ICD10

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Halamka Does FY16 Strategic Planning

As we gather together stakeholders for strategic planning of next year’s priorities, what are we hearing and what we have learned? 1. Clinicians are overwhelmed by the current demands of Meaningful Use, hundreds of quality measures, population health, care management, and patient/family engagement. All of these are good ideas individually but the sum of their requirements overwhelms providers. In an era when we’re trying to control costs, adding more clinical FTEs to spread the work over a large team is not possible. The end result is that providers spend hours each night catching up on the day’s documentation and are demanding better tools/automation to reduce their strain.

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Halamka's Reflections on US Health IT Policy Trajectory

I’m in China this week, meeting with government, academia, and industry leaders in Guangzhou, Shenzhen, Beijing, Shanghai,  and Suzhou. The twelve hour time difference means that I can work a day in China, followed by a day in Boston. For the next 7 days, I’ll truly be living on both sides of the planet. I recently delivered this policy update about the key developments in healthcare IT policy and sentiment over the past 90 days. I’ve not written a specific summary of the recently released Quality Patient Program proposed rule which provides the detailed regulatory guidance for implementation of MACRA/MIPS, but here’s the excellent 26 page synopsis created by CMS which provides an overview of the 1058 page rule...

Halamka: 2015 In Review

It’s now December and as each year ends, I always look back on the challenges and achievements of the past 12 months. Here’s my sense of 2015. ICD10 - billions were spent, countless other projects were delayed, and the transition occurred on October 1 without a major incident...Did we get our money’s worth? I have argued and will continue to assert that ICD-10 benefited no one. The diagnoses used are more variable so there is less precision in their use. Clinical documentation (in general in the industry) does not have the specificity needed to justify the more granular ICD-10 codes. The notion that quality measures can now be computed more accurately from ICD-10 coded administrative data is just not true...

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John Halamka Looks Back at 2014

2014 was quite a year. Thinking back to December 2013, I cannot believe that so much has happened. Let’s take a look at the major HIT events that shaped 2014 and what they portend for 2015 Read More »

Munnecke on "Dots-First" vs. "Links-First" Metadata Approach, or Why ICD10 is Going to Fail

Note that, even in 1986, the Committee on Veterans’ Affairs was savvy to, and advocating the use of metadata (then called the “data dictionary – a roadmap to the database.”  It understood its use in VistA (then called DHCP), its role in portability (then with the Indian Health Service), and hopes to use it for the Department of Defense’s Composite Health Care System. Read More »