2016 Winter ACHENTX Executive Connection by ACHENTX

WINTER 2015

THE ICD-10 ISSUE

6 F E AT U R E S 4 President’s Message Winjie Tang Miao, FACHE 5 Regent’s Message John Allen, FACHE 9 Member Spotlight 18 National News 20 Event Encore 22 Education Committee 23 ACHENTX Education Event

A New World of Healthy Design - That You Wear

Myths of ICD-10-CM/PCS Addressing Why it is Not Feasible to use SNOMED CT in Place of ICD-10 or Wait for ICD-11—and Other Misperceptions

The Impact of the ICD - 10: How Implementation will Affect the Healthcare Executive’s Mission

Editor-In-Chief

Dr. Valerie A. Shoup, PE, FACHE

Contributing Editor

John Whittemore

Contributing Writers Creative Direction

Fraser Hay, FACHE Amanda Bloom Amanda Oâ&#x20AC;&#x2122;Neal Brumitt, FACHE Stan Kovarik LaToya Rivers Mike Belkin, FACHE Michael Vinson, FACHE

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info@northtexas.ache.org

Caleb Wills

Questions and Comments: ACHE of North Texas Editorial Office, c/o Executive Connection 250 Decker Drive | Irving, TX 75062 p: 972.413.8144 e: info@northtexas.ache.org w: achentx.org 2015 Chapter Officers

2015 Board of Directors Teresa Baker, FACHE John Peter Smith Health Network Jennifer Conrad CORGAN Jessica Fuhrman, FACHE BroadJump Forney Fleming University of Texas at Dallas Michael Hicks, MD, FACHE UNT Health Science Center Ben Isgur PricewaterhouseCoopers

President Past President

Dresdene Flynn White, FACHE Strategic Leadership Solutions

Kristin Jenkins, JD, FACHE DFW Hospital Council Foundation

Winjie Tang Miao Texas Health Resources

Kevin Stevenson, FACHE ERDMAN

Secretary

Janet Holland, FACHE BroadJump

Treasurer

Pam Stoyanoff, FACHE Methodist Health System

Regent

John Allen, MHA, MPH, FACHE UNT Health Science Center

Demetria Wilhite University of Texas at Arlington Chip Zahn, FACHE Surgical Care Affiliates

The ACHE of North Texas e-magazine, The Executive Connection, is published quarterly (Spring, Summer, Fall and Winter) and includes information on the latest regulatory and legislative developments, as well as the quality improvement and leadership trends that are shaping and influencing the healthcare industry. Readers get indepth reporting on the issues and challenges facing hospital and health system leaders today. We make it our job to tell you about the great things the organization and Chapter are doing every day to ensure the health of our community. If you have any news and updates that you want to share with other members, please e-mail your items to info@northtexas.ache.org. Microsoft Word or compatible format is preferable. If you have a graphic or picture that you'd like to include, please send it as a separate file. The following are the types of information that our members shared in past ACHE of North Texas magazines, Advocacy Issues, Legislative Issues, Educational Opportunities, Awards / Achievements, Promotions (Members On the Move), Committee Updates, journal submissions, conference submissions, and workshop participations, sharing mentoring experiences, etc.

Outgoing President’s Message

elcome to the final ACHE North Texas newsletter for 2015! The holiday season is always a time for celebration and giving thanks and I’d like to use my last message to do the same. The ACHE North Texas general membership meeting was held on November 5 at The Joule hotel in Dallas. That evening, we celebrated the achievements of outstanding members including Fraser Hay as the Young Healthcare Executive of the Year and Scott Hurst as our Volunteer of the Year. Fraser currently serves as the Professional Services Officer at Texas Health Presbyterian Hospital Plano and is as the chair of our Advancement Committee. Scott Hurst is the Senior Director, Physician Networks at Children’s Health. Scott has not only been an active member of our Membership and Networking committee, but has also served as a mentor in ACHE North Texas’ mentorship program. I was lucky enough to attend the Mentorship Ceremony a few weeks ago where I heard firsthand how Scott has made a positive impact in the lives of his mentees. Congratulations to both Fraser and Scott! We also held our annual Case Study competition. Four teams from local graduate programs participated. Congratulations to UT Dallas for winning the grand prize of $3,000. Their excellent presentation and analysis certainly impressed our panel of judges. I am also thrilled to announce the appointment of John Whittemore as the first Executive Director for ACHE North Texas. John was selected among many qualified candidates and we are excited he has chosen to lead our chapter. In his new role, John will be responsible for furthering our strategic goals – growing the educational and networking value of ACHE North Texas through sponsorship development, chapter growth and efficient operations.

John has built his career focusing on membership association management including, most recently serving as the managing director for the Asian Health Care Leaders Association, the National Forum for Latino Healthcare Executives and the Rainbow Healthcare Leaders Association. Prior to that, he was with the Young Presidents’ Organization/World Presidents’ Organization, an international organization with a mission to help young CEOs of substantially large companies develop their leadership skills and network with each other. Many of you have already had a chance to meet John at various events this fall. In the spirit of giving thanks, please join me in giving a huge thank you to Jessica Fuhrman for serving as our interim director for much of this year. Her diligence and dedication ensured that the chapter functioned seamlessly through our leadership transition. I’d also like to recognize all of our committee chairs for creating enriching opportunities for all of us. It is because of their efforts that we continue to be one of the top performing ACHE chapters in the country. Finally, I’d like to thank my fellow board members for their service this year and extend my appreciation to Josh Floren and Chip Zahn as they complete their board service. Next year, Dresdene Flynn White will be taking the helm as your board chair. Dresdene has been an active board member for several years and I know she will lead this chapter to even greater success. As always, I encourage you to find a way to participate, get involved and make the most of your membership. For more information on how to become involved or to send us feedback on our programs visit us at our website or send us an email at info@northtexas.ache.org. It has been a privilege and honor to serve as your board chair this year. All the best, Winjie Miao

A Publication of the American College of Healthcare Executives of North Texas Chapter | WINTER 2015

Regent’s Message Dear Colleagues,

On the education front, I would also

During the holidays I hope you will find

Texas Hospital Association (THA)

like to invite you to the upcoming

time to pause and reflect on those things that bring you joy and for which you can be thankful. This is especially important in a time of the fast paced changes we are facing in healthcare: changes to EHR Incentive (meaningful use) Program; introduction of the

Conference in Dallas on January 21-22. This event will provide ACHE members educational opportunities focused on telemedicine and financial management and several renowned guest speakers, include ACHE Chairman Richard Cordova. Mr. Cordova will be speaking the morning of January

“Cadillac tax” for employer based health insurance; increasing penalties for 30 day hospital readmissions;

22 during the ACHE breakfast. Click here for more information or Google “THA Conference 2016.”

reductions in reimbursement (see OPPS fee schedule); new post-SGR

The North Texas Regional Advisory

regulations such as the Merit-Based

Council (RAC) has been exploring

Incentive Payment System…to name

opportunities for interregional

a few. These changes undoubtedly

collaboration-perhaps in the

require a high level of our time and energy, so now is a time to seek rest! Since my last message, Mike Belkin and I have spoken to undergraduate and graduate students at the University of Texas at Arlington and the University of Texas at Dallas about the benefits of ACHE. Although we discussed the value and importance of advanced education, earning the FACHE credential, and taking advantage of ACHE educational and networking opportunities, our meetings with these students largely focused on leadership. I was impressed with their high level of interest in how they could build their leadership skills-they understand education by itself does not guarantee career success. I am excited about the ongoing opportunities to speak to these future healthcare leaders.

form of an educational clusteramong and between the North Texas, East Texas, and Midwest Chapters. In particular, RAC team members have focused on bringing collaboration opportunities closer to our rural hospital partners. We are considering planning an event next summer that will bring us all together. Be watching for more information in the coming weeks! I wish you the very best during the upcoming holidays. Please feel free to send me your suggestions and feedback as we seek to provide our organizations with the very best leadership possible. John G. Allen, CMPE, FACHE Regent for Texas - Northern

A Publication of the American College of Healthcare Executives of North Texas Chapter | WiNTER 2015

A New World of Healthy Design–That You Wear Wearable technologies have the power to make communicating with health care providers seamless and easy—opening up a new frontier for data tracking and treatment.

Image via Giuseppe Costantino

Gary Wellman is living the dream. Every morning, he is treated to the nearly cloudless sky that frames Arizona’s nearby Santa Rita Mountains. A retired basketball coach, 72-year-old Wellman happily shares that he “lives on a golf course in Green Valley,” and likes to keep busy. “You can’t sit around when you have arthritis and diabetes like I do.” About a year ago, Wellman hopped out of his golf cart, stood up to reach for his clubs and found himself on the ground. He suffered from numbness in his feet, a common symptom of diabetes. After that day, Wellman says, “I began to fall a lot on the course. My doctors did all kinds of tests and came up with nothing.” That is until Wellman’s physician suggested he participate in an experimental treatment for loss of balance conducted

in the lab of Bijan Najafi, PhD, a surgeon and director of the Interdisciplinary Consortium on Advanced Motion Performance at the University of Arizona. Health in Motion Najafi is one of a growing number of health experts tapping the potential of, an emerging group of objects, often-wearable, that are internet-enabled to track and protect health. All of these “smart” gadgets could eventually become part of what some are calling the “Internet of Things” – a vast network of objects that seamlessly gather data and talk to each other. We’re heading towards a day when a barely detectable system of sensors could make communicating with health care providers easy, or even let our bodies do the communicating for

A Publication of the American College of Healthcare Executives of North Texas Chapter | WINTER 2015

us. Ideally these objects will help trigger healthy decisions and inform healthy choices. To give Wellman back his balance and mobility, Najafi’s team attached biosensors to his midsection, hips, knees, and ankles, then linked them all to a computer. During a series of workouts, Wellman would dance what he called his hula. “I moved my hips in sort of a circle. When I reached the proper position, a colored dot would appear at certain points along a grid on the computer screen.” Ever the sportsman, Wellman worked hard to raise his skill level. “I got really proficient by the end,” he says. Wellman is now back on the golf course and steady on his feet. “When I start to lose my balance, I can correct it with a hip motion before I fall,” he says. Naiafi’s achievements were heralded at the recent 2015 American Institute of Architects (AIA) Design and Health Research Consortium, convened by the Robert Wood Johnson Foundation. The AIA consortium supports revolutionary, university-led research in design and health – and that’s where personal devices come in. The balance-enhancing treatment is designed to help diabetics, cancer patients, and the frail elderly by guiding them through exercises that they might otherwise avoid because of the fear of falling. “We created a game-based exercise using foot, ankle, and body movements,” says Najafi, who is working on a home version. The game retrains the brain by proving real-time feedback, or provides a workout with safe activities that can be challenging and engaging. Najafi is also perfecting smart sox— stockings with biosensors that give physicians real-time data on the existence or progress of inflammation—a precursor

to foot ulcers—in people with diabetes. “These patients may not feel any pain as the ulcers develop,” says Najafi, noting that the annual tab in the U.S. for footulcer care is between $9 billion and $13 billion. Smart sox have the potential to prevent ulcers by showing doctor and patient where to relieve pressure before the ulcer occurs. Beyond Fitbit Najafi’s game-based exercises, smartsox, and other devices are being tested by health design engineers in labs cross the country. They may seem similar to the latest apps and wearable technology flooding the market, but there is one critical difference—clinical accuracy. Many of these devices are also unique in that they can gather information without the need for the wearer’s intervention. “Research shows that after a few days, 40 percent of users no longer pay attention to health apps,” says Thomas Fisher, dean of Minnesota’s college of design. One project, by the Center for Connected Health at Partners Healthcare and funded by RWJF, aims to change this statistic. The Center is developing an interactive “engagement engine” that will help consumers select and use trackers to develop and stick to physical activity

plans. Other researchers are thinking about how to reach kids by leveraging the digital gadgets they already use, but for health. Fisher says a potential benefit of these wearable devices and trackers is to, “help people to remain ambulatory and independent, and give health care providers the information needed to improve care and prevent illness.” His department recently won a silver medal from NASA for applications that will help protect the health of astronauts. In the Wearable Technology Lab at the University of Minnesota, director Lucy Dunne, PhD, focuses on clothing that transmits data as the wearer moves. To test her most recent design, Crystal Compton, a design student, slipped into a comfortable black top that looks like regular fitness wear. “As I bend halfway down, elongating my spine and bringing my shoulders forward, conductive threads woven into the shirt send data on body position to a computer,” Compton explains. The shirt may be used for many things, but the current goal is to measure the movement and shape of the spine during scoliosis treatment. Decoding Stress Devices with sensors can do more than capture movement – they can reflect

A Publication of the American College of Healthcare Executives of North Texas Chapter | WINTER 2015

back to us how we feel. Imagine a device that could accurately report your body’s stress response at the molecular level or alert you the moment your immune system is under attack. Precisely measuring these clues to how people fare in certain environments and situations through biosensors is the work of Esther Sternberg, MD, research director at the University of Arizona Center for Integrative Medicine, one of 11 centers selected as founding members of the AIA research consortium. Immune system proteins “can be measured through perspiration,” Sternberg says. “Our goal is to eventually measure them in real time as well as indicators of inflammation.” In her research, Sternberg and her team found that levels of specific molecules correlated with symptoms of anxiety, stress, and depression. Dunne also has one more accomplishment in mind—saving lives. One of her latest projects is a glove designed specifically for firefighters. They look like regular industrial work gloves, but they will give the bravest a power reserved for superheroes— the ability to detect the presence or absence of objects in the dark. The sensors in the gloves will prevent them from tripping in smoke-darkened rooms, falling through holes often created as buildings give way to flames. “Linking body, environment, and technology to help people is where we are headed,” Fisher says. “The Internet of Things is moving quickly through huge advances.” The Internet of Things is taking us towards a day when a barely detectable system of sensors could make communicating with health care providers seamless and easy—perhaps letting our bodies do the communicating for us.

Here’s a look at some of other developments in the evolution of digital health from RWJF grantees: › The Health Data Exploration Project is looking at ways to use “personal health data for public good.” There has been an explosion in the amount of personal health data collected through apps, wearable self-trackers and other “Internet of Things”-type technologies. Taken together, this personal health data could provide new insights in the health of the population, and guide decisions about how to improve public health. › Agile Science is exploring a new way to conduct faster, more adaptable research that can help us more quickly understand how tools and technologies can help create healthier behaviors, such as getting more sleep or exercising more. › The Atlas of Caregiving recognizes that caring for a family member’s health is hard work, and can have health consequences for the caregivers. To come up with better ways to support caregivers, investigators will deploy wearable technologies to learn about the day-to-day lives of caregivers across different situations. The information will be used to help shape technology development, service delivery, and policy development.

A Publication of the American College of Healthcare Executives of North Texas Chapter | WINTER 2015

Member Spotlight Amit Malhan, MHA

Meet Amit Malhan, a student Member of ACHE. Amit received his MHA from University of Texas at Dallas. Currently he is a Ph.D. candidate at University of North Texas who volunteers with our ACHE North Texas chapter. What are you doing now? Currently I am enrolled in PhD program in Logistics and Supply chain Program at University of North Texas (UNT) as a fellow. Through this program, I am also working as SME from UNT on healthcare project for National Institute of Health (NIH) grant. The NIH grant involves collaboration with researcher, professors and healthcare experts on research topics of healthcare and supply chain. In addition I am serving as a mentor for undergraduate students at college of business at UNT. In your opinion, what is the most important issue facing Healthcare today? The most important issue faced by healthcare is lack of cohesive system that leads to decrease in quality and increase in cost. System should start working in a unified way instead of separate silos. Accountable Care organization is a step towards in that direction, but it will take considerable amount of time to prove its effectiveness. On top of it different policies by different authoritative bodies makes the problem at the hand even worst. How long have you been a member of ACHE? I have been member of ACHE since fall 2013. I joined as student member and then became involved as communication

committee member of north Texas chapter. Why is being a member important to you? Being a member provides me with networking opportunities and keeps me up to date with current healthcare trends. At conferences and events, you meet and interact with leaders in healthcare and it may develop to mentor-mentee relationship. On top of all this benefits, we get access to top notch publication. In terms of career development, we are provided wide variety of career support services like job portal, fellowship, internships and career management. For student member, it provides financial assistance too. ACHE case competition that is held annually for students and judged by executives and industry experts takes your thinking and thought process to a whole new level. What advice would you give early careerists or those considering membership? First and foremost know what you want, second have a plan for it and third have a backup plan of that plan. Focus is the key here. Go for the membership and get involved in your local ACHE chapter. It will open the doors of opportunities that you canâ&#x20AC;&#x2122;t even think of which is complimented with great learning and tips from healthcare leaders. Tell us one thing that people donâ&#x20AC;&#x2122;t know about you. I am a rock guitarist and have tracks accepted in a Hollywood music library. If music is your passion, do contact me.

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A Publication of the American College of Healthcare Executives of North Texas Chapter | WINTER 2015

MYTHS OF ICD-10-CM/PCS ADDRESSING WHY IT IS NOT FEASIBLE TO USE SNOMED CT IN PLACE OF ICD-10 OR WAIT FOR ICD-11—AND OTHER MISPERCEPTIONS By Sue Bowman, MJ, RHIA, CCS, FAHIMA

As the US healthcare industry experiences yet another delay in ICD-10-CM/PCS implementation, misunderstandings surrounding the ICD-10-CM/PCS transition continue to perpetuate. This article addresses a few of the most common misperceptions—myths that need to be exposed with factbased evidence: › The idea that replacement of ICD-9-CM is not a necessity. › The increase in the number of codes from ICD-9 to ICD-10 increases the difficulty of using the new code set. › SNOMED CT or ICD-11 represent viable alternatives to ICD-10-CM/PCS implementation.

ICD-9-CM Must Be Replaced

Replacing ICD-9-CM is not optional. Almost 25 years ago, the National Committee on Vital and Health Statistics (NCVHS) expressed concern that the ICD classification might be stressed to a point where the quality of the system would soon be compromised. More than 10 years ago, NCVHS sent a letter to the Secretary of the US Department of Health and Human Services (HHS) recommending the ICD-10 code sets be adopted as replacements for the ICD-9-CM code set. Both costs and dangers are associated with continued use of the outdated ICD-9-CM coding system. ICD-9-CM is obsolete and no longer reflects current clinical knowledge, contemporary medical terminology, or the modern practice of medicine. Its limited structural design lacks the flexibility to keep pace with changes in medical practice and technology. The longer ICD-9CM is in use, the more the quality of healthcare data will decline, leading to faulty decisions based on inaccurate or imprecise data. After reviewing ICD-9-CM codes, healthcare providers often don’t know precisely what was wrong with patients or what treatments they received. By continuing to use this outdated code set, US healthcare providers have a limited ability to extract the information that will optimize public health surveillance, exchange meaningful healthcare data for individual and population health improvement, or move to a payment system that is based on quality and outcomes.

An inability to uniquely capture new technologies and services, along with using codes that do not reflect current clinical knowledge and practice, severely restricts the reliability and validity of US healthcare data. The ability to accurately analyze the provision of healthcare services and whether reimbursement is fair and equitable is compromised. If data on new diseases and technology or important distinctions in diagnoses and procedures cannot be captured, it is not possible to effectively analyze healthcare costs or outcomes. Electronic health records (EHRs) and interoperability require a modern coding system for summarizing and reporting data. Without ICD-10-CM/PCS, the US investment in EHRs will be greatly diminished, as the value of more comprehensive and detailed information will be lost if it is aggregated into outdated, broad, and ambiguous codes such as those in ICD-9-CM. Further declines in coding productivity and accuracy can also be expected as long as ICD-9-CM is in use. The ambiguity and obsolete clinical terminology used in many ICD-9-CM codes make the system difficult to use and leave reported codes open to interpretation.

ICD-10-CM/PCS Facilitates Accurate and Efficient Code Reporting Just as the size of a dictionary or phone book does not make it more difficult to look up a word or phone number, an increased number of codes does not make it harder to find the right code. In fact, the correct code is easier to find in a more comprehensive and detailed code set—just as it is easier to find a word in a comprehensive dictionary. Coding is easier when detailed and precise codes are available. If a dictionary is incomplete, or the words are vague or nonspecific, it is more difficult to find the correct definition—just as the inability to find a code that accurately describes a particular health condition is frustrating. As noted above, the ambiguity of ICD-9-CM and the use of outdated terminology makes ICD-9-CM more difficult to use since the codes are open to multiple interpretations. Greater specificity and clinical accuracy makes ICD-10-CM/ PCS easier to use than ICD-9-CM. Increased specificity,

A Publication of the American College of Healthcare Executives of North Texas Chapter | WINTER 2015

clinical accuracy, and a logical structure facilitate—rather than complicate—the use of a code set. When the expansion of codes in ICD-10-CM is examined more closely, it is much less daunting. The major reason for much of the code expansion is identification of the affected side of the body. This specification of laterality accounts for 46 percent of the total increase in the number of codes. And for those ICD-10-CM codes with greater clinical detail than is found in ICD-9-CM, much of that detail was requested by organizations representing clinicians because this level of detail was thought to be clinically significant. With the growing emphasis on linking quality and payment, and the movement toward valuebased purchasing, it is clear this additional clinical detail will be important. For example, ICD-10-CM contains significantly more detail than ICD-9-CM regarding specific types of surgical complications and types of devices, implants, or grafts involved. The Alphabetic Index and electronic tools will continue to facilitate proper code selection. The improved structure and specificity of the ICD-10 code sets will facilitate the development of increasingly sophisticated electronic tools to aid the coding process. An individual provider will never use all of the codes in a given code set, but instead will only use those relevant to their specific patient population.

SNOMED CT and ICD-10 are Complementary Systems Clinical terminology and classification systems play separate but equally important roles in healthcare delivery. Neither a clinical terminology nor a classification can serve all current and future uses for coded data required in the US healthcare delivery system. Terminologies and classifications are designed for distinctly different purposes and satisfy diverse user requirements. A standard clinical terminology enables clinicians to represent detailed information in a consistent, reliable, and comprehensive way.10 A clinical terminology such as SNOMED CT is an “input” system designed for the primary documentation of clinical care. It is the global clinical terminology that adds processable meaning to the EHR. When implemented in software applications, SNOMED CT can be used to represent clinically relevant information consistently, reliably, and comprehensively as an integral part of producing EHRs. The International Classification of Diseases (ICD) is the international standard diagnostic classification that organizes content into meaningful standardized criteria and enables the storage and retrieval of diagnostic information for

epidemiological and research purposes. ICD is the foundation for the identification of health trends and statistics on a global scale. The ICD defines the universe of diseases, disorders, injuries, and other related health conditions. It organizes information into standard groupings of diseases, which allows for: › Easy storage, retrieval, and analysis of health information for evidenced-based decision-making › Sharing and comparing health information between hospitals, regions, settings, and countries › Data comparisons in the same location across different time periods15 ICD allows the counting of deaths as well as diseases, injuries, symptoms, reasons for encounters, factors that influence health status, and external causes of disease. It is the diagnostic classification standard for clinical and research purposes. These include monitoring of the incidence and prevalence of diseases, observing reimbursement and resource allocation trends, and keeping track of safety and quality guidelines.

well-suited for the secondary purposes for which classification systems are used because of their immense size, considerable granularity, complex hierarchies, and lack of reporting rules. Health records created and stored in electronic environments (i.e., electronic health records) require the use of uniform health information standards, including a common medical language. Together terminologies and classification systems provide the common medical language necessary for interoperability and the effective sharing of clinical data. The benefits of health information technology investments cannot be achieved without using the latest available versions of terminology and classification standards. SNOMED CT and ICD-10-CM/PCS used together in EHR systems can contribute to patient safety and evidence-based high-quality care provided at lower cost by leveraging a “capture once, use many times” process. Information captured in SNOMED CT can be repurposed through linkage to ICD. Classification systems allow granular clinical concepts captured by a terminology to be aggregated

The International Classification of Diseases and Related Health Problems, 10th Revision, Clinical Modification (ICD-10-CM) is a US version of the World Health Organization’s ICD-10 and was developed for use in reporting morbidity data in all healthcare settings. The International Classification of Diseases 10th Revision Procedure Coding System (ICD-10-PCS) has been developed as a replacement for Volume 3 of the International Classification of Diseases 9th Revision (ICD-9-CM). Classification systems are “output” rather than “input” systems and are not designed for the primary documentation of clinical care. Classification systems group together similar diseases and procedures and organize related entities for easy retrieval. They group ideas for aggregation and analysis and add statistical value to data. Essential to the big picture of healthcare, classification systems are intended for secondary data uses, including: › Measurement of quality of care › Reimbursement › Statistical and public health reporting › Operational and strategic planning › Other administrative reporting functions19 SNOMED CT and ICD are designed for different purposes and each should be used for the purpose for which it is designed. While ICD’s focus is statistical, SNOMED CT is clinicallybased and focused on capturing the information needed for clinical care. The standard vocabulary afforded by SNOMED CT supports meaningful information exchange to meet clinical requirements. ICD-10-CM and ICD-10-PCS, with their classification structure and conventions and reporting rules, are useful for classifying healthcare data for administrative purposes, including reimbursement claims, health statistics, and other uses where data aggregation is advantageous. A clinical terminology intended to support clinical care processes should not be manipulated to meet reimbursement and other external reporting requirements. Such manipulation represents the potential to adversely affect patient care, the development and use of decision support tools, and the practice of evidence-based medicine. Clinical terminologies are not

into manageable categories for secondary data purposes. Clinical data “input” into EHR systems can be transformed by ICD into “output” governed by reporting rules and guidelines for use. The benefits of using SNOMED CT increase exponentially if it is linked to modern, standard classification systems for the purpose of generating health information necessary for secondary uses such as statistical and epidemiological analyses, external reporting requirements, measuring quality of care, monitoring resource utilization, and processing claims for reimbursement. HHS does not believe SNOMED CT qualifies as a standard for reporting medical diagnoses and hospital inpatient procedures for purposes of administrative transactions. HHS has consistently maintained that it does not consider adoption of SNOMED CT to be a viable alternative to ICD-10-CM/PCS implementation because these code sets are designed for distinctly different purposes. To maximize the value of health information, classifications and terminologies should be used appropriately according

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to their purpose and design. Instead of selecting a single classification or terminology to serve all clinical functions, multiple classifications and terminologies should be used for the functions for which they are ideally suited, and only linked as needed. Together terminologies and classifications provide the common medical language necessary for interoperability and the effective sharing of clinical data. Linked together, ICD and SNOMED CT support better data collection, more efficient reporting, data interoperability, and reliable information exchange in health information systems. Healthcare systems will benefit from better data while reducing data capture and reporting costs. ICD-10-CM/PCS and SNOMED CT can both contribute to the improvement of the quality and safety of healthcare and provide effective access to information required for decision support and consistent reporting and analysis.

US Can’t Afford to Wait for ICD-11 Based on the World Health Organization’s current timeline, ICD11 is expected to be finalized and released in 2017. For the US, that date is the beginning, not the end, of the process toward adoption of ICD-11. Regardless of the benefits of ICD-11, the US would still need to evaluate the code set for national use and likely develop a national version to allow for the annual updating demanded by Congress and US stakeholders. Also, since ICD-11 does not include a procedure classification system, a procedure coding system for use in the US would need to be developed. The process of evaluating ICD-11 for use in the US, developing a national modification to meet US information needs, and developing a procedure coding system would take at least a decade, followed by the rulemaking process to adopt ICD-11 as a HIPAA code set standard. In the case of ICD-10, it took eight years to develop a US modification of ICD-10 and a procedure coding system, and 19 years for a final rule to be published. Five years after publication of this final rule, and 24 years after the World Health Assembly endorsed ICD-10, the US has still not implemented ICD-10-CM/PCS. The US cannot wait another 10-25 years to replace the ICD-9CM code set. As noted above, replacement of ICD-9-CM is long overdue. Waiting until ICD-11 is ready for implementation in the US is not a viable option, as waiting that long to replace the ICD9-CM code set would seriously jeopardize the country’s ability to evaluate quality and control healthcare costs. US healthcare data is being allowed to deteriorate while the demand increases for high-quality data that can support new healthcare initiatives such as the “meaningful use” EHR Incentive Program, valuebased purchasing, and other initiatives aimed at improving quality and patient safety and decreasing costs. In a 2013 report on the feasibility of skipping ICD-10 and going right to ICD-11, the American Medical Association Board of

Trustees recommended against skipping ICD-10 and moving directly to ICD-11, as this approach is fraught with its own pitfalls. Concerns cited in this report included: › ICD-9 is outdated today and continuing to use the outdated codes limits the ability to use diagnosis codes to advance the understanding of diseases and treatments, identify quality care, drive better treatments for populations of patients, and develop new payment delivery models. › The US market will miss out on the improvements in the ICD-10 codes that align with today’s diagnosis coding needs, including the addition of laterality, updated medical terminology, greater specificity of the information in a single code, and flexibility to add more codes. › Skipping ICD-10 will impede the ability of the industry to build on their knowledge and experience of ICD-10, which is expected to be needed for ICD-11. Learning the medical concepts, training efforts, and overall implementation efforts for ICD-11 will be more challenging if ICD-10 is not implemented first. › Implementing ICD-10 is expected to reduce payers’ reliance on requesting additional information, known as “attachments,” which could reduce burdens on physicians, but this opportunity would be delayed until ICD-11 if ICD-10 is not implemented. › The timeframe to have ICD-11 fully implemented could be as long as 20 years, unless there is a strong commitment by the industry to implement it faster. Implementing ICD-10-CM/PCS is an important step on the pathway to ICD-11. ICD-10-CM has informed ICD-11 development, as updated clinical knowledge and additional detail considered important for use cases such as quality and patient safety monitoring have been incorporated into the US code sets. Transitioning to ICD-10-CM/PCS in 2015 will provide an easier and smoother transition to ICD-11 at some point in the future. By preparing information systems now to accommodate ICD10-CM/PCS, they will also be better able to accommodate the transition to ICD-11. And just as modifications to ICD-10 have been incorporated into ICD-10-CM through the annual update cycles, it is anticipated that content additions in ICD-11 that are not already included in ICD-10-CM will be incorporated into ICD-10-CM over time, which will facilitate the transition to ICD-11. Due to the structural limitations and obsolescence of ICD-9-CM, modifications to ICD-9-CM to reflect changes in the World Health Organization version of ICD would be impossible, complicating and disrupting a future transition to ICD-11 if the ICD-10-CM/PCS code sets are not implemented first. Excerpted from Journal of AHIMA with permission. Copyright 2014 by the American Health Information Management Association. All rights reserved. No part of the publication may be reproduced, stored in retrieval system, or transmitted in any form or by any means, electronic, photocopying, recording or otherwise without prior permission from the publisher.

A Publication of the American College of Healthcare Executives of North Texas Chapter | WINTER 2015

The Impact of the ICD - 10:

How Implementation will Affect the Healthcare Executiveâ&#x20AC;&#x2122;s Mission

ICD-10 Implementation in the United States has been long overdue. October 22, ACHE members gathered at Texas Health Presbyterian Hospital to discuss the effect of the updated coding system on healthcare management practice. James Sammons, M.D., FACHE, Chief Medical Officer at Texas Health Arlington Memorial Hospital, moderated the discussion. He compared the implementation of ICD-10 to the perception of the transition to “Y2K”. The distinguished panel consisted of: Jason Wachsmann, M.D., Assistant Professor at University of Texas Southwestern Medical Center and Associate Medical Director of Radiology at Parkland Hospital and Healthcare System; Terrance Govender, M.D., C-CDI, CHBC, Director, Healthcare Practice at Navigant; and Julie Pratt, RHIA, CCS, Corporate Inpatient Coding Manager at Texas Health Resources. The panel offered advice and testimonial on how to navigate the new coding system and the ever evolving patient care workflows. The focus of the discussion was on best practices for physician documentation and respective coding for services rendered. Roughly 50 chapter members and interested health care professionals attended the event. Dr. Govender responded with a unique perspective to a few questions about the impact of ICD-10 on reimbursement. Dr. Govender

attended medical school in South Africa and practiced in the UK. Both locations have been utilizing ICD-10 principles since 1994, so the specificity requirements are simply a minor change in documentation practice for physicians. Dr. Wachsmann shared the preparation process for the new coding practices including practice charting, and training of various physician groups. Pratt conveyed how effective coding practices directly impact a hospital’s bottom line. Productivity management of coders and their partnership with physicians must be founded on clear communication and documentation. Overall organizations are adjusting to the learning curve, yet are forging well at the journey’s onset. Shared best practices entail preparation and education of staff who are engaged in the documentation. Dr. Govender also projected there may be payment delays rather than changes in reimbursement due to carriers adjusting to the new codes respective to compensation for services rendered and encouraged organizations to appeal reimbursements if necessary. The ACHE North Texas members thank Texas Health Presbyterian Hospital Administration for hosting an intriguing event and we are grateful for our engaged attendees. For more information on future events, please visit us achentx.org or send us an email at info@northtexas.ache.org.

A Publication of the American College of Healthcare Executives of North Texas Chapter | WINTER 2015

National News Save the Date for the 2016 Congress on Healthcare Leadership

ACHE’s Congress on Healthcare Leadership brings you the best in professional development, exceptional opportunities to network with and learn from peers, and the latest information to enhance your career and address your organization’s challenges in innovative ways. The 2016 Congress on Healthcare Leadership, “Leading Well,” will be held March 14–17 at the Hyatt Regency Chicago.

Call for Innovations

ACHE would like to invite authors to submit abstracts of their posters for consideration for the 32nd Annual Management Innovations Poster Session to be held at ACHE’s Annual Congress on Healthcare Leadership. We are interested in innovations around challenges your organization has faced, such as in the areas of improving quality or efficiency, improving patient or physician satisfaction, implementation of electronic medical records and optimizing the use of new technology. All accepted applicants will be expected to be available to discuss their posters on March 14 between 7 a.m. and 8 a.m.; posters will remain on display from March 14–16, 2016, at Congress. Please go to ache.org/CongressPosterSession for the full selection criteria. Abstracts should be submitted as an email attachment to PosterSessions@ache.org by Jan. 19, 2016.

More than 4,000 healthcare leaders attended the 2015 Congress on Healthcare Leadership. Join us in 2016 and be part of the dynamic, energizing event that draws the top healthcare leaders from across the nation and around the world. This premier healthcare leadership event provides: • Education on current and emerging issues • More than 140 sessions of practical learning from healthcare’s top leaders • Opportunities to connect with your peers • Career-enhancement workshops The opening date for Congress 2016 registration and to reserve hotel accommodations is Nov. 11, 2015.

Apply for a Tuition Waiver

To reduce the ACHE educational programming barriers for ACHE members experiencing economic hardship, ACHE has established the Tuition Waiver Assistance Program. ACHE makes a limited number of tuition waivers available to Members and Fellows whose organizations lack the resources to fund their tuition for education programs. Members and Fellows in career transition also are encouraged to apply. Tuition waivers are based on financial need and are available for the following ACHE education programs: • Congress on Healthcare Leadership •Cluster Seminars •Self-Study Programs •Online Education Programs •ACHE Board of Governors Exam Review Course All requests are due no less than eight weeks before the program date, with the exception of ACHE self-study courses—see quarterly application deadlines on the FAQ page of the tuition waiver application. Incomplete applications and applications received after the deadline will not be considered. Recipients will be notified of the waiver review panel’s decision not less than six weeks before the program date. For ACHE self-study courses, applicants will be notified three weeks after the quarterly application deadline. If you have questions about the program, please contact Teri Somrak, associate director, Division of Professional Development, at (312) 424-9354 or tsomrak@ache.org. For more information, visit ache.org/TuitionWaiver.

Access Complimentary Resources for the Board of Governors Exam

For Members starting on the journey to attain board certification and the FACHE® credential, ACHE offers complimentary resources to help them succeed so they can be formally recognized for their competency, professionalism, ethical decision making and commitment to lifelong learning. These resources, which include the Exam Online Community, the Board of Governors Examination in Healthcare Management Reference Manual and quarterly Advancement Information webinars, are designed to be supplements to other available Board of Governors Exam study resources, such as the Board of Governors Review Course and Online Tutorial. • The Exam Online Community is an interactive platform to learn and glean study tips from other Members taking the Exam. Participants can discuss Exam topics with experts and have the option to participate in study groups. Interested Members may join the Exam Online Community at bogcommunity.ache.org. •The Reference Manual, found at ache.org/FACHE, includes a practice 230-question exam and answer key, a list of recommended readings, test-taker comments and study tips. • Fellow Advancement Information webinars provide a general overview of the Fellow advancement process, including information about the Board of Governors Exam, and allow participants to ask questions about the advancement process. An upcoming session is scheduled for Dec. 10. Register online at ache.org/FACHE.

Encourage Your Members to Apply for Fellow Status

The importance of earning the distinction of board certification as a Fellow of the American College of Healthcare Executives cannot be overstated. Encouraging your chapter members to take the next step in advancing their career by achieving Fellow status benefits their professional goals and the healthcare management profession as it demonstrates a healthcare leader’s competence, leadership

skills and commitment to excellence in the field. The minimum requirements to submit a Fellow application include: ACHE membership; a master’s or other advanced degree; a healthcare management position with a minimum of two years healthcare management experience; three references from current Fellows (one of which must be a structured interview); and a copy of the Member’s current job description, organizational chart and resume. Upon submitting the application, applicants have three years to complete the remaining requirements for advancement to Fellow. Fellow applicants who successfully meet all requirements by Dec. 31, 2015, including passing the Board of Governors Examination, will be eligible to participate in the 2016 Convocation Ceremony at the 2016 Congress on Healthcare Leadership. Direct your members to ache.org/FACHE to review all requirements and to apply.

ACHE Announces Nominating Committee 2016 Slate

The ACHE Nominating Committee has agreed on a slate to be presented to the Council of Regents on March 12, 2016, at the Council of Regents meeting in Chicago. All nominees have been notified and have agreed to serve if elected. All terms begin at the close of the Council meeting on March 12. The 2016 slate is as follows. Nominating Committee Member, District 1 (two-year term ending in 2018) Stephen M. Merz, FACHE Vice President and Executive Director, Behavioral Health Yale-New Haven Hospital New Haven, Conn. Nominating Committee Member, District 4 (two-year term ending in 2018) Ed Hamilton, FACHE System Director, Strategy Development INTEGRIS Health Oklahoma City Nominating Committee Member, District 5 (two-year term ending in 2018) Kim A. King, FACHE Founder and President Strategy Advantage Manhattan Beach, Calif. Governor (three-year term ending in 2019) John Botsko Jr., FACHE Owner and President BrightStar Care Bonita Springs, Fla. Governor (three-year term ending in 2019) Michael J. Fosina, FACHE President NewYork-Presbyterian/Lawrence Hospital Bronxville, N.Y.

Governor (three-year term ending in 2019) Carrie Owen Plietz, FACHE CEO Sutter Medical Center, Sacramento Sacramento, Calif. Governor (three-year term ending in 2019) David L. Schreiner, FACHE CEO Katherine Shaw Bethea Hospital Dixon, Ill. Chairman-Elect Charles D. Stokes, FACHE COO Memorial Hermann Health System Houston Additional nominations for members of the Nominating Committee may be made from the floor at the annual Council of Regents meeting. Additional nominations for the offices of Chairman-Elect and Governor may be made in the following manner: Any Fellow may be nominated by written petition of at least 15 members of the Council of Regents. Petitions must be received in the ACHE headquarters office (American College of Healthcare Executives, 1 N. Franklin St., Ste. 1700, Chicago, IL 60606-3529) at least 60 days prior to the annual meeting of the Council of Regents. Regents shall be notified in writing of nominations at least 30 days prior to the annual meeting of the Council of Regents. Thanks to the members of the Nominating Committee for their contributions in this important assignment: Diana L. Smalley, FACHE Cheray T. Burnett, FACHE Christine M. Candio, RN, FACHE Brian C. Doheny, FACHE John M. Haupert, FACHE Ted W. Hirsch, FACHE Fred B. Hood, FACHE CAPT Anne M. Swap, FACHE

ACHE Call for Nominations for the 2017 Slate

ACHE’s 2016–2017 Nominating Committee is calling for applications for service beginning in 2017. All members are encouraged to participate in the nominating process. ACHE Fellows are eligible for any of the Governor and Chairman-Elect vacancies and are eligible for the Nominating Committee vacancies within their district. Open positions on the slate include: • Nominating Committee Member, District 2 (two-year term ending in 2019) • Nominating Committee Member, District 3 (two-year term ending in 2019) • Nominating Committee Member, District 6 (two-year term ending in 2019) • 4 Governors (three-year terms ending in 2020) • Chairman-Elect

A Publication of the American College of Healthcare Executives of North Texas Chapter | WINTER 2015

National News (con’d) Please refer to the following district designations for the open positions: • District 2: District of Columbia, Florida, Georgia, Maryland, North Carolina, Puerto Rico, South Carolina, Virginia, West Virginia • District 3: Illinois, Indiana, Iowa, Kentucky, Michigan, Minnesota, Nebraska, North Dakota, Ohio, South Dakota, Wisconsin • District 6: Air Force, Army, Navy, Veterans Affairs Candidates for Chairman-Elect and Governor should submit an application to serve that includes a copy of their resume and up to 10 letters of support. Per the approval of the Governors Review Task Force Final Report by the Governors in November, the application to serve will be updated online by Jan. 1 2016. For details, please review the Candidate Guidelines, including guidance from the Board of Governors to the Nominating Committee regarding the personal competencies of ChairmanElect and Governor candidates and the composition of the Board of Governors. Candidates for the Nominating Committee should only submit a letter of self-nomination and a copy of their resume. Applications to serve and self-nominations must be submitted electronically to jnolan@ache.org and must be received by July 15, 2016. All correspondence should be addressed to Christine M. Candio, RN, FACHE, chairman, Nominating Committee, c/o Julie Nolan, American College of Healthcare Executives, 1 N. Franklin St., Ste. 1700, Chicago, IL 60606-3529. The first meeting of ACHE’s 2016–2017 Nominating Committee will be held on Tuesday, March 15, 2016, during the Congress on Healthcare Leadership in Chicago. The committee will be in open session at 2:45 p.m. During the meeting an orientation session will be conducted for potential candidates, giving them the opportunity to ask questions regarding the nominating process. Immediately following the orientation, an open forum will be provided for ACHE members to present and discuss their views of ACHE leadership needs. Following the July 15 submission deadline, the committee will meet to determine which candidates for Chairman-Elect and Governor will be interviewed. All candidates will be notified in writing of the committee’s decision by Sept. 30, 2016, and candidates for Chairman-Elect and Governor will be interviewed in person on Oct. 27, 2016. To review the Candidate Guidelines, visit http://www.ache.org/ newclub/ElectedLeadersArea/REGSERV/candguid.cfm. If you have any questions, please contact Julie Nolan at (312) 424-9367 or jnolan@ache.org.

Women’s Breakfast Event The North Texas ACHE chapter held a women’s breakfast event October 7th. The event highlighted opportunities for greater representation of women in healthcare leadership positions. Britt Berrett, Ph.D., author of Patients Come Second: Leading Change by Changing the Way you Lead, moderated the discussion of women in the workplace. The panel consisted of talented, dynamic healthcare leaders, refined women working among a predominately male peer group. Dr. Barrett began the discussion by asking, “How did you get where you are today?” The group replied with candid responses. Virginia Rose-Harris, MBA, FACHE, VP of Texas Health Presbyterian’s Margot Perot Center for Women and Infants, indicated that when her career in healthcare began, she recognized a need for improved customer service. Harris cultivated financial success in For-Profit and Not-For-Profit settings by focusing on patient engagement, a focus to gain competitive advantage in the healthcare market. Laura Irvine, MHA, FACHE, EVP at Methodist Health System for Integration and Alignment, obtained her MHA at Trinity University. Irvine was inspired by the business side of healthcare. Irvine encourages early careerist to take the time to understand the clinical professionals’ experience as the clinical leaders know the important initiatives required for success. Nancy Vish, RN, Ph.D., President and CNO at Baylor University Medical Center Dallas, worked as an ICU nurse for many years in various regions of the country. Dr. Vish stated, “If the staff isn’t happy, the patient will not be happy, and leadership will spend more time managing than leading.” Kris Gaw, MBA, EVP of Parkland Hospital and Health System Operations started in finance and worked in a variety of administrative roles, from patient access, to business affairs, to chief of human resources, to COO. She attributes continuing education as helping her become a better leader as her career progressed. A record breaking 80 registrants interested in the topic of diversity in healthcare filled the La Cima Club. In response to the observation that most organizations are led by boards consisting predominately of older men; the group supported the need to change this phenomenon. Rose-Harris stated, “Women’s voices at the table are not speaking just to talk but are making a point” that could leverage the value of diversifying leadership. Gaw encourages women to have “confidence in their personal competence”; confidence will distinguish the individual as a professional. Dr. Berrett asked the panel to comment on the qualities demonstrated by the best boss of their career. Unanimously the group listed confidence, wit, humility, mentorship, and humor as identifying characteristics. Continuing the conversation, the panel identified the qualities needed in today’s leadership pool. The leadership should be inspirational, exude competence, demonstrate emotional intelligence, have analytical skills, and be capable communicators.

A Publication of the American College of Healthcare Executives of North Texas Chapter | WINTER 2015

EVENT ENCORE

The panel and attendants shared vibrant dialogue. Rose-Harris indicated that making technology work in our organizations is a significant element of valuebased care. Vish related that improving healthcare is , “Always about paying it forward.” Irvine conveyed that being willing to learn is critical to one’s success. Also, Gaw emphasized that mastering the art of managing up is helpful. North Texas ACHE is appreciative to the La Cima Club for hosting the annual women’s event. The attendees represented many of ACHE North Texas’s professional women and some brave men from the chapter. For more information on future events, please visit us achentx.org or send us an email at info@northtexas. ache.org.

ACHENTX General Dinner Event Summary 2015 North Texas ACHE’s Chapter General Membership Dinner was a meeting of the minds for the region’s healthcare’s leadership. Josh Floren, FACHE, President of Texas Health Presbyterian Hospital Plano, moderated the leadership updates. Board Nominations for the succeeding year included: Jared Shelton, Texas Health Presbyterian Hospital Dallas; Nancy Vish, FACHE, Baylor Heart and Vascular Hospital; and Corey Wilson, FACHE, Texas Health Harris Methodist Fort Worth. 2016 Officers include: President, Dresdene Flynn White, FACHE; President-Elect, Janet Holland, FACHE; Past President, Winjie Tang Miao; Secretary, Kevin Stevenson, FACHE; and Treasurer, Pam Stoyanoff, FACHE. Our new chapter president, Dresdene Flynn-White, moderated the annual overview. This year has been a progressive year; we realized advancement of 28 members to Fellow designation; 19 members passed the Board of Governors Exam; 31 mentee/mentor matches completed the Mentorship program, and chapter membership numbers over 1,600. The Communications Chapter redesigned the website, held five face-to-face panel education events, conducted ten well attended networking events so far with over 500 members in attendance, and ACHE North Texas members participated in a community service event at the Dallas Market Exchange. The numerous award recipients evidenced the level of engagement of our chapter members. The dinner guest speaker, Susan Dentzer, presented a comprehensive synopsis of the evolving health care market.

have resulted in expanded care initiatives as healthcare teams engage increasingly in ACOs. She highlighted how states such as Texas that didn’t expand Medicaid are still increasingly engaging in population health. Examples of successful public health initiatives included Kentucky’s functioning HIE, and South Carolina’s two-thirds decrease in teen pregnancy in five years. According to Ms. Denzer, currently many continuing educational events deliberate the Affordable Care Act; while she reviewed some of the ACA’s positive impacts, she candidly stated,” ACA isn’t the only thing going on in healthcare.” Increased use of medical devices in EHR and elsewhere to create actionable activity will become common place by 2020. Innovation and research are a prime focus at this time. An example of this was the identification of a relationship between depression and flora in the gut, and changes in the treatment of this disease expected in the coming years. Susan Dentzer suggested topics to further explore such as the increased closings of rural health systems and the fact that the United States has a greater mortality rate than other rich nations. She responded to the great debate of how to determine value in health care by comparing CMS, who is focusing on measuring outcomes from the clinical encounters and patients’ perspective to the core principles of public health. For example, 26% more diabetics received healthcare coverage in the last year resulting in increased clinic visits. However, in the long run there will be fewer amputations, and this decreased critical usage benefits everyone. The North Texas Chapter would like to thank the Joule Hotel for extending your lovely venue. Also, we would like to extend our appreciation to the members for participating in our annual wrap up as we are excited for professional development opportunities for next year. For more information on future events, please visit us achentx.org or send us an email at info@northtexas.ache.org.

The over 110 attendees conversed with excitement as Susan Dentzer highlighted health policy opportunities. Her experience as a PBS new analyst, as a Senior Policy Adviser at the Robert Wood Johnson Foundation, and as a global health leader, provided ripe focal points for an audience of forward thinkers. Ms. Denzer discussed how delivery and payment reforms

A Publication of the American College of Healthcare Executives of North Texas Chapter | WINTER 2015

The Education Committee The Education Committee completed its final double panel in Dallas on October 22 presenting The Impact of the ICD-10: How Implementation Will Affect the Healthcare Executive’s Mission and Technology Innovation Changing the Face of Healthcare Delivery. Join us on December 7 from 9:00am-3:00pm at Texas Health Harris Methodist Fort Worth for our On Location Program (6 Face-to-Face Credit Hours) presenting Possibilities, Probabilities, and Creative Solutions: Breakthrough Thinking for Complex Environments featuring ACHE national speaker Kevin E. O’Connor, CSP.

Mark your calendar for our educational events in 2016: › 1/21/2016: (3 Face-to-Face Credit Hours) 2 breakout sessions at the Texas Hospital Association Annual Conference and Expo › 2/25/16: (3 Face-to-Face Credit Hours) › 4/28/16: (3 Face-to-Face Credit Hours) › 6/23/16: (1.5 Face-to-Face Credit Hours) Local Program Council › 8/25/16: (3 Face-to-Face Credit Hours) › 10/27/16: (3 Face-to-Face Credit Hours)

A Publication of the American College of Healthcare Executives of North Texas Chapter | WINTER 2015

ACHE North Texas Education Event August 27, 2015 Panel 1: Health Insurance Exchanges and their Effect on Healthcare Delivery Organizations Dresdene Flynn-White moderated Panel 1. Panelists included: Tricia Nguyen, M.D. EVP Population Health, Texas Health Resources; Pricilla Goode, MAS, Director of Accountable Care Network at UT Southwestern; Blu Pannoff, J.D., Client Counsel, Public and Private Health Insurance exchanges; and Jay Beck, VP Strategic Marketing, Texas Health resources. The topic was introduced by an assertion that incorporating health insurance exchanges, medical excellence, and five star service was the recipe to success in the current healthcare market. Panelists indicated that the health insurance exchange is the place for people to buy insurance as most of the large insurance companies are part of the exchanges. Accountable care networks, contract with the exchanges to become the service providers of choice. Providers today must understand their risk tolerance, have technology to gage their risk, and must understand and be able to teach the concept of population health within their network of providers. The ACO’s need a strategy of how to contract with other healthcare providers and with the healthcare exchanges. The conclusion was that public exchanges will continue to grow and ACO’s must become savvy with operating within the parameters of today’s healthcare market. ACO’s must embrace technology as approximately 66% of consumers indicated they wanted more technology solutions for healthcare. Panel 2: Achieving the Triple Aim in Healthcare Brett Lee moderated Panel 2. Panelists included: Valerie Anderson, RN, BSN, MAOM, VP Clinical Effectiveness and Patient Safety, Methodist Health System; Tony Gilman, CEO, Texas Health Services Authority; and Steve Hadzima, M.D., Chief Medical Officer, Texas Health Presbyterian Hospital Plano. North Texas ACHE had a great turn out for Part two of our 3rd quarter educational event. Participants were treated to a great panel focused on “Achieving the Triple Aim”, facilitated

by Brett Lee from Tenet Healthcare, Valerie Anderson from Methodist Health System, Tony Gilman from the Texas Health Services Authority, and Dr. Steve Hadzima from THR. Each panelist provided a very unique look into their organizations approach to achieving the Triple Aim. Dr. Hadzima discussed how the evolution of data assimilation has allowed THR to gain deeper insight into the systems quality and efficiency while furthering the integration of physicians. Valerie explained how the approaches and outcomes associated with Methodist’s employee health campaign can be applied to larger populations. Valerie added that employees are a population as well and should be included in the discussion about population health. Tony described how the Texas Health Services Authority is committed to the Triple Aim as the organization works to make Health Information Exchanges common practice within in the State of Texas. Although population health was a hot topic during the Q&A, many of the 65 attendees had questions related to the adoption of a standardized HIE in Texas. Tony noted that all the major health systems in Houston are using the Greater Houston Health Connect HIE. “They are trusting a 3rd party to integrate all of their disparate data”, Tony commented. In the closing minutes, Valerie made a comment that stuck with many members; “We are educating patients at the end of their acute episode. They lived for 40-50 years and we think that a 10 minute education session will change lifelong habits. We need to be more proactive and start approaching population health from infancy and childhood.” ACHE North Texas appreciates the Heart Hospital, Baylor, Plano, for hosting the event and thanks the members and panelists for the lively exchange on the issues related to the current healthcare environment. For more information on future events, please visit us achentx.org or send us an email at info@northtexas.ache.org.

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2016 Diversity Award Dresdene Flynn-White represented ACHE North Texas at the Chapter Leadership Conference. She accepted ACHE National’s 2015 Regent’s Award for commitment to diversity. ACHE of North Texas embraces diversity within the healthcare management field and values initiatives that promote diversity. This summer, the chapter funded its first student to intern at a local hospital through the Institute for Diversity’s (IFD) Summer Enrichment Program. This program provides a rich opportunity for both the student and organization to experience the healthcare environment, particularly as it relates to the issues of population health and workforce diversity. IFD has indicated this is its first collaboration with an ACHE chapter, which will serve as a model for other chapters. In 2014, the chapter board committed to hold at least once education event per year based on the topic of diversity. The 2015 event on diversity hosted by the chapter was based on ACHE’s program, “Diversity in Healthcare Management: Value-Added Business Sense.” The event had a robust panel discussion that highlighted the importance of diversity. A panelist noted that within North Texas alone, there are more than 238 languages spoken, underscoring the need for hospitals to develop cultural competence. The chapter has worked hard to create an inclusive environment. The priority is reflected by the various activities and initiatives sponsored by ACHE north Texas.

Inspiration and excellence We proudly support the North Texas chapter of the American College of Healthcare Executives and their mission to be the premier professional membership society for healthcare executives and to meet its members’ professional, educational, and leadership needs.

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