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Job hunting has changed drastically from 20 years ago when newspaper classified ads and personal interactions were the best way to find open positions. You would go door to door to apply, make telephone calls, and snail mail and fax resumes and cover letters to the employers. Today, you scour through thousands of job listings […]
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Doctors are very wary about the idea of medical miracles but the idea of miraculous healing has been around for thousands of years. For those people who are facing terminal or severe chronic illness the desire for a miracle healing can be immense. Is this a legitimate hope or a false hope?
Whether miracles still happen today depends on your definition of the word miracle. If by miracle you mean that something is totally against the laws of nature then I would suggest that they never did happen.
However, if by miracle you mean a turn around in serious, or terminal illness when the doctors thought there was very little chance of recovery, then, of course they do still happen.
How can I be so sure? Most doctors who have been practicing for years have stories of people who have done much better than could have ever been expected given their diagnosis, prognosis (expected outcome) and treatment. Discussion on them is usually kept to the coffee room rather than the research unit.
It is also a matter of logic. If you have 100 people with a terminal condition then not all of them die at the same instant. They die one at a time. And for every 100 people then the last 10 will die later than the first 90. That is logical. And someone has to take longer to die than all of the others in that group of 100. Also within that group of the last survivors are some people who have such a good quality of life that some would describe them as miracle survivors.
The important question is whether there is a reason for some to take longer to die than others, or whether it is just chance? Fortunately research has answered some of these questions for us. While chance is probably always a component there are many things that those who survive much longer than others all have in common.
Ground breaking research was published in the academic journal Qualitative Health Research in 2008 which described the quality of such survival as personal resilience. What was really interesting is that all of the survivors had a very large number of personal qualities and ways of interpreting life that were in common to all of them regardless of whether the person was male or female, how old they were (23 – 90 years) or how much education they had during their lives (18 months to graduate degrees and further training).
The survivors decided early on in their illness to live each day with the best quality that they could make. They lived each day to the fullest and their quality of life was self defined. These were people who came to live their own lives, not controlled by others or by their disease process, but so that they could take charge for today.
Of course they were often constrained by their illness. If you are on a drip and confined to one room there are lots of things that you can’t do. However within those constraints there were still lots of things the survivors chose as important for that time, such as being in charge of their own toileting or choosing to put make-up on for visitors. They did not allow their quality of life to be defined by their illness but by their own values and the way they chose to live on that day. The focus was on what was possible not on what they could not do.
Every person was different in the way they chose to define what was quality for them. However it was really interesting to find that by focusing on their own interpretation of quality of life that each person did come to a quality of life that anyone, whether medical carer or dispassionate observer would agree was quality. Each person ended up symptom free for at least an extensive period of time. Their disease remitted or apparently disappeared.
The fact that remission is physically possible means that there is a biological pathway for remission to occur in anyone and so hope is legitimate. Doctors worry about giving what they call false hope. However if there is just one case ever that has gone into remission means that there must be hope and when there is hope there is justification for exploring possibilities for improving the quality of life for those who are seriously and terminally ill.
Dr Harriet Denz-Penhey is an internationally recognized health researcher who has done groundbreaking research into patient self care in serious illness. Want to learn more about unexpected recovery from terminal illness? Claim Harriet’s popular free e-course, available at http://www.beatthemedicalodds.com/.
Internships present wonderful opportunities for individuals and students to start their careers in practically any field. If you are planning on creating a job in the medical industry, you are likely interested in the many internship opportunities that are available in this industry today. The following paragraphs will briefly review the various positions that are available to individuals like you.
The medical industry has many unique segments within it. Whether you are interested in executive positions, physician positions, or you are just interested in the lower end positions that are available in this industry, there are internships available that will suit you perfectly.
No matter which segment of this field you are interested in though, you will be able to acquire a great deal of skills and knowledge about how this industry operates if you obtain an internship position. Interns often complete real world tasks that keep businesses moving forward and they often help physicians complete their primary objectives.
If you are seeking out a career in the administrative portion of this industry, you can easily find an internship that revolves around administrative duties available today. These positions often work with the practical aspects of medical facilities relating to customer records, supply management, and billing.
There are also many positions that lead to more significant roles within the medical community available as well. These positions often help interns learn about the management of facilities and they help interns learn about the more complex issues relating to the business aspects of medical professions. These positions are perfect for individuals who would like to eventually become executives in this industry.
Individuals who are planning on becoming doctors in the future often become interns as well, but their roles in the medical community often differ from those who are interested in more basic operations within this field. As an intern who is in the process of becoming a doctor, you will likely have much more experience than other interns and you will possess the training that is needed to actually assist doctors in a direct manner as they serve their patients.
As an intern, you will be in a great position to learn about how this industry operates and you will have a chance to improve your skills and knowledge concerning the fields you are hoping to build a career within. Many internships within this industry are paid internships as well. For this reason, if you are hoping to obtain an internship within the medical establishment today, you can expect to earn income and you can expect to acquire the knowledge you will need to become successful in the future.
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One of the greatest benefits that individuals enjoy is the fact that they can have vital medical device technology right at their fingertips in the comfort of their own home. Through years of innovation and technology medical devices have gone through some serious transformations that has allowed them to not only become more user-friendly but in addition to that they have become much more affordable. Many years ago the thought that so many difference devices would be able to be used in the home setting was unthinkable. One such great example is a pulse oximeter and blood pressure monitor. Both products were the type that you would typically just find in the hospital setting. One is made specifically for measuring the pulse rate and blood oxygen saturation while the other is made to strictly measure the blood pressure of individuals. If one was to use these two things at home to monitor their health they really did not have any access to them.
Then what occurred is that there was some major technological advancements in chip technology and semiconductors. Through such pulse oximeter innovation the products were able to be manufactured to be firstly smaller and more portable and secondly much less expensive. So essentially if you have a health condition like lung cancer where you need to closely monitor your oxygen levels or whether you have high blood pressure then what you can do is to easily follow your health levels. The other great benefit of the advancement is actually the fact that the pulse oximeter products became significantly cheaper and more affordable for regular home consumers. The hospitals have budgets that are able to withstand expensive health items, but regular individuals need to have the ability to have access to their monitoring systems while still being conscious of their budgets and financial capabilities.
The highest quality pulse oximeter products can be found at http://www.pulseoximetersupply.com
Related Medical Coding Articles
Computer-assisted coding: Where are we today?
by Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, CDIP
In our computer-savvy tech world, the medical field has been notoriously slow to respond to newer technologies and applications of computer-assisted enhancements. However, in the HIM market, computer-assisted coding (CAC) has been touted to boost coding accuracy and productivity, in addition to being an important tool for the remote inpatient coder.
Background
The term CAC denotes technology that automatically assigns codes from clinical documentation for a human to review, analyze, and use, according to the Journal of AHIMA.
Currently, there are a variety of methodologies, software, and integration interface applications that enable a CAC application to read text and assign codes. This type of software reads the information in a similar way to how a spell-check application works on a traditional computer. According to some users, data-driven documentation (e.g., documentation that is dictated or typed) is more accurately processed by the CAC software than documents that are scanned into the system for the software to use.
CAC software works through recognition; it learns words and phrases, as well as learning the areas within a specific document where standardized words and phrases appear. CAC software also has the ability to discern the context or meaning of those words and phrases. The program then analyzes and predicts what the appropriate ICD-10-CM/PCS codes should be for the documented diagnoses and procedures it finds within the specified documents.
Software providing CAC functionality has been available for over 10 years, but it has come to the forefront of inpatient coding with the implementation of ICD-10-CM/PCS. CAC has allowed hospitals to reduce lag times and enhance DRGs while also finding missed MCC/CC diagnoses. The usage and integration of an electronic health record (EHR) has also played a role in better code assignment and usage for data analysis and outcomes.
It is yet to be shown whether CAC actually enhances a coder’s productivity rate. On the upside, CAC does give the coder a great place to start when working on a difficult inpatient record. CAC is now where we were more than 20 years ago when encoders were first introduced into the inpatient hospital marketplace for coding, abstracting, and data analysis.
Pros and cons of CAC
Due to the complexity of inpatient care records, clinical documentation, and the complexity of medical terms and abbreviations, many hospitals only use CAC together with intervention by human coders. However, the latest CAC software technology employs a type of natural language and syntax processing to compare, contrast, and extract specific medical terms from electronic data or typed text?so CAC stand-alone technology does exist. In studies conducted by AHIMA, though, the combination of a CAC with a coder/auditor has been proven to be just as good, or better than, a coder or CAC alone.
The biggest challenge CAC poses might be getting buy-in from the hospital coding and HIM staff. The HIM, coding, and clinical staff must all be a part of the changes and be on board with learning how to use this technology enhancement. In the past, there has been some uncertainty and fear related to CAC eliminating coders’ jobs. However, a good CAC solution in conjunction with HIM management allows coders to apply their critical thinking and analytical skills to create well-coded documentation of patients’ care. This, in turn, results in more accurate DRG assignment and reimbursement for the facility.
HIM and coding staff’s responsibility and role in the fiscal revenue stream will change as a result of CAC and similar technology. With this change must comes the acceptance that it takes both a human and a computer to successfully transform a CAC product into good financial outcomes and even better documentation.
As coders will surely agree, the final code selection for inpatient records should be based upon coders’ knowledge of coding guidelines, clinical concepts, and compliance regulations. When working with CAC, the coder has the ability to agree with or to override codes that the software determines.
Coders have the education to understand why a diagnosis or procedure should or should not be coded in a specific situation, and by using CAC, they can help the software learn to identify the importance of specific documentation and its relation to ICD-10-CM/PCS codes.
Many CAC vendors will try and sell their product based on the following list of features and benefits:
As we’ve said, it hasn’t been shown that CAC actually increases coders’ productivity. In reality, their productivity will probably stay the same, as a coder will still have to audit the information to determine whether the code generated by the software is correct. But in regard to the other CAC benefits on the above list, coder satisfaction should not be overlooked.
During AHIMA’s pilot testing of CAC software, the organization weighed in on some of the potential issues with using CAC software alone (with no human intervention). AHIMA noted that within specific areas of the pilot CAC testing in ICD-10, the coders did not accept 75% of the diagnosis codes presented, and they did not accept 90% of the procedure codes presented within the code sets. However, the information that the CAC software presented did give the coders a good starting reference to drill down to a more comprehensive diagnosis or procedure code.
Coders and CDI personnel will still need to be in charge of the following:
CAC, clinical documentation, EHR, and providers
Integration of clinical documentation from providers and physicians has always been a challenge, and combined with the implementation of ICD-10, it has presented a huge impetus for the adoption of CAC technology in hospital- and facility-based organizations.
Unfortunately, physicians still don’t provide thorough documentation, instead relying on CDI and coding staff to guide them. There has always been a disconnect in the language spoken by providers and the language spoken by coders. Physicians document in their comfort zone and fall back on terms such as "pneumonia," whereas a coder is looking for much more specificity. The integration of an EHR-based program and CAC for providers can lead to a good team relationship for both parties.Many CAC programs integrate well with hospital-based CDI programs and EHRs. These combination interfaces allow more real-time processing of possible code selection prior to the coder’s audit and review of the final code selection.
When the CAC software identifies these possibilities, there is an opportunity to identify and improve the DRGs with MCCs and CCs, as well as more quickly address areas for query and missed procedures or diagnoses.
Wrapping it all up
It is evident that coders and HIM professionals need to make a commitment to embrace change, which includes new technologies and integration of learning processes and opportunities. A hospital’s success depends on the coder acting as part of a team that will strive for successful outcomes for both the patient and the hospital.
Editor’s note
Webb is an E/M and procedure-based coding, compliance, data charge entry, and HIPAA privacy specialist with more than 20 years of experience. Her coding specialty is OB/GYN office/hospitalist services, maternal fetal medicine, OB/GYN oncology, urology, and general surgical coding. She can be reached via email at [email protected], and you can find current coding information on her blog at http://lori-lynnescodingcoachblog.blogspot.com. This article originally appeared on JustCoding, and opinions expressed are those of the author and do not represent HCPro or ACDIS.
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