Issue link: https://viewer.e-digitaledition.com/i/96739
EHRs and the Mystery of Meaningful Use As 2012 winds down, one of the biggest question marks hanging over the heads of hospital CEOs involves the use of electronic health records (EHRs). Since the enactment of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, health systems and practice groups have been vying for a piece of the $17.2 billion pie. Unfortunately, meaningful use stipulations seem to inherently favor large health systems with a lot of capital, as successful EHR implementation requires a hefty ���nancial investment up front. In addition to purchasing an EHR product and hiring outside consultants to explain the complex meaningful use clauses, hospitals must also invest the time to train physicians and staff members. They also need to unify and consolidate any disparate electronic ���ling systems. Financial penalties for failing to achieve meaningful use will be doled out starting in 2014. Hospitals and physician groups that haven���t yet started the process are quickly running out of time. The Future of Affordable Coverage Looking forward, 2013 is shaping up to be a big year for new ideas. One of the most promising of them involves the Affordable Insurance Exchange (AIE). The Center for Consumer Information and Insurance Oversight (CCIIO), a subset of the Centers for Medicare & Medicaid Services, has proposed the AIE as a way to promote a competitive private health insurance market. While speci���cs around AIEs are still forming, the general objective is to create a one-stop shop where small businesses ��� including physician practices ��� can compare insurance rates and enjoy the same purchasing power as a large entity. As the CCIIO notes, the provision of the PPACA prohibiting discrimination against people with pre-existing conditions will force the hand of insurance companies holding out on competitive prices. According to the Congressional Budget Of���ce, these state-based exchanges will reduce average premiums by as much as 10%. AIEs are due to be up and running by 2014. The future of the country���s health care system may depend largely on executive branch activity in the coming year. Over the next 12 months, the major questions facing the Department of Health and Human Services and the health care community at large will be: + How will EHR implementation affect smaller entities? THE NEW ERA OF MODERN MEDICINE WHILE HEALTH CARE reform slowly comes to fruition, medical breakthroughs continue to advance at breakneck speeds. Here are a few highlights: ROBOTIC SURGERY Since its debut in 1999, the da Vinci Surgical System has raised the bar for nearly every type of surgery. Recently, robotic technology has been applied to spinal surgery through use of the Mazor Renaissance guidance system, which signi���cantly reduces the incidence of permanent nerve damage. Supplementary advances are also increasing the noninvasiveness of robotic surgery. Fire���y, a ���uorescent imaging dye, is now being used to help robotic surgeons remove kidney tumors with enhanced accuracy. Seen through a ���uoroscopic camera, the dye helps surgeons differentiate between healthy and cancerous tissue, making it possible to spare more healthy tissue and reduce surgical trauma. LAPAROSCOPIC SURGERY The push for minimally invasive surgery has led to the recent development of single-port laparoscopic surgery (SPLS). SPLS utilizes one incision in the abdomen to access the procedural area, thus minimizing scarring and postsurgical pain. The single-port approach has been utilized for a wide range of procedures, among them bariatric surgery, appendectomy, colectomy, hysterectomy and hernia repair. + Will initiatives such as AIEs be able to tackle the challenge of affordable health care coverage? TRANSCATHETER AORTIC VALVE REPLACEMENT + Will accountable care organizations be able to overturn the broken health maintenance organization system? in the United States. As the nation���s elderly + Will wide-scale initiatives to incentivize preventive care work? Heart disease remains the No. 1 cause of death population continues to grow, the need for minimally invasive cardiac device implantation is ever-present. Some of the ���rst successful attempts at transcatheter aortic valve replace- W hat are your answers to these questions? Join the conversation at www.mdnews.com. I ment (TAVR), a minimally invasive procedure to implant a new device called a transcatheter heart valve, were seen in 2012. TAVR allows surgeons to implant the valve without having to cut through the chest wall or perform a cardiopulmonary bypass.