We live in the digital age, a time of unprecedented information generation and information consumption. Consumers have grown facile in their navigation of the information industry landscape, and have developed expectations of ready access to the data they need to make better, more satisfying decisions for themselves as to where their time and money is most rewardingly spent.
Health decisions are no exception to this new paradigm. Just like the ratings, the cost, and the availability data people use to consider what shoes to buy or restaurants to patronize, more and more patients are seeking a similar level of information to guide their decisions for where and with whom to pursue their care. This is not to equate the more superficial decisions we all make with little consequence to the decisions we make when considering where to receive safe and clinically sound healthcare.
Finding a care team with the clinical expertise to navigate a person safely through their new cancer diagnosis is clearly a vastly different premise than deciding on a pair of boots to buy. That said, it would be naive to think that patients don’t behave like consumers when they can, or that the information they want to make those care decisions remains optional in the competitive market of attracting and retaining patients.
Indeed, studies of consumer behavior bear that out. Consumers want to make informed decisions, and more than half will go online to research providers before selecting one, typically starting with a general internet search. This desire for due diligence with additional research is true even when they have a specific provider recommendation in hand.
To meet patient expectations in the successful selection and scheduling of a provider, we need to acknowledge the importance of being able to readily access the desired information – information that makes it easier for patients to determine if a provider aligns with their clinical needs, logistical requirements, and personal preferences. Savvy health systems embrace the need to surface this provider data, and in so doing, attract and retain a broad customer base.
Certainly locations, cost, languages, gender, publications and education are among the other types of data that influence a patient’s selection of a provider. And this is to say nothing of how a picture of the provider, their professional statement, or their reputation as captured in online ratings and reviews can further assist in the conversion of a consumer’s interest into a booked appointment.
With so many different factors influencing a patient’s decision, the numerous online sources of that data, and the varied accuracy of the data that is available, satisfying customer demand for data can seem daunting to say the least. But health systems need to take action to consolidate, curate, and make this information available to attract and keep customers effectively.
Have you reviewed the changes to the Circulatory System section in the ICD-10-CM 2019 Official Guidelines for coding and reporting? To support medical necessity and payment for your cardiology CPT codes and cardiology HCPCS codes, your ICD-10-CM coding needs to be spot-on. And that doesn’t mean just checking the ICD-10-CM index in your manual or cardiology coding tool. You’ve got to have the Official Guidelines down cold, or at least know where to find them when you need them. As you use the ICD-10-CM code set for 2019 cardiology coding, make sure you’re aware of these revisions to the Official Guidelines (OGs) so your coding complies with the rules.
Check for 2 Changes When Coding Hypertension with Heart Disease
In 2018, section I.C.9.a.1 of the OGs (Hypertension with Heart Disease) stated that “Hypertension with heart conditions classified to I50.- or I51.4-I51.9, are assigned to a code from category I11, Hypertensive heart disease.”
Watch out: In the 2019 OGs, the code listing changes to “I50.- or I51.4-I51.7, I51.89, I51.9.” You’ll continue to use additional code(s) from category I50.- (Heart failure), to identify the heart failure type, when applicable. What’s different? The change removes I51.81 (Takotsubo syndrome) from the guideline.
Clarity on when to code separately: The Hypertension with Heart Disease subsection gets an additional clarification for the instruction about when to code those heart conditions separately from the hypertension. The 2018 wording was “if the provider has specifically documented a different cause.” The 2019 wording is “if the provider has documented they are unrelated to the hypertension.”
See a Similar Documentation Clarification for Hypertensive CKD
The Hypertensive Chronic Kidney Disease subsection sees an update like the one above for separate coding of hypertension and heart disease. Here’s the exact wording in section I.C.9.a.2:
2018: “CKD should not be coded as hypertensive if the physician has specifically documented a different cause.”
2019: “CKD should not be coded as hypertensive if the provider indicates the CKD is not related to the hypertension.”
Know Proper Sequencing for Pulmonary Hypertension
The 2018 OGs had incorporated changes for Pulmonary Hypertension (I27.-) in section I.C.9.a.11. A clarification in 2019 assists by better defining sequencing rules.
The 2018 OGs said that for secondary pulmonary hypertension, you should “code also” associated conditions or adverse effects of drugs or toxins and base the sequencing on the reason for the encounter.
The 2019 OGs revise the instruction to base sequencing on the reason for the encounter “except for adverse effects of drugs (section I.C.19.e).” The section referenced covers coding for Adverse Effects, Poisoning, Underdosing, and Toxic Effects.
Steer Clear of Subsequent AMI Coding Mistakes
Codes and OGs for myocardial infarction got a facelift in 2018, and the 2019 OGs continue to add clarification about how to code properly.
The new instruction added to section I.C.9.e.4 states, “If a subsequent myocardial infarction of one type occurs within 4 weeks of a myocardial infarction of a different type, assign the appropriate codes from category I21 [Acute myocardial infarction] to identify each type. Do not assign a code from I22 [Subsequent ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction].”
The new instruction goes on to state, “Codes from category I22 should only be assigned if both the initial and subsequent myocardial infarctions are type 1 or unspecified.”
By Pauline Farris, who speaks Portuguese, English, Spanish and Italian. She is a voting member of the American Translators Association and an active participant of the Leadership Council of its Portuguese Language Division.
Pauline Ferris
Technological advancements always happen so our lives can become a lot easier. We have incorporated technology into every aspect of our lives, from housework to teaching and now even in the health sector. Artificial intelligence has had a great effect on how healthcare works and has helped us take great steps towards making it more efficient and approachable.
Not only does it offer a way to save a lot of time when it comes to treating patients but in general it can help make everyday tasks a lot easier for medical practitioners. There are so many different ways to incorporate AI technology in health and here are some of the reasons why it is so important and useful.
Eliminate waiting time by virtual nursing assistants
One of the biggest complaints in most hospitals and clinics is the fact that patients have to wait so long in order to get checked by a doctor. In the UK, college hospitals in London are starting to introduce AI technologies which will help with taking notes of the patients’ symptoms and prioritizing them based on the severity of their conditions.
A great technology that can truly cut down the wait time for all the patients and make the doctor’s job a lot easier is a new tool called scribes. This great tool works similarly to other tools we already have inside our homes, for example Alexa. If you have ever paid a visit to the doctor, you probably have notices how much time it takes for the doctor to write down all your information and create a record.
This tool simply listens in to your conversation and records everything that is being discussed. At the end of the appointment, the doctor can make it automatically create a record of what has been mentioned in the visit. This can help save a lot of time for both the patient and the doctor.
Another problem is that people who want to book an appointment have to wait a big amount of time in order to actually meet with the doctor. Artificial intelligence can provide the patients with a way to get a better understanding of their condition as well as write down and understand their symptoms and help them cope with their health issue until they can visit the right practitioner.
Making patents’ diagnosis a lot easier
The good thing about AI technologies is that they can store and recall a very large amount of data without any effort. Most doctors work for an extreme amount of hours every week and while they are always prepared to handle any case, some external help could really help them with diagnosing a patient.
The main focus of AI technology in these situations is to provide hospitals with tools which will help make consultations a lot quicker and diagnoses more accurate. These tools will remind the doctors to ask additional questions depending on the patient’s symptoms, order additional tests and even suggest fitted treatment plans which can decrease the healing time and make treatment a lot easier for both the patient and the doctor.
By Brooke Faulkner, freelance writer, @faulknercreek.
The proliferation of wearable mobile-connected devices has done a lot of good for people trying to lead healthier lives. People are able to gather data about their sleep to help them get better rest, track insomnia, stress, and exercise, and keep up to date on their own daily routines and health.
Many of the devices exist not just as trackers but as ways for people to motivate themselves to exercise more, go to bed at more regular times, and other little things that slip by in the daily grind.
Specialists can access information far more quickly and easily to help us with medical problems. With the way technology is advancing, you can now even also use online apps to calculate sleeping patterns and wake up times.
Healthcare Data in the Modern Age
Sleep is absolutely related to health. Many health issues affect our sleep or are caused by issues with sleeping. A number of medical professionals are interested in how, when, and for how long we sleep. These days, that information is stored in digital medical records, which have a number of advantages. Specialists can access information far more quickly and easily to help us with medical problems.
There are, however, disadvantages to medical records being easily accessible and easily updatable. Privacy and security have become major concerns for healthcare providers, as the records contain our most sensitive information, which proves highly valuable to hackers.
Official medical records, however, are just the tip of the iceberg. We use the internet not only as a go-to for advice about medical conditions, but as a method to voluntarily record all sorts of data about us. Recording, storing, and tracking sleep data on our personal devices gives us a lot of power to “do it yourself” when it comes to preventative health and tracking changes in our sleep patterns. This ease of use, however, comes with a cost. It’s not all about sinister hackers, either; that data can be used in all sorts of ways that are, while not outright damaging, at least partially invasive.
Wearables, Bluetooth and Data
Tech companies are working on more advanced ways to use high-tech devices to track our sleep. These include wearables and even devices that don’t need to be attached to the body. The amount of information gathered, and its accuracy, varies greatly by device. The Bluetooth connectivity and the ability to store, track, and share the data the devices collect are parts of their appeal.
The number and type of people who benefit from this information is vast. Sleep disorders are a common side effect of other medical disorders, and managing sleep is an important part of living a healthy lifestyle, especially for people who are at greater risk for certain conditions.
You don’t need to have or be at risk for medical complications to make use of sleep data, however. There are plenty of careers in the U.S. which require people to work long or unconventional hours. Night shifts and long shifts, such as those worked by nurses, can cause havoc with the circadian rhythms that regulate our sleep. This can create complications for otherwise completely healthy people. Being able to self-regulate with the help of wearable devices is a great advantage.
By Georgia Mitsi, PhD, MBA, senior director and head of digital healthcare initiatives, Sunovion Pharmaceuticals Inc.
Georgia Mitsi
Innovation is not a choice but rather a growth mindset, which creates an environment for building a sustainable business. This mindset allows for objectivity and contributions towards a bigger shared purpose. Innovation is about challenging the status quo with processes that do not work and trying new ways. Innovation is driven by positivity and optimism. Innovation offers options and it should be pursued relentlessly because it provides new opportunities for employees to grow and become even more engaged and productive.
Ultimately, innovation can help to ensure a company’s future. But, harnessing innovation does not need to be daunting, and can be done in small steps.
Many types of companies within the healthcare ecosystem have been leveraging technology to harness innovation, and the pharmaceutical industry in particular is exploring new ways to do so, which is changing the established business model. Technology offers opportunities to redefine the future of the pharmaceutical industry and to contribute towards innovation. Technology though is not a panacea and while it is still rapidly evolving, the focus should be on the “how” and not necessarily the “what” of technology. With regard to digital health care, there are three “hows” that should be considered:
Prevention: How can we protect people from getting sick?
Diagnosis: How can we improve people’s healthcare experience?
Monitoring: How can we better support people and their families during the most challenging periods of their lives?
The new category of digital therapeutics has the potential for creating easy-to-use solutions for all three areas—prevention, diagnosis and monitoring.
It is important to think for a moment how life has changed to understand how the pharmaceutical business can take advantage of the changing dynamics.
Let’s imagine Jenny. Jenny has a place that she calls home; a place that feels secure, relaxed and happy. She has a family, pets and friends. She shops to cover her basic needs and creates opportunities for entertainment. When she gets sick, she goes to the doctor, to the pharmacy and from time to time she may end up at a hospital for additional tests. But Jenny has also a demanding job and a long commute. Her life is busy and time is the most precious commodity. Technology has provided Jenny with the opportunity to make her life more convenient because a lot of her basic needs can be met online. She can easily order groceries, buy clothes, connect with her family and friends, make restaurant reservations, plan her next vacation, work online, read books, complete financial transactions and even receive medical services and medications. Therefore, technology contributes to Jenny’s well-being by making her life more convenient.
Payers don’t accept deleted CPT codes, so your claims can’t succeed if your medical procedure codes are out of date. But do you know how often you need to update your CPT code set? It may be more often than you think. Here are some pointers to keep in mind to give your claims their best chance at accurate payment.
Make the Biggest Transition with January Updates
Each year, a new CPT code set is effective on January 1. For instance, for CPT codes, 2018 codes will give way to the 2019 code set on Jan. 1, 2019.
If you use an online CPT code search product, you’ll want to be sure that the updates are searchable January 1. It’s also helpful if the CPT lookup includes deleted codes (marked with the deletion date) because you use the code set based on the date of service. You may need access to previous code sets to finish filing claims and for working on appeals.
Reminder: You need to update your CPT modifiers list, as well as your procedure code lookup resource each January.
Plan for These Other Regular CPT Code Set Releases, Too
The AMA, which owns and maintains the CPT code set, implements certain types of codes more than once a year. You should be aware of these updates and have a strategy for ensuring you have them when you need them. All specialties may see CPT updates throughout the year, but path/lab coders need to watch for a few special categories that apply to them.
Category III and vaccine codes: Category I vaccine codes and Category III codes (temporary codes for emerging technology and services) are implemented January 1 and July 1. You’ll typically find them posted on the AMA site six months before the codes are effective, giving you time to learn how to apply them.
Category II: Category II codes are tracking codes that you may use for performance measurement programs, like MIPS. The AMA site indicates you may see release March 15, July 15 and November 15, with implementation three months after release.
Molecular pathology tier 2 codes: To help with reporting MoPath procedures, these codes go from approved to effective quickly. After approval by the CPT Editorial Panel, codes are released to the AMA site March 1, September 1, and December 1. The effective date may be as soon as one month after the release.
Administrative MAAA codes: Similar to the MoPath codes, Multianalyte Assays with Algorithmic Analyses (MAAA) see a quickened schedule. After Panel approval, the codes are released to the AMA site March 1, September 1, and December 1. The effective date is typically one month after release, although some codes are held until the major January 1 update.
The American Medical Association (AMA) has created a new resource to help physicians extend care beyond the exam room with technologies that are “changing the way patients interact with healthcare.” The Digital Health Implementation Playbook offers a guide to the most efficient path for applying digital health solutions including key steps, best practices, and resources to accelerate and achieve digital health adoption. The AMA made this announcement in conjunction with the Digital Health Collaborative and Connected Health Conference.
Physicians are optimistic about the potential of digital health innovation to benefit medicine and expect to use more digital health tools in the near future, however, complex factors inhibit adoption. During an AMA-convened summit this year, innovators, researchers, physicians and decision makers warned that adoption and implementation of digital health solutions can be difficult and time-consuming.
“Implementing digital health technology has been a challenge for those without a clear course to success,” said AMA chair-elect Jesse M. Ehrenfeld, M.D., M.P.H. “The AMA is committed to making technology an asset, not a burden, and the Playbook provides the medical community with widespread access to a proven path for implementing digitally enabled health and care. The Playbook’s road map is based on institutional knowledge and best practices convened by the AMA from a wide array of experts in the field.”
The Playbook is designed for care teams and administrators in medical practices of all sizes and areas of specialty. The Playbook is a living document that will be updated to include new content over time. As the Playbook evolves, it will provide a helpful 12-steps process to guide the implementation of a variety of digital health solutions. The first six stepsare fundamental to the implementation of any digital health solution. The subsequent six steps focus on specific digital health solutions and the unique considerations relevant to that specific technology.
Currently, the Playbook provides resources for the implementation of remote patient monitoring (RPM) using devices, trackers and sensors to capture and record patient generated health data outside of the traditional clinical environment. RPM provides clinicians the opportunity to apply patient generated health data to improve the management of chronic disease and engage patients in their own care.
As more connected devices and wearables are validated as accurate, reliable and effective health care tools, the medical community is increasingly looking to integrate digital health and mobile health technology into medical practices to better understand and manage chronic diseases outside of the practice environment as health care shifts toward value-based reimbursements.
The current decade has seen the boom of wearable tech. Today, we have embraced this tech and are using it in daily routine. Apart from being a fashion statement and geeky, these devices serve a noble purpose. They watch out for you. Yes, they keep an eye on your health and help to save you against several issues. In the following, I will explain that in detail.
Wearable tech comes in several forms including:
Wristbands
Watches
Shoes
Headbands
Eyeglasses
Necklaces
Belts
Caps
Shirts
Most of these products contain sensor collect raw data. They feed this data to a database for analysis. The analysis triggers a response. The response can be an alert to a physician to contact the patient suffering from abnormal symptoms. These can help the doctor communicate with the patient and give them advice.
People who spend their time juggling between tasks more likely ignore their health. This negligence makes the test consume more time and delays reports. Therefore, wearing something that remains in contact with human skin to continuously and carefully monitor someone’s activity and fitness in real time can have its benefits. In short, wearable tech offers timely awareness on various health issues to both the patient and doctor.
With that said, following are four ways that help healthcare services improve their approach:
Real-time health monitoring
The rapid growth in tech has improved remote health monitoring. The real-time health monitoring devices are playing an important role and the products are developed to consider cost, usability, accuracy and security of data.
The technology also facilitates two-way communication between the doctor and patient, offering up-to-date healthcare information. The RMS system comes with two interfaces, one geared toward the user, and the second one designed for the doctor. The patient interface contains wearable sensors to extract medical data of the patient.
The listening port transfers information to a web server that accesses the data for doctor’s interface. For instance, a remote monitoring device with diagnostic framework finds an underlying health issue in real time. It can help avoid a potential health issue and let the patient recover. This system is compatible with several wearable sensors to extra the data and helps to learn different parameters including:
Heart rate
Blood pressure
Body temperate
These parameters help to detect severe issues beforehand.
Fitness
Healthcare centers like Beach Pain Center encourage the adoption of modern tech in a fitness routine. Wearable tech helps people with their fitness resolution, improving their chances of success. Fitness wearable helps to monitor or even tracking fitness metrics as the distance walked on run calorie consumption and even quality of sleep. These trackers sync to a computer for real-time tracking for health-related data.
These trackers are geared towards fitness maniacs or people trying to achieve a healthier outlook, like practicing chiropractic. It guides the user towards success.
The proliferation of wearable mobile-connected devices has done a lot of good for people trying to lead healthier lives. People are able to gather data about their sleep to help them get better rest, track insomnia, stress, and exercise, and keep up to date on their own daily routines and health.