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Earlier this month, panelists of the US Senate’s committee on Health, Education, Labor and Pensions, part of an ongoing a series of discussions focusing on how to improve electronic health records and create an interoperable health system, recommended that meaningful use stay the course.

Senator Lamar Alexander (R-Tenn.), who continues to push regulators on health IT capabilities and regulation, also pushed panelists about their thoughts on meaningful use Stage 3 asking them if it would be best to slow down finalization of the rule. “We can’t go back,” said Meryl Moss, chief operating officer at Providence, Rhode Island-based Coastal Medical, in response to the committee, Fierce reports.

Providers can’t improve quality if they can’t measure or track quality, which is what meaningful use is helping to do, she said.

“We have to stay the course … absolutely we have to stay the course,” Timothy A. Pletcher, executive director of Michigan Health Information Network Shared Services, said in the committee. “We’re getting better across the board, we’re all learning. Even the quality measures, which are such a challenge in Meaningful Use Stage 3, start to bring that into alignment.”

But Fierce points to an industry truth: Many industry leaders are not so supportive of meaningful use, including the American Medical Association, the Medical Group Management Association, the American Hospital Association and the College of Healthcare Information Management Executives.

Additionally, support is gaining for the softening of proposed rules of some of the requirements of the meaningful use program for 2015 through 2017, but there are concerns. For example, the MGMA is urging CMS to finalize the rule “as quickly as possible,” but also was “very disappointed” that the rule was not released as an interim final rule, which would have “significantly reduced industry confusion and provided eligible professionals (EPs) and their vendor partners much needed additional time.”

The American Hospital Association says that the rule provides “much needed relief” but that the multitude of additional program changes creates confusion and added burdens on providers.

The Healthcare Information and Management Systems Society’s comments take a more balanced approach, supporting much of the proposed rule, as well as suggesting there be an increased focus on outcomes over process and a phased-in approach for patient electronic access and secure measures. HIMSS also recommends that CMS address the tight timelines between the issuance of the final rule and the looming end of 2015.

Fierce reports, however, that the Consumer Partnership for eHealth and Consumer-Purchaser Alliance — comprised of 50 different patient, labor and related organizations – is not happy with the changes, specifically, to the requirement that 5 percent of patients view, download or transmit their electronic health information or securely message their providers, saying that the 5 percent is “more than attainable” and calling it a “dramatic retreat” from making patients and caregivers true partners in improving health.

The rule, published in the Federal Register in April, would grant providers additional flexibility in meeting Stages 1 and 2 of the program, such as shortening the reporting period for 2015 from one year to 90 days. The rule also makes changes to align Stages 1 and 2 to CMS’ proposed vision for Stage 3 of the program. Comments on the rule were due June 15.

It’s interesting to note that, in regard to meaningful use Stage 3 anyway, in a statement to CMS, CHIME stated, “We doubt many providers could participate in 2018 successfully, and with so few providers having demonstrated Stage 2 capabilities, we question the underlying feasibility of many requirements and question the logic of building on deficient measures.”

CHIME also urged CMS to make several changes to the proposed rule for Stage 3, including:

• A 90-day reporting period for the first year of Stage 3 compliance, at least for payment adjustment purposes;
• Modify requirements for and retain the 90-day reporting period for providers attesting to meaningful use requirements for the first time, whether in a Medicare or Medicaid context;
• Eliminate patient action thresholds for the care coordination objective;
• Reduce the number of required measures in multi-measure objectives, health information exchange and care coordination;
• Create hardship exceptions for providers switching vendors;
• Allow providers to take a 90-day reprieve during any program year for upgrades, planned downtown, bug fixes related to new technology or optimizing the use of new technology within new workflows; and
• Allow, in limited circumstances, paper-based means to achieve measure thresholds.

Additionally, the organization, which continues to voice its concerns with meaningful use, said it was “troubled over the requirement that all providers must attest to meaningful use Stage 3 by 2018, regardless of prior participation and experience with the program.

“While we acknowledge policymakers’ intention to make each Stage more difficult than the last, we are concerned with the strategy that envisions Stage 3 serving as both the apex of MU requirements and as a starting point for those providers with no experience at Stage 1 or Stage 2 of the EHR Incentive program,” CHIME said. “We worry some of the objectives pose too great a stretch for seasoned meaningful users, let alone those who have never participated in the program.”

CHIME CEO and president Russell P. Branzell, FCHIME, CHCIO added: “In order to realize the network effects of meaningful use, we need as many providers as possible participating in the program. As proposed, this rule may do more to deter, rather than encourage, on-going participation.”

As meaningful use continues its track, it’s fair to say there will be many developments ahead, and much support for and against the program as a whole or its parts. And, as long as interested parties in Washington (Alexander) remain interested in the regulation, we’ll continue to see headlines regularly.

Healthcare analytics is used in the marketing of business software and consulting services, making extensive use of data, statistical and qualitative analysis, explanatory and predictive modeling. Currently the most prevalent application for real-time health care analytics is within clinical decision support (CDS) software. These programs analyze clinical information at the point of care and support health providers as they make prescriptive decisions. These real-time systems are “active knowledge systems, which use two or more items of patient data to generate case-specific advice.”

Analytics is no small factor for healthcare organizations in the months ahead and will be a key issue for measurement. The global healthcare analytics market accounted for $5.5 billion in 2014 and is expected to grow at nearly 25 percent to reach $32.4 billion by 2022. Seemingly a bit off and likely some room for error here, but with the rise of analytics tools and because of how it helps healthcare organizations in reduction of patient’s stays and readmissions in hospitals, improved quality care, fraud identification and prevention of chronic diseases, the software and related solutions are likely going to be a big play in healthcare’s future.

The factors contributing to the market growth are many and include better efficiency of healthcare of organizations, federal healthcare mandates and increasing healthcare IT adoption. However, lack of skilled labor with analytical skills, patient data security and privacy issues are inhibiting the growth of the market.

On the payer side, realizing the benefits of such solutions, Humana, an early IT adopter, is reported to be making analytics the foundation of its clinical operations and consumer engagement efforts, reports Enterprise Apps Today.

The insurer’s predictive models have already helped it identify almost 2 million members at high risk of diseases and closed 4.3 million instances of gaps in care by identifying which members would benefit from regular communication with a provider. Predictive analytics, proving its worth, also has helped Humana lower hospital readmission rates by about 40 percent by using real-time analytics to determine which members were most likely to be readmitted.

According to the site, its more than 15,000 care managers and other professionals help coordinate care for its members, ensuring they make changes to lifestyle, diet and other areas. And all of those efforts are powered by analytics.

Although most insurers haven’t seen “analytics as a key component of doing business,” Humana has benefited from a mature technology infrastructure, a supportive CEO and an analytics team composed of professionals with different backgrounds. “These are deep problems, and we need the best multidisciplinary talent working on them,” a spokesperson told the site. “It’s not something just public health people can solve, or just computer science people can solve.”

Given the perceived power of analytics and data use in health, are you using it to help your patients or organization stand out? Are you seeing the benefit in the health data push? How do you plan to use such solutions to better the work you do?

From the very beginning less than two years ago, the HIMSS Innovation Center has been a marquee venue for organizations “wishing to build their brands and market their health IT-related services both locally and globally.” Since the beginning, Alego Health has worked with HIMSS to help bring collaborators and health IT organization to the center and to Cleveland, where we are based, in an effort to encourage our colleagues and the whole industry forward to tackle some of the greatest healthcare challenges of our time.

In just two years, we and nearly two dozen other organizational collaborators, have established a presence at the 30,000-foot facility located on Cleveland’s lakefront. Through this partnership, and attracted also by the HIMSS Innovation Center presence on the 4th floor of the Global Center for Health Innovation, collaborators have dedicated exhibition space and other benefits relating to the use of the facility and participation in HIMSS events.

Alego Health is one of only a few, select groups who help found the effort.

We advocated for the establishment of the HIMSS Innovation Center as a natural fit with the Global Center for Health Innovation next door. Because of our partnership with the HIMSS Innovation Center we can showcase our services during events and through presentations to customers, interview candidates for employment during recruitment events at the center, and conduct training programs for employees and partners there.

Our interactive exhibit at the HIMSS Innovation Center includes six iPads and two InTouch screens, through which individuals can learn more about Alego Health and the work we do in healthcare, serving hospitals and healthcare organizations across the United States.

As one of the nation’s premier full-service health IT providers, Alego Health sees its presence at the HIMSS Innovation Center as key to our brand and market positioning, of course, but also to our work with healthcare organizations of all sizes to advance the continuum of patient care through the adoption of technology. By being part of this effort, we believe we are better equipped to help take on some of the most pressing issues our colleagues in healthcare try to tackle every day.

We’re not alone in our efforts, of course. HIMSS Innovation Center Founding collaborators include Federal Health Architecture, HealthIT.gov, and MCPc. Industry collaborators are CareFusion, Cleveland Clinic Innovations, Fujitsu, IHE USA ICSA Labs, Netscout Systems and OnX Enterprise Solutions. Supporting collaborators are Calfee, Halter and Griswold LLP, CDW Healthcare, Cardinal Health, Direct Consulting Associates, John Carroll University, Juniper Networks, ScriptPro, Sectra, and Total Voice Technologies.

“Many organizations are inquiring about reserving space at the HIMSS Innovation Center,” said John Paganini, HIMSS senior manager of interoperability initiatives. “There are increasing opportunities to create awareness as events are added and the Global Center for Health Innovation continues to become the premier destination for healthcare professionals.”

We know there’s more to it, though, than advancing only our objectives. HIMSS Innovation Center collaborators also gain visibility among healthcare organizations searching for interoperability solutions, as the center hosts and works virtually with organizations wishing to take advantage of the new HIMSS Interoperability Services program. The HIMSS Interoperability Services program provides a road map to both vendors and providers seeking interoperability and facilitates access to testing tools, resources and subject matter experts. The center facilitates physical and virtual interoperability testing for health IT product vendors, healthcare providers and health information exchanges.

Finally, as the effort continues to growth, so will the number of and the importance of events that call the center home. As was the plan from the start, the innovation center features state-of-the-art conference and educational facilities where it has already hosted more than 190 events with more than 9,000 attendees since opening in October 2013. Organizations having used the facility for meetings include Apple, Association of Perioperative Registered Nurses (AORN), Bernstein, Cleveland Clinic, GE Healthcare, HIMSS North America and various HIMSS chapters, Integrating the Healthcare Enterprise (IHE), John Carroll University, Johnson Controls, Metro Health, PartsSource, Philips, Republican National Convention, University Hospitals Health System and Verizon. There are too many others to name, and so many more to come!

While we continue to be proud of the work we do and the healthcare clients we serve, there’s a special place in our hearts here at Alego Health for what we are helping build in partnership with HIMSS at the HIMSS Innovation Center. If you’re able to, join us here in the effort or at a future event. Or, if you’re excited about the future of healthcare and want to be part of its innovation, help spread the word about what’s taking place here in Cleveland or contact us. We’re glad to help you innovate healthcare.

According to a newly released ICD-10 Industry Readiness Survey from the Workgroup for Electronic Data Interchange (WEDI), only three-quarters of physician practices say they will be ready for ICD-10 implementation by Oct. 1, 2015. The remaining one-quarter of physician practices say they are “unsure” about their ICD-10 preparation levels. For the survey, 621 people said they took part in WEDI’s 11^th ICD-10 readiness survey and of those who participated, 453 were healthcare providers, 72 represented vendors and 96 included representatives of health plans. The point of the survey is to help garner a more thorough perspective regarding how prepared various segments of the healthcare industry actually are for the coming transition this fall. Additionally, WEDI uses the information gathered from them to help identify struggling stakeholders toiling over compliance hindrances.According WEDI, lack of readiness may lead to disruption in claims processing. Only about 20 percent of physician practices have started or completed external testing and less than 50 percent responded said that they were ready or would be ready for October 1. Thus, organizational leadership, in a letter sent to the Health and Human Services (HHS) Secretary, shared the findings from its survey and encouraged the department to continue to leverage its communication channels to promote the need for compliance because of the impact that non-compliance could have on the industry.

Regarding the survey, although much of the healthcare industry is nearing a state of readiness, physician practices are far from done, WEDI said, stating that it is critical to closely monitor industry progress and testing results as the compliance deadline approaches to gauge what might occur on Oct. 1, 2015, to identify industry challenges and prepare for any anticipated issues. WEDI, in a statement, said it strongly encourage HHS to leverage its communication channels to continue promoting the need for compliance. “It is critical to closely monitor industry progress and testing as we approach the compliance date to gauge what might occur on Oct. 1, 2015,” states Jean P. Narcisi, chair of WEDI, in a statement. “In light of our most recent findings, we are hopeful that industry leaders take the necessary steps to help ensure that the transition to ICD-10 is completed with minimal disruption to the healthcare industry.”

Other findings of the survey include:

• Nearly 20 percent of physician practices and 75 percent of hospitals and health systems have started or completed external testing
• Less than half of physicians and 60 percent of health plans say they will be ready come October
• Nearly 90 percent of hospitals and health systems confirm readiness by the compliance date

WEDI offers the following recommendations for HHS:

• Expediently provide complete transparency regarding the readiness levels of individual Medicaid agencies, by state
• CMS’s recently announced ombudsman should be appointed quickly, well before October 1
• The go-live ICD-10 support plan should include leveraging WEDI’s and CMS’ implementation support program, with additional support needed for local determination codes (LCDs)

Given the overwhelming shortage of preparedness of ICD-10 and the amount of time organizations have had to ready for the implementation, there remains a good deal of concern for healthcare organizations to get their gears aligned. Some may have been holding out hope that another last minute delay was going to occur, but at this point, with less than 50 days before its change over, there’s only one way forward. As procrastinators may not place themselves in a fatal situation, it’s definitely time for a little expedited concern. Even if time is running out for help prior to change to the new code set, practices may need a little assistance post change. Outside consultant partners may be the most readily available source of assistance who can provide the quickest results in the most efficient manner.

The US Senate’s Health, Education, Labor & Pensions Committee continues its march toward a world where interoperability is the norm and various competitive systems work together no matter the markets or locations they serve. The attention of the committee is currently focused on a possible delay to the Stage 3 of meaningful use. The committee’s chairman, Republican Senator Lamar Alexander, has gone so far as to ask the Department of Health and Human Services to look into doing so.

As recently as a few weeks ago, the committee heard from members of the health IT community.The most recent committee saw testimony from the likes of Allscripts CEO Paul Black and DirectTrust CEO David C. Kibbe, MD, among others. Kibbe said that interoperable health information exchange is being hindered, despite progress in the past two years. However, he said he feels as though information blocking by healthcare provider organizations is still a problem, and that exchange of direct messages and attachments is needed now.“In my opinion, the responsibility for assuring secure interoperable exchange resides primarily with the healthcare provider organizations, not the EHR vendors, and not the government,” Kibbe said. “Healthcare provider organizations must come to realize that acting in the best interest of patients is to assure that health information follows the patient and consumer to whatever setting will provide treatment, even if that means in a competitor’s hospital or medical practice. And they must demand collaborative and interoperable health IT tools from their EHR vendors to make this routine and ubiquitous as a practice in every community in the United States. However, there is a role for government to encourage and incentivize collaborative and interoperable health information exchange.”

Kibbe went on to explain that persisting information blocking problems include: local EHR and provider organization policies; EHR product design or implementation flaws; lack of or inadequate product/service support; high pricing for HIE-enabled software upgrades; and registration and “whitelisting” requirements for message exchange.Allscripts’ Black testified, though, that interoperability among vendors and among providers does happen. Though he does have stake in the game, he said, “It is important to note that there are many examples of providers who have worked through the process of establishing connectivity and are making it work. It is true, however, that today not all stakeholders in the healthcare industry seem to be equally motivated to make information liquidity a reality.”

This most recent meeting focused on lack of interoperability, but what’s important about this committee is that it is helping to advance the conversation on some obvious and contentious issues that seem only to have lurked in the corners until now. For example, for most of this years, Alexander, and Democratic co-chair Parry Murray (Wash.) have tried to push for health IT reform. Given the partisan politics in most areas of Washington, D.C., these two have found what appears to be some common ground in getting us to a more efficient, centrally aligned and sharing place.During another recent hearing, Alexander said that EHR technology frustrates providers and could inhibit use “We’ve got to get to a place … where more doctors, particularly the smaller physicians’ offices, want to adopt these systems, can afford the cost and can be confident that their investment will be of value,” he said.In April, the two committee leaders announced a work group to identify ways to encourage improvement of the technology.  “As we focus on making our healthcare system work better for families, electronic health records could not be more important,” Murray said. “Having more and better information can make all the difference for patients, so I look forward to working with chairman Alexander and members of our Committee to strengthen our nation’s health IT infrastructure and improve quality of care and patient safety in Washington state and across the country.”

This month, in the meeting with Kibbe and Black, Alexander said, “The electronic systems at both (of my) hospitals don’t talk to each other. My usual hospital says it will charge Vanderbilt a huge fee to send my electronic records. My usual hospital says it can’t share them for privacy reasons. Or, my usual hospital won’t send them because they cite concerns about data security.”According to Healthcare IT News, Alexander said he wants to finish what was started in Stage 1 before moving on to the final stage, which requires providers to send electronic summaries for 50 percent of patients they refer to other providers, receive summaries for 40 percent of patients that are referred to them and reconcile past patient data with current reports for 80 percent of such patients.Even as healthcare’s constituents become more involved and more vocal — part of the conversation to help Congress bring details of healthcare’s inner workings to life — the benefit to these meetings and testimony is not that they are actually leading to any actionable solutions, but that they are actually happening at all, and they are generating interest from both parties, as well as a few headlines that help drive the conversation further.

Telemedicine is the major thing, the last 18 months have shown the interest in the subject is overwhelming. As such, a new survey reveals that nearly 60 percent of doctors will meet their patients via video – and just as many would refer their patients to a hospital that offered telemedicine consults with specialists. The “Telehealth Index: 2015 Physician Survey” showcases the results of more than 2,000 primary doctors in which American Well and QuantiaMD found that there is overwhelming support for video-based telemedicine more than telephone or e-mail communications.

According to the survey, 57 percent of the physicians surveyed favor video visits, while 31 percent said they aren’t sure and 12 percent rejected them outright, of course, considering the source, perhaps there’s something to be said about the results of the survey.
Physicians said they feel that video visits will improve their workflow and boost income, rather than add new patients or keep the ones they have. According to mHealth News, almost 80 percent cited “flexible work-life schedule” as their primary reason for wanting video visits, while 67 percent picked “earn more income” and 66 percent chose “improve patient outcome.” On the other end of the spectrum, attracting new patients scored 41 percent and retaining existing patients took 37 percent of the vote.
According to the site, when asked to evaluate the uses of telemedicine, about 90 percent of physicians see the form of communication as a platform for delivering concierge services to fee-paying patients. Other uses listed were medication management (86 percent), minor urgent care (85 percent), birth control counseling (83 percent), home healthcare (82 percent) and chronic condition management (80 percent).
“There’s a sea of change going on within the physician community,” Roy Schoenberg, MD, CEO of American Well, said in a statement. “Doctors see value in virtual visits for their patients and also in managing their own work-life balance. We’ve seen weekly physician inquiries about practicing online triple in less than six months.”
In fact, telemedicine has become so popular that even Congress is considering changes that would modernize the 50-year-old program, including allowing it to pay for a broader array of telemedicine treatments to more people, according to Bankrate.
According to the current rules, Medicare is restricted to paying for a limited amount of telemedicine used to deliver healthcare to rural areas; Medicare hasn’t been a frequent payer, Bankrate reports.
Veterans Health Administration uses telehealth, as does prison systems that have been using telemedicine for years to provide routine care to inmates. “Using telemedicine more broadly could also cut insurance costs. Human resources consultancy Towers Watson estimates the savings at $6 billion a year for companies that buy coverage for employees,” the site reports.
According to the American Well survey, physicians said they saw a value for telemedicine in specialty care consults, listing dermatology, psychiatry, infectious disease, pain management, neurology and cardiology as the top specialty consults for which they’d use video visits.
Finally, 70 percent of physicians said video visits provide the most accurate diagnosis; 25 percent selected phone consults; 5 percent chose e-mail; and 1 percent selected text messaging.

While clinical video consultations lead the market today with sessions in non-clinical settings and will represent the majority within four years. Thus, telehealth video consultations are set to take off, even though the digital health industry is still in its formative years, it has a firm foothold and is poised for strong growth in the coming years, according to a new report Tractica. According to the research firm, telemedicine is set to expand in terms of use cases, deployments and adoption of the technology.

According to the organization’s new report “Telehealth Video Consultations”, examines the market and technology issues surrounding telehealth video consultations for both clinical and non-clinical applications, telehealth video consultation sessions will increase from 19.7 million in 2014 to 158.4 million per year by 2020. The market intelligence firm anticipates that while clinical consultations currently constitute more than three-quarters of the market, growth throughout the next several years will be especially strong in non-clinical settings.
The firm suggests that non-clinical video consultations will outnumber clinical consultations by 2019.
According to the report, key technology enablers for growth in the telehealth market include: better video conferencing technologies, increased penetration of connected devices and broadband adoption. As well, several market factors are making the use of telehealth technology more valuable, including physician shortages, rising healthcare costs, the need to serve aging populations and the number of people living with chronic diseases. In addition, telehealth video consultations lend themselves to a wide range of medical treatments and use cases; “providers and payers alike are finding quantifiable value in deploying video-based patient monitoring solutions, both in terms of positive patient outcomes and cost savings” the report claims.
Barriers remain to broader adoption of telehealth video consultations, though, including the initial high cost of deploying services, particularly in the clinical environment. In addition, not all payers reimburse for services rendered via video conferencing, and telehealth video consultations continue to face resistance by some physicians, patients and regulatory bodies.
“Telehealth video consultations lend themselves to a wide variety of medical treatments and use cases,” said principal analyst Charul Vyas in a statement. “The flexibility and efficiency of video conferencing is helping healthcare providers and payers to achieve tangible value in deploying video-based patient monitoring solutions, both in terms of positive patient outcomes and cost savings. However, the market still faces a variety of challenges, including the high initial cost of deploying services, inconsistent reimbursement models for telehealth consultations, and some continuing resistance by physicians, patients, and regulatory bodies.”
The Tractica report also presents forecasts for telehealth sessions and revenue during the period from 2014 through 2020, segmented by session type and world region.

The Harvard Business Review claims that the Internet of Things (IoT) is emerging as the third wave in the development of the Internet. The first phase, the fixed phase, began in the 1990s and connected one billion users via PCs, followed by the second phase where the mobile Internet of the 2000s connected two billion users via smartphones (on its way to 6 billion). The IoT is expected to connect 28 billion “things” to the Internet by 2020, ranging from wearable devices, such as smartwatches to automobiles, appliances and industrial equipment, and the repercussions span industries and regions, the magazine reports.

In healthcare, IoT when used for healthcare may be able to help those with chronic conditions, and could have an economic impact of more than $170 billion to $1.7 trillion a year, according to a recent report from McKinsey & Company.

By 2025, the report estimates that the IoT will have a “total potential economic impact” of almost $4 trillion up to a possible $11.1 trillion per year. That healthcare figure is based on “cost savings in treatment and the value of longer lives and improved quality of life that patients with chronic conditions could enjoy if IoT monitoring helps them avoid disease complications,” the report adds, FierceHealthIT reports.

However, the challenges of health IoT will remain, most notably a lack of interoperability between systems and devices. This will require coordination of technology, capital investment cycles, provider organization and more, the McKinsey report says. According to the site, the healthcare industry must make changes for IoT to have full impact that includes payers realizing investments in IoT is justified; patient acceptance of wellness and health devices must grow; and privacy and security must be addressed. Finally, the supply of the technology will have to continue to innovate, and business users will have to make investments in both technology and the culture and structure. Policymakers also will need to ensure the safety of devices, if they can, which may be a bit of a problem, honestly, given interest in such development by hacks.

The movement is too big to ignore for those in healthcare and given the current level of investment in stationary and wearable and smart devices, there will be much movement and desire to see this market move forward in the most efficient manner. Research firm Gartner says that the current 4.9 billion connected “things” in 2015 will expand to 25 billion by 2020, so there’s even a swing in the estimate in the number of products that will be connected to the web. But this movement is bigger than refrigerators telling us that we’re out of milk. The IoT is going to be bigger and more profound in its changes to the world we live in; healthcare will never be the same.

At its peak, ICD-10, 510, meaningful use and electronic health records combined will likely pale in comparison to what we’re about to see in the IoT of things, especially in relation the care provided. To be sure, the conversations we’re having now about what’s seen some very cutting edge issues will be likely primitive in comparison in the very near future. For example, personalized sensors will record health parameters, minimizing the need for direct patient-physician interaction by providing continuous data throughout activities of daily living.

The Internet of Healthcare Things matters because it changes the way we see, save, sample, select and search data. Now you can get continuous sampling of your health and relay that data to where somebody can actually interpret that data, every second of the day, every day of the year for our lifetimes, from the cradle to the grave.

And the scary thing, or the inspiring thing, is that these capabilities exist today, now. The Internet of Things is very real and alive, especially in healthcare.

ICD-10 is upon us and despite any last-minute come-from-behind play, like a phased or delayed rollout, it looks like the Oct. 1, 2015, deadline for the transition will finally stand. Given that likely fact, and the fact the transition was delayed from Oct. 1, 2014, healthcare organizations are still not prepared for the coming change.

ICD-10 is the 10th revision of the World Health Organization’s International Classification of Diseases (ICD) coding system, codes used to capture diagnoses in all healthcare settings, while ICD-10-PCS (Procedure Coding System) codes are used to capture procedures only in inpatient settings. As you know, the ICD-10 code set is set to replace ICD-9 in the US in October. All medical practices will need to switch to ICD-10 by the deadline or they will no longer be able to obtain reimbursement for the care they provide to patients. Payers, clearinghouses, billing services and all other entities covered by HIPAA will need to comply with ICD-10.

The California Medical Association (CMA) recently conducted a survey of physician practices to evaluate their readiness for the transition. With only a couple months before the deadline, you’d think practices would be well on their way to the preparation and planning process, but the survey indicates otherwise. More than half of respondents (51 percent) said they were only minimally prepared, while 21 percent indicated they were not at all prepared.

CMA notes that the results are concerning “particularly since Congress has reaffirmed that they want to move forward with the implementation of ICD-10 with no more delays.” Additionally, hospitals and insurance companies have told lawmakers that they are ready for the October 2015 deadline and are pushing for Congress to stick with the October 1 implementation date.

However, healthcare providers behind in the ICD-10 conversion preparations may benefit from following the ICD-10 Quick Start Guide provided by the Centers for Medicare & Medicaid Services (CMS). ONC provides five steps that providers will need to take when it comes to their ICD-10 conversion preparations are the following: (1) developing a plan, (2) training the healthcare staff, (3) updating system processes, (4) working with vendors and health insurers, and (5) testing workflow processes and systems.

According to EHR Intelligence, when it comes to training the clinical staff and moving forward with conversion preparations, there should be a focus on new clinical concepts and documentation obtained through ICD-10 codes. “When training coding and administrative staff including coders, billers and practice management employees, the focus should be on ICD-10 fundamentals.”

Since CMS provides resources — including webinars, national provider calls and presentations, the Road to 10 website, and email updates – physicians should take advance of them. Physicians can also rely on payers, third-party consultants and vendors for additional support, should they need it. EHR Intelligence offers a good place to start: Identify the top 25 most common ICD-9 codes used in one’s medical facility. Common diagnosis codes are also available on the Road to 10 website and other resources. “Teach your healthcare and coding staff how to code the most common cases using the ICD-10 coding set. Using reports via one’s practice management software and billing documents, providers can better identify the most commonly used ICD-9 codes,” the site reports.

Once the top 25 codes are gathered and there is still time before the ICD-10 implementation deadline, providers are encouraged to expand ICD-10 coding of typical cases past and additional 50 or more codes. This would ensure the majority of a provider’s cases are managed effectively under ICD-10.

Even though the ICD-10 coding set has expanded to more than 68,000 codes, providers will only need to use a small section of the set. Along with training staff, updating system processes is vital for one’s ICD-10 conversion preparations. All hardcopy and electronic forms need to be updated while information gaps should be resolved before the October 1 deadline.

Clinical documentation will need to include laterality, the number of encounters (initial or subsequent), kinds of fractures, and other information about related complications. It is useful to put together a documentation checklist detailing new concepts that should be captured with ICD-10 codes. Once systems are in place, ICD-10 end-to-end testing is crucial to ensure a healthcare facility is prepared for the October 1 deadline.

We’re less than 100 days from the ICD-10 implementation deadline and there’s a less than likely possibility that we’ll receive another delay, but, of course, weirder things have happened.  That doesn’t mean there hasn’t been some movement by lawmakers on Capitol Hill who continue to push for transition periods or outright bans of the code set while surveys reveal that participation in testing still lags.

Despite numerous delays for ICD-10 in the past, members of the House Energy and Commerce Committee’s Subcommittee on Health made clear at a February hearing that they do not want to see the transition delayed yet again. Strong language, but much the same was said by officials at the Center for Medicare and Medicaid Services last in 2014 at the annual Health Information and Management Systems Society (HIMSS) when they suggested that there would be no delay and just months later, it was delayed again.

However, in March, 100 physician groups–led by the American Medical Association–expressed concern in a letter to Acting Centers for Medicare & Medicaid Services Administrator, Andrew Slavitt, about ICD-10 issues, such as testing and lack of contingency planning, FierceHealthIT reports.

Bills continue to be introduced to stop or delay the deadline again. For example, representatives Diane Black (R-Tenn.) and Gary Palmer (R-Ala.) have bills pleading for grace periods for the transition. Black’s bill would require an 18-month transition period to the new code set. Palmer’s bill would provide a grace period of two years during which physicians and other providers would not be “penalized for errors, mistakes and malfunctions relating to the transition,” Fierce reports.

Rep. Ted Poe (R-Texas) introduced a bill that would ban ICD-10 entirely.

At this point it’s a long shot. Folks are concerned, though. That’s where the fear comes from; the constant calls for delay. Resources are stretched, money is limited and as the deadline looms, it’s close to say many organizations are near panic. Even if they bring in outside resources, as we can attest, now it’s too late for them to be much good at this late point.

So, as the issue continues to be debated, perhaps while doing so we should be getting out Is, Cs and Ds in order and get down to brass tax and get ready for the coming change. Not preparing for the change only hurts oneself and their organization.

Like the Coalition for ICD-10 suggest, at this point, just days from the transition, a grace period, as referenced above, would compromise the ability of Medicare to monitor quality of care and could be a massive risk when it comes to audits.

Recently the Centers for Medicare & Medicaid Services said its second round of ICD-10 testing, which involved 875 providers, clearinghouses and billing agencies in April, had an 88 percent acceptance rate. However, a new survey from eHealth Initiative released last week found testing lagging among 271 providers polled. Only 34 percent said they have completed internal testing and just 17 percent have completed external testing.

Unfortunately for the industry, according to MedPage Today, with the ICD-10 implementation date looming, a recent survey of more than 1,100 physicians, payers and vendors from the Workgroup for Electronic Data Interchange found that the biggest obstacle to industry readiness is the belief that there will be another delay.

Really, though, do we have the time to think that way anymore; not likely.