Dr. Halamka with his great wisdom and knowledge politely poses the question of which should come first and it’s indeed a good question.  He’s a hands on guy and we are lucky that he takes time to share some of the detailed information he offers as nobody comes close as far as knowing the use and circulation of medical data.  Below he talks about his plans in working to meet federal compliance but also poses the question of perhaps elevating Sno-Med priorities first, a good question to ask.  When you stop and go back to his personal history in college in California and living in the same house as those who ended up creating HP, well it doesn’t get more extensive than this and I said we should figure out how to clone some of his wisdom recently.

Dr. Halamka Becomes Harvard Professor -How Can We Clone His Expertise As A Role Model

You can read his entire blog post here on the topic and get his input.  He makes one profound statement in the fact that ICD-10 is not just an IS function but involves all levels of the enterprise, as everything else is today, complicated.  He acknowledges that fact when it seems many others slide over it.  He’s also a practicing doctor so again a very unique individual or “hybrid” that sees both sides of the coin and we don’t have enough of those folks out there today.  In case you missed earlier this year, he was featured with Apple at the release of the IPad 2, so valuable knowledge doesn’t get better than this. 

How the Ipad is Changing Medicine-Apple Endorsement from Dr. Halamka At Harvard Medical With Real Time Applications and User Information

I just certainly wished we had more top executives with real “hands on” health IT” knowledge as it sure makes a difference and saves time and money too with cutting out additional reports and outsourcing studies as when you have the knowledge directly upstairs you can certainly field a lot more questions without the reliance of studies as one has “been there, done that”.  His IS group is now just beginning their ICD-10 project to have an October 1, 2013 live date, so again this gives you a pretty good idea on how complicated Health IT systems are today and the amount of time it takes to prepare data aggregation and transitions.  Again, I wish more in the world, especially those who makes laws had a greater awareness in this area as we sometimes get bills and laws with impossible time frames and provisions for compliance.  BD

Although BIDMC has finished its 5010 work in anticipation of the January 1, 2012 deadline, we're just beginning our ICD10 project for an October 1, 2013 go live.

As I've written about previously, I believe that ICD10 implementation should be delayed until after Meaningful Use Stage 3 (2016) to enable widespread adoption of structured clinical documentation including vocabularies like SNOMED-CT which will provide the necessary detail for coders using ICD10.   Moving forward with ICD10 in the absence of enhanced electronic clinical documentation makes no sense.

Our ICD10 Steering Committee includes a multi-stakeholder group from inpatient, ambulatory, finance, HIM, our physician's organization,  and IS.   ICD10 is not an IS project, but is an enterprise project involving all operational areas.

If ICD10 was delayed until 2016, our approach would be different.    We'd focus on getting widespread provider adoption of SNOMED-CT on the front end, then limit ICD10 implementation to back office functions, mapping clinically focused SNOMED-CT codes to administrative ICD10 codes for billing.  Let's hope wise folks at CMS realize the benefits of such an approach.

Life as a Healthcare CIO: ICD10 Kickoff meeting


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