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HIPAA Security: Need Help
Performing Your Risk Analysis?
"The thought of performing a risk analysis can be
daunting, especially to those who have never performed
one before. Nevertheless, each covered entity must perform
a risk analysis of the threats to its electronic protected
health information (EPHI) to comply with the security
rule," says HIPAA consultant Gwen Hughes. If you haven't
already started your risk analysis, the explanation
below of the basic approaches and sample formats may
help.
There are two basic approaches to performing a risk
analysis, quantitative and qualitative. The security
rule does not mandate a specific approach so organizations
are free to decide which method will work best for them.
- The quantitative approach involves identifying
threats to the organization's EPHI and then calculating
the monetary impact should the threat occur. This
approach allows the organization to compare the
cost of the safeguard against the monetary impact
should the threat occur.
- The qualitative approach involves identifying
each threat and assigning a numerical score (from
low to high) as to the threat's likelihood and impact
should the threat occur. The organization then determines
the level of threat it is willing to accept.
"Once the risks are identified, each organization can
then use this information as the basis for discussing,
prioritizing, and budgeting safeguards and counter measures
to protect its EPHI. By doing so, each organization
can reduce the risks to its EPHI to a reasonable and
appropriate level," says Hughes. |
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Coding: A Coding Change
That Warrants Attention
"One of the new ICD-9-CM code changes that warrants
close attention to avoid mistakes is a notation that
instructs coders to code acute bronchitis separate from
the chronic condition," says Kathy Johnson, Manager
of CARE's Coding and Consulting Services.
Other ICD-9-CM changes include:
- New codes for concussion, encephalopathy,
septic shock and spinal fusion.
- New V codes for current long term
use of antiplatelet/antithrombotic medications,
nonsteroidal anti-inflammatories and steroids.
- Changes to the sections for laparoscopic
surgical procedures and diseases of the respiratory
system.
For a convenient table listing the ICD-9-CM changes
see the Medicare Learning Network (MedLearn)
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JCAHO: Want to Avoid Inaccurate
Core Measure Press?
Imagine a headline in your local newspaper. The
headline uses the core measure data you provided to
the Joint Commission and Centers for Medicare and Medicaid
Services to cast your hospital in a negative light.
What's worse is the data isn't accurate. This scenario
could happen, particularly if your organization has
not reviewed it's documentation and abstracting procedures
in light of the core measure requirements.
During a recent audit, the Joint Commission found a
number of hospital data collection problems. For example,
they found inaccurate population of core measure fields
from hospital billing systems indicating the patients
were discharged home rather than to another facility.
Such errors can have a significant impact on whether
a patient is even included in the core measure population,
and therefore the organization's reported performance
for that measure.
"At St. Joseph's Hospital, we implemented a validation
process for core measures data," says Janice Midcap,
RHIT, CPHQ, Director of HIM. "Prior to reporting the
data, it's reviewed or validated by a second clinician.
If there are discrepancies, a team reviews the discrepancy
and inaccuracies are corrected. They also address patterns
of problems and refine documentation procedures as indicated.
Over the past few months we've been able to improve
the quality of our data collection and abstracting.
There have been fewer and fewer discrepancies and we
feel good about the quality of the data we're able to
provide."
According to the Joint Commission, hospitals with the
highest degree of accuracy in their study were those
that had:
- Assessed their record in light of
the core measure documentation requirements.
- Educated their physicians and data
abstractors.
- Assessed the resources required to
support core measures collection and abstraction
and.
- Incorporated core measure accuracy
in their performance improvement process.
To access core measure data, visit the CMS web site. |
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Happy Thanksgiving!
 In the spirit of this great
holiday, the editorial staff of The CARE
Dialogue wish to thank you and our more than 3,500 readers
for all the wonderful feedback and success of our e-newsletter.
May you, your family and friends enjoy a very happy
Thanksgiving.
Click on the cornucopia for an interactive Thanksgiving
timeline, created by the Library of Congress. |
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Publisher:
Leslie Fox, MA, RHIA
Editor:
Gwen Hughes, RHIA, CHP
Editorial Board:
Sue Danforth, RHIA
Roberta Peters, MS, RHIA
Patty Thierry, MBA, RHIA, CCS
Dianne Willard, MBA, RHIA, CCS-P
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