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Healthcare IT Leadership Requires a Thick Skin

Scott Mace, for HealthLeaders Media, September 25, 2012

It's probably only the public nature of such healthcare systems that exposes their woes to so much inspection. Systems with much more private governance may be in similar straits. But it can't be a good time to be a county hospital.

Not to dwell on Contra Costa's misfortunes, but if you think dealing with EMRs is scary, there are more dangers just around the corner.

The things I'm learning about ICD-10 downright scare me. This is a huge change to healthcare and the costs are considerable. In 2011, CMS urged providers to make sure they have a line of credit to cover interruptions or unforeseen changes in reimbursement due to the often unpredictable effects of the coding changeover.

I can understand why the AMA howls about ICD-10, including a comment from AMA president Jeremy Lazurus, MD.  But I also know the transition is key to HHS's plans to control costs and reduce fraud and abuse. More precise coding means the difference between a payer knowing that an amputated finger was barely nicked, to one where the injury was massive. Today's old-fashioned coding lumps it all together. That is unsustainable.

And yet, at Monday's HFMA Northern California chapter meeting in Santa Clara, I also learned that the very nature of ICD-10 makes the kind of analytics that healthcare so desperately needs harder to produce. Joseph Nichols, a Seattle-based consultant, just released a white paper about this that is required reading.

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