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Wednesday, January 21, 2015

ICD-10: Be Very Afraid

Providers Fear ICD-10
By Katie Wike, Health IT Outcomes

Experts at AHIMA say ICD-10 deadline fears could be a contributing factor to physicians’ reluctance to perform testing.

Usually, providers cite financial reasons, time constraints, and limited staff when explaining their reluctance to adopt ICD-10. Now, an AHIMA report published by Perspectives in Health Information Management indicates that - put simply - fear is a factor as well.

The top concerns cited by the physicians participating in the AHIMA focus groups were
  • electronic health record software readiness
  • increase in documentation specificity and time
  • ability of healthcare professionals to learn a new language
  • inadequacy of current training methods and content
EHR Intelligence reports many of these physicians “expressed straight-up fear about how the new codes will impact their practices.”...
Will Congress kick this can down the road yet again? Rumors waft that such may be embedded in the next "SGR Doc Fix" legislation.

On the other side of the coin, ya gotta love this:
Why another ICD-10 delay could threaten national security
January 20, 2015 | By Susan D. Hall, Fierce Health IT

Though some medical groups keep pushing for yet another delay in ICD-10, Juliet Santos of consultancy Leidos Health, argues that another delay could be a threat to national security.

Santos, in an article at ICD-10 Monitor, says another delay could hobble the United States in the public surveillance of deadly health threats.

"Sicknesses and plagues have become weapons in modern-day warfare. Weaponized bioterrorism is rampant in other countries. ... We cannot prevent, monitor, track, manage, and control what we cannot see or find," Santos writes, mentioning ICD-9's non-specific and sometimes missing codes.

The new coding system will allow the U.S. to respond better to deadly outbreaks such as Ebola, she says. Although the specificity of ICD-10 has been the brunt of jokes--it includes nine different codes reflecting injury inflicted by a turkey--in ICD-9, Ebola is classified as 078.89, Other specified diseases due to viruses, a designation used for multiple viral diseases that have not been assigned a specific code. In ICD-10, it would have its own code--A98.4, Ebola.

"ICD-10 allows us to track and monitor patients with diseases similar to Ebola, because the codes are specific, the severity of illness is detailed, and we can determine illness rates as well as death rates," Santos writes...
Ahhh... yes, Ebola. Might the significantly increased granularity of ICD-10 vis a vis ICD-9 mitigate the coding problem I have called "Lossy Compression?"


These two animatronic co-presenters provide dramatic evidence of just how far life-like anthropic robotics have come.


 Wow. This one's a doozy.
...The job of prophets has always been to strip commoners of their ability to make independent decisions. Today’s prophets of disruptive innovation are showing us the road to becoming Roman patricians spending our entire lives sprawled on fainting couches while being fanned and fed gorgeous grapes by beautiful machines. The first thing we must do is to offload decision making to the precursor of the slave-savant machine of the future, so it can learn and practice the art and science of pleasuring us. Letting your GPS decide how to get from point A to point B is one example, and letting Google decide what you should read is another, although the latter may soon become obsolete, since enjoying grapes on your couch does not require any reading. Letting your “phone” decide when you should stand and when you should sit, when to eat and what to eat, and when you feel and how you feel is the next step in our evolution towards a perfect union between amino acids and silicon compounds.  

Perhaps nothing illustrates our glorious path to heaven on earth better than health care, and befittingly so, since health is life, hence health care is life care, is everything. The old definition of health care included mostly restorative medical activities to one’s health, but as the value of people keeps declining in an overpopulated global economy, and the costs of repairs are increasing, a more expansive, machine oriented, definition seems in order. People, you see, are essentially carbon-based machines, like say cars, the only analogy simpleminded voters seem to comprehend. To reduce your lifetime expenses on your car, and to enjoy a reliable vehicle for the duration, you need to have all the maintenance done on schedule (e.g. oil changes, tire rotation, filters, belts, etc.), drive carefully and obey the law, use the car sparingly, without too much starting and stopping, and you should wash and wax regularly, and generally keep it nice and clean inside and out.

You get the recommended preventive care for your model, all the screenings and tests, so any early signs of malfunction can be addressed, and you swallow all the recommended additives to make operations smooth and well lubricated, without undue stress to any of your parts, especially the feeble brain part. You refrain from reckless activities, and keep your mind and body clean on the inside and on the outside. The prophets, or futurists, as they prefer to be addressed today, are guiding us to all sorts of little silicon parts that we can incorporate in ourselves on the incremental road to transferring the limited intelligence functionality of biological creatures to superior artificial components. This simple process of artificial evolution towards a brighter future does not seem to come naturally to most people. These things never do. This is precisely why piety and obedience need to be enforced by cannons and laws, and here and there a few weaklings or outright skeptics must be made examples of what people should fear most...
From "Artificial Intelligence" by Margalit Gur-Arie

More to come...

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