The Great ICD-10 Debate: Healthcare Coding Transforms

Many business executives slow down and get a chance to smell the roses during the summer, but I'm predicting health IT leaders will have little time to chill out during this vacation season. Court rulings and federal rules likely will keep them preoccupied.

The first and biggest event could come by the end of this month, namely the Supreme Court's ruling on the constitutionality of President Obama's healthcare reform. Although the Patient Protection and Affordable Care Act isn't IT centric, many of its programs, including accountable care organizations (ACOs) and health insurance exchanges (HIX), are fueled by IT.

If the Court knocks down the Act, healthcare leaders will need to reevaluate their plans and participation in ACOs, and those decisions will then influence the order of their health IT priorities and spending. ACOs represent new payment models that are tied to coordination of care and quality. Although some of these new ACO efforts are already up and running--in large part because of a recently launched Pioneer ACO program by the Centers of Medicare and Medicaid Services (CMS)--lots of other new ACOs might get swept by the wayside.

Similarly, if the court overturns the Affordable Care Act, burgeoning health insurance exchanges--marketplaces where the uninsured in each state by 2014 can shop for coverage—also will sputter. The exchanges are expected to provide consumers with online tools to compare features and costs of policies. Without the reform law's individual insurance mandate, the need for HIXs evaporates.

[Read If Court Squashes 'Obamacare,' IT May Suffer: HIMSS.]

Publication of the HITECH Act's Meaningful Use Stage 2 final rules will likewise capture healthcare leaders' attention this summer. That's likely to happen sometime in July, though it could come a little later. A couple of years ago, when the feds were finally done ironing out the details of Meaningful Use Stage 1, CMS published those final rules on July 28, 2010. So, don't be surprised to see a similar timeline for Meaningful Use Stage 2's final rules.

By now, healthcare IT leaders have a pretty good idea of what to expect in the final rules, considering that CMS issued the proposed rules in March. Now it's a matter of seeing what public comments--including those from medical associations, consumer organizations, and health IT groups--CMS will consider when drafting the final regulations.

It's the accumulation of those seemingly small details in the Meaningful Use Stage 2 rules that could tilt the priorities that health IT organizations focus on during the coming year or two.

For instance, should CMS insist that hospitals release information to patients about their hospitalizations within 48 hours of being discharged? Should healthcare providers be required to have 40% of patient medical images accessible through their certified EHRs? Those can be huge undertakings for organizations not yet tied into health information exchanges, which can help with heavy image sharing. Those sorts of fine points could make IT leaders redeploy some tech talent to focus more time working on secure patient portals, internal systems integration, and custom interface development rather than other projects.

In any case, the rules and rulings coming over the next few weeks and months should keep healthcare CIOs and other leaders on high alert.

Finally, on a personal note, this is my final column for InformationWeek Healthcare, as I will be leaving to start Stage 2 of my own health IT-related editorial career. Thanks to all who helped make my many years reporting and writing at InformationWeek, and especially at InformationWeek Healthcare, such a rich experience.

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