Crowded Plates: For CIOs, Policy Mandates are Piling Up

Discussions on Stage 2 are at a fever pitch, says CHIME’s director of public policy, Jeff Smith. “The awareness of the meaningful use policy is the highest I have ever seen on Capitol Hill,” he says. Anita Samarth, president of Clinovations, a Washington, D.C.-based consulting firm, is betting on some kind of delay or extension. However, most experts are unsure whether or not all the talks will amount to anything.

Healthcare Informatics has dug deeper into the thoughts of these industry leaders on these regulatory demands in HIT Voices, a three-part series. See what else Anita Samarth, Ed Marx, and George T. Hickman/Russ Branzell had to say on Meaningful Use, ICD-10, and other policy topics.

Also please feel free to vote in our poll on whether or not the Stage 2 timeline should be altered and weigh in at our LinkedIn Group

ICD-10: A SCARY REALITY

As CIOs weigh the decision of whether or not to attest to Stage 2, many are moving ahead full force on ICD-10, which will have to be implemented by Oct. 1, 2014 or providers will see an effect on their Medicare reimbursement. Boston-based Beth Israel Deaconess Medical Center CIO, John Halamka, M.D., goes as far as to say ICD-10 is a higher priority, along with HIPAA, than meaningful use.

“Ask yourself, ‘What are the things you cannot miss?’ If you delay a go-live of an application; your users may be frustrated. If you don’t get your compliance and regulatory mandates, you may go out of business. ICD-10, if you don’t do it on time, you can’t send bills out. If the Office of Civil Rights believes you aren’t safe guarding data, you get huge fines. It’s the regulatory and compliance mandates, specifically around ICD-10 and security, which are the top priorities,” Halamka remarks.

Branzell of CHIME says that many CIOs in advanced electronic environments who have already attested to Stage 1 are asking, “Why do Stage 2, considering the financial risk of ICD-10?”

At Texas Health Resources, senior vice president and CIO Ed Marx confides that his organization is moving forward with ICD-10 as if the Oct. 1, 2014 date isn’t going to change, even as some associations continue to ask for a delay (CMS officials have been clear in their intention not to delay the required transition date beyond Oct. 1). “We’re feeling pretty good with our vendor, with our internal HIM, that we’re going to make those dates,” says the industry veteran.

Other CIOs have similar mindsets. Randy McCleese at St. Claire Regional says his organization is preparing for the transition as if the date was cut in stone and it’s become one of their big focuses. Hickman says that at Albany Medical Center, ICD-10 testing will force the organization to put a freeze on plans to bring in new software by April or May of next year. He adds that even though the organization is on track to transition to ICD-10, a lot of work left remains.

“Many things that we do, don’t keep me up at night; this one does,” Hickman acknowledges. “There are so many moving parts to it, and so many interrelationships.”

The difficulties of this ICD-10 transition and the fact that most don’t see the compliance date being moved again have made it an inescapable reality for CIOs. HIPAA compliance, mentioned by Dr. Halamka, is another looming policy element that is top of mind for many CIOs. Texas Health’s Marx says the organization has “doubled down” on its security measures.

ACO FORMATION

If it’s not meaningful use, ICD-10, or even HIPAA, then it’s payment model reform under the ACA, including the voluntary accountable care organization (ACO) program and the mandatory value-based purchasing program. For many organizations, like McCleese at St. Claire Regional Medical Center, ACO formation is a front-and-center issue.

This year, the center is joining with the Bon Secours Health System to form an ACO. To help with data reporting and analysis, St. Claire hired an analyst to focus on the ACO. The analyst told McCleese that he didn’t initially understand the extent of the ACO initiative.

“He said, ‘I had no idea it was anywhere near this big.’ I said, ‘Now you understand why I said you need to go out of your analyst role into this role to make sure we can get the data we need,’” recalls McCleese. “We as an organization, and I think I’m hearing this in the industry, this is the future of healthcare and the way we are going to get paid. So we want to make sure we get it right.”