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No Grain of Salt with PEPPER

All healthcare executives should be granted honorary MHA degrees—Masters of Healthcare Acronyms. On a daily basis, C-suite denizens, especially CIOs, are engulfed in bizarre phraseology that would challenge the most gifted linguist.

Among the pure technology acronyms, electronic record stand-ins are my favorite. In true role reversal, sources even ask me during interviews to explain the distinction between the EMR and its cousins, the EHR and PHR. The possibilities are endless. EMR stands for electronic medical record. In contrast, EHR means electronic health record. Maybe it’s simply the difference between medicine and health! Likewise, PHR, or personal health record, makes me think of all those impersonal records created by harried physicians who see 30 patients a day.

Technology does advance quickly, and so do the acronyms. One way to install EMR technology used to be an ASP—a set-up in which rented software is accessed remotely, sometimes through a VPN. I thought I had the application service provider concept down cold. Then I got an e-mail pitch from a vendor describing itself as a “BSP.”

In Dilbert-like fashion, I fired back a simple question. “What is a BSP?” The answer: “A BSP differs from an ASP in that it tailors a software package to its customer’s needs.”

I wonder if a BSP also does men’s suits?

But EMR acronyms pale in comparison to Medicare’s complex terms. Take PEPPER. It stands for “Program for Evaluating Payment Patterns Electronic Report.” PEPPER is a Medicare initiative that is an offshoot of the “Payment Error Prevention Program,” spiritedly called “PEPP.” As one trade magazine explained, “PEPPER was developed by the QIOSC in response to the QIO community’s desire to share hospital-specific information in the FATHOM reports.”

Trying to fathom what all this means, I turned to AQAF, a Medicare contractor that offers PEPPER-related support services to Alabama hospitals. As the AQAF Web site explains, the training is “at the direction of CMS through TMF Health Quality Institute, which is under contract with CMS as the Hospital Payment Monitoring Program (HPMP) Quality Improvement Organization Support Center (QIOSC), and is responsible for developing PEPPER.”

I’m guessing it all has something to do with reimbursement.

—Gary Baldwin