7 Steps to Take after Graduation

May 14, 2011

Congrats!!  It’s graduation time!  Are you a little nervous?  Here are seven tips to follow your dreams, find success, and make a difference.

1)  Commit to something bigger.

There is no sugar-coating it, healthcare is tough!  Odds are that within the first year, you’ll either quit or think about quitting. However, it’s hard to quit on something bigger than yourself. Have a goal. Be on a mission. Change the world. Save a life.

If you want to succeed, you must commit yourself to a bigger cause.

2) Figure out what you love.

I guarantee you will not truly succeed if you’re doing anything you don’t love.  Healthcare is just too hard  if you don’t love it.  Find your calling and chase it!

3) Start doing it. Now.

If you don’t love what you’re doing, make a change.  Don’t put it into your 5 year plan.  Start today.  Even if you have to get/keep your day job until you can do what you love full-time, get started!  Volunteer or do per diem work on the side to gain experience.

4) Meet others who love what you love.

Few people can win alone anymore.  The world is too complex and we need people to pick us up when we’re tired, broken, and failing.  It’s a war out there, and you will fail, fall, and need help.  Find others, learn from them and win.  Together you are stronger.  (If you need help finding others in your specialty, check out the free Clear Medical Network forums on Facebook, Twitter, and Linkedin)

5)  Make long-term plans, not short-term ones.

If you’ve committed yourself to something special, keep your eye on it.  Make short-term adjustments, but focus on the big picture.  It’s too easy to get distracted these days, so you need to be working towards long-term goals.  Don’t waste energy on achieving short-term goals. Everything should lead toward the end goal.

6)  Don’t be selfish.

You will need to give things, thoughts, and time away before you get anything in return.  I’m not sure exactly why, other than people like nice people and are willing to help them in return.

Give, give, give.

7) Take your magic step.

If you will succeed, there will be one magic step only you will discover.  The very nature of our world is that we cannot all have the same path, the same steps towards our dreams.  You will need to take a unique step along the way, and it will be something that only you will find.

Call it magic or whatever you’d like, but you’ll need it and I can’t tell you what to look for.  We all have a step in life that we will need to take to achieve our dreams.

When you see yours.  Take it!

Let me know if we can help.

Have a great day,



Aaron is a former nursing home administrator, HIM Director, and consultant.  He is also the creator of the Clear Medical Network and an 8pm Warrior.


Facebook for Healthcare 101

November 11, 2010

For the sake of keeping this short enough, I’m going to assume that you’ve registered on facebook.com and have gone through their quick setup process.  For help getting started, follow facebook’s recommended setup steps and check out this 8 minute guide for new facebook users.

Congratulations, you are now part of the largest social network in the world!

Here’s some basic info about the human network you’ve just joined:

  • Earlier this year, it was named #1 most visited website in the US (more than Google)
  • Every month 30,000,000,000 pieces of information (links, pictures, videos, etc.) are shared by its 500+ million users
  • People spend 700,000,000,000 minutes per month on facebook

That’s a lot of zeros! 

During the sign-up process, you should have gone through facebook’s step by step guide to setup your profile and find your friends.  Don’t worry if you don’t have many friends on facebook right away.  Believe me, they will come.  (An 80+ year-old relative of mine signed up a couple months ago and has at least 20 friends now on facebook) 

Now let’s bring the professional side into it.  I truly believe that facebook has the potential be a major force in supporting healthcare professionals to reduce burnout, share best practices, and get quick answers to issues.  Using facebook as a tool, communities have formed to provide peer support and helpful Q&A.

Here are some of my personal favorite facebook communities:

Specifically, notice how the first two groups have a lot of people answering the questions of their group members on their “Wall” tab.  I would recommend using the search box on the top of the facebook screen to find other associations that you are a member of offline. 

Next step?  Jump in!  Comment.  Post questions.  Help others.  These communities are built on us, and they are at their best when you and I are sharing.

Have questions about facebook?  Post questions you might have in the comment box below and I’ll see if I can help.


About the Author:  Aaron lives in Milwaukee, WI with his wife and two children and is the President & CEO of Clear Medical Solutions.  When he’s not leading new initiatives, he periodically takes on interim leadership or consulting projects.  He also enjoys teaching, speaking, writing, and sharing his passion for people and their healthcare. 

Concerned about Healthcare Reform? Don’t forget ICD-10…

August 16, 2010

Obviously preparation for the pending healthcare reforms in the US will be a massive undertaking.  In addition to caring for a larger patient base, we’ll all be scrambling to find more doctors, nurses, therapists, and all kinds of other allied medical professionals.  It’s going to be interesting to say the least, and just like you, we’re preparing for that side of things at the Clear Medical Agency.

However, before that fun officially begins, there will be a fundamental change in how we code and bill for our services.  For those of us involved with healthcare finance, we know that the money to run the hospital or clinic goes through coding (and obviously billing), so when we see that deadline steadily approaching, there’s plenty to be nervous about.

  • Coders (and everyone else in your organization that uses codes) will need to learn a new and larger code set
  • Coders will now need to go to school and study anatomy
  • Your billing software will need to be updated and tested to accomodate 5010
  • Coding productivity will suffer just as we need it most

We’ll continue to keep you updated on new developments, so feel free to subscribe to our blog emails on the upper right side of the home page.  In the meantime, it’s time to educate your board and all team members that may not be aware of what ICD-10 is, and what the transition may involve. 

Here’s a short guide to start with, courtesy of our HIM Circle team:

An Abridged Guide to ICD-10 As you probably have heard by now, on October 1, 2013, the ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets.  We’ve compiled information directly from the CMS website to help provide a basic introduction and some steps to help prepare for ICD-10.  In the future, we’ll be posting more updates.  If you’d like to have those updates sent to you, simply subscribe on the right side of blog’s … Read More

via Clear HIM Matters

If you are curious about what our HIM Circle team is doing to prepare for ICD-10, feel free to join their forum on Linkedin at http://www.LinkedHIM.com, subscribe to their blog at http://www.ClearHIMMatters.com, or follow their quickly growing facebook forum at  http://www.HIMfacebook.com.

Your First Big HIPAA Privacy Breach?

June 3, 2010

As the HIM Circle initiative continues to expand, the peer support community is proving to be more helpful than ever as changes to HITECH, HIPAA, and ICD-10 come along. 

One of the big issues emerging from our research with HIPAA Privacy and the new breach notification  rules relates to the use of copy machines that your department or traditional ROI vendors may be using. 

This short report by CBS News shows how one covered entity (Affinity Health Plan) had a massive HIPAA Privacy breach related to their copy machines.  In response, they had to notify the government, the media, and over 400,000 individuals.  (Excerpt from the HITECH Breach Notification Interim Final Rule at bottom)

See the report here:

After following up on the story, we believe that the healthcare group in the video did a great job of handling the situation after it came out.  Now all of us in HIM have a Clear call to action to avoid putting our patients and facilities at risk. 

Criminals have no doubt also seen the report, so if you use a large copier/printer/fax machine to make paper copies of records for patients, providers, or 3rd party requestors, your patient’s PHI may be at risk.

We’ve developed some guidelines for our partner HIM Departments and members of our Health Information Exchange to help protect their PHI:

1)      If your copier/printer lease is ending soon, make sure you talk to your service provider about ways they plan on protecting the information stored on the machine’s hard drive.  You may want to involve your IT department in the discussion.

2)      If your copier/printer has been switched out lately due to the end of a lease, technical problems, etc., then you may want to check and see what precautions were taken and what happened to the machine after it left your department.  It may still be carrying the PHI of your patients on the hard drive.

3)      If your department or traditional ROI vendor use a large copy/printer/fax machine to make or send HIM Circlecopies of records, you may want to consider switching to our Health Information Exchange program we started to meet HITECH requirements for electronic disclosure to patients/requestors. 

The new Health Information Exchange technology that we are providing to hospitals/clinics for free is not only helping maintain compliance with new HITECH requirements, but will help avoid PHI being stored on hard drives on your department and ROI vendor machines.

For paper, the exchange uses small high speed Fujitsu scanners that send the information directly to a secured exchange site, bypassing the need to copy, or fax information.  For paperless records, our system is able to get records directly from the EMR, bypassing the need to use the big copier/printer machine and the associated costs of paper and ink.

If you’re curious how the system works, email me at Aaron@ClearMedicalSolutions.com and I would be happy to share more information with you. 

4)      If you are buying a new copier/printer, some models have security options that clear the hard drive after every scan.  As the video mentioned, it’s about $500.  However, the cost of not taking the precaution could add up to even more in fines, hassle, and lost patients if a problem were to occur.

To see what others think about this topic, visit http://www.HIMfacebook.com or http://www.LinkedHIM.com for discussions.


Excerpt from the HITECH Breach Notification Interim Final Rule

“The regulations, developed by OCR, require health care providers and other HIPAA covered entities to promptly notify affected individuals of a breach, as well as the HHS Secretary and the media in cases where a breach affects more than 500 individuals.  Breaches affecting fewer than 500 individuals will be reported to the HHS Secretary on an annual basis. The regulations also require business associates of covered entities to notify the covered entity of breaches at or by the business associate.” 

Read more…


About the Author:  Aaron lives in Milwaukee, WI with his wife and two children and is the President & CEO of Clear Medical Solutions.  When he’s not leading new initiatives, he periodically takes on interim leadership or consulting projects.  He also enjoys teaching, speaking, writing, and sharing his passion for people and their healthcare.

Thank You for Your Sacrifice!

April 4, 2010

Getting called in at 3:00 AM for an emergency…working double shifts when the unit is short…verbal and physical abuse from ungrateful patients…pushing yourself further and further…and further yet. 

For what?

Outsiders would say that it’s for the money, but I find that amusing.  If someone is smart enough to go through all the years of school (and get into that particular school in the first place), they are smart enough to get a very well-paying job that doesn’t have people suing them, barking at them, waking them up, or exhausting them for their entire career.  On top of that, when you take out student loan interest, taxes, and malpractice insurance, the outside world looks even better.

That’s why I believe it is a sacrifice. 

But it’s not just physicians, nurses, or other clinical people.  It’s many others in our industry, as well. 

I know CFO’s and CEO’s working till 9pm regularly to make building projects happen.  I know surgeons that leave home for the OR around 4 AM many days, get home at 6 PM, and then get called back later that day when they’re on call.  Not just for a week, but for a career. 

I know nurses covering double the normal patient loan when the unit is short, and it’s short a lot.  I know specialists that skip sleep after a night of responding to emergencies, just to make sure they get their clinic visits fit in.  I know Agents at Clear Medical Agency who have worked for days (and sometimes weeks) on little to no sleep in order to support these same people during their tough times.

I’ve seen the leadership challenges.  I’ve seen the exhaustion. 

I’ve seen the sacrifice.

For many people around the world, this time of year (Passover and Easter) is about Sacrifice.  I think it’s a great time to thank you for your sacrifice to others.  Pass it on!

For those of you who have to work on Easter.  Thank you for yet another sacrifice.  For those who get the day off, enjoy a well deserved break!

Thank you!



About the Author:  Aaron lives in Milwaukee, WI with his wife and two children and is the President & CEO of Clear Medical Solutions.  When he’s not leading new initiatives, he periodically takes on interim leadership or consulting projects.  He enjoys teaching, writing, and sharing his passion for people and their healthcare.

A New Day in Healthcare

March 21, 2010

Insider sources in Washington D.C. have confirmed that the vote on healthcare reform will successfully pass the House, the budget for the bill will then be reconciled by the Senate, and then the President will sign into law one of the most significant pieces of legislation in almost a generation.

Today truly is a new day in healthcare. 

Whether you’re for it or against it, there is no doubt that it will make significant changes to almost 1/6 of the US Economy, add millions of regular users to the healthcare industry, and usher in a new era of growth to an industry already poised to experience tremendous growth as the Baby Boomers retire. 

So, you might be wondering how this affects you?  In this posting, we will attempt to provide a basic overview of what will happen.  While it will vary by what part you play in the industry, it is certain to affect everyone:

Patients will:

  1. be required to carry health insurance
  2. get help from the government if they qualify under a certain income threshold
  3. not have lifetime caps on insurance coverage
  4. not be excluded from some option of coverage due to pre-existing conditions
  5. pay a tax on very expensive health insurance plans (The so-called Cadillac Plans) 
  6. see Medicare Advantage plans begin to disappear
  7. see the value of their health benefits reported on their W-2 forms

Clinical Professionals (Doctors, Nurses, Therapists, Leaders, etc.) will:

  1. see the number of potential patients rise as the program begins implementation
  2. see changes in reimbursement methods and amounts
  3. see encouragement of doctors and caregivers to reorganize to provide more efficiency and quality of care
  4. have fewer uninsured patients that need care

As with any new entitlement, someone will have to pay for it.  In this case, it will be paid for by new taxes, State budgets, and some cuts in Medicare budgets.  Also, as was the case with Medicare and Social Security, the costs will probably outgrow the current plans for taxes and cuts, and new taxes or deficits will be needed. 

The impact this bill will have on insurance companies, Medicare, Medicaid, businesses, and taxes is not certain.  The country is sharply divided on the matter, and there will be many legal battles and objections from States.  Periodically, I’ll update our readers here on what we’re seeing on the horizon as things change.  However, history has shown us that these sort of reforms are hard to reverse. 

For your reference, we have provided a helpful timeline below to outline when different phases will begin.  Let me know if we missed anything, and please subscribe to the blog (in the upper righthand corner) if you are interested in getting more updates in the future.  This is important stuff, and we’ll get through it together.


Within One Year

  • Insurance companies will be barred from dropping people from coverage when they get sick.
  • Lifetime coverage limits will be eliminated and annual limits are to be restricted.
  • Insurers will be barred from excluding children for coverage because of pre-existing conditions.
  • Young adults will be able to stay on their parents’ health plans until the age of 26. Many health plans currently drop dependents from coverage when they turn 19 or finish college.
  • Uninsured adults with a pre-existing conditions will be able to obtain health coverage through a new program that will expire once new insurance exchanges begin operating in 2014.
  • A temporary reinsurance program is created to help companies maintain health coverage for early retirees between the ages of 55 and 64. This also expires in 2014.
  • Medicare drug beneficiaries who fall into the “doughnut hole” coverage gap will get a $250 rebate. The bill eventually closes that gap which currently begins after $2,700 is spent on drugs. Coverage starts again after $6,154 is spent.
  • A tax credit becomes available for some small businesses to help provide coverage for workers.
  • A 10 percent tax on indoor tanning services that use ultraviolet lamps goes into effect on July 1.


  • Medicare provides 10 percent bonus payments to primary care physicians and general surgeons.
  • Medicare beneficiaries will be able to get a free annual wellness visit and personalized prevention plan service.
  • New health plans will be required to cover preventive services with little or no cost to patients.
  • A new program under the Medicaid plan for the poor goes into effect in October that allows states to offer home and community based care for the disabled that might otherwise require institutional care.
  • Payments to insurers offering Medicare Advantage services are frozen at 2010 levels. These payments are to be gradually reduced to bring them more in line with traditional Medicare.
  • Employers are required to disclose the value of health benefits on employees’ W-2 tax forms.
  • An annual fee is imposed on pharmaceutical companies according to market share. The fee does not apply to companies with sales of $5 million or less.


  • Physician payment reforms are implemented in Medicare to enhance primary care services and encourage doctors to form “accountable care organizations” to improve quality and efficiency of care.
  • An incentive program is established in Medicare for acute care hospitals to improve quality outcomes.
  • The Centers for Medicare and Medicaid Services, which oversees the government programs, begin tracking hospital readmission rates and puts in place financial incentives to reduce preventable readmissions.


  • A national pilot program is established for Medicare on payment bundling to encourage doctors, hospitals and other care providers to better coordinate patient care.
  • The threshold for claiming medical expenses on itemized tax returns is raised to 10 percent from 7.5 percent of income. The threshold remains at 7.5 percent for the elderly through 2016.
  • The Medicare payroll tax is raised to 2.35 percent from 1.45 percent for individuals earning more than $200,000 and married couples with incomes over $250,000.  The tax is imposed on some investment income for that income group.
  • A 2.9% excise tax in imposed on the sale of medical devices. Anything generally purchased at the retail level by the public is excluded from the tax.


  • State health insurance exchanges for small businesses and individuals open.
  • Most people will be required to obtain health insurance coverage or pay a fine if they don’t. Healthcare tax credits become available to help people with incomes up to 400 percent of poverty purchase coverage on the exchange.
  • Health plans no longer can exclude people from coverage due to pre-existing conditions.
  • Employers with 50 or more workers who do not offer coverage face a fine of $2,000 for each employee if any worker receives subsidized insurance on the exchange. The first 30 employees aren’t counted for the fine.
  • Health insurance companies begin paying a fee based on their market share.


  • Medicare creates a physician payment program aimed at rewarding quality of care rather than volume of services.


  • An excise tax on high cost employer-provided plans is imposed. The first $27,500 of a family plan and $10,200 for individual coverage is exempt from the tax. Higher levels are set for plans covering retirees and people in high risk professions.

Some information was gathered from our friends at Reuters.  To view their original report, please visit:  http://www.reuters.com/article/idUSN1914020220100319


For more information about the Clear Medical Solutions team, please visit http://www.ClearMedicalSolutions.com or join our free network of healthcare professionals at http://www.ClearMedicalNetwork.com.

Minimization of Human Error within the Scope of Health Information Management

December 2, 2009

There can be no doubt that the HIM field has become increasingly complex as it has evolved.  Though this evolution has brought about innumerable benefits, it has also brought about a degree of risk that could be considered directly proportional to the former.  This risk is associated primarily with human error and the potentially adverse effects such error may cause.

It is clear that simple mistakes during patient registration can have far-reaching consequences.  Such mistakes can take the form of duplicate records or even erroneous records due to the confused entering of information into other individuals’ files.

The problem begins at registration, which is typically burdened by time constraints.  Most registrars are instructed to enter a patient into the system within two minutes upon arrival so that treatment may be promptly administered.  Erroneous or duplicate file information can be either due to pure accident or, unfortunately, negligence during the registration process.

What is particularly problematic about faulty patient information is that it eventually filters through the larger and more circuitous medical information framework which could potentially cause incidences such as faulty billing, unnecessary treatment (which may prove quite dangerous depending on the circumstance), or wasted time and money in the pursuit of correcting inaccurate file information.

The operational gap between patient registration and HIM departments seems to have led to the exasperation of these problems.  This reality has been recognized by medical professionals and subsequently has lead to the creation of less distance between the two entities, effecting remarkable results.

It has widely become protocol for HIM departments to work more closely with registration staff, providing individuals with feedback and education regarding the consequences of faulty medical recording.  Not only this, but many institutions have set higher standards for the minimization of mistakes during the entrance process, some implementing layoff at three cumulative faulty registrations per year.  Alterations in communication between these departments has lead to vast improvements, the likes of a nearly 60% decrease in duplication rates within some institutions.

Essentially, what was once a considerable problem is now far less of one thanks to the ingenuity of HIM professionals.  The result is less correction, less patient injury, less time, and less money.

Questions: Do you think registration errors are a problem in the facility you work at? Do you have any ideas as to how this process can be improved?

About the Author:  Patricia Heise is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearNursingMatters.com blog.

Dimick, Chris. “Exposing Double Identity at Patient Registration.” Journal of AHIMA 80, no.11 (November 2009): web extra.

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