John Halamka: 'Shrinking budgets' will define next National Coordinator's reign

For the next National Coordinator for Health IT to succeed in "an era of shrinking budgets," extensions of both the reporting period for Meaningful Use Stage 2 and the deadline for ICD-10 readiness may be necessary, according to John Halamka, CIO at Boston-based Beth Israel Deaconess Medical Center.

In a recent post to his Life as a Healthcare CIO blog, Halamka--a FierceHealthIT Editorial Advisory Board member--says that while former ONC chiefs David Blumenthal and Farzad Mostashari presided over the "regulatory" and "implementation" eras, respectively, the next coordinator's reign will occur in the "consolidate our gains" era.

"Grants largely run out in January 2014," Halamka says. "Budgets are likely to shrink because of sequestration and the impact of fiscal pressures."

Halamka says that the next coordinator will need to keep all of the colliding regulatory deadlines from "breaking the camel's back," calling provider compliance with all of the forthcoming new requirements "nearly impossible." In listing a series of responsibilities Mostashari's successor assume, he jokes, "I did not include parting the Red Sea, so maybe there is a mere human who could do this."

With regard to an ICD-10 deadline extension, Halamka says that it's "clear" at least six more months are necessary. "Maybe encourage voluntary ICD-10 transactions on Oct. 1, 2014, but allow a six-month grace period without regulatory enforcement for the industry to catch up with the software, training and process change needed?" he asks.

For Meaningful Use Stage 2, Halamka suggests an 18-month window of attestation. "I realize this could delay future stages of Meaningful Use, but the industry needs a breather to consolidate our gains," he says.

Halamka, who is one of several individuals thought to be in the running to replace Mostashari at ONC, raised similar concerns about looming regulatory deadlines in a post last month.

Mostashari, in a recent interview with FierceHealthIT, said that the next National Coordinator will need to focus heavily on interoperability and the sharing of information with other providers and patients. He also said that his successor must be willing to trust his or her team. "I certainly feel like I've been carried and that our rules are smarter and our policies better because of that trust in team and community," Mostashari said.

To learn more:
- read Halamka's full post

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