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Here's the exception -- a completely subjective list of our top 10 health IT trends of 2011, ranked in no particular order.
- Blumenthal out, Mostashari in. The Office of the National Coordinator for Health IT (ONC) made a coaching change, as the football guys like to call it. In this case it wasn't Tony Sparano getting unceremoniously dumped midseason by the Miami Dolphins, but, rather, an orchestrated transition -- think Jim Caldwell and the Indianapolis Colts. Former national health IT coordinator David Blumenthal, M.D., safely ensconced in the Harvard ivory tower he left to serve his two years in Washington, remains comfy with his old mates, often returning to speak at ONC events to advocate for national health IT adoption.
- ICD-10. The Oct. 1, 2013 U.S. health care transition to ICD-10 codes draws closer. The natives are getting restless -- including the American Medical Association, whose house of delegates voted to vigorously oppose it, and the staggeringly large number of organizations that fill out survey after survey and say they aren't ready for ICD-10 implementation. The Centers for Medicare and Medicaid Services (CMS), however, remains firm in its resolve to flip that switch.
- Meaningful use stage 2. What specific criteria will be included in the proposed rule, expected in February? What will be out? These questions will be answered in 2012 -- but many more will be raised -- as vendors tune up their software for ONC certification and customer EHR implementation. Meaningful use will rank among the top health IT trends for years to come.
- Cloud computing. As providers adopt EHR systems and comply with various federal and state patient data retention laws, health care data centers are more overstuffed than a child full of holiday cookies. Providers -- and the IT staffs who serve them -- still seem distrustful of cloud computing services, but the health care sector is getting closer and closer to that meeting of the irresistible force and immovable object. Something's gotta give. Perhaps server virtualization implementation will give the health care cloud a kick in the pants.
- Health data privacy and security. With providers reporting more and more data breaches -- and HIPAA rules possessing more punitive teeth -- locking down data to comply with federal laws is becoming more important than meaningful use. State patient privacy laws and overlapping state consumer protection statutes differ widely. The nationwide harmonization of these rules, we believe, will rank among the health IT trends of 2012 or 2013.
- Accountable care organizations. Can these health systems, which purport to save money by using quality reporting and analytics to keep patients healthier, jump from the theoretical realm into actual practice? A couple large analytics-savvy providers voted "no" with their pocketbooks and declined to sign up for CMS pilot projects, leading analysts to wonder if those providers thought there would be no savings left to share after all the IT-heavy reporting mechanisms were put in place. But 32 pilot ACOs did sign up. Perhaps there's hope after all.
- The economy, stupid, again. Maybe that's what will ultimately drive the move to the ACO model, putting patient data in the cloud, effective ICD-10 implementation and meaningful use stage 2. Or provides will choose two -- or one -- of the above and skip the rest because there's not enough IT budget to support them all. Plus, negotiating health IT contracts is hard enough.
- EHR systems aren't all sunshine and flowers. While we hear an awful lot about the easiest, smoothest EHR implementations, there is a dark side to EHR use. What will happen to older private-practice physicians -- or the just plain technology impaired docs -- is anybody's guess. Ours: They'll join hospitals or large physician groups and let their IT people worry about the nuts and bolts of EHR implementation.
- Medical specialists. Clearly, the meaningful use rules tilt toward the primary care docs, who create the patient's definitive record. So where does that leave specialists, who hop from hospital to hospital or work referrals (or both) to build their patient base, yet are still eligible for EHR incentives? While some specialists are achieving meaningful use, most struggle to fit in.
- Personal health records. Google Health bit the dust, and Microsoft recently reconfigured its efforts to serve the health care sector. Someone's going to figure out how to make PHR services work. It's in the regulations, right?
Let us know what you think about the story. What health IT trends from 2011 are we missing? Email Don Fluckinger, Features Writer.