Some industries have to endure regulation. Healthcare is one of them. And a variety of changes and additions in the regulatory and policy arenas will mean change for care providers of all stripes, as anyone seeking a health care informatics degree should know.
The tricky part, though, is to understand that the state of policy is in a period of flux. Success for the coming future will mean flexibility and the ability to respond to shifts in what regulation requires. According to a Healthcare Informatics interview with an industry consultant, two major issues are electronic health care records and ICD-10 diagnostic codes.
Electronic health care records aren’t a new issue. For years, many health care providers have struggled to implement the systems. By putting medical histories, charts, tests, and treatment results into an electronic form, the expectation is that providers will be able to more seamlessly share information and find what they need without the massive inefficiencies and resulting rework that often happens today.
Just one problem: there haven’t been standards for EHRs. Two providers with software from two different providers can have information in incompatible formats. Sharing might now require special translation software to convert information between formats. This is where public policy comes into play. The Affordable Care Act — Obamacare — will address the need for an EHR standard as the industry has yet to create one.
Depending on the standard, some care providers could find that their computer systems don’t fully support it. That could leave vendors and providers scrambling to get into compliance, only having to do so while still maintaining system availability for current patients.
IDC-10 refers to the newest International Statistical Classification of Diseases and Health Related Problems. This is the tenth version, hence the numeric suffix. This newest incarnation (actually started in 1983 and completed in 1992) is supposed to go into use in October 2014.
The problem for health care providers is that it’s a major change from IDC-9, which has been long in use. A change in diagnostic codes has three impacts. One is on how care providers communicate with each other. Old knowledge of how to indicate a condition could be useless. The second issue is billing. Insurance companies, Medicare, and Medicaid all insist on the proper diagnostic codes. Use the wrong ones and payments could be tied up even more than usual. Third, as with EHRs, will be the system implementation. With so many thousands of changes, the chances of implementation error are high, meaning that proper quality assurance will be critical.
Experts in health care IT and informatics will have to keep a constant policy vigil to understand how they will have to do their jobs not just today, but tomorrow.