From an industry perspective, we all need to make sure that “Meaningful Use” is near the top of our agenda for 2010. On December 30, 2009, the Centers for Medicare and Medicaid services announced a notice of proposed rule making for implementation of the provisions of the American Recovery and Reinvestment Act of 2009 (ARRA), that will provide incentive payments for “meaningful use of certified health information technology” to eligible professionals and eligible hospitals participating in Medicare and Medicaid programs. In order to meet the public comment deadline of March 15, 2010, AHIMA has formed a Meaningful Use Response Team to review the proposed rule. I feel honored to have been asked to serve on the Eligible Provider (sub) team. There is no simple definition for “Meaningful use”. Instead, it carries several components of using “certified” electronic health record (EHR) technology:

1) In a meaningful manner

2) To electronically exchanging clinical information with other healthcare providers in order to promote quality of patient care.

3) To electronically submit clinical quality measures.

There is a series of criteria that must be met in order to prove “meaningful use”. AHIMA has a dedicated web page where you can find the latest information on ARRA www.ahima.org/arra. There, you can also find a series of white papers on the Meaningful Use Notice of Proposed Rule Making. I encourage you gain knowledge of this industry change so that you will understand how you can help your organization obtain financial incentives for using certified EHR technology.

The AHIMA House of Delegate (HoD) teams continue to meet virtually every other month. The grid below provides you with a high level snapshot of each team’s current projects. If you have specific questions about the projects/initiatives, please contact the delegate serving on that team.

Goal #1 - Capitalizing Communication. Have you seen our new, dynamic website? If not, click here! Our webmaster, Lisa Ramsey, has worked tirelessly to transition our website to one that provides a more efficient way for you to obtain timely information, while being easy to navigate.

Speaking of efficiencies, how do you like the new format for Footprints? Valerie Dobson, Publications Chair, has taken us from an Adobe file to a true electronic newsletter.

Goal # 2 - Expanding Education. Cory Grimshaw, Education Chair, has worked diligently to get our first distance education offering on the calendar for the month of February. Kelly McLendon, RHIA has presented “Breach of PHI/Notified Enforcement: Are you Ready?”

For those of you who were not able to attend the Coding Roundtable meetings in September, or on February 26th, I am hopeful that you can attend the one scheduled for Friday, April 30, 2010 at the Grove Park Inn Resort and Spa in conjunction with our annual meeting. Dina Williams, Coding Roundtable Chair, and her committee have done a great job this year in providing you with opportunities for coding education.

Annual Meeting time is almost here again! Come join us at the beautiful Grove Park Inn Resort April 28-30 for NCHIMA’s 60th Annual Meeting. Audrey Chase, Vice President, and her program committee have prepared an action packed agenda that you will not want to miss.

The NCHIMA Executive Board is working on several other industry-related projects for the Spring/Summer. We have partnered with the North Carolina Health Information Management Systems Society (NCHIMSS) to hold a North Carolina “Hill Day” in May 2010. For more information, contact Deanie Auton, our Delegate for Legal Affairs. We are also planning an ICD-10 Summit in June 2010. Lee Ford, Special Project Chair, will be organizing this event for NCHIMA.

Please mark your calendars for the dates below: · Coding Roundtable Meeting - February 26, 2010 in Rutherfordton

· AHIMA Winter Team Talks - March 22, 2010 in Washington, DC

· AHIMA Hill Day - March 23, 2010 in Washington, DC

· Annual Meeting - April 28-30, 2010 at The Grove Park Inn, Asheville

· Hill Day in North Carolina (May 2010)

· ICD-10 Summit (June 2010)

Are you ready for the challenges that 2010 brings? Is your agenda for this year growing? Don’t give up, embrace it!

Amy

NCHIMA 60^TH ANNUAL MEETING

Audrey Chase, RHIA, Vice President

“Changes in Latitude, Changes in Attitude, Navigating HIM”

The Program Committee is actively planning for our 2009 annual meeting. Our meeting will be held April 28 - April 30, 2010 at the Grove Park Inn in Asheville, NC. Please come join us for many educational and networking opportunities! NCHIMA’s mission is to promote the quality, access and security of health information in all healthcare settings for the benefit of the members, healthcare consumers, providers and other users of clinical data. With today’s trying times in healthcare, we must learn how to navigate in a sea of constant change. Don’t miss the boat…come join us in Asheville!

Agenda

The draft agenda is included in this issue of Footprints for your review. We have a variety of topics which will be presented by excellent speakers! We will be applying for 20 continuing education hours. We are proud to offer a Coding Roundtable again in 2010, in conjunction with the annual meeting.

Registration

For your convenience, we will be using online registration through CVent again this year. Additional details of the meeting will be sent to you via an electronic invitation in February. You may register for the entire meeting or specific days. Please visit AHIMA.org to update your member profile in order to ensure we have your current e-mail address.

Fees

The registration fees are as follows:

                                                                                                      Members      Non-Members     **Students           

Full Meeting / Early registration (by 3/26/10)	$275.00	$375.00	$75.00
Full Meeting / Late registration (after 3/26/10)	$325.00	$475.00	$75.00
Wednesday ONLY	$150.00	$175.00	$30.00
Thursday ONLY	$150.00	$175.00	$30.00
Friday ONLY (Coding Roundtable)	$100.00	$125.00	$15.00

 **Student Fee Note: The fees for students are to cover the cost of meals/breaks only.

Hotel Accommodations

We have contracted with two hotels this year. Additional information about the hotels and their amenities will be included in your electronic meeting invitation. The block rooms are on a first come, first serve basis, so reserve your room quickly! The group rates are as follows:

NCHIMA 2009-2010 Program Committee

Effective August 7, 2009, the N.C. Controlled Substances Reporting System Act was expanded to allow more meaningful use of the State’s controlled substance database by physicians and pharmacists.  Since that time, Health Information Management professionals continue to wrestle with the practical implications of this law.  The purpose of this update is to outline the significant implications of the law and its practical impact on operations. 

Designed to help reduce drug diversion and abuse, the Controlled Substances Reporting System is a database populated with information from pharmacists filling Schedule II-V controlled substance prescriptions.  Every 7 days, pharmacies must submit certain prescription information to the State, such as the patient name, physician DEA number, and type of controlled substance.  Physicians can register to access the database and review the prescription history of their patients. 

Previously, only the State was allowed to use the confidential database information for proscribed purposes;  other users were not allowed to disclose or discuss the database information.  These restrictions were problematic because they prevented physicians from recording in the medical record the database information upon which they were basing the patient’s plan of care.  In addition, the law appeared to prohibit physicians from discussing the patient’s drug-seeking tendencies with other providers, including those with access to the database. 

The revised Act addresses both of these important issues.  Under N.C.G.S. § 90-113.74(g), a person authorized to prescribe or dispense the controlled substance is now allowed to discuss or share the database information with other authorized database users.  For example, if a registered physician sees in the database that Dr. Jones prescribed a controlled substance to the patient, that physician can now contact Dr. Jones to discuss the matter, so long as Dr. Jones also has access rights to the database; if Dr. Jones does not have access rights, then the physician cannot share or discuss the database information with him.

The other notable change to the Act is the addition of N.C.G.S. § 90-113.74(h), which states that persons who are licensed or approved to practice medicine or perform medical acts, tasks or functions are now allowed to retain the data in the patient’s confidential health care record.  By clearly allowing the information to be recorded in the medical record, the physician can make health care decisions based on documented evidence.  As with all information in a medical record, the database information continues to be subject to the confidentiality protections of HIPAA and the physician-patient privilege.  

For purposes of release of information, data submitted under the Act is confidential and is not considered a public record.  A federal or state officer, whose duty it is it enforce the laws of North Carolina or of the United States relating to controlled substances has the right to access prescription records.  However, access to the medical record is beyond the scope of this Act and requests for access must be handled pursuant to HIPAA and state law. 

To learn more about the Controlled Substances Reporting System or to register as a user, please see Controlled Substance

• Urinary Catheter
  
• Catheter Removed
  
• Reason for Continuing Urinary Catheterization
  

• 3 way catheter
  
• Coude catheter
  
• Council tip catheter
  
• Foley
  
• Indwelling
  

• External
  
• Texas
  

• Allowable Value “1” – there is documentation that the patient was in the ICU and receiving diuretics.
  

§ Notes for abstraction – Allowable Value “1” does not require physician/ANA/PA documentation; however it must be documented that the patient was in the ICU on POD1 or POD2 AND that they were receiving diuretics.

• Allowable Value “2” – there is a physician/advanced practice nurse/physician assistant documentation of reasons for not removing the urinary catheter postoperatively.
  

§ Notes for abstraction – Allowable Value 2 REQUIRES physician/ANA/PA documentation of the specific reason the catheter is not being removed. An order to “continue catheter” will not suffice. This documentation can ONLY be found on POD1 or POD2.

• Allowable Value “1” must have both ICU documentation AND documentation that the patient is receiving diuretics. Physician order cannot be used as diuretic documentation – you need to show administration.
  
• The physician must document specifically why the catheter is to remain after POD2.
  

• Physician order
  
• Operative report
  
• Progress notes