Susan Lucci - Healthcare Documentation Discussion

Smart Moves for Smarter EHRs

2011-12-09T09:54:00.001-07:00

In a couple of recent articles that are not connected, there is an underlying connection. One, in "For the Record" discusses The Hazards of Note Bloat and the unintended consequences of having a lot of information that doesn't truly say much about the complexity of the patient's condition, not to mention that it is "difficult to view, notes lengthen and errors accumulate." But wait, aren't EHRs supposed to reduce errors? The article goes on to explain how narrative (dictation/transcription) notes have been reduced, but not completely eliminated. It also discusses speech recognition and its implementation this month.

The next article talks about the value of outsourcing as a cost-savings process to reduce costs and how this is happening in a big way in Canada. This model has been shown again and again to be cost effective and many hospitals across the US have already embraced this practice to help reduce costs.

In yet another article, 3 major healthcare groups were identified as having caught the financial flu and are not doing particularly well at this time.

In reviewing the 3 unrelated articles, it became apparent that there may be a myopic view of how to balance reducing costs with optimal EHR utilization. Consider this. EHRs are here to stay. We need them and the value they bring to healthcare overall. What we don't need is documentation that doesn't improve the quality of the patient encounter. We need streamlined, content-rich, not bloated notes that drone on endlessly with what the previous note stated. We need to optimally enable physicians so they have the time to see a growing patient population, not spend endless hours doing their own data entry. We also must get the level of detailed specificity now that will be needed as the ICD-10 date edges ever closer. Healthcare organizations must be fiscally healthy enough to provide care and continue to be viable as baby boomers get to Medicare age. So yes, they do absolutely need to cut costs in the right places but keep those that enhance their revenue capabilities.

Here's the conundrum in summary. If healthcare organizations and hospitals focus only on reducing costs at the expense of eliminating medical transcription/editing, they are using a tunnel vision approach that will reduce costs but will simultaneously fail to optimize reimbursement. Complete, detailed documention renders optimal coding, which leads to appropriate and optimal reimbursement. If this process becomes muddy through "note bloat" or abbreviated input from extremely busy clinicians, the revenue cycle process may breakdown and the endless cycle of trying to reduce costs and not optimize documentation will continue.

Stop the broken cycle of cost-cutting measures as the only option. It's time to see the bigger opportunity and realize the value gained in the outsourced model of quality dictation/transcription and speech editing process to capture all the details needed for ICD-10 today. This can get healthcare organizations over the financial flu and on the road to recovery. By adopting a practice of excellent documentation practices, these 3 unrelated items can become related in a way for long-term success with the EHR and improve patient outcomes as one of the most important goals.

MedScribe HIM: The Future Begins Here!

2011-08-22T14:33:00.000-06:00

During this evolving landscape we see in health care documentation, there have been so many changes recently that it is difficult to keep up. One thing that is sure, this trend is not going to slow down. EHR technology and other enabling technologies are here and there are new processes for documentation emerging rapidly. At the AHDI ACE convention, I watched Joe Weber's presentation on Valadoc that was innovative and new!

With all this happening, a wonderful opportunity presented itself for me to join a HIM organization that has been around since 1961. That's right - they aren't new, and they have some fantastic new ideas on how to take their organization forward. Because their vision and direction was so compelling, effective today, I have joined the MedScribe team!

The MedScribe HIM organization will provide a suite of solutions for HIM and this will surely be a company to watch. I am so excited to begin this new adventure and together with Privacy Officer Services organization, you could say that will keep me very busy. Keep in mind that saying, "If you want something done, ask the busiest woman you know!" I'll be busy but I will be doing what I love in an organization destined for great things!

Privacy Officer Services

2011-04-27T09:27:00.007-06:00

A new day and a new adventure begins. In working with MTSOs for a number of years, and with the requirements of HITECH making the headlines, I have decided to start something new and provide a number of services and solutions for MTSOs in efficiently achieving compliance in the area of privacy and security. Privacy Officer Services officially begins today.

This new business is designed to support MTSOs in the development of their customized policies and procedures for privacy and security, to assist with completing their required security assessment and a number of other services like employee training, education, monthly updates, quarterly updates for the business website, and weekly updates in news in and around privacy and security as well as technical developments. There are many more and there is a solution for every MTSO.

My goal is to help these business associates achieve the HITECH requirements in a cost-effective manner so that their current staff can continue on with the business at hand in continuing to deliver on-time patient reports, deliver on the quality promised and provide the customer experience their clients expect.

By outsourcing their privacy officer reponsibilities to me, they will gain efficiencies in a number of ways like having a knowledgeable resource available every day without having to add to their employee count. Having someone who can attend meetings, and present to potential and existing clients on their privacy solutions can be a huge advantage in the world where we see and hear about security breaches nearly every day.

It's a new world filled with legal requirements and challenges for MTSOs - this is a way to check a very important responsibility off the "must-do" list and put this into the hands of someone they know and can trust to provide the right solution today.

Medical Transcription - The Gold Mine

2011-04-05T09:33:00.005-06:00

While EHRs are going in rapidly across the country, it's important to remember that the demand for value in reducing costs, improving patient safety and providing access to more Americans still leads the charge when it comes to why we move to electronic systems in health care. One of the best ways to enhance the value in EHR systems data mining and research is to keep a robust, detailed record of each individual patient who has a unique history unlike any other. Medical transcription/editing captures details provided by clinicians that are crisp and precise filled with data and information that can get us to the goal of improved patient outcomes through the application of secondary healthcare data. There are a number of reporting agencies that are making results available to anyone who is interested in taking a look. Organizations like the Leapfrog Group, Health Grades, Bridges to Excellence along with a score of others, provide information on various diseases and outcomes. Some secondary data use reporting is required such as core measures reporting. And when I say required, I mean that there is a 2% penalty in market-basket outcomes if you choose not to report. It is probably reasonable to anticipate that the number of hospitals reporting outcomes and the agencies to which they report will also increase. This is why it is a key fundamental and logical approach that the use of dictation and medical transcription or medical editing with speech recognition tools will be the best way to capture these necessary details and be able to produce content-rich results when reporting outcomes to continuously improve care. Nine of 10 Healthcare executives agree in a survey conducted by Pricewaterhouse Coopers (PWC) that secondary use of health information will significantly improve the quality of care and that those benefits will improve in the future. A clear two/thirds anticipate a huge increase within the coming two years. (1) Consider the AMIA findings of the gains that can be made from the expansion of knowledge about diseases, treatments and make strides in public health along with advances in privacy and security. (2) There is much to be gained as we move into this era of using secondary data to advance healthcare and this can best be achieved if we continue to capture the details provided by clinicians through the dictation and interpretation process. The outcomes, however, will only be as good as the content from which the information comes - that's why dictated/transcribed reports are a gold mine of information. To in any way short-cut details will severely limit the wide-range of benefits.

Medical Transcription - In Home Offices

2011-01-07T16:06:00.005-07:00

Just for fun!!!! Who needs a break from the news? I know I do. Some of the headlines are just way too depressing and all the talk about repealing health care reform just makes me tired. So here's a little diversion that I hope will bring you a smile. These lyrics should be sung to the melody, Friends in Low Places - so get your Garth on folks and sing along!

Friends In Home Office Places

I stay home and work, not because of the perks
It's the job that I chose from the start
The money's not great, barely puts food on the plate
But in healthcare I'm doing my part

You think that it's grand, what I do with my hands
But it comes with superior skills
I know I belong, you can tell from this song
While I keep trying to juggle my bills

Cause I've got friends in home office places
Where the internet sings and they keyboard races
To the goal of the day, and I'll be okay
Oh I'm not hooked on financial status
Think I'll slip on down to my Facebook pages
Oh I've got friends in home office places

Things happen so fast, my IM's a blast
And now I have new SRT
Before you can say, social media's the way
I've got to Tweet my trip to DC!

Today's EHR
Is demanding so far
To keep up with Obamacare
Docs need us today, to help them relay
That important O2 sat on room air

I've got friends in home office places
Where the internet sings and the keyboard races
To the goal of the day, and I'll be okay
Oh I'm not hooked on financial status
Think I'll slip on down to my Facebook pages
Oh I've got friends in home office places

Challenges in 2011

2010-12-29T15:59:00.009-07:00

As we start a brand new year, it is going to be particularly important to take notice of all that is happening in healthcare documentation. The sense of urgency for hospitals and providers to adopt EHR technology is on the rise and shows no signs of slowing down, despite the challenges, expenses and the myriad of complexities also known as meaningful use.

So what is an MT to do? Do we just go through our normal day and hope that our job is not the one eliminated? Or should we look at credentials, education and find new roles that we can do? Personally, I think it is a mistake if we don't get active in taking a long, hard look at this head-on instead of hoping that we can ride the wave to the shore.

We have heard for years that medical transcription and coding are similar (from the standpoint of clinical knowledge) and yet they remain, for the most part, very separate processes. It seems prudent to revisit these 2 tasks and see how we might bring them closer together in an effort to gain efficiencies and speed up the billing process. Having worked as both a coder and a transcriptionist, I know the skill sets are very similar. We must know and understand the language of medicine, A&P, pharmacology, disease process and so much more.

Even aside from the obvious coding option, there are others that come to mind. For those who aren't necessarily resigned by geographics or other requirements to working at home, becoming a scribe may be an option. There are probably individuals working as scribes who will tell you it isn't the same job and I completely acknowledge that it's not the same, however, it still comes back to all the medical knowledge and then training to perform the tasks that the physician needs for entry into the EHR. It can be learned, and you clearly have a huge head start.

Then what about analytics, quality reporting and a host of other tasks that we can learn? There are many options, and AHDI is exploring these with several current initiatives, but there is one step first. We need to understand that much of what will take place when the nation's healthcare goes electronic hasn't quite yet been fully determined. The roles are still being discovered. So the potential is there -- and it won't come without additional training, possible college preparation and credentials. This is just simply a call to keep eyes and possibilities wide open.

What can you do today? Start learning all you can about these new systems and keep your networks strong. Be informed and don't be afraid to consider going back to school. At a time when I thought I wouldn't need to go back to school, I find myself today enrolled at the University of Cincinnati in their BS HIM program to convert my RHIT to RHIA. Funny thing is that I looked into this program back in 2006 and decided not to do it, because I didn't think I needed to. Of course the enrollment advisor reminded me that had I done it then, I would already have gradutated. I guess the moral of this story is never say never - you might be surprised by the necessities in an evolving career!

EHR Process: Speak Your Preference

2010-05-18T10:09:00.007-06:00

EHRs and meaningful use (MU) are getting so much publicity. There is the carrot (financial incentive) and stick (reduced reimbursement) approach to get them in place by 2014 with the promise of reducing costs, improving patient outcomes and patient safety. Through all of this publicity, seems we haven't heard enough from the chief care giver - the physician.

Many of the EHRs that have been approved by CCHIT don't include a dictation/transcription option. CCHIT may not ultimately be the approval body. Interestingly enough, MU definitions haven't been finalized. So there are goals to meet that haven't been fully defined and timelines that associations like the AMA and AHA along with a host of other national groups that have spoken clearly about how the all or nothing MU criteria plan is ill-advised. They agree that the timeline is not realistic.

We probably all can agree that EHR implementation without meaningful use doesn't get us to the goals promised. And we understand that it is a given to migrate away from paper records. However, the rush to get it done seems to put physicians and a practical improved approach to healthcare delivery in the system that we have, in the backseat.

Let's look at this from an objective perspective. Now we have healthcare reform. That's great news for so many who don't have healthcare today. It means that an additional 32 million (estimated) Americans will have access to healthcare who previously did not or did if their conditions became critical enough for them to present to the ER. What will healthcare reform do to physician case loads? To hospital census? Let us not forget that we have an aging population with baby-boomers approaching retirement. Do we have enough physicians for all this increased volume?

Now let's look at how many EHR systems approach healthcare documentation. They are designed for the physician to become the data entry clerk - and in truth, many are operating this way today. VA's VISTA system, Kaiser Permanente, and there are a host of EHRs designed for ambulatory settings and physician office practice that utilize the same approach.

Here's a thought. Do you see the president of a bank entering deposits and counting out cash at his bank? No, so why would we ask our most highly educated member of the healthcare delivery team to become a data entry clerk?

Currently 1.2 billion patient reports are created by expert medical transcriptionists who have trained and many have become credentialed in their field. Narrative dictation captures the unique circumstances of each individual patient. No two patients are alike in their history and even presenting symptoms. And to leave out important details of the patient's additional illnesses can most certainly impact hospital and physician revenue. So why would we A. slow physicians down entering the detail and B. risk lower reimbursements?

The purpose of this blog post is just simply this. Consider: The physicians who are mostly going to be time and resource-impacted by EHR implementation need to speak out in favor of the ability to continue to document patient encounters in the most efficient and complete way. Physicians' voices must be heard in this evolution to electronic records. What EHR systems must do is provide an avenue for physician choice in documentation practices.

If physicians want to self-enter - then that should be an option. However, for those physicians with a patient case-mix that is complex and those with multiple medical problems, their option to continue to dictate will mean the difference in their ability to increase the demand on their time as patient loads increase.

Physicians - please speak up - be sure that you have options in how you document patient encounters. You are the CEO of the healthcare delivery team and the process needs to provide better patient safety and ensure that your time is optimized while ensuring appropriate reimbursements for all you do.

Happy Holidays!

2009-11-29T16:47:00.021-07:00

The holidays are here. Can you believe it? It's time to consider what you are thankful for, to enjoy some quality time with family and friends and to cherish what is meaningful in your life. It is also time to plan for the year ahead and think about what you want to achieve. Not so much like the New Year's resolutions we make with good intentions because they don't always last, but think more long-term and make plans to get there with a list that has dates and interval checks along the way.

Been putting off finishing that college degree? Get on track to complete it. Been thinking about your first or a new credential? Begin to study and prepare so that you can celebrate when you successfully get that achieved! Thought about running for a leadership office? Maybe this is the year to throw your hat in the ring. Whatever it is, make a serious to-do list that has something special in it - something that allows you to check it off the list, but you end up way better off once it is done! This is a way to get energized!

This year, I am incredibly thankful for the amazing friendship and support from MTs everywhere as I have traveled across the US serving as president of AHDI. I am so inspired by all those who have attended meetings and participated on committees and work groups to provide a strong future for us in this profession. There is so much to do, and the way everyone is pulling together to get us there, I have every confidence we will prevail.

So this holiday when you are contemplating your future, ask yourself, have I reached my full potential? Is there more I could do? Should do? If _______ happens, what will I do next? Prepare for the unexpected, continually improve yourself, plan for success, and decide to be great! How will you make 2010 your best year yet?

The EHR in Prime Time

2009-09-14T07:57:00.005-06:00

Did you happen to catch CBS Sunday Morning yesterday, 9/13/09? Well if you didn't here's a link but the lead story was the EHR and all its benefits. David Blumenthal, MD, National Coordinator, spoke and others who are leading the charge. The move to the EHR is part of President Obama's healthcare reform initiative, Title XIII of ARRA that was signed into law in February. And we need to get this done.

There is little doubt that the improvements that a fully integrated and nationally linked healthcare system can bring to us as a country. Improved outcomes, less waste, faster information available when every minute counts - all of these are crystal clear, valid and important to achieve. My only concern is that we don't want to fail to capture the critical details of the patient's unique set of circumstances at the risk of getting it done faster.

There have been plenty of articles written about some of the shortcomings of new systems as well as the merits of others. This is a decision that cannot be lightly made nor should it be made hastily without all the considerations a decision of that magnitude should receive.

I am confident that these decisions will be well-made and that meaningful use will help ensure that these goals are optimally met. We do need to utilize enabling technologies like Health Story project to preserve the details of every patient's story and include this through technological solutions so that no critical issues are overlooked or left out. Physicians have so many pressures on their time with increasing patient loads. Allowing them to continue to document in this manner will help them continue to focus on the work they do best - and that is diagnose and treat their patients. You can have transcribed reports that are fullyl minable in an EHR.

Check out the story on CBS Sunday Morning and tell me what you think.

ACE Summary!

2009-08-06T11:00:00.002-06:00

Gaylord Opryland, Nashville, TN – Music City USA was the scene for the 31st annual AHDI Annual Convention and Expo. And what an event it was. We kicked the event off with a Wednesday night welcome reception and everyone showed up in their jeans and boots to learn a few line dances from 3 very talented instructors. Later (once we had a few steps figured out), we were entertained by Les Richardson and County Line. What an awesome event and everyone was there!

Thursday morning we heard from our opening keynote, Donna Hartley who shared her incredible story with the message being that you can be more than a survivor, you can really thrive even in tough situations. She shared 9 tips you can do to get the most out of your career and your life.

At 10:00 AM the exhibit hall opened and our exhibitors were there with new offerings and great solutions for our members. Next followed the afternoon educational sessions with 3 tracks, medical, industry and MT practice. There were so many wonderful sessions to attend that it was really difficult to choose. What I did was buy the CD so I wouldn’t miss a thing.

Thursday afternoon was the continuation of the QA Summit (first launched in Louisville, KY at the MTIA meeting) and the summit leaders spent time in lively discussion on blanks and how best to address that segment of what is often a dissatisfaction indicator. Our next steps are clear and we will continue on towards a white paper on quality for our industry standard.

Friday morning early Nick van Terheyden, MD spoke on the Health Story Project (www.healthstory.com). This is the solution that uses CDA language to deliver narrative text in a format that is searchable data in the EHR. This is one of the single most important developments for our sector and every one in our profession should know about and begin to talk about how this will get implemented at every MTSO and every hospital across the nation. This is what builds the bridge from dictation and allows physicians to continue to be efficient (dictate, their preferred method of documentation by over 80%) and still allow the information to be formatted for EHR systems.

Next, we had the opportunity to hear from Bruce Mast, our Thursday morning keynote on the evolution of our role. That was a powerful, eye-opening session that proposed many possibilities based on the knowledge of our professionals – not the method of how we do it.

Then on Saturday morning, we were incredibly fortunate to have Jonathan Perlin, MD, PhD speak to us about what’s happening in healthcare and the opportunities that will abound with healthcare reform. His background and experience with both the VA and currently as the Chief Medical Officer for HCA puts him in a key position to share his insight with our members. He has also been named one of the top 10 physicians in America.

Then with an afternoon filled with outstanding educational sessions, it was time to wrap it all up with our first ever, Integrity Awards Red Carpet event and after party. The paparazzi was there snapping photos of our members who were dressed to the nines and everyone looked fabulous! The awards were presented then everyone moved over to the Gaylord’s Fuse nightclub for music, food and beverages. There was more dancing and fun for all there and as the main part of the conference concluded, we all agreed that this was one of the best events ever. The Gaylord facility was filled with greenery, waterfalls and blooms from all over the world. And speaking of the “world” their waterway complete with boat rides shares water from 17 countries worldwide.

For those who just didn’t get enough of the conference, Sunday morning the Managers and Supervisors special interest group conducted their annual event (8:00 – 11:30 AM) with great attendance and content-rich topics about how they are working and evolving in this new generation of EHR systems with SRT technologies and it was an excellent event with panel discussions and idea sharing.

When it was time to leave, I anticipated a feeling a sadness that it was over, but surprisingly, most of what I was thinking was how great the event was and how much more there is to look forward to. Our sector is evolving and as we prepare for this future, gaining knowledge and being involved in these changes at this level is something I treasure. For those who could not attend, I encourage you to get as much information as you can. If you aren’t a member, consider joining your professional association because there’s never been a more important time to be connected. The next few years are going to be amazing and we all need to be involved in securing our place as the knowledge worker for the future. Our roles will evolve, and the more visibility we have, the more opportunities we’ll have to stake our claim and say, “Yes I can do that – I have the expertise.”

Nashville, Here I Come!

2009-07-25T06:43:00.005-06:00

As the song goes..."Well my bags are packed and I'm ready to go"... And I couldn't be more excited about annual conference this year. ACE at the beautiful Gaylord Opryland is going to be one of the most amazing conventions we have ever had. We are doing so many new things this year. AHDI is always looking for more ways to share the latest information with attendees and this year there are many events with a new flair.

We are for the first time, doing a simulcast of a panel discussion with our closing keynote, Bruce Mast, Linda Yanisiewski, MTIA president, Peter Preziosi, CEO of AHDI and MTIA and me. One of the reasons we thought this was important is because we understand that times are tough and not everyone can travel to a convention. But we thought it would be innovative to take some of the convention to you.

This year our initiatives have been clear from January 1, 2009! We must produce an SRT curriculum and it is ready. We must update the QA standards for our industry - that collaborative work is well underway to be complete this year and we are having a face-to-face meeting in Nashville to continue to advance the work. We must continue to be visible in Capitol Hill. This work continues not only at our summit, but meetings have continued all year long and we have retained a lobbying firm, Dewey Square Group to ensure our voices are heard. We must develop our future roles that will evolve with the EHR and that work is well underway. We need to draft an open letter to all MTs to unite for the purpose of a louder, stronger voice in showing tremendous value we bring to healthcare and that has been drafted. And we must do all of these things and more for every person working in this sector and help support them in getting credentialed because it is high-time for us to join the rest of the healthcare field in doing that and having better tools/resources such as the Interfix Knowledge Base (KB).

We know that these are challenging times. We also know that if we sit quietly on the sidelines, that change will take place without our input or consideration. As the saying goes, out of sight, out of mind and it does happen when we are silent and invisible regardless of our many contributions. We can let change happen to us, or we can actively participate in ensuring that healthcare reform includes healthcare documentation professionals.

So as many of us gather in Nashville, (making this our first ever green conference in keeping with that socially responsible initiative) for those of you who can't make it this year, I wanted to be sure you know that AHDI is working for all of you who are working at home, in offices and in hospitals and clinics and we will continue to work on your behalf to secure a great future.

Hope: Where to Find it

2009-06-29T17:08:00.004-06:00

We have talked about change - now let's shift the focus to another word that we must keep close at hand and that's "hope." In difficult times when the economy is down, it's hard to remain hopeful when the headlines are less than encouraging. But if you have your health, a job, and a place to live, you are ahead of about 1/3 of the world's population. We've heard growing up that it is so important to be thankful for all we have, but often it is easier to see what we don't have and what would be nice to have and we lose focus on all that is right with our lives, our jobs and our future.

The other day, I signed up online for a 401K plan with my employer. It was a great process and the 401K plan itself is a great one with a well-known company with many offerings. But I was less than excited to see the return rate of the investment choices. All but 2 were in negative numbers (and had been for longer than 2 years) and the 2 that weren't were less than 2 points each. Pretty discouraging and I nearly considered not signing up. But then I got to thinking that this big economic situation we are in won't solve itself. It is going to take each of us to do a few things to help us turn this thing around. We have to keep on moving forward every single day. So where do we find hope?

Suggestion #1. Watch President Obama on Wednesday night, 7/1 during his live Town Hall meeting. Better yet, submit a question and get involved. I agree that we can't fix the economy without fixing healthcare at the same time - it is too great an issue and this is something that not only affects everyone, it costs everyone. Let's get it solved.

Suggestion #2. I read somewhere recently that we have to give up all hope of creating a better yesterday. Yesterday is gone, but there is still time today to be the best you can be, make a difference for someone else, contribute where you can, and take a first step of many to have a hopeful, realistic tomorrow. Tell someone you appreciate them and ask your boss how you can help your company be more successful. You may be surprised at the response.

Suggestion #3. No matter your current situation, challenge yourself to create a positive outlook for tomorrow. Rather than seeing things as hopeless, envision that this is a difficult situation and then set out to make tomorrow better than the day before. Ask yourself what should I do next to get back on track.

We cannot undo the past and we also should not worry about the future. The past is gone, the future is not here yet, but our opportunity today is large and alive. Healthcare reform will happen. We have had the opportunity to speak to the decision-makers about meaningful use and we have continued to speak up and our voices are being heard.

What if we all decided that the most important thing we could do is work together as a profession and help healthcare decision-makers realize how valuable our contributions are? What if we help make the point that healthcare reform can take place better with us meaning that EHR systems are in use, nationwide with narrative text? What if we decided that the issues we sometimes take issue with in this profession are really not big issues at all? What if we all finally realized that as healthcare evolves, we need to be right in step with it and engage in the process? That's meaningful use of all of our time. That would spell a very hopeful future!

Changes in Healthcare, Changes in Medical Transcription

2009-05-25T07:56:00.004-06:00

Let’s talk about change for a minute, shall we? Change is something that happens in every aspect of our lives – we get older (dang it!), our kids do, we move and relocate, we get new cars, we utilize better technologies, we have way more than 3 or 4 channels on TV, we don’t have to wash dishes by hand, we have energy efficient appliances that do more, cost less to use and in general improve our efficiency.

All change is not bad – but change is a fact of life. Let’s face it, many of us used to transcribe on typewriters with carbon paper or at the very least white out. We have seen various renditions of voice capture hardware. Long distance used to cost hundreds and hundreds of dollars on even modest plans. Now most everyone gets unlimited long distance for about $25 or perhaps even VOIP for a flat rate.

This industry has witnessed many changes and evolutions. We must embrace change – many of us should be change-agents by now because of the many changes we have witnessed, been through or otherwise led changes.

Most of you know what kind of crisis healthcare is in. And you also know that we have a President who vows to fix healthcare so everyone can have access. The debate is long and volatile about how to exactly get it done the best way, however, we know that the “status quo is not an option on the table,” as stated by Barack Obama. We have already been impacted in many ways by healthcare reform.

The drive to push costs down is being driven by a huge number of reasons. MS-DRG changes, ICD-10 upcoming, RAC audits nation-wide, POA (present on admission) to name a few and with 54% of the nation’s hospitals operating in the red and 80% of those with 500+ beds in the red, our healthcare system must change and is changing - now. That means we must evolve with this change.

I know many people like their present routines and don’t want to change, but the EHR is shrinking our market share. That’s simply the truth. Those with the best skills, the most differentiators and the willingness to change and evolve as our sector does will never worry about a job.

Did you know that people who are optimistic about change, even life-altering change live longer than those who are not? These people have the secret recipe of not only making lemonade with the lemons that come their way, they are also constantly seeking out enough lemons to make lemon meringue pie! Be creative and keep a smile close at hand.

We are not witnessing an end-game strategy, it is an evolving shift - and as Darwin said, “it’s not the strongest or the largest of the species that survives, but the one most adaptable to change.” So please everyone know what’s going on in our profession, be the best you can be – make yourselves indispensible to your employer! Be flexible and know what the drivers are in what’s taking place here and let’s move forward together and succeed!

Happy Memorial Day Weekend!

MT Relevance in Healthcare's Future

2009-05-06T18:07:00.006-06:00

There is a lively discussion taking place here not just on the topic of mandatory credentialing but also the facts around MT relevance and our place in healthcare documentation's future. There are a number of great issues being presented and the burning questions seem to be larger than life.

Read this and more below:

For the purposes of history, very few professions willingly seek regulation and credentialing. AAMT/AHDI has always known we would have our work cut out for us by going down this road. But history has also shown that professions that are unwilling to self-regulate will either be (a) forced into regulation by the government or (b) forced out of relevance by technology and automation. Any unregulated, noncredentialed profession that can’t demonstrate a significant value-add is bound for marginalization. And unless you’re completely isolated from what’s going on in our industry right now, that is exactly what’s happening to our profession

Here is a final excerpt from that final post made by Lea Sims regarding what our choices are when faced with the reality of what is happening and why we need to engage this entire sector. We must face the facts of the transformation that is taking place - thought provoking:

...So…it’s really up to every MT, not to AHDI. How long can you count on your behind-the-scenes, no-credential, no-accountability, low-visibility role to sustain you in healthcare? Most experts say that within the next 5 to 10 years, a great deal of what you are doing will be automated (if you don’t believe that, you should be attending HIMSS) and all healthcare might need an MT for is to capture some complex narrative at the acute care level. All “normals” will give way to automation. All “templates” will give way to automation.

What value will you demonstrate to healthcare of the future? What cost-saving solution can you demonstrate? What ability to protect the patient can you market? What assistance with clinical decision-making can you offer? Instead of arguing with me here about what you are NOT, how much time are you spending thinking about what you ARE? You can say “no” to “risk management” as a value-add role, but what are you willing to say “yes” to? That’s all healthcare is going to listen to, folks.

When it comes to the art of this profession, at the end of the day, is our role to simply document what is dictated or is there an element of critical thinking involved? I have to say that some of the many MTs I know make sound decisions and corrections every day, many times a day - because they have the skill to do so. There is compelling information here that we all need to consider as those who would suggest that our role is clerical and therefore potentially just an expense that systems and technology can replace or do we choose to validate our skills and evolve them to the next wave in healthcare reform?

The issues around AHDI and what we do in support of MTs is substantial. That too, has evolved. Yes it is true that AAMT was different in earlier years, but as all things must, we had to change our mission and direction because frankly our members needed more. In order to provide membership with relevant and meaningful offerings, we too had to evolve with healthcare. Membership in AHDI is substantive and provides value in many forms. Through the Knowledge Base (KB), advocacy, credentialing, continuing education, leadership development, standards of practice, networking and more.

Will end this here but would ask that our members start speaking up and share what you think. And don't just tell us - tell those who are hearing misinformation. What is AHDI doing that we need to do more of? What aren't we doing that we should? And what do you think about some of the comments that have been made on this post? Do you agree or disagree? What further points need to made. We are listening - and your thoughts matter.

The Perfect Day

2009-04-20T21:35:00.008-06:00

Everyone has a vision of the perfect day. Sunshine blue skies at the beach. Fresh powder on the slopes for spring skiing. A quiet afternoon with a favorite book. A day at the spa for pampering and indulgence. The list goes on and everyone has their own vision of what that day might look like. For me, the perfect day would be the one where the following takes place:

Morning: Healthcare documentation professionals everywhere have joined forces and now more than 200,000 have found common ground and been heard clearly above the noise and chatter of healthcare reform. They have united and have secured their future as professionals who have for years contributed tremendous value to patient care. This profession was long thought of as adding cost, but it has come to light that this documentation sector adds exceptional value to accuracy and completeness in a patient's medical reports. It is what we do, and yet so few people know it or appreciate our knowledge. They say "we type what is dictated." Anyone who has ever done this job knows it is so much more than that. Until we as a profession can put aside the pointing fingers at problems, placing blame, quit focusing exclusively on pay first, measure our contributions and begin to demonstrate the value add, we cannot experience that perfect day. Are you ready for that perfect day? I say it is long overdue. No matter how tough we think we have it, we don't have to look very far to see those in much worse circumstances. We have time to recast our future, but we cannot do it alone. Let's work together towards that perfect day.

Afternoon: The next part of my perfect day would be the evening news stating that scientists around the world have confirmed that we have finally slowed and turned back the clock on global warming. The news report would go on saying....Evidence now shows that so many people continue to do little things to make a big difference and there is now solid proof that the polar ice is once again gaining mass and polar bears are making a strong recovery. Fewer species are facing extinction and our timeline for climate change has dramatically improved. And with alternative energy sources and creative technologies, there is an excellent chance we can turn this around completely. Now that would be a perfect end to a most excellent day!

This week, we will celebrate Earth Day on 4/22 and National Arbor Day on 4/24. As we think about the things we can do to improve our world, let us also think about how we sustain our professional world and move it forward for a better career and one that brings not only job satisfaction at the end of each day but the promise for even better days ahead where we embrace new technologies and put our expertise to work. Now wouldn't that really be a perfect day? Be part of the solution - take action - talk to your employer today about the tremendous value you provide every day!

What Tomorrow Holds

2009-04-01T14:00:00.002-06:00

We talk about an evolving profession and evolving our careers in healthcare documentation's future. One that works within EHRs and can utilize our expertise and critical thinking skills combined with our command of the language of medicine in a relevant and contributing way. Trying to look into the future and see what these jobs might look like is not an easy task but it is one that we must begin to contemplate to help us with this evolution and to identify the matching of a very extensive skillset with demands of a system that many of us have not yet seen.

One of the most important things for us to do is to stay involved. Stay connected, continue to network and stay informed on the technology that will form the basis of electronic healthcare delivery. Again, I am convinced that there is a great future ahead for all of us with the knowledge that we have as point and click will not adequately capture the entire patient's story. But what else might we do? Speech recognition is a great tool and can help create tools to use for those who don't want to transcribe in the traditional manner.

The evolution as I see it is one based on getting far more closer to real-time documentation. This is something that I wrote about in a futuristic article in Plexus, July 2008, called Headlines: 2018. The future gets closer everyday and when we try to imagine what that future might look like, we can begin to imagine how we are a big part of the solution to help our colleagues in HIM pull all the parts together. Quality of the entire EHR - dictated reports, clinician entered reports, we can ensure quality and content completeness in all parts of the record. Let's think of chart completion or as we called it in the old days, chart analysis or chart deficiencies done remotely? How about chart auditing done remotely? What if those facilities who use scribes utilized a technology like Blue Tooth and enabled this process to be done just as fast, but remotely?

The challenge is on - let's find those new future jobs and let's step up to fill them. What are your thoughts about how we can help bridge the gap to the allied health professions worker shortage?

Happy St. Patrick's Day

2009-03-17T19:31:00.005-06:00

Hope your day for the "wearin' of the green" has been enjoyable from the top of the mornin' to the wee hours of the night. As this day is coming to a close, I wanted to get a quick update out here before I leave for Sacramento, CA to attend the AHDI-West inaugural meeting.

This is truly an exciting time for this new regional that combines the states of Oregon, California, Utah, Idaho, Arizona, Hawaii and Alaska. It's a great concept that originated from the members and holds the promise to create synergies and combine these areas and considerable resources to create a greater strength and sense of purpose. You can check out their new website here .

Another bit of news is that the MTIA conference is right around the corner, April 22-25 and don't forget the Quality Summit will take place on April 25. Check out this link to get the scoop from the press release on this important summit.

Last week, I attended an industry advisory meeting in Atlanta and was really inspired by the content and ideas that were exchanged during this meeting. The attendees were HIM professionals, IT experts, leaders in the healthcare documentation industry with open collaboration on what challenges lie ahead. It becomes clearer to me with every passing day that we have tremendous opportunities to do more and provide more support and solutions for the healthcare documentation sector. I encourage everyone to consider what else we might do, how else might we contribute to help solve the growing demand for timely, quality, complete information for patient care. In the rush to solve the challenge of healthcare reform, we must not hastily forget the skills and expertise the knowledge worker can bring as part of the solution to this growing problem. Technology alone will never be the answer. Technology in the hands of well-trained experts is what can really make the difference.

Share your ideas - How can medical transcriptionists bring more in terms of solutions for healthcare docuementation? What else might we do with the advent of the EHR?

The Health Story Project

2009-02-25T18:22:00.006-07:00

Have you heard of the Health Story Project? Have you heard about CDA4CDT? Perhaps you have heard about the +20 billion dollars (and likely more) set aside for health IT as part of the stimulus package for economic recovery and healthcare reform? Maybe you have heard that the EHR is targeted for nationwide implementation by a goal date of 2014? If you answered yes to any of these questions, then every MT will want to learn more about the Health Story Project. Here's why.

One of the objections to narrative text in the EHR is that it is not searchable or minable for data research. Because currently, it is in free-form without an established standards and formats it does not lend itself well to easy tagging for search processes (more). A shift to templated systems or point and click technology alone cannot capture the relevant details and unique circumstances of each patient admission. Something that we can all agree on is that the potential to improve patient care, reduce costs, eliminate redundancy in testing and to gain efficiencies via e-prescribing absolutely exists by migrating to electronic records. The best way to do that and keep the details present, to ensure that DRGs continue to be optimized and to ensure that patient safety comes first, Health Story provides that process.

The Health Story Project by way of CDA4CDT (clinical documentation architecture for common document types) is a process that allows narrative text to be translated in the EHR as searchable, retrievable text. Since more than 80% of physicians prefer dictation and transcription as the method of choice for documenting patient encounters, this process is the way to ensure that the continuation of dictation and transcription will be able to deliver the structured text research outcomes while providing a level of granularity and detail that can only be captured through the dictation medium.

What you can do? Urge your MTSO employer to join the Health Story Project and the many MTSOs who are using this process to enable full functionality of hospital EHR systems while still allowing physicians to record patient encounters in the method that is their preference and the one that allows them more patient care time. Don't work for an MTSO? No problem, talk about it at your hospital - and if your hospital outsources any of their work, ask them to include a request for CDA4CDT in their RFPs.

The time has come for us to take an active role in our future and beginning to have conversations about relevant strategies to help ensure your success and career are here today. Click here to learn more from a physician's perspective.

Going Green/The Economy/Evolving Together

2009-02-12T09:58:00.013-07:00

People everywhere are doing it. They are finding ways to conserve and move our world back to better health. It all ties in with good stewardship and sustainability. We know that we want to reduce our dependence on foreign oil. Steps are being taken to develop alternative energy sources and if each of us recycles, makes fewer trips in the car, and reduces waste, we all save money and resources in the long run. Make sure you absolutely have to have a paper copy before you hit "print." Plant a tree and bring more oxygen to offset the CO2 impact. click here to see how you can participate. Little things can make a big difference and the things we do in our home CAN help change the world. For more info click here

Betty Honkonen wrote an awesome article for Advance that is available for your reading pleasure by following this link. click here In this article Betty points out how important it is to stay connected in economical downturns. The other compelling point that is critical to success in times like these where changes in healthcare are happening rapidly, is to remember the most important investment you make when times are tight is the investment you make in yourself. Keep yourself at the top of your profession. Staying connected in a networking mode to those who are leading the evolution of these changes can make a difference, particularly if you find yourself in an organization that is downsizing or eliminating certain technologies all together.

Layoffs are happening everywhere read more and no business sector is exempt. The investment in your credential, and in your association should be a priority for you most especially at this time. When employers are selective about who gets hired, make sure that you set yourself apart with a credential that tells the employer that continuing education is important to you. We have a community of solutions and no one should have to face these challenging times alone AHDI. The community of MTs has far more in common in today's evolving healthcare than ever before.

Fortunately the economic stimulus bill has finally passed and although this is a first step to financial recovery, jobs creations, and housing market stabilization, it will certainly take some time to get through it. As healthcare documentation continues to evolve, the actions we take collectively to create and establish careers that support this next evolution, will be much more impactful if everyone in this sector can find a way to work together toward that common goal. When we can as a unified profession emphasize the strengths and contributions we make to healthcare to those who who are making decisions, demonstrate how the knowledge worker's inclusion in healthcare's future is necessary, we then will have an opportunity to play a significant role in the EHR that is absolutely on the way.

Career Step adopts Interfix KB

2009-01-12T08:39:00.005-07:00

Exciting News: On January 7th, 2009, Career Step announced that it has incorporated the Interfix Knowledge Base (KB) www.interfix.biz into it's curriculum. This health information tool is designed to help students as well as practitioners with a robust search process to quickly find medical terminology, lab values, pharmaceutical words with dosing and diagnosis information, and information in the AHDI (Association for Healthcare Documentation Integrity) Book of Style 3rd edition. It also contains a physician database that allows search methods based on different criteria. You can search by location, specialty, name, etc. This comprehensive tool provides state of the art search parameters including wild card searching and the one of the best things about the Interfix KB is that unlike random web searches, this information is validated and accurate.

One other significant advantage that this application provides is electronic-based membership to AHDI. This gives the user access to the professional association for healthcare documentation and opens the door to a great future through information, educational processes, credentialing opportunities and networking.

This research tool will assist medical transcriptionists verify the information they seek in a single step rather than having to search and check various locations for trustworthy information. This represents remarkable progress and revolutionizes previous lookup procedures.

Read the full story by following this link: http://www.careerstep.com/blog/?p=307

Holiday Wishes

2008-12-29T19:06:00.005-07:00

Happy New Year! I sure hope this has been a good holiday season for you. This past year has not been a great year economically for many of us, but it will certainly be one that we will all remember. We have an opportunity with each new year to commit ourselves fully to making each New Year better than the one before. It is up to each of us to seize the opportunity for change and take action to bring about that change. No one can make us get exercise, go on a diet, finish that degree, or get involved in a worthy cause except ourselves. The life we lead is the one we live and the degree to which it is fulfilling is in our own hands to either accept it or choose to improve some part of it (unless of course you are fortunate enough to be living the perfect life - LOL).

So as 2009 begins with our New Year's resolutions and commitments for a better year, I will start with a few commitments of my own:

1. To lead my association, profession and coworkers with the highest standard of ethics, integrity and values that ensure that our actions and work is the finest it can be.
2. To take active steps that advance our profession bringing visibility to the important work we do in relationship to quality of documentation, quality patient care and safety, and quality of life.
3. To seek to continually listen and learn so that the foundation of wisdom (knowledge) is at the basis of all decision-making.
4. To do all within my power to educate and develop awareness with those I meet about the fragileness of our planet and to instill a desire in others to do more to help ensure a vibrant earth for many generations to come.

So what if we were all to take a really good long look at our profession? Where is it going if we keep doing what we have always done? Then what if we took a look at the future of healthcare documentation? How/where do we fit in? Finally, what we can do to make our own personal future brighter and filled with the maximum potential? If you were to do this and you decided that we could make a difference by being present, by taking personal action to ensure our own success, then I can't WAIT to work with you to make it happen in 2009! Together we can do this! Yes we can!

Making History - Making it Count

2008-11-17T12:27:00.004-07:00

Well, we did it! We elected the nation's first African-American President and so many experts thought this day would come, but not for many years yet. As a people, we can be a surprising lot. How we approach a challenge doesn't fit every model and our ability to rise to an occasion is truly second to none.

The point here is not about politics as that is a topic that can get heated (ya think?) as we all have our fundamental beliefs in which is right - left or right, but based on the voters, we are going to be putting our faith and trust towards the left. However, somewhere in the middle, at the end of the day, we are all one country and now Barack Obama is entrusted with getting us out of a number of big problems, the magnitude of which haven't faced our country since the 30s.

You may be asking, ok Susan, so what is the point? The point is that people have different ways of viewing and reacting to the challenges that face us as individuals. Some people take action and choose to make a difference by stepping up to lead a committee or a group or join with like-minded folks for various causes. Some like to find the person (or group) who is responsible and blame them, and some take a realistic view and say what can I do - what is my role in all of this and how can I make my situation better?

Make no mistake, the economy is the real deal - times are tough and money is tight. We will likely be asked to participate in our nation's recovery to a certain degree and we may have to make choices and sacrifices. Healthcare is still not optimal and it will take years for it to evolve to the next stage, but we must be actively involved in that if we want to ensure our success in future roles.

On a personal note though, we really all do own our own success. No one can make us happy or rich or successful. It is up to us. When you consider your position now, your lot in life and you compare it to where you really want to go, what will you do to help yourself get there? How will you make your plan work to get you to your goal? Will you be a leader, a blamer or an action-taker?

Election Time is Here

2008-10-09T20:20:00.008-06:00

November 4th is approaching and it will be time for all of us to cast our ballots. I wouldn't be at all surprised if we see record turnout at the polls and for good reason. This is extremely important with the serious issues facing our nation. The economy, healthcare, the environment and so many others. These are critical issues and we need strong leadership to help us navigate the complexities of making sound decisions to get us back on firmer ground.

Some of the issues important to us nationally are important to us as healthcare documentation professionals. They hit very close to home. I don't know anyone who hasn't had to re-evaluate some of their expenditures in view of the economy. Many folks are trying to make better decisions when it comes to the environment. There are more recycling efforts and people are trying to have less impact on the planet than ever before. Healthcare is in a big mess and we cannot sustain the rate of of increased costs and premiums, so it is time to put a good solution in place.

Since the focus of our work is healthcare documentation, it is incredibly important that we follow the legislation that will shape healthcare in these next few years. Be sure to keep informed as new developments take place. A good way to do that is through the AHDI legislative issues group listserv. Contact me and I will be sure to connect you with the right folks so you can stay informed.

Still the questions to consider are what healthcare solutions do you think will work the best? What do you think the risks and benefits are? How will these decisions affect us as healthcare documentation professionals?

What Really Matters

2008-07-25T07:50:00.002-06:00

News headlines are generally painting a picture of bad news on many fronts. The economy, the war, the price of gas, the price of food, energy and the housing market overall. These are very serious matters and by now, many of us are looking for ways to stretch our earnings to compensate for these more expensive times.

Taking it into perspective, we are a very resourceful group of professionals and we will work our way through this. Although working in healthcare is a relatively recession-proof vocation, it is not entirely that way, and this is no time to be complacent. It is also not a time when we can just count on our line of work to always be here - it is changing rapidly and some have already felt the shift to electronic documentation at their place of work.

In the future, the healthcare documentation professionals with credentials, experience with the most challenging work types and dictators, educational backgrounds, those who embrace new technologies to assist them in becoming more productive are going to be the ones in high demand as time and the EHR moves forward. This is a fact that you can hang your hat on.

There will be new jobs emerge and those who make it their goal to seek these out, find their niche and raise their hand to say, "I can do this and here's how it will help," will be the ones to move into the electronic documentation future.

So what really matters? Getting involved, being part of the solution and always remembering that your knowledge, your expertise, your future depends totally on YOU. The actions you begin to take today will map your future success. Take charge of your career, ensure your success and participate in leading the evolution of healthcare documentation. No one can do this for you and the more voices there are saying that our expertise makes for a better healthcare outcome, the more likely we are to be heard. AHDI is the channel for your voice to be heard. Check us out and get involved today. www.ahdionline.org

Advocacy in DC

2008-05-19T16:00:00.005-06:00

Just back from DC and what an experience we had! This is our association's 3rd National Advocacy event and my 2nd. The excitement in the air was undeniable and as we heard one success story after another, it was clear that we are continuing to make incredible progress in getting our message out there to our law-makers.

Synopsis in brief. I met with both Senators' aides from Colorado along with my congressman's aide. In addition, I personally delivered letters for Colorado and for New Mexico. I also had the good fortune to accompany 2 other staff members from TRS on appointments with another Congresswoman in Colorado and Senator Max Baucus of Montana. We actually met just outside the Senate floor in the Senate Reception room (see photo in blog).

Carrie Boatman, CMT, RPhT, Past President of AHDI visited with her legislators and showed them real-life examples of errors that she encounters daily. Our current President, Betty Honkonen, CMT, AHDI-F received a commitment from Congresswoman Ginny Brown-Waite to write legislation related to military spouse access to funding for educational purposes.

It just doesn't get any better than that and I really have to hand it to Betty for getting our message across so vividly that it prompted action to write legislation! What's also very amazing is that people who were there for the first time, made appointments, spoke to their Senators about issues and pending legislation like pros, and went above and beyond to ensure the future of our profession!

On this, the beginning of National MT Week, I can't think of a better way to kick it off than to be getting ready to write thank you notes to those with whom I met, and to continue to keep this relationship ongoing. Advocacy doesn't end here, it continues and I would absolutely encourage you to consider this worthy action next time you hear the call.

I am reminded today of the following...."Go placidly amid the noise & haste & remember what peace there may be in silence...speak your truth quietly & clearly...keep interested in your own career, however humble; it is a real possession in the changing fortunes of time..." Interesting that Desiderata dates back to 1692 and yet is just as true today. If everyone in this profession did 1 thing - just 1 this year to help secure our place in the EHR health system of tomorrow, it would become self-evident that the contributions to quality healthcare documentation are best achieved with a highly-skilled and professional work force!

Happy National MT Week Everyone!

Update: April 2008

2008-04-15T22:38:00.006-06:00

As I write this, our CEO Peter Preziosi, our board member and treasurer, Sherry Doggett and MTIA board member, George Catuogno are presenting at the annual HCCA conference in New Orleans, LA. With nearly 1000 in attendance, this is a huge conference with 8 or more educational tracks each day in the area of Healthcare Compliance.

Next week, many of us will meet in Long Beach, CA for the annual MTIA conference. This 3-day event marks the second where MTIA and AHDI have been partners working together on initiatives that make our two organizations stronger because of our singular focus on healthcare documentation making it the best it can be.

In Mid-May, nearly every state in the US is expected to be represented in Washington, DC as we visit with senators and legislators to remind them (yes we've been there before) what we do and how our knowledge makes a difference in the quality content of healthcare documentation.

These are the things that your fellow members and leaders are working on. We are opening new doors to those people in healthcare who are dedicated to topics like compliance, reduced risk, patient safety and better patient outcomes. These are the things that matter most in healthcare delivery and as MTs, we are on the frontlines of ensuring patient safety every single day with every report we transcribe.

Recently, I had an opportunity to visit and view an electronic health record system that is fully operational. It was amazing and in the HIM Department I visited, there were NO paper charts. Not a single one, and believe me, I was scouring the department in search of paper. Finally, I found some paper and ran over to see what it was. Somewhat disappointed, I must tell you it was an email printed out - nothing to do with patient care. Then I thought to myself, "Wow, they've really done it - a completely paperless HIM department." And the reality of that change hit me like a freight train.

So as I visited further, as I learned about what this meant to the hospital in terms of improvements, I also learned that there were things that weren't all positive. Workflow issues are magnified. While there is an electronic system, the master patient index (MPI) issues of duplicate patient records still exist and are even more difficult to identify. There are issues of physicians entering their own progress notes and reports - many of which have been identified with quality issues or reports that lack complete required content, according to medical staff bylaws. Coders are finding many of the CPOE errors and are bringing them forward for clarification and correction.

Where gains have been made in reducing dictation, most of these gains have been made at the clinic level, and there are still challenges of content there. There is inconsistency in documentation practices from clinic to clinic and although guidelines have been established, it is not easily enforced.

The takeaways are many. The EHR is becoming more prevalent and this will continue. The EHR doesn't eliminate the need for dictation, and in fact at this hospital, the same number of MT employees are there that were there before the installation. What is no longer in place is outsourcing as most of what the outsource company did was the clinic work, which is mostly completed by the physicians now. In fact, there is a potential need to grow the inhouse MT staff at this hospital and to implement a QA process. It might be a good idea to extend the random QA review to include all records to help ensure that the quality of all documentation meets the QA standard established. This may open a few more doors and opportunities if someone were to ask me !?!?!

All of this said to point out that AHDI is working on many fronts to bring into clear focus what your professional association is doing to bring recognition to the value proposition that experienced MTs bring to healthcare documentation. Also to let you know that figuratively speaking, I have actually been to the EHR Mountain for a first glance and I have seen its potential! I have learned a bit about the value it brings and better, how MTs absolutely fit into the future picture. I will return to the "mountain" soon and gather even more information and share more insights here on my blog. So stay tuned.

So for now, please remember that the expertise you have as a trained, experienced and with more credentialed MTs entering the workforce, we have a huge potential to bring better patient outcomes because of our knowledge. It is the quality grounding we have that will help us to remain important and required team players in the future! Being involved with your professional association is the way to stay informed, keep your saw sharpened and evolve with the technology that we employ! Let me know what you think? Would love to get your perspectives!

2008 We're on Our Way!

2008-02-18T18:04:00.003-07:00

Can you believe February is here? This is a leap year, an election year, and a milestone year for me as president-elect of AHDI. So many exciting things are happening in our industry and profession.

Betty has kicked off the year and is an energized dynamo for the military spouse initiative. She has already presented in a number of locations and the number of military spouses enrolled in approved schools is on the rise. The numbers are approaching or above 400 now and we all are excited to see the pace at which this is catching on. It's really the perfect fit for someone faced with the fact that it's not if they will need to move, it's when. What a great career for people on the move. With the ease and portability of our profession, it's a perfect fit.

Next month, I will be attending and participating in the NWCP Leadership Conference on the Ides of March (3/15) in Vancouver, Washington. This is a full-day workshop packed with leadership presentations from 9 AM until 5 PM. Mark your calendars and attend this great event. http://www.oamt.org/2008_nwcp_leadership_conference_info.htm

Next, in April is the CAMT Annual Meeting April 4-6 in Ontario, CA. www.calaamt.org. Each year, California puts on a fantastic annual meeting filled with information and dual tracks customized for each attendee's preferences. Don't miss this great opportunity for education, networking and keeping up-to-the minute with the latest developments and trends in our profession.

Also in April is the MTIA conference April 23-26. Go to www.mtia.com and click on annual conference to get more information on this exciting 4-day event in beautiful Long Beach, CA. This 19th annual meeting will include 3 educational tracks and opening keynote by Nate Booth and closing keynote, Jeff Goldsmith, PhD.

Our Advocacy Day, in partnership with MTIA and AHDI, is coming up May 15-17, 2008 and it's going to be a 3-day event this year in Washington DC rather than just 2 days as previously.
http://www.ahdionline.org/scriptcontent/lig.cfm There are a number of excellent speakers lined up so please get involved and be an advocate for our profession and for the legislation that impacts what we do.

That's the spring line up for me, so far. It's an exciting year so far and I look forward to all the opportunities to meet and talk with so many members as well as to work on strategic initiatives that help promote our profession and position us as the knowledge experts that are essential to quality healthcare documentation in the evolving future. Please share your ideas, your comments and help contribute to our success in the year ahead. My personal best to each of you.

Christmas and New Year's

2007-12-26T09:35:00.000-07:00

Often, the holidays are immediately followed by increased bills, and a few increased pounds. Neither of which are particularly welcome, and certainly then close behind are the obligatory resolutions for the New Year. Typically, we have good intentions to avoid the first two and live with the third, but even the best laid plans sometimes don't come through.

This year, I thought I would beat the odds and shop within my budget and avoid the temptation of overeating. So far, I haven't exactly prevailed with both. LOL Although I am proud to say that this is the best after Christmas credit card bill ever and the only temptations of Christmas sugar-fare were the decadently melt-in-your mouth Christmas sugar cookies from Walmart with the white or green icing. They are just way too good and so we bought several boxes of them.

Now for the New Year's resolution part. This year I am confident that I will stick with it. Mostly because I will not promise to go on a diet (duh! the mere mention of that word sends my metabolic rate into a coma). What I will do is promise to eat healthy and keep exercising, hiking and this winter, snow shoeing at every opportunity. I also am dedicating the next 3 years of my life to the profession that I love. As President-elect of AHDI for 2008, I intend to immerse myself in contributing as much of my time to helping us move forward and improving our position as key members of the healthcare delivery team. This is a resolution that I will have no trouble keeping. It is something that I am passionate about and will provide an ROI unlike anything I have done before. I am excited to have been elected to serve!

It seems that the important aspect of making a resolution is to make it reasonable yet challenging - one you can live with and one that adds to living. What resolution could you make that would add meaning to your life?

What are you Thankful for?

2007-11-26T10:08:00.000-07:00

At Thanksgiving time each year, many families will ask everyone at the table to say what they are thankful for that year. Many people don't look forward to this time to share their feelings openly at the dinner table and some actually do. Why do you suppose this is not the main attraction at the Thanksgiving meal? You could guess that it's personal and each person may have their own list of things to be thankful for that it might not be the most popular? Or that they just don't like to share their inner-most feelings while dining and slipping into that turkey coma?

Well whatever the reasons and certainly there are probably just as many reasons for not wanting to share as there are reasons for being thankful, it seems clear that it should never be about giving the most popular reason for being thankful. It has to be real and true for you or it's not worth saying. It could be something as simple as being thankful for having good health, for family members, or for not getting a traffic ticket, or for having made really good 401K investments this year despite the economy. One reason is no greater than another, because it seems that the reasons we are thankful are as individual as we are.

Although this was never a tradition at our dinner table when I grew up, it always seemed like a good idea, so this year, my husband and I talked about this, and after sharing what we were thankful for, we decided, this will be our tradition, since 2007. LOL We found out that we are really thankful for each other, for our home and for our jobs. We are both doing what we love and love what we do. We are thankful for our health and our enjoyment of the great outdoors and the wildlife that we often are fortunate enough to see.

So, what are you thankful for this year?

Military Spouse Initiative Update

2007-11-07T09:06:00.000-07:00

Have you heard the news yet? Peter Preziosi, PhD has received a special invitation from the Secretary of Defense to attend a kickoff launch recongizing the military spouse intiative. And guess where it is being held? The Pentagon! Woo-hoo - now that's big news!

As you may know there are over 200 military spouses enrolled in AHDI approved schools for medical transcription because it is a career that moves with you. Because of this and the many efforts made to get the word out about this opportunity, that it has caught the attention of many military spouses across the nation.

We look forward to these students graduating and going to work in their new chosen career. We are ready to help them enjoy all the success they are working towards and we hope that through the Pentagon's recognition of what a good fit medical transcription is for military spouses, that we will see this grow and grow.

From the Ends of the Earth

2007-11-05T16:26:00.000-07:00

Have you seen the Today show broadcasting from the Arctic Circle, the Equator and Antarctica? I watched a portion of it today with great interest as they are highlighting some of the most important regions in our world to monitor and better understand climate change.

If you saw any of the Planet Earth series televised earlier this summer, you know what peril Polar Bears are facing, and there are many other species at risk too.

Makes you wonder how high the water will rise.... if icebergs and glaciers continue to melt. And you probably know that with warmer temps, the mosquito season is lasting much longer these days and the multiple problems associated with that.

Whether you believe that global warming is happening from man-made causes or just a radical shift in weather patterns, the data is in that the earth is warming up at a pretty fast pace.

What things are you doing to reduce the size of your carbon footprint? Do you think it's enough to help turn things around? Will there soon be legislation on a large scale to change current energy usage? What will the earth look like 100 years from now?

This obviously isn't medical transcription related, but a mini-diversion to think about how we preserve this precious spinning globe we call home.

Philadelphia - AHIMA 2007

2007-10-15T15:08:00.000-06:00

AHIMA Update: Philadelphia, PA

Saturday: 10/6 - The managers and supervisors special interest group 2nd annual meeting was held with 30 attendees. Brenda Hurley and Carol Croft were there and were active participants. I had attended the one in Denver last year and was pleased to be there for this year’s event. Also from the board, we had Vallie Piloian, Betty Honkonen, and Cathy Baughman in attendance. Sherry Doggett a new board member and Jefferson Howe hosted this event for the second year doing an outstanding job of putting together meaningful speakers and topics of interest. During this day-long session, various panel discussions and presentations on timely topics such as compensation, dictation best practices – experiences from Maine Medical Center, Training for MTs and SRT MT/editors, templates and standards, among others. It was a great day of learning and networking.

Sunday: 10/7 - The day began with the MTIA quarterly board meeting with CEO, Peter Preziosi seated between Jay Cannon, MTIA President and Cathy Baughman, AHDI President. Vallie as the liaison for the board and Betty as President-elect were seated at the table. I attended the morning sessions of the board meeting and then spent some time in the AHIMA House of Delegates meeting. They do struggle with so many of the same issues we do. Worker shortages, instructor shortages, changing technologies, preparing for a future transformed and the presence of healthcare system that is moving from treatment of disease to prevention and then ultimately to prediction. They are in favor of higher levels of required college education at the master’s level for the RHIA credential as evidenced in the Vision 2016. (as an aside, I remember well hearing President then, Merida Johns, PhD talk about Vision 2006 in 1996 thinking how far in the future that seemed – now we are past that and moving towards 2016 – can you believe how time flies?).

Monday: 10/8 - Opening Session: Robert Kolodner, MD is head of the Office of the National Coordinator for HIT (ONC). He reminded everyone that even with the advances in technology that we have, most of our health information remains in silos where it is not interconnected and readily available between systems. To this end, ONC is collaborating with HHS to create the federal health IT architecture. He says we need 5 pieces to solve our healthcare puzzle. 1. Standards in health IT products. 2. Privacy and security policies. 3. The national health information network (NHIN) “to link us together.” 4. Adoption of interoperable health IT. And 5. Governance to coordinate all the pieces of the puzzle.

At the ribbon-cutting, AHDI members Betsy Ertel and Monica Haddox stood right next to Bryon Pickard, President of AHIMA as the exhibit hall was opened for the 79th annual conference. Their picture appeared in the daily newspaper provided to all attendees of the convention.

Monday afternoon, Peter Preziosi along with the AHDI board members from the MTIA Steering committee and MTIA board members met with the AHIMA board to discuss projects we had been working on together and a general update along with ideas and possibilities of future collaborations. I am working on the TAT white paper with MTIA and AHIMA as the co-chair with Sean Carroll.

Tuesday: 10/9 - Two excellent speakers kicked off the day in general sessions. The first was Pam Dixon of the World Privacy Forum talks about the damage of medical identity theft and the big problems that occur and downstream from this. Trying to solve and restore information when this occurs is not so easy. HIPAA does not provide the support or teeth for access and swift resolution when this occurs. To solve, we need: 1. National set of processes to standardize handling of medical identity theft. 2. Create red flag alerts for medical records that prompt healthcare organizations to react in the potential presence of fraud. 3. Create Jane/John Does file extractions in cases where fraud is evidenced. 4. Have dedicated healthcare personnel trained to respond to medical identity theft incidents. 5. When insiders commit this, asking for ID won’t help. 6. Create materials to educate patients and providers.

Next up was Benjamin Carson, MD who did a great job in framing the understanding and content of the nation’s first NHIN. Nine RHIOs have been awarded the contracts worth $22.5 million to create the blueprint for how to develop this on a national scale. This is a very exciting first step towards a fully interoperable healthcare network. For more information go to www.hhs.gov/healthit

Wednesday: 10/10 - General sessions today close the convention. First up with was a panel discussion on Quality, Data and EHRs – Will They Come Together? Dennis O’Leary, MD, (head of the Joint Commission) Janet Corrigan, PhD, MBA, (National Quality Forum) and Richard Umbdenstock, FACHE (CEO of the American Hospital Association). During this panel, the group presented on their special areas of expertise in how all these items will work together to bring us to an electronic health record that ensures quality for all.

The closing keynote was John Walsh from America’s Most Wanted speaking on living life with a mission. Through his tragedy in 1981, John has been instrumental in getting so much done for missing children and missing people across the nation. He was happy to report that they had just caught their 961st criminal the day before. He reports that when you are driven with a purpose and goal, you can make things happen and more than once, he was escorted out of media sessions and hearings. But he persisted. He related his personal story with sorrow and grief and the outcomes in establishing missing children networks when at the time his son went missing there was nothing like that. Not even the FBI would take the case, because it simply wasn’t something they did. He encouraged all in attendance to live their lives with purpose and he commended the excellent mission of solving the challenge of medical identity theft among the others to which health information professionals are dedicated.

This summary above just highlights some content from the general sessions which represent about half of each day. The exhibit hall was overflowing with vendors – about 220 in all. There were 8 different tracks for educational sessions, 3 scheduled for each day and each day, the tracks were different, as well. On Monday, in the Data Capture track, Brenda Hurley and Holly Woemmel did an excellent job presenting on the need to standardize healthcare formats, a topic very timely and relevant for everyone in HIM.

This conference was one of the best ever and they just seem to be growing every year and becoming more valuable. I don’t have the exact attendance of this conference yet, but it is likely the best attended conference yet. We must all strive to reach MTs in the same way and let them see and hear the exciting changes that are taking place in healthcare. Interest in our profession and how it evolves with the advent of these new technologies has never been more needed. This is the time to be engaged, involved and keeping up with the transformation that is taking place each day.

If anyone would like more information on the convention or has any specific questions on the tracks, educational content or just information in general about this incredible week, please contact me at slucci@transrs.com.

Dollars and Sense

2007-09-28T21:40:00.000-06:00

Many people in our industry will agree that there aren't enough medical transcriptionists for the amount of work that is out there today, yet we continue to see an inverse of the law of supply and demand.

In a profession where it takes years to gain expertise and skill given difficulty factors of both content and dictation, and when there is a shortage of professionals to fill the openings, what is the best way to attract and retain the best MTs and QA staff?

How do we plan for the future? Do we need to retool our workforce now? In what ways? And what additional skills do we need to develop in preparation for the next generation? Share your thoughts here!

Healthcare Insurance for All - Can It Work?

2007-09-19T19:51:00.000-06:00

Although I don't usually get into political conversations easily (other than on subjects on the environment - yes, I am an admitted environmentalist - but that's a topic for another day - LOL), I am very intrigued with Hillary Clinton's return to proposing universal healthcare insurance for all Americans.

Honestly, I thought this was a good idea when she proposed it some 13 years ago, although clearly not in the majority on that point of view, but I would ask this question for your consideration and comment. If we have a plan for health insurance for all, will this bring us to a better place?

Obviously, insurance premiums have sky-rocketed and for so many Americans, affording health insurance is just not an option. The other question that I would ask you is this a good move for Hillary in her bid for Presidency? Is this the right time to do this? Will this help or hurt her campaign? She is leading in all the polls, but when election day comes will her quest to ensure good healthcare for all be embraced nationally? What do you think?

Initial Post

2007-09-12T17:15:00.000-06:00

One of the things that I have been considering lately is not only what the future holds for medical transcriptionists, but how our jobs may change. In a recent article that I have written, I tried to fast-forward into the future and see what might be happening in the area of healthcare documentaiton. Here is a little excerpt from that article that will be published soon.

The year is 2017: In breaking healthcare news today, leading healthcare documentation administrators (HDAs) have made yet another contribution in the area of helping to save lives.

Today, the situation was different but a life was saved because of the swift action by the trained and credentialed HDAs involved. A cutting-edge procedure for graphite-composite complete spinal replacement, recently developed by Amastep Aheadforu, MD where patients can come in for a complete or partial spinal replacement and go home within 24 hours. This has been a lifesaver for patients with chronic back pain with bone or disk conditions, hemiplegia and quadriplegia.

In the surgical case today, the patient's chart contained 2 discrepancies. One was in the H&P stating first that the patient had no history of heart disease and yet in the past medical history it stated that the patient was status post MI. Bringing this to the attention of the surgeon before the procedure began, the HDA alerted him and a cardiology consultant was asked to be on stand-by, just in case, also adjustments were made to allow considerations for the patient who indeed was on blood thinners. The second item found was that the patient’s last labs showed borderline diabetes type 2 in a post-menopausal female. The HDA very alert to the fact that this patient was a middle-aged male, brought that also to the attention of the surgeon in real time....

Now although we don't have spine-replacement surgery yet, and smart cards are not in place universally, we do have the skills and knowledge to do the things mentioned in this article. Even though it takes place in the future, there will be opportunities for us to leverage our expertise in helping to ensure that all patient records contain the right information and that discrepancies are corrected.

In the AHDI "Have You Read Your Medical Record" campaign, bringing awareness to the general public about access to and the information contained in each medical record is extremely important, and the message needs to be carried on. As the EHR evolves, the proliferation of healthcare data will be significant and if 1 or 2 or 5 things are incorrect, it can have life-threatening consequences.

Our experience helps us be the ideal candidates to help ensure that this information is taken care of in real time for every patient. What are your thoughts on this potential future for us? Do you have other ideas suggestions that you would like to discuss?