Modern Practice Podcast

Why Risk Adjustment Is So Important

This episode of the award-winning podcast examines the importance of risk adjustment. Dr. Tomas Villanueva leads the discussion on the impact of this crucial aspect of documentation that can affect hospital outcomes.
 
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
 
Guest:Erica Braun, MS, RN, CCDSSenior Consulting DirectorClinical Documentation ImprovementVizient
 
Show Notes:
[01:29] Defining risk adjustment – maintaining an apples to apples comparison
[02:41] Capturing comorbid conditions to the highest level of specificity
[04:08] Capturing the low-hanging fruit
[05:47] Case mix index issues
[07:44] Severity of illness and risk of mortality
[08:52] Addressing query fatigue
 
Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Erica Braun’s email: erica.braun@vizientinc.com
 
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Challenges in Documenting Spinal Surgery, Part 3

On this episode, Dr. Tomas Villanueva and a leading clinical documentation expert finish their discussion on the need to correctly document everything involving spial surgery. Spinal surgery represents a complex challenge for documentation specialists and clinicians alike, and this episode will clear up what is needed to be successful in coding and documenting these procedures.
 
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Guest:Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRCConsulting DirectorClinical Documentation ImprovementVizient
 
Show Notes:
[00:31] Query opportunities and low-hanging fruit
[01:53] Blood loss and the whole clinical picture in querying
[02:50] Using that “magic word” can make a difference – coding to an MCC
[03:43] Other query opportunities
[10:36] When the documentation is wrong
[12:44] Reconciliation and feedback needed
 
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Mack’s email: rachel.mack@vizientinc.com
 
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Challenges in Documenting Spinal Surgery, Part2

On this episode, Dr. Tomas Villanueva continues his discussion with a leading clinical documentation expert on the need to correctly document everything involving spinal surgery. Spinal surgery represents a complex challenge for documentation specialists and clinicians alike.
 
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Guest:Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRCConsulting DirectorClinical Documentation ImprovementVizient
 
Show Notes:
[00:41] Rise in spinal surgeries
[01:23] Coding challenges and parameters
[01:53] Predicaments for coding and CDI specialists
[07:22] Common DRGs for spinal surgeries – the need to use the “magic words”
 
Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Mack’s email: rachel.mack@vizientinc.com
 
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Challenges in Documenting Spinal Surgery, Part 1

Spinal surgery represents a complex challenge for clinical documentation. Difficult to code and representing query situations that can be demanding, this is the area of focus for this episode of Modern Practice. Joining Dr. Tomas Villanueva is a leading expert returning to the podcast to talk about the challenges of spinal surgery documentation.
 
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
 
Guest:Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRCConsulting DirectorClinical Documentation ImprovementVizient
 
Show Notes:
[01:26] Around 1.62 million procedures per year
[02:22] Procedures on the increase (2.4 times the level of 15 years ago)
[03:54] The most common spinal diagnoses
[05:15] Often not caught by primary care
[06:20 Less common reasons for spinal surgery
[07:09] Reasons for planned surgeries—often a last resort
[08:45] Risks for avoiding surgery
 
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Mack’s email: rachel.mack@vizientinc.com
 
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Capturing Mental Health Diagnoses in CDI, Part 2

In this episode, we continue our discussion about the value of diagnosing mental health and why it's important to make that diagnosis. Dr. Tomas Villanueva Welcomes back a leading expert who is well-versed in the documentation of mental health.
 
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
 
Guest:
Connie Ryan, MBA, RN, CDIP
Consulting Director, Clinical Documentation Integrity
Vizient
 
Show Notes:
[01:14] Overcoming reluctance to diagnose mental health
[03:58] Mental well-being impacts physical well-being
[04:36] Chronic conditions, depression and mortality
[05:31] First steps in making mental health diagnosis a part of practice
[07:04 Don’t make assumptions about patient mental health
[08:31] Focus on education and keep lines of communication open with providers
 
Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Connie Ryan’s email: connie.ryan@vizientinc.com
 
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Capturing Mental Health Diagnoses in CDI, Part 1

In this episode, we discuss a topic that clinicians would rather avoid at times, diagnosing mental health. It can take clinicians out of their comfort zone and has little financial incentive. However, it's important to make that diagnosis when needed, and this podcast will examine why.
 
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
 
Guest:
Connie Ryan, MBA, RN, CDIP
Consulting Director, Clinical Documentation Integrity
Vizient
 
Show Notes:
[01:14] No incentive
[02:39] Reasons beyond reimbursement to make a mental health diagnosis
[04:36] The value-based care angle
[05:02] Developing a plan: gathering data, prioritizing conditions, measuring
[06:13] Helping providers get comfortable; keep communication lines open
[07:31] Major depressive disorder: a starting point
[08:31] Monitor, evaluate, assess and treat
 
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Connie Ryan’s email: connie.ryan@vizientinc.com
 
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Emerging Treatments for Atrial Fibrillation, Part 3

In this episode, we finish our three-part series updating therapeutic approaches in the field of electrophysiology. Joining us again is a leader in the field, who explains ablation therapies for atrial fibrillation, including the latest therapy to emerge: pulsed field ablation.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Guest:Thomas Munger, MDChair, Heart Rhythm DivisionAssociate Professor of MedicineMayo Clinic
Show Notes:
[00:47] Recap of AF ablation
[02:08] Electroporation
[04:47] Research and specifications for pulsed field ablation
[06:33] Anticoagulation and pulsed field ablation
[07:41] Preparing for pulsed field ablation: staff readiness, pain, costs
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Munger’s email: munger.thomas@mayo.edu
More information (Vizient): Additional pulsed field ablation resources
Information on improving an electrophysiology program (Vizient): Optimizing your EP program  
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Emerging Treatments for Atrial Fibrillation, Part 2

On this episode of our award-winning podcast, a leading expert in electrophysiology explains the pathophysiology of atrial fibrillation and how therapies for it have evolved over the years, with pulsed field ablation emerging as the newest approach.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizientGuest:Thomas Munger, MDChair, Heart Rhythm DivisionAssociate Professor of MedicineMayo Clinic
Show Notes:
[00:50] Atrial fibrillation: pathophysiology and risk factors
[03:20] Treating rhythm and treating rate
[02:44] Electrophysiology and the only organ that moves constantly
[07:01] Efficacy of ablation and other treatments
[09:40] Pulsed field ablation
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Munger’s email: munger.thomas@mayo.edu
More information (Vizient): Additional pulsed field ablation resources
Information on improving an electrophysiology program (Vizient):
Optimizing your EP program  
Subscribe Today!
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Emerging Treatments for Atrial Fibrillation, Part 1

Atrial fibrillation ablation therapies have progressed from rather primitive approaches to improved treatments that have emerged in recent years. In this series of our award-winning podcast, we discuss the history of the practice of electrophysiology and improvements that field has experienced.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Clinical Operations and QualityVizient
Guest:Thomas Munger, MDChair, Heart Rhythm DivisionAssociate Professor of MedicineMayo Clinic
Show Notes:
[01:06] History of electrophysiology
[01:55] Training to become an electrophysiologist
[02:44] Electrophysiology and the only organ that moves constantly
[04:22] Seizure of the heart
[05:22] The discipline of electrophysiology and evolving practice of ablation
[07:47) The types of ablation
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Munger’s email: munger.thomas@mayo.edu
More information (Vizient): Additional pulsed field ablation resources
Information on improving an electrophysiology program (Vizient): Optimizing your EP program
Subscribe Today!
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Mental fitness for physicians, Part 3

Years of medical school, residency and fellowships have proven to do little in teaching physicians how to care for themselves. Physician burnout is at an all-time high. On this episode, a physician who is a  leading expert on physician stress discusses how to improve mental fitness in those who’ve given their lives to the care of others.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Guest:Cecilia Cruz, MD, MPH, CPCC, ACCFounder and Chief Executive OfficerMarpe, LLCBoard-certified emergency medicine physicianFormer co-chair of QualityDivision of Emergency MedicineNorthShore University HealthSystem
Show Notes:
[00:34] Physician suicide
[02:44] Need connection
[04:03] What organizations need to do
[06:20] A learned skill and resource
[06:37] Mental fitness
[08:20] The Marpe approach
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Cruz’s email: ceciliacruz@marpejourney.com
Dr Cruz’s Linkedin page:
Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn
MARPE, LLC website:
https://www.marpejourney.com/
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