The only person who enjoys change is a baby with a wet diaper

 YEAH. to wit

The Challenge of ICD10 Adoption
by John Halamka

On October 1, 2013, the entire US healthcare system will shift from ICD9 to ICD10. It will be one of the largest, most expensive and riskiest transitions that healthcare CIOs will experience in their careers, affecting every clinical and financial system...

...Most small to medium healthcare organizations are desperate. They are consumed with meaningful use, 5010, e-prescribing, healthcare reform, and compliance. They have no bandwidth or resources to execute a massive ICD10 project over the next 2 years...

And don't forget PQRS, HIE, and various QIO 10th Scope HIT related initiatives. At times it all seems pretty crazy. One astute commenter in the foregoing Halamka post:

ICD-10 is one piece of a much larger picture. What is the common denominator of: meaningful use, value based purchasing, the March ACO regs, Medicare’s hospital and physician quality reporting initiatives? They all impose “nice to have” documentation requirements which subtract clinician time from direct patient care in the name of “transparency” and “accountability”.

Health care providers added one million jobs since 2007, despite declining utilization in virtually every category of service (hospital admissions, physician visits, etc.). A lot of those jobs were to cope with the escalating complexity of reporting requirements in the payment transaction.

Halamka is exactly right: we need to be simplifying and consolidating payment transactions, and reducing the documentation burden on caregivers. And it isn’t for provider convenience (or enabling them to hide quality defects) , but for the impact on cost and the patient’s experience of care. The micromanagement of medical practice has reached crisis stage.

FROM ACROSS THE POND

September 27, 2011, 7:40 AM
Lessons From Britain’s Health Information Technology Fiasco
By STEVE LOHR, NY Times
Government press releases tend to be bland, earnest blather. But not one posted on the British Department of Health’s Web site last Thursday. Its headline: “Dismantling the NHS National Programme for IT.”

To translate the acronyms a bit, the NHS is Britain’s state-run National Health Service and the program in question was the ambitious drive to computerize England’s health records and let doctors, clinics and hospitals share patient information electronically. The project, begun in 2002, was budgeted at £12 billion (about $19 billion) and the government hailed it as “the world’s biggest civil information technology program.”

The British digital health project has been a slow-motion train wreck for some time with last week’s announcement mainly confirmation — and a pledge to change course. (The announcement was also a political gesture, as the Conservative government of David Cameron tries to get as much distance as it can from an unpopular initiative, begun by Tony Blair’s Labor government.)

Yet the United States is about to begin its own government-funded drive to accelerate the adoption of electronic health records, with Washington set to hand out more than $20 billion in incentive payments over the next five years. So what are the lessons to be learned from the English experience? ...

OK, first lesson? Guess.
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A SHOUT-OUT TO MY WIREC PEEPS

I was on a HITRC Practice Workflow and Re-design CoP call and web presentation yesterday (9/27) during which we had a presentation by WIREC, the Washington-Idaho REC, a QualisHealth QIO REC contract initiative (like our own).

They are all over it (and, they are not the only ones). I cannot say enough good about these people. One slide that I screen-captured:

Bring it. Lean.

I started this blog on May 10th 2010 touting Lean for health care.
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QUICK UPDATE FROM THE DEPARTMENT OF
"IS OUR CHILDREN LEARNING?"

Yeah, I know...
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OCTOBER 1ST UPDATES

First, from The Health Care Blog:

Adverse Events is an interesting place.
As is Stratasan.com.



More shortly...