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Saturday, February 18, 2012

Welcome to Las Vegas, HIMSS12

I'll be there, camera gear, notebook in tow, and my learning cap on. Hope everyone has a great week.


Click above for the article.


Erick and I talked about it yesterday. We'd thought HHS was going to announce the Meaningful Use Stage 2 Final Rule yesterday (there had been some HIT press buzz about it). Nope. But, it may well happen during HIMSS week.

Given that HHS has pushed Stage 2 back to 2014, it looks like a moot point for RECs. Our funding goes away next year, and, while, the the industry more broadly may have a lot at stake (notably EHR vendors), we'll be out there trying to compete with private consultants, FFS. "Sustainability" Fever is now all the rage.

We shall see.

[Sorry, The Power of Photoshop Compels Me. Just a bit of fun.]

BTW: Were I a Medicare EP 2011 Stage 1 Year One Attestor -- assuming I could continue to hit the now-annual Stage 1 numbers for 2012 and 2013 -- I'd have likely collected ~87% of my $44k potential -


Stage 2 will be an interesting Sell. I am certainly going to probe the opinions of myriad more knowledgeable HIMSS attendees on this.


If HHS Delays ICD-10 Long Enough, Could the U.S. Adopt ICD-11 Instead? By TOM SULLIVAN

The case for leapfrogging ICD-10 and holding out for ICD-11 just got a lot more curious. And though it’s not here yet, when ICD-11 is ready, it will be something ICD-10 cannot: A 21st Century classification system. Now that HHS Secretary Kathleen Sebelius has thrown her department’s hat in the ring, saying late Wednesday that HHS intends to delay ICD-10, the most pertinent question is how long will HHS push back compliance? “My opinion is that CMS won’t be able to announce three months or six months of delay for ICD-10,” says Mike Arrigo, CEO of consultancy No World Borders (pictured at left). “They will need to announce a delay from October 1, 2013 to at least October 1, 2014 because of CMS fiscal planning calendars."...

...Perhaps the most problematic reality the nascent ICD-11 faces today is that because the U.S. government mandated ICD-10 before anything was known about ICD-11, it ostensibly appears that the people thinking about ICD-11 are limited to the WHO’s ICD-11 Revision Steering Committee....

...“I guess my question is: Has HHS looked at ICD-11?” Grider wonders. “I am just guessing but I would say no. With healthcare reform, meaningful use and now ICD-10 everybody is spread very thin. And I can see that when I go into the hospitals, into the medical practices to help them with the ICD-10 transition and see their condition. Everybody is trying to continue business as usual while doing this and that’s been a real challenge. And I know the government is spread thin with all the regulations and everything they’re trying to do, so I wonder if they’re even thinking about it.”...

Interesting. Article link is in the title. We'll see if there's any supportive chatter on this topic this week in light of all of the ICD-10 pushback we're seeing.

Apropos of my REC/HIE HIPAA P&S work, been reading though this of late.
We live in an age of “big data.” Data has become the raw material of production, a new source of immense economic and social value. Advances in data mining and analytics and the massive increase in computing power and data storage capacity have expanded, by orders of magnitude, the scope of information available to businesses, government, and individuals. In addition, the increasing number of people, devices, and sensors that are now connected by digital networks has revolutionized the ability to generate, communicate, share, and access data. Data create enormous value for the global economy, driving innovation, productivity, efficiency, and growth. At the same time, the “data deluge” presents privacy concerns that could stir a regulatory backlash, dampening the data economy and stifling innovation. In order to craft a balance between beneficial uses of data and the protection of individual privacy, policymakers must address some of the most fundamental concepts of privacy law, including the definition of “personally identifiable information,” the role of consent, and the principles of purpose limitation and data minimization...

Yeah. I have some picks with some of their conclusions. I'll be particularly curious this week regarding the ePHI P&S presentations and expertise. I've been following privacy issues since prior to grad school. While some of the core concerns (and mistaken beliefs) haven't changed much, the technologies useful for invading privacy -- with increasing ease and surreptitiousness -- most certainly have:
Data collection arms race feeds privacy fears Joseph Menn, Feb 19th SAN FRANCISCO (Reuters) - This week's revelations that Google Inc, Twitter and other popular Internet companies have been taking liberties with customer data have prompted criticism from privacy advocates and lawmakers, along with apologies from the companies. They are the latest in a long line of missteps by large Internet companies that have faced little punishment for pushing privacy boundaries, which are already more expansive than most consumers understand. Despite all the chatter about online privacy and the regular introductions of proposed data protection laws in Congress, Silicon Valley is in the midst of a veritable arms race of personal data collection that is intensifying. Many innovative companies, most prominently Facebook, base virtually all of their services on the ability to personalize, which requires them to know their users well. Their business models likewise depend to an increasing degree on the ability to target a banner advertisement or other marketing pitch to an individual. Millions of times each day, the right to advertise to a specific user is auctioned off in a fraction of a second by computers talking to one another...
Again, article link in the title. Lots to consider. A couple of quick thoughts:
  • You have no 4th Amendment Right to Privacy when it comes to private sector snooping into any and all aspects of your lives. Your remedies are limited to tort claims and a hodgepodge of specific state and federal privacy laws (that may entail both civil and criminal sanctions);
  • HIPAA protections only apply to PHI used by "Covered Entities" - providers, health plans, and clearinghouses.
I cringe when I see some of my Facebook friends chatting up their late medical encounters and Rx regimens. Moreover, I find it a bit creepy when I start seeing numerous topically targeted ads in the wake of my Google searches or the occasional click-thru's. I know that there are battalions of acutely web-savvy Gen-Y data miners working feverishly to quietly cull, bank, model, and sell every knowable fact and inference of interest about me and everyone else -- most of the activity unregulated.

Again, Dr. Sweeney:

Today’s globally networked society places great demand on the dissemination and sharing of person-specific data for many new and exciting uses. Even situations where aggregate statistical information was once the reporting norm now rely heavily on the transfer of microscopically detailed transaction and encounter information. This happens at a time when more and more historically public information is also electronically available. When these data are linked together, they provide an electronic shadow of a person or organization that is as identifying and personal as a fingerprint even when the information contains no explicit identifiers, such as name and phone number. Other distinctive data, such as birth date and ZIP code, often combine uniquely and can be linked to publicly available information to re-identify individuals. Producing anonymous data that remains specific enough to be useful is often a very difficult task and practice today tends to either incorrectly believe confidentiality is maintained when it is not or produces data that are practically useless...

- 2001, Dr. Lataya Sweeney (PDF), now with the ONC HIT Policy Committee. That was more than a decade ago.


Dial Back the Hype

by DAVID WHELAN, for The Health Care Blog, Feb 19th

Health Care Is Analogue
Medicine is easy to diss for being a Luddite field. Doctors don’t use email like other professionals. The paperwork is out of control. Hospitals are big, messy service businesses. There’s a feeling that any service can be better with technology.

This diagnosis is true. But the cure is not necessarily as simple as adding software. (Although that is happening with the widespread implementation of electronic medical records.) What’s harder to grasp is that health care is not just a service. It’s an experience. And while many services can be replicated online, human experiences can not. There’s no real electronic replacement for being seen by your doctor. When you take a pill you can’t do it over the Internet. You obviously can’t get virtual surgery.

So it’s true that you can point a finger at health care and say it lacks tech. But it’s not because the technology doesn’t exist. It may be that technology doesn’t really fit. To make a comparison to another “experience sector”: the Web also can’t replace a vacation. It can enhance it, perhaps. But it’s a human experience existing in three-dimensional space...

Yeah, but I'm sure I will be witness to and reporting on a lot of unbridled enthusiasm and over-the-top rhetoric starting in the morning.

"It may be that technology doesn’t really fit."

I commend to everyone once again "Medicine in Denial" by Lawrence MD and Lincoln JD Weed.

Oh, yeah, btw:



The majority of the money is going to hospitals thus far (~74.5%). To be expected, I suppose.


Click the cover page image above for the full downloadable PDF file link.

Just in...
Health IT adoption rising, thanks to HITECH Act and despite politics
In this U.S. election year, and on the eve of the Health Information and Management Systems Society's HIMSS 2012 conference, it seems that pure politics, not practical or technical considerations, are shaping health IT adoption policy -- especially as the Centers for Medicare and Medicaid Services agrees to postpone ICD-10 implementation at the American Medical Association's behest...
Good article. Click the headline.


I'm sitting the the Media Center, in a cubicle with a network hookup. They provide great lunch chow. Everyone is so nice. I forgot to bring my camera USB cable, so I can't dump and share any photos 'til I get home (my Sony Alpha 500 camera side port is proprietary). I'll be shooting as much as I can, like I did at the ONC Regional in L.A.

I'm told I can't shoot in the Exhibition Halls (once they open tomorrow). Which is drag, because that's where all the visual drama will be. I'd be in High Cotton could I shoot the Exhibitions.

Much more to come. It'll be a great week. HIMSS12 is really sort of the Comdex of HIT World (albeit with much more emphasis on topical learning; it's way more than just a trade show).

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