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Eyes Wide Shut – January, 2014 Meaningful Use Stage 2 Readiness Reality Check

Posted on January 13, 2014 I Written By

Mandi Bishop is a healthcare IT consultant and a hardcore data geek with a Master's in English and a passion for big data analytics, who fell in love with her PCjr at 9 when she learned to program in BASIC. Individual accountability zealot, patient engagement advocate, innovation lover and ceaseless dreamer. Relentless in pursuit of answers to the question: "How do we GET there from here?" More byte-sized commentary on Twitter: @MandiBPro.

Happy New Year?

As I begin the 2014 Meaningful Use measures readiness assessment and vendor cat-herding exercises, I’m reflecting on this portion of CMS’s Director of E-Health Standards and Services, Robert Tagalicod and the ONC’s Acting National Coordinator Jacob Reider’s statement regarding the Meaningful Use timeline modification: “The goal of this change is two-fold: first, to allow CMS and ONC to focus efforts on the successful implementation of the enhanced patient engagement, interoperability and health information exchange requirements in Stage 2.” (Previously published on EMRandHIPAA.com.)

I call BS.

If the “goal” is a “successful implementation”, then CMS failed miserably by not addressing the START of the quarterly attestation period for Stage 2, which is still required in 2014. CMS and the ONC need more time to successfully implement the measures, and they are bureaucratic agencies that don’t directly deal with patient medical care. Why wasn’t the additional time required to truly succeed at this monumental task extended to the healthcare provider organizations? Because the agencies want to save face, and avoid litigation from early adopters who may be already beginning their 2014 attestation period amidst heroic back-breaking efforts?

Here’s a reality check for what a large IDN might be going through in early January, in preparation for the start of the 2014 quarterly attestation period. Assume this particular IDN’s hospitals’ fiscal year runs October-September, so you MUST begin your attestation period on July 1. You have 6 months.

As of December 31, 2013, only 4 of the 8 EMRs in your environment completed their 2014 CEHRT certification.

Each of those 4 EMRs has a different schedule to implement the upgrade to the certified edition, with staggered delivery dates from March to July. The hospital EMR is not scheduled to receive its certified-edition upgrade until April. You pray that THIS implementation is the exception to your extensive experience with EMR vendor target timelines extending 6-8 weeks beyond initial dates.

The EMR upgrades do not include the Direct module configuration, and the vendor’s Direct module resources are not available until 6-9 weeks after the baseline upgrade implementation – if they have knowledgeable resources, at all. Your hospital EMR vendor can’t articulate the technical infrastructure required to implement and support its own Direct module. Several vendors indicate that the Direct module configuration will have to be negotiated with a third-party. Your clinicians don’t know what Direct is. Your IT staff doesn’t know how to register with a HISP. Your EMR vendor doesn’t support a central Direct address directory or a lookup function, so you contemplate typing classes for your HIM and clinical staff.

The number of active patient problems requiring manual SNOMED remediation exceeds 60,000 records in your hospital EMR. You form a clinical committee to address, but they’re estimating it will take 6 months of review to complete. You’re contemplating de-activating all problems older than a certain date, which would whittle down the number and shorten the timeframe to complete – but would eliminate chronic conditions.

There are still nagging questions regarding CMS interpretation of the measures, so you ask for clarification, and you wait. And wait. And wait. The answers impact the business rules required for attestation reporting, and you know you need any help you can get in whittling down the denominator values. Do deceased patients count in the view/download/transmit denominator? If records access is prohibited by state/federal law, does that encounter count in the view/download/transmit denominator?

Consultant costs skyrocket as you struggle to find qualified SME resources to blaze a trail for your internal staff. Their 60-to-90-day assessments inevitably end with recommendations for “proof of concept” and “pilot” approaches to each of the 2014 measures, which don’t take into account the reality of the EMR upgrade timelines and the looming attestation start date. Following their recommendations would delay your attestation start by 9-12 months. So, your internal staff trudges forward without expert leadership, and you throw the latest PowerPoint deck from “Health IT Professionals-R-Us” on the pile.

Who needs testing, when you can go live with unproven technology the day it’s available in order to meet an arbitrary deadline? Healthcare.gov did it – look what a success that turned out to be!

But wait, this is real clinical data, generated by real-world clinical workflows, being used to treat real patients, by real healthcare providers. By refusing to address the start of the 2014 attestation period, CMS and the ONC are effectively using these patients and providers as lab rats.

I did not give permission to be part of this experiment.

Scanning Is a Feature of Healthcare IT and Will Be Forever

Posted on October 11, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

When I first started writing about EMR and EHR, I regularly discussed the idea of a paperless office. What I didn’t realize at the time and what has become incredibly clear to me now is that paper will play a part in every office Forever (which I translate to my lifetime). While paper will still come into an office, that doesn’t mean you can’t have a paperless office when it comes to the storage and retrieval of those files. The simple answer to the paper is the scanner.

A great example of this point was discussed in this post by The Nerdy Nurse called “Network Scanning Makes Electronic Medical Records Work.” She provides an interesting discussion about the various scanning challenges from home health nurses to a network scanner used by multiple nurses in a hospital setting.

The good people at HITECH Answers also wrote about “Scanning and Your EHR Implementation.” Just yesterday I got an email from someone talking about how they should approach their old paper charts. It’s an important discussion that we’re still going to have for a while to come. I’m still intrigued by the Thinning Paper Charts approach to scanning, but if I could afford it I’d absolutely outsource the scanning to an outside company. They do amazing work really fast. They even offer services like clinical data abstraction so you can really enhance the value of your scanned charts.

However, even if you outsource your old paper charts, you’ll still need a heavy duty scanner for ongoing paper that enters your office. For example, I have the Canon DR-C125 sitting next to my desk and it’s a scanner that can handle the scanning load of healthcare. You’ll want a high speed scanner like this one for your scanning. Don’t try to lean on an All-in-One scanner-printer-copier. It seems like an inexpensive alternative, but the quality just isn’t the same and after a few months of heavy scanning you’ll have to buy a new All-in-One after you burn it out. Those are just made for one off scanning as opposed to the scanning you have to do in healthcare.

David Harlow also covers an interesting HIPAA angle when it comes to scanners. In many cases, scanners don’t store any PHI on the scanner. However, in some cases they do and so you’ll want to be aware of this so that the PHI stored on the device is cleaned before you dispose of it.

Certainly many organizations are overwhelmed by meaningful use, ICD-10, HIPAA Omnibus, and changing reimbursement. However, things like buying the right scanner make all the difference when it comes to the long term happiness of your users.

Sponsored by Canon U.S.A., Inc.  Canon’s extensive scanner product line enables businesses worldwide to capture, store and distribute information.

EMR Market is Growing, But It’s Not What It Was

Posted on September 11, 2013 I Written By

James Ritchie is a freelance writer with a focus on health care. His experience includes eight years as a staff writer with the Cincinnati Business Courier, part of the American City Business Journals network. Twitter @HCwriterJames.

The EMR market is likely to grow at more than 7 percent per year through 2016, according to a new report.

The estimate comes from London-based research and advisory firm TechNavio. The company wrote in its analysis, “Global Hospital-based EMR Market 2012-2016,” that “demand for advanced health monitoring systems” and for cloud-computing services were major contributors to demand.

On the other hand, according to the company, implementation costs could be a limiting factor.

The TechNavio figure is actually a compound annual growth rate of 7.46 percent. That means substantial opportunity for the many companies referenced in the report, including Cerner Corp., Epic Systems Corp., AmazingCharts Inc. and NextGen Healthcare, to name a few.

Another research firm, Kalorama Information, in April reported that the EMR market reached nearly $21 billion in 2012, up 15 percent from the year before, driven by hospital upgrades and government incentives.

About 44 percent of U.S. hospitals had at least a basic EHR in 2012, up from 12 percent in 2009, according to the Office of the National Coordinator for Health IT.

In the United States, at least, future growth might require more resources and creativity to achieve. You might remember the recent post “The Golden Era of EHR Adoption is Over,” by Healthcare Scene’s John Lynn, positing that the low-hanging fruit for EMR vendors, the market of early adopters and the “early majority,” is gone, leaving a pool of harder-to-convince customers.

But the TechNavio report is broader, considering not only the Americas but also Europe, the Middle East, Africa and Asia Pacific. That’s truly a mixed bag, as while health IT is at a preliminary stage in many developing markets, it’s highly advanced in countries such as Norway, Australia and the United Kingdom, where, according to the Commonwealth Fund, EMR adoption by primary-care physicians exceeds 90 percent.

When EMR initiatives get a firmer foothold in countries such as China, where cloud-based solutions could well prevail, growth rates for those areas might exceed — several times over — the overall figure predicted by TechNavio.

And in the United States, certain pockets, such as the rural hospital market, still present huge opportunity. Fewer than 35 percent of rural hospitals had at least a basic EMR in 2012, but the enthusiasm is clearly there, as that number was up from only 10 percent in 2010, according to the Robert Wood Johnson Foundation.

It looks like it’s still a great time to be an EMR vendor. But it’s not the same market that it was even a couple of years ago, and success in the new era might require looking at new markets and approaches.

Without This EMR Step, You Might Never Get It Right

Posted on August 29, 2013 I Written By

James Ritchie is a freelance writer with a focus on health care. His experience includes eight years as a staff writer with the Cincinnati Business Courier, part of the American City Business Journals network. Twitter @HCwriterJames.

It’s not hard to find physicians and nurses who say that far from improving health care, the EMRs they use are something to work around.

Billing problems, lost productivity and even diminished quality of care are common complaints, sometimes long after the implementation kinks should have been worked out. In some cases, doctors who bought into EMRs as a way to operate more effectively and efficiently have found themselves disappointed enough to look for hospital employment, try new practice models or even close their doors, as HealthcareScene.com founder John Lynn has written.

Often the problem lies deeper than the technology, according to a recent white paper from TechSolve, a Cincinnati-based consulting group. After all, an electronic overlay does little good when it serves only to automate bad processes.

TechSolve is promoting a process-mapping approach to EMR for hospitals through its Lean Healthcare Solutions unit. It’s part of a trend toward applying the efficiency techniques of Japanese manufacturers to EMRs and other aspects of health care.

Like Toyota and other pioneers of lean, health care providers should rely on line workers to help root out waste, according to TechSolve.

“While you may be inclined to dismiss negative comments as resistance to change, staff may be aware of design issues that the design team, PI facilitator, and vendor were not,” TechSolve consultants Sue Kozlowski and Alex Jones wrote.

They offered seven steps to ensure maximum benefit from an EMR, a few of which I’ll share. I suggest downloading the full paper for a complete view.

TechSolve recommends thinking about process improvement before getting started with an EMR. Of course, if it’s too late for that, the firm and others in the space are happy to step in later, as well.

Here’s what TechSolve advises:

  • Map your current processes. This can be done with help from your process improvement team or an outside group. In some cases, it’s best to assign a team to each service line.
  • Compare current and future states. Color-coding is one way to do this, highlighting visually for staff members how their work will change.
  • Prioritize issues that affect patient care and payment timing. An “issues list” can be created and then reviewed after “go live” to make sure problems have been corrected. Also, examine how well staff members are adhering to the new processes, asking questions such as, “Where are they using work-arounds, and where have they found new capabilities in the system?”
  • Process map again. This new snapshot is the baseline going forward. It can serve as a reference for staff members when they’re in doubt and as a training tool for new hires.

We’re all looking for technology that makes our lives easier right away. But when it comes to EMRs, there’s no true turnkey solution. Making a system pay off requires investments, particularly of time, well beyond the sticker price.

Under traditional reimbursement models, though, planning is not what brings in the revenue. It’s easy enough to see why hospital employment, with guarantees of a salary and IT assistance, is becoming a more and more attractive option for physicians who want to limit expenses and risk.

Hospitals, though, have no plan B. They’ll have to marry their IT to efficient processes or else.

Things Your EMR Will Never Do

Posted on August 15, 2013 I Written By

James Ritchie is a freelance writer with a focus on health care. His experience includes eight years as a staff writer with the Cincinnati Business Courier, part of the American City Business Journals network. Twitter @HCwriterJames.

EMRs can be powerful tools for building practice efficiency.

But they can’t do it all.

Ruth Sara Hart-Schneider, sales and marketing director for Cincinnati-based Salix, says health care providers are still paying too many people to move too much paper. Her firm helps them to fill the gaps left after even the most successful EMR implementation.
Ruth Sara Hart-Schneider is sales and marketing director for Salix
Salix specializes in workflow automation, business process outsourcing and litigation support. Health care makes up about 30 percent of its workload.

Hart-Schneider works with physician practices, hospitals and a variety of other health care clients, such as durable medical equipment firms and clinical research organizations. She deals with 26 EMR systems.

Note: If you catch her hanging out by your fax machine, don’t be alarmed. It’s part of her job.

Here’s what Hart-Schneider had to say:

Can you explain more about what your company does in health care IT?

We support health care companies in leveraging the electronic data they already have. We help them to avoid having redundant systems or people hand-filling forms or electronic systems generating paper systems. We work around the electronic systems in an office, like EMRs and practice management systems. Usually an office will have both, but there are all these other functions that have been left on the table.

What are some examples?

Most EMRs we deal with are not set up for prior authorization requests. And every state has its own forms for different programs — Medicaid HMOs, workers’ compensation. Particularly for practices dealing across state lines, it becomes cumbersome for the staff. EMR companies don’t want to program all these forms for all the states, and they change constantly anyway. That’s a sweet spot for us. Prescription monitoring is another one if the practice is giving many narcotics. Also, EMRs don’t interface with many of the tools the carriers have out there for eligibility, benefits and claims status. Some other areas are disability, return-to-work forms, immunization logs for pediatrics and certificates of medical necessity for things like wheelchairs and oxygen.

When practices invest in EMRs, do they realize how much they’ll still need to do on paper?

They’re trying to meet meaningful use. When they choose a system, they know what it will do. It’s not a tool to manage your office. Still, people get frustrated with how many repetitive tasks their employees have to do even after all this money has been spent. For example, a group had a pulmonary function testing machine that wouldn’t talk to the EMR. They would print the report and then walk over and scan it into the EMR. A lot of equipment is like that.

How do you identify the inefficiencies in a practice?

If you stand by the fax for 10 minutes and watch what comes through, you’ll have a pretty good idea. You can also look around at the stacks of paper. You can ask people what they’re behind on.

How do you help?

Salix will work with an organization to help them identify their biggest pain points and then customize a solution that will free up staff time and save them money. We look for the best tools for each application. We like FileBound, which has an ASP model product that meets all the HIPAA security requirements, has a very reasonable price point and allows unlimited users without user fees.

Among our services: We can help with the auto-population of forms, we can provide data-entry services for labs and test results that are faxed in and we can help provide interface solutions for equipment that’s not hooked to the EMR. For a surgery practice, as one example, we can help design and implement systems so that the manager can look at tomorrow’s schedule and ensure that all pre-certs have been completed.

How important is it to address these areas?

Most often, there are higher-level tasks that aren’t getting done because staff is bogged down in some very menial, basic and repetitive tasks. You don’t need your nurse spending time on data entry or filling out school forms.

Is it realistic for a practice to go completely paperless?

Yes, but not in the near future. You couldn’t do it yourself. Vendors and everyone else that you deal with would have to be paperless, too, and that’s not happening. Many of the nursing home and hospice operators I talk to say they’re not going electronic because they don’t have the money. I think some things will always come in on paper.

EMR & Patient Safety, Meaningful EHR Measures, and the Patient Portal “Switch”

Posted on January 20, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.


What an important topic of discussion. In fact, it makes me want to look at writing a whole series of articles on the patient safety issues using an EMR and also the patient safety issues of not using an EMR. Much of it I’ll be covering in my EHR benefits series, but quite a different angle. Although, the ethics side of it could be really interested. I’m glad Dr. Wes is starting this discussion.


I keep wishing it was interoperability, but I do think we could go way too far when it comes to adding more measures and end up with measures that provide little to no value if we’re not careful.


I love that people think that implementing a patient portal is as easy as flipping a switch. I can have a full EMR at my fingertips in 2 minutes by signing up at one of the Free EHR, but that misses so many important parts of implementing an EMR. The same goes for a portal. It takes a little more thought to implement a patient portal than just flipping a switch.

The Fiscal Cliff of Primary Care

Posted on December 20, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The Hello Health blog has a really interesting article up discussing what they called the Primary Care Fiscal Cliff. The thing I like most about the post is the data they provide on what’s happening with primary care doctors. Take for example this list of statistics:

  • Primary care practice income rose just $500 from 2008-2011
  • Operating expenses of a practice continues to rise each year
  • Primary care physicians can spend an average of 13 hours a week of uncompensated care worth over $30,000 in lost revenue a year
  • The cost of a traditional electronic health record can easily exceed $20,000 in the first year with a 5-year projected cost approaching $50,000 per physician

I’m not sure that the US government’s fiscal cliff has much relationship to the primary care doctor fiscal cliff (except for the possible Medicare cuts), but it’s very safe to say that primary care doctors are in a real financial predicament.

In the Hello Health post they suggested from their own research that practice finances and EHR are the two issues keeping primary care physicians up at night. I’m sure these findings won’t be a surprise to any primary care doctors. Plus, it’s worth noting that the finances of a primary care practice are tied to an EHR in many ways.

I have often questioned how much influence the government EHR incentive money has had on getting doctors to adopt EHR. Whenever I do, I usually get a response from a primary care doctor saying that they wouldn’t be implementing an EHR if it weren’t for the EHR incentive money and that they were depending on the EHR incentive money to help cover the new EHR expense.

In my recently started EHR benefit series I’m hoping to expand the thinking when it comes to EHR revenue implications. There are still tens of thousands of primary care doctors that need to implement an EHR or replace their existing EMR. Understanding the financial ties to EHR will help a practice ensure a more successful EHR implementation.

At the core of the question is whether EHR software is a financial benefit or a financial loss. The cop out answer to that question is that it depends on how you implement the EHR and which EHR you implement. I wish someone would take the time to study the top 20 EHR companies and evaluate how practices have done pre-EHR implementation and post EHR implementation. Plus, they’d need to take into account the cost of an EHR. That type of study would produce a lot of interesting EHR data.

My gut feeling having participated in numerous EHR implementations and heard from thousands of other EHR implementations is that the result is usually a wash. In most EHR implementations I don’t think there’s a net financial gain or loss. There are outliers on both sides of that spectrum, but I think for most it has some pros and some cons.

With that said, I think there are long term benefits to a practice that has an EHR. While the immediate financial returns may not come, I think that the EHR in a practice is going to be essential for many of the financial gains a practice wants to achieve in the future. The most obvious example is becoming part of an ACO. Can you really get the financial benefits of being in an ACO without an EHR? I think the answer will likely be no. You need the EHR data to obtain and report on the ACO improvements your practice achieves.

First Hand EMR User Experiences, Slaying the Paper Dragon, and EMR GUIs

Posted on July 1, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Time again for a quick look around some of the EHR and Health IT topics being discussed on Twitter. It’s an interesting time for healthcare IT on Twitter. They’ve started accepting nominations for what they’re calling the #HIT100. A number of people have already nominated my @techguy and my @ehrandhit Twitter accounts as a #HIT100 nomination. I’m honored that people would consider me in that group. I’ll be interested to see who ends up making it on the list. Those lists aren’t perfect, but I enjoy them for discovering new people I didn’t know about.

Also, before I go through some tweets, be sure you check out the Around Healthcare Scene post on EMR and EHR.


I love Inga from HIStalk and I love these first person perspectives and comments on EMR software. We need more doctors, practice managers, nurses, etc talking about their experience. Props to Inga for putting that together.


I love the concept of the “paper beast.” Such a perfect description and something that so many people forget about when their planning their EHR implementation. Dealing with the existing and future paper (yes, paperless is a myth) is an absolute must in a good EHR implementation.


This is a topic we’ve discussed many times before. Although, I think we need to keep pointing it out so that physicians take a good hard look at the documentation method of EHR software. There are so many options out there that doctors shouldn’t settle for something less than optimal.

HIMSS Stage 7 Hospitals, HIE Decreases Lab Orders, EHR Implementation Depends on Teamwork

Posted on April 8, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Happy Easter to everyone reading this and to those who celebrate it. To those who don’t celebrate it, I’d suggest you go and buy the delicious Cadberry chocolate eggs. Not the ones with the creme filling, but the ones in the purple bag. They’re stunningly delicious and should be on sell tomorrow. Unless you live in Las Vegas, and then please leave them so I can buy them. Thanks! While these delicious chocolate eggs have little to do with the true meaning of Easter, they do provide a lot of joy and that’s core to Easter for me.

Easter aside, let’s take a look at some of the various EMR and Healthcare IT related tweets that have come out recently.

This is interesting when you add it to all the reports that say that the US healthcare system is so much worse than the rest of the world. Of course, the US health system is much larger than most other health systems. It also might point to the HIMSS stage 7 status having little real meaningful as far as health IT adoption. It could also point that HIMSS hospital stages aren’t looked at internationally so no one takes the time to meet them. Basically, I wouldn’t read too much into these numbers.

This tweet goes in nice contrast to the report that circled around recently that doctors were more likely to order tests using an EHR than pre-EHR. Mostashari and others took exception to the study and wrote lengthy responses to the study. Of course, the more I read these studies the more disappointed in how most media reports the studies. They make for good headlines, but when you dig deep into the studies you realize that they often have a much more limited scope than what the headline suggests.

I have no idea who “Mike on Healthcare” is (Looks like he’s @MichaelCrosnick on Twitter), but looking at the blog post that Lucia links to I’d like to meet Mike. In that post, he highlights the importance of getting staff buy-in during an EHR implementation and the idea of physician champions. Those are two of my core elements when talking about an EHR implementation. Great to have Mike adding to the collecting EHR knowledge in the healthcare IT blogosphere.

Top Five ICD-10 Pitfalls – “Top 10″ Health IT List Series

Posted on December 30, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Today is going to be the last day looking at other people’s “Top Health IT Lists” since tomorrow I think I’ll create my own Top 10 Health IT 2011 List and then for the New Years I’ll see about doing a Top 10 Health IT in 2012 list. However, today let’s look at something that will likely make the Top 10 2012 Health IT issues: ICD-10. Government Health IT recently wrote an article what they call the Top 5 ICD-10 Pitfalls.

1. Reporting: I’m sure that many think that ICD-10 is just going to happen and be fine. They’ll assume that their reports are just going to work with ICD-10 since they worked with ICD-9. Don’t be so sure. Test the reports so you know one way or another. Diving a little deeper beforehand is a lot better than learning about the problems after.

2. Overlooking impacted areas: Much like an EHR implementation, don’t forget the other people that are affected by ICD-10. Involve everyone in the process so that they can share their concerns so they can be addressed. Plus, by having them involved you’ll get much better buy in from the staff.

3. Teaching old dogs new tricks: ICD-10 is a different beast and will require significant training even if you have an expert ICD-9 coder with years of experience. Don’t underestimate the cost to train your coders on ICD-10.

4. Preparing for impact on productivity: The article mentions Canada’s loss of productivity during their implementation of ICD-10. Do we think we’re going to be any different? Remember also that productivity loss can come in a lot of different places (which is kind of a repeat of number 2 above).

5. Communicating with IT vendors: It’s one thing to trust that your EHR and other health IT vendors are prepared to deal with ICD-10. It’s another to blindly follow whatever you’re being told. Remember at the end of the day it’s your organization that will suffer if your health IT vendor is not ready. I like to use the phrase, trust but verify.

Be sure to read the rest of my Health IT Top 10 as they’re posted.