Predictions and trends for 2014: Chris Dimick on how vendors can prepare for the next era of healthcare
Chris Dimick, editor-in-chief at Journal of AHIMA, discusses healthcare technology industry predictions and trends for 2014, touching on ways vendors can best prepare for the next era of healthcare.
Dodge: What were your top two or three takeaways from AHIMA that you feel will have the greatest impact on the industry in years to come?
Dimick: The biggest lesson learned at the AHIMA convention is that the move to electronic health records and other health IT systems will change every aspect of healthcare, not just HIM, and that in the near future data will be king. I think some just assume that health IT impacts those in IT and the physicians using the equipment. But it goes well beyond that. Several speakers at the conference said that the future state of healthcare will be driven by demographics, technology, and value-based purchasing initiatives – which are all based on data and information. Everyone is looking for a magic cure for what ails the American healthcare system. At AHIMA, people were saying that while it isn’t magic, electronic health data and health information have an enormous role to play in this ongoing transformation – and must play a role. In fact, data holds the key to lowering healthcare costs and improving care processes, if it can be collected and analyzed in the right way.
Dodge: How has Journal of AHIMA adapted to the changing editorial environment over the years?
Dimick: Just as many of our readers have been encouraged to do, instead of shying away from technology we have tried to embrace it. Three years ago we launched our digital edition of JAHIMA, which allowed us to be read on tablets and other electronic readers. We have also moved beyond the written word by creating audio and video features for our audience, which we include in the digital edition and on the Journal of AHIMA website. Audio/video gives us the opportunity to reach our audience and share information in a new and exciting ways. Recently we have added significant resources to our website, which launched with the intent that it be a place we could break news and relate shorter, more specific articles to a wider audience. The site is free and open to the public, versus the subscription-only print and digital editions, and features content not included in print. This allowed us to extend our message to the general public. In print, we have worked to make our articles more visually appealing with artwork, graphics, and short sidebars. Magazines can’t get away with large blocks of black text anymore.
Dodge: What are the biggest challenges you see for vendors in the coming year?
Dimick: In the HIM world, 2014 will be the year of dealing with the industry’s switch to the new ICD-10-CM/PCS medical coding system, as well as working to get electronic health record systems up to the standards of the government’s “meaningful use” EHR Incentive Program, which offers financial payments of implementing and using EHR systems. Many vendors are having problems meeting the requirements of meaningful use for their clients. With ICD-10, many vendors are overwhelmed with requests to help with the transition. Both of these changes impact all sectors of healthcare, not just vendors or HIM. With meaningful use, patients will have better electronic access to their health information. While most in HIM support this and other patient engagement initiatives, it means having to revamp their systems and learn new workflow processes. With ICD-10, the way HIM professionals code and submit medical bills to payers will completely change. The United States is currently using ICD-9-CM, which offers a limited language to properly code and describe complex medical charts for payment. ICD-10 adds thousands of codes to the rulebook, which will lead to increase specificity, but also increased work for HIM to code.
Dodge: How do you anticipate ICD-10 impacting healthcare organizations across various leadership levels (C-suite through coders)?
Dimick: For years JAHIMA has worked to remind the industry that ICD-10 does not just impact coders, but every facet of a healthcare organization from the CEO down to the clerical worker. The reason being, coding is what gets the bills sent out and paid. The C-suite should be interested because many expect coder productivity to go down in the first months of ICD-10, which will impact financial reimbursement. But also, ICD codes are used for many other reasons beyond just billing, and are engrained in many systems and processes across a healthcare organization. If the transition to ICD-10 is not done right, many systems will need to be retroactively revamped, and some processes could fall out of order or compliance with regulations. This could be a huge headache for everyone in a facility. But, if you have been preparing for the change, the issues should be minimal.
Dodge: The marriage of clinical and financial outcomes is a rising and imperative trend we’re seeing organizations adopt. How do you see that partnership driving the next phase of healthcare delivery?
Dimick: The future of healthcare lies with value-based purchasing, or “pay-for-performance” initiatives. The federal government has already started to transition to pay-for-performance reimbursement models, and as the largest provider of healthcare in the country typically what they do is eventually mimicked by all private insurers. Pay-for-performance moves healthcare away from the fee-for-service model it has used for ages and instead pays provides based on how well they can make their patients. The details on how this will be done effectively and fairly are still emerging; but at its core this payment system marries clinical and financial outcomes, and uses health information to determine if care outcomes have improved and warrant payment.
This is very interesting for many of our readers, since it puts healthcare documentation in the center of the payment model. Many would agree that health information documentation needs radical improvements, and this move to pay-for-performance is likely to be the catalyst for that long overdue improvement. Some have mixed feelings on whether pay-for-performance is a good thing, and I’ll remain unbiased. But, if all goes as promised by the government, it does have the potential to greatly improve the care patients receive since it promotes payment for wellness versus just treating illness. That is, if all goes as promised.
Dodge: How do you see mobile applications and technology shaping healthcare? Any specific resources you’ve found most/least engaging?
Dimick: I think mobile healthcare, or mHealth, has the potential to completely change the way individuals interact with their personal care as well as their care providers. It seems like the mHealth industry is moving toward the ultimate goal of putting a physician in your pocket at your beckon call. It seems like sci-fi, but it is real and is already here. This is both thrilling and, some feel, dangerous if the information provided through mHealth is misinterpreted or misused. From the HIM side, there are vast privacy and security worries and risks that come with the use of mHealth (i.e., storing personal information on a smartphone device that is the target of thieves and hackers). Another HIM problem with mHealth is getting the information out of the medical device or app and into a patient’s long term healthcare record. Most current EHR systems don’t have this ability, so the information remains siloed and inaccessible by the people who need to see it most (providers).
As far as resources on mHealth, I found a recent infographic done by Fast Company very compelling. The piece includes information on a mHealth device or app that can treat every part of the human body. This shows that mHealth isn’t a thing of the future… it is here now!