New year brings more health IT chal­lenges, Lieber says

Modern Healthcare - - FRONT PAGE - H. Stephen Lieber H. Stephen Lieber is pres­i­dent and CEO of the Health­care In­for­ma­tion and Man­age­ment Sys­tems So­ci­ety.

Last year at this time, the first mean­ing­ful-use in­cen­tive pay­ments from the CMS grabbed the head­lines with Jan­uary 2011 as the in­au­gu­ral month for the ex­change of funds be­tween the fed­eral gov­ern­ment and el­i­gi­ble hos­pi­tals and providers. Now, a year later, or­ga­ni­za­tions are col­lect­ing their in­cen­tive pay­ments; the CMS dis­trib­uted $2.5 bil­lion in in­cen­tive pay­ments through the end of De­cem­ber 2011, ac­cord­ing to a year-end CMS re­port.

Thus, mean­ing­ful use be­gan a year of deadlines, one that con­tin­ues into 2012, as we look at not only mean­ing­ful use, but also other com­pli­ance dates. And I be­lieve 2011 in­tro­duced more in­ter­ac­tion be­tween provider and pa­tient—on­line and with mo­bile de­vices. But let’s start with mean­ing­ful use in 2012. Mean­ing­ful use:

In my in­ter­ac­tions as head of the Health­care In­for­ma­tion and Man­age­ment Sys­tems So­ci­ety with dif­fer­ent health­care ex­ec­u­tives and pro­fes­sion­als, mean­ing­ful use re­mains the topic of anal­y­sis and in­trigue. El­i­gi­ble hos­pi­tals and pro­fes­sion­als con­tinue to eval­u­ate what it takes to reach Stage 1 (of mean­ing­ful use) and qual­ify for elec­tronic health record in­cen­tive pay­ments. In Septem­ber 2011, HIMSS An­a­lyt­ics re­ported that 10% of U.S. hos­pi­tals re­ported hav­ing the ca­pa­bil­ity to meet all 14 core process mea­sures and at least five of the 10 process menu mea­sures tracked in its study. In its De­cem­ber 2011 re­port, HIMSS An­a­lyt­ics noted 9% of U.S. hos­pi­tals re­ported this to be the case. While the over­all data show a slight de­crease in readi­ness for meet­ing Stage 1 of mean­ing­ful use, a num­ber of seg­ments showed in­creased ca­pa­bil­ity to achieve Stage 1.

For ex­am­ple, the HIMSS An­a­lyt­ics re­port of Septem­ber 2011 showed 17% of aca­demic med­i­cal cen­ters were ready to achieve Stage 1; in De­cem­ber 2011, that num­ber in­creased to 24% of aca­demic med­i­cal cen­ters.

The De­cem­ber 2011 re­port also found in­creases in five seg­ments of hos­pi­tals ready to reach Stage 1 of mean­ing­ful use: 400 to 499 beds. 500 or more beds. Ur­ban hos­pi­tals. Multi-hospi­tal sys­tems. Hos­pi­tals at Stage 5, 6 or 7 on the HIMSS An­a­lyt­ics EMR Adop­tion Model.

Im­prov­ing qual­ity with health in­for­ma­tion tech­nol­ogy has been the hall­mark of those hos­pi­tals, med­i­cal prac­tices, com­mu­nity health cen­ters and public health sys­tems that have won the HIMSS Davies Award of Ex­cel­lence and been rec­og­nized by HIMSS An­a­lyt­ics as Stage 7 hos­pi­tals. They fo­cus on im­proved pa­tient care, fewer med­i­cal er­rors and in­te­grated de­liv­ery of sys­tem of all as­pects of care through health IT. These ac­com­plish­ments aren’t ruled by deadlines, but are on­go­ing, be­cause of in­no­va­tions in use of data and en­hanced and in­te­grated-care de­liv­ery. ICD-10:

De­spite the pro/con po­si­tion­ing on im­ple­men­ta­tion of ICD-10, this is the year to pre­pare for the Oct. 1, 2013 dead­line, when providers and pay­ers must tran­si­tion to this new cod­ing sys­tem. One dead­line has al­ready gone by with Jan. 1, 2012, as the com­pli­ance date for Hipaa-re­lated 5010 trans­ac­tions. I men­tion these deadlines be­cause the work in­volved with them can­not be ig­nored or min­i­mized. HIMSS has worked with some 30 in­dus­try or­ga­ni­za­tions to de­velop the ICD-10 Play­book, an on­line tool to help un­der­stand and meet these com­pli­ance deadlines.


I’ve also seen new em­pha­sis on use of mo­bile tech­nolo­gies at the point of care as clin­i­cians and pa­tients en­gage with each other. Pa­tients want to ac­cess their own health in­for­ma­tion on­line. And this year, peo­ple on both sides of the stetho­scope are in­ter­act­ing with pa­tient por­tals, mo­bile ap­pli­ca­tions and e-mail con­ver­sa­tions.

HIMSS in­tro­duced its MHIMSS ini­tia­tive in De­cem­ber 2011 rec­og­niz­ing the mul­ti­ple mo­bile tech­nolo­gies avail­able to all of us in the health­care de­liv­ery con­tin­uum. The MHIMSS plat­form ex­tends, and ful­fills, our mis­sion as a cause-based or­ga­ni­za­tion fo­cused on im­prov­ing health­care de­liv­ery with the best use of health IT. Em­pha­siz­ing tech­nol­ogy, data ex­change and work­flow, MHIMSS in­cludes the com­po­nents of care de­liv­ery that en­com­pass a mo­bile con­nec­tion. HIMSS12:

At HIMSS12 (himss­con fer­ on Feb. 20-24, we have new and fa­mil­iar faces, ses­sions and ex­hibits. Some are fo­cused on top­ics I have dis­cussed here. At­ten­dees can visit Knowl­edge Cen­ters to find, in one lo­ca­tion, in­for­ma­tion, ed­u­ca­tional ses­sions and ex­hibits on six top­ics. Col­lab­o­ra­tion con­tin­ues with new con­fer­ences within our an­nual con­fer­ence and ex­hi­bi­tion, in­clud­ing Vir­tual HIMSS12 de­signed for health­care pro­fes­sion­als who can’t travel to Las Ve­gas, but want to be part of HIMSS con­fer­ence ex­pe­ri­ence.

If you read my Feb. 6 post on the HIMSS Blog (, you will find more on new con­ver­sa­tions I ex­pect to see this year at the con­fer­ence. I have read blogs and other ar­ti­cles that in­clude the ven­dor per­spec­tive as they talk about their in­volve­ment in help­ing el­i­gi­ble hos­pi­tals and pro­fes­sion­als reach Stage 1 of mean­ing­ful use. With more than 1,000 ex­hibitors at HIMSS12, I plan to see just how much the ven­dor com­mu­nity con­tin­ues this dis­cus­sion, one about their valu­able con­tri­bu­tions to meet­ing this ini­tial stage of mean­ing­ful use of the elec­tronic health record.

This par­lay will not end at HIMSS12 be­cause, as of this writ­ing, we are wait­ing for re­lease of the pro­posed rules for Stage 2 of mean­ing­ful use. So, it looks as if I will have my theme ready for next year’s col­umn.

Im­prov­ing qual­ity with health in­for­ma­tion tech­nol­ogy has been the hall­mark of groups rec­og­nized by HIMSS.

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