Editor's Desk: This Week in Government Health IT

By Tom Sullivan
09:21 AM

Will Wal-Mart buy and implement Costco’s EHR and practice management systems? And what the H-E-Double-Hockey-Sticks is really going on in healthcare during these last days of 2011?

Costco on Tuesday announced that it will be reselling Allscripts applications and Etransmedia hosted services to members who happen to double as doctors – the idea being to enable members to “keep as much of the $44,000 in stimulus funds as possible.”

More welcome financial relief came this week intertwined with the final medical-loss ratio rule, which means that payers are now permitted to include the coding conversion costs under quality improvement activity (QIA), which means parts of the ICD-10 conversion can be included in the 80 or 85 percent of premiums that insurers are required to spend on clinical care.

While at it, CMS opened the flood gates to public comments “on the treatment of ICD-10 conversion costs in the final rule.” Given the expense and contentious nature of the unfunded mandate that is ICD-10, it's easy to envision a tide of such comments rushing in to CMS.

On the other side of the proverbial coin, one venture capitalist said that a lot of money is going into health IT right now. “It’s a really good place to be right now,” he said at the mHealth Summit, where myriad mobile health technologies are on display – and among the debates brewing are whether patients or physicians will be the true drivers of mHealth moving forward. As one commenter pointed out, IT shops will play just as critical a role in the implementation of mobile wares. And they’ll need to, too, since workers are adopting mobile devices faster than health organizations are putting governance policies in place.

The danger: Mobile devices are already one of the leading causes of data breaches, according to the second annual Ponemon study on patient privacy – and breaches are on the rise by 26 percent. Between the lines of that study are truths darker than mere accidental data losses or even criminal enterprise for which medical records boast a street value some 50 times that of other records. Consider enemy terrorists getting their hands on TRICARE records and knowing what our troops are not vaccinated against, then being able to use that data in a bioterrorism attack. Perhaps even worse, ID Experts Rick Kam told me that “there’s going to be a giant data spill of health information” and it will cause more damage than BP wreaked on the Gulf because once it’s out, “healthcare information cannot be put back in the box.”

A sobering thought that providers who happen to belong to Costco might take into account before subscribing to its new cloud-based EHR and PM applications, or patients considering Wal-Mart’s rumored health services. It’s hard enough for providers to protect your medical records because data security is not among their core competencies, does anyone really believe retailers can?