Healthcare CIOs & the Supreme Court

David Wagner, Managing Editor | 3/29/2012 | 3 comments

David Wagner
I’m not in the business of predicting the Supreme Court. But a lot of people who are believe that the court will strike down all or some of President Obama’s healthcare reform law, also known as Obamacare, this summer. The uncertainty of healthcare reform, of course, has a direct bearing on what CIOs will do in the near future.

The changes we’ve talked most about here at E2 -- EMRs and meaningful use -- aren’t really under threat. The funding for those comes from another law called HITECH. What is at stake, among other things, is ICD-10, a new billing and coding system (cleverly named, as it is supplanting ICD-9). It is supposed to go into effect in late 2013, but it was likely to be delayed even before the Supreme Court put Obamacare in doubt.

ICD-10 is intended to increase the accuracy of electronic billing. According to this article, it will expand the number of medical diagnosis codes from 14,000 to 67,000. The main goals were to eliminate billing fraud and improve reporting, but there was also a general belief that drilling down to specific procedures (whose codes will go from 13,000 to 85,000) might help lower costs, because certain procedures could be renegotiated or even eliminated when seen in more detail. At the very least, it was hoped ICD-10 would improve reimbursement systems.

All indications are that at least some justices are prepared to strike down the entire law, which would effectively end ICD-10 unless Congress put it in a separate bill -- an unlikely occurrence with the current Congress. Justice Antonin Scalia practically admitted he was ready to strike down the entire law without really caring what was in it. “You really want us to go through these 2,700 pages? And do you really expect the court to do that?” When challenged that at least it would be easy for his clerks, Scalia said, “I don't care whether it's easy for my clerks. I care whether it's easy for me.”

Apart from my personal outrage (and perhaps naivete) that the Supreme Court could strike down 2,700 pages of law without actually reading them, it is a clear indication that at least some of the court is ready to attack the entire law, not just the individual mandate.

With that in mind, what’s a CIO to do? This Information Week article suggests that institutions that have already started traveling down the path of IT changes will likely continue. The value of EMRs, health information exchanges, and even new payment structures like pay for outcomes or value-based pricing (both requiring EHRs to be effective) are too high to abandon.

But the slower the start you got, the more likely it is you won’t bother finishing the job. It is only human nature. And with government mandates and subsidies potentially disappearing, the impetus will be gone.

Still, unless you’re truly strapped for the budget, the smart CIO should probably try to keep going. Meaningful use and EMRs are still being subsidized. In many ways, they’re the “front end” of other initiatives like health information exchanges and ICD-10. Once you’ve paid to put those in place, your hardest work is over. Take the chance to transform your organization. It will be worth it to your patients and to your bottom line. Also, if you keep pushing away, you won’t be one of those people who wasted three months only to find out that you bet on the wrong reading of the tea leaves.

View Comments: Newest First | Oldest First | Threaded View
tekedge   Healthcare CIOs & the Supreme Court   3/29/2012 9:23:21 PM
Re: 50,000 new codes?
@David - yes you are right .Being in the healthcare industry,I can say that my company is moving ahead with the ICD-10 changes. From all the indications I have seen,EMR is expected to handle most of the heavy jobs.
David Wagner   Healthcare CIOs & the Supreme Court   3/29/2012 2:25:43 PM
Re: 50,000 new codes?
@kstaron- This is, of course, why ICD-10 was in danger before the Supreme Court ruling. But the belief is that EMR will allow for medical billing coders to me easily adjust, and it should mean fewer coders are need to handle bigger traffic.

The goal is to have the EMR handle as much of it as possible.
kstaron   Healthcare CIOs & the Supreme Court   3/29/2012 2:19:17 PM
50,000 new codes?
If a supreme court justice doesn't want to look at the 2,700 pages of new codes, it seems likely medical billers aren't going to have it any easier. When there are 65,000 codes that someone has to enter, the system may become overloaded with mistakes, elimitaing any saving in fraud prevention. Anybody out there who wants to learn 50,000 new codes?

The blogs and comments posted on do not reflect the views of TechWeb,, or its sponsors., TechWeb, and its sponsors do not assume responsibility for any comments, claims, or opinions made by authors and bloggers. They are no substitute for your own research and should not be relied upon for trading or any other purpose.

More Blogs from David Wagner
David Wagner   5/30/2014   21 comments
For almost three and a half years I have had the pleasure and real privilege to write the Geekend for you every Friday. Fortunately, that privilege isn't ending, it is just moving to our ...
David Wagner   5/23/2014   69 comments
Most of us have gone through the pain of losing a beloved pet. Maybe you lived a long and happy life together, and it died peacefully. Maybe it was tragically struck down by a car or a ...
David Wagner   5/22/2014   47 comments
It is a rare thing when you find me advocating for the government to get more involved in regulating technology, but when it comes to the Internet of Things, that is what I'm advocating. ...
David Wagner   5/21/2014   13 comments
E2 has long trumpeted the days when 3D printers would sit on our desks and print prototypes, consumer goods, and even body parts right from our desk, but a new cloud manufacturing company ...
David Wagner   5/16/2014   40 comments
With Disney's success with the Avengers franchise, geeks everywhere are being treated to an outrageously large number of TV shows and movies based on comic book superhero characters. For ...
Latest Archived Broadcast
We talk with Bernard Golden about accelerating application delivery in the cloud.
On-demand Video with Chat
Register for this video discussion to learn how tablets can provide true business usability and productivity.
E2 IT Migration Zones
IT Migration Zone - UK
Why PowerShell Is Important
Reduce the Windows 8 Footprint for VDI
Rethinking Storage Management
IT Migration Zone - FR
SQL Server : 240 To de mémoire flash pour votre data warehouse
Quand Office vient booster les revenus Cloud et Android de Microsoft
Windows Phone : Nokia veut davantage d'applications (et les utilisateurs aussi)
IT Migration Zone - DE
Cloud Computing: Warum Unternehmen trotz NSA auf die „private“ Wolke setzen sollten
Cloud Computing bleibt Wachstumsmarkt – Windows Azure ist Vorreiter
Like Us on Facebook
Twitter Feed
Enterprise Efficiency Twitter Feed
Site Moderators Wanted
Enterprise Efficiency is looking for engaged readers to moderate the message boards on this site. Engage in high-IQ conversations with IT industry leaders; earn kudos and perks. Interested? E-mail:
Dell's Efficiency Modeling Tool
The major problem facing the CIO is how to measure the effectiveness of the IT department. Learn how Dell’s Efficiency Modeling Tool gives the CIO two clear, powerful numbers: Efficiency Quotient and Impact Quotient. These numbers can be transforma¬tive not only to the department, but to the entire enterprise.

Read the full report
The State of Enterprise Efficiency in the Virtual Era: Virtualization – Smart Approaches to Maximize Gains
Virtualization is a presence in nearly all enterprise data centers. But not all companies are using it to its best effect. Learn the common characteristics of success, what barriers companies face, and how to get the most from your efforts.

Read the full report
Informed CIO: Dollars & Sense: Virtual Desktop Infrastructure
Cut through the VDI hype and get the full picture -- including ROI and the impact on your Data Center -- to make an informed decision about your virtual desktop infrastructure deployments.

Read the full report
A Video Case Study – Translational Genomics Research Institute
e2 Video

On the Case
TGen IT: Where We're Going Next

7|11|12   |   08:12   |   10 comments

Now that TGen has broken new ground in genomic research by using Dell's storage, cloud, and high-performance computing solutions, the company discusses what will come next for it and for personalized medicine.
On the Case
Better Care Through Better Communications

6|6|12   |   02:24   |   11 comments

The achievements of the TGen/Dell project could improve how all people receive healthcare, because they are creating ways to improve end-to-end communication of medical data.
On the Case
TGen IT: Where We Are Now

5|15|12   |   06:58   |   6 comments

TGen is breaking new ground in genomic research by using Dell's storage, cloud, and high-performance computing solutions.
On the Case
TGen IT: Where We Were

4|27|12   |   06:45   |   10 comments

The Translational Genomics Research Institute wanted to save lives, but its efforts were hobbled by immense computing challenges related to collecting, processing, sharing, and storing enormous amounts of data.
On the Case
1,200% Faster

4|18|12   |   02:27   |   12 comments

Through their partnership, Dell and TGen have increased the speed of TGen’s medical research by 1,200 percent.
On the Case
IT May Improve Children's Chances of Survival

4|17|12   |   02:12   |   8 comments

IT is helping medical researchers reach breakthroughs in a way and pace never seen before.
On the Case
Medical Advances in the Cloud

4|10|12   |   1:25   |   5 comments

TGen and Dell are pushing the boundaries of computing, and harnessing the power of the cloud to improve healthcare.
On the Case
TGen: Living the Mission

4|9|12   |   2:25   |   3 comments

TGen's CIO puts the organizational mission at the heart of everything the IT staff does.
On the Case
TGen Speeding Up Biomedical Research to Save More Lives

4|5|12   |   1:59   |   6 comments

The Translational Genomics Research Institute is revamping its computing to improve speed, storage, and collaboration – and, most importantly, to save lives.
On the Case
Computing Power Helping to Save Children's Lives

3|28|12   |   2:13   |   3 comments

The Translational Genomics Institute’s partnership with Dell is enabling them to treat kids with neuroblastoma more quickly and save more lives.
Tom Nolle
The Big Reason to Use Office

3|18|14   |   02:24   |   46 comments

Office and personal productivity tools come in a first-class and coach flavor set, but what makes the difference is primarily little things that most users won't encounter. What's the big issue in using something other than Office, and can you get around it?
E2 Editors
SPONSORED: Mobile Security — A Use Case

3|4|14   |   04:27   |   16 comments

New mobile security solutions can accommodate a wide array of needs, including those of a complex university environment.
Tom Nolle
Killing Net Neutrality Might Save You Money

1|16|14   |   2:13   |   16 comments

The DC Court of Appeals voided most of the Neutrality Order, and whatever it might mean for the Internet overall, it might mean better and cheaper Internet VPNs for businesses.
Tom Nolle
The Internet of Everythinguseful

1|10|14   |   2:18   |   19 comments

We really don't want an "Internet of Everything" but even building an Internet of Everythinguseful means setting some ground rules to insure there's value in the process and that costs and risks are minimized.
Tom Nolle
Maturing Google Chrome

12|30|13   |   2.18   |   25 comments

Google's Chrome OS has a lot of potential value and a lot of recent press, but it still needs something to make it more than a thin client. It needs cloud integration, it needs extended APIs via web services, and it needs to suck it up and support a hard drive.
Sara Peters
No More Cookie-Cutter IT

12|23|13   |   03.58   |   21 comments

Creating the right combination of technology, people, and processes for your IT organization is a lot like baking Christmas cookies.
Sara Peters
Smart Wigs Not a Smart Idea

12|5|13   |   3:01   |   46 comments

Sony is seeking a patent for wigs that contain computing devices.
Tom Nolle
Cloud in the Wild

12|4|13   |   02:23   |   15 comments

On a recent African trip I saw examples of the value of the cloud in developing nations, for educational and community development programs. We could build on this, but not only in developing economies, because these same programs are often under-supported even in first-world countries.
E2 Editors
SPONSORED: Is Malware Evading Your IPS?

11|18|13   |   03:16   |   4 comments

Intrusion prevention software is supposed to detect and block malware intrusions, but clever malware authors can evade your IPS in these five main ways.
Sara Peters
Where Have All the Mentors Gone?

9|27|13   |   3:15   |   38 comments

A good professional mentor can change your life for the better... but where do you find one?
Tom Nolle
SDN Wars & You Could Win

9|17|13   |   2:10   |   5 comments

VMware's debate with Cisco on SDN might finally create a fusion between an SDN view that's all about software and another that's all about network equipment. That would be good for every enterprise considering the cloud and SDN.
Ivan Schneider
The Future of the Smart Watch

9|12|13   |   3:19   |   39 comments

Wearing a bulky, oversized watch is good training for the next phase in wristwatches: the Internet-enabled, connected watch. Why the smartphone-tethered connected watch makes sense, plus Ivan demos an entirely new concept for the "smart watch."
Tom Nolle
Cutting Your Cloud Storage Costs

9|4|13   |   2:06   |   3 comments

Cloud storage costs are determined primarily by the rate at which files are changed and the possibility of concurrent access/update. If you can structure your storage use to optimize these factors you can cut costs, perhaps to zero.
Sara Peters
Do CIOs Need an IT Background?

8|29|13   |   2:11   |   23 comments

Most of the CIOs interviewed in the How to Become a CIO series did not start their careers as IT professionals. So is an IT background essential?
Ivan Schneider
The Internet Loves Birthdays

8|27|13   |   3:25   |   69 comments

The Internet has evolved into a machine for drumming up a chorus of "Happy Birthday" messages, from family, friends, friends of friends who you added on Facebook, random people that you circled on G+, and increasingly, automated bots. Enough already.