Health IT – ICD-10 Battle Is Taking the Form of a World Heavyweight Title Fight

The battle between the health IT industry and provider associations over ICD-10 adoption is imminent.

Imagine the MGM Grand Arena in Las Vegas filled to capacity with enthusiastic fans awaiting the start of an epic boxing match. A heavyweight title fight that will sure to go down in the history books as one of the best fights of all time. Of course, a main event of this magnitude must begin with the distinct voice of legendary ring announcer Michael Buffer’s claim-to-fame cadence – Let’s Get Ready to Rumble!

Let’s meet the contestants:

In one corner stand the provider organizations with the American Medical Association (AMA), for the moment, taking the lead role in the battle. But take note that the American Hospital Association (AHA) and the Medical Group Management Association (MGMA) both share similar views but have yet to officially enter into the battle. The common ground shared by all provider organizations is that physician practices and providers will ultimately be the ones incurring the cost and owning the responsibility of implementing ICD-10. The key issue the AMA has voiced is that ICD-10 implementation offers no direct benefit to patient’s care and that the conversion will create a significant burden on the practice of medicine.

In the other corner is the health IT industry organizations with the American Health Information Management Association (AHIMA) taking the lead role in the battle. The AHIMA’s position is that all healthcare providers need to stay the course in order to meet the ICD 10 implementation deadline of October 1, 2013. It does appear that perhaps the Academy of Professional Coders (AAPC) may join the AHIMA in the fight in the very near future. The AHIMA’s position is urging all healthcare providers to stay the course with ICD 10 transition related activities.

The battle between industry and providers over ICD-10 is being fought between those who stand to profit in the near-term and those who represent the providers that will have to finance and implement ICD-10. And while the battle is currently being fought by the association generals, there are a host of tech vendors, coding service providers, foot soldiers, if you will, who will inevitability join the fight as well.

It’s very early in this fight and it appears that the AMA maybe winning the early rounds. The Centers for Medicare and Medicaid (CMS) Administrator Marilyn Tavenner, in response to the advocacy efforts of the AMA, announced that the agency would take another look at the timeline for converting from the ICD-9 billing code set to ICD-10.

Aside from the cost associated with the transition and the impact to provider organizations, is there a downside to a delay in ICD-10 implementation?

Current speculation is that CMS may push the deadline for ICD-10 implementation back one year. If this becomes the case, this means that the U.S. healthcare system can’t complete all aspects of healthcare reform. Information the government needs to collect to provide effective clinical research on what treatments work and which ones are less effective is tied to the more specific information gathered by the use of ICD-10 codes. Those that are advocating for an implementation delay clearly don’t understand the benefits of the more detailed coding ICD-10 will bring. For example, one of the changes in ICD-10 is to better track follow-up care. It is important to healthcare funders and the public to know what specific follow-up care is being given for a particular event or illness. This one outcome of ICD-10 implementation will promote better patient care and outcomes.

Another downside to delaying ICD-10 implementation is that healthcare organizations cannot effectively complete strategic planning if rules like this keep changing. Any significant delay to the current ICD-10 implementation deadline could raise the implementation cost to medical practices.

One other key downside to delaying implementation is the fact that the United States is already a decade behind the rest of the world in using the most up-to-date International Disease Classification System – ICD-10. Can the United States continue to remain behind the rest of the world knowing that the ICD-11 beta is projected for the 2014-2015 timeframe?

Whether the government moves to delay ICD-10 implementation or not, this is the time for medical practices to review their health IT systems and infrastructure in order to develop a strategy that will optimize those systems to make the transition to ICD-10 easier. ICD-10 is a critical component to the many other healthcare initiatives currently underway to transition the country’s healthcare system to the twenty-first century. There’s really no point in moving forward with the other healthcare reform initiatives if the data that is being pushed out remains in ICD-9 format.

Mature Age Students: The New Generation Our Health Care Sector Needs?

The mature age student is studying because they choose to. Often they have come to a point in their lives where, through experiences both good and bad, they have found themselves, their passions and desires and are now ready to commit to doing something with those drivers. Generation X is not your typical mature age student. They are commonly men and women who are no longer under their parent’s roof, and are making a life for themselves with little assistance from common avenues of support. Many are raising children single-handedly.

The mature aged student frequently juggles multiple jobs, children, a standing in their community, a social life, their studies, and a never ending thirst to be better, to do more and to make their lives worth something greater than the individual.

The women are not pursuing marriage as a mechanism for material security and well being. They are out there doing it for themselves and often alone. The men are also doing it hard, trying to find their place in a society which has emasculated them since the feminism movement took root. They have kids, but not necessarily living under the same roof.

So where is the support for the mature aged X Gen who have played hard, defined themselves through experiential means, who have burned themselves out on striving for achievements, money, fame, fortune, professional prowess, and recognition. These ‘X-Genners’ have risen like the proverbial phoenix out of the fires of oppression known as the traditional husband/wife scenario and into the world of self support and fierce independence. But with this independence there comes a price. Our freedom has set us loose from our support networks of parents, wives, husbands, partners and we find ourselves disconnected from each other and more problematic, from ourselves.

Often our gypsy-like nature has resulted in unstable living arrangements, high debt and little assistance to help facilitate a life change into the next phase of self development. Our quest has been to live hard, learn much and at the end of it all, we find ourselves thinking… there has to be more to life than this. We are ready to step into our power and pass on what we have learned to our communities.

The X Generation is the new movement in health care of this nation. In recent years there has been a massive influx of X-Genners returning to formal and informal studies, many of us have not before completed an undergraduate degree, and we are commonly turning to fields of studies that are completely unrelated to our previous lives. Amongst the students I cross paths with through my mindfulness and meditation training is aspiring nurses, social workers, psychologists, bio-med and education. These progressive and open minded students are intent upon affecting healing change upon the world. They are the souls that will guide our next generation of children and teens into a peaceful, healing and authentic society. Interestingly, their drive to healing pursuits comes from their own direct experience with trauma, illness and major life disruptions that have forced a different view, a new way of being.

And what a great place for them to direct their attentions. They are perfectly suited to the health care industry. These students are well traveled, have a wealth of personal first hand experience of how tough the world can be if in a weakened or dis-empowered position in society. They have developed a deep emotional intelligence, understanding and compassion for their world and they have grown to know themselves intimately. Many of them have moved from being cared for, to being the carers of children, parents and grandparents.

Yet, the admirable qualities of tenacity, resilience, motivation and passion that the mature aged student possesses along with their multi-skilled and learned talents seem to have no support from government or other organisations to support their transition into this new era.

The government desperately needs the mature age student. The severe shortage of health workers is becoming an epidemic of mythic proportions. Government is throwing money at education facilities in the form of scholarships and bursaries, discounted health care programs, commonwealth supported undergraduate degrees and Austudy. And yet, we are faced with a post-study debt that continues to make study a financially debilitating endeavour.

Most of the Government subsidies such as Austudy are aimed at school leavers, many whom are still living with parents or have financial support from family members, This subsidy doesn’t even cover the rent for most mature aged students, in fact moving from Newstart allowance to Austudy in order to study full time, rent assistance is removed entirely. Why is it assumed that if you are an older student you no longer pay rent?

Centrelink Newstart offers marginally more financial support, but only if you are looking for full time work whilst studying. Working full time precludes full time study if either is going to be of any worthwhile quality. Part time study requires part time work, but this is no-mans land and there is no support at all, and yet this is the reality for the majority of mature aged students with family commitments thrown in.

The Commonwealth supported placements in health care have helped, certainly, but does the government understand how expensive the educational costs such as books, equipment, uniforms, extracurricular requirements such as vaccinations, CPR certificates, travel to placements, etc. are for the student in a health related undergraduate degree, not to mention the ancillary costs like day care and days of work lost due to placements, residential schools, lectures and tutes. It’s astronomical.

Educational Institutions are trying, but still falling short in helping mature aged students to make ends meet and raise their families whilst noses are in the books. Many Universities have grants and equity funding for financial hardship situations, but these programs are not promoted. Flexible, online and distance education is becoming a very efficient and do-able method of learning offered by many Universities and this intelligent use of technology is to be commended. I would like to see more educational institutions offering crèche or day care services with government or student services subsidy to assist parents to get to lectures, libraries and allow study time on campus. This would greatly ease the pressures of juggling commitments around family responsibilities.

In these trying financial times, when managing the cost of living has raised beyond the reach of most single income families, it seems remiss for the government to leave the financial assistance to independent charities and welfare organisations such as the Salvation Army and the Smith Family. But for many, turning to welfare assistance has become a depressing and humbling reality… ‘Thank God for the Salvos’ has become a common catch cry.

I am a single, white, female who doesn’t own my own home, who stands independently from her parents, with two toddlers who require full time focus and attention, and who has experienced the pain and suffering of the world alongside the wondrous and exciting. I have trialed all that life has to offer, and now I wish to give back via the health care industry. Am I a minority? No. I am the archetype of the next generation of health care workers. I am an example of the type of student the education system needs, the type of worker the health system needs – desperately. I am at a point in life where, through first hand experience, I have learned what it is to care for self and others, and I have honed the skills of commitment, self motivation, compassion and responsibility with which to succeed at my goals.

There is a myriad of support for the under-privileged, uneducated and inexperienced, but virtually nothing for those in the world who are older, and trying to do it for ourselves, who are following our passions despite the challenges and road blocks… and we are ready to help others. We have paid our taxes, we have worked hard, and we are now changing directions. The government and educational institutions need to keep up and lend a greater hand.

By Kristy Lee Rackham©2011
Author of Head Space-Meditate Your Way to Study Success

Gyms and Health Clubs – Do They Give You Any Benefits?

In the US “me”-oriented culture, where everyone wants their 15 minutes of fame now! (plus a pill that makes them beautiful, slim and in top shape while keeping them young), gyms and health clubs are an interesting throwback to yesteryear.

Although they have evolved a great deal, our gyms and health clubs still operate on a premise of hard work, sweat, commitment, and discipline. They continue to be an icon in the health and beauty industry as a basic building block in our health/fitness, anti-aging, weight-loss and body-sculpting routines.

So what do you get for all of this hard work and effort? How about the following:

  • Qualified Instruction This is one of the main reasons that we join a gym or health club. We want to learn how to get in shape and stay in shape! Most gyms and health clubs have at least one qualified instructor that can set you up on a fitness program. Their expertise can save you not only thousands of hours of learning curve time but also keep you from hurting or even killing yourself!
  • Hi-Tech Equipment A well equipped gym or health club has thousands and sometimes hundreds of thousands of dollars of fitness equipment. Most of us have neither the space nor the money to reproduce this flexibility of cross training, specialty training and time efficiency.
  • Consistent Routine Getting out of the house regularly and into a routine is one of the keys to achieving peak health and fitness. When the daily visit to your local gym or health club becomes routine, you are one step closer to realizing your fitness goals. If you work out at home it is much easier to get distracted and put off that very important workout until tomorrow.
  • Peer Encouragement/Workout Partners Seeing and interacting with others that are working towards similar fitness goals is a big motivator. Unless you are an extreme introvert, it’s beneficial to train with others. A gym or health club offers that opportunity to meet new friends and develop training partners that ultimately help us to achieve our fitness goals.
  • Learning new recreation/activities If your gym or health club offers additional classes or activities, these can broaden your exercise or health/fitness base. For example if you join a large health/fitness complex you might have the opportunity to try out their tennis, racquetball, swimming, sand volleyball, spinning, yoga, karate, dance classes, etc. You may never have originally thought of incorporating a new learning activity into your health/fitness routine, but it will now be available – all it takes is a commitment to learn something new!
  • Social activities/new friendships Many gyms and health clubs offer singles get-togethers or special travel functions (for example cruises, rafting trips, cooking classes) that enable you not only to meet new friends, but also to incorporate health and fitness into your daily life. It is much easier to do that when your friends share the same dedication to a healthy lifestyle!

For many people, these benefits present a very convincing argument that gyms and health clubs repay many times over the time, money and effort involved in using them.

Chris Poff