A time to focus on value
Transcription
A time to focus on value
April 2009 | Issue 7 3 Navigator 3M Health Information Systems A time to focus on value Hospitals face daunting challenges in this economic downturn. According to the American Hospital Association’s November 2008 survey1 of 763 U.S. hospital CEOs, the executives reported: • A 38 percent decline in admissions and a 30 percent decline in elective procedures Jon Lindekugel President, 3M Health Information Systems • A 33 percent increase in interest expense and a 65 percent increase in accounts receivable • A 51 percent increase in the proportion of patients “unable to pay for care” and a 37 percent increase in the need for subsidized services • An inability to issue bonds to raise cash (11 percent of the respondents) We see similar trends with our clients. Revenue is falling. Margins are thin. Less cash on hand makes it more difficult to expand services and create new revenue streams. As economic pressures strain the financial health of hospitals, they are delaying capital spending, cutting administrative costs, and reducing both staff and services. At the same time, hospitals face increased pressure from the continuing Recovery Audit Contractor (RAC) program, and from regulatory changes, such as Medicare withholding for hospital-acquired conditions (HACs), the transition to ICD-10, and the economic stimulus package with its directives for implementing electronic health records. These regulatory issues and economic pressures call for a sharpened focus on real value. But what can be done now to address these challenges? The good news: there is much that can be done. Hospitals are only beginning to tap the potential gains from health information process improvement and analysis. Here are just a few examples of how 3M products and services can help our clients improve clinical and financial outcomes along the healthcare continuum: • Reduce operating costs and revenue on hold by linking tools for speech recognition, transcription and document management with coding solutions, such as remote coding and computer-assisted coding. • Improve coder productivity, speed up reimbursement, and improve accuracy by using computerassisted coding tools. A recent 3M study found the time spent coding can be reduced by an average of 29 percent using 3M™ Codefinder™ Computer-Assisted Edition. • Help reduce claims denials and costly write-offs for both physician » CONTINUED ON PAGE 3 www.3Mhis.com | www.3Mhis.com/Navigator 4 10 8 11 In This Issue Spotlight | 1, 3 News and Views | 8-9 A time to focus on value Product updates, industry insights and more Industry Insight | 4-5 Products and Services | 10-11 Creating value in tough times Roadmap to Health Information Exchange Customer Profile | 6-7 Event Calendar | 12 Mary Washington Hospital Conference and tradeshow schedules *For a free online subscription to 3M Navigator, go to www.3Mhis.com/Navigator 2 3M Health Information Systems » CONTINUED FROM PAGE 1 | A TIME TO FOCUS ON VALUE groups and hospitals by employing online tools to validate medical necessity before rendering services. • Increase hospital case mix index, typically by 2-4 percent, with a potential 4:1 return on investment, by implementing documentation improvement programs. Most hospitals can recoup program costs within five months. • Add net revenue to the hospital’s bottom line by analyzing and executing a comprehensive and defensible pricing structure. • Capture full and accurate reimbursement, reduce vulnerability, manage the cost of compliance, prevent potential takebacks, and avoid claims denials from the start by taking a proactive approach to such regulatory compliance issues as HACs, MSDRGs, ICD-10, and RAC audits. • Reduce systems costs, reduce record deficiencies, and improve overall quality by moving to a true EMR that gives physicians and other providers online access to medical records from anywhere. • Enhance the transfer of patient data—connecting thousands of providers, departments, and facilities—by implementing electronic health information networks. For 3M, the real value comes down to aligning our strategy and internal processes with our clients’ strategy and processes. This requires an open dialogue about how we’re doing and how we can become easier to do business with. This means enhanced processes for pricing, contracting, software implementation, delivery of services, and ongoing support to align with our clients’ operational needs. The value—for our clients and for us—comes in making sustainable changes to core processes within a hospital’s workflow that can impact overall revenue, reduce costs, address quality and compliance, and increase productivity. Source: American Hospital Association (Nov. 2008). Rapid Response Survey, The Economic Crisis: Impact on Hospitals. Http://www.Aha.Org/aha/research-andtrends/health-and-hospital-trends/2008.html 1 We look forward to building the value of our ongoing partnership. For more information on how our solutions can assist your organization, contact your 3M sales representative, call us toll-free at 800-367-2447, or visit us online at www.3Mhis.com. We welcome your ideas for how we can work together to address the challenges of these times: [email protected] www. www.3Mhis.com | www.3Mhis.com/Navigator 3 Industry Insight: Creating value in tough times: 3M clients speak out on value Edward Barreto Record completion operations manager, University of California-San Diego Soaring costs and a rising federal deficit portend substantial challenges for financing health care in the U.S. through gains in productivity and by focusing on revenue integrity and quality. According to reports issued by the Department of Health and Human Services1, the U.S. has seen several years of double-digit increases in healthcare costs since the millennium began. CMS projects that by 2018 national health expenditures may reach 20.3 percent of the Gross Domestic Product (GDP), some $4.4 trillion, with annual growth rates outpacing the economy as a whole. Edward Barreto, record completion operations manager, University of California-San Diego, San Diego, Calif. At the same time, many healthcare dollars are wasted on inefficient processes. In tough economic times, every business has to dig deeper to find ways to cut costs, streamline processes and maintain viability. Healthcare providers are no different. Navigator talked to 3M customers about how they are finding ways to maintain and even build return on investment 4 Teri Phillips, RHIA, MBA Manager, health information St. Anthony’s Memorial Hospital Four years ago, our record completion rate was at an average of 30 days, which not only held up accounts receivable, but also violated a California statute mandating completion in 14 days. This was happening even though we had a fine and suspension program in place for non-complying physicians. We created a development team comprised of health information services, the medical staff executive committee, and medical records oversight to figure out how we were going to make this policy work. Our physician champion came up with the idea of clinical system lockout. Physicians who don’t complete their 3M Health Information Systems records can’t access the system. There are exceptions when patient care is an issue, and of course we give physicians every opportunity to dictate their reports by e-mailing many reminders. As a result, we reduced our delinquency rate to 9.4 percent, and 85 percent of discharge summaries are dictated on the day of discharge. We couldn’t do this if we didn’t have an integrated suite of software tools that all work together, from transcription to signature authorization to document management to our provider histories. We have an add-on software tool designed for physicians that’s very popular—it lets them create and edit their clinical reports online—and we have several hundred physicians and other ancillary areas that use it: social work, physical therapy, occupational therapy all utilize it, and some physicians like it for discharge summaries. Teri Phillips, RHIA, MBA, manager, health information, St. Anthony’s Memorial Hospital, Effingham, Ill. complete 180 degree change. She loved the product, and we saw a significant gain in her productivity. Productivity gains are obviously the end result you want with speech recognition; we are seeing some transcriptionists showing gains of 40 percent. DRG Software and analysis tools, which enabled us to see the added value of every diagnosis. We’ve been working with that for a number of years now and we’ve learned a lot, and so have our coders, such as how specificity affects reimbursement and profiling. Our physicians really like our electronic signature and document imaging software; they can access medical records from their office, their home, or anywhere in the hospital. Not having to handle the paper record when they complete it has been wonderful for them. With our most recent system upgrade, we got some voice recognition reporting tools that I’ve just started using. I am working on getting a true picture of average lines per minute with editing versus average lines per minute transcribing. Although our dictation volume continues to increase, we’ve seen a dramatic decrease in our cost per line per dictation. Based on what we currently produce and our end costs, the per-line cost has decreased by 28 percent since fiscal year 2002/2003. My hope over time is to increase the volume of work recognized and outsource a percentage of that at a decreased cost per line for outsource vendors. Julie McArthur, manager, transcription services, Providence Health Care, Vancouver, BC Freda Scott, RHIA, assistant director of medical information services, Vanderbilt Medical Center, Nashville, Tenn. We also had utilization management (UM) people doing concurrent documentation review as an add-on to their responsibilities. As we got closer to MS-DRGs, we decided to move documentation review to HIM and make it a dedicated position. We started with five people and now we have 10. When UM was doing it, they were generating 800 queries over a nine month period; now we generate 1,000 to 1,200 every month. We’ve seen a major change in our performance scores, especially our mortality numbers, just through better documentation and coding. This year, we moved up to 15th in U.S. News and World Report’s list of best hospitals in the nation. So we’ve come a long way! When we were getting ready to implement speech recognition, one of my biggest doubters turned into one of my biggest champions. She volunteered to be in the pilot program so she could prove it wrong. Her actual words were, “This will not work.” Well, her whole attitude did a We’ve had a consulting relationship with 3M for years. In about 2003, they started by helping us understand the impact of mortality and severity on our hospital profiling. At that time, we didn’t fare so well when we benchmarked against our peers. So we brought in 3M™ APR At St. Anthony’s, we’ve completely automated document management, which has made it possible to reassign staff to help coding or transcription as needed. Coding can process records more quickly, and they can communicate easily with physicians electronically to increase their accuracy. So bills are generated quicker, too. Patient accounting can do insurance verifications right away because everything is accessible. That all adds to the financial stability of the hospital. Source: The Centers for Medicare & Medicaid Services, Office of the Actuary. National Health Expenditure Projections 2008-2018. http://www.cms.hhs.gov/ NationalHealthExpendData/downloads/ proj2008.pdf 1 www. To learn more about how 3M solutions can help your organization, contact your 3M representative, call us toll-free at 800-367-2447, or visit us online at www.3Mhis.com. www.3Mhis.com | www.3Mhis.com/Navigator 5 Customer Profile: Mary Washington Hospital Fredericksburg, Virginia Transforming patient information from a paper-based to an electronic system is a major project for any hospital, requiring the careful selection of appropriate systems, proper implementation and the understanding and cooperation of hospital staff and providers. 3M products used • 3M™ ChartScan™ Software • 3M ChartRelease Software ™ ™ • 3M™ ChartView™ Software • 3M™ ChartFact™ Software • 3M™ Electronic Signature Authentication (ESA) Software • 3M™ ClinTrac™ Clinical Abstracting Software Mary Washington Hospital, a busy acute-care hospital serving Northern Virginia, was undergoing a significant expansion of its services, when Evelyn Bickley, the hospital’s health information management (HIM) director, received a mandate to improve efficiency and reduce costs in her department. Snapshot An outdated paper-based system had created roadblocks in the flow of patient data and staff attempts to keep up resulted in higher than acceptable error rates. Requests for files could take up to one week to fill, and delays in processing paper charts meant growing coding backlogs, longer A/R days, and more back-end rework when claims were denied. Type of facility: Mary Washington Hospital is a full-service hospital based in Fredericksburg, Virginia. It is the flagship facility of the Medicorp Health System, a nonprofit regional network of healthcare facilities and wellness services. In addition, the hospital was renting off-site space to store thousands of paper files. A full-time staff person was needed simply to transfer files to and from the hospital each day, since the HIM department was located in a separate building. Number of beds: 420 with plans for expansion into a new acute care facility. Mary Washington Hospital Services: A broad range of specialties and services, including acute care, behavioral care, birth center, cardiology, emergency, oncology, palliative care, radiology, surgery and a sleep center. A process and system overhaul was certainly needed, and timing was crucial, because the organization was adding two new facilities: a 40-bed behavioral unit and a 100-bed acute care hospital. The HIM department needed to • 3M™ ChartScript™ Software • 3M™ ChartID™ Software • 3M™ Coding and Reimbursement System • 3M™ ProviderID Software 6 The challenge 3M Health Information Systems find a way to bring records under control in an environment of rapid growth. After evaluating a number of options on the market, Mary Washington selected 3M’s suite of document management applications, including 3M ChartScan, 3M ChartView, and 3M Electronic Signature Authentication (ESA) Software, for their comprehensive features and ability to integrate with the 3M Coding and Reimbursement System and 3M ClinTrac Clinical Abstracting Software already in place at the hospital. “Our goal was to eventually eliminate paper in our department,” says Bickley. “We knew the 3M products would work together to make our coding, abstracting, and chart management processes much more efficient and accurate.” The approach In the planning stage, HIM staff presented the new program at medical staff and departmental meetings for months leading up to implementation. Hospital staff participated in hands-on software demonstrations to understand the impact on day-to-day workflow. In the process, HIM identified what would be of particular importance to various constituencies and shaped the plan to reflect the needs of key stakeholders. “It was very interdisciplinary, including involvement of nursing leadership, which was essential,” says Bickley. “Our goal was to eventually eliminate paper in our department. We knew the 3M products would work together to make our coding, abstracting, and chart management processes much more efficient and accurate.” – Evelyn Bickley, HIM director, Mary Washington Hospital Within six months of going live with ER records, Mary Washington had all areas live and operational immediately afterwards. “I initially anticipated needing six additional staff people just to implement the new system,” notes Bickley. “But staff acceptance made the changeover happen much faster than we expected. We pretty much lock the file room door and rarely access the records. That’s how quickly they switched to the new process.” The results The move from a manual paper-based system to an electronic one has had a significant impact on efficiency. With 3M™ ChartScan™ and 3M™ ESA software applications in place, the hospital has shortened the timeframe for processing discharge records from five days or longer to under 12 hours. “It’s a huge time-savings,” notes Bickley. “Previously, we could never keep up with the manual paperwork and the analysis. Coders would be looking for charts we didn’t even have assembled yet.” In fact, efficiency was so improved that once the backlog of current files was under control, staff had time to go back and scan archived records into the new system. Within a year, all patient records were available either electronically or on microfilm housed onsite, eliminating the need and expense of offsite file storage. In fact, the HIM department has been able to streamline processes enough to reduce the number of full-time HIM employees by nine percent. Bickley has also seen the accuracy of her staff’s work improve beyond expectations. Before the transition to the 3M applications, it was difficult to track errors, so quality control was a haphazard process. “Errors would be identified with the old paper system, but there was no way to determine accountability,” Bickley says. Today, staff responsible for document processing receives feedback on a weekly basis, providing consistent, high quality results. Productivity has risen sharply with the move to an electronic patient record. The integration of the 3M chart management applications with 3M coding and abstracting software has enabled easy access to the record, making it possible to assign seven coders to work from home. “The opportunity to use remote coders means we can be very selective in hiring,” Bickley reports. “We can attract experienced coders from all regions of the state.” Physicians and staff are also realizing the benefits of remote access. With the 3M™ ChartView™ interface, clinicians can instantly access patient charts from the past two years from any facility within the MediCorp health system or offsite if necessary. “We’re now planning to roll out the system to our physician practices, so that all of our physicians have access,” says Bickley. While the move to an electronic patient record required careful planning and active support from key departments, most staff members adjusted to the new paperless environment, and a year later, wonder how work was accomplished before the transition. “I think the impact outside our department has been even greater than we anticipated,” Bickley comments. Software tools all working together have enabled a quantum shift in work processes and efficiency at key points along the patient data stream. “I call it one-stop shopping, the integration of images with coding and abstracting,” adds Bickley. “There’s no going out to another application, it’s all right here. And that just makes it so easy.” Proven results at Mary Washington Hospital • Records scanned in 12 hours and available online to coders, physicians, and key staff • Streamlined HIM workflow, improving productivity enough to reduce FTEs by nine percent • Eliminated costs associated with offsite storage of paper records and reduced supply costs www. For more information on how our solutions can assist your organization, contact your 3M sales representative, call us toll-free at 800-367-2447, or visit us online at www.3Mhis.com. www.3Mhis.com | www.3Mhis.com/Navigator 7 News and Views: Product updates, industry insights and more China delegation meets with 3M Health Information Systems experts On Monday, Feb. 23, 2009, a delegation of key stakeholders from China’s Ministry of Health and China’s Health Economics and Research Institute (CHEI) visited 3M offices in Washington, DC, to meet with and learn from experts and leaders from 3M Health Information Systems. “China is in the midst of major healthcare finance reform,” says Brian Mitchell, APAC regional manager for 3M Health Information Systems. “This meeting laid the groundwork for exploring opportunities to collaborate with and assist the China Ministry of Health in addressing the healthcare financing and information challenges it faces.” Brian Mitchell APAC regional manager 3M Health Information Systems www. For more information on our international solutions, call us toll-free at 800-367-2447, or visit our international web site for 3M Health Information Systems: www.3Mhis.com/international. 8 3M Health Information Systems ICD-10 Ready Leading up to the October 2013 implementation of ICD-10, 3M Health Information Systems is providing a consistent roadmap for meeting the challenges and realizing the benefits of this landmark transition. 3M coding solutions are used worldwide by nearly 5,000 healthcare organizations and more than 180 managed care and payer organizations. The 3M™ Coding and Reimbursement System already provides ICD-10 references for coders, and an ICD-10 comparison tool is included in the April 2009 release. Watch for ICD-10 articles by 3M experts in upcoming issues of the Journal of AHIMA and the Healthcare Financial Management. www. To learn more about ICD-10 and how 3M can help you make a smooth transition, contact your 3M sales representative, call us toll-free at 800-367-2447, or visit us online at www.3Mhis.com/ICD-10. The RACs finalize efforts. Are you ready? With almost half of the country in the first stage of the Recovery Audit Contractor (RAC) rollout, hospitals need to shore up their processes in anticipation of the RAC audits. Prior to conducting audits, the RACs have some work to do. First and foremost, the RACs will conduct outreach education targeted for hospitals in each state along with the Centers for Medicare and Medicaid Services (CMS) and the state hospital associations. Before reviewing Medicare claims, the RAC contractors have many behind-thescenes activities to complete, such as having CMS approve any new issue for review. According to the American Hospital Association, the first RAC audit activity under the permanent program is anticipated for May 2009. CMS had previously announced that the RACs would begin with audits of “black and white” billing issues (e.g., automated audits not requiring the review of medical records). As each RAC demonstrates competency to move to the complex audits that require a review of the medical record, hospitals will receive requests for records from the RACs. Each notification of a record request or denial will start a chain of events for hospitals in responding to the RACs. Being prepared for RAC audits is more than tracking and responding to the contractors and their findings. It requires more attention to compliance and prevention activities as a proactive measure in addressing RAC audits. Connecting RAC efforts to prevention of future improper payments is essential. The 3M™ RAC Ready Program is designed to help providers move from reacting to the RAC activities and simply logging them to preparing for the audits on an ongoing basis. This program addresses several needs of hospitals, including: • A baseline assessment to identify vulnerabilities • Managing inappropriate short-stay admissions through improved case management processes • Addressing coding accuracy through coding compliance software that now includes a RAC tracking tool www. For more information on the 3M RAC Ready Program and the timeline of anticipated RAC activities with the associated hospital actions, go to www.3Mhis.com/racs. www.3Mhis.com | www.3Mhis.com/Navigator 9 Products and Services Roadmap to Health Information Exchange For years, healthcare providers and consumer organizations have pushed for better transfer of patient data among different care providers, departments, and facilities. With the recent allocation of $300 million in the federal economic stimulus bill for Health Information Exchange (HIE), more funding may soon be available for such initiatives. As organizations move to take advantage of the funding, 3M experts are ready to help them plan and implement a successful HIE. HealthInfoNet links a third of Maine’s physicians A year ago, 3M launched a pilot for Maine’s statewide HealthInfoNet. This groundbreaking HIE places Maine among the first states in the nation to build and operate a statewide electronic health information network. The pilot project is now live and seamlessly connects more than 2,000 providers in 15 hospitals, about a third of the state’s practicing physicians. In the coming months, HealthInfoNet will expand to the entire state, linking 20,000 healthcare providers who serve a population of over 1.3 million people—and saving the state about $50 million in annual healthcare expenses.1 LouHIE will offer free health record banking services to 1.2 million citizens In January 2009, 3M was selected as the prime contractor for the Louisville Health Information Exchange (LouHIE). The initiative will offer free health record banking services to all 1.2 million citizens within the Greater Louisville area. The LouHIE health record bank will enable consumers to accumulate, store, and manage their patient data in a personal health bank record, including granting their healthcare providers access to the data, if they wish. The project is expected to be a model for other states that want to create HIEs with health record banks. Although HealthInfoNet and LouHIE represent two different types of HIE, they are supported by the same core architecture: the 3M™ Enterprise Master Person 10 Index, 3M™ Clinical Data Repository, and 3M™ Healthcare Data Dictionary. As the prime contractor for both projects, 3M partnered with frontend portal vendors to integrate their best-of-breed products into flexible, highly scalable solutions. Regional and state clinical information-sharing networks can be an important means of reducing medical errors, fostering patient health, and controlling healthcare costs. According to Dr. Lee Min Lau, 3M chief medical informaticist, 3M’s experience with HealthInfoNet provides a framework for forming other statewide HIEs. She is presenting this framework at an educational session of the Healthcare Information and Management Systems Society (HIMSS) Conference in April 2009. Shaun T. Alfreds, MBA, and David M. Witter, Jr. MA, “The Impact of Electronic Health Information Exchange (HIE) Services in Maine: Avoidable Service and Productivity Savings Estimates Related to HealthInfoNet Services,” prepared for the Maine HealthInfoNet Stakeholder Group, Main Quality Forum, Nov. 2008. 1 www. For more information on our HIE solutions, contact your 3M sales representative, call us toll-free at 800-367-2447, or visit us online at www.3Mhis.com. 3M Health Information Systems Pilot sites for 3M™ Codefinder™ Computer-Assisted Edition Using 3M™ Codefinder™ Computer-Assisted Edition, two healthcare organizations have automated time-consuming manual documentation review. The functionality has freed coders to focus on coding accuracy and compliance, while gaining productivity in the process. Installation at Eastern Maine Medical Center Early this year, 3M completed installation of the 3M Codefinder Computer-Assisted Edition at Eastern Maine Medical Center (EMMC) in Bangor, Maine, and Women’s Hospital in Baton Rouge, La. The launch capped nearly a year of product development and is the first of several scheduled beta installations. Mandy Reid Coding manager Eastern Maine Medical Center Mandy Reid, RHIT CPC, coding manager, says EMMC faced a shortage of qualified coders, compliance pressures, and ever-changing payment regulations. The medical center looked to 3M and computer-assisted coding as a way to streamline coder workflow. She calls 3M’s dedication to improving the coding process “amazing.” Burke explains that most hospitals have a variety of document types that their coders use, including both paper and electronic, images and text. His team’s collaboration with the pilot sites has helped 3M design a system that can help optimize coding workflow within the HIM environment, even if the hospital uses some scanned images and paper documents. According to Reid, “3M has been supportive and responsive in listening to the needs of today’s coders through the development of computer-assisted coding. We are looking forward to improved productivity without sacrificing the much-needed coders’ expertise.” Because the system complements existing coding workflow, it has been easy for coders to use. “The learning curve is much less than for most new systems,” Burke says. “Coders are able to begin using the system the first day it goes live.” A recent 3M study found improvements in productivity should be significant. Coders were able to reduce the time spent coding records by an average of 29 percent. Furthermore, they were able to adapt to the system with less than one hour of training and practice. As more hospitals adopt computer-assisted coding, Burke says the new technology affects more than coder productivity and workflow. It can also impact staffing and budgets. He says, “It’s important that the goals of optimizing workflow include adequacy of documentation, accuracy of coding, minimizing physician time in the documentation process, minimizing cost, and optimizing revenue.” Lessons learned Experience at the pilot sites has helped the 3M development team better understand how to help hospitals improve their coding processes. Jason Burke, 3M product marketing manager, says, “We have learned how important it is to have a system that is focused on improving workflow and not just producing codes.” www. To learn more about computer-assisted coding and how 3M can help you, contact your 3M sales representative, call us toll-free at 800-367-2447, or visit us online at www.3Mhis.com/codefinder. www.3Mhis.com | www.3Mhis.com/Navigator 11 Event Calendar Events & Trade Shows Health Information Management Systems Society (HIMSS) Annual Conference and Exhibition April 4-8 Chicago, Ill National Institute for Case Management (NICM) Case Management Conference & American Case Management Association (ACMA) Annual Meeting April 18-22 Boston, Mass. Medical Transcription Industry Association (MTIA) April 22-25 Louisville, Ky. Health Care Compliance Association (HCCA) April 26-29 Las Vegas, Nev. Association of Clinical Documentation Improvement Specialists (ACDIS) May 13-15 Las Vegas, Nev. America’s Health Insurance Plans (AHIP) June 3-5 San Diego, Calif. Healthcare Financial Management Association (HFMA ANI) June 15-16 Seattle, Wash. HFMA CFO Session June 17 Seattle, Wash. Virtual HIMSS June 9-16 online event Indian Health Services (HIS) Summit July 7-9 Denver, Colo. Health Forum and the American Hospital Association Leadership Summit (AHA) July 23-25 San Francisco, Calif. Association for Healthcare Documentation Integrity/ACE July 29-Aug. 1 Nashville, Tenn. 3M Health Information Systems National Users Group Aug. 11-14 St. Paul, Minn. Force Health Protection Aug. 14-21 Albuquerque, N.M. Siemens Innovation Aug. 9-12 Philadelphia, Pa. McKesson Insight Conference Sept. 9-12 Orlando, Fla Epic Users Group Conference Sept. 22-25 Verona, Wis. American Health Information Management Association (AHIMA) National Convention Oct. 3-8 Grapevine, Texas For a comprehensive list of events, visit our events calendar on www.3Mhis.com. To learn more about the 3M Health Information Systems National Users Group (Aug. 11-14, St. Paul, Minn.), visit us at www.3Mhis.com/2009usersgroup. 3 Health Information Systems 575 West Murray Boulevard Salt Lake City, UT 84123-4611 U.S.A. 800 367 2447 www.3Mhis.com 3M, Codefinder, ChartScan, ChartView, ChartScript, ClinTrac, ChartRelease, ChartFact, and ChartID are trademarks of 3M Company. The International Statistical Classification of Diseases and Related Health Problems – Tenth Revision (ICD-10) is copyrighted by the World Health Organization, Geneva, Switzerland 1992-2007. Please recycle. Printed in U.S.A. © 3M 2009. All rights reserved. Published 04/09 70-2009-9048-2