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The Health Insurance Portability and Accountability Act of 1996 (HIPAA) instructed CMS to adopt a standard coding systems for reporting medical transactions. The use of Level III codes was discontinued on December 31, 2003, in order to adhere to consistent coding standards.
Many sashiko patterns were derived from Chinese designs, but just as many were developed by native Japanese embroiderers; for example, the style known as kogin-zashi, which generally consists of diamond-shaped patterns in horizontal rows, is a distinctive variety of sashiko that was developed in Aomori Prefecture.
Various items in Aomori Prefecture featuring kogin-zashi patterns. Kogin-zashi (こぎん刺し) is one of the techniques of sashiko, or traditional Japanese decorative reinforcement stitching, that originated in the part of present-day Aomori Prefecture controlled by the Tsugaru clan during the Edo period (1603-1867).
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For example, in 2002, Cedars-Sinai Medical Center in Los Angeles, CA attempted to implement a new EMR system, but the US$34 million system failed due to numerous factors. The physicians were unhappy because of the new physician order entry system for medications , labs and procedures was more time-consuming than doing the orders by hand.
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