I love that expression: "in the weeds." It has entered into the realm of jargon but, nevertheless, it so clearly describes how I have been feeling about the HIS implementation guide I have been writing with Melanie Merriman. Thoroughly in the weeds with the HIS and trying not to get choked, trying to sort through the gazillion details, trying to pull out the non-essential and get to the heart of the matter.
The original title of this blog post was "In the Weeds with the Hospice Item Set" but I changed it because I am FINALLY out of the weeds with the HIS! The Hospice Item Set: A Step-by-Step Implementation Guide (Guide) is finished and it is now available for ordering and download!
I have written quite a few regulatory type manuals for hospices during my career and the process is usually similar. Researching and reading to try to deeply understand the regulations, envisioning how the regulations will impact the daily operations of hospice programs, then figuring out what tools and resources might help hospices save time and make compliance less onerous. Then it is a matter of sorting through it all and trying to write/develop something that is not utterly tedious and boring or, barring that, at least something that is user-friendly and useful.
I like what we have done with the HIS Guide. I loved working with Melanie (as I always do) and I believe what we have created will help hospices that may be struggling to sort it all out. And now that I am finally out of the HIS weeds I can more clearly describe features of the Guide and how it might be helpful.
It is not a cursory overview and it is not redundant
At this point hospices should have a pretty good idea of what the HIS is. We went way beyond that to try to figure out how hospices will actually do what they have to do to meet the requirements. We were also committed not to simply regurgitate all that CMS has provided in terms of resources and training.
The CMS resources provide training and explain how to fill out each HIS data element on the HIS forms. We refer to the CMS resources often throughout the Guide with suggestions for who in your hospice needs to read or review what. But the CMS resources do not provide any help with the processes a hospice needs to put into place so that two HIS records can be completed and submitted for every single patient within the prescribed deadlines. Our goal was to get into the operational realm and detail how hospices can manage the HIS process.
As I described in my salami blog post (here), we divided the HIS process into five manageable chunks (functions): Collecting, Abstracting, Reviewing, Converting and Submitting. Each of these functions must be completed for every single HIS-Admission and HIS-Discharge record, both of which must be completed and submitted for every single patient admitted to the hospice on or after July 1, 2014. We describe the "nitty gritty" of each function and discuss how to most efficiently and cost effectively complete each one.
There is A LOT of HIS nitty gritty and we tried to cover all of it. All of Chapter 3, for instance, is devoted to the complex task of managing HIS deadlines and timeframes (see my blog post here on what I think about the HIS completion deadlines). Also, throughout the Guide we gave consideration to hospices that have a supportive EMR vendor (or will use another vendor) and those that don't. If your hospice does have an EMR vendor, we have a tool that lists the questions you need to ask your EMR vendor so you can be absolutely certain all your bases are covered? If you don't have an EMR vendor, what do you need to do? We cover that as well. Managing deadlines and dealing with (or without) EMR vendors are just two of the nitty gritty items we cover in the Guide.
Tools and resources
Like other Weatherbee guides and manuals, this one includes a number of tools and resources that we hope will help. Among the tools and resources there is an Excel spreadsheet to help manage HIS deadlines, a data mapping tool to help crosswalk your hospice's electronic or paper-based documentation system to the HIS data elements and four PowerPoint presentations for training staff.
Hospices will need to hit the ground running with the HIS. For short stay patients admitted and discharged within the first week of July, both the HIS-Admission and HIS-Discharge records will need to be submitted within the second week of July (or earlier). NOW is the time to prepare.
Please check out the Table of Contents for The Hospice Item Set: A Step-by-Step Implementation Guide to see what we covered in the text and all the tools and resources that are included.
The Guide is available for purchase as of today (May 27, 2014). Hospices can order it online and download it immediately. If you are "in the weeds" with the HIS - the Guide will help you get out.
Posted by: Heather P. Wilson, Ph.D. CEO, Weatherbee Resources