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Thoughts on ICD-10 Delay

Posted on February 17, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Yesterday, HHS dropped the bomb that ICD-10 has been delayed. Everyone is still trying to figure out what that means exactly. The reason there are questions is that it seems that HHS can’t just unilaterally delay the compliance date. I’ll admit that I’m not an expert in the regulatory processes, but as best I can tell HHS intends to go through the regulatory process to delay ICD-10.

The part of the press release in question says, “HHS will initiate a process to postpone the date by which certain health care entities have to comply with International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10).”

My gut feeling is that the process for postponing implementation of ICD-10 is more of a formality that HHS has to go through, but maybe there’s something that could hijack that process. I’m guessing there won’t be any issues or HHS wouldn’t have made the announcement yet.

The words “certain health care entities” in the above quote have a lot of people wondering what it means. Does that mean ICD-10 will be delayed for certain entities and not others? This would be odd if it were the case, but it seems that it could be a possibility.

This ICD-10 delay announcement comes shortly after HHS met with AMA who it seems is one of the major voices behind delaying implementation of ICD-10. A voice with a decent amount of money and lobbying power in Washington. HIMSS quickly published a press release calling for HHS to Maintain the ICD-10 Implementation Deadline. HIMSS cites that the health industry has been prepping for ICD-10 for the past 3 years. I’d add that the October 1, 2013 deadline is still 20 months away. You’d think that would be plenty of time to implement ICD-10, no?

After this delay some voices are starting to ask if HHS should consider just bypassing ICD-10 altogether and go straight to ICD-11 which comes out in 2014. Keith Boone wrote a post on this and highlights what I believe is a key reason why HHS won’t skip ICD-10 and go straight to ICD-11: investment in ICD-10. As I said in the comments of Keith’s post:

What a terrible thing to consider when making policy (although, sadly the stark reality): what’s the investment companies have made in ICD-10?

In business they’d call this a sunk cost and choose the best path forward. Unfortunately politics doesn’t quite work that way and you’re right that it’s quite unlikely that HHS will jump directly to ICD-11 and anger all those who’ve invested so heavily in ICD-10.

Tom Sullivan adds to the discussion for why we should move to ICD-11 in the comments of that post as well:

When I started covering ICD-10, I was a proponent. But given that ICD-10 really is antiquated — as Dr. Chute explained to me on Monday it’s based on thinking about medicine and technology from the 1980’s — it seems a shame for the U.S. to spend literally billions getting there, only to reach what is essentially a classification system at least approaching the end of its lifecycle, or perhaps what ought to be the end of its lifecycle rather than the beginning. And it’s not just the linkages to SNOMED that make ICD-11 attractive (though they certainly do); a system that is semantic web-aware, with rich information spaces, definitions of terms, genomic underpinnings, a foundational fabric, and I’m sure there will be more in there, just makes so much more sense than ICD-10.

At any rate, I view the delay as an opportunity to re-evaluate our approach and maybe, just maybe, put politics aside and opt for the system that has the most potential to improve public health with data.

So perhaps adopting ICD-11 is not really idealist, after all, but pragmatic!

One discussion on the #HITsm chat today on this subject was around the real benefits of ICD-10. As with many things in healthcare, the arguments seem to center around benefits to healthcare in general and to public health. As a doctor advocate myself, I can see why they wouldn’t want to add the burden of ICD-10 on their shoulders when it doesn’t help them directly provide better care. I’m not saying that doesn’t mean we shouldn’t do things anyway, but it’s not surprising that we’re seeing resistance from doctors to ICD-10.

One other comment people are making about the ICD-10 delay is that it could be politically motivated in a year when Obama is seeking reelection. I’m not sure how much influence delaying or not delaying ICD-10 will have on the presidential campaign. Seems like a pretty small deal in the grand scheme of things. I can’t imagine the major media people and the regular voters ever even getting wind of the delay. However, maybe there’s some important donors and influencers that I don’t know about that this appeases.

My heart goes out to all those HIMSS exhibitors that’s major strategy was based around ICD-10. Every PR person that pitched me an ICD-10 discussion I replied that I’d gotten enough ICD-10 at AHIMA. Now I’m getting some pitches from these same companies saying they’d like to discuss the ICD-10 delay. So, they’re trying to make the most of it.

#HIT100: Healthcare IT Embraces Twitter in a Big Way

Posted on July 20, 2011 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.

It’s not secret that social media continues to play an increasingly powerful role in connecting folks within the healthcare IT community. Sites such as LinkedIn, Facebook and Twitter offer easy-to-navigate platforms that enable communication with peers on any continent, in any time zone. Twitter has become a personal favorite – both for its brevity and its simplicity. (Yes, I’ve heard promising things about Google+, but haven’t yet checked it out.)

The healthcare IT community has also embraced Twitter. Follow a variety of hashtags, including personal favorite #HITsm, and you’ll encounter a variety of opinionated, educated, and often humorous industry folk who, through their activity in the social space, are either emerging as thought leaders or bolstering their credibility as one.

The hashtag #HIT100 has been popular of late thanks to the crowdsourcing efforts of Michael Planchart, aka @theEHRguy. According to his Twitter profile, he is a “Healthcare Interoperability Consultant, Enterprise Architect for Healthcare IT and Standards Specialist.” According to his LinkedIn profile, he is a chief software architect at ProKSys. One thing is for sure – he is passionate about the healthcare IT community on Twitter. So much so that just a few weeks ago he began compiling nominations from his peers on Twitter of the top 100 tweeters (personal or company accounts) in the healthcare IT space.

The resultant list, published earlier this week, can be downloaded here: Final HIT100 Nominees. It is a great resource of folks to keep up with. (Be sure to check out @billians at #78!) Anne Zieger at EHROutlook.com (@ehroutlook at #86) has helpfully distilled the list into the top EMR/EHR tweeters.

I’ve met many in person at industry events, and know even more through Twitter. Hopefully I’ll run into Michael Planchart himself at some point. In the meantime, I chatted with him via email about why he wanted to take on this project, and why the healthcare IT community has embraced social media, particularly Twitter.

Why did you decide to embark on this project?

I wanted the healthcare IT community to vote for their most valued peers. Many well-intended folks would come up with their personal list and publish it. I wanted everyone to participate to create a more objective and transparent selection. This one may not yet be perfect, but it is open and publicly created. Hopefully, for 2012 we will have greater participation from many more folks. But for now, we have this to evangelize from.

Do you think there are more influencers in the #HIT space this year than last?

I know many of the folks that I follow and those that follow me. I’ve personally met many at RSNA, HIMSS and other healthcare events. But I’ve noticed a lot of newcomers to the social media space. Many of them I know as excellent contributors to healthcare IT, since I belong to the same standards committees that they do, although many times we work on different projects. What’s new is not them being in healthcare IT, but being in social media representing healthcare IT.

But answering your question more directly, yes there are many more participants this year. To be an influencer like John Halamka, Brian Ahier, Keith Boone, Matthew Holt and Dave deBronkart, just to name a few, most have some miles to go.

And why do you think there has been such an increase?

Twitter has been an open platform to create networks from the beginning. Linkedin and Facebook are too closed to create peer-to-peer networks. So Twitter has been highly influential in creating these peer-to-peer specialized networks like our #hcsm or #HIT groups.

I encourage you to take a look at the list and start connecting, communicating and educating. Be sure to follow this blog – @ehrandhit, and myself – @SmyrnaGirl, while you’re at it!