Seven Signals of Change in 2011

CHICAGO, Jan. 12, 2011--This year promises monumental changes to health information management (HIM) as new technology, funding and policies take flight for the first time. "We have dealt with major change before but I think it is different this time because there seem to be fundamental, systemic changes occurring on a scale and pace I haven't seen in 35-plus years of doing HIM," says Lydia Washington, MS, RHIA, CPHIMS, a director of practice leadership at AHIMA. Seven stories unfolding in 2011 illustrate the sweeping changes underway, which Washington and other HIM experts discuss in the January cover story in the Journal of AHIMA. 

  1. Meaningful Use

The first group of eligible hospitals and professionals will report their stage 1 meaningful use of certified electronic healthcare technology to the Centers for Medicare and Medicaid Services for the 90-day period ending in March, while work on stage 2 criteria will continue throughout this year. 

The initial meaningful use reports should reveal whether the rule's health IT and clinical quality measures are appropriate and what impact the meaningful use had on clinical care. 

  1. Regional Extension Centers

The health IT regional extension centers (RECs) will face their first true test of effectiveness this year. Mid-2011 marks the RECs' halfway point through their first two-year government grant, and midpoint grade cards could affect future funding. 

  1. ICD-10

Coders will begin to seek refresher courses on anatomy and physiology, which is a crucial checkpoint for the approaching October 2013 implementation. The final rule that established the ICD-10 switch estimates that coders will require 50 hours of training to use ICD-10. However, coders need to seek background training in 2011 in order to master the greater level of detail that ICD-10 requires. 

  1. Health Information Exchange

Testing of a simplified version of the Nationwide Health Information Network (NHIN)-called the Direct Project-began this month. NHIN will allow healthcare organizations and health information exchanges the ability to use the Internet-based information exchange network without a formal government contract. The first round of NHIN governance rulemaking will take place this summer. 

The testing and rulemaking will dictate how all healthcare professionals must use NHIN, while ensuring that records meet privacy, security, patient consent, and data quality standards. 

  1. Health IT workforce

The first graduates of the federally funded health IT training program will emerge in March as the Community College Consortia to Educate Information Technology Specialists in Health Care. The program provided more than 80 community colleges nationwide with nearly $70 million, and is intended to produce thousands of health information professionals to assist with electronic heath record (EHR) implementations. 

  1. Privacy and security

Major modifications to the HIPAA privacy and security rules will propel unprecedented changes to HIM operations. The final rules, expected this year, will require covered entities to track medical record disclosures for payment, treatment and operations. Those covered entities that purchased EHR systems on or after January 1, 2009, must provide an accounting of all record accesses starting January 1, 2011. Entities with older systems have until 2014 to comply. 

  1. Quality measures

Medicare quality reporting programs will change as the provisions in the 2010 Affordable Care Act are finalized and launched this year. Among the provisions are insurance and Medicare regulations and value-based purchasing initiatives, which allow patients and payers to use quality measures data to select those providers who offer the highest quality healthcare at the lowest cost. Medicare will also increase the link between payments and the quality of care that is reported. 

The "Seven for 2011" report is accompanied by a sidebar highlighting eight more stories to watch this year, including the HIPAA 5010 transaction standards that are set to take effect January 1, 2012. 

Also in this issue

The January Journal of AHIMA includes our feature story, "Sorting out Advance Directives," which discusses how some directives grant access to another person's medical  records while others deny access. 

Read these articles and more in the January issue of the Journal of AHIMA or online at 


Representing more than 60,000 specially educated Health Information Management professionals in the United States and around the world, the American Health Information Management Association is committed to promoting and advocating for high quality research, best practices and effective standards in health information and to actively contributing to the development and advancement of health information professionals worldwide. AHIMA's enduring goal is quality healthcare through quality information.