Monday, March 11, 2013

The future of the Semantic Web: cultural heritage and privacy

By Dr. Heather Packer, Research fellow, the University of Southampton.
After attending both the International Semantic Web Conference (ISWC) and the Joint International Semantic Technology Conference (JIST), I considered what this meant for research and development in this exciting area.
Some of the most interesting work presented at ISWC and JIST were in the areas of cultural heritage, such as the recording of personal stories, and integrating historic maps with new timelines. This was highlighted in the opening keynote at JIST, which was given by Eero Hyvönen of Aalto University in Finland, presenting its work on using Semantic Web technologies to preserve Finnish cultural heritage.
These included the preservation of ancient shoemaking methods, through the digitisation and documentation using Semantic Web metadata with multimedia, interviews and written sources. Secondly, the complete transcription of the Finnish national epic, the Kalevala, into a Semantic narrative, and the process by which topics are linked from their own ontology portal, so that topical connections in the Kalevala narrative can be made with other Finnish cultural heritage work.
Aalto University's work shows that Semantic Web technologies, such as its Cultural Sampo ontology portal, allow cultural heritage artefacts and narratives from multiple sources to be brought together and automatically cross-referenced. Examples were shown where the cross-linking between sources has already benefitted researchers, with technical barriers easily overcome.
In the future, I am aiming to work towards a Semantic Web which will allow narratives to share workflows and stories about companies, as opposed to more traditional methods like statistics calculated from databases. These narratives can be used to explain things based on people's past experiences and their interests (taken from their actions on the web), to make them both more useful and engaging.
One problem, however, arises from where is it acceptable to gather and use data. Many of the people I have spoken to in academia and industry have said that information taken from their emails is too intrusive and people as a whole are unwilling to use such a system. However, people are more willing to adopt systems that use information from social networks where they can freely censor information about themselves.
Yet in my experience the most useful information is often to be found precisely in private online places such as email and calendars. In the future I would like the Semantic Web to allow me to attend a conference in another country, and automatically (with optional and minimal input) handle my flights, hotels, conference registrations and restaurant recommendations based on preferences that I had made in the past, such as price range and hotel recommendations and amenities.
In addition to academic research, the Semantic Web also has applications for business and handling personal data. The latter, in particular, has recently seen its research spurred on by a number of initiatives, including the midata initiative from the UK government's Department for Business, Innovation and Skills (BIS). The initiative, which is due to start in 2013, mandates that companies must supply data they hold about a person back to that person in a machine readable format, and under an open licence.
The Semantic Web provides an obvious framework for enabling this at low cost to businesses - there are already numerous examples of marking up personal data under appropriate licenses such as the Open Government license used on data.gov.uk. Semantic Web technologies would therefore enable businesses to comply with new data protection legislation in a cost-effective manner. End-users that receive their data will also benefit, because there are numerous analysis, visualisation and storage mechanisms which already work with Semantic Web data.
The need for storing, managing, using and sharing personal data continues to grow. In response, numerous business startups which focus on providing such services have been launched. Meanwhile groups such as the W3C Read Write Web community group are discussing approaches to using Semantic Web techniques for publishing, receiving and sharing private data. For users this means that it will be easier to make their data work for them, including sites that use your data to help you save money, such as Bill Monitor, which analyses your mobile phone bill to find out how much you can save by getting a new phone contract. It is very likely that similar services will exist in the future for other utilities, such as electricity, gas, and broadband.
The future of the Semantic Web is making it easier to access increasingly richer presentations of our history and heritage, and also publish, and thus increase the amount of cultural heritage material being preserved and made available online. The future of personal data is also one which is expanding rapidly, towards the goal of helping people to make more financially beneficial purchases, and to better manage their private data.

Sunday, March 10, 2013

Determining the right tool for your transcription needs

As we move into the 21st century, there are probably two most important tools that reign in the medical transcription domain. They are digital recorder and telephone dictation. With times this debate has heightened as in which of these two tools is the most efficient for transcription needs. Now you might be wondering; why I have changed my focus from medical transcriptionists to tools that medical practitioners use for recording their interaction with the patient. As I have already discussed in my previous blogs it has become mandatory for medical practitioners to record their patient records for getting insurance from the insurance companies. Now this is a very crucial component wherein these two tools play a very important role.
Now let me start off with different options that medical practitioners had in the past. The old Dictaphone machines were quite large and stationary. With times; handheld tape recorders were used which were followed by micro and mini-cassette tape recorders. However, it was found that there were lot of limitations in these tools. One of the prime being portable caused the challenge of being lost or misplaced easily. The other limitation was that they needed to be connected with a PC to download the files being transcribed. Now it is not that easy to download the files popping out of a tape, putting in a new one and continue recording. Hence; there was a need to introduce a digital recorder with a removable memory card and a memory card attached to your PC. This was a huge change.
Today medical practitioners have two options as discussed earlier. Both these options require several factors for optimal usage – low ambient or background noise, clear dictation and knowledge of how to use them.
Now digital recorders have the various features of a tape recorder like slide switches for pausing, rewinding and fast forwarding. Less expensive ones have buttons instead of slide switches and it takes quite some time to use them effectively. Handheld recorders are portable that can be carried anywhere which is a great advantage. As the medical practitioner can dictate the notes on the go while examining the patient. But the one limitation of the digital recorders is that the dictation needs to be downloaded on a PC – either through USB cable or a removable storage disk reader and upload it to the transcriptionist’s computer. There are different formats that are provided by the manufacturers but most of them are highly compressed and easily downloaded by the transcriptionist.
On the other hand; telephone dictation systems can be operated only through telephone and that too a landline phone rather than mobile phones. This is done to ensure high quality of recorded voice.  Since they are not portable; medical practitioners cannot use them while examining the patients.  The beauty of this recording system is that once the file is recorded it is automatically saved. It does not require to be uploaded to computer; and then sent to the transcriptionist. The entire file movement is done through the dictation system and is done securely. There is no time delay in uploading the files as they are automatically saved with the system.
Ultimately it is the choice of the medical practitioner to decide on the preferably method for dictation. But medical practitioners who have become habituated to tape recorders now use digital recorders as they are similar in dictation style. Others who have learned dictating through hospital-based telephone use telephone-based dictation system. Then there are others who make their decision based on the system which is more automated. Now in this case telephone dictation system win the race as they can be automatically saved; thereby providing embedded security and queue up the dictation by transcription as soon as the medical practitioner finishes dictating.

About Mediscribes

Mediscribes, Inc. is one of the fastest growing Medical Transcription & document management systems providers in United States, based in Metro Louisville. Mediscribes is an ISO 9000-2001 certified company, rendering cost-effective consolidated transcription solutions to major hospitals, clinics, and other healthcare facilities in United States. Mediscribes is the most value-providing organization in the market today with a strong presence in America and offshore locations. The firm specializes in providing highly accurate transcription adhering to ADHI guidelines in unbeatable turnaround time with robust & proven document management system as its vantage point to its esteemed clientele.
Mediscribes provides end-to-end transcription solutions as its primary offering. For our customers, we focus on dictation systems, both ASP as well as enterprise level solutions, with the help of our most valued asset   ezVoiceIntelligence (ezVI), providing specialty-specific qualitative transcription along with a “whole nine yards” document management system. Mediscribes specializes in EMR data integration as well. Our data dispatch department is highly proficient in integrating transcribed reports into any type of EMR. Healthcare facilities that do not have EMR get the option to use our web-based file monitoring interface called eTranscribe for global access to their data. eTranscribe has special features of E-signing, E-faxing, auto-printing, and user-friendly document search criteria.
For additional information, please visit http://www.mediscribes.com

Friday, February 15, 2013

ICD-10-CM Coding for Latrogenic Blood Vessel Injuries

Some of the more common causes of blood vessel injury include gunshot wounds, stab wounds, blunt trauma (including blunt trauma with fracture or dislocation) and iatrogenic injuries. With more procedures being performed using intravascular techniques of late, the number of iatrogenic injuries to blood vessels has increased. Understanding the differences between ICD-9-CM and ICD-10-CM coding for blood vessel injuries occurring as a complication of a surgical procedure will help with correct code assignment when ICD-10-CM is implemented.

In ICD-9-CM, codes for iatrogenic injuries of blood vessels are found in Chapter 17, Injury and Poisoning. An injury to a blood vessel complicating a surgical procedure is reported with one of three nonspecific codes, as follows:


998.11 Hemorrhage complicating a procedure; 998.12 Hematoma complicating a procedure; and 998.2 Accidental puncture or laceration during a procedure.
It should be noted that no distinction is made in ICD-9-CM for intra-operative or postoperative hemorrhage or hematoma.

In ICD-10-CM, codes for intra-operative and post-procedural blood vessel injuries are found in Chapter 9, Diseases of the Circulatory System. ICD-10-CM classifies body system-specific, intra-operative and post-procedural complications within each body system chapter, rather than in Chapter 19 (Injury, Poisoning and Certain Other Consequences of External Causes Medical Transcription).

While ICD-10 codes for intra-operative and post-procedural complications affecting blood vessels are not specific to the site of the injury, they are specific to the body system affected, which in the case of blood vessel injuries is the circulatory system. Codes are also specific to the type of injury – hemorrhage and hematoma or puncture and laceration. Hemorrhage and hematoma codes are specific to whether the complication occurs during a surgical procedure or postoperatively, and these codes are also specific to some types of procedures (including cardiac catheterization, cardiac bypass, other circulatory system procedure or other procedure). Puncture and laceration codes are specific to whether the blood vessel injury occurred during a circulatory system procedure or during a procedure being performed on another body system.

For intra-operative hemorrhage and hematoma of a blood vessel or other circulatory system organs or structures, the following codes apply:

  • I97.410 – Use when the hemorrhage or hematoma complicates a cardiac catheterization procedure.
  • I97.411 – Use when the hemorrhage or hematoma complicates a cardiac bypass procedure.
  • I97.418 – Use when the hemorrhage or hematoma complicates another circulatory system procedure.
  • I97.42 – Use when the hemorrhage or hematoma complicates a procedure on a body system other than the circulatory system.

For post-procedural hemorrhage and hematoma of a blood vessel or other circulatory system organs or structures, the following codes apply:

  • I97.610 – Use when the hemorrhage or hematoma complicates a cardiac catheterization procedure.
  • I97.611 – Use when the hemorrhage or hematoma complicates a cardiac bypass procedure.
  • I97.618 – Use when the hemorrhage or hematoma complicates another circulatory system procedure.
  • I97.62 – Use when the hemorrhage or hematoma complicates a procedure on a body system other than the circulatory system.

For accidental puncture and laceration of a blood vessel or other circulatory system organ or structure, the following codes apply:

  • I97.51 – Use when the accidental puncture or laceration occurs during a circulatory system procedure.
  • I97.52 – Use when the accidental puncture or laceration occurs during a procedure on another body system.

Wednesday, February 6, 2013

ICD-10-CM Coding for Latrogenic Blood Vessel Injuries


Some of the more common causes of blood vessel injury include gunshot wounds, stab wounds, blunt trauma (including blunt trauma with fracture or dislocation) and iatrogenic injuries. With more procedures being performed using intravascular techniques of late, the number of iatrogenic injuries to blood vessels has increased. Understanding the differences between ICD-9-CM and ICD-10-CM coding for blood vessel injuries occurring as a complication of a surgical procedure will help with correct code assignment when ICD-10-CM is implemented.

In ICD-9-CM, codes for iatrogenic injuries of blood vessels are found in Chapter 17, Injury and Poisoning. An injury to a blood vessel complicating a surgical procedure is reported with one of three nonspecific codes, as follows:

998.11 Hemorrhage complicating a procedure;
998.12 Hematoma complicating a procedure; and
998.2 Accidental puncture or laceration during a procedure.

It should be noted that no distinction is made in ICD-9-CM for intra-operative or postoperative hemorrhage or hematoma.

In ICD-10-CM, codes for intra-operative and post-procedural blood vessel injuries are found in Chapter 9, Diseases of the Circulatory System. ICD-10-CM classifies body system-specific, intra-operative and post-procedural complications within each body system chapter, rather than in Chapter 19 (Injury, Poisoning and Certain Other Consequences of External Causes).

While ICD-10 codes for intra-operative and post-procedural complications affecting blood vessels are not specific to the site of the injury, they are specific to the body system affected, which in the case of blood vessel injuries is the circulatory system. Codes are also specific to the type of injury – hemorrhage and hematoma or puncture and laceration. Hemorrhage and hematoma codes are specific to whether the complication occurs during a surgical procedure or postoperatively, and these codes are also specific to some types of procedures (including cardiac catheterization, cardiac bypass, other circulatory system procedure or other procedure). Puncture and laceration codes are specific to whether the blood vessel injury occurred during a circulatory system procedure or during a procedure being performed on another body system.

For intra-operative hemorrhage and hematoma of a blood vessel or other circulatory system organs or structures, the following codes apply:

I97.410 – Use when the hemorrhage or hematoma complicates a cardiac catheterization procedure.
I97.411 – Use when the hemorrhage or hematoma complicates a cardiac bypass procedure.
I97.418 – Use when the hemorrhage or hematoma complicates another circulatory system procedure.
I97.42 – Use when the hemorrhage or hematoma complicates a procedure on a body system other than the circulatory system.

For post-procedural hemorrhage and hematoma of a blood vessel or other circulatory system organs or structures, the following codes apply:

I97.610 – Use when the hemorrhage or hematoma complicates a cardiac catheterization procedure.
I97.611 – Use when the hemorrhage or hematoma complicates a cardiac bypass procedure.
I97.618 – Use when the hemorrhage or hematoma complicates another circulatory system procedure.
I97.62 – Use when the hemorrhage or hematoma complicates a procedure on a body system other than the circulatory system.

For accidental puncture and laceration of a blood vessel or other circulatory system organ or structure, the following codes apply:

I97.51 – Use when the accidental puncture or laceration occurs during a circulatory system procedure.
I97.52 – Use when the accidental puncture or laceration occurs during a procedure on another body system.

Monday, January 7, 2013

Guidelines to follow in Coding forPostoperative Pain in ICD-10-CM

Normally Postoperative pain is considered as a normal phase of healingmethod following many types of surgery. Such pain is frequently kept undercontrol using typical measures like pre-operative, non-steroidal, provocativemedications; local anesthetics that is injected into the operative wound beforesuturing; postoperative analgesics; and even intra-operative or post-operativeinjection of epidural analgesics, that form many kinds of surgeries.
When post operative pain is documented to the current, which is far awayfrom the routine and expected for the appropriate surgical method surgical, doyou think it is a reportable diagnosis. Also note that coding for Postoperative pain in ICD-10-CM, which is not considered on daily basis or expected further in future, iscategorized by whether the pain is pertaining with a definite, documentedpostoperative complication.
Extreme coding forPostoperative Pain in ICD-10-CM not reported due to a Specific PostoperativeComplication
Remember that Postoperative pain not related with a precisepostoperative complication is conveyed with a code from Category G89, This Painnot shown or classified anywhere else.
Postoperative pain in ICD-10-CM mainly has four codes as given below.
G89.12 Acute post-thoracotomy pain;
G89.18 Other acute post-procedural pain;
G89.22 Chronic post-thoracotomy pain; and
G89.28 Other post-procedural pain that is chronic
In any case, if the documents fail to mention whether the post-thoracotomyor post-procedural pain is acute or chronic, consider the default is acute.
Extreme level of PostoperativePain reported Due to a Specific Postoperative Complication
Any coding for Postoperative pain reported that is taking place due to a specific postoperative complication isalways documented with its specified code for that particular complication thatalso includes Injury, poisoning and many other consequences of external causes.There is an extra additional code from category G89 that may be documented todefine the pain more appropriately whether it is post-thoracotomy or otherpostoperative pain, which is acute or chronic in nature.
Before we get into any discussion of postoperative pain generating dueto a definite postoperative difficulty, it is very crucial to fully apprehendthe general guidelines pertaining to coding of complications of care, which aredescribed in Section I.B.16 of the draft version in year 2013 of the ICD-10-CMOfficial Guidelines and Reporting. All these guidelines are very much alike tothose that are present in ICD-9-CM. The main factors to bear in mind whencoding complications of care are given below:
  • Allotment of code depends on theprovider’s reporting of the relationship between the situation and the medicalcare or method used.
  • Remember, not all conditions occurringduring the course of medical care or carrying out procedures are considered ascomplications.
  • In any case, if you find the reportingdone is not clear, you reserve the right to question the person concerned whowrote it.

AboutMediscribes

Mediscribes, Inc. is one of the fastest growing Medical Transcription & document management systems providers in United States,based in Metro Louisville. Mediscribes is an ISO 9000-2001 certified company,rendering cost-effective consolidated transcription solutions to majorhospitals, clinics, and other healthcare facilities in United States.Mediscribes is the most value-providing organization in the market today with astrong presence in America and offshore locations. The firm specializes inproviding highly accurate transcription adhering to ADHI guidelines inunbeatable turnaround time with robust & proven document management systemas its vantage point to its esteemed clientele.
Mediscribes provides end-to-end transcription solutions as itsprimary offering. For our customers, we focus on dictation systems, both ASP aswell as enterprise level solutions, with the help of our most valued asset   ezVoiceIntelligence (ezVI), providingspecialty-specific qualitative transcription along with a “whole nine yards”document management system. Mediscribes specializes in EMR data integration aswell. Our data dispatch department is highly proficient in integrating transcribedreports into any type of EMR. Healthcare facilities that do not have EMR getthe option to use our web-based file monitoring interface called eTranscribefor global access to their data. eTranscribe has special features of E-signing,E-faxing, auto-printing, and user-friendly document search criteria.
For additional information, please visit http://www.mediscribes.com

Sunday, January 6, 2013

Sustain Your Business Records by ChoosingBest Transcription Company

Today with the upcomingglobalization, the services of transcription are offered by many medium andlarge businesses. If you notice, there are vast numbers of establishedcompanies for Business Transcription available; theyare professionally trained to transcribe your desire needs at affordable rates.Generally, meaning of Transcription is the method of recording the audioinformation into a text format. These transcription services also include thewritten data that is once heard of the audio. All this is done under thesupervision of trained experts and professionals.
There are different forms ofTranscription available in various formats like Business Transcription, Audio Transcription Services, ConferenceCall Transcript, and Digital Transcription. This transcription alsomakes use of customized and optimized software, which controls thetranscriptionist to virtually create a flawless copy from the audiotranscription.
Many events pertaining tobusiness take place in big organization like seminars, business meets,conferences, which are recorded by various audio and videotranscription equipments like utilizing a small tape recorder etc.
A couple of significant data ormeetings might have been recorded in cassette tapes or gramophone, which arenow a days out of date. These cassette tapes requires to be digitalized intothe required format like utilizing  someequipments that contains some software like Audacity, which edits the sound andother audio encoders like MP3 etc.
What is required by the customersis they just need to discard the physical audio tapes at the premises of anybusiness transcription service provider's office.
Today, we observe that as far asdigital era is concerned, every single business recordings are transcribed invarious modes of digital audio and video formats. Most of the digital transcription companiesoffering digital services accept almost all kinds of audio formats like .WAV,AIFF, real audio, midi ,Ogg etc along with different video formats likeAVI,MPEG/MPEG4,,MkV, RM/RMV,MOV, WMV etc. and this way they offer their digitaltranscription service solutions. What these companies do is ask the clients toupload the digital files directly into their safe FTP web server. Why does itbecome essential for any business company or organization to obtain the serviceof a good quality transcription company?
Many times it happens that, mostof the famous business companies, in spite of having in house transcriptionbusiness fail to meet the terms due to lack of professionals. The major reasonor cause of such failure maybe because they over burdened their employees withextra burden of transcribing the business activities.
Initially these unskilled or semiskilled staff met with difficulties in recording Moreover these semi skilledstaffs were encountered with difficulties in transcribing complicated accents,voice disturbance and long and hectic hours of editing process etc. All thesedifficulties form a major part of failing to provide good quality oftranscription services and solutions.

Monday, December 31, 2012

Guidelines to follow in Coding forPostoperative Pain in ICD-10-CM


Eventually,deciding whether to report postoperative pain as an additional diagnosis relieson the documentation, which, again must specify clearly that the pain occurredis not normal or routine for the method if an additional code is used. If thereporting sustains a diagnosis of non-routine, critical or more pain followinga procedure, then it is necessary to decide whether the postoperative pain ishappening due to difficulty of the method, which also must be reported in clearterms. After this we can allot accurate codes.

Normally Postoperative pain is considered as a normal phase of healingmethod following many types of surgery. Such pain is frequently kept undercontrol using typical measures like pre-operative, non-steroidal, provocativemedications; local anesthetics that is injected into the operative wound beforesuturing; postoperative analgesics; and even intra-operative or post-operativeinjection of epidural analgesics, that form many kinds of surgeries.

When post operative pain is documented to the current, which is far awayfrom the routine and expected for the appropriate surgical method surgical, doyou think it is a reportable diagnosis. Also note thatcoding for Postoperative pain in ICD-10-CMwhich is not considered on daily basis or expected further in future, iscategorized by whether the pain is pertaining with a definite, documentedpostoperative complication.

Extreme coding forPostoperative Pain in ICD-10-CM not reported due to a Specific PostoperativeComplication

Remember that Postoperative pain not related with a precisepostoperative complication is conveyed with a code from Category G89, This Painnot shown or classified anywhere else.

Postoperative pain in ICD-10-CM mainly has four codes as given below.

G89.12 Acute post-thoracotomy pain;
G89.18 Other acute post-procedural pain;
G89.22 Chronic post-thoracotomy pain; and
G89.28 Other post-procedural pain that is chronic
In any case, if the documents fail to mention whether the post-thoracotomyor post-procedural pain is acute or chronic, consider the default is acute.

Extreme level of PostoperativePain reported Due to a Specific Postoperative Complication

Any coding for Postoperative pain reported that is taking place due to a specific postoperative complication isalways documented with its specified code for that particular complication thatalso includes Injury, poisoning and many other consequences of external causes.There is an extra additional code from category G89 that may be documented todefine the pain more appropriately whether it is post-thoracotomy or otherpostoperative pain, which is acute or chronic in nature.

Before we get into any discussion of postoperative pain generating dueto a definite postoperative difficulty, it is very crucial to fully apprehendthe general guidelines pertaining to coding of complications of care, which aredescribed in Section I.B.16 of the draft version in year 2013 of the ICD-10-CMOfficial Guidelines and Reporting. All these guidelines are very much alike tothose that are present in ICD-9-CM. The main factors to bear in mind whencoding complications of care are given below:

  • Allotment of code depends on theprovider’s reporting of the relationship between the situation and the medicalcare or method used.
  • Remember, not all conditions occurringduring the course of medical care or carrying out procedures are considered ascomplications.
  • In any case, if you find the reportingdone is not clear, you reserve the right to question the person concerned whowrote it.

AboutMediscribes

Mediscribes, Inc. is one of the fastest growing Medical Transcription & document management systems providers in United States,based in Metro Louisville. Mediscribes is an ISO 9000-2001 certified company,rendering cost-effective consolidated transcription solutions to majorhospitals, clinics, and other healthcare facilities in United States.Mediscribes is the most value-providing organization in the market today with astrong presence in America and offshore locations. The firm specializes inproviding highly accurate transcription adhering to ADHI guidelines inunbeatable turnaround time with robust & proven document management systemas its vantage point to its esteemed clientele.

Mediscribes provides end-to-end transcription solutions as itsprimary offering. For our customers, we focus on dictation systems, both ASP aswell as enterprise level solutions, with the help of our most valued asset   ezVoiceIntelligence (ezVI), providingspecialty-specific qualitative transcription along with a “whole nine yards”document management system. Mediscribes specializes in EMR data integration aswell. Our data dispatch department is highly proficient in integrating transcribedreports into any type of EMR. Healthcare facilities that do not have EMR getthe option to use our web-based file monitoring interface called eTranscribefor global access to their data. eTranscribe has special features of E-signing,E-faxing, auto-printing, and user-friendly document search criteria.

For additional information, please visit http://www.mediscribes.com

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