Five Themes to Remember from HIMSS14

Now that the dust has settled from the 2014 annual conference of the Health Information and Management Systems Society, five themes have emerged that are getting the most attention. Do you agree?

ICD-10

ICD-10 was thought to be one of the most pressing federal mandates facing healthcare providers. Centers for Medicare & Medicaid Services (CMS) Administrator Marilynn Tavenner made it clear at HIMSS there would be no further delays.

But, late in March another one-year delay of the codeset was added at the eleventh hour to a bill primarily focused on Medicare physician reimbursement. After the House approved the bill through a voice vote, the Senate conducted a straight “up or down” roll call vote on the bill, which prevented senators from removing any sections of the bill.

John Halamka, MD, CIO of Beth Israel Deaconess Medical Center (BIDMC) in Boston, says BIDMC has been working on ICD-10 implementation for two-and-a-half years, including a complete redesign of workflows and retraining of staff.

The original ICD-10 regulations estimated an organization like BIDMC would need to spend $600,000 to successfully make the transition. Halamka says he has spent about $5 million and expects total spending to reach $8 million.

The American Health Imformation Management Association says that stakeholders already have made “enormous” investments in ICD-10 preparedness, and this delay impacts 25,000 students in health IT programs who only have learned to code ICD-10.

Stay tuned for more on this surprising turn of events.

Meaningful Use Stage 2

The other big federal mandate nipping at the heels of healthcare providers is Meaningful Use (MU) Stage 2. Now that people are implementing Stage 2, Elizabeth Holland, director of the Health IT Initiatives Group at CMS, her office is receiving more in-depth questions, she says. The implementation phase is when issues rise to the top and Holland and her team can help providers by prioritizing and issuing guidance.

During ONC’s Town Hall meeting at HIMSS14, members of the office’s leadership team shared how they are working to advance the national health IT agenda.

This is the year, says Robert Tagalicod, director of CMS’ Office of eHealth Standards and Services, that MU Stage 2 makes healthcare more patient centered. It is during Stage 2 that we will see how providers are benefiting from transparency of the information in our healthcare system, he adds.

Since the conference, ONC announced that popHealth, its open source quality software, has been certified as a 2014 edition EHR module.

ONC created popHealth in 2010 as a free electronic tool that could import data, then calculate, display and export electronic clinical quality measures (eCQMs), wrote John Rancourt, public health analyst at the Office of Health Information Exchange, in a post on ONC’s Health IT Buzz blog.

Mobile and Telehealth

Since the conference, the American Telemedicine Association (ATA) has asked Department of Health and Human Services Secretary Kathleen Sebelius to lift “unnecessary restrictions on healthcare delivery that prohibits millions of Americans from accessing quality medical care.”

“The current language creates artificial barriers to care including patient location restrictions and communications technology restrictions,” wrote Jonathan Linkous, CEO of ATA.

Meanwhile, the Federal Communications Commission (FCC) launched a new mhealth task force, CONNECT2HEALTHFCC, that will look at ways of accelerating adoption of healthcare technologies.

“We must leverage all available technologies to ensure that advanced healthcare solutions are readily accessible to all Americans, from rural and remote areas to underserved inner cities,” said Chairman Tom Wheeler in a statement.

Patient Engagement

Patient engagement is an integral part of MU Stage 2 and, therefore, a big focus for providers this year.

A 2012 survey of 2,000 patients conducted by the National Partnership for Women & Families found that patients whose providers used an EHR thought the technology allowed doctors to deliver better care than those who relied on paper records. Patients felt the EHR helped doctors better keep up with a medical history, have timely access to relevant information and helped avoid errors and unnecessary testing, says Christine Bechtel, who spoke during HIMSS14.

“This coming year, we’ll spend more on healthcare than on everything else we buy combined,” says Ed Park, executive vice president and COO of athenahealth, who also spoke at HIMSS14. Park discussed the customer-centric success of Amazon and what healthcare can learn from the online giant.

Healthcare remains an enormously complex team sport, Park said. “We have to work together.” Amazon architected itself for collaboration from the get go. “What if we put the patient at the center of that kind of collaboration?” Park asked. The idea was unheard of a few years ago but recently, several consortiums and alliances have popped up focused on patient centeredness and interoperability.

“This is a call for action. Start with the patient at the center of care. He or she needs it, we need it and maybe it will make a difference.”

During the panel discussion of national coordinators of health IT, current coordinator Karen DeSalvo, MD, MPH, MSc, said she is interested in seeing how consumer drivers will force providers to adopt health IT in ways that are more accessible. “Patients are going to start to demand this in a way we haven’t experienced before.”

Privacy & Security

Privacy and security were represented in several sessions at HIMSS14 with topics such as patient matching and incident response driving greater scrutiny of cyber security.

Health industry consortium HITRUST and HHS recently began conducting monthly cyber threat briefings to help organizations better understand current and probable cyber threats and share best practices for cyber threat defense and response.

The briefings come as cyber-attacks targeted at healthcare industry organizations continue to rise. Also since the conference, the U.S. Secret Service began investigating a breach of personal patient information at two Detroit-area hospital systems, and Skagit County in Washington state became the first local government to face a fine for violating several HIPAA rules relating to privacy, security and breach notification.