My First HL7

HL7 Working Group Meetings (WGM) – #HL7WGM in my social media-oriented mind– are bustling, busy, eventful gatherings held three times a year that draw standards-minded people from around the world. I experienced my first HL7 WGM January in San Antonio, and from my short amount of time in the health IT (HIT) industry and little experience with standards in general, you could say I was overwhelmed but learned a ton.

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Has the Clock Run Out on Electronic Claims Attachments?

With the shift towards value-based care, payers still need access to clinical information for reimbursement decisions as well as for cost and quality metrics and standardizing enough of the clinical record to satisfy the anticipated attachments reg would be an excellent next step in that direction.

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CDA in the Wild: Conclusion (Installment #8)

Clinical Documents were never meant to hold 10 pounds of coded data. CDA is a 5-pound bag, containing the actual words, either written directly by a clinician or spoken and transcribed, with the minimal coding necessary for the use case.

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What is AUR and Why Do We Care?

AUR is more than an airport code for a commune in southern France (Aurillac, if you are curious). AUR is an important facet of public health. Using the Antimicrobial Use and Resistance (AUR) reporting module, hospitals can report and analyze antimicrobial use and/or resistance data.

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Why Payers Should Play with FHIR

This blog introduces participants working on clinical data exchange and value-based care to HL7’s Fast Healthcare Interoperability Resources (FHIR) standard and Connectathon, an event that tests FHIR’s interoperability mettle. Since Connectathon 1 in 2012, the buzz around FHIR has grown exponentially. Word on the street is HL7 has trouble finding hotel conference rooms large enough to fit all attendees! HL7 will host Connectathon 14 in January 2017 in San Antonio.

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What Eligible Clinicians Need to Know About Proposed Changes to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)

The Medicare Access and CHIP Reauthorization Act of 2015 changed the way Medicare rewards clinicians for providing quality care. CMS released a proposed rule in April 2016 to carry out key provisions of MACRA and implement two payment paths available to “eligible clinicians” (EC) as part of the proposed “Quality Payment Program”: (1) the Merit-Based Incentive Payment System and (2) the Alternative Payment Model Incentive. The proposed “Quality Payment Program” replaces the Sustainable Growth Rate (SGR) formula for paying eligible clinicians based on value and quality of care, which aligns with CMS’s goal to replace Fee-for-Service (FFS) volume-based payment with a value-based system.

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Does Risk-Adjustment for Sociodemographic Status (SDS) Have an Impact on Hospital Performance?

Ongoing research examines the impact of applying sociodemographic status (SDS) risk-adjustment to the Centers for Medicare & Medicaid Services (CMS) quality reporting programs. The main driver for investigation is a community assertion that SDS risk-adjustment is necessary to accurately gauge the quality of care given to patients of diverse backgrounds. Contrary to popular belief, recent research produced evidence that SDS risk-adjustment has little to no impact on hospital performance ratings.

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