Navigating a changing healthcare environment

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The Official Coding Guidelines implemented October 1, , reiterated in Coding Clinic 4 th Quarter , included some changes that cannot be overwritten by facility-specific policy and warrant a closer look.

Zika virus infections A Possible, probable, suspected, terminology does not apply. Much like HIV that must be confirmed before coding, avian flu must be confirmed before coding, so now is true for Zika virus infection. Lots of people are being tested for such viruses, but only those confirmed by the provider are coded. Non-confirmed cases may be coded to Z The more we revisit these changes and put them into practice, the easier the changes are to accept and soon they become the new reality.

As we approach the season that reminds us to be thankful for all our blessings, let us appreciate the opportunities that change presents and work together to be the very best we can be. For more information please email us at contact eclathealth. As a provider of comprehensive healthcare support services that include medical coding, medical billing, and healthcare revenue cycle consulting, our goal is to live up to our name by crafting business partnerships that work brilliantly in a symbiotic nature.

Related Articles. The steps include:. Change management can make or break an organization. But far too often, healthcare organizations fail to engage the staffers on the front lines. Passive and active resistance from these teams can stymie our best efforts to affect change long-term. Transforming change management in healthcare from a top-down declaration to a process of engaging staff at every level can create a community of problem solvers to achieve a shared goal.

As a result, organizational culture improves and the chance of a successful change management initiative is higher. Change management in healthcare organizations is a delicate balancing act between worker engagement and management strategy. Because these efforts are labor-intensive, it is often advantageous to have the assistance of external expertise to ensure the success of your change management initiative. C4H helps healthcare organizations and health-focused nonprofits to optimize their efforts and better serve their community.

Contact us to discuss how we can facilitate change in your organization. According to the Centers for Disease Control, diagnosing people living with HIV and providing them with treatment would greatly reduce risk of transmission, preventing about 90 percent of new infections. Effective leadership is key to success across every industry, but managing a team in a critical field like healthcare — where good leadership is a need-to-have, not a nice-to-have — can feel especially stressful.

Leaders must constantly strive to increase their knowledge and expertise, as well as keep up with the latest innovations in an industry that's always changing. What is capacity building, and how can it help your health service organization grow and thrive? Capacity building means more than just an organization's current ability to perform its mission; rather, it impacts a nonprofit's capacity to deliver on goals over time, to expand its capabilities, and to further succeed in its mission or take on more work.

Change may be inevitable but even expected changes can cause upheaval for nonprofits. Given the constraints — such as tight financial resources and overstretched staff — that so many organizations must maneuver within, navigating change can add another layer of complexity.

The method was introduced in , when the FDA approved the drug Truvada — which blocks an enzyme that allows HIV to replicate itself within the body. Health Equity aims to enable better opportunities for organizations and public health professionals to respond to racial, health, and structural disparities at the local level.

Learn more here. In this six-week program, you will be matched with a cohort of CDC-funded CBO managers from across the country to learn and practice methods to accelerate organizational change. As the U. EHE initiative are vital to regain momentum, advance innovation, and achieve health equity. Capacity for Health is a capacity building assistance CBA provider and have many resources available. Why is it, then, that organizational efforts at change management so often fail?

What models are available to ensure your change management efforts will succeed? Engage core stakeholders at every level. Develop a roadmap for the change initiative.

Gather staff to put the plan into action. Remove obstacles and adapt as they occur. Initiate changes and track progress.

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Payors, providers, and consumers are all demanding a value- and outcomes-based health environment, which will be fueled by the increased use of technology, real-world data, and new comparative-effectiveness research rules. Pharma companies will need to be able to overcome the commercial and market-access risks that could accompany this shift.

The implication, especially in primary care and broader public and population health, is a shift away from highly innovative treatments toward highly effective solutions, especially solutions that shift accountability toward the consumer. In addition, more openness can be expected across the industry as companies create precompetitive platforms for better data sharing and knowledge synthesis.

These opportunities can help accelerate new-product development and produce, distribute, market, and monitor products with improved capital efficiency. McKinsey: You mention openness and open platforms. What is Pfizer pursuing in this area? The former is a trial with one investigator remotely monitoring patients who conduct their trial activities through the Web and local labs, and the latter is collaboration with medical centers and electronic-health-record players to radically improve the way adverse events are reported, measured, and used.

We are also playing a leading role in the PACeR Partnership to Advance Clinical Electronic Research program in New York, one of the preeminent health-information exchanges being established in the country.

In addition, our partnership with Private Access is focused on establishing new Internet-based standards for patient privacy rights that enable better health care data liquidity and help connect patients, physicians, and researchers with tailored information, tools, and technology that will lead to more informed decisions about patient care, including clinical-trial participation.

We also have a collaboration with Merck and Lilly on the Asian Cancer Research Group that demonstrates the possibility of setting up open-access research and data sharing for shared value. Last but not least, our work with Sage Bionetworks further illustrates the value of creating industry utilities either in commodity areas, where costs should be shared across the industry, or in knowledge areas, where the synthesis of currently siloed knowledge creates more value and more wins for all participating stakeholders.

Does Pfizer see it this way? If so, what is Pfizer doing about it? There are numerous examples of companies using real-world insights to drive patient compliance and demonstrate product value or safety. We also established a partnership with MDxHealth for companion diagnostics in oncology. These are all early experiments, but in general, precision medicine and precision care are important areas of strategic interest to us, and we are actively pursuing strategies and models to develop world-class capabilities in each, to shape the future and meet evolving customer needs.

McKinsey: You mention pharmaceutical companies conducting studies using real-world data. What do you think about the scores of academics conducting high- and low-quality real-world studies?

Kristin Peck: This has been a reality for years, as the quality of studies on pharmaceutical products has been variable in the past. The difference going forward is that more data will be available, meaning more opportunities for impactful real-world outcomes research that can improve care. Unfortunately, this may also increase the odds of rogue analyses that grab disproportionate media attention.

This is an important area where pharma, academics, private payors, and governments should come together to advance data standards that increase the liquidity of health care data and define research standards in order to maintain transparency and research integrity while reducing counterproductive noise in the system.

What areas are you most interested in exploring further? And what characteristics are you looking for in potential partners? Kristin Peck: Let me make a general statement about connected-health models first. Governments, the private sector, and civil society have to agree on and advance incentives on both the supply side and demand side to sustainably generate medical and business-model innovation that delivers stepwise value to public health.

Such models need collaborative innovation at their foundation, as well as a process for value cocreation and risk sharing among partners. New nurses are rarely ready to care for complex patients with multiple co-morbidities and often feel overwhelmed. Experts agree that nurses do not achieve initial competency until their second or third year.

However, a new nurse who has only been on the job for six months receives the same patient load as one with much more experience. New nurses must move from the latent knowledge they accrued to applied knowledge.

This move requires pattern recognition. And that takes time, experience, and more than six months. Working nurses need to see the big picture. Management should shelter new nurses from the constant bombardment that staff nurses experience. New nurses can find it hard to recognize subtle patient changes that may signal an impending deterioration or change in condition. It's best to know the signs to look for in the patient population they serve—from post-operative patients to patients in nursing homes and healthcare centers.

New nurses have their own set of challenges. But we are so lucky to have them and want them to thrive.