2011 in Review

As 2011 draws to a close I thought we’d look back over the past year and highlight some of the important events related to the intersection of nephrology and health IT. We have reviewed many of these topics on this blog, which year-to-date has seen 108 posts, numerous comments and countless page views. Without further adieu . . . the big stories of 2011, in no particular order:

1. Meaningful Use: Easily the most talked about HIT topic in 2011, the EHR Incentive program is off and running. During its first full year the program has not quite met HHS’ expectations. While the final numbers are not in, through the end of November CMS reported over 150,000 eligible professionals had registered for the program. However, less than 22,000 have successfully demonstrated meaningful use, including 280 nephrologists. Adding hospitals to the mix, through the end of November CMS has paid $1.8 billion in EHR Incentives. I would characterize this as a start, albeit a slow one.
2. Google exits the PHR space: Google is one of the most respected IT enterprises in the world. When they walk away from something, we should all stop and take notice. We may never know why they abandoned their personalized health record line of business, but if I were Microsoft, and Google left the dance, I would be looking for a chair to sit in when the music stops playing.
3. Steve Jobs’ passing: Regardless of whether you are a Mac user or a PC user, there is no denying the impact Jobs had on our world. Through the summer of 2011 Apple’s innovative iPad had sold 25 million units. More than any other, this single device is changing the face of health IT at the point of care. Hopefully the company’s innovative success will continue without its iconic leader.
4. The ACO Final Rule: With much fanfare, the Accountable Care Organization final rule arrived. Last week CMS announced the 32 Pioneer ACOs, which are largely concentrated within a few states (6 in CA, 5 in MA, 3 each in MI and MN). Robust HIT will be a key feature of the successful ACO. The CMS Innovation Center is contemplating other ACO opportunities. Stay tuned.
5. Delays: There have been several. The stage 2 meaningful use objectives have been delayed until 2014; the 5010 transaction standards deadline has been delayed until the end of March 2012; and CMS will not be capable of electronically receiving Clinical Quality Measure data in 2012 as they had originally anticipated. Perhaps they have fallen victim to the planning fallacy.
6. The eRx Penalty: At the 11^th hour, CMS served up a couple of additional hardship exemptions for providers. Unfortunately many providers will still face a 1.0% haircut on all of their 2012 Medicare Part B claims. Even more bizarre from my perspective is the fact that the meaningful use hardship exemption will not be available next year. If you demonstrate meaningful use in 2012 (which includes a heavy dose of e-prescribing) you will still face the penalty unless you separately let CMS know you e-prescribed. Perhaps the left hand does not know what the right hand is doing!
7. FMC names tech-savvy CMO: Earlier this month Frank Maddux became the Chief Medical Officer at Fresenius Medical Care. Frank cmes out of the box with more knowledge about health IT than nephrologists who have been running the race their whole careers. Hold onto your hats.
8. ESRD QIP-P4P Arrives: Last week I provided a brief overview of one of the first pay-for-performance programs to which nephrologists will be widely exposed. This is an important precedent and one to watch as 2012 unfolds.

I am certain there were many other events in 2011 worth highlighting. Please comment and let us know which ones you found important during the year.

Happy New Year! We look forward to bringing you more news and commentary at the intersection of nephrology and health IT in 2012.