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The HIT Decade

January 4, 2010
by Neal Ganguly
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A Retrospective Look

January 1, 2000. A new decade began and we all breathed a sigh of relief as the lights stayed on and computers kept humming along. Years of hard work culminated in a relatively uneventful New Year’s Day in 2000. However, complacency was not an option, and attention shifted to Ambulatory Payment Classifications (APCs) which had to be in place by August of 2000. November saw the launching of the Leapfrog Group and the first signs that clinical systems and quality would be a growing area of focus for IT. The publication of the final HIPAA Privacy Rule in December was a nice way to end the year.

Seen as IT’s next Y2K, courtesy of the federal government, the final privacy rule dominated the landscape in 2001. Understanding the regulations, fending off legions of expert consultants and developing plans for compliance kept IT departments and others busy that year. In fact, the privacy and transaction set components of HIPAA would keep hospital IT personnel busy until 2003. Imagine how long it would have taken without the federal focus on ‘administrative simplification.’

During the first half of the decade, the Leapfrog Group was not the only wind of change blowing in the clinical direction. The Joint Commission began to put a stronger focus on clinical quality requiring more and more data to demonstrate compliance with “core performance measures”. The gathering of data often involved tremendous manual effort in terms of chart reviews and analysis. As CMS and other regulatory bodies jumped on the bandwagon, more and more hospitals realized that clinical systems would need to become more robust to support the changing environment.

HIPAA, the gift that won’t stop giving, reared its head again in 2005 with the security regulations taking effect. Clinical system implementations in inpatient settings as well as niche areas such as the emergency, and surgery departments also picked up pace in the last half of the decade. Document management and workflow systems rode the automation wave in hospitals. While hospitals were busy implementing these systems they began to recognize that the fun didn’t stop when the system was ‘turned on’. Culture change became a defining theme without which the money and time invested in new systems would not bear fruit.

The decade ended with an unprecedented focus on health information technology. The decade’s last two administrations believed in the value of health information technology. The Office of the National Coordinator for Health Information Technology (ONCHIT, ONC for short) was established and the nation saw the naming of its first CIO and CTO. The new president carried a blackberry and used email.

Now we sit in January of 2010, half way through the 550 plus pages of proposed meaningful use rule. Thinking about what’s on the horizon. Health Reform, RAC audits, HIPAA 5010, ICD-10, PHR, HIE/RHIO, Quality Reporting, CPOE…..

Looks like this will be a busy decade too.

Happy New Year everyone!

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