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Medication Adherence
Medication Adherence- An overview

Medication adherence is defined by the World Health Organization as the degree to which the person’s behavior corresponds with the agreed recommendations from a healthcare provider. It includes whether patients take their medications as prescribed as well as whether they continue to take a prescribed medication. Typical non-adherence to medications is 50% and 24-90% in mental health. The…

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7030 implementation strategy
Nalashaa’s 7030 Implementation Strategy

With enough knowledge on HIPAA 7030, let’s now look into ways to put this theoretical knowledge into practice; more specifically, let’s look into how Nalashaa implemented theory into practice. Nalashaa Healthcare provides a complete suite of frameworks, tools, checklists that provide an end-to-end offering to the Healthcare plans for implementing the HIPAA 7030 version. HIPAA…

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7030- Need for Change and Implications

The proposal for the next version of HIPAA EDI standards in the 5010 series is the hot topic in the healthcare industry. Healthcare industry being most data-intensive, the people associated with it have reasons to familiarize themselves with the new upgrade. The new version would be called 7030 and accommodating the new version becomes important…

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Nalashaa’s MU3 Certification Process!

So far we have discussed the challenges and solutions of MU3 implementation and the process of the certification. To discuss further and to impart knowledge, Nalashaa HealthCare is organizing a Webinar on Medicaid MU3 2018. Through the webinar we intent to share tips and tricks on the fastest path to certification, managing the proctor relationship,…

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MU3 Certification Management Handbook

In the previous section, we have discussed the challenges while implementing MU3 and the how to solve them like an expert. Now that we have an understanding of the challenges to be expected and the ways to tackle them, we will get into the processes of MU3 certification. Though it might look like a lot…

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Meaningful Use Stage 3 Certification: Challenges and Solutions

According to The Centers for Medicare and Medicaid services (CMS), by the start of 2019, hospitals will be required to use 2015 certified EHR technology. Though, ample time is given for the implementation, there are some major challenges up ahead for the certification, especially when it comes to the thresholds of meeting some of the…

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Medicare Home Health Conditions of Participation (CoPs) – A quick look

What are the changes for home health EHRs following the new Conditions of Participation (CoPs)? A home health agency (HHA) is an essential component in the healthcare ecosystem when care involves chronic conditions. The new home health Conditions of Participation (CoPs) finalized in January 2017 centers on how HHAs qualify to participate in Medicare and…

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PCMH – To be certified or not?

Primary care practices have been given the added responsibility of coordinating advanced patient care with physicians, to ensure quality care is delivered, where and when required. More than 10% primary care practices have been recognized as Patient Centered Medical Homes or PCMHs. These would bridge the gap between treatment and coordination. There are some great…

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Value-Based Reimbursement Is a Top Expectation of Patients

Value-based reimbursement has reached its tipping point and is here to stay. Of the payers and providers surveyed in the latest McKesson report, just 3% was exclusively fee-for-service. Value-based reimbursement is a proven strategy that will continue to take market share away from fee-for-service operations. What remains, however, are a few questions. How soon is…

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Value-Based Healthcare is Forcing EHR Innovation

Modern electronic health records (EHR) has come to represent an umbrella term for health information technology (IT). Basically, all the tech running a hospital system. That often means installing separate solutions for each department and cobbling together an interface that fails to truly integrate the data. It’s a system that was designed to support a…

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Part 3 – FHIR: Why every EHR should follow the FHIR path

Here as we wrap up our 3 part series on FHIR, we will discuss the business implications which FHIR brings along with it. If you have not read Part 1 or Part 2, please do so to understand more about FHIR and why it stands for the changing, better times for the healthcare industry. Business…

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Part 2: FHIR – The Holy Grail

In the previous week, we have the Part 1: From HL7 to FHIR, where we discussed about HL7 and the shortcomings which we have all come across while working with it in today’s times. The changing times needed a better and well equipped interoperability standard, from where we have FHIR. Here we shall go deeper…

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This job isn't always easy
Part 1: From HL7 to FHIR

In this digital era, every individual wants to see updated health data as he/she moves around the healthcare ecosystem i.e. providers, patients and caregivers should have the data available, discoverable and easily understandable. Furthermore, to support business intelligence, analytics, clinical decision support and other machine-based processing, the data must be structured and standardized in a…

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This job isn't always easy
Is your EHR ready for CCM workflows?

Chronic care management (CCM) is a recent service eligible for a modest monthly reimbursement from Medicare. While the additional revenue can be healthy for your bottom line, ineffective workflows can quickly drain your potential revenue and even bring you into the red. Smart use of existing electronic health records (EHR) can help close the gap,…

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Overcoming the Technical Challenges of Chronic Care Management

The new payment model for chronic care management (CCM) offered by Medicare is a positive step toward value-based reimbursement. CPT code 99490, the latest introduction, seems simple on the surface: provide 20 minutes of non-face-to-face oversight and preventative care each month for patients with chronic disease. That requirement, however, belies its true technical challenge. Finding…

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An overview of MACRA – MIPS, APMs and more..

MACRA Medicare Access and CHIP Reauthorization Act (MACRA) is an Act that makes fundamental changes to the way Medicare payments to physicians are determined, how they are updated, and how they incentivize physicians. This act: Repeals the Sustainable Growth Rate(SGR) methodology for determining updates to the Medicare physician fee schedule(MPFS), establishes annual fee updates in…

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Modified Stage 2 for EHR Incentive Program

All the providers will need to take into account the new Final Rule released by CMS in October. Here’s all what you need to know about the Modified Stage 2 for EHR Incentive Program in 2015 through 2017. Goals for the Modification: Align with Stage 3 to achieve overall goals of programs Synchronize reporting period…

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HIPPA Technical Safeguards

With OCR raising the seriousness levels of all covered entities in the healthcare Eco-system, it’s important for providers as well as Independent Software vendors (ISVs) to comprehend the various requirements that HIPAA imposes. The write-up below touches upon these requirements from a software capability perspective. Technical safeguards focus on the technology that stores or processes…

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How does Technology stand up to the Data driven Healthcare model?

Data driven healthcare solutions is to be the way ahead for the healthcare industry. Gone are the days when personal experience and word of mouth were the drivers behind healthcare decisions. Today’s patient needs numbers to validate what you have to say, and these numbers should be made available to them to make an informed…

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Consumer Driven Healthcare – How it stands for the Payers?

For the first time, many Americans are comparing and analyzing healthcare plans before buying one most suited to them. This is a huge change from how health plans were looked at earlier in the system. But, many of the first time insurance buyers are not health literate, which makes it difficult for them to understand…

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How Clinical Data gains importance in the face of Incentive Payouts for Healthcare Payers?

Researchers at University of Washington Tacoma have developed a machine-learning predictive analytics tool that forecasts with 82 percent accuracy the probability a patient will be readmitted within 30 days. In 2011, the federal government estimated that 30-day Medicare readmissions for all causes cost a whopping $26 billion annually, with $17 billion being attributed to avoidable…

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ICD-10 – Bringing in practicality to the anxiety

Amongst all the legislative activities, we still have October 1, 2015, as the date set for now as the deadline for ICD-10 code set switch-over. The Centers for Medicare & Medicaid Services announced last Monday that it would work with the American Medical Association (AMA) to ease the transition to ICD-10. For the first 12…

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Patient Safety Reporting & Healthcare Payouts

March 8 – 14 was the patient safety awareness week, and as we at Nalashaa look deeper into our goal – accountable healthcare; we will be understanding Patient Safety Reporting in this post. Patient safety event reporting is one of the quality improvement requirements as mandated by the Affordable Care Act (ACA).  At a Senate…

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QOPI – Aiming to assess and improve cancer care

Quality Oncology Practice Initiative (QOPI) is a program by the American Society of Clinical Oncology (ASCO) exclusively for outpatient chemotherapy clinics and practices, to work as a tool to measure performance and target improvements. In 2012, the number of registered QOPI participants was 200, spread across 42 states. In a period of 2 years, the…

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PQRS Claim-based Reporting

As discussed in previous post, PQRS reporting can be done using various methods: Claims-based Registry-based Qualified Electronic Health Record (EHR) Qualified Clinical Data Registry (QCDR) Group Practice Reporting Option (GPRO) PQRS Claim-based reporting The eligible professional must satisfactorily report on 50% of eligible instance for individual measure or 20 patients when reporting a measure group…

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An Introduction to Physician Quality Reporting System (PQRS)

PQRS is an abbreviation for Physician Quality Reporting System formerly known as the Physician Quality Reporting Initiative (PQRI). It is a reporting program that uses a combination of incentive payments and negative payment adjustments to promote reporting of quality information by eligible professionals (EPs). Payment Adjustments The program provides an incentive payment to practices with…

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ICD-10: How to leverage the data?

ICD-10 has always been linked to billing, and this is one of the biggest areas, no doubt. But, the data collected via ICD-10 coding practices will find uses in a much wider arena. Moreover, these can be seen as the added benefits of having a thoroughly tested, and well – implemented ICD-10 coding system. Apart…

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Doc – in – a – box: Urgent care clinics

Urgent care clinics or minor emergency setups are springing up all over riding on the need for quick medical assistance and owing to the waiting periods at regular hospitals. One of the main difference between these clinics and regular hospitals is these clinics do not take Medicaid, and hence are not required to attend to…

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Connected Healthcare Services

The healthcare industry is undergoing a significant change with connected health being the way ahead. To create effective connections, we need to ensure a network architecture which will help in serving the needs of all those involved, from care givers to lab technicians to patients. Blue button initiative is a step in patient empowerment, allowing…

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Building connected healthcare services

The healthcare industry is undergoing a significant change with connected health being the way ahead. To create effective connections, we need to ensure a network architecture which will help in serving the needs of all those involved, from care givers to lab technicians to patients. Blue button initiative is a step in patient empowerment, allowing…

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Genetics Cloud: A tremendous aid to medical screening

Cloud computing can help in considerably reducing the time and effort put in by genetic researchers by storing and analyzing individual gene sequences at a much faster rate than what can be done locally on a system. Further these gene sequence information which is stored on the cloud can prove to be far more effective…

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Wearable technology and EHR

The mobile health monitoring space is a staggering USD 9 billion as of today, and is only getting bigger. Wearable technology will make the process of health data collection simpler, and empower a large user base. Fitbit, Jawbone, Nike, Withings are some of the names which have made it big in the wearable devices space.…

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ICD-10 switch for non-covered entities

The switch to ICD-10 coding standards is mandatory for all HIPAA-covered entities that use electronic medium for claim transactions. Ideally, this standard does not apply to those which will operate via paper claims. But, there are many non-covered entities that are making the transition to ICD-10 coding standards, even though they are not required to…

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Wearable technology, the hope for those living with Parkinson’s

Parkinson’s disease (PD) is a slow degenerative disease which kills the brain cells causing tremors and some extend of rigidity, and loss of motor functions. It eats away at the dopamine releasing neurons, resulting in a drop in dopamine within the brain, causing the locomotive difficulties in patients. The most common side effect for patients…

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ICD-10 testing strategy for 2014

With the delay in ICD-10 in late March 2014, there has been a general aura of unsettlement in the healthcare IT space, with providers being unsure on what is expected of them, and by when. In the AHIMA summit held in April 2014, 88% of the healthcare participants were unhappy with the ICD-10 delay and…

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Wearable technology and cloud: The next generation of healthcare

Recently, we spoke about personalized medicine and the role they play in today’s medical practice. These solutions have successfully helped to monitor and manage the medical conditions of many patients. Last week, Miss Idaho proudly displayed her insulin pump during one of the rounds of the beauty pageant, and was applauded by the jury and…

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Why small practices should look at cloud based EHR systems closely?

Cloud based EHR are gaining momentum and is almost set to surpass the traditional client server EHR systems. Many small practices see the benefits associated with the cloud and having the EHR in the cloud seems to be the most compelling proposition for many of them. For a cloud based EHR system, the practice data…

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Future of Healthcare: Personalized Medicine and Digital Health

This is the first part to a series which will cover the role of healthcare IT in biotechnology and medical sciences. The future of healthcare lies in two major components: Digital Genetics Let us understand how these two major advancements in healthcare will change the face of the industry. Genetics At present, the healthcare practice…

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How to best integrate Blue Button with EHR?

The Blue Button initiative was aimed at allowing patients to download their EHR information from their MyHealth accounts and opening up the healthcare content from inaccessible sources. The aim was to make this file ‘very simple’ and hence this information was provided in a plain text or PDF format. These formats are only usable for…

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CAC Implementation for ICD-10

Computer Assisted Coding or CAC has gained importance with the ICD-10 implementation road map underway at most healthcare providers. The CAC software will help preserve accounts receivable and accounts payable resulting in accurate, compliant medical coding and reimbursements. Traditionally this process was performed by coders, but with the recent changes in the coding standards, and…

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Blue Button+: A guide for EMR/EHR/PHR ISV’s (Part 2)

We had previously discussed the methodology for Bluebutton+ to access data in the EMR/EHR/PHR system in the first part of our discussion. In the previous post we had skipped the registration process, which we will be covering in this part. The goal of Meaningful Use aims to provide consolidated information for patients and healthcare providers.…

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A Successful mHealth strategy crucial for Meaningful Use

The mHealth market is forecasted to reach $58.8 billion by 2020. For Meaningful Use Stage 2 incentive pay outs, one of the key essentials is that the providers need to successfully engage patients in their own health decisions. Why do we need a mHealth strategy? To move towards these goals and to comply with accountable…

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How is the HL7 interface affected by the ICD-10 codes?

HL7 interface engine is an integration platform specifically for the healthcare industry and its numerous legacy systems. The data from these legacy systems are under many circumstances non compatible with other systems in the network and at many times with the payer systems. HL7 also provisions for integration with outsourced services like teleradiology, hence lowering…

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Blue Button+: A guide for EMR/EHR/PHR ISVs (part 1)

What do you need to know about the Blue Button+? The Blue Button initiative started in 2010, to empower patients with their health data and improve quality of patient -clinician interaction. Blue Button+ extends the concept to include standardized data formats and added features for trusted, automated exchange of healthcare data, and advanced parsing to…

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Moving forward after the ICD-10 delay

As the Senate passed the bill putting into motion the ICD-10 delay, there are many questions which have been popping up. There are many providers who have been ready or who would be ready by the October 1, 2014 deadline and for them to roll back to the previous coding practice would be wasteful and…

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ICD-10: A cloud approach

Does this mean things should be slowing down? This is a golden opportunity for healthcare ISVs who are preparing to embrace cloud and provide easily scalable solutions to move ahead with their plans. A hosted service model or Software- as-a-service (SaaS) certainly offers potential in easing the pains of organizations in the midst of HIPAA…

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What do we mean that ICD-10 is more specific?

While there are dozens of minor distinctions between ICD-9 and ICD-10 the three fundamental changes are: There is expanded detail for many conditions (e.g., viral hepatitis has been expanded from ICD-9 070, a single 3-digit category, to ICD-10 B15-B19, five 3-digit categories Conditions were transferred around the classification (e.g., hemorrhage has been moved from the…

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ICD-10: Effective Implementation and Testing

ICD-10 codes need to be implemented by the practice management, billing and EHR vendors to ensure a smooth transition and bill reimbursements. One of the major risks in this transition process is having a vendor not prepared in assisting you with updated, tested software. Without proper guidance and a chalked out schedule from the vendor,…

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