Electronic Health Records


Epic, ICD-10, government shutdown are hottest topics of 2013

By Jennifer Bresnick

- Healthcare is in the middle of a massive shakeup, and there are plenty of big stories to go along with the changes.  From Dr. Farzad Mostashari’s departure from the ONC to the Stage 2 and Stage 3 meaningful use delay, the industry has been rocked by a series of big announcements and major reforms.  Want to know what news drew the most eyeballs in 2013?  Here is a countdown of the top ten most read stories from EHRintelligence during the past year.

10. What can predictive analytics do for healthcare reform?

The shift from pay-for-service to pay-for-performance in healthcare means that healthcare organizations and providers must approach care delivery in a different way, moving from diagnostic care to preventive medicine. Part of the challenge of adopting a forward-looking approach is having the right tools, namely health IT systems with the ability to predict what’s next.

9. Top ten ICD-10 readiness questions to ask your vendors

Providers, payers, and vendors all need to be on the same page at the same point, and yet the struggle to synchronize and streamline everyone’s efforts seems to be causing significant anxiety leading up to October 1, 2014.  Providers have the most to lose from the lack of vendor readiness, since it’s their revenue that stands to suffer.  Here are ten questions you should be asking your vendor in the run-up to implementation.

READ MORE: Seema Verma Confirmed to Serve as New CMS Administrator

READ MORE: CVS Chooses Epic EHR System for Specialty Care Management

READ MORE: AMA Leads Call for Addressing EHR Quality Reporting Programs

8. Understanding ICD-10: Crosswalks and General Equivalence Mappings

GEMs are not a substitute for learning how to use ICD-10 codes, nor do they simply and automatically translate one code to another in a completely reliable way.  But they can be a useful tool for comparing and translating data during the transition process, and can be beneficial for research and informatics before and after ICD-10 comes into effect.

7. What’s behind the 17% EHR Incentive Program dropout rate?

The pace at which eligible providers are leaving the EHR Incentive Program is higher than most high school dropout rates. Despite the continued increase of new providers joining the program, the rate of failure is astonishing and somewhat troubling.  If meaningful use can’t hold on to participants by offering big incentives, what will happen when that money goes away – and what does that say about the deeper issues underlying EHR adoption in the United States?

6. Meaningful Use payments get chopped under sequestration

CMS has officially announced that the 2% reduction in Medicare will extend to meaningful use payments under the program.  There was some hope that meaningful use would be spared due to the fact that the funding for the initiative was not in the general Medicare budget pool, but providers will in fact see a 2% reduction in reimbursement for all payments processed after April 1, 2013.

5. Epic EHR adoption partly to blame in Maine hospital debate

The decision to shutter the emergency room at St. Andrews Hospital in Boothbay Harbor, Maine, has one local selectman questioning the high costs of the implementing an electronic medical record provided by Epic Systems.

4. CMS 1500 Medicare claim form gets an ICD-10 update

The paperwork has received its ICD-10 facelift, and the current version will no longer be accepted by CMS on April 1, 2014.  While there will be a transition period during which both versions of 1500 form will be accepted, providers will get an advanced screening of some of the documentation and administration challenges they will face with the new code set, slated to take effect on October 1, 2014.

3. Detail and specificity: What your ICD-10 documentation should look like

What should your documentation actually look like?  ICD-10 will require physicians to be specific about some new variables when documenting such a case, including the type of encounter, applied specificity (did she lose consciousness?), acute or chronic condition, relief or non-relief of symptoms, and the external cause of the accident including the activity being performed and the location where the accident took place.

2. What the government shutdown means to Medicare, Medicaid

For the Department of Health & Human Services, the first of October was supposed to be all about open enrollment in health insurance exchanges. Instead, it’s now focused on supporting its current activities while dealing with the repercussions of a government shutdown. Indeed, as the federal agency revealed in its contingency plan, 40,512 members of staff will be furloughed with 37,686 being retained “as of day two of a near-term funding hiatus.” That’s a 52/48 split for those doing the math.

1. Why are hospitals choosing Epic over other EHR vendors?

The success that Epic Systems has had in getting health systems and hospitals to sign sizeable contracts to implement and maintain their EHR systems cannot be argued. That being said, the EHR industry leader has caught its fair share of flak from critics as a result of its price tag or the demands it places on healthcare organizations and providers when it comes to adopting Epic.




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