The end of a year brings many things, but from a journalistic perspective perhaps nothing signals the change in the calendar as much as the wave of retrospectives of the year gone by.
In keeping with that spirit, then, it seems appropriate to begin to look at the year in health IT through the eyes of one of the industry's most ubiquitous stakeholders and observers, Beth Israel's John Halamka.
Halamka, who is CIO of Beth Israel Deaconess Medical Center, chairman of the New England Healthcare Exchange Network and co-chair of the HIT Standards Committee, offers an array of observations of what was, to put it mildly, another busy year.
Concerning ICD-10, the deadline for which it seemed might never actually arrive: "Billions were spent, countless other projects were delayed, and the transition occurred on October 1 without a major incident. We're monitoring daily cash at all our hospitals and there has not been significant impact on denials, payments, or discharged but not final billed accounts. Did we get our money's worth? I have argued and will continue to assert that ICD-10 benefited no one."
The problem, he says, is that "clinical documentation (in general in the industry) does not have the specificity needed to justify the more granular ICD-10 codes. The notion that quality measures can now be computed more accurately from ICD-10 coded administrative data is just not true."
On meaningful use, the funding for which essentially ran out this year, his views might best be summed up as, "The program achieved its goals; may it rest in peace." Just as with ICD10, he argues, "we need to turn the IT agenda back to customers -- patients and providers -- who want improved quality, safety and efficiency. As we've seen with Stage 2, it is too early to propose a Stage 3, because we do not really know what has worked in Stage 2."
The HIPAA Omnibus Rule and elements of the Affordable Care Act are also lifted up for comment, but in the name of looking forward as well as backward, let's jump to the cloud. As Halamka succinctly puts it, "2015 was the year in which the cloud became a viable option for just about every application in healthcare. Amazon and Google both agreed to sign business associate agreements. Many companies offering cloud-hosted services agreed to indemnification clauses for privacy breach. At this point, the cloud can be more reliable, more secure, and more agile than local hosting."
As Halamka notes, many organizations are either moving or thinking of moving significant pieces of their IT systems to the cloud. Which gives us a glimpse at what will likely be one of the big stories to watch in the year ahead.