Top 10 Government Health IT stories of 2014

Big data. Cybersecurity. EHR interoperability. ICD-10. Patient privacy.

Those and the Defense Department’s mammoth electronic health record procurement and Veterans Affairs proprietary VistA EHR dominated reader interest during the last 12 months.

Some of these topics — notably the ostensibly out-of-nowhere ICD-10 delay by Congress — were quite surprising while others have been brewing for years and will likely continue well into 2015 and beyond.

Without further ado, then, here are the ten most popular Government Health IT articles of 2014.

1. Avoiding interoperability pitfalls: Best practices for sustainable HIE: Applying hard-learned lessons to the real-world challenge of health information exchange is going to be critical to its success. “Sustainability requires that you think through the long-term community value for an HIE asset. Without advance planning, you may realize years down the road that your organization has not put the right infrastructure in place to manage new care models.”

2. Top 3 issues facing patient privacy: “You have greater privacy rights regarding the size of a shirt you purchased online than you do about information in your mental health records …” And so begins our look at three biggest issues in the electronic health records era where “it’s possible to improperly disclose identifiable electronic health information of millions of patients almost instantly.”

3. The dark side of the bill pushing back ICD-10, SGR: “It’s a sham. It’s a lie. Nothing but gimmicks,” one U.S. Senator said, another claimed it “violates the budget,” while a third  challenged any of the voting Senators to publicly state that they had actually read the Protecting Access to Medicare Act of 2014. None did. Nor did anyone mention ICD-10 or the provision prohibiting Health and Human Services from mandating a compliance deadline before Oct. 1, 2015. But the bill passed and kicked the Sustainable Growth Rate can on down the road, pushing ICD-10 back along with it.

4. ICD-10 — the day after: ICD-10 has many in the industry afraid but the conversion itself is not what concerns John Showalter, MD, the most. “I know for a fact that the CIO or someone is going to ask me how ICD-10 is on about October 7 and I won’t know,” Showalter, CMIO of University of Mississippi Medical Center said. “The first 90 days, I know my physicians are going to do this, they’ll ask me how they’re doing and I won’t be able to tell them.” Indeed, Showalter is predicting a blackout period in the first few months after the compliance deadline — whenever that day may come.

5. 3 questions with IBM exec on Apple, Epic and the DoD: In what is at least a strong contender for most surprising partnership of the year, Apple aligned with IBM, a deal that will see Big Blue resell and support iPads and iPhones. The head of IBM’s public sector unit discusses that opportunity, as well as the potential for an Epic EHR to come pre-loaded on Apple devices and what the vendors might be thinking about pursuing the DoD’s open EHR bid.

6. Is Epic more interoperable than most people think? The EHR vendor taking more heat than any other for not sharing patient data went on a rare offensive in August wherein it claimed to have strong support for HL7 as well as Healtheway protocols Direct and Connect. President Carl Dvorak claimed Epic connects to 26 other vendors systems, 21 HIEs, 29 HISPs and 28 eHealth Exchange members.

7. 10 things DoD wants in its next EHR: Call it the EHR contract of the century, or at least the century thus far.  The Defense Department’s massive modernization climbs as high as $11 billion and we all know the potential federal deals have to grow from there. With so many bidding on the work, here’s a look at DoD’s wish list for the product it selects.

8. At VA, all 2015 budget roads lead to VistA: Congress allocated $16 billion to the Department of Veterans Affairs’ and a sizable chunk of that “is headed largely in one direction.” That would be the VA’s EHR VistA, which one analyst suggests “has fallen behind the times.”

9. The big data shift from predictive to prescriptive analytics: “With genetics and genomics using external data sources, I think the possibilities of evidence-based medicine, and being able to drive that to drive better protocols on the clinical side is endless in terms of the possibilities.” James Noga said that. As CIO of Partners HealthCare, Noga views big data as capable of not only predictive analytics but, perhaps more advantageous, prescriptive analytics.

10. ONC lays down 10-year interoperability plan milestones: No one said it was going to be easy. Or quick. ONC, for its part, is still hammering out the details of a 10-year roadmap to interoperable electronic health records and intends its plan to be something the industry can rally behind along the way to a learning health system.

These uber-trends not going anywhere anytime soon. They were all, in fact, prominent in Government Health IT reader favorites from last year.

What are you expecting to be the biggest story of 2015?

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