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Shortage of Coders Jeopardizes Health Care Reform

Michael Vizard
Slide Show

Health Care IT Still Needs Critical Care

Despite focusing on compliance and security issues, progress to date has been somewhat limited.

Health care reform may be in serious jeopardy, but it has little to do with politics or any forthcoming rulings emanating from the highest court in the land.


One of the less appreciated aspects of health care reform is an International Classification of Diseases, 10th edition, Clinical Modifications (ICD 10) requirement that calls for a completely new approach to the codes that are used in the electronic medical records (EMR) that hospitals rely on to classify patients. There are not only new codes in ICD-10, there are also additional digits because health care organizations have run out of digits to classify various medical procedures and conditions.


Scheduled to be implemented by Oct. 1, 2013, Pradep Nair, senior vice president for health care at HCL America, a unit of HCL Technologies, says ICD 10 is the health care equivalent of the Y2K projects that required so much coding effort starting back in 1998. But it turns out that there is a serious shortage of people who know how to code for ICD 10. The end result, says Nair, is that there is some serious doubt about attaining the health care IT goals for 2013 that have been mandated by the U.S. Department of Health and Human Services. In fact, if a health care organization is not already working on this transition, Nair says the chances are good that it's unlikely that organization is going to make the deadline.


This is a significant issue, says Nair, because a huge amount of the data that needs to be accessed is locked up in mainframe systems that health care providers and insurers have been relying on for years. The ICD 10 requirements mean that these organizations are being forced to embark on massive application modernization projects. Some health care organizations are so ill-prepared to finance this modernization that Nair says it's likely we'll see some significant mergers and acquisitions across the health care industry.


No one knows where the U.S. government will be compelled to grant extensions, but Nair says that it is unlikely that even a new administration would halt the shift to EMR because both political parties are keen to reduce health care costs. So, no matter what, the pressure is on.


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