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No Shortage of Excitement (This Week) in Healthcare IT

When I began contemplating the subject of this blog earlier in the week, I thought I’d make room for thoughts on recent improvements in EMR adoption in the small practice and physician community, and the general state of optimism and enthusiasm some op-ed pieces would have us believe is finally taking hold of the industry. But then came along the potential delay of ICD-10, which also begs a quick comment or two.

A bill that included an effort to delay the ICD-10 compliance date a full year was passed, but only after partisan drama over the fact that legislators received the proposed bill just a day before the vote on it was to take place. I tend to turn to AHIMA on ICD-10 matters, and its official stance is fairly obvious:

ahimaicd10tweet

Its reasoning is similar to that of the Coalition for ICD-10, which in a letter to the CMS, stated: “ … any further delay or deviation from the October 1, 2014, compliance date would be disruptive and costly for health care delivery innovation, payment reform, public health, and health care spending. By allowing for greater coding accuracy and specificity, ICD-10 is key to collecting the information needed to implement health care delivery innovations such as patient-centered medical homes and value-based purchasing.

“Moreover, any further delays in adoption of ICD-10 in the U.S. will make it difficult to track new and emerging public health threats. The transition to ICD-10 is time sensitive because of the urgent need to keep up with tracking, identifying, and analyzing new medical services and treatments available to patients. Continued reliance on the increasingly outdated and insufficient ICD-9 coding system is not an option when considering the risk to public health.”

AHIMA has even started a campaign to encourage its constituents to email their senators to urge them to also vote no when it comes to delaying ICD-10. At the time of this writing, the Senate vote is not yet scheduled. I don’t feel the need to restate my support of no further delay. You can read it here.

With regard to the other hot news items of the week, I was intrigued by the findings of the SK&A survey, which found that the EMR adoption rate for single physician practices grew 11.4%. One reason SK&A gave in the survey analysis was due to the “availability of more than 450 different solutions to fit their practice needs, size and budget.” Call me crazy, but I’m willing to bet that many solutions will not exist in the next three to five years thanks to market consolidation. What will these physicians do when their EMR vendor closes up shop? Time will tell, I suppose.

March 28, 2014 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

Will Healthcare.gov Experience Prompt HHS to Delay ICD-10?

I don’t think it will be news to anyone reading this that HHS is getting hammered for their implementation of Healthcare.gov. Sebelius congressional testimony was brutal. Certainly the botched implementation of Healthcare.gov will have long lasting impacts on all future HHS IT projects.

While not purely an IT project, I wonder if the experience of Healthcare.gov will have an impact on the ICD-10 implementation. Will HHS be gun shy after the Healthcare.gov debacle that they’ll delay ICD-10 to avoid another one?

My gut reaction is that I don’t think this will happen, but it’s worthy of consideration.

On October 1, 2014, HHS’s IT isn’t ready to accept ICD-10, then you can read the headline already: “HHS Botches Another IT Project.” For those of us that work in healthcare IT, we know that ICD-10 has deep IT implications. Not the least of which will be CMS being ready to accept the ICD-10 codes. While you’d think this is a simple change, I assure you that it is not. Plus, if CMS isn’t ready for this, a lot of angry doctors and hospitals will emerge. It will be a major cash flow issue for them.

We still have almost a year for HHS to get this right. Plus, HHS has had years to plan for this change so they shouldn’t have any IT challenges. Although, if they do have IT challenges this extended time frame will damage them even more. The article will say they had plenty of time and they still couldn’t implement it properly.

With the comparison, there are also plenty of reasons why ICD-10 is very different than Healthcare.gov. In many ways, ICD-10 is a project implemented by companies outside of HHS as opposed to a project run by HHS. First, I think it’s unlikely that HHS won’t have their side ready for ICD-10. Second, their part of ICD-10 is very little compared to what has to be done by outside payers, hospitals, and doctors offices.

If ICD-10 has issues it will likely be seen as the payers or healthcare organizations not being ready as opposed to HHS. That’s not to say that HHS won’t have some damage if they force an ICD-10 mandate and people aren’t ready. They could have some collateral damage from it, but not the same as Healthcare.gov where the product is really their own product.

Plus, if ICD-10 goes bad, consumers/patients won’t know much difference. No patient cares if you code their visit in ICD-9 or ICD-10. They’ll still get the exact same care when they’re visiting the doctor. If ICD-10 goes bad, it will be doctors and hospitals that suffer. That’s a very different situation than Healthcare.gov which was to be used by millions of Americans.

I hope that HHS doesn’t delay ICD-10 based on their experience with Healthcare.gov. If HHS becomes gun shy about any project that IT touches, nothing will ever get done. That’s a terrible way for an organization to function.

November 4, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

A Practice’s View of ICD-10

In our recent article about AMA’s call to Halt ICD-10, we got a really interesting practice perspective on ICD-10 that I thought I’d share. The comments come from Sue Ann Jantz who works at a medical practice. Sue brings up some really interesting points that I think are on the minds of many practices and doctors. The final one about 3rd party payer systems is an important one.

In your recent article -
The American Medical Association’s most recent call to halt implementation of ICD-10 codes brings to light an interesting angle to the coding story – one that I hadn’t recognized until I read up on just why the AMA has consistently made it known that the switch is a bad idea.

My two cent’s worth:
See, all of the coding changes are going to fall on the physicians — they won’t be able to pawn it off on anyone else, like a nurse or a coder/biller or an administrator. Remember, they do MEDICINE, not transcription, billing, personnel or business.

This is especially true of docs in large organizations such as hospitals and multispecialty clinics (MSC), who believe they have to do all the extra preventative care things because the government tells them to — not realizing that the incentive payment has some administrator licking their chops. As far as most Admins are concerned, getting the docs to do extra work doesn’t cost the hospital or MSC anything, so, why not?

Add to that the perfect storm that’s brewing: HITECH act —> electronic records and meaningful use (MU), ACA —> ACOs and reconfiguration of alliances, and then ICD-10 —-> total rearrangment of charting/documenting (plus the unknown).

And you are surprised there’s smoke coming out of the AMA’s ears? Personally, I am concerned there will be meltdown in the medical community. As far as most of them are concerned, this is all Obama’s fault, and they are furious and busy telling everyone who comes in that Obama is the devil. Granted, those that blame Obama are the one I’ve heard — so that’s probably a limited group in Kansas.

At a coding seminar recently, the presenter asked how many were going to get out before ICD-10 kicked in. Most of the room of 50 people raised their hands – about 80 percent. Further, they said their physicians were going to retire before that happened as well. ICD-10 is slated to go into effect Oct. 1, 2014. Everyone is supposed to be signed up for health insurance by Dec. 31, 2014, bringing anywhere from 15 million to 30 million people into the health care system looking for a provider.

Do you think this might be a problem?

That said, individually, all three of these things are long overdue. Had each been done when they needed to happen, we wouldn’t be in this fix now. Plus, ICD-10 will go into effect and a few months later, ICD-11 will be implemented everywhere else in the world — some think we should skip to ICD-11 … but we probably have enough on our plates at the moment.

Politically, Sebelius has to get this done before the end of Obama’s term. I hope it doesn’t crash us. I am working on it all as if it’s all going to happen. We are not part of an ACO, we probably won’t get to MU1 even though we are working on it because there isn’t enough money in it, although we did do the Adopt/Implement/Upgrade part of the HITECH act. So, that only leaves ICD-10. and I am working on our templates, those instruments of the devil by Sebelius’ standards. Without templates, we wouldn’t have a prayer.

And none of this addresses the 3rd party payer systems … which will probably crash if the early tests are indicative. That means we will not get paid. So I am stockpiling money for that time now.

January 16, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.