Community hospitalists also discussed bundled payments and the recent changes in Medicare consult codes. “As a hospitalist service, I want to be involved in divvying up the money,” said Dan Allen, MD, a group director in Des Moines, Iowa. “I don’t know where it’s going, but I want to have a seat at the table.”
When asked by Dr. Nelson if they had noticed a significant change in reimbursement due to Medicare’s elimination of consultation codes, few in the room raised their hands. In fact, Dr. Nelson explained, “you can bill initial hospital care instead of initial hospital consult.”
“If done right, you might get paid better,” Dr. Rosenfeld added.
Health Information Technology on the Hospitalist Radar
Health information technology (HIT) isn’t for geeks anymore. A year after a mostly tech-savvy room discussed the basics of introducing more IT aspects to HM, nearly three dozen hospitalists clamored for SHM to take advocacy positions on everything from best practices to best vendors.
“SHM could help us all speak the language we need to speak,” said Tosha Wetterneck, MD, MS, a hospitalist with the University of Wisconsin Clinic in Madison. “Visibility, transparency—give us the words.”
Participants in last year’s group focused on the technical side of IT. This year’s attendees talked about the need for SHM to create portals for shared information, message boards to spur interinstitution conversations, and, perhaps, a weekend boot-camp-style course to introduce novices to basic IT information.
“SHM needs to take a stand now,” said Damascene Kurukulasuriya, MD, FACP, CMD, CCD, a hospitalist in perioperative medicine at the University of Missouri Health System in Columbia. “We need to be part of the solution.”
To that end, Kendall Rogers, MD, assistant professor at the University of New Mexico School of Medicine and chair of SHM’s IT Task Force, says the society is making progress. More hospitalists have been encouraged to sign up for the BioMedical Informatics course at the Marine Biology Laboratory in Woods Hole, Mass. The weeklong course is an introduction to the use of computer technologies and information science related to biomedicine and health science, according to the program’s Web site (www.courses.mbl.edu/mi/). The cost of travel, housing, and meals are fully paid for by the National Library of Medicine, making the fellowship even more appealing for cash-strapped hospitals and HM groups. “It’s a hidden program,” Dr. Rogers said.
Dr. Rogers and SHM CEO Larry Wellikson have toured the country meeting with top officials from the largest IT vendors, including Cerner and GE Healthcare. An IT committee has formed, with subcommittees dedicated to policy, quality, and leadership/education. But Bob Lineberger, MD, medical information officer at Durham Regional Hospital in North Carolina, says a nuanced message will take time.
“Our focus is just coming into focus,” Dr. Lineberger conceded. “We do need to come up with a position statement.”
Education in HM: How to Grow Rock Stars and Champions
What skills does a hospitalist need to know to practice well that they didn’t learn in residency? That was the question new SHM President Jeff Weise, MD, SFHM, posed to about 20 hospitalists attending the special-interest forum on educational initiatives at HM10. Led by Dr. Wiese and SHM Education Committee co-chair Vikas Parekh, MD, FHM, the discussion focused on what SHM can do—or perhaps do better—in this capacity.