The Alliance will collaborate to build “a proof of concept across the next 12-18 months” to try to accomplish the following projects:

• Patient Linking and Matching – Provide a way for vendors to identify patients as they move from setting to setting, in a robust and seamless industry-wide data environment.
• Patient Access and Consent Management – Foster a HIPAA-compliant, patient-controlled means to simplify the management of consents and authorizations for data sharing.
• Record Locator Service and Directed Query – Enable providers to match the locations of a patient’s previous health care encounters, no matter where the encounter occurred, and gain access to that data in an industry standard way”.

Some comments from InformationWeek Healthcare:

“To be understood, all of this has to be viewed in the context of three facts of life in health IT. First, the meaningful use stage 2 criteria, which kick in next year, include interoperability criteria that exceed the capabilities of most providers today. Second, the industry is moving toward accountable care and population health management, requiring new responses from EHR and HIE vendors alike. And third, this historic trend is likely to change how healthcare providers view the offerings from health IT vendors as their perspective broadens beyond their enterprises.

Right now, the trend is still moving in the opposite direction: An increasing number of healthcare organizations are switching from their current best-of-breed systems to Epic, which offers proven, physician-accepted solutions that are integrated across hospitals and ambulatory care. That’s understandable, because Epic eliminates most of the need for complex, hard-to-maintain interfaces within enterprise systems.

This movement explains the jockeying that is going on between Epic and its leading competitors, which would like to reduce Epic’s advantage in systems integration by becoming interoperable with each other. At the same time, this approach will help them give their customers the interoperability they need to show meaningful use.

But in an interview with InformationWeek Healthcare, Doug Fridsma, director of the office of science and technology in the Office of the National Coordinator for Health IT (ONC), said that the “vertical integration” approach in vendor product suites was outdated. “In accountable care organizations and in the new ways in which healthcare is being delivered, they’re going to become less vertically integrated and more horizontally integrated,” he predicted.

Because of the need for interoperability across care settings and business entities, he added, “Vendors that try to sell everything to people will have increasing problems.”

In regard to the launch of CommonWell, Fridsma said, “Any efforts that improve information flow are a good thing.” The willingness of vendors to open their systems and establish standards for information exchange, he noted, is a positive step as long as its purpose is to improve the quality of care.

While CommonWell, the IWG/eHealth Exchange consortium and the Surescripts clinical interoperability network are all trying to achieve the same goal, Fridsma saw no problem with that if all of these initiatives adhere to certain nationally recognized standards. He compared this evolution to that of the Internet, which is based on standards such as FTP and HTTP.”

From Forbes:

“In a bid to put a private sector stamp on the push for interoperability, a group of electronic health records vendors led by McKesson formed the CommonWell Health Alliance yesterday. “Everyone in the industry has been invited to participate,” said John Hammergren, McKesson’s chief executive officer, at the press conference for the launch.

“No, we were not asked to join,” says Carl Dvorak, chief operating officer of Epic Systems. “We found out about it when you guys did.” Epic is one of the leading vendors of electronic health records. The privately-owned company generated $1.5 billion in revenues last year; almost half of the country’s electronic health records are Epic’s.

Dvorak questions the purpose of the alliance, when national interoperability standards already exist (mostly in the form of government-led or public-private initiatives), and refutes the industry’s perception that Epic is a closed platform. “That couldn’t be further from the truth,” he says, pointing that one-third of Epic electronic health record transactions are with non-Epic systems.”

From FierceEMR:

“While the CEOs involved in Monday’s CommonWell Health Alliance announcement–in which five electronic health record vendors agreed to work together for improved interoperability–made it clear that all EHR vendors have an open invitation to join, Epic CEO Judy Faulkner said this week that her company has not, to date, been asked to participate.

Faulkner also said that the collaboration appears to be more of an attempt to compete with her Verona, Wis.-based company, which boasts $1.5 billion in annual revenue, according to Bloomberg.

“It appears on the surface to be used as a competitive weapon and that’s just wrong,” Faulkner told Bloomberg. “It’s wrong for the country.’”

From Information Week HealthCare:

“The alliance plans to start testing early components of its data exchange infrastructure within the next year, including:

– cross-entity patient linking and matching services;

– patient consent and data access management; and

– patient record locator and directed query services regarding recent patient encounters.

Although patient identity management and the record locator will be centralized, the Alliance will use a peer-to-peer architecture that allows users to view data without aggregating it in a data warehouse. The goal will be to allow patient information from outside sources to flow automatically into the EHRs of clinicians when they need it.

Patterson stressed the need for a unique patient identifier, which, he noted, Congress has long resisted. “We’re the only country with a major healthcare system that doesn’t have a universal patient identifier,” he said.”

From EHR Intelligence:

“The collaboration will attempt to institute standards for unique patient identifies in order to ensure that the right record is associated with the proper patient.

While a national patient identification number is the subject of some debate among privacy experts and government officials, health IT leaders and HIE advocates are generally behind the idea. “We’re the only western country that doesn’t have a national health care ID,” Neal Patterson, founder, chairman and CEO of Cerner told Forbes.  “We’re digitizing the content of an entire industry by automating the electronic health record. Without a national ID and the ability to create true data that can be safely and securely sent between individuals, we are going to introduce new systemic risk back into the system.”

The CommonWell Alliance will be responsible for defining, promoting, and certifying a national infrastructure with common standards and best practices.  It will issue a seal of approval to products that meet the criteria for its infrastructure, hoping to bring industry leaders together in an effort to get a national health information exchange ecosystem off the ground. “The formation of this alliance takes health care a step closer to broad industry interoperability,” said McKessen CEO John Hammergren. “A national and trusted health information exchange will break down the information silos in health care and should dramatically improve the quality and cost effectiveness of care delivery. Creating data liquidity between all HIT developers is fundamental to improving patient care, enhancing the vitality of the health care industry, and strengthening the long-term health of our nation.”

From Search HealthIT:

“Intermountain Healthcare CIO Marc Probst said the potential CommonWell-versus-Epic faceoff reminded him of the 1980s VHS-versus-Betamax videocassette format war. One of the patient data formats eventually will become the dominant standard if CommonWell formats gain traction and they battle head-to-head for market share.

But that’s only if CommonWell gets off the ground. “It feels like desperation to me,” Probst said. “It seems a little reactionary to me. Would these guys have naturally done this?” Of course, for his health care system, the CommonWell announcement doesn’t really affect him one way or another; Intermountain created its own EHR.

He does see one silver lining, however. “Anything that drives to standards helps us in what we’re trying to accomplish,” Probst said. “If this drives us to two [standards], sweet. That’s a way-different deal than thirty.”
 

In 2011 US health care spending grew 3.9 percent to reach $2.7 trillion, marking the third consecutive year of relatively slow growth. Growth in national health spending closely tracked growth in nominal gross domestic product (GDP) in 2010 and 2011, and health spending as a share of GDP remained stable from 2009 through 2011, at 17.9 percent. Even as growth in spending at the national level has remained stable, personal health care spending growth accelerated in 2011 (from 3.7 percent to 4.1 percent), in part because of faster growth in spending for prescription drugs and physician and clinical services. There were also divergent trends in spending growth in 2011 depending on the payment source: Medicaid spending growth slowed, while growth in Medicare, private health insurance, and out-of-pocket spending accelerated. Overall, there was relatively slow growth in incomes, jobs, and GDP in 2011, which raises questions about whether US health care spending will rebound over the next few years as it typically has after past economic downturns.

To put things in perspective, the economy has been sputtering along at 2.5% to 3% increases recently. However, the 3.9% increase in healthcare spending, the lowest recorded in the half century that the National Health Expenditure has been calculated,  is not so unsustainable.  Yet if these costs are growing in a relatively stable and not-too-terribly unsustainable way, how we do we account for the following:

While ObamaCare won’t take full effect until 2014, health-insurance premiums in the individual market are already rising, and not just because of routine increases in medical costs. Insurers are adjusting premiums now in anticipation of the guaranteed-issue and community-rating mandates starting next year. There are newly imposed mandates, such as the coverage for children up to age 26, and what qualifies as coverage is much more comprehensive and expensive. Consolidation in the hospital system has been accelerated by ObamaCare and its push for Accountable Care Organizations. This means insurers must negotiate in a less competitive hospital market.

Although President Obama repeatedly claimed that health-insurance premiums for a family would be $2,500 lower by the end of his first term, they are actually about $3,000 higher—a spread of about $5,500 per family.

Health insurers have been understandably reluctant to discuss the coming price hikes that are driven by the Affordable Care Act. Mark Bertolini, CEO of Aetna, the country’s third-largest health insurer, broke the silence on Dec. 12. “We’re going to see some markets go up by as much as 100%,” he told the company’s annual investor conference in New York City.

Insurers know that the Obama administration will denounce the premium increases as the result of greedy health insurers, greedy doctors, greedy somebody. The Department of Health and Human Services will likely begin to threaten, arm-twist or investigate health insurers in an effort to force them into keeping their premiums more in line with Democratic promises—just as HHS bureaucrats have already started doing when insurers want premium increases larger than 10%.

Evidence has accumulated that some people inherit genes that increase their risk for the condition. A project is underway to stop the dementia before it starts, by giving drugs to those with genes that are a risk factor for Alzheimer’s.

Despite decades of efforts, there is not a clear understanding of the neurological cause of Alzheimer’s. After many millions of dollars spent, countless studies and the efforts of some of the world’s best scientists, we can treat the symptoms and alleviate some of the suffering, but not heal the patient.

There has been great interest among scientists in preventing this disease. Now, a never-before attempted project is underway to use genetics to find those at risk for the disorder, and then to give them a drug called crenezumab.

It is possible crenezumab administered to normal people with family histories of the disease may prevent dementia symptoms from occurring.

Can crenezumab cure Alzheimer’s?

Scientists are particularly interested in individuals who aren’t yet showing symptoms of the disorder, but who have genes or family histories that predispose them to early-onset Alzhemier’s.

An extensive, multi-year, interdisciplinary initiative to measure the possible preventive benefits of crenezumab is being underaken by teams of researchers associated with the pharmaceutical firm Genentech, the Banner Alzheimer’s Institute and the National Institutes of Health.

The effort will administer crenezumab to 300 individuals who are members of families that have been identified as carrying genes connected to early onset Alzhemier’s. The goal is to find out, as stated in a Genentech news release, “if we intervene before cognitive function deteriorates, can we prevent the disease?”

If the answer is yes, it could be a game-changer for those who carry genes increasing risk for Alzheimer’s disease. Family histories and gene sequencing could give individuals crucial information about their risk status, and those who are at higher risk could take crenezumab or another beta amyloid-interacting drug.

Plaques, tangles and the biology of dementia

Scientists have examined the atrophied brains of the severely afflicted and found plaques and tangles. Researchers found these are associated with a complex, sticky material called beta amyloid that seems to be more present in the brains of those with the severest symptoms than in normal adults’ brains.

It’s not quite clear whether the plaques and tangles this material forms are the sole or primary cause of the memory problems and other mental deficits seen with Alzheimer’s patients. Alternatively, the material might be the result of nerve cells coping with the disease, and thus an effect, not a cause.

Scientists have slowly been discovering certain compounds that interact with the plaques and tangles in potentially therapeutic ways. Laboratory science will have real world medical benefits if crenezumab prevents the formation of the plaques and tangles, and slows or prevents dementia symptoms.

Family history and genes offer clues to Alzhemier’s

Researchers have looked at different varieties of Alzheimer’s disease. Intriguingly, a minority of patients who are 30 to 60 years old have an early-onset variant. This subtype is more often inherited and called “familial Alzheimer’s disease.”

Overall, a series of genes on chromosomes connected to the disorder have been discovered, including for the more common common adult-onset Alzheimer’s type that generally afflicts those over 60. Family histories and DNA sequencing have added to what is still a very partial understanding of this condition, and researchers hope this will continue as more related genes are found.

Currently, genetic tests can detect genes that affect the likelihood of developing the memory loss and other cognitive problems characteristic of the disorder. However, the National Institutes of Health states, “It is unlikely that genetic testing will ever be able to predict the disease with 100 percent accuracy because too many other factors may influence its development and progression.”

Science may never have a completely accurate model of all such factors, but it will be very significant if crenezumab prevents or slows the onset of dementia symptoms for those that genetic tests reveal to be at risk. Those families in Columbia who show an unusual incidence of early-onset Alzheimer’s disease may be helping to push scientific knowledge into the new era of genetic medicine.

Read the whole article here.

I have been harping on the need for EHR systems developers to pay very close attention to some of the more subtle but very important aspects of EHR usability and Quality Control.

(If you are in a position of responsibility in this area and want help, don’t be afraid to get in touch, I have a deep background in usability)

Medscape reported results of a large (n=21,202) survey:

1. 26 percent of physicians say that EHR decreased productivity in their practice

2. 23 percent say they experienced more efficiency after implementing EHR.

3. 15 percent saw higher productivity after implementing EHR.

4. 5 percent reported increased practice revenue as a result of EHR.

5. 5 percent reported more medical errors after EHR implementation.

6. 5 percent experienced lower costs after implementing EHR.

7. 5 percent of physicians say the EHR had no effect on their practice.

8. 36 percent of physicians say the EHR had a positive impact on the physician-patient relationship at their practice.

9. 30 percent of physicians say EHR had a negative impact on their practice, most often citing less eye contact with the patient and less conversational time.

10. 34 percent of physicians say the EHR had no impact on the physician-patient relationship.

11. 44 percent of the physicians with EHR have already attested to meaningful use.

12. 31 percent plan to attest within the year.

13. 14 percent say they won’t attest for meaningful use.

14. 11 percent plan to attest sometime after 2012.

15. 83 percent of physicians with EHR say they plan to apply for incentives.

“Last year, CMS launched an incentive program that bestows up to $44,000 under Medicare or up to $64,000 under Medicaid on clinicians who demonstrate meaningful use of EHRs, with “meaningful” defined as improving and streamlining the quality of patient care. In 2015, penalties kick in for physicians who have yet to go digital with Medicare patients.

Medical societies routinely suggest amendments to proposed federal regulations in a process that resembles negotiating the price of a car: The government comes in with high demands, the medical societies lobby for the bar to be lowered, and the final regulations usually land somewhere in between.

That kind of haggling occurred in 2010, when CMS proposed its so-called stage 1 measures for meaningful use. One measure was that physicians must electronically transmit at least 75% of their prescriptions to pharmacies. The societies said these standards were too tough, and CMS subsequently relaxed them, setting the electronic prescription threshold at just 40%, for example.

The same give-and-take is shaping up for the proposed stage 2 measurements, which will take effect in 2014, except that the changes sought by the societies are far more extensive. The medical societies recommended, for example, that CMS survey physicians on stage 1 meaningful use criteria to find out what worked and what did not, what kept participation in the incentive program at a low level in 2011, and what should be done to improve stage 2 measures. Only then should the government proceed with raising the bar, the medical societies said.

In addition, the societies want CMS to drastically alter its timetable for penalizing physicians under Medicare for failing to demonstrate EHR meaningful use. Under the proposed stage 2 criteria, CMS would dock physicians 1% of their Medicare pay in 2015 based on their performance either in 2013 or the first 9 months of 2014. “CMS is essentially pushing up deadlines for participation by up to 2 years,” the medical societies stated. It urged an end to this so-called backdating and said that CMS should allow physicians to avoid the 2015 penalty by demonstrating meaningful use in the first half of that year.”

A minor theme of my dissertation was the particular issue of knowledge representation for cardiac “body knowledge” or “body cognition” disorders compared to autism. Psychiatrists, neurologists, pediatricians, psychologists, and other clinicians wrestle with how different one autistic patient is compared to another. The new classifications for autistic spectrum disorder coming out in the 2013 DSM-V will re-work how autism is defined, hopefully leading to better diagnoses. I write about this issue for DailyRX:

“Much discussion has centered on exactly who should be considered autistic, based on which diagnostic rules doctors should use. Diaglogue among clinicians, scientists, and patient advocates has focused on the proposed reworked definitions to be published by the American Psychiatric Association’s Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders in mid-2013.

Currently, the 4th edition of the DSM categorizes autism, Asperger’s disorder, childhood disintegrative disorder, and “pervasive developmental disorder not otherwise specified” as separate conditions.

If the proposed changes are indeed ratified and published, the larger category of “autistic spectrum disorder” will be used to categorize individual experience and behavior, ranging from mild to severe impaired functionality.”

“Companies have tried to collect reviews of doctors since the early days of the Web, and RateMDs.com has gathered more than most. The founder, John Swapceinski, was inspired to create it after his success with a site called RateMyProfessors.com, which is well known for the “hotness” rating that college students assign (or not) to their teachers.

“Anything that people spend time or money on ought to be rated,” he said. RateMDs now has reviews of more than 1,370,000 doctors in the United States and Canada.

But getting in the faces of the previously untouchable professional class has inevitably led to legal threats. He says he gets about one each week over negative reviews and receives subpoenas every month or two for information that can help identify reviewers, who believe they are posting anonymously.

Over at Angie’s List, service providers have sued reviewers, whose names are known to the company, “a handful” of times, according to the company. Angie’s List has paid their legal fees in the past, but a co-founder of the site, Angie Hicks, said she could not commit to doing that in every case in the future.

None of the litigants at Angie’s List have been doctors so far, but that doesn’t mean they are thrilled with her health reviews. “They told me that ‘patients aren’t smart enough to figure out whether I’m a good doctor,’ ” she said. “But I told them that these conversations have been happening all along.” The only difference with the site, she pointed out, is that the doctors get to listen in.

Some doctors have silenced patients anyway. Several years ago, a physician reputation management service called Medical Justice developed a sort of liability vaccine. Doctors would ask patients to sign an agreement promising not to post about the doctor online; in exchange, patients would get additional privacy protections.

This struck me as the height of audacity, and when I shared my feelings with the company, I was informed that the agreements had outlived their usefulness. What neither its vice president of marketing, Shane Stadler, nor its founder and chief executive, Jeffrey Segal, told me, however, was that the company had retired the agreements in the wake of a lawsuit related to them and a complaint filed with the Federal Trade Commission.

Medical Justice has now turned 180 degrees and embraced the review sites. It helpfully supplies its client doctors with iPads that they can give to patients as they are leaving. Patients write a review, and Medical Justice makes sure that the comments are posted on a review site.

Sound coercive? Not to Mr. Segal, a lawyer and former neurosurgeon who says he has 150 to 200 active physician accounts for the service. “The reality is that every health care system is asking for feedback, even Medicare,” he said.

Other doctors have taken matters into their own hands. Writing in the online magazine Slate in 2008, Dr. Kent Sepkowitz, of the prestigious Memorial Sloan-Kettering Cancer Center in New York, gleefully recounted his creation of fake reviews on a couple of sites.

These physicians are probably outliers, though. The American Medical Association speaks for most doctors. Robert Mills, a spokesman, sent me a statement that he said was from the A.M.A.’s president, Dr. Peter W. Carmel, that read, in part, “Anonymous online opinions of physicians should be taken with grain of salt and should not be a patient’s sole source of information when looking for a new physician.”

This, however, is almost exactly the same statement it provided to its own publication, American Medical News, in 2008, when it was attributed to Dr. Nancy H. Nielsen, the president-elect of the A.M.A. at the time. Had they achieved some kind of mind meld?

When I pointed this out to Mr. Mills, he got Dr. Carmel to the phone rather quickly.

“To advise people anonymously through an open site when this is an important decision for people’s lives, I don’t think it’s proper,” Dr. Carmel told me. “The evidence that’s given on many of these consumer sites is undocumented, unverified and anonymous. It may well have nothing to do with actual patient treatment.’”

“Bellevue, Wash.-based health IT vendor Edifecs surveyed 50 healthcare professionals representing payors, providers, government and other stakeholders at its February ICD-10 summit and published the results in a Feb. 27 white paper.

There was less consensus regarding the effects of a one-year delay compared with a two-year delay, indicating a majority believe that the longer the delay, the more negative its consequences.

The vast majority (90 percent) of respondents believed that the deadline should not be moved more than a year. Questioned about a one-year delay, 58 percent of respondents said it would be “costly, but manageable” compared to 37 percent who said it would be “beneficial.” Questioned about a two-year delay, 56 percent said it would be “potentially catastrophic,” 22 percent said it would be “costly, but manageable” and only 4 percent said it would be “beneficial.”

While moving the deadline provides organizations with more time to comply, researchers indicated that the major concern with a delay is cost. Many organizations have contracted with consultants or hired employees specifically for the transition to ICD-10 and will now have to decide whether they will continue setting aside funds for those positions or if they will be cut, researchers wrote. More than 70 percent of respondents said they believed that the Centers for Medicare & Medicaid Services (CMS) should reimburse organizations for the delay, 49 percent predicted an 11 percent to 25 percent increase in total ICD-10 transition budgets for each year of delay and 37 percent predicted a 26 percent to 50 percent increase in total ICD-10 budgets for each year of delay.

The uncertainty surrounding a new timeline for implementation is currently most stressful for healthcare organizations, according to researchers, who suggested that quickly completing an evaluation should be the top priority for the CMS.

“In 2009, Americans spent $7,960 per person on health care. Our neighbors in Canada spent $4,808. The Germans spent $4,218. The French, $3,978. If we had the per-person costs of any of those countries, America’s deficits would vanish. Workers would have much more money in their pockets. Our economy would grow more quickly, as our exports would be more competitive.

There are many possible explanations for why Americans pay so much more. It could be that we’re sicker. Or that we go to the doctor more frequently. But health researchers have largely discarded these theories. As Gerard Anderson, Uwe Reinhardt, Peter Hussey and Varduhi Petrosyan put it in the title of their influential 2003 study on international health-care costs, “it’s the prices, stupid.”

As it’s difficult to get good data on prices, that paper blamed prices largely by eliminating the other possible culprits. They authors considered, for instance, the idea that Americans were simply using more health-care services, but on close inspection, found that Americans don’t see the doctor more often or stay longer in the hospital than residents of other countries. Quite the opposite, actually. We spend less time in the hospital than Germans and see the doctor less often than the Canadians.

“The United States spends more on health care than any of the other OECD countries spend, without providing more services than the other countries do,” they concluded. “This suggests that the difference in spending is mostly attributable to higher prices of goods and services.”

On Friday, the International Federation of Health Plans — a global insurance trade association that includes more than 100 insurers in 25 countries — released more direct evidence. It surveyed its members on the prices paid for 23 medical services and products in different countries, asking after everything from a routine doctor’s visit to a dose of Lipitor to coronary bypass surgery. And in 22 of 23 cases, Americans are paying higher prices than residents of other developed countries. Usually, we’re paying quite a bit more. The exception is cataract surgery, which appears to be costlier in Switzerland, though cheaper everywhere else.

Prices don’t explain all of the difference between America and other countries. But they do explain a big chunk of it. The question, of course, is why Americans pay such high prices — and why we haven’t done anything about it.

“Other countries negotiate very aggressively with the providers and set rates that are much lower than we do,” Anderson says. They do this in one of two ways. In countries such as Canada and Britain, prices are set by the government. In others, such as Germany and Japan, they’re set by providers and insurers sitting in a room and coming to an agreement, with the government stepping in to set prices if they fail.

In America, Medicare and Medicaid negotiate prices on behalf of their tens of millions of members and, not coincidentally, purchase care at a substantial markdown from the commercial average. But outside that, it’s a free-for-all. Providers largely charge what they can get away with, often offering different prices to different insurers, and an even higher price to the uninsured.

Health care is an unusual product in that it is difficult, and sometimes impossible, for the customer to say “no.”

Some chatter on this at: http://www.icd10watch.com/blog/we-still-have-icd-10-implementation-plan

Over at DotMed, here is some scuttlebutt:

How long the delay would be for isn’t known. Still, the news drew praise from the AMA, which formally announced its opposition to the October 2013 ICD-10 deadline in a meeting last November.

“The timing of the ICD-10 transition could not be worse for physicians,” Dr. Peter Carmel, AMA’s president, said on the group’s website this week. “Burdens on physician practices need to be reduced — not created — as the nation’s health care system undertakes significant payment and delivery reforms.”

In defense of the current deadline, HIMSS said many of the “larger providers” have already taken steps necessary to put ICD-10 in place in time. In fact, HIMSS said 90 percent of 302 health care IT executives responding to its recent leadership survey said they would meet the original deadline, according to a study the group intends to share next week at its annual conference in Las Vegas. HIMSS also said 67 percent of respondents to the survey said ICD-10 implementation is their number one financial IT priority.

“While HIMSS understands and recognizes that there are providers facing resource challenges to meet the compliance date, the conversion to ICD-10 code sets will affect more positive outcomes for patients,” the group said in its announcement.

Of course, ICD-10 isn’t the final stop on the line. As America braces for ICD-10, ICD-11 is already in the works.

The actual writ from HHS:

HHS announces intent to delay ICD-10 compliance date

As part of President Obama’s commitment to reducing regulatory burden, Health and Human Services Secretary Kathleen G. Sebelius today announced that HHS will initiate a process to postpone the date by which certain health care entities have to comply with International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10).

The final rule adopting ICD-10 as a standard was published in January 2009 and set a compliance date of October 1, 2013 – a delay of two years from the compliance date initially specified in the 2008 proposed rule. HHS will announce a new compliance date moving forward.

“ICD-10 codes are important to many positive improvements in our health care system,” said HHS Secretary Kathleen Sebelius. “We have heard from many in the provider community who have concerns about the administrative burdens they face in the years ahead. We are committing to work with the provider community to reexamine the pace at which HHS and the nation implement these important improvements to our health care system.”

ICD-10 codes provide more robust and specific data that will help improve patient care and enable the exchange of our health care data with that of the rest of the world that has long been using ICD-10. Entities covered under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) will be required to use the ICD-10 diagnostic and procedure codes.