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Federally-Mandated Medical Coding Gums Up IT Ops
Lucas123 writes "The change over from a medical coding system in use since the 1970s to an updated version that adds more than 50,000 new 7-character codes is being compared to Y2K as an IT project that is nearly impossible to complete on time. ICD-10, which replaces ICD-9, adds far more granularity to medical diagnosis and treatment. For example, ICD-9 has one code for a finger amputation. In contrast, ICD-10 has a code for every finger and every section of every finger. An 'unfunded mandate,' the change over to ICD-10 codes is a multi-year project for hospitals, state Medicaid organizations, and insurance providers. The effort, which affects dozens of core systems, is taxing IT operational budgets at a time when shops are already under the gun to implement electronic health records."
Surely if the specification lists the data in a structured way, they don't need to be hard-coded. Can't you just stick them all in a database and do lookups? Can't the authority give that the requisite structure?
"But everyone should know everything." -markab
Medicare, like any insurer may change it's paperwork in an effort to make the process more accountable. As it's an international standard that has already progressed to ICD-10-CM, it's probably about time.
The force that blew the Big Bang continues to accelerate.
the people who dreamt up the new coding system didn't even try to make it backward-compatible with the old one, hence the headaches and waste of money.
If ICD-10 was a superset of ICD-9, in a way similar to how UTF-8 is a superset of ASCII, the transition would be perfectly seamless and painless...
"A door is what a dog is perpetually on the wrong side of" - Ogden Nash
http://www.wfaa.com/news/texas-news/Man-dies-while-raping-elderly-South-Texas-woman-123777409.html
I can't decide which is more surprising: that this guy rode his bike 2 miles to rape a granny, that he was a paroled sex offender, or that he was a spic.
An 'unfunded mandate,' the change over to ICD-10 codes is a multi-year project for hospitals, state Medicaid organizations, and insurance providers. The effort, which affects dozens of core systems, is taxing IT operational budgets at a time when shops are already under the gun to implement electronic health records."
This is good as well. Insurance company profits are ridiculous and hopefully this will force them to invest a lot of those profits in the American economy to do this work. Complaining about expense when replacing systems in a organization that is fraught with malpractice (misdiagnosis, amputating the wrong limb, dispensing the wrong medication) is ridiculous. This is akin to the government complaining about the cost of replacing infrastructure when the alternative is your car plunging in the river on your morning commute.
TFA makes no mention of meaningful use, which is really taxing things... while it was marketed as being a way for health systems to earn monetary incentives by upgrading to EMRs, in reality what's going to happen everywhere, to every health system in the coming years is that one size fits all criteria is being foisted upon them in the form of very costly IT projects.
While there is a monetary payment from the government for the first few years for being in compliance, the cost to obtain financial reward X is significantly greater than X, but you have to do it anyway because non-compliance will result in heavy fines eventually.
And all these expenses are being piled on in economic times when health systems are already being crushed financially due to the state of the economy (lower patient volumes in general), terrible medicare/medicaid payouts, and the weight of supporting the government-insured, under insured, and uninsured (in that order) in general.
I know it's no surprise that national-level HIT management by the federal government has turned out to be not so grate akshully, but it is worth pointing out that Meaningful Use in the health care reform legislation is much worse than ICD-10
In my last project i was involved in making a tool called HPower10 which will allow organizations to effectively migrate from ICD 9 - 10. Similarly i was also a part of a HIPAA 4010-5010 migration tool. You can find more details here: http://www.hexaware.com/icd-transition.htm
I'd love to be apart of that product manager's commission :( so what if it's going to take 5-10 years...
It may be an "unfunded mandate", but it will probably help eliminate thousands of medical errors (mistaken amputations, incorrect medicine given to patients, etc.)
How hard could this be? Isn't there a conversion table so you can (using the finger example) - mark all legacy data as the first finger, first joint - with a migrated data flag so you know it's probably not digit accurate?
Do they seriously have to review each record to get it right for old data? If so - that is unreasonable.
Are you telling me this is going to happen ?? Think of the children !! Why am I not surprised /. is supporting this ?? It's true. /. are co
HOLD ON !!
Scratch that. I was reading the text on the stall;s wall here.
The effort, which affects dozens of core systems, is taxing IT operational budgets at a time when shops are already under the gun to implement electronic health records.
For the most part, this isn't my problem.
ICD-10 has been on the radar for a while now. At least a couple years. And it's Federally mandated. So we didn't have any problem adding the necessary funds to our budget this year.
Each of our HIS vendors has already got ICD-10 stuff ready to go. We'll have to pay them for their time, or a software release, or whatever... But, as far as my own labor is concerned, it'll basically involve giving them remote access or throwing a disc in the drive.
Most of the labor involved is in our coding department. They're going to have to send folks out to get (re)trained in the ICD-10 stuff. They are, understandably, a little stressed. But they've been working on this for a while, too.
"Work is the curse of the drinking classes." -Oscar Wilde
Due to that update, one guy almost lost a hand, as he was mistakenly sent to amputee it.
At the risk of sounding like I'm sending in a Whaaaaambulance, this seems like a worthy project. Seriously, is anyone suggesting that we should still be stuck in the 70s with healthcare diagnostics? It would be a frigging laugh if someone suggested that since it's too difficult for IT to do, healthcare diagnostics should not try to catch up to where it should be.
And really? The Feds needed to mandate this to get it done? With all the noise about how private healthcare really has out backs and we don't really need government healthcare, this seems like a pretty good example of exactly why we DO need government healthcare.
No sympathy for the whiners.
As the spouse of a Physician (hospitablist) and a System Admin for a medical practice, I can tell you first hand that is a cluster f&*%. The effect this crap is to slow down physicians with tasks that they really should not be doing, (read data entry). That is exactly what these regulations are doing. And to keep productivity up, some doctors are resorting to hiring scribes who follow them around, just increasing costs that will get absorbed somewhere. It all looks good on paper but the effect is reducing productivity of the people on the front lines.
Conservative, mod down for violating
being compared to Y2K as an IT project that is nearly impossible to complete on time.
That sounds like good copy to a lowly journalist, but as someone "who was there" during Y2K, what was "nearly impossible"? We knew it was coming, we planned, the bosses mostly used it as an excuse to semi-fraudulently ram upgrades thru and as a powerful weapon to grab more budget money. It was way, big time, trivial.
Besides, just think about it. The entire world's IT department, all those guys who can't close open relays, blah blah blah all somehow 100% successfully did the nearly impossible... yeah uh huh.
"Science flies us to the moon. Religion flies us into buildings." - Victor Stenger
While this is definitely a huge pain, I have little sympathy for those complaining about the timing of this when the standard was finalized in 1992.
ICD-10 has been out for nearly 20 years. There was a 5 year timeline to get ICD-10 implemented, and there was likely a few years of discussion with major Medi* billers before that to let them know this was coming along.
Much like the FCC and HDTV, health care companies must have ignored the mandates until it was too late, whined and cried about how they couldn't meet such a strict deadline and pretty please can we extend it for another 5 years. Repeat until our health care records system is completely unusable.
Though, wow, I would have thought VistA would have ICD-10, but it's being bolted on now. Strange.
What is the ICD-10 code for being a dickless idiot. They could save time by automatically adding it to the record of all Federal employees. OK - maybe not the FBI - honestly I didn't mean you, I was just sayi.....
And this is why Government interference has made health costs skyrocket. My great-grandfather practically lived in a hospital during the late 40s and early 50s (he was paralyzed). Back then it was possible because the cost of the room was no more expensive than renting a hotel room. He was a poor farmer, but still able to pay the bill out of his own pocket.
So what's changed since then?
- Government regulations that require TONS more paperwork (like ICD-10), additional labor just to do that paperwork, and thereby cause costs to skyrocket.
My AC stalker: " I personally agree with your posts most of the time, but that won't keep me from modding you troll"
If you really have a problem with extending a field by a few bytes, you're using the wrong language. By now, you should expect the world is going to change constantly. If it's a surprise to you at this point congress is going to re-invent healthcare ever two years to boost their ratings, please beat yourself with your keyboard.
Let me guess, the people complaining are using z/os hardware and wrote everything in cobol accessing a ADABAS database. Some idiot business manager said, "It ain't broke, lets not upgrade" and decided to continue using their billion dollar IBM dildo for the next 15 years.
Not so hard as they say, ICD10 to ICD9, I did it before from pseudo ICD9 to real ICD9, just gimme a job. I think the real problem is within health professional workers. :)
Don't visit the link above, everyone. -sigh- Especially at work.
I quite don't understand the whining here. Germany for example is using ICD-10 (first in a slightly modified version, now the standard one) since 2000, over ten years!
As always the USA are only very slow in adoption but other countries have shown that it can be done and that it does not warrant the whining we are seeing here.
So shut the fuck up and just do it already. And after that continue with adoption of metric units.
maybe we can use this to pinpoint where you assholes waste so much cash
is that why you whine about it?
intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
You don't work in the medical field do you? ICD codes are built into a lot of medical applications. For a famous slash dot car analogy, this is like trying to convert a U.S. car manufacturing plant over to use all metric.
The funny part is that US car makers are already converted over to metric.
I guess it wasn't that hard.
Due to that update, one guy almost lost a hand, as he was mistakenly sent to amputee it.
.
"Work on ICD-10 began in 1983 and was completed in 1992"
As pretty much everyone else has already said, if you don't have a system that can quickly and easily update from ICD-9 to ICD-10, you're so far behind the IT implementation curve that you should be drug out into the street and shot.
It's 2011. They've had many, many years to upgrade, and now they're poised to paid by the government to do so. Hell, my employer stands to gain $50 million dollars over the next couple years from implementing key portions of the HITECH provisions in ARRA. For those reading, that's more than half of my (quite large and well-funded) health system's annual budget.
For our part, we just slapped down a couple hundred thousand for a product that hot-swaps our ICD-9 coding for ICD-10, and also tosses in a problem list that physicians can use that's tied to these coding schema, potentially improving efficiency and accuracy as well. The only excuse, and I mean ONLY excuse for ICD-10 being a problem is poor IT leadership within the health system/hospital--a failing which is incredibly, unbelievably common.
I'm lucky, I work in an IT shop that actually has its shit together.
What they are saying is that ICD-10 is implemented through ID-10-T managment?
I try to think of these kinds of things as "job security". Yes, they're a headache for all involved. Self-centered and a bit callous, I know, but then again those traits are the basis for modern capitalism.
...XML!
. . . is that you don't need to change historical data. There is a hard, day forward switchover date in October 2013. The lookup problem is that there is not a one to one relationship between the old codes and the new ones. The lookup would need to contain a level of intelligence that just simply isn't contained anywhere within the context of the data set. This means that every level needs to comply to get the data. You don't just need the space for the correct number of digits, or add logic to append a "19" or "20" in front of your year. - The doctor needs to be retrained (NOT an easy task since many already "know" everything they will ever need to know) to record the information from the encounter with the patient. - Then the coder needs to select the right codes (assuming the system they use can even handle the new codes). - The billing system needs to be capable of transmitting the new codes (new EDI x-12 rules go into effect in Jan 2012 to support this) - The payer's claim system need to be able to store the new codes - The contract between payer and provider on what amount will be paid for what service needs to be completely rewritten - The payer's examiners / adjudication process must be able to interpret the codes vs. the treatment codes to decide whether to pay the claim at all (Diagnosis = stubbed toe: treatment = removed kidney. . . no pay)
"Federally-Mandated Medical Coding"? Why are you hyphenating with an adverb ending in -ly? What is with this trend? It's redundant. Either drop the hyphen or drop the -ly. Or "Federal Lee-Mandated" if someone in the federal government named Lee is doing the mandating.
And "The change over from..."? In this context, "changeover" is one compound word.
This is one of the ways that the government "creates" jobs. Now we just need for them to mandate telephone sanitizers.
I thought the 2009 stimulus package had $30 Billion which was to be paid to hospitals to update their systems? The only backup I have for this is an I, Cringley article I read over the weekend but I'd feel he'd of all IT writers would be a reasonably reliable and impartial source. Definitely a far more reliable source than the average Slashdot submission.
"All great wisdom is contained in .signature files"
ICD-10 IS a dramatic improvement over ICD-9, and you want hospitals to invest the time to implement it. Why?
- The US is the only industrialized in the world that is not using it (this matters if you want your medical records to be accessible when you travel)
- ICD-9 cannot accurately characterize diseases with enough granularity for use besides billing (this matters if you want electronic health care records that are accurate, enable things like clinical support systems, and better medical research)
- With ICD-10 and more specific links between disease, we can better track the progression of disease through populations (this matters if you want get the bird flu and want proper treatment and response, which in ICD-9 is characterized as "pneumonia" because theres no code for it)
So I understand that theres a knee-jerk tendency to say "the man is foist all this on me!" But this time the men, and women, are making an improvement thats going to save lives and money in the long run.
We're waiting to leapfrog from ICD-9 to ICD-11. We're expecting to save a boatload of effort that way.
the preceding comment is my own and in no way reflects the opinion of the Joint Chiefs of Staff
I am a programmer for one of the largest hospitals in Chicago, and I can tell you from our perspective this is a nightmare.
For example, we have sets built for each area in the hospital to make it easier for clinicians to choose a diagnosis such as when they are updating the patients problem list (part of Meaningful Use) or ordering. Someone in Hem-Onc probably will never have the opportunity to enter a diagnosis for amputation so we remove that option for them. These sets will all need to be rebuilt. By hand.
In addition, for each procedure or medication there is a linked diagnosis for billing. All of these medications (we have over 100k in our system right now) and procedures (over 50k) will need to be re-linked to the new appropriate diagnosis. And it's not as easy as "All procedure X should be linked to diagnosis group Y", it's much more fine grained than that.
Then there are clinical concepts that will need to be linked, such as those released by IMO and SNOMED.
And the interfaces to external systems, be it radiology, billing, or external like NEBO will have to be modified to distinguish between ICD-9 (for historical data) and ICD-10 and send the appropriate HL7 messages.
And the reports that are based on ICD codes. Oh, the reports.
This whole thing is a real headache.
But I do agree that, since ICD-10 was finalized in 1993, and has been in use around the world since around then, EMR vendors should have seen this coming and at least built nice tools to make it easier.
What's the issue here? Some slow-to-evolve hospitals are complaining they can't keep up? Any system that has a decent EHR can implement ICD-10 with relative ease. Even the federal US Department of Veterans Affairs has been working on planning its implementation for years now, so, if the government can even do it - why can't all these "advanced" private sector places do it on time? Rubbish.
Pardon me for stepping in your Ayn Rand fantasy world, but that's not the important thing that's changed. Costs of government mandated paperwork are not a significant part of the problem of exploding costs. Deregulation of the insurance industry and over-regulation of drug sales and production have been much, much worse on the bottom line.
Speaking as a person working in the field of medical billing and collections for the last two decades, the problem is not government paperwork - in fact HIPAA was a huge benefit to both patients and providers once the pain and suffering of implementing it was done - the problem is mostly in the private sector - principally the insurance companies.
Government mandates that force individuals to use for-profit insurance companies are making things worse, yes, but fundamentally the insurance industry makes money by not paying claims for as long as possible. Every day they can delay paying for your emergency C-section generates profit for them. In practice, this is a Darwinian "invisible hand" acting on insurance providers that selects for inefficiency and poor customer service. The insurance company that is the slowest to pay, and pays the least, makes the most profit, and then buys out the faster, better paying providers. Thus an entire secondary industry has sprung up that does nothing but force insurance providers to pay up, generally by creating and tracking massive amounts of paperwork.
Government is not fixing the problems, but it's not creating them by mandating paperwork - it's perpetuating them by pandering to "all regulation is bad" ideologues who are preventing simple and effective health care regulation. Things will get worse if the government continues to permit the consolidation of private insurance companies. Things were vastly better before the insurance companies were allowed to buy each other out by the Reagan and Clinton administrations, who never met a monopolist they didn't like.
If the automobile and health industries were nationalized, we could solve these economic incentive misalignments, eliminate income tax, and still balance the budget. If individuals were free to decide for themselves what drugs they should be allowed to take, the costs of medical testing would drop through the floor. But nobody will back those simple measures, because the right wing won't stand for nationalizing of rich men's cash cows, and the left won't stand for letting people make their own mistakes.
Hmm, I have to code my charts all the time - but maybe that has to do with working at a University, and the patients are pretty varied.
This is overlooked time and again.
Our software has supported both longer than I can remember so I don't get what the point is. ("coding system" + "code") is just a surrogate key into a bigger table of codes. Does software actually exist that uses an ICD-9 code directly as a key? LOL. Amateurs. (Unfortunately, it seems a lot of medical software is actually written by medical people, who at the end of the day don't have a clue about software. Or DB design.)
Hello,
I am a surgeon, and I can tell you a lot of the cost is from all the middle men (ins companies), and defensive medicine. It's not the doctors who are making the big bucks. One of my patients said to me.
"Yeah Doc, the bill was big, but your part of the bill was peanuts - I feel sorry for you."
Most MDs pay about 10% off the top of profits for a billing service because it's so complex.
Many additional x-rays, lab tests are also ordered because we worry about "missing" something, and being sued. There are articles published about MDs doing that - its a real phenomenon. That's probably another 10% as well.
Large malpractice insurance (average $30k to $200K per year!!)- guess who has to pay for that...
Insurance companies - they are a new middle man. A whole industry has popped up, and the patient care has to burden the cost. They also inundate doctors offices with paperwork (20 page disability forms)- making it a pain in the ass to collect money. Many groups hire Physician assisstants to fill out paperwork, because there is so much of it.
SO yeah - costs have gone up,
..........FULL STOP.
I am not a medical doctor but in my opinion: Health insurance was supposed to spread the high cost of unlikely treatments among the people purchasing it. Since higher volume leads to higher profits for the insurance companies, health insurance morphed into paying for low cost, high-likelihood procedures as well. There is reinforcing feedback since more volume means higher profits at a fixed profit percentage. The side effect is that executive salaries skyrocket since they are managing more money. Also, since direct feedback to the insured person's wallet was removed, every insured person does not consider if the procedure is worth the cost at the time of service. They are "paying for" and "need to get their money's worth from" the insurance so they deserve the procedure whatever the cost and whatever the efficacy. Of course, this causes costs to spiral upwards. The insured get their medical benefits, the insurance executive get higher profits, the doctors get higher profits, and insurance costs keep going up. Executive then try to start excluding insured with expensive conditions from their insurance rolls, start charging different rates for different age brackets, and blocking people with lapses in coverage from getting insurance unless they have no preexisting conditions. In my opinion, health insurance percent coverage of treatment should be based upon what percentage of your life you have purchased health insurance coverage and not on whether you could get and pay for health insurance that month.
The ICD-9/ICD-10 change over is a ballbuster, but is far from the worst of the lot. Useless "meaningful use" requirements based on closed standards that aren't complete or even accurate, at best, and contradictory at worst and the clusterfuck of the new ASC X12 formatting are both bigger pains in the ass, though I guess I'm lucky that the software I work on was at least clueful enough to store the codes in a database...
I'm on my 6th week of overtime now thanks to this BS.
- What is the ICD10 code for the middle finger, because that is the basic system we have for health care in this software industry.
- The ICD9, 10 codes are driven by insurance and payment systems. There would be a more health based system if there was single payer health care in the country. The VA had the biggest most robust electronic health record system, but it was tossed away like Microsoft throws away standards for profits.
- Lack of standard API and billing considerations make the competing software systems incompatible anyway, think early file transfer between MS and Apple and Unix and IBM mainframes. Think competing ERP systems and "seamless" integration of SAP and Oracle business systems. Not happening.
- The lack of user interface design and design errors in electronic health record software is killing people. And vendors do not get nailed for the deaths, blaming
the "users" for basic design problems.
Yeah, I did that stuff for a living, it was worse than when I made nuclear weapon launch systems. I am a bad person. But not as bad as the insurance company presidents. And I post AC for a reason.
Having gone through an entire long term consulting gig assessing EMRs (electronic medical record packages) and installing and helping to run and EMR for a largish medical practice, I've seen firsthand a bit of the mess that is IT in medical practice. IDC-9 and IDC-10 are just the tip of a very big iceberg. It is already (for all practical purposes) impossible to run a medical practice even with IDC-9 without an EMR and practice management interface. These electronic tools are very expensive initially, a total pain to maintain (and an ongoing expense to maintain), and more often than not terribly designed and clunky for the physicians, nurses, lab, and office staff to use. IDC-10 is the icing on the cake -- with it it is absolutely impossible to try to continue to operate "by hand". The government is armtwisting medical practices towards the use of electronic medical records and practice management in various other ways -- notably by promising a time (soon) where in order to be reimbursed for various services e.g. medicare a practice will have to file electronically.
As has been pointed out, although there are various (completely inadequate) standards for EMRs in play out there, "compatibility" is a low bar to clear and everybody adds their own bells and whistles, making any sort of switch between EMRs a major data port and conversion problem. Training and service, often as not, involves phone banks in India and opaque accents. Many/most of the EMRs have for all practical purposes no serious internal security -- no encryption of connections, trivial authentication, and rely on vpns and control of the internal network for security. Of course HIPAA provides no useful security guidelines in the first place, so the more you can make security someone else's problem, the more profitable your EMR is. In general, scaling of EMRs is poor (with a few large scale hospital-based exceptions) and they are, of course, enormously Windows-centric because that too makes a lot of things somebody else's problems. Such as security, installation, cost, scalability...
It's really quite sad. EMRs "should" make medical practice much more efficient and facilitate a large portion of the enormous burden of documenting everything in real time for physicians, in addition to facilitating billing and insurance claims and the overall practice financials and access to e.g. labs and other auxiliary services. Most do, to some extent, accomplish these goals. But they fall far, far, short of what they could accomplish, especially with a truly portable EMR interface that wasn't locked to any particular operating system and that had a "real" security layer in place. Having real standards and a federal cross-platform cross-application certification process would make things even better -- one could actually disconnect the user interface from the back end data and let users (e.g. physicians) choose the interface that suits them best across all vendors on any common database back end.
Too bad this will absolutely never happen...
rgb
Even when the experts all agree, they may well be mistaken. --- Bertrand Russell.
What I think TFA is trying to express is NOT limited to ICD. That's a "low hanging fruit" which doesn't include the other coding enhancements required for EHR conformance. ICD is a way of expressing complains and maladies via a coded system so that everyone can understand it if it appears as a part of your public medical record. In other words, everyone has to say code xxxx1 = "breast cancer" so that when you show up in an ER 6 months after a diagnosis, they can tell what's going on. The elephant in the room isn't the malady descriptions, its the coding of procedural treatment (SNOMED-CT), laboratory procedures (LOINC), RX allocations (RXNORM and the NDF), and how its billed back to insurance (CPT), and more importantly how they interconnect.
We make EMR systems targeted towards radiology, and I can say with conviction that the whole CCHIT process has thrown GE and Siemens (and their ilk) into absolute chaos. They are, today, faced with fixing their old systems to be modern/conformant, and then trying to keep them updated going forward on a MUCH more aggressive maintenance schedule than they are used to. Oh, and every month that they can't do it, their customers will see as lost revenue from govt. reimbursements. Unenviable is an understatement, it will be a financial disaster for GE if they start losing people en masse to Epic and other new players.
As someone who makes "meaningful use" based systems, I can tell you its no joke to implement. CCHIT certification alone encompasses 25k pages of standards that have to be followed to the letter and proven via testing for qualification.
In a way, it's a strange twist that the big players (GE/Siemens/Merge) lobbied to make the qualifications as hard as they currently are in order to limit new competition, and are now sinking into the pit they themselves dug. Sick, but hilarious simultaneously.
Imagination is the silver lining of Intelligence.
Only half-joking there.
1. ICD is ridiculously comprensive as described. Also, it loses even some "human readable" sense. The old ICD9 codes at least were grouped by the body system...so you knew head injuries would at least be all in the 1xx.xx or something. The new ones are a jumble ONLY a computer lookup will do. CMS has crosswalks for free from ICD9 to ICD10 that get you most of the way there. http://www.cms.gov/ICD10/
2. The real point of all the KNOWN expensive stupidity in the healthcare system is to FORCE everybody to get bought up into a giant, Stalinist IDN (Integrated Delievery Network) eventually, so the gov't and big insurance, and big medicine can all keep huge $$$ without the pressure of real competition.
P.S. Gee...why is the AMA allowed to own and license the CPT's, the main billing codes of physicians? Why doesn't the gov't ever challenge the AMA and buy or make a new set? ICD9 and ICD9-CM are from the WHO...as is the DRG.
The healthcare system is a stupid stupid waste! There should be no such thing as a "non-profit" entity in medicine...you would see value and efficiency in about 30 secs if Docs and other peeps actually had to COMPETE for patients on the basis of value. Obama-care just entrenches the current wasteful system. It's sick.
As a former IT Admin for a medical clinic I can tell you that the medical software out there is generally outdated and usually running on older OS's and architectures. The doctors and other medical professionals want to do their jobs and not get bogged down in the technology. "If it works - don't fix it" is usually what they want - Not upgrading machines, software or anything else. Most of the time they point to the learning curve to teach people how to do things with new equipment (yes, some of the proprietary software out there is running -- still running -- on Win 98 and NT machines) or new software. Mandating EMR's (EHR) and "new" codes are good for patients for the most part. Unfortunately, Doctors and Software companies that supply them are very change resistant for a number of reasons.
I work in health, ICD10 codes have been in for ages.
Depends what country you are talking about though, this could be Switzerland? not sure, the article is a disappointingly poor on details of location, pretty unfortunate for a news site....
A quote from the troll gmhowell says it all:
"I do whatever amuses me at the moment. Sometimes that is trolling. As far as AC? I only do that to avoid undoing moderations." - by gmhowell (26755) on Wednesday April 20, @12:49AM (#35877174) Homepage
Your own words prove to us that you're online trash gmhowell, you scumbag troll.
This IS why nobody here takes you seriously, or pays you any heed: You're a troll!
The above not enough? Well, here's more from you:
http://slashdot.org/comments.pl?sid=1907528&cid=34543612
And here also:
http://slashdot.org/comments.pl?sid=2087330&cid=35846218
("3 strikes, & you're out" - And, there's NO DENYING you are a troll, gmhowell. (Especially when you admitted it there in the links above, literally, in your own words!))
George's a jerk in real life also. I know him. George M. Howell is just another dime a dozen web page flunkie http://www.google.com/search?hl=en&source=hp&q=George+M.+Howell&btnG=Google+Search who thinks he knows about computers. George M. Howell's a joke. Now that I see how he spends his time online bothering others I stand by what I said even moreso.