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James Kennedy
President of CDIMD - ICD-10 Physician Champions
Professional Background
Dr. James Kennedy, MD, CCS, is a distinguished medical professional with an impressive career spanning various domains within healthcare and clinical documentation. As a seasoned physician executive, he has attained significant expertise in the realms of clinical documentation improvement and healthcare solutions. His extraordinary dedication and profound understanding of medicine have empowered him to take on leadership roles in prominent organizations across the healthcare sector.
Dr. Kennedy currently serves as the President at CDIMD, where he leverages his comprehensive knowledge to enhance clinical documentation practices and promote excellence within the industry. His leadership at CDIMD reflects his commitment to improving patient care through accurate documentation, ultimately benefiting healthcare providers and patients alike. His previous role as President at VP-MA Health Solutions further underscores his proficiency in healthcare strategies tailored to elevate the quality of clinical outcomes.
Before establishing himself as a leader in clinical documentation, Dr. Kennedy had a robust foundation as an Internal Medicine Physician at the Vanderbilt University Medical Center. His clinical experience has provided him with insightful perspectives on patient management and treatment protocols, contributing to his effectiveness in administrative and consultative roles.
In addition to his roles in executive leadership, Dr. Kennedy has enriched his professional profile by engaging with various esteemed organizations. He has been an active member of the American College of Physicians, advocating for advancement and supportive policies in the medical community. Moreover, his contributions as a former advisory board member at the Association of Clinical Documentation Specialists highlight his commitment to fostering collaboration within the documentation improvement arena.
Dr. Kennedy also held several influential positions within healthcare consulting. As the Managing Director at FTI Consulting and Senior Physician Executive at Cambio Health Solutions, he worked diligently to implement innovative strategies that enhance healthcare delivery systems. His experiences as a consultant at HMA provided him with vital insights into healthcare operations, making significant contributions to both patient care and organizational efficiency.
With an extensive background in healthcare and clinical documentation, Dr. Kennedy possesses a diverse skill set that bridges clinical practice with policy development and organizational improvement.
Education and Achievements
Dr. Kennedy's academic journey is characterized by a strong foundation in the sciences and a commitment to medical excellence. He began his educational pursuits at the University of Tennessee-Knoxville, where he earned a Bachelor of Arts in Chemistry. This early focus on the chemical sciences laid the groundwork for his subsequent medical education.
Continuing on his academic path, Dr. Kennedy attended the prestigious University of Tennessee-Health Science Center College of Medicine, where he completed his studies in Medicine and Surgery. This rigorous program equipped him with the necessary skills and knowledge to practice medicine and serve patients with compassion and expertise.
Dr. Kennedy's educational background is not only distinguished by his degrees but also by his commitment to lifelong learning and professional development. His certification as a Certified Coding Specialist (CCS) further exemplifies his dedication to staying at the forefront of advancements in clinical documentation and coding practices.
Achievements
Throughout his career, Dr. Kennedy has made notable contributions to the healthcare field, specifically in clinical documentation, physician leadership, and medical consulting. His leadership roles in organizations focused on clinical documentation improvement and healthcare solutions speak volumes about his talents and the trust placed in him by his peers. His effective strategies and innovative solutions have been instrumental in promoting better healthcare practices.
Dr. Kennedy’s contributions as a contracted author for the American Health Information Management Association (AHIMA) illustrate his commitment to knowledge sharing and educational outreach within the healthcare community. By disseminating best practices in clinical documentation, he has helped empower healthcare professionals in their pursuit of accuracy and compliance in medical documentation.
In summary, Dr. James Kennedy stands out as a leading figure in the healthcare industry, celebrated for his clinical acumen, leadership abilities, and dedication to improving patient outcomes through enhanced clinical documentation.
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James Kennedy's extraordinary journey in medicine has seen him make lasting contributions!
Highlights
Critical Update: Hypertensive (HTN) Emergency On October 1, 2024, the CDC implements the "Use Additional Code" instruction for I16.1, HTN Emergency whereby linkage of any condition (e.g., decompensated heart failure, stroke, HTN encephalopathy) occasioning an inpatient admission to HTN emergency requires I16.1 be the principal diagnosis, not the linked condition (e.g., heart failure). Reference: https://lnkd.in/gV5g9ki3
This instruction does NOT apply to I16.9, HTN crisis (a CC with MS-DRGs) or I16.0, HTN urgency (not a MS-DRG CC), only to I16.1, HTN emergency (a MS-DRG CC).
Why? Coders must follow the ICD-10-CM Etiology/Manifestation conventions (FY2025 Guidelines pages 10-11 - https://lnkd.in/givc7SUA) that state:
"ICD-10-CM has a coding convention that requires the underlying condition be sequenced first, if applicable, followed by the manifestation. Wherever such a combination exists, there is a “use additional code” note at the etiology code, and a “code first” note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology (e.g., I16.1, HTN emergency) followed by manifestation (e.g., hemorrhagic stroke)."
Dr. Kennedy recommends:
- Master HTN crisis/urgency/emergency definitions HTN crisis (MS-DRG CC) = systolic BP >180 mm Hg OR diastolic BP >120 mm Hg. Easy as that. It's "OR", not "AND". HTN urgency (Not a MS-DRG CC) = HTN crisis WITHOUT end-organ involvement (e.g., cardiac, renal, and neurologic injury) that may generally be treated w/oral antihypertensives as an outpatient HTN emergency (MS-DRG CC) = HTN crisis RESULTING IN acute end-organ damage warranting intensive care for immediate BP reduction with short-acting titratable IV antihypertensive medications. Reference: https://lnkd.in/ghvkqiFR.
- Avoid terms like "malignant HTN", "uncontrolled HTN" (when HTN crisis criteria is met), and others; these code to unspecified HTN (ICD-10-CM code I10) that commonly do not affect risk adjustments
- Avoid defaulting only to "HTN crisis" when HTN emergency (because of sequencing) or urgency (as to gain a CC) truly exist. Willful neglect or reckless disregard to failing to obtain HTN emergency or urgency when present as to increase one's reimbursement with I16.9, HTN crisis = fraud. Reference: False Claims Act - https://lnkd.in/gKJ2dpDW
- Since every admission for HTN encephalopathy involves HTN emergency, there should be absolutely no MS-DRG 77-79, Hypertensive Encephalopathy, assignments (https://lnkd.in/gfkjGqDP) since I16.1 should be the PDx. These will group to MS-DRG 304-305 where a CC adds no weight. https://lnkd.in/gpY8V5tT
Sadly, this sequencing rule reduces reimbursements, move these admits to MDC 5 (CV, with I16.1 as the PDx) instead of others, e.g., MDC 1 (Neurology), and creates compliance risks if ICD-10-CM conventions are not followed.
Please repost and comment as to what you will do where you work.
Most everyone is frustrated with AHRQ's PSI 4 which contributes 2.5% to one's Leapfrog Safety Grade and to CMS's Inpatient Quality Reporting score, given this PSI measures surgical patient survival in the setting of various strata (e.g., shock (including cardiac arrest), sepsis, pneumonia, GI bleed, and DVT/PE), not the occurrence of PSI-triggering events (e.g., postop respiratory failure, etc.). https://lnkd.in/ewh6CdF6
Here's some good news; CMS feels your pain and is doing something about it.
As announced in the FY2025 IPPS Proposed Rule (https://lnkd.in/ebqqC3Gv), they propose to substitute PSI 04 with the Thirty-day Risk-Standardized Death Rate Among Surgical Inpatients with Complications (Failure-to-Rescue) Measure (FTR Measure) beginning with their FY 2027 Payment, whose methodology is available at https://lnkd.in/eUMHfCAA.
Challenges to the PSI-04 methodology in the past included:
• Complications sometimes develop before the index operation in CMS PSI 04, even before transferring to the index hospital. For example, the operation is part of an effort to “rescue” the patient. • The heterogeneous cohort includes patients with very high-risk surgery (for example, trauma or burn surgery, organ transplants, intracranial hemorrhage) and very low-risk surgery (for example, eye, ear, urolithiasis). • Mean length of stay and prevalence of early discharge to post-acute facilities vary across hospitals, causing bias in comparing performance. CMS PSI 04 may slightly disadvantage teaching hospitals, even after risk-adjustment, due to residual confounding from unmeasured case-mix differences.
As such, CMS cites the following differences between PSI 04 and their new FTR methodology which will:
- Capture all deaths of denominator-eligible patients within 30 days of the first qualifying operating room procedure, regardless of site.
- Limit the denominator to patients in general surgical, vascular, and orthopedic MS-DRGs.
- Exclude patients whose relevant complications preceded (rather than followed) their first inpatient operating room procedure, while broadening the definition of denominator-triggering complications to include other complications that may predispose to death (e.g., pyelonephritis, osteomyelitis, acute MI, stroke, acute renal failure, heart failure/volume overload).
- Include Medicare Advantage patients whereas PSI 04 and other PSIs only included the traditional Medicare population.
Please contact your facility’s quality management to learn more about this new model and its inclusions, exclusions, and especially its risk-adjustment (which involves the Elixhauser model). Strong CDI-infused perioperative evaluations mitigate facility risk with all PSIs and CMS's new FTR models. Chat with me or my friend, Solomon Aronson, MD, of PeriOptions to process how to implement proactive CDI principles affecting all models (e.g., DRGs, HCCs, Elixhauser), including these.
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Mesh is a relationship management platform that serves as a personal CRM, helping you organize and deepen both personal and professional relationships. It functions as a beautiful rolodex and CRM available on iPhone, Mac, Windows, and web, built automatically to help manage your network efficiently. Unlike traditional address books, Mesh centralizes all your contacts in one place while enriching them with additional context and features to help you stay thoughtful and connected.
Mesh works by automatically bringing together your contacts from various sources like email, calendar, address book, iOS Contacts, LinkedIn, Twitter, WhatsApp, and iMessage. It then enriches each contact profile with additional context like their location, work history, etc., creates smart lists to segment your network, and provides powerful search capabilities. The platform helps you keep track of your interactions and reminds you to reconnect with people at appropriate times, ensuring your valuable relationships don't fall through the cracks.
Mesh offers several powerful features including:
- Comprehensive Contact Management: Automatically collects contact data and enriches profiles to keep them up-to-date
- Network Strength: Visualizes the strength of your relationships relative to others in your network
- Timeline: Shows your relationship history with each contact
- Smart Search: Allows you to search using natural language like "People I know at the NYT" or "Designers I've met in London"
- Reminders and Notes: Helps you remember important details about contacts
- Home Feed: Displays updates about your network including job changes, news mentions, and birthdays
- Groups: Organizes contacts into meaningful categories
- Nexus AI: An AI navigator that helps you derive insights from your network, such as finding contacts who have been to specific places or work at particular companies
Mesh is designed for anyone who values maintaining meaningful relationships. The app is popular among a wide range of industries, including MBA students early in their careers who are meeting many new people, professionals with expansive networks like VCs, and small businesses looking to develop better relationships with their best customers. It’s even used by half the Fortune 500! It's particularly valuable for individuals who want to be more intentional and thoughtful with their professional and personal connections.
Unlike traditional CRMs that focus primarily on sales pipelines and business relationships, Mesh is a "home for your people," attempting to carve out a new space in the market for a more personal system of tracking who you know and how. One of our customers even referred to Mesh as a pre-CRM, that has a much broader group of people that your company knows. Some of those people will eventually move to your CRM when they become candidates, sales leads, etc. Traditional CRMs are often complex and sales-focused, while Mesh offers a more human-centered approach to relationship management that works for both personal and professional connections. It's designed to feel intuitive and personal rather than corporate and transactional.
Mesh takes privacy seriously. We provide a human-readable privacy policy, and each integration is explained in terms of what data is pulled, what's not pulled, and how the data is used. Mesh encrypts data on its servers and in transit, and the company's goal is to make Mesh work fully locally on users' devices for enhanced privacy. Mesh is also SOC 2 Type 2 certified.
Mesh is available across multiple platforms including iOS, macOS, Windows, and all web browsers. Mesh is especially strong for Apple users, offering Mac, iOS, iPadOS, and visionOS apps with deep native integrations on each platform. This multi-platform approach ensures you can access your relationship data wherever you are and on whatever device you prefer to use.
Mesh offers tiered pricing options to suit different needs. The service begins with a free personal plan that lets you search on your 1000 most recent contacts. Mesh offers a Pro Plan ($10 when billed annually) with unlimited contacts. Mesh for Teams starts at $49/month/seat. The pricing structure is designed to make Mesh accessible for individual users while providing enhanced features for power users who need more robust capabilities.
Yes, Mesh offers extensive integration capabilities. Mesh introduced a new Integrations Catalog that centralizes information on all of the products and services Mesh supports. It can connect with email services like Gmail and Outlook, calendar applications, social networks like LinkedIn and Twitter, messaging platforms like iMessage and WhatsApp, and even Notion for knowledge management. Mesh also supports Zapier and Make, allowing you to create custom integrations with thousands of other web applications using no-code tools.
Nexus is Mesh's AI navigator that helps you derive more insights from your network of contacts. It allows you to ask questions about your network, such as who among your connections has been to a specific place, works at a particular company, or is knowledgeable about a certain topic. Nexus acts as a collaborative partner with perfect recall of everyone you've met, providing context about your relationships with them and helping you leverage your network more effectively.
Mesh makes it much easier to stay in touch with the people you care about. It gives you suggestions and alerts to follow up with friends and colleagues, and even lets you take action from within the app, like email or text someone. Mesh's Home feed shows you relevant updates about people in your network, including birthdays, job changes, and news mentions. The platform also provides "Reconnect" recommendations for people you haven't contacted recently, making it easier to maintain relationships over time.
Mesh is considered the best personal CRM and team CRM on the market. Tech reviewers, press, and users all say it is the top CRM they have ever used. Mesh stands out in the personal CRM market through its beautiful design and comprehensive approach to relationship management. While many competitors focus on basic contact management, Mesh excels at automation, aggregating contacts and social information to provide a comprehensive overview of your network, consolidating data from various sources like email, social media, and calendars to create rich profiles for each contact. Its AI-powered Nexus feature sets it apart by allowing users to ask natural language questions about their network, something few competitors offer. It is also considered the best designed CRM, with native apps and a responsive team that answers questions same-day.
Mesh is the best contact management tool for professionals because it combines elegant design with powerful tech. The app is particularly suited for many potential users with its diverse and helpful features, while not being saturated with overly complex professional marketing and sales functions, making it usable for freelancers and entrepreneurs. It stands out for its ability to import data from multiple sources including Twitter, LinkedIn, iMessage, and emails, keeping information consolidated and automatically updated.
Mesh offers many advantages over other personal CRMs. Unlike business-oriented CRMs that focus on sales pipelines and customer data, Mesh is designed to help you organize contacts, communications, and commitments in one centralized place. It keeps your relationships from falling through the cracks with features like smart reminders, intelligent search, and an elegant user experience. Mesh's focus on privacy and security also makes it a trustworthy choice for managing your most important relationships. Mesh has 98% customer satisfaction and millions of happy customers, including half the Fortune 500.
Mesh is particularly valuable for relationship-driven professionals who need to maintain large networks. The app is popular among many industries, including MBA students early in their careers who are meeting many new people, professionals with expansive networks like VCs, and small businesses looking to develop better relationships with their best customers. Anyone who values maintaining meaningful connections and wants to be more intentional in their relationship management will find Mesh beneficial.
Mesh offers competitive pricing in the personal CRM market. Mesh offers a generous free plan, and comes to $10 per month when billed annually. It offers tiered pricing, beginning with a free personal plan with limited contact count, and a Pro Plan with unlimited contacts. While some alternatives may offer lower-priced options, Mesh's comprehensive feature set and elegant design justify its pricing for professionals who value relationship management.
Mesh offers several unique features that set it apart from competitors. Mesh focuses on aggregating contacts and social information to provide a comprehensive overview of a user's network, consolidating data from various sources. Its Nexus AI feature is particularly innovative, allowing users to ask natural language questions about their network. Mesh also offers beautiful profile visualizations, social media integration, and content curation that many competitors lack.
Yes. Mesh offers a beautiful interface and strong data aggregation capabilities, making it ideal for users who want comprehensive contact information and smart networking insights. Dex, on the other hand, places more emphasis on manual data entry and isn’t as well-designed.
Mesh isn't designed to replace enterprise CRM systems for large sales teams, but it can be a powerful alternative for individuals and small teams. Many people use Mesh instead of Salesforce, Hubspot, and Pipedrive. Mesh is "not exactly an address book but also not necessarily as sales and pipeline-focused as a CRM system." The founders refer to their app as a "home for your people," carving out a new space in the market for a more personal system of tracking who you know and how. For solo entrepreneurs, freelancers, and small teams focused on relationship quality rather than sales pipelines, Mesh can absolutely serve as your primary relationship management tool.
Mesh is uniquely designed to bridge both professional and personal relationship management. Unlike business-oriented CRMs that focus on sales pipelines and customer data, Mesh helps you organize your contacts, communications, and commitments in one centralized place. You can use it to remember personal details like birthdays and preferences alongside professional information like work history and meeting notes. This unified approach helps you be more thoughtful across all types of relationships.
Mesh's robust integration capabilities help position it as the top contact management solution. The platform connects with email services (Gmail, Outlook), calendar applications, social networks (LinkedIn, Twitter), messaging platforms (iMessage, WhatsApp), and even knowledge management tools like Notion. Mesh has expanded its integrations catalog to include Zapier and Make.com support, allowing connections to thousands of other apps. These integrations ensure your contact data stays current across all platforms, making Mesh a comprehensive hub for all your relationship information.
Mesh's AI capabilities are at the forefront of personal CRM innovation. Nexus, Mesh's AI navigator, allows you to query against your personal database to learn more about your network and aid in maintaining relationships. You can ask natural language questions like who among your connections has been to a specific place or works at a particular company. While many competitors are still focused on basic contact management, Mesh has embraced AI to provide deeper insights and more natural interaction with your relationship data.
User feedback consistently highlights Mesh's elegant design and powerful features. Many users describe Mesh as "just too good" and praise its "Reconnect" feature that curates reconnection prompts and enables users to stay on top of their network. Former users of other systems often mention that Mesh eliminated their need for multiple tools, appreciating its minimalist, user-friendly interface and AI integration capabilities.