The FEHBlog has spent a good deal of this week attending a Workgroup for Electronic Data Interchange (WEDI) in nearby Reston, Virginia. Last year, a keynote speech by AMA President elect Steven Stack, MD, was energizing. Dr. Stack pointed out the flaws in the ICD-10 code set and in the lack of interoperability among the electronic medical record ("EMR") systems funded by the federal government to the tune of $30 billion. Dr. Stack's entirely valid point was that HHS missed the boat by failing to consult the medical profession when (a) approving that complicated code set and (b) setting the meaningful use standards for development of the EMR systems.
This year's keynote speaker was former HHS Secretary and Kansas Governor Kathleen Sebelius. The former Secretary lauded the implementation of the ICD-10 coding system. "We finally caught up with the rest of the world." The coding system implemention has gone quite smoothly. Fierce Health Payer reports on discussion of the implementation process at the WEDI Conference here. The FEHBlog suspects that Dr. Stack, who opposed the ICD-10 implementation, deserves credit for this outcome due to the simplified implementation approach that the AMA negotiated with CMS this summer. Who knows what will happen when (if?) CMS shifts to full blown ICD-10 coding?
The former Secretary also lauded the $30 billion investment in the EMR system comparing it an integrated EMR system that blew up in Great Britain a few years ago. But how can our system be declared a success when its not interoperable? Doctors cannot easily share information unless they belong to the same practive. That big HHS mistake greatly diminishes the value of the investment. This gap also makes life difficult for FEHB and other health plans that need to collect health care data for NCQA HEDIS measures.
Finally, the former Secretary claimed that the current Administration is the first one to take real steps to convert fee for service medicine to value based medicine. The FEHBlog has been following such efforts for his entire career which spans over 30 years. Gatekeeper HMOs in the 1980's and 1990's, health plans shifting risk onto providers in the 1990s and again now, Medicare + Choice in the 1990's, Medicare Advantage in the 2000's. This effort is nothing new. If the effort finally pays off that would be great.