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The Role of Healthcare Data Governance in Big Data Analytics

On Friday last week, the online news publication HealthITAnalytics.com published a feature story about the importance of data governance, “The Role of Healthcare Data Governance in Big Data Analytics.” The author, Jennifer Bresnick, does an excellent job of explaining what data governance is, how it differs from information governance, and why healthcare IT professionals need to take a […]

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Medical Billing and Coding: Exciting Changes Ahead

It’s an interesting time to be in healthcare, especially medical billing and coding! Over the next few years we will see major changes that will help us spend our healthcare dollars more wisely, and keep people healthier. These changes will have a profound impact on patients’ and physicians’ daily lives. Let’s take a look at some of the […]

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Hierarchical Condition Categories Part 1: What’s all the Buzz About?

There is quite a bit of discussion around Hierarchical Condition Categories (HCCs) these days. And for good reason: as the risk adjustment model used since 2004 to determine reimbursement for various Medicare plans, the HCC framework is progressively being applied to numerous healthcare reform initiatives. In this two-part series, we break down the basics of […]

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How to Use Standardized Healthcare Terminologies to Meet Your Quality Care Goals

In the seminal work Crossing the Quality Chasm, published by the Institute of Medicine in 2001, there was a clear call to action for the U.S. healthcare system. This work has driven much of what we are seeing in healthcare information management today. Crossing the Quality Chasm called for healthcare to be safe, effective, patient centered, timely, efficient, and […]

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Mastering the Data Normalization Cycle

A healthcare provider or payer that goes through a data normalization project will want to make sure its investment in time and money continues to pay off down the road. You’ve obtained executive buy-in, conducted a data inventory, identified key constraints, prioritized projects, established a governance structure, and embarked on your first initiative. Ideally your project resulted […]

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Maximizing MIPS Reimbursement

Laying the Right Foundation for Data Management In the first edition of this two-part series covering MACRA and MIPS, we provided an overview of MIPS and its impact on terminology management and quality reporting. Part 2 will discuss why terminology management is critical to maximizing reimbursement under the new rule. The stakes for quality and cost performance […]

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MIPS Raises the Stakes on Clinical Documentation and Quality Reporting

In this two-part series, we will explore the basics of MIPS and its impact on terminology management and quality reporting. It’s no secret that quality reporting has presented notable challenges to hospitals and physicians. Access to clean, accurate data is necessary for reporting, yet providers continue to struggle with full and consistent capture of data […]

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Implications to Using Old and Outdated Codes

Many were relieved after the ICD-10 implementation deadline. But, though October 1st2015 is now long past, it does not mean the end of dealing with healthcare terminologies and the complexities set into motion for healthcare providers and payers. As we all know, healthcare is a constantly changing industry. New medical breakthroughs as well as newly discovered diseases […]

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Data Normalization: Mapping to Existing Standards vs Creating Local Standards

If you’ve followed the previous steps outlined in this blog series, you should have a good idea of how to pursue data normalization within your healthcare organization. But challenges will continue to arise once you get underway. One of the decisions a healthcare provider or payer will face in the course of a project is whether to […]

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The Benefits of Mapping CPT to LOINC

Payer-based care and utilization management programs are essential for managing member health, closing care gaps, and managing risk. Research data indicates that capturing members’ vast healthcare histories and normalizing that information for consumption can enable a care management program that enhances the effectiveness of provider-based care initiatives. Obviously, provider-based care plans and face-to-face clinician-patient relationships […]

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Are you Dealing With Lackluster Data Analytics?

A recent HealthITAnalytics.com article, “Quality Metrics, Data Analytics are Top Value-Based Care Fears,” highlighted some of the problems that health systems and ACOs are having with data management and analytics. Author Jennifer Bresnick wrote, “…providers confess that the big data analytics competencies required to make the most of value-based reimbursements may be too much for […]

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5,500+ Updates Are Coming to ICD-10

It has been five years since those of us in the healthcare industry have had to prepare for updates to the ICD code set. During this time, updates were put on hold while the industry prepared for and underwent the ICD-10 transition. Now that ICD-10-CM and ICD-10-PCS have been successfully implemented, it is time to […]

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How to Normalize Your First Project with Your Data Normalization Solution

So far we have outlined the steps from securing executive buy-in to establishing a governance process—you should be ready to start your first normalization project (I know I am!). A project team that has gone through an impact analysis and prioritized its data normalization projects will probably have a short list of likely project candidates. The two […]

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Webinar Recap: Code Groups – The Building Blocks for Your Analytic Initiatives

Code groups and analytics initiatives—the two go hand-in-hand. Healthcare organizations are increasingly realizing that effective management of code groups (also known as value sets) is imperative for aligning with healthcare’s Triple Aim and positioning within the value based landscape. The necessity of this function within a healthcare organization’s greater terminology management strategy was recently underscored […]

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Establish a Governance Process with Your Data Normalization Solution

In our last blog, we discussed selecting your first project to use for data normalization. A healthcare provider or payer pursuing a normalization project must establish a governance process to ensure the organization doesn’t revert to a chaotic data state. This post discusses the creation of a solid governance structure that preserves your investment in good […]

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Prioritize Your Data Normalization To-Do List with an Impact Anaysis

Welcome back!  So you have: Obtained executive buy-in Inventoried your systems Identified system constraints Identified organization constraints Now it’s time to decide on your first data normalization project. In this blog post I will provide insights into how to choose a project that you can complete successfully. Even though you now have executive buy-in, it […]

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Identify Constraints that May Impact your Data Normalization Plan

At this point in the integration of your data normalization solution, the project team has a strong executive sponsor and has assessed the healthcare organization’s data normalization needs. So far so good. Now it’s time to identify the constraints that might hinder the normalization initiative. Those constraints will determine the pace of the project and […]

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Why LOINC Promotes Semantic Interoperability

With such a strong industry-wide focus on the need to meet meaningful use standards, it’s easy to forget that terminology standardization has value for a provider beyond the big-picture goals of regulatory bodies. This is certainly true in the case of LOINC®, the standardized terminology used for reporting laboratory results. The average clinician is not even aware of […]

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The Importance of Taking an Inventory of Your Data Normalization Needs

In a previous blog post, I discussed the importance of data normalization and the need for executive-level support as the first step in the implementation process. This post focuses on the next step: taking an inventory of your data normalization needs. A healthcare system will be hard-pressed to reach its desired data destination if it has […]

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Four Reasons Data Normalization is Key to the Future of EHRs

Electronic Health Records (EHRs) originated as an attempt to digitize traditional paper medical records (hence the early moniker “Electronic Medical Record” (EMR), implying the system is an electronic representation of a paper medical record). There were certainly drivers for this shift from paper to electronic records, such as enhanced storage, retrieval, update, availability of patient […]

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