Life as a CIO Blog by John D. Halamka MD

As an eternal optimist, I always look forward to the year ahead and forget the bruises of the year that has passed.

What innovations can we expect in 2015?

In previous posts, I’ve discussed the emergence of FHIR to support standardized query/response APIs for EHRs. I’ve discussed the “post EHR era” and the rise of new workflow tools. I’ve emphasized the importance of social, mobile, analytics and cloud.

How is all of this going to come together in 2015?

Let me illustrate three examples from recent discussions with industry leaders.

1. Radiology Clinical Decision Support – The 2014 Sustainable Growth Rate bill contained completely unrelated mandates for radiology ordering clinical decision support:

(i) IN GENERAL.—The Secretary shall specify qualified clinical decision support mechanisms that could be used by ordering professionals to consult with applicable appropriate use criteria for applicable imaging services.
(ii) CONSULTATION.—The Secretary shall consult with physicians, practitioners, health care technology experts, and other stakeholders in specifying mechanisms under this paragraph.
(iii) INCLUSION OF CERTAIN MECHANISMS.—Mechanisms specified under this paragraph may include any
or all of the following that meet the requirements described in subparagraph (B)(ii):
(I) Use of clinical decision support modules in certified EHR technology (as defined in section 1848(o)(4)).
(II) Use of private sector clinical decision support mechanisms that are independent from certified EHR technology, which may include use of clinical decision support mechanisms available from medical specialty organizations.
(III) Use of a clinical decision support mechanism established by the Secretary.

(i) IN GENERAL.—For purposes of this subsection, a qualified clinical decision support mechanism is a mechanism that the Secretary determines meets the requirements described in clause (ii).
(ii) REQUIREMENTS.—The requirements described in this clause are the following:
(I) The mechanism makes available to the ordering professional applicable appropriate use criteria specified under paragraph (2) and the supporting documentation for the applicable imaging service ordered.
(II) In the case where there is more than one applicable appropriate use criterion specified under such paragraph for an applicable imaging service, the mechanism indicates the criteria that it uses for the service.
(III) The mechanism determines the extent to which an applicable imaging service ordered is consistent with the applicable appropriate use criteria so specified.
(IV) The mechanism generates and provides to the ordering professional a certification or documentation
that documents that the qualified clinical decision support mechanism was consulted by the ordering professional.
(V) The mechanism is updated on a timely basis to reflect revisions to the specification of applicable appropriate use criteria under such paragraph.
(VI) The mechanism meets privacy and security standards under applicable provisions of law.
(VII) The mechanism performs such other functions as specified by the Secretary, which may include a requirement to provide aggregate …read more