“HIT Policy Update With John Halamka , MD” A Complimentary Webinar From healthsystemCIO.com Sponsored by Hyland Software, developers of OnBase Your Line Will Be Silent Until Our Event Begins Thank You! Slide Deck: http://goo.gl/iMXpqO Webex Support 1-866-223-3239 Event # 661 748 825
Housekeeping • Moderator – Anthony Guerra, editor-in-chief, healthsystemCIO.com • Ask A Question • We will be holding a Q&A session after the formal presentations. • You may submit your questions at any time by clicking on the QA panel located in the lower right corner of your screen, type in your questions in the text field and hit send. Please keep the send to default as “All Panelists.” • Download the Deck • Go to: http://healthsystemcio.com/presentation/policyupdate-2013q4-webinar.pdf • Shortened link below appears on all slides. • View the Archive • You will receive an email when our archive recording is ready. • Separate registration is required. Slide Deck: http://goo.gl/iMXpqO Webex Support 1-866-223-3239 Event # 661 748 825
Agenda — 45 Minutes • 20 minutes: John Halamka, MD, CIO, Beth Israel Deaconess Medical Center • 5 minutes: A Word From Our Sponsor: Julie McDonald, Business Analyst, Hyland Software • 20 minutes: Q&A w/John Halamka Slide Deck: http://goo.gl/iMXpqO Webex Support 1-866-223-3239 Event # 661 748 825
“HIT Policy Update With John Halamka, MD” Slide Deck: http://goo.gl/iMXpqO Webex Support 1-866-223-3239 Event # 661 748 825
The Regulatory Agenda • HIPAA Omnibus Rule • Affordable Care Act • ICD10 • Meaningful Use Stage 2 Slide Deck: http://goo.gl/iMXpqO Webex Support 1-866-223-3239 5 Event # 661 748 825
Slide Deck: http://goo.gl/iMXpqO Webex Support 1-866-223-3239 Event # 661 748 825
The HIPAA Omnibus Rule Timeline • February 17, 2009 - The American Recovery and Reinvestment Act of 2009 (ARRA) was signed into law. ARRA includes the Health Information Technology for Economic and Clinical Health (HITECH) Act, which mandates the US Department of Health and Human Services to develop new regulations related to the HIPAA provisions. • September 23, 2010 - The Interim Final Rule goes into effect requiring Covered Entities to notify patients when a breach of their unsecured, protected health information occurs. • January 1, 2012 - Deadline to begin using the ASC X12 Version 5010 Transaction Standards October 1, 2013 - Transition to ICD-10 code sets for medical diagnosis and inpatient procedures. • January 17, 2013, the U.S. Department of Health and Human Services (HHS) releases the Omnibus Final Rule, implementing the changes required by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009. • March 26, 2013 – The Omnibus Final Rule takes effect. • September 23, 2013 – Covered Entities, Business Associates, and subcontractors must be in compliance with most provisions under the Final Rule. Slide Deck: http://goo.gl/iMXpqO Webex Support 1-866-223-3239 Event # 661 748 825
HIPAA Omnibus Rule Issues • Accounting of Disclosures • Pay out of pocket information release restrictions • Enforcement Slide Deck: http://goo.gl/iMXpqO Webex Support 1-866-223-3239 8 Event # 661 748 825
Enterprise Security Planning Slide Deck: http://goo.gl/iMXpqO Webex Support 1-866-223-3239 Event # 661 748 825
Affordable Care Act • The Affordable Care Act will realign incentives with pay for quality instead of pay for quantity. • Redundant and unnecessary testing will become a cost not a profit center. • Tracking patient care across the care continuum will be a key element of risk management. • Health Information Exchange will be essential to meeting these demands. Slide Deck: http://goo.gl/iMXpqO Webex Support 1-866-223-3239 10 Event # 661 748 825
ICD-10 • Delays unlikely • Testing is a concern • The value of ICD-10 is markedly increased with clinical documentation improvement and computer assisted coding methodologies Slide Deck: http://goo.gl/iMXpqO Webex Support 1-866-223-3239 11 Event # 661 748 825
ICD-10 Project Risks Category Risk Description Risk Impact Prob Impact Action Plan High High Edu/CDI Lack of engagement in ICD- Physicians under-educated & Mandatory physician training, Ongoing 10 remediation effort from unprepared for ICD-10; impacts rev training may need to occur for high impact physicians cycle through claim delays and areas. denials, and audits. High High Edu/CDI Loss of Coders/Validators Backlog of claims (DNFB) will Contracting with multiple coding firms; increase implementation of career ladder High High Finance AR and DNFB not minimized Predicted increase in AR will Collaboration between PFS and HIM to going into ICD-10 materially affect cash position of identify how coding productivity can be organization; DNFB impact will increased, and identify gaps and delays in increase number of bills not receivables submitted within allowed window Med High Finance Payers, Partners and Delays processing of claims; delays Participate in MHDC collaborative testing Trading Partners are not payments; may exceed filing program; Identify ICD-10 requirements ready for ICD-10 at date of deadlines; affects cash position between vendor/BIDMC charge systems compliance and individual billing vendors; work with vendors to remediate potential issues Med High Tech Other priorities prevent Delays testing, increases risk at go- Document amount of effort spent on other remediation of key systems live priorities Med High Work-flow Resistance to transition of Continued use of paper fee tickets Roll-out outpatient billing system prior to outpatient billing from paper that cannot adequately support ICD-10 compliance date so that physicians fee tickets to on-line system broader range of ICD-10 diag codes; can become familiarized before impacts productivity, increased risk transitioning to new code set of claim audits Slide Deck: http://goo.gl/iMXpqO Webex Support 1-866-223-3239 12 Event # 661 748 825
Meaningful Use Changes • Stage 2 is now a three year cycle beginning in 2014 • Stage 3 begins in 2017 • The certification program moves from a waterfall approach to an agile approach. • No changes to 2014 • No delays for hospitals or professionals Slide Deck: http://goo.gl/iMXpqO Webex Support 1-866-223-3239 13 Event # 661 748 825
Original Timeline (note 2016) Slide Deck: http://goo.gl/iMXpqO Webex Support 1-866-223-3239 14 Event # 661 748 825
Planning for the Future Topic Description and Topic Status Result Notes Standards to support image Assigned to the Clinical Operations Image Exchange High exchange WG Additional standards to support transport of data to and from Data Transport TASK COMPLETED High patients Standards which support flexible Quality reporting and platforms for measuring and High measurement reporting quality Standards to support closed loop Referral Workflow High referral workf1ow Record Locator Services Standards which support Record High Locator Services Standards to record care plans/care Slide Deck: http://goo.gl/iMXpqO Care Plans High team Webex Support 1-866-223-3239 Event # 661 748 825
Planning for the Future Topic Topic Description and Notes Status Result Content Gaps (Lab Orders) Clinical Operations WG reported out Lab Orders Medium during June HITSC Standards Supporting Digital CMS presented to HITSC on July Digital Signature Medium Signature 17; Content Gaps (Terminology) Terminology Medium Improvements to standard to facilitate unambiguous parsing, Parsing and record sharing Medium longitudinal record sharing, and bulk record sharing Standards to record advanced Advanced Directives Medium directives/care preferences Standards for application APIs programming interfaces supporting Medium modular application integration Standards for clinical decision support, both knowledge representation and application CDS Medium programming interfaces (APIs) for query/response to knowledge Slide Deck: http://goo.gl/iMXpqO resources Webex Support 1-866-223-3239 Event # 661 748 825
Planning for the Future Topic Description and Topic Status Result Notes Standards which support defect Defect Reporting Medium reporting to PSOs Standards needed for registry support including structured data Registry Support / SDC Medium capture and transmission to third party repositories Standards which support Query/Response of PDs query/response of provider and Medium patient identity in directories and Patient Identity Slide Deck: http://goo.gl/iMXpqO Webex Support 1-866-223-3239 Event # 661 748 825
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