement an electronic health record? This is the story of how Hall Health Primary Care Center (HHPCC), a community-based primary care center at the University of Washington (UW) in Seattle, did just that.

Post-acute PPS: Changing the Way We Code

Author: Dougherty, Michelle

Source: Journal of AHIMA

Publication Date: June 1999


HIM professionals in post-acute care are reinventing their roles to accommodate the new coding demands of a prospective payment system. Here are some of the developments that are creating new interest in coding issues for post-acute settings.
Three major forces -- the prospective payment....

Common (and Uncommon) Ground

Author: Dixon-Lee, Claire

Source: Journal of AHIMA

Publication Date: June 1999


On a trip to Dublin this spring, I met with several officers of the Healthcare Informatics Society of Ireland. During this visit, we talked about health information management, finding common ground on topics like:
Year 2000 compliance
the need for clinical vocabulary....

On the Line: Professional Practice Solutions

Author:

Source: Journal of AHIMA

Publication Date: June 1999


Q: I work in a skilled nursing facility and want to know if it is mandatory for all states to use Resource Utilization Groups III (RUGS III). If so, when was the deadline?
Q: Where can I find information about a system that will allow for the electronic transmission of Minimum....

Are HIM Programs Going the Distance

Author: Garrie, Robert L.

Source: Journal of AHIMA

Publication Date: June 1999



As the Internet booms and technology proliferates, distance education, like other innovations, has become a hot property. A few years ago, forecasters predicted that by 1998, more than half of higher education institutions nationally would be involved in distance education. ....

Cultivate a Desire to Learn

Author: Dixon-Lee, Claire

Source: Journal of AHIMA

Publication Date: July 1999


As I travel the country meeting many of you, I am very curious about the diversity of jobs, skills, and settings in which you work. The creativity, independence, and resourcefulness that come with career redefinition fascinate me. All of us working under the umbrella of health informat....

Automated Coding: The Next Step?

Author: Beinborn, Julie

Source: Journal of AHIMA

Publication Date: July 1999


Automated coding technology may be key to the evolution of the coding and billing processes. How do these systems work, and how will they change the role of the coder? The author offers a preview.
Technology is changing many aspects of healthcare, and coding is no exception.

R....

Roundtable Takes on Compliance Challenges

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: July 1999


The Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) and the Health Care Compliance Association conducted a one-day joint roundtable on healthcare compliance to gain new insights into the challenges of creating effective compliance programs. The ro....

After Automated Coding, What?

Author:

Source: Journal of AHIMA

Publication Date: July 1999


As technology progressively automates more processes, what will HIM jobs look like in the future? In 1998, AHIMA published Evolving HIM Careers, which offers in-depth looks at seven new roles for HIM professionals, including the role of the clinical data specialist. Here are som....

Coders and Physician Liaisons: a Winning Combination

Author: Stavely, Starla

Source: Journal of AHIMA

Publication Date: July 1999


Never have so many HIM professionals had so much to worry about in the area of coding. Combine the need to keep an eye on case mix and a vigilant effort to prevent fraud and abuse, throw in a lack of physician documentation, increasingly stiff competition for the chart on nursing units, and co....

Where We've Been, Where We're Going

Author: Scichilone, Rita A

Source: Journal of AHIMA

Publication Date: July 1999



As conditions in the healthcare industry have become more challenging, many jobs have evolved. Not least among them in the HIM world is the role of the coder. In more ways than one, coding professionals are making their mark in the industry. And today, changes in coding requirements are pa....

Job Hunting in the Electronic Age

Author: Picard, Angela

Source: Journal of AHIMA

Publication Date: July 1999


Professional networking is a major factor in the success of your career, and it certainly is a critical element in the job search process. As Perry Ellie, MA, RRA, president of H.I.M. Recruiters, says, "Statistics show that up to 80 percent of all employment opportunities are found through net....

Best Practices: What Works

Author: Carrier, Danielle

Source: Journal of AHIMA

Publication Date: July 1999




Medical record accuracy, record completion time, physician satisfaction—all of these are indicators of how well an HIM department is performing. The findings of a UHC benchmarking study may point the way to best practices that can be shared and adapted.

What....

Group Builds Consensus on Laboratory Test Policies

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: July 1999


The Balanced Budget Act of 1997 (BBA) mandated that the Health Care Financing Administration (HCFA) use a negotiated rulemaking process to develop national administrative and coverage policies for clinical diagnostic laboratory tests under Medicare Part B. The BBA stipulates that the p....

HL7 Overview

Author: Quinn, John

Source: Journal of AHIMA

Publication Date: July 1999


As one of the co-developers of Health Level Seven (HL7), I am very close to the issue. So in describing it, I'm going to start with the basics, beginning with the current definition that has evolved over HL7's brief existence:

"The Health Level Seven (HL7) Standard, an ANSI approved....

Tools for Defining Data

Author: Shakir, Abdul-Malik

Source: Journal of AHIMA

Publication Date: September 1999


Similarly, data dictionaries, data sets, and data models have much in common, but many significant differences. Each can be used to define data, especially data that needs to get from point A to point B. This article describes each of these tools and the value they add to health information ma....

Eye on Genetics

Author:

Source: Journal of AHIMA

Publication Date: September 1999


Secretary of HHS Donna Shalala appointed the chair and members of the Secretary's Advisory Committee on Genetic Testing. The committee will "help the department formulate policies on the development, validation, and regulation of genetic tests, particularly DNA-based diagnostics,&quo....

Name Game: Updating Our Credential Titles

Author: Dixon-Lee, Claire

Source: Journal of AHIMA

Publication Date: September 1999


In October, the 1999 AHIMA House of Delegates will consider a proposal to officially change the name of two AHIMA credentials. The proposal is the result of several years of analysis, member input, and review of more than 1000 potential certification titles, as well as the work of cons....

Using Electronic Resources to Recruit and Hire Employees

Author: Picard, Angela

Source: Journal of AHIMA

Publication Date: September 1999


Hiring the right employees for HIM jobs presents a unique challenge for employers. However, electronic resources offer more options for an employer's searching and recruiting efforts. With these tools, employers can go beyond the traditional methods of print advertising and/or retaining the se....

Compliance Efforts Get Some PEPP

Author: Bryant, Gloryanne H.

Source: Journal of AHIMA

Publication Date: September 1999


Earlier this year, the Office of the Inspector General (OIG) informed the Health Care Financing Administration (HCFA) that "the DRG system is vulnerable to abuse by providers who wish to increase reimbursement inappropriately through upcoding, particularly so within certain DRGs.&....

Getting Ready for APCs

Author: Scichilone, Rita A

Source: Journal of AHIMA

Publication Date: September 1999


While most healthcare practitioners support accurate coding, the challenge remains for HIM professionals: how to achieve coding accuracy in a system of imperfect data capture methods and changing reimbursement methodologies. Greater emphasis on coding specificity and completeness for reimburs....

PPS + New Technology = Growing Pains

Author: Blumenthal, Jane E

Source: Journal of AHIMA

Publication Date: September 1999


It's been a little more than a year since the prospective payment system (PPS) came into play in skilled nursing facilities. The post-acute PPS, initiated by the federal government under the 1997 Balanced Budget Act, was set in place to reduce the federal government's healthcare expend....

Intranets -- From EMR to ER and Beyond

Author:

Source: Journal of AHIMA

Publication Date: September 1999


In the article, "Next Generation: How Internet Technology Propels the Electronic Medical Record" (Journal of AHIMA, September 1999), we spotlighted a few of the many facilities using Web technology for the EMR. A complete list of facilities with similar systems is probably beyond the scope of t....

Position Yourself to be a Player

Author: Eichenwald, Shirley

Source: Journal of AHIMA

Publication Date: October 1999


As a result of the rapidly changing healthcare information systems environment, a variety of career opportunities are emerging for HIM professionals. This is a sure sign that the transformation of the HIM profession, envisioned for more than a decade, is actually happening. To take ful....

Corrections Connection

Author: Zender, Anne

Source: Journal of AHIMA

Publication Date: October 1999


During his work day, Mark Barnard, ART, performs functions similar to HIM professionals in other settings: processes medical records, enters data, and responds to requests for information. But for Barnard, there also is an important difference. Namely, the people whose health informati....

Risk Management 101

Author: Collins, Patricia

Source: Journal of AHIMA

Publication Date: October 1999


The decision to implement a computer-based patient record (CPR) system is a substantial commitment of time and resources. Making it a reality in your organization requires a number of steps, not the least of which is risk assessment. Assessing the risks associated with the CPR should ....

By the Rules: Making Security Policies Stick

Author: Zender, Anne

Source: Journal of AHIMA

Publication Date: October 1999


Considerable attention has been paid to the development of organizationwide information security policies—especially what they should contain and how they should be put in place. But enforcing these policies isn't always easy. We asked four information security experts to give us....

Promoting Excellence with HI&T Week

Author: Keough, Tim

Source: Journal of AHIMA

Publication Date: October 1999


The fields of health information management and information technology are more exciting and challenging than ever. With our knowledge of information, policies, and procedure—and their patient care implications—HIM professionals play a vital role in facing the challenges of t....

Fresh Look at HEDIS

Author: Carpenter, Jennifer E.

Source: Journal of AHIMA

Publication Date: October 1999


The National Committee for Quality Assurance (NCQA) created the Health Plan Employer Data and Information Set (HEDIS) as a standardized performance measurement system. It measures the quality of healthcare received through managed care plans. The measurement system lets healthcare cons....

Unique Patient Identifiers -- What Are the Options?

Author: Appavu, Soloman I.

Source: Journal of AHIMA

Publication Date: October 1999


HIPAA has brought patient identifiers into the spotlight. But what's the best option? The author of a national study offers an overview.
Envision all of the players in the healthcare system—patients, providers, health plans, and payers. Now, envision all of the day-to-day processes t....

Compliance: Offense Is the Best Defense

Author: Nika Lee, Sister M.

Source: Journal of AHIMA

Publication Date: October 1999


Growing up in southern Indiana—the heart of basketball country—one of the earliest things I learned was that the best defense is a good offense. That piece of wisdom applies to many situations, including the defensive environment of healthcare today, as our government takes initiativ....

Retaining Your Employees-- A New Perspective

Author: Fox, Leslie Ann

Source: Journal of AHIMA

Publication Date: October 1999


Opportunities abound for HIM professionals—but how can you, as a manager, create a work environment in which employees will want to stay? This process begins with managing yourself. Here's a new way to think about employee retention.
Unemployment is at a 30-year low. The....

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