If you live and love the EMR, EHR and Healthcare IT world like I do, then you’re enjoying all the big news that’s coming out right now. A part of me thinks that the big news is coming out because HIMSS is so close, but some of the news seems like it might not necessarily be timed directly to HIMSS. (To see company news coming out at HIMSS, check out our EMR, EHR and Healthcare IT News site.)

For those not keeping track, here’s a quick run down of some of the major news pieces I’ve seen that really point to larger trends in healthcare IT:

Meaningful Use Stage 2
We know that meaningful use stage 2 is imminent. It’s just a question of when we’re going to hear it. In fact, it might be announced as I’m writing this post. Neil Versel first queued us into the Meaningful Use Stage 2 Announcement prior to HIMSS, but the Twittersphere is also full of rumors about the announcement. Brian Ahier commented on my Facebook message about it:

Nothing is official until it’s released, but since Monday is a holiday it is very unlikely they will wait until next week. My understanding is that the review at the OMB is complete and the proposed rule is ready to be published…

For those who want a sneak preview on what to expect in meaningful use stage 2, check out Jennifer Dennard’s meaningful use stage 2 post.

ICD-10 Delayed
Many have wondered if ICD-10 would be delayed with most arguing that 5010, meaningful use and ICD-10 was a lot to change all at once. Two days ago I got an email from someone saying they thought ICD-10 wouldn’t be delayed. I replied that I wasn’t sure either way, but it seemed like there was movement that could make a delay quite possible. Although, I must admit that I didn’t even think the ICD-10 delay announcement would happen so quickly.

Regardless of prognostication, ICD-10 is going to be delayed. You can read my thoughts on the ICD-10 Delay on EMR Thoughts.

HIMSS Acquires mHealth Summit
Maybe this feels like bigger news since it’s so close to HIMSS and I can see how powerful this conference has become. You can read the press release on the acquisition here. This isn’t that surprising since HIMSS had partnered with the mHealth Summit last year. I think this spells really good things for the growth of the mHealth Summit. I’m not sure I’d want to be another mHealth conference, but there’s a niche for the right event.

I still have a hard time distinguishing mHealth from healthcare IT in general. There could be some differentiation, but I still believe that over time the dividing line between the two is going to be hard to see. Richard Scarfo, HIMSS’ vice president of vendor events (previously mHealth Summit director) is right to be concerned that it will be HIMSS 2.0.

Navinet Acquired by Blues Plans and Lumeris
Read more about the acquisition here. I must admit that I’m still trying to process exactly what this means. Although, one thing I’m sure it means we’re moving the tectonic ACO plates that will be necessary to change how we pay for healthcare.

Vince Kuraitis and Leonard Kish provide some interesting insight in this Google+ thread asking whether this is a shift from institution (enterprise) centered IT to patient centric IT or if it’s becoming payer centric IT. They also mention United’s restructuring of payments and Aetna’s acquisition spree as indicators of the shifting plates of healthcare reimbursement.

Aneesh Chopra as Senior Advisor to the Advisory Board Company
This isn’t as big of news, but it just came out so I thought I’d throw it in. For those that don’t know Aneesh Chopra is now former CTO of the US. Everyone just wondered what he’d do next. Brian Ahier posted that Aneesh Chopra landed at The Advisory Board Company where he worked previously for about 10 years. Looks like Aneesh and his energy and enthusiasm will still be around healthcare. I think that’s a very good thing.

Ever since the American Recovery and Reinvestment Act became law in February 2009, giving birth to the phrase “meaningful use,” I’ve wondered when private insurers would follow the federal government’s lead and start offering financial carrots and sticks for using and not using EHRs. After all, one of the purposes of the Medicare and Medicaid incentive program was to address the fact that payers tend to reap the greatest financial gains from hospitals and physicians adopting EHRs, even though most if not all of the cost of acquiring the technology falls on the provider.

Federal officials have made it clear all along that “meaningful use” is just that, the meaningful use of the technology. The government was not simply going to write checks so providers could go out and buy technology. As the country’s largest purchaser of  healthcare services, CMS wanted some value for its money (not exactly something you hear every day when it comes to government spending).

I’d been hearing for years that major commercial health insurers also were willing to share some of the savings from EHR adoption, but not until the largest payer of them all, Medicare, did so first. The private sector usually does follow Medicare’s lead when it comes to major policy shifts. Medicare now has done so, but private payers have been mostly silent. Mostly.

This month, as InformationWeek reports, Humana teamed up with Allscripts Healthcare Solutions to offer physician practices financial incentives for purchasing Allscripts EHR systems. The deal is similar to one Humana cut last year with Athenahealth. A few Blue Cross and Blue Shield plans, notably in Massachusetts and Rhode Island, have led similar programs at the state level, with eClinicalWorks the main partner.

But unless I’m forgetting something, Humana is the only big payer that has jumped into the game. Where are the UnitedHealthcares, Aetnas, Cignas and WellPoints of the world?

Payers, it’s time to make good on the lip service you gave years ago and start passing on some of the savings you will realize from Medicare, Medicaid and hundreds of thousands of providers spending billions of dollars on EHR technology and health information exchange efforts.

The HITECH Law Blog had a post recently titled “Commercial Payors Implementing EHR Meaningful Use Criteria in P4P Programs.” Here’s a short excerpt:

On August 5, 2010, four major commercial health insurance payors participated in the Health Industry Forum in Washington, D.C., to discuss private industry collaboration with the United States Health & Human Services Department (HHS) to support providers in the adoption of certified electronic health records (EHRs). Leading the Forum’s panel discussion was David Blumenthal, M.D., Chief of the Office of National Coordinator of HIT. All four payors will include the Meaningful Use criteria in their pay for performance (P4P) programs.

The 4 insurance groups identified are Aetna, Inc and its subsidiary, ActiveHealth Managent, United Health Group (UHG), Wellpoint, Inc, and Highmark, Inc. (Blue Cross Blue Shield).

The author of the blog also asserts that now that the government has created the final meaningful use rule, it will clear the way for the commercial payors to implement it as well. The press releases from the 4 companies about this change are really vague and so it’s hard to say exactly how these companies will implement the meaningful use criteria.

In fact, this almost feels like it’s a little warning shot from the commercial payors. It seems like they’re testing the waters to see how doctors and practices will react to this type of announcement. Plus, I’ll be surprised if we see any major implementation of meaningful use by commercial payors until we see the first physicians showing meaningful use to the government. That way the commercial payors can sit back and watch the impact on physicians of having to show meaningful use to the government. If it goes poorly (like the bad PQRI incentives), then I can see commercial payors backing off the meaningful use bandwagon.

The theme I did read in all the press releases is that it’s valuable for commercial payors to have information from an EHR. Now I think the payors are just trying to figure out the best way to achieve that outcome. Will it be meaningful use? Will it be some other method? They don’t really care. They’re just concerned with their outcomes.

If commercial payors do require meaningful use, I think it’s going to be a really ugly outcome.