D'Arcy Gue

Healthcare Policy Mandates Posing Unforeseen Challenges

August 30, 2013

Healthcare Industry, HIPAA & Security, ICD-10, IT Project Management 3 Minute Read

The second largest HIPAA breach impacts more than four million people.

Advocate Health Systems, one of the nation’s largest healthcare systems announced that over four million patient records were compromised when computers were stolen from an administrative building on July 15. Healthcare IT News notes that this is the second largest reported breach in history. The data that was stolen includes patient names, addresses, dates of birth, Social Security numbers and clinical information.

With the Omnibus HIPAA deadline quickly approaching (September 23, 2013) we’re going to see an increase in breach notifications. Providers need to be hyper-aware of privacy and security precautions required to keep the increasing amount of electronic health records safe.

Weaknesses in ICD-10 mapping processes may pose risks of fraud.

Complexities imposed by the new ICD-10 code set creates a breeding ground for fraudulent activity. A recent Government Health IT piece tackles the questions providers should be asking themselves when developing mapping processes for ICD-9 to ICD-10 coding.

The author makes an excellent point — “…if the rest of the globe is any indicator, it is likely that the U.S. will be accepting data with a blend of ICD-9 and ICD-10 codes for years to come. This will impact providers, billers, health plans, and anyone who analyzes U.S. health care claims data, but each party is essentially left to its own devices to re-map the codes.”

Provided in the article are methods for mitigating the risks of fraudulent coding. Take the time to review the recommendations and integrate them into your ICD-10 transition plan.

CIOs and policy experts provide opinions on the impacts of policy mandates.

Policy issues are overloading IT departments in hospitals across the country — stage 2 requirements are on the horizon; the ICD-10 deadline is only a little more than one year away, and privacy and security compliance issues are a constant concern. All of this, on top of day-to-day activities, has CIOs in over their heads and seeking reprieve. While we don’t see any break in the near future, one solution is prioritization.

Healthcare Informatics held interviews with seven CIOs and policy experts, and discussed the challenges related to the measures and the issue of prioritization.

Health IT spending is off the charts.

With new mandates, comes new technologies, processes, and people — these require more money. Healthcare IT news published a piece this week that claims that health IT spending will be over $34.5B in 2014.

Technology Business Research Inc. surveyed 225 IT decision makers across the C-Suite and line-of-business managers at payers and providers. They also conducted 25 qualitative, in-depth interviews to uncover spending intentions, priorities and perceptions.

Plans for spending offer opportunities for vendors who specialize in business intelligence and analytics, database and technology, and systems management.

Three out of four healthcare providers plan to hire IT professionals in the next year.

The demand is high and the qualified pool of candidates is small. Many providers have reported project delays due to staffing shortcomings.

The latest Healthcare Informatics article cites some interesting stats related to health IT staffing:

  • 43 percent of providers and 56 percent of vendors cited a lack of qualified talent pool was their biggest challenge to staffing their environment.
  • 76 percent of healthcare providers currently outsource a service rather than hire directly
  • 67 percent of healthcare CIOs were reporting IT staff shortages according to a 2012 CHIME survey

The issue of staffing shortages is not going to go away. What do you think it will take to create a stronger health IT workforce?

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