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Greed is not good when it comes to doctors, patients and medicine

by Chris Rangel, MD Gordon Gekko is wrong. Greed is not good. Not when it comes to health care providers. The socioeconomic study of what motivates people is a fascinating field of study, not the least of which is because of how counter-intuitive it is. For example, it seems normal to assume that the more someone is rewarded for their efforts, the more effort they will put forth toward those rewards. These rewards (increasing salary, bonuses, benefits, status, etc) are known as “extrinsic” motivators and for menial and/or repetitive jobs that have little need for regular complex planning, evaluation, or creative problem solving like unskilled manufacturing, manual labor, or GOP membership, the system works as expected with bigger monetary rewards leading to bigger efforts. (...) Read the rest of Greed is not good when it comes to doctors, patients and medicine No comment | Tags: Health reform , Hospital , Patient | Category: Health policy and politics

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What Are EMR Vendors Planning for ICD-10?

I remember when I first started my job at a healthcare facility 5+ years ago, I ran into these codes they called ICD-9. Yes, this was all very foreign to me, but I learned quickly the meaning of ICD-9. I also learned quickly that the EMR vendor which had been selected (before I was there) didn’t provide a list of ICD-9 as part of their EMR software (they do now). They did provide an upload feature and so we exported a list out of our old PMS, cleaned them up a little and then uploaded them into the new EMR. Not a fun or effective process even that way. Obviously, we’ve come a long way in five years. There are plenty of free lists of ICD-9 codes around the net that people can use, manipulate and add to their EMR software pretty easily. However, I couldn’t help but wonder what solutions were being offered for EMR vendors planning for ICD-10. Yes, EMR vendors do have until October 1st, 2013 (which has been moved back a bunch of times so let me know if it’s been changed again) and so maybe EMR vendors aren’t concerned about it yet. Although, I’m guessing that many have already put a lot of thought into preparing for ICD-10. My question for EMR vendors is, how are you planning to handle the ICD-10 codes? We’re talking about going from 14,315 diagnosis codes to 69,101 diagnosis codes. The National Center for Health Statistics (NCHS), the Centers for Medicare and Medicaid Services (CMS), AHIMA, the American Hospital Association, and 3M Health Information Systems have put together some General Equivalence Mappings (GEMs) that I believe try to do some mapping between ICD-9 and ICD-10. However, like translating a language there’s rarely a one to one match. With 4+ times as many codes there couldn’t be. So, certainly there’s the question of how you’re going to make the transition from ICD-9 to ICD-10 coding? Although, at a simpler level, how are you planning to get the almost 70k ICD-10 codes in your system? Does anyone know of a database of these codes that’s available for EMR vendors? Is each EMR vendor going to try and create their own? What’s happening in this regard? And maybe the answer is….ask us once we’re done dealing with stage 1 meaningful use. ICD-10 isn’t until stage 2 or stage 3 meaningful use. Related posts: NoMoreClipboard’s PHR Integrations with EMR Vendors My very first meeting with a vendor at HIMSS was... My EHR Certification Recommendations – For EMR Vendors No one asked (well at least not publicly), but I... Should ARRA be Paying EMR Vendors? I understand that looking at the ARRA EHR stimulus money...

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