Tuesday, July 21, 2009

eCommerce continues to be a bright spot in the economy

While brick and mortar stores like Circuit City are bankrupt, leaving hollow buildings and for lease signs in their wake, Amazon.com continues to make advances in market share. Amazon, not Best Buy realized the largest gains. Best Buy market share in fact declined in speciality electronics.


Innovative software and solutions that make Amazon and other on-line sites more frictionless will be an important growth category in the future. Also, multi-channel eRetailing will be increasingly important.

Click "play" below to watch the video.
Contact No World Borders for more information on eCommerce solutions.


Wednesday, July 15, 2009

Rand Study Details Costs and Benefits of switching from ICD-9 to ICD-10 Medical Coding

The Americal Recovery and Reinvestment Act (ARRA) provides incentives to modernize health care, including the upgrade to a new medical coding standard, ICD-10. Despite both incentives and mandates, health insurance companies, hospitals, and others want more data on the cost and benefits of the change over. We felt this data provided a good independent view of these issues.

The RAND Corporation was asked to provide research to answer these questions:

  • What are the costs and benefits of switching from ICD-9’s diagnostic codes to those of ICD-10-CM?
  • What are the costs and benefits of switching from ICD-9’s procedure codes to those of ICD-10-PCS?
The research was conducted by the Science and Technology Policy Institute (operated by RAND from 1992 to November 2003) for the Department of Health and Human Services, under contract ENG-9812731.

Summary

Statistical models led to these conclusions

Cost (March 2004 dollars)

"Our best guess is that the cost of conversion will run $425 million to $1.2 Billion in one-time costs plus somewhere between $5 million and $40 million a year in lost productivity.

Benefits
  • More-accurate payments for new procedures - between $100 million and $1.2 Billion
  • Fewer miscoded, rejected claims - between $200 million and $2.5 Billion
  • Reduced "improper" or exaggerated claims (including fraud ) - between $100–$1 Billion
  • Better understanding of the value of new procedures - between $100 million to $ Billion.
  • Improved disease management - between $200 and $1.5 Billion

Conclusion

"It is likely that switching to both ICD-10-CM and ICD-10-PCS has the potential to generate
more benefits than costs."

Methodology

RAND estimated the cost of systems reprogramming by sampling payers, providers, and software vendors; dividing their answers by membership (in the case of payers) or revenue (in the case of providers and software vendors); and extrapolating to the entire population.

Their anecdotal comment was that "Most observers believe that ICD-10-CM and ICD-10-PCS are technically superior to their ICD-9-CM counterparts. If nothing else, they represent the state of knowledge of the 1990s rather than of the 1970s. They have also been deemed more logically organized, and they are unquestionably more detailed—by a factor of two in diagnoses (and twenty for injuries) and by a factor of fifty in procedures."

Tuesday, July 14, 2009

Global Lessons: Planning and Preparation are Keys to ICD-10 Success

The Americal Recovery and Reinvestment Act (ARRA) provides incentives to modernize health care, including the upgrade to a new medical coding standard, ICD-10.

The
Gartner Group, a leading research organization has called the transition to ICD-10 “a momentous change.” However, it also states that, “In the long run, ICD-10 is a key enabler for quality improvement, better management planning and better care.” Better care, isn’t that what every provider organization is trying to achieve?

For more than a decade, AHIMA has warned of the problems that exist with the ICD-9-CM system, while artfully promoting the value proposition of ICD-10. The AHIMA site offers a wealth of information from which CIOs and other senior executives can benefit.

We need first to understand some of the baseline deficiencies inherent as we continue to use the ICD-9-CM system. ICD-9-CM is obsolescent. The system is quickly running out of space for new codes, thereby limiting the inclusion of new procedures and diagnoses. Further, it is not sufficiently precise to fully enable an EHR, conform to pay-for-performance reporting requirements, adversely affects DRGs by grouping different procedures into a single code, and decreases our already considerable investment in SNOMED-CT.

Whether you work for a provider or payer, keep this in mind as we move to the October 1, 2013 compliance date.

  • HIPAA X12 5010, the EDI standard required for implementing ICD-10 has an earlier date than 2013.
  • Implementation of the EDI standard needs to be well in hand for your organization by 2011. That isn't far away if you are a large enterprise organization.
  • Process impacts are easy to miss if IT and busines aren't partnered.
  • Planning and preparation are keys to success
  • Education is a must
  • Network and reach out to others to learn from their experiences
We can learn from ICD-10 implementations that have already taken place in other countries. Thailand *yes Thailand* implemented ICD-10 in 1994. The U.S. is implementing a version of ICD-10 which the W.H.O. granted permission for it to modify, ICD-10-CM

Here is a summary of lessons learned from the Canadian experience with ICD-10 implementations.

According to a post from AAPC:

"The International Classification of Disease (ICD) is used for classifying diseases and other health problems recorded on many types of vital records including death certificates and hospital records. The International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10-WHO) is maintained by the World Health Organization and was endorsed by the 43rd World Health Assembly in May 1990. Many countries around the world began implementing ICD-10 for mortality statistics in 1994. In the natural progression of coding medical records, various countries around the world began to contemplate the idea of using ICD-10 for morbidity data.

Since the World Health Organization (WHO) holds the copyright to ICD-10, those countries seeking to modify the system had to request permission to do so. All modifications must be approved by WHO to keep certain standards and conventions in place. By imposing standards and restrictions the coding integrity is maintained allowing for comparative analysis between counties on global conditions and diseases.

Countries that have sought and gained approval to create their own ICD-10 include Australia (ICD-10-AM), Thailand (ICD-10-TM), Germany (ICD-10-GM), Canada (ICD-10-CA) and the United States (ICD-10-CM).

Of particular interest to the United States is the experience Canada had in the implementation of ICD-10. Our neighboring country, Canada sought approval to modify ICD 10 from WHO in 1995, began work to modify the codes in 1999 and commenced adoption in April 2001.

The rollout of the new code set in Canada was different in some respects from the anticipated rollout in the United States. Canada’s universal, single-payer system is funded and regulated at the federal level but coordinated at the provincial level. In the Canadian ICD-10 rollout, each province had the ability to determine the date for their specific implementation. As a result, provincial implementation of ICD-10-CA was staggered beginning in 2001 with completion by April 2005. We do not have a single-payer system nor do our states have the same control as the Canadian provinces; as such, our implementation effort will not be staggered.

A somewhat interesting challenge that Canada had was that when they rolled out the ICD 10 system, Windows-based computer software was just making the scene. Not only were Canadian coders faced with a new code set, but they were also faced with the challenge of changing from using hardbound books to desktop Windows-based applications for their reference materials.

What they did implement that we should take note of as we embark on this journey is focused attention to planning and early commitment from industry stake holders including government leaders and agencies, professional associations, colleges and universities, providers and vendors.

The Canadian experience suggests three key points to remember:

  • Planning and preparation are keys to success
  • Education is a must
  • Network and reach out to others to learn from their experiences

Whether you work for a provider or payer, keep this in mind as we move to the October 1, 2013 compliance date."


Wednesday, July 8, 2009

Official Google Blog: Introducing the Google Chrome OS

Official Google Blog: Introducing the Google Chrome OS

Google Announces Chrome OS

Late this evening Google announced on its blog that it was entering the operating system business with Google Chrome OS. We are sure to read many stories in the coming days, but thought we would share a quick analysis with our readers as to the business and technology impacts we see:

• The effort marks the latest attack by Google on Microsoft

• Whether it can challenge Microsoft's dominance in the market remains unclear. In the months since its launch, the Google Chrome browser has done little to challenge Microsoft's lead in the browser software.

• The Web browser *is* Google's operating system. The Linux based Chrome OS, as it is called, will add a new layer of windowing software to manage what a user sees on a display screen. Instead of requiring programmers to write programs specifically for the operating system the Google engineers said that the Chrome operating system will simply run programs written for the Web (whether for a Windows, Mac, or Linux browser).

• The Google blog post stresses that the Chrome operating system is a separate effort from Android (the mobile computing OS) -- though, like Android, it will be "open source," meaning other developers can have access to and modify the code.

• The software is designed to work Intel Corp. and AMD chips used in most conventional PCs -- as well as chips that are the standard in cell phones and are expected in netbooks later this year.

• Google's operating system announcement could galvanize critics, including privacy groups and competitors, who argue that the online search company already collects vast amounts of information about consumers' Internet use.

• While Google is still a tiny player in many of the new markets it is exploring, like mobile phone software and online applications, some worry it could leverage its massive online search market share to quickly grow its share of new industries as well, gathering even more data about its users.

Are you considering going to market with a new technology offering? No World Borders can help segment the market, provide insights and recommend partnerships.