Health systems will tackle technology challenges including mobile, manpower, meaningful use, and other mandates.
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Slideshow: Health IT Boosts Patient Care, Safety
While there are currently about 13,600 ICD-9 codes, the number of codes will increase more than five-fold, to approximately 69,000 with ICD-10. The new coding system, which will be required in 2013 for all medical billing related to anyone covered under Health Insurance Portability and Accountability Act (HIPAA) rules, brings more detail to diagnoses and procedures in the codes used on claims.
For instance, a single code under ICD-10 would not only represent the treatment of a broken foot bone, but would also indicate that the office visit was a follow-up appointment for a fracture that was healing normally or not. Also in preparation to the change over to ICD-10, beginning in January 2012, healthcare providers must change the standards they use for electronic healthcare transactions from Version 4010/4010A1 to Version 5010. Without Version 5010 standards being in place and tested prior to ICD-10, healthcare providers face delays in claims being transacted and payments being paid from the Centers of Medicare and Medicaid Services (CMS).
"ICD-10 -- the sober reality of the level of work required will hit hard," said Marc Probst, CIO at Intermountain Healthcare in Utah. "Tension is already rising between the numerous government mandates, and 2011 does not look like the year a lot of relief will be forthcoming," he said.
Accountable Care Organizations
If you're still hungry for even more government mandates, stay tuned. Also on the regulatory scene in 2011, more details will emerge from CMS about its requirements for accountable care organizations (ACOs), which got a boost in the healthcare reform legislation that passed in 2010.
"The ACO model has the potential to help drive real efficiencies and process reengineering," said Jennifer Covich Bordenick, CEO of eHealth Initiative, a non-profit organization that advocates the use of health IT and whose 200 members include patient groups, healthcare providers, health plans, and researchers.
The emerging rules from CMS for ACOs will include details of how these healthcare provider organizations will be financially rewarded for improving quality and coordination of patient care and reducing costs. Health IT is important for ACOs working to making those care improvements happen, and so healthcare providers eyeing to participate in ACOs will need to pay close attention to matching their IT strategies with the emerging CMS requirements.
With healthcare reform, meaningful use, ICD-10, and other mandates on the plates of healthcare providers, "the industry is going through changes that are unprecedented to leverage technology" to improve quality of care and process efficiencies, said Kaiser Permanente's Fasano. "The investments in technology [by the healthcare industry] will be great" in 2011, he predicts.
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