The former leader of the federal government's healthcare information technology push once again repeated the call for consumers to have portable health information records during a speech Monday at the American Health Information Management Association's 78th annual convention.David Brailer, who resigned in May after two years as the head of the Office of the National Coordinator for Health Information Technology at HHS, said, "Something big is at stake. Portability is not a byproduct of our work, it is a purposeful result."President Bush in 2004 helped drive the movement with an executive order calling for most Americans to have a portable electronic health record by 2014. Brailer also called on AHIMA members to help with another Bush call for increased transparency in healthcare pricing and quality reporting so consumers can make informed decisions. "Today," he said, "that's nearly impossible."Brailer, a physician and IT entrepreneur who founded a healthcare data analysis company, CareScience, said what brought him to the job in Washington was the chance to help shift power to consumers so that they would have a greater role in healthcare decisionmaking. "It's going to be a decade before that plays out," Brailer said. "That's where most of my time is going to be spent in the future, making sure that consumers have a seat at the table." Brailer praised AHIMA for its work in promoting healthcare IT. "There is no professional body in my mind today that can deal with these efforts with the same level of passion, professionalism and neutrality as you," Brailer said. He also lauded a decision by the AHIMA House of Delegates, which voted Sunday to open up membership to individuals who have an interest in the work of the association and are willing to abide by its code of ethics but who do not hold professional certification from AHIMA. AHIMA president Jill Callahan Dennis said the decision would eliminate the designation of "associate member" and offer noncertified members, including clinical documentation specialists and clinical IT specialists, greater membership rights. "We really wanted to broaden our domain," Dennis said. "We are finding we have more and more common interests with those folks." Dennis said the increased role IT has in healthcare, "isn't driving it, but it is certainly a factor." Brailer noted that in recent weeks he had called publicly for passage of healthcare IT legislation that would provide exceptions and safe harbors from Stark self-referral and anti-kickback laws for hospitals and other healthcare facilities that provided physicians with subsidies to buy IT systems. Brailer supports a provision in the Senate version of the IT legislation, S. 1418, that would grant exceptions and safe harbors only to systems that HHS certifies for "interoperability," shorthand for their capability of moving data from one IT system to another. The House version, H.R. 4157, does not contain a link between interoperability and the exceptions and safe harbors, and reconciling the differences between the two bills was a key sticking point with House and Senate staffers trying to negotiate a compromise. Congress adjourned without reporting the IT legislation out of the conference committee, and Hill watchers give it dim prospects for passage during this 109th Congress in the few weeks of the lame-duck session that remain after the Nov. 7 election. Word of the likely failure of the legislation drew a scattering of groans from attendees during a packed conference educational session on the transition from the International Classification of Diseases 9th Revision, or ICD-9, coding system to the two ICD-10 codes. The legislation set a 2010 deadline for implementation of ICD-10 in the U.S., which is in wide use by healthcare systems elsewhere in the world. Session co-presenter Patricia Wilson told attendees the conversion from the inpatient and outpatient diagnostic codes ICD-9-CM (clinical modification) to ICD-10-CM will mean a more modest increase from the current 13,000 diagnosis codes to about 30,000 diagnosis codes for the ICD-10-CM base code set, and will be "more straightforward" because the replacement codes are "direct descendants" of the ICD-9 code set. Shifting from the 4,000 procedure codes in ICD-9-CM to the 90,000 in ICD-10-PCS (procedure coding system) will be the harder transition, Wilson said, not only because of the greater number of codes, but also because they are independent of the current ICD structure and conventions. Mapping between the old and new set of procedure codes during the transition period will be much more difficult, she said.
HITS @ AHIMA Brailer presses for portable health data
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