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July 2017

Editor's Note: Coulda Been a Contender
By Lee DeOrio
For The Record
Vol. 29 No. 7 P. 3

The game of "what ifs" is not recommended. Generally, it's a fruitless endeavor fraught with regret and disappointment supported by little to no evidence. Still, like Terry Malloy, a one-time promising boxer who laments his turn in life in the classic On the Waterfront, we're all prone to ruing decisions or wondering why our grandiose plans were derailed.

In the health care arena, the game of what ifs can have far-reaching effects on a broad level or reside in a one-on-one interaction between a caregiver and a patient. Its setting can be Washington, D.C., or a tiny office in rural Iowa. The game itself can evolve over a period of years or occur during a routine check-up played out thousands of times each day. For example, consider the following what ifs:

• The Office of the National Coordinator for Health Information Technology didn't change directors at nearly the same rate the Yankees swapped managers during the stewardship of George Steinbrenner. Would policy be streamlined and consistent?

• Doctor appointments occurred on time. As it stands, visits are a series of brief encounters, each of which are preceded by 15-minute waits. It's a psychological ploy designed to create the illusion of progress. I'm not sure why care can't occur all at once.

• Physicians had a larger say in EHR development from day one. It's hard to believe the complaints and frustration show no signs of abating so many years into the technology's existence.

• HIM professionals had a larger say in HIT implementations. Few technology projects don't affect medical records, whether it be documentation, data protection, or release of information. It's hard to believe the experts in managing medical record content wouldn't have a great deal to contribute to the conversation.

• The ICD-10 delay never occurred. The countless hours and dollars spent reeducating coders and diverting attention away from day-to-day operations will never be recovered. Politics reared its ugly head to derail a swift transition and curtail opportunities for health care organizations to improve operations in other areas.

• The patient matching problem was resolved years ago. By all accounts, some obscure legislation is the main stumbling block preventing health care organizations from more thoroughly identifying patients. It's a head-scratcher that this lingering issue continues.

• PHRs took flight. Whether it was consumer apathy or unfriendly software, the idea of patients maintaining a thorough account of their health care using one tool never took off.

• Telehealth reimbursement concerns were addressed when the technology first emerged. Imagine how widespread virtual visits would be if providers knew from the start how they would be compensated.

• Meaningful use never existed. Mind explodes.