Breaking into the medical technical writing field

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BREAKING INTO THE
MEDICAL TECHNICAL
WRITING FIELD
10/19/2010
Traci Wilbanks, Senior Technical Writer
2
Introduction
How I got in the door
My Medical Experience
3


Started as a technical writer for a durable medical
equipment (DME) company and transitioned into the
role of a business systems analyst in the IT
organization.
Currently working for a clinical decision support
system (CDSS) software company in the Operations
organization.
Medical Experience is a Must?
4



The requirement for medical experience seems to
depend on the organization’s structure and to whom
the technical writer role reports.
Medical experience seems less important for
technical writers in the IT organization.
Having basic knowledge of the health care
workflow from claim to payment helps as does
knowledge of industry jargon and standards
organizations.
5
Writing in the Medical Arena
Personal experience is still experience
As a Patient
6


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You know that the healthcare system is complex.
Every provider has different rules and processes for
submitting claims and getting paid, but the overall
process is fairly standard.
Your experience with your own health care or the
health care of a family member is helpful because
it gives you a different perspective which can help
you better serve your end users.
Major Streams in Healthcare
7
Payers


Care and claims
management
Its customers are members
Pharmacies


Provide drugs
Its customers are patients
and providers
Providers


Physicians, hospitals and
other facilities
Its customers are patients
Suppliers


Provide anything prescribed
that is not a drug
Its customers are patients
and providers
8
Knowing the Major Players
Big insurance companies are not the only big
guys on the playing field
As Medicare/Medicaid Goes, So Goes
the Nation
9


The Centers for Medicare & Medicaid Services
(CMS) is a branch of the U.S. Department of Health
and Human Services. CMS is the federal agency
that administers the Medicare program and
monitors the Medicaid programs offered by each
state. http://www.cms.hhs.gov/
CMS dictates the direction and initiatives of medical
billing and medical software companies because
meeting CMS’s requirements satisfies a large
portion of its patient base.
The VA
10


The United States Department of Veterans Affairs
not only provides its members with health care
benefits, but it also administers the care through its
facilities.
With 1,400 sites of care, the VA operates the
largest integrated health care system in the nation.
CMS + VA
11


As of August 2010, 25.4% of US adults were
insured through a government program such as
Medicare, Medicaid, or military/veterans’ benefits.
This figure is about 13% higher than the 22.5% of
US adults receiving government health insurance in
January 2008, one month after what is generally
considered to be the December 2007 starting point
of the current recession.
- Gallup-Healthways Well-Being Index
The Joint Commission
12


The Joint Commission is an independent, not-forprofit organization which accredits and certifies
more than 18,000 health care organizations and
programs in the United States.
The mission of the Joint Commission is to continuously
improve health care for the public, in collaboration
with other stakeholders, by evaluating health care
organizations and inspiring them to excel in
providing safe and effective care of the highest
quality and value.
Guidelines and Compliance
13



In order for providers to get paid, they have to be
compliant with established guidelines.
Most health care organizations look to the Joint
Commission for these guidelines.
Guidelines cover a variety of areas based on the
type of health care program (i.e. ambulatory care,
home care, hospitals, laboratories, etc.).
14
Client Systems & Technology
Setting the Pace of Progress
User Interfaces & Hardware
15


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The technology underpinning most medical billing
systems is antiquated (e.g. green screen terminal
emulators to view AS400 data).
Organizations often have several disparate systems
with no interoperability.
The hardware in larger institutions (i.e. hospitals,
suppliers, etc.) is often a decade behind current
levels which limits the innovations proposed by
Development.
16
What is Healthcare Reform’s Impact?
Paying attention to politics is critical
HITECH Act
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

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
Health Information Technology for Economic and Clinical
Health Act
The HITECH Act is part of the American Recovery and
Reinvestment Act of 2009 in which $19.2 billion is intended
to increase the use of Electronic Health Records (EHR) by
physicians and hospitals.
If physicians and hospitals are “meaningful users” of EHR
systems, they are eligible for reimbursements which could
cover the costs of implementation.
EHR system vendors are clamoring to demonstrate
adherence to meaningful use guidelines to become a
certified EHR; government money is only available if a
certified EHR is purchased.
Data Interchanges
18



HL7 – Health Level 7; clinical and administrative
data domain; one of several American National
Standards Institute (ANSI) accredited Standards
Developing Organizations (SDOs)
SNOMED CT – Systemized Nomenclature of
Medicine Clinical Terms
Recommended reading – Principles of Health
Interoperability HL7 and SNOMED by Tim Benson
Competitive Bidding
19



The Medicare Modernization Act of 2003 established
requirements for competitive bidding for certain
Durable Medical Equipment, Prosthetics, Orthotics, and
Supplies (DMEPOS).
The intent is to set more appropriate payment amounts
for these items which will result in reduced out of pocket
expenses for Medicare beneficiaries.
This act forced medical suppliers to enhance existing
intake and billing systems to establish whether or not
the supplier won the bid in a given area and what the
fixed price is. Rounds of bidding happen every 18
months requiring the systems to remain flexible.
20
What Should You Know?
Getting your foot in the door may require a little
research
Acronyms
21

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
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
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
HIPAA – Health Insurance Portability and Accountability Act
PHI – Protected Health Information
HCPCS Codes – Healthcare Common Procedure Coding
System
ICD-9/ICD-10 Codes – International Statistical Classification
of Diseases
EMR/EHR – Electronic Medical Record/Electronic Health
Record
LOINC – Logical Observation Identifiers Names and Codes
NDC – National Drug Code
NPI/UPIN – National Provider Identification/Unique
Provider Identification Number
Third Party Organizations
22


Clearing houses – entities which process or aid in
the processing of information (e.g. perform billing
functions for a supplier, offer consolidated list of
guidelines)
Drug Database Publishers – provide metadata
about drugs including descriptions, pricing, and
interactions
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