HHS report says EHRs can distort info, inflate health claims
A new report released by the Office of the Inspector General for the Health and Human Services Department (HHS) Jan. 8, 2014, casts a distrustful eye on how electronic health records (EHRs) are used. The report, “CMS and Its Contractors Have Adopted Few Program Integrity Practices to Address Vulnerabilities in EHRs,” says that in digitizing medical records “certain EHR technology features may be used to mask true authorship of the medical record and distort information to inflate healthcare claims. The transition from paper records to EHRs may present new vulnerabilities and require the Centers for Medicare & Medicaid Services (CMS) and its contractors to adjust their techniques for identifying improper payments and investigating fraud.”
Two actions are to blame, according to the report:
1. Copy-pasting information (also know as cloning). “When doctors, nurses or other clinicians copy-paste information but fail to update it or ensure accuracy, inaccurate information may enter the patient’s medical record and inappropriate charges may be billed to patients and third-party healthcare payers,” the report says. “Furthermore, inappropriate copy-pasting could facilitate attempts to inflate claims and duplicate or create fraudulent claims.”
2. Overdocumentation. The report describes this as “inserting false or irrelevant documentation to create the appearance of support for billing higher level services.”
Two recommendations are made:
1. “CMS should provide guidance to its contractors on detecting fraud associated with EHRs. CMS could work with contractors to identify best practices and develop guidance and tools for detecting fraud associated with EHRs.
2. “CMS should direct its contractors to use providers’ audit logs.”
Read the report and its recommendations in full at http://1.usa.gov/K2ADdm.
Infectious Agents
Copper-infused hospital wing aims to combat HAIs
In a bid to win the war on hospital-acquired infections (HAIs), Sentara Healthcare is banking on copper, which has long been known to possess natural antimicrobial properties, to be its secret weapon. In the United States, HAIs account for nearly 1.7 million infections and 100,000 deaths each year. A 2009 CDC study estimates the annual direct costs of HAIs between $35.7 billion and $45 billion.
Opened on Nov. 16, 2013, the 129-bed East Tower at the Sentara Leigh Hospital site in Norfolk, VA, is a hospital wing where the patient rooms and most clinical spaces have been outfitted with antimicrobial copper-infused surfaces, including countertops, over-the-bed tables and bed rails. In early 2014, Sentara will add antimicrobial copper-infused textiles, ranging from bed linens to patient gowns, throughout the entire new facility. The use of the copper-infused surfaces and textiles will be part of an evaluation to determine whether they decrease the development of infections, and thus the need for antibiotics prescribed as a result of HAIs. This will be the world’s largest-known study to date of durable, biologically active antimicrobial surfaces.
The secret to these materials is a copper technology developed by Richmond, VA-based Cupron, a biotechnology company that has developed ways to isolate copper so that it can be stabilized and embedded in a variety of materials. Cupron partnered with EOS Surfaces in Norfolk, VA, to develop Antimicrobial Cupron Enhanced EOS Surfaces, which have been approved by the EPA for their ability to kill greater than 99.9 percent of harmful bacteria within two hours of exposure. It is the only copper-infused antimicrobial surface with this EPA-approved public health claim.
Meaningful Use
CMS proposes extending MU Stage 2; delaying Stage 3
The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) announced in a dual-authored blog post Dec. 6, 2013, a new timeline for implementing meaningful use for the Medicare and Medicaid EHR Incentive Programs.
Under the proposal, Stage 2 will be extended through 2016, and Stage 3 will begin in 2017 for those providers that have completed at least two years in Stage 2.
“The goal of this change is two-fold: first, to allow CMS and ONC to focus efforts on the successful implementation of the enhanced patient engagement, interoperability and health information exchange requirements in Stage 2; and second, to utilize data from Stage 2 participation to inform policy decisions for Stage 3,” the post stated. “The phased approach to program participation helps providers move from creating information in Stage 1, to exchanging health information in Stage 2, to focusing on improved outcomes in Stage 3.”
CMS anticipates the release of the proposed rulemaking (NPRM) for Stage 3 in the fall of 2014, including further details on the new timeline. The final rule with all requirements for Stage 3 would follow in the first half of 2015.
In the blog, ONC also proposed a more regular approach to updating certification regulations.
Read the full blog post at http://go.cms.gov/1d1oCNr.
Awards
Edward Marx named CHIME-HIMSS 2013 CIO of the Year
Edward W. Marx, FCHIME, FHIMSS, has been selected as the recipient of the 2013 John E. Gall Jr. CIO of the Year Award. Marx is Senior Vice President and Chief Information Officer at Texas Health Resources in Arlington, one of the largest faith-based, nonprofit healthcare delivery systems in the United States and the largest in North Texas in terms of patients served. He will receive the award at the Annual HIMSS Conference and Exhibition in Orlando on Feb. 25, 2014.
The award, sponsored by the College of Healthcare Information Management Executives (CHIME) and the Healthcare Information and Management Systems Society (HIMSS), recognizes healthcare IT executives who have made significant contributions to their organization and demonstrated innovative leadership through effective use of technology. The boards of directors for both organizations annually select the award recipient.
The award is named in honor of the late John E. Gall Jr., who pioneered implementation of the first fully integrated medical information system in the world at California’s El Camino Hospital in the 1960s.
Marx’s distinguished career in the healthcare industry spans 24 years, 16 of which have been spent as CIO. Concurrent with his career in healthcare, he served 15 years in the Army Reserve, first as a combat medic and then as a combat engineer officer. He has been leading Texas Health’s Innovative Technology Services professionals in developing and implementing strategies to enhance the patient and provider experience through the application of IT since 2007.
Before joining Texas Health, Marx was CIO of University Hospitals Health System of Cleveland. He previously served in a variety of IT leadership roles with healthcare organizations such as HCA (Tennessee), Parkview Episcopal Medical Center (Colorado) and Poudre Valley Health System (Colorado).
Resources
Optimize your HIMSS14 experience
With the HIMSS14 show just around the corner (February 23-27,
Orange County Convention Center, Orlando), there is no shortage of resources that can help you get the most from the event.
Plan to hear awesome keynote speakers: Potential 2016 presidential hopeful Hillary Rodham Clinton; Aetna Chairman, CEO and President Mark T. Bertolini; and CMS Administrator Marilyn Tavenner impart their wisdom.
Check out the Enhanced HIMSS Interoperability Showcase: The big news this year is that HIMSS has expanded its Interoperability Showcase by merging it with the Meaningful Use Experience. Get involved in this interactive environment where health IT solution providers collaborate to maximize their technology offerings and connect with clinicians, technicians and key decision makers. See firsthand the realization of connected health and patient empowerment across the U.S. healthcare landscape.
Spend some time in the Intelligent Hospital Pavilion: Featuring the Intelligent Medical Home, watch real-time data flow from the patient at home back to the local hospital.
Get your hands dirty: The Hands-on Connected Patient Learning Gallery will showcase HIT products and services that address e-engagement with providers and patients.
Get a front row seat at BeaconNation Live: Learn about 17 selected Beacon Communities that are using health IT as a foundation for improvement and innovation.
Take a tour: Explore Nemours Children’s Hospital at Lake Nona Medical City, an innovative, Davies Award-winning Stage 7 hospital.
Use the planning brochure: Target and locate key sessions, vendors, exhibits and events ahead of time so you can make the most of your time once you get to the event.
Be there even if you can’t be there: If you are unable to attend HIMSS14 in person, you can still get in on the action. HIMSS14 Online provides access to select portions of both live and on-demand events – for up to 90 days past the event close – for a one-time fee of $49. Participants get myriad benefits, including conference highlights in “news broadcast” format, access to a networking lounge and social media center, and opportunities to earn continuing education credits. If you plan to attend the conference in person, add HIMSS14 Online to your registration so you won’t miss a beat.
Stop by the Career Services Center: Explore this centralized location on the show floor for recruiters, job seekers, consultants and others who contribute to the development of the health IT workforce.
Go to www.himssconference.org for more information.
Kudos
Angela Kennedy is AHIMA’s new Board President/Chair
American Health Information Management Association (AHIMA) members have elected Angela Kennedy, Ed.D, MBA, RHIA, as President/Chair of the organization’s 2014 board of directors. Kennedy’s official one-year term began Jan. 1, 2014. Dr. Kennedy has been serving in this role since June 29, 2013, following the passing of President/Chair Kathleen A. Frawley, JD, MS, RHIA, FAHIMA.
Dr. Kennedy is a professor and Chair of the Department of Health Informatics and Information Management at Louisiana Tech University in Ruston, LA. Her professional experience includes working in health information, cancer registry and medical staff services, as well as quality management and quality and project management consulting for rural health information systems implementation. She has 14 years of higher education experience in areas of instruction, administration and research.
In her AHIMA role, Dr. Kennedy will work with the board and CEO Lynne Thomas Gordon, MBA, RHIA, CAE, FACHE, FAHIMA, to provide strategic direction to the nonprofit association for health information management (HIM) professionals. The 71,000-member organization aims to protect the accuracy of patient health information as well as safeguard and preserve its privacy.
