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Archive for December, 2011

MGMA Calls for New Contingency Plan for HIPAA 5010 Transaction Standards


The Department of Health and Human Services should “immediately” issue an expanded contingency plan on the transition to the new Health Insurance Portability and Accountability Act (HIPAA) Version 5010 electronic transaction standards, since many practices and state Medicaid agencies are not ready for the transition, the Medical Group Management Association (MGMA) recommended Dec. 19.

According to the latest research from MGMA, many state Medicaid plans are unable to accept Version 5010 claims and “a significant number of practices” have not yet completed the software upgrades and health plan testing needed for the transition.

The new contingency measures should permit health plans to continue accepting HIPAA Version 4010 transactions and resolve Version 5010 claims that lack all the required data. Additionally, this contingency plan should last for a minimum of six months, MGMA said.

Currently, the compliance date for implementation of these standards is Jan. 1, 2012.

“We have been tracking the Version 5010 coordination between physician practices and their key trading partners throughout 2011 and it is clear that a significant number of these stakeholders are not ready to meet the January 1 compliance date,” Susan Turney, president and chief executive officer of MGMA, said in a statement. “Our main concern is that the failure to implement Version 5010 by the compliance date will impact payment to practices for the services they provide.”

“We oppose requiring the submission of a transition plan and timeline as a needless bureaucratic exercise that adds to the workload of the providers who have to produce them and the government employees who have to review them,” she said.

Implementation of Version 5010 is a prerequisite for using the updated International Classification of Diseases, 10th Revision (ICD-10) Clinical Modification diagnosis and ICD-10-PCS inpatient procedure code set in electronic health care transactions effective Oct. 1, 2013.

On Nov. 14, the Centers for Medicare & Medicaid Services announced that it would not initiate enforcement of the new HIPAA transaction standards until March 31, 2012 (see previous article).

Additional MGMA Findings

According to findings from a survey conducted by MGMA and the American College of Medical Practice Executives (ACMPE), 32 percent of study respondents reported that their organizations’ practice management system software has been upgraded to the HIPAA Version 5010 standards and that internal testing was complete.

Nearly 25 percent of those respondents indicated that either their software has not yet been upgraded or that testing is not even scheduled, the release said.

Additionally, less than 18 percent of respondents to the survey said they have completed testing with their Medicaid plans, and 79 percent of study respondents indicated that testing with all major commercial health plans remains incomplete.

Overall, the study found that less than 14 percent of respondents rate their 5010 implementation status as fully complete.

NASA Challenges Students to Train Like Astronauts


nasa
Everybody knows that if you want to be an astronaut, you need to have top-notch math and science skills. But astronauts also need the strength and muscle coordination to navigate a zero-gravity environment, so even the best students can’t cut it at NASA unless their bodies are in top shape, too. To help the next generation of students become physically and mentally prepared to be astronauts, NASA is taking a page out of First Lady Michelle Obama’s fitness playbook and launching the Train Like an Astronaut project.

The program, which is developed by the same NASA scientists and fitness professionals that work with current astronauts, provides “structured, hands-on science activities” and connects “physical Earth-based needs to the requirements of exploring space.” Each mission—”Do a Spacewalk,” for example—contains a student-friendly “mission briefing, mission assignment, and mission purpose, plus vocabulary and related NASA facts,” as well as information about proper nutrition. The missions and corresponding teachers’ guides are downloadable in both English and Spanish, and are aligned with health and physical fitness education standards.

Charles Lloyd, NASA’s human research program education and outreach manager, says one of NASA’s goals is “to inspire our youth to stay in school and master professions in the sciences and engineering fields” so they can carry on the important work of space exploration. Let’s hope Train Like an Astronaut catches on in schools so we can ensure there’s a next generation of fit explorers.

This article was originally posted at http://www.good.is/post/nasa-challenges-students-to-train-like-astronauts/

The learning cycle and the power of asynchronous learning activities


When grappling with the concept of learning I often talk about the importance of reflection.  However, another key concept is asynchronicity (I’m not entirely sure that’s a word).  I’ve reflected on this previously withinAsynchronous = Time and Space Learning.  In that post I talked about how learning is more likely to occur when given time and space.  I wanted to tease this out a bit more in relation to learning itself.

Learning is hard, really hard.  It’s a skill just to recognise when it’s happening and cultivate it effectively.  Often, the pain associated with it is viewed negatively.  But the pain needs to gritted out because this is an important stage of the process.  Marilyn Taylor characterised learning as a continuous process of disorientation, exploration, reorientation and equilibrium (see p53 of this).  It’s a cycle and the desired state is multiple loops through the cycle.  For every stage the flexibility, time and space offered by asynchronous learning activities is preferable to a purely synchronous involvement from formal education.  Of course, for synchronous learning events you always have the time afterwards to reflect.  But if you have a formal learning experience where everything is synchronous, the asynchronous times the learner has alone are not facilitated, not supported and without structured communication or collaboration when they need it the most.  You may be thinking “so what” but this is the point of formal education – to structure, facilitate and, in some senses, manufacture the learning.  When you structure in asynchronous learning activities through the various guises of learning technology tools and carefully facilitate such activities the stages of Taylor’s cycle are given the best chance of being rowed through by the learner.  It’s easy for learners to capsize in the first time they encourage the disorientation stage and they’ll keep doing this every time they encounter it.  Pretty soon they shy away from the mental states associated with the learning cycle.

I think this has contributed to the a vast mass of humans who don’t really know how to learn properly.  They grew up on a diet of synchronous learning and the difficult process of moving through the learning cycle wasn’t supported in any way.  The tragedy is they carry it through their adult life and have trouble becoming lifelong learners thus inhibiting their potential.  I am still honing my learning skills but I keep trying and am able to support the process through various social media tool (like this one).  BTW, learning overall is great.  The “ah ha” moments are worth the pain.  It’s a bit like going for a run but that metaphor can wait for another posting.

A couple of asterisks to this post.  There is, of course, a lot of literature out there on learning theories and models.  For this post, I chose one that describe a process I recognise.  Also, the statement: “there are vast mass of humans who don’t really know how to learn” is based on anecdotal evidence.  I think I have a somewhat informed decision but would welcome insights from others on this.

This article was originally posted at http://tpreskett.blogspot.com/2011/12/learning-cycle-and-power-of.html

10 Things Chemical Plant Operators Need to Know About OSHA’s New Chem NEP


On Nov. 30, OSHA announced the launch of its PSM National Emphasis Program for chemical facilities (Chem NEP). The new Chem NEP expands nationwide a previous 2009 Pilot Chemical Facilities Process Safety Management NEP, which had covered only a few OSHA regions, and established policies and procedures for inspecting workplaces covered by the PSM Standard.

The inspection process under the new Chem NEP includes detailed questions designed to gather facts related to PSM requirements and verification that employers’ written PSM programs are adequately implemented in the field. The intent of the NEP is to conduct focused inspections at facilities randomly selected from a list of worksites likely to have covered processes. The director of OSHA, Dr. David Michaels, announced at the launch of this new NEP that during “the pilot Chemical NEP, [OSHA Compliance] found many of the same safety-related problems that were uncovered during our NEP for the refinery industry … As a result, [OSHA is] expanding the enforcement program to a national level to increase awareness of these dangers so that employers will more effectively prevent the release of highly hazardous chemicals.”
Below are the 10 most important things chemical plant operators need to know about the new nationwide Chem NEP:

 

1. It is effective immediately and has no expiration.
Programmed inspections will begin immediately in all regions. Unlike the Refinery PSM NEP and the Pilot Chem NEP, this directive does not include an expiration date.

 

2. It expands the Chem NEP nationwide.
Whereas the pilot NEP involved only a few select regions under federal OSHA’s jurisdiction, the new nationwide Chem NEP applies to all OSHA regions. And unlike the pilot chem and refinery NEPs, states are required to participate in this emphasis program. If the approved state OSHA plan already has some version of a Chem NEP or wants to implement its own version (within 60 days), the state plan must demonstrate to federal OSHA that its program is at least as effective. Otherwise, the states must adopt this directive.

3. Targets for Chem NEP inspections include:
The types of workplaces inspected under the new Chem NEP are similar to the pilot. OSHA will assemble a master list for each region based on employers who: (1) submitted Program 3 Risk Management Plans to EPA; (2) have a NAICS code for Explosives Manufacturing; (3) appear in OSHA’s enforcement database as having been cited in the past for PSM-related issues; and (4) are known to the area office as operating a PSM-covered process. Any workplaces selected for inspection under OSHA’s Site-Specific Targeting Plan, which also happen to operate a PSM-covered process, will be inspected under the Chem NEP directive. Likewise, inspections arising from an employee complaint, referral or incident involving a PSM issue also will be conducted under the Chem NEP directive. Complaints, referrals and incidents unrelated to PSM may still result in an inspection under this directive at the area director’s discretion.

 

VPP- or SHARP-approved facilities are partially exempt. (They are exempt from programmed inspections, but may be subject to inspection under the Chem NEP upon an employee complaint, incident or referral related to PSM.)

4. The selection of unit(s) includes:
OSHA will attempt to identify “the most hazardous process” as the selected unit(s) for inspection under the Chem NEP. The selection of the unit(s) will be based on the following:
· Quantity of chemicals in the process;
· Age of the process unit;
· Number of workers and/or contractors present;
· Incident and near-miss reports and other history;
· Input from the union or operators;
· Ongoing maintenance activities; and
· 119(o) Compliance Audit findings.

5. Inspection scheduling expectations include:
Every OSHA area office across the country is expected to complete 3-5 programmed Chem NEP inspections per year. The sites selected for inspections will consist of approximately 25 percent workplaces that use ammonia refrigeration and 75 percent all other workplaces with a PSM coverage process.

6. It emphasizes implementation over documentation.
Like the pilot NEP, compliance officers will be focused on implementation of PSM elements in the field rather than relying solely on the quality of the written PSM program.

 

7. It features dynamic list questions.
Like the pilot NEP, the dynamic list-based evaluation under the Chem NEP is a mandatory gap analysis formatted in a series of questions to facilitate evaluation of compliance with various elements of the PSM standard. The list of questions rotates periodically and will not be publicly disclosed. The questions are accompanied by guidance for CSHOs as to what documents to request, interview topics and questions to cover, and potential citations to issue. Each dynamic list includes 10-15 primary and 5 secondary questions. Questions are designed to elicit a “Yes,” “No” or “N/A” determination of PSM compliance, and any “No” will normally result in a citation.

8. The following documents and presentations will be requested:
During a Chem NEP inspection, employers will be asked to produce the following documents:
· List of PSM-covered processes;
· List of units and maximum intended inventories;
· Three years of OSHA 300 logs for employer and contractors, and contract employee injury logs;
· Summary description of PSM program;
· PFDs, P&IDs, Plot Plans and electrical classification drawings for the selected unit(s);
· Description of process and safety systems, safe upper and lower operating limits and design codes and standards for the selected unit(s);
· The initial PHA and the most recent Redo or Revalidation for the selected unit(s) (including PHA reports and worksheets, recommendations and action items and schedule for addressing and completing recommendations and action items); and
· PSM incident reports for the selected unit(s).

 

Before a walkaround inspection, OSHA will request the following presentations:
· Overview of the company’s PSM Program and how it is implemented;
· Identify personnel responsible for implementing each PSM element;
· Description of records used to verify compliance; and
· Process description for the selected unit(s).

 

9. A single issue will yield multiple citation items.
As we reported about the refinery NEP, OSHA was turning a single issue into multiple violations. The agency has memorialized this practice in the Chem NEP directive. The directive advises CSHOs that a single valve change, for example, could implement 11 different PSM elements, and each should be considered for individual citation items.

 

10. Abatement verification and documentation is now mandatory.
Under the pilot NEP, some citations required employers to simply certify that abatement had been completed. Under the new Chem NEP, however, abatement verification and documentation is now mandatory. The NEP also directs CSHOs to review past PSM-related citations issued to the same employer going back 6 years, and identify potential failures to abate and possibly repeat and willful violations.

http://ehstoday.com/standards/osha/OSHA-Chem-NEP-1208/

21st Century Skills are so last century!


The new mantra, the next big thing, among educators who need a serious sounding phrase to rattle around in reports is ‘21st Century Skills’. I hear it often, almost always in some overlong, text-heavy, Powerpoint presentation at an educational conference, where collaboration, creativity and communication skills are in short supply. Thank god for wifi!
But does this idee fixe bear scrutiny? In a nice piece of work by Stepahnie Otttenheijm, she asked (radical eh?) some youngsters what 21st C skills they thought they’d need. Not one of the usual suspects came up. They were less vague, much bolder and far more realistic. Rather than these usual suspects and abstract nouns, they wanted to know how to create and maintain a strong digital identity, be nice, recognise what’s learnt outside school, learn how to search use my Facebook privacy settings. My suspicion is that they know far more about this than we adults.
Collaboration & sharing
Young people communicate and collaborate every few minutes – it’s an obsession. They text, MSN, BBM, Myspace, Facebook, Facebook message, Facebook chat and Skype. Note the absence of email and Twitter. Then there’s Spotify, Soundcloud, Flickr, YouTube and Bitorrent to share, tag, upload and download experiences, comments, photographs, video and media. They also collaborate closely in parties when playing games. Never have the young shared so much, so often in so many different ways. Then along comes someone who wants to teach them this so called 21st C skill, usually in a classroom, where all of this is banned. I’m always amused at this conceit, that we adults, especially in education, think we even have the skills we claim we want to teach. There is no area of human endeavour that is less collaborative than education. Teaching and lecturing are largely lone wolf activities in classrooms. Schools, colleges and Universities share little. Educational professionals are deeply suspicious of anything produced outside of their classroom or their institution. The culture of NIH (Not Invented Here) is endemic.
Communication
Again, we live in the age of abundant communication. There’s been a renaissance in writing among young people, who have become masters at smart, concise dialogue. The mobile has taken communication to new levels of sophistication. They know what channel to use, in terms of whether it’s archived or not, synchronous or asynchronous. Texts and Facebook comments are archived, some messages are not (voice and; BBM). You call people, synchronously, when you want them to make a decision. Text is asynchronous, therefore slower, more relaxed. They can also handle multiple, open channels at the same time. What do we educators have to offer on this front? Whiteboards?  Some groupwork round a table? Not one single teacher in the school my sons attend has an email address available for parents. I’ve just attended two major European conference where only a handful of the participants used Twitter. What do we know – really?
Problem solving
Problem solving is a complex skill and there are serious techniques that you can learn to problem solve such as breakdown, root-cause analysis etc. I’m not at all convinced that many subject-focussed teachers and lecturers know what these generic techniques are. Problem solving for a maths teacher may be factoring equations of finding a proof but they’re the last people I’d call on to solve anything else in life. Do teachers actually know what generic problem solving is or is it seen as some skill that is acquired through osmosis when a group of kids get together to make a movie?
Creativity
Beware of big, abstract nouns. This one has become a cipher for almost everything and nothing. I have no problem with art and drama departments talking about creativity but why does creativity have to be injected into all education. Creative people tend to struggle somewhat at school where academic subjects and exams brand them as failures. When it comes to creativity, my own view is that the music, drama and other creative skills my own offspring have gained, have mostly been acquired outside of school.
Critical thinking
I have some sympathy with this one, as critical thinking is sometimes well taught in good schools and universities, but it needs high quality teaching and the whole curriculum and system of assessment needs to adjust to this need. However, as Arun has shown, there is evidence that in our Universities, this is not happening. Arun (2011), in a study they tracked a nationally representative sample of more than 2,000 students who entered 24 four-year colleges, showed that Universities were failing badly on the three skills they studied; critical thinking, complex reasoning and communications. This research, along with similar evidence, is laid out in their book Academically Adrift.
Digital literacy
Across the Arab world young people have collaborated on Blogs, Twitter, Facebook and Youtube to bring down entire regimes. Not one of them has been on a digital literacy course. And, in any case, who are these older teachers who know enough about digital literacy to teach these young people? And how do they teach it – through collaborative, communication on media using social media – NO. By and large this stuff is shunned in schools. We learn digital literacy by doing, largely outside of academe. To be frank, it’s not something they know much about.
Conclusion
Beneath all this, is there just a rather old, top-down, command and control idea – that we know what’s best for them? Isn’t it just the old master-pupil model dressed up in new clothes? In this case, I suspect they know better. There’s a brazen conceit here, that educators know with certainty that these are the chosen skills for the next 100 years. Are we simply fetishising the skills of the current management class? Was there a sudden break between these skills in the last compared to this century? No. What’s changed is the need to understand the wider range of possible communication channels. This comes through mass adoption and practice, not formal school and university. It is an illusion that these skills were ever, or even can be, taught at school. Teachers have enough on their plate without being given this burden. I’ve seen no evidence that teachers have the disposition, or training, to teach these skills. In fact, in universities, I’d argue that smart, highly analytic, research-driven academics tend, in my experience, often to have low skills in these areas. , formal environment is not the answer. Pushing rounded, sophisticated, informal skills into a square, subject-defined environment is not the answer. Surely it’s our schools and universities, not young people, who need to be dragged into the 21st century.
This article was originally posted at  http://donaldclarkplanb.blogspot.com/2011/11/21st-century-skills-are-so-last-century.html

Ways To Make Money From Your Job Through Learning


Evert business has to struggle hard to extract the best performance out of employees. While some companies use the mix of various managerial tools, there are others who believe in the process of earning from learning. As a matter of fact, learning is one of the simplest ways to improve the performance of human resource of an organization. For those organizations, which seek to find cost effective ways of imparting learning process, e-Learning is the best tool at hand.

However, learning is sometimes frustrating and uninteresting. But when learning is inherent in a job, the task of the management becomes easier. There are various things that one must incorporate in order to accelerate the process of learning. Firstly, if employees know that have to learn, things will get pretty difficult for the management because employees have a tendency to repel new changes. As such, learning should be inherent in the business, so that the employees know that they are gaining something out of the process.

E-learning is straightforward and uncomplicated. Organizations that have incorporated e-learning in daily routine have witnessed improved performance overall at all levels. Management might have several issues with a new system, just like the employees, but the top management needs to find the return on investment. Needless to mention, just like employees, management, too has to involve a lot of efforts and time, which often can be of real worry.

There are many companies in the world, which have been hugely benefitted from the earning from learning process. On the onset, it can be said that the process works largely for employees. However, there are many companies, which use the technique for improving their output. It is like a source of motivation for the employees, unlike monetary motivation, that seeks to bring the best from them without giving extra pressure on the job.

Earning is the prime concern for both employees and the organization, but doing the same job constantly for years reduces the pleasure of doing it. When the effectiveness of the mind improves, there is an increased desire to do things better and faster, which in turn can be of immense benefit to the business itself. Instead of hiring new staff and training them for new jobs, improving the abilities of present staff is a much better concept because the management can control them better. Learning and earning are essential components of every business that wishes to grow and develop on a constant basis.

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