Tuesday, January 3, 2012

Thoughts on the Year Ahead

While 2011 was a year of incredible change (Meaningful Use Stage 1, 5010, Pioneer ACOs, State HIE planning, security challenges, compliance/regulatory pressures), I'm hopeful that 2012 will be a year of heads down work.   As I've said before, planned work that is appropriately resourced is a joy, no matter how challenging.  It's the unplanned work which needs to done within the budget/resources/timeline of existing projects that's the emotional drain.   Here are the significant projects I see for 2012:


Despite the best efforts of many people to explain the burden of ICD10 and the lack of benefit, it appears that ICD10 will continue forward with a October 1, 2013 implementation date.   BIDMC will spend $500,000 on application analysis, education, and project planning, then an unknown amount (could be $5 million or more) on remediation of vendor systems.   I predict that 25% of the capacity of IT will be consumed by ICD10 in 2012.    If we're lucky and have a perfect go live, no one will notice.   Depressing.

Meaningful Use Stage 2 including inpatient clinical documentation

Meaningful Use Stage 2 will likely include replacement of paper-based inpatient progress notes with electronic  (not scanned) documentation.   We've been thinking about the best way to approach this leveraging templates, macros and social-networking like group documentation.    This is an exciting project that will make the clinical record much easier to read, improving clinical care coordination and communication.

ACO Planning

Healthcare reform will require a completely different approach to care, focused on wellness, not just treating disease.   Not only will we need new business intelligence and health information exchange capabilities, we'll also need new decision support functionality based on care plans, pathways, and event driven medicine (new data triggers interventions).


2011 was a year of increased regulatory enforcement and compliance automation requirements.   I believe 2012 will be the same with a focus on conflict of interest tracking, learning management systems for compliance education, and enhanced revenue cycle systems that provide decision support at the point of care to ensure all regulatory requirements are met.


2011 saw an explosion of malware and viruses compounded by an increase of mobile personal devices accessing clinical content.   It's likely that we'll need to augment our security team and infrastructure to address the escalating cold war with hackers who have turned identity theft into a business.

Let us hope 2012 is a year of innovation, creativity, and incremental progress.   I remain optimistic that the  chaos of 2011 built a foundation for achievement in 2012.

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