What do you mean top priority? Everything is #1 on the list.

A phrase often heard in the halls of an IT Department for a healthcare provider. With Meaningful Use Stage 2, ICD-10, technology upgrades and updates (XP to Win7 anyone?), break-fix, and migration of new clinical build, IT departments are constantly challenged with more and more operational priorities than anytime in their department’s past. How is executive leadership supposed to decide what their priorities are when everything is mandated and operations feels that they have just given IT millions of dollars to implement this EHR that was supposed to be the panacea for the disease of inefficiency and lack of interoperability?

We actually have to support and maintain this new system? We need to make sure that the new system can interface with the other clinical systems that we have across the organization and be able to update interfaces, update the system when we need to transition to ICD-10? We thought this wasn’t going to need more money, more people and additional storage space in the data center. Do we really need that new mobile application? I don’t use my phone to access my EMR so why would a patient want to engage us that way?

Many organizations across the country have had to change the way they think. Operations and IT need to realize that they are now connected even more closely ‘at the hip’. Everything is so inextricably linked to technology now that it is difficult, if not impossible to distance yourself from operational decision making without information technology being involved.

ICD-10 – One year to go!

By now, healthcare organizations should be either executing their ICD-10 plans or just starting a year long effort to transition to ICD-10 by October 1st, 2014 and finally bringing the United States on par with the rest of the developed world. If you haven’t started by now, well, you are late out of the starting gate!

Healthcare Providers must realize that much of 2014 would be focused on Testing with EHRs and Third Party systems and testing with their primary payor organizations and clearinghouses. Training the physicians and coders on the new IC 10 codes and diagnosis terms and giving them practice through a Dual coding period is something that each organization would be contemplating.

Being able to leverage Computer Assisted Coding (CAC) and good, continuous training of existing coders is something that each organization must focus their efforts on. It is much easier to train an existing employee than find and on-board a new coder so incentives for staying with the organization must be thought through by HR, Medical Record and Operational leadership teams. Regular organizational steering committee updates should be a part and parcel of this initiative so that everyone is on the same page and communication is not misaligned or misunderstood.

Overall, a good project charter, project schedule and testing plans that have the buy in of all of the parties in this organizational wide initiative is a must.

So can Hospitals get their bills paid now?

One of the areas that many individuals, organizations and political parties fail to recognize is that for years, Emergency Departments have not got their bills paid and the hospitals have had to bear the brunt of unpaid bills and patients fear getting sick or making that trip to Emergency or the doctor. Will the Affordable Care Act solve this dilemma and will the opening of the new Health Insurance Exchanges (not to be confused with the Healthcare Information Exchange) be a turning point for many to be able to get preventative and emergency care covered? This was the hope. While the bill is not perfect and I know that many in the country, who don’t know the details of the ACA think it was a bad idea, I felt it was at least a start to thinking about healthcare in a different way. Many times, I have mentioned in my writing that we needed to think differently and I believe this is the first step towards that. While entitlements are not the answer, something obviously needed to get done to solve our health problems in the United States.

On a recent trip to Hong Kong, I got to understand how far behind we were in terms of change. In talking to a friend of mine who was a doctor there, they thought that the U.S. had an interoperable electronic health record capability for decades and that when they implemented theirs in the early part of the 21st century, that they were following us. It came to her as quite a surprise that we were actually following them.

I would buy stock in for profit healthcare providers if I were you…this might be the start to better financial results for them.