Why is it harder in the US for ICD 10 implementation – we are the only country that ties the coding to reimbursement.  This means a ton more money for subsidiaries of insurance companies to cash in bigger.  Nobody pays much attention to all their technology subsidiaries today but they are big and many.  For this matter the AMA is not alone and some of the top Health IT folks in the country feel the same way.

Dr. Halamka Speaks About Health IT–“CIOs are on Overload” and It Would be A Blessing to Stall Off ICD-10 to 2016 - The Straw Breaking the Camel’s Back

Many times with just straight “figurehead” executives who have never written a stick of code to understand the time and mechanics made very questionable decisions and downright refuse to listen to the advice of those who do have a eloquent background.  This is becoming more of a problem as in the past IT folks were able to make the job look easy as we didn’t have as much code working with other code out there, not to mention the expense, so the “pinhead” executives still can’t figure out what is up and what is down. 

ICD-10 One of the Largest, Most Expensive and Riskiest Health IT Translations–Other Countries Use ICD Codes, But US Is the Only Country Using Codes For Reimbursement

This is why we need more “hybrids” in key positions, as Bill Gates said at Berkeley last year to the graduating class; those who have more than one area of focus and expertise will be the ones with the “real” value and who we need in executive and political positions.  He’s right, but we don’t seem to have a Congress that embraces that idea either as most seem to be just  digitally illiterate or “non participants” for the most part with technology (other than Facebook and solitaire) and listen to the figureheads “who have no hands on experience with the mechanics of writing code.” 

It will come back to bite and bite hard as we continue with the “Attacks of the Killer Algorithms”.

Let me say this though, the consultants in Health IT who want to make money will convince you otherwise that we “have” to have these and again double fold here in the fact that the government is still for what ever reason riding this expensive horse and secondly, they want to make money selling more algorithms.  Software, by the way is nothing but a bunch of algorithms working together to quote Bill Gates again. 

Let us also not forget that using more codes that are more complex and  difficult add the perfect playground for more software companies to create even more algorithms and again pump up their sales and at some point the bubble will burst when nobody can pay the bill.  In a similar situation, the SEC is mulling over that exact idea too with their “real time” monitoring of transactions to which there are alternatives, but the current idea they are looking at, well again, nobody can afford it so it runs rampant with so many digital illiterates trying to make decisions in this area that don’t want to listen to the experts in this area and boy what an ugly scenario we have building too.  Here’s a classic post from December 2010 and darn it sure likes it’s getting somewhere near this today and when the bubble bursts, I think it will really stink.  BD

Health IT The Next Bubble and How Long Will It Take to Pop–Probably When The Money Runs Out

Washington -- Citing high implementation costs and coinciding federal mandates, the American Medical Association has urged House Speaker John Boehner (R, Ohio) to stop the switch to the new diagnosis coding sets known as ICD-10.

Requiring doctors to use ICD-10 would offer no direct benefit to patient care, said AMA Executive Vice President and CEO James L. Madara, MD, in a Jan. 17 letter to Boehner. He said requiring all physician practices to use new diagnosis codes starting Oct. 1, 2013, also would interfere with concurrent efforts by doctors to implement electronic medical records and satisfy other Medicare quality improvement requirements. AMA delegates adopted policy opposing the switch to the enhanced code sets during the Association's Interim Meeting in November 2011, but Dr. Madara's letter is the next step toward effecting a legislative solution.

ICD-10 contains about 68,000 codes, while the current ICD-9 standard has only about 13,000 codes. The AMA says the switch represents a significant administrative burden, as the costs of implementing ICD-10 range from about $83,000 to $2.7 million depending on the size of the physician practice.



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