I think the title here makes a real good point on data complexity and certainly other countries can learn from the US if they might have the same idea with using ICD codes for reimbursement…think about it and just imagelook at the mess not to mention the huge expense the US has..is it worth it…with economic times I would guess most other countries would say not.  We all learn from each other and I can’t help but wonder how other countries view our complex Health IT system.  What do we get for all these expenditures besides consultants racking in tons of money and quite a few of them now are owned by insurance companies too…with record profits still showing on the books. 

Do Some Think That Health IT Costs and Systems Grow On Trees-Certainly Starting To Give That Impression of Late

The article quoted below is from Dr. Halamka at Harvard Medical so if they calculate shortages and the inaccuracy of the projections calculated by CMS and HHS, where does that leave the rest of us?  He further goes on to state the expense of all of this coming at a time when economic conditions are not great for many hospitals and providers today.  He presents some statistics that the Federal Register predicted their cost would be around $300,000, when in fact the cost they will bear is more like $ 5 million. 

Again we all know we have members of Congress who don’t do math very well and seem to ignore technologies that would help them but that’s kind of the way they function as I call them the “non participants” of the digital age, even with consumer Health IT.  We never hear them as role models but rather it’s the old paradigm of “its for those guys over there”. This is not his first addressing of the subject and more can be read and heard at the post below.  Dr Halamka is one of the few “realist” we have as a tremendous resource today

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

Shoot if these folks in Congress won’t listen to Harvard, who will they listen to one wonders?  The article further goes on to say that costs could easily double the benefits received too.  It’s the same old stuff with nobody wanting to do the right math it seems.  You know when you think about this a case for a public option is certainly looking a lot better.  Most in lawmaking still think IT Infrastructure Costs and Time grows on trees, in other words we come right back around to digital illiteracy and the “non participants” who are flat out lost. 

I shake my head when I see nonsense such as a Facebook contest being promoted for use during disasters, how about riots?  Are those a disaster?  I would not recommend in that case:)  If something like this comes around then we have another issue, define what is a disaster…<grin>. 

HHS Seems To Be Confused on Social Networks–Facebook for Disaster Support Contest, Give Me a Break Use Twitter Like Everyone Else Does

Oh they just don’t get it not to mention how this kind of nullifies their efforts to protect privacy when they talk Facebook and privacy in the same sentence.  Somebody along the line might want to tune in here and listen to how numbers are skewed and how dirty algorithms are out there today for profit as well. 

“Numbers Don’t Lie, But People Do”–Radio Interview from Charles Siefe–Journalists Take Note, He Addresses How Marketing And Bogus Statistics Are Sources of Problems That Mislead the Public & Government

This kind of circles around to another post I made a while back with lack of collaboration, we have tons of innovation but nobody collaborates well and this is where others can take a lesson from tech Giants.  What if Microsoft didn’t collaborate with Google, where would we be today? There are levels and places to collaborate and other areas where you compete, and tech gets it, the rest of the world doesn’t.  Even our US CTO still keeps pounding his chest about innovation, same old story but leaves out the collaboration portion of the puzzle.  Oh well….BD 

Innovation Without Collaboration Is Fouling Up The US Healthcare IT System–We Need Both As We Can’t Stand on Innovation Alone

On October 1, 2013, the entire US healthcare system will shift from ICD9 to ICD10.   It will be one of the largest, most expensive and riskiest transitions that healthcare CIOs will experience in their careers, affecting every clinical and financial system.   It's a kind of Y2k for healthcare.
Most large provider and payer organizations, have a ICD10 project budget of $50-100 million, which is interesting because the ICD10 final rule estimated the cost as .03% of revenue.  For BIDMC, that would be about $450,000.   Our project budget estimates are about ten times that.

Most small to medium healthcare organizations are desperate. They are consumed with meaningful use, 5010, e-prescribing, healthcare reform, and compliance.   They have no bandwidth or resources to execute a massive ICD10 project over the next 2 years.

What's needed is a fresh look at the reimbursement system. While ICD is used in other countries, it is not used for reimbursement purposes. Rather, it is used for health statistics and reporting. Using it for reimbursement adds an entirely different dimension. Because it is used for reimbursement, the U.S. version requires numerous extensions. Read this as more codes and more complexity.



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