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Washington Debrief: To ICD-10 or Not to ICD-10?

June 25, 2013
by Jeff Smith, Director of Public Policy at CHIME
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To ICD-10 or Not to ICD-10:  That is the Question This past week was all about ICD-10.  HHS is resolved to keep the current deadline and the American Medical Association (AMA) is keeping to its “Stop the implementation of ICD-10” mantra.  “There are no plans for any more extensions,” ONC chief Farzad Mostashari, M.D. told attendees at the HIMSS ICD-10 Forum.  “There are no plans for any more extensions,” he reiterated.  During his keynote at the ICD-10 Forum, Dr. Mostashari discussed the importance of the new code set in the context of other programs such as Meaningful Use.  “At the end of the day, this massive transformation isn’t going to be about ICD-10,” he said.  It’s going to be about paying for higher quality healthcare, in addition to improved population health, more patient engagement and better transitions of care.  Mostashari also highlighted a National Library of Medicine crosswalk between SNOMED and ICD-10, which he says will spur private sector business and ease doctors’ transition.  Meanwhile the AMA made news this week through its annual gathering of AMA House Delegates.  The AMA board of trustees issued a brief report in May suggesting it would not be feasible to skip to ICD-11 from ICD-9.  So this week the AMA House of Delegates rejected the report, with members adding that the AMA seems to be “out of ideas” on how to stop the implementation of ICD-10. 

CHIME is an official signatory to a coalition letter to members of the US House of Representatives and Senate opposing “any actions to further delay full compliance with the planned adoption of ICD-10.”

Hospitals Push for Unique Device Identifier for Stage 3 Five healthcare systems are urging the ONC’s Health IT Policy Committee to recommend the inclusion of Unique Device Identifiers (UDIs) in electronic health records.  Geisinger Health System, Intermountain Healthcare, Kaiser Permanente, Mayo Clinic and Mercy have been working to establish a system that collects UDI data for safety surveillance, device research and managing inventory.  The five hospital systems are part of the Healthcare Transformation Group (HTG) which formed to share best practices and drive needed positive change across the healthcare supply chain.  The group "strongly" encouraged the Meaningful Use Workgroup and HIT Policy Committee to recommend new EHR certification criteria and Meaningful Use objectives to incorporate UDIs of implanted devices into patient EHRs.  The action comes as FDA is poised to release the final UDI rule, which arrived at the White House Office of Management and Budget last week. The agency is also working on several initiatives that are part of its postmarket surveillance plan and working toward the goal of including UDIs in EHR.  "The project, which is an expansion of a U.S. Food and Drug Administration UDI demonstration project currently underway, will eventually provide a pathway to implement UDI into each HTG healthcare system's clinical processes, tracking devices from manufacturer to patient," the HTG team noted in a press release.

ACA Implementation – Reports Discuss Insurance Exchange Progress Two Government Accountability Office (GAO) reports released last week detailing progress on Federally Facilitated Health Insurance Exchanges and Federal and State efforts for Small Business Exchanges sparked discussions in the public and private sectors. GAO reported that, “While CMS has met project schedules, several critical tasks, such as final testing with federal and state partners, remain to be completed.” Several Republicans took this opportunity to say this is evidence that the exchanges will not be completed on time. According to a media article, despite this partisan criticism, industry representatives are not as concerned. In the article, Dan Mendelson, CEO of Washington, D.C.-based consultancy Avalere Health said, “‘It's actually very complimentary of CMS,’ as it mentioned the agency has met project schedule deadlines.” 

On the IT front, the report also notes that, “CMS indicated that it completed development of the information- technology systems necessary for it to carry out the plan management function, such as to collect plan data and certify qualified health plans (QHP).”

Edited by Gabriel Perna