Eight Predictions for ’ 18
Privacy and Security
The study of astrology for the purposes of predicting life and terrestrial events dates back
thousands of years and spans ancient and
modern civilizations in Asian, European, and
North and Central American cultures. Horoscopes, usually not
taken seriously, are ubiquitous in magazines and newspapers.
There is perhaps no domain of HIM more interested in predicting the future than privacy and security. Cyberattacks and
cybersecurity events have providers on edge—and will continue
to throughout 2018.
“I think that HIM professionals need to get more experience
and education in cybersecurity. They need to be at the table.
They need to lead business continuity and disaster recovery discussions for cyber situations—such as ransomware and denial
of service (DOS) attacks,” Downing says.
She points to two online tools that HIM professionals can
use to track cyber events as well as track careers related to cybersecurity. One is available at http://cyberseek.org/heatmap.
html and another is found at www.fireeye.com/cyber-map/
Lauren Riplinger, JD, senior director of federal relations at
AHIMA, says the Department of Health and Human Services’
Office for Civil Rights (OCR) is expected to do a number of
things in the privacy space in 2018. HIM professionals should
The issuing of additional “minimum necessary” requirements
Guidance around mental health information (what can/
cannot be shared with families, etc.) as mandated by the
21st Century Cures Act
Guidance on data sharing for research purposes as required by the 21st Century Cures Act
An advance notice of proposed rulemaking (ANPRM) on
accounting for disclosures
A notice of proposed rulemaking on the penalty sharing
provision of the HITECH Act (i.e., the distribution of a civil
penalty or monetary settlement to an individual harmed
by a breach)
“We may also see something come out of OCR under an
administration-wide strategy to institute ‘regulatory reform.’
What this may or may not look like from OCR is currently unclear,” Riplinger says.
More Top Topics to Watch in 2018
Visit the Journal of AHIMA website for additional hot HIM topics and stories to watch in 2018, as predicted by AHIMA’s subject matter experts.
Rules and Regulations
While fortune cookies are associated with Chinese food, their creation is entirely American.
The treats are loosely linked to the prophecies
of the Chinese philosopher Confucius. Some
cookie fortunes contain lucky numbers, stemming from ancient
numerology practices, and almost all offer predictions—the
content of which can be very unpredictable. Open one cookie,
and a soothing analogy for living life to the fullest awaits. Open
another, and a cryptic warning follows.
Unpredictability is certainly prevalent in Washington, DC
lately, with even the best prognosticators uncertain what to expect from the fast-moving, ever-changing political landscape.
As of press time in early December, there was still uncertainty
around year-end negotiations in Congress over raising the debt
ceiling, appropriations for the 2018 budget—which impacts the
budgets of the Office of the National Coordinator for Health IT
(ONC) and the Office for Civil Rights (OCR)—and the potential
for additional Medicare reimbursement cuts under the 2011 Budget Control Act and sequestration. Even with regulations already
enacted, like the 21st Century Cures Act, there is uncertainty
around how its provisions will be implemented and enforced.
For example, ONC’s forthcoming definition of “information
blocking” will be a major story to watch in 2018, AHIMA’s HIM experts predict. The way the definition is written will have an impact
on a large portion of electronic health record (EHR) users. The 21st
Century Cures Act requires ONC to define information blocking so
the Office of Inspector General can start enforcing against the practice—issuing up to a $1 million fine, per occurrence, for providers
who purposely hinder the exchange of health information.
The 21st Century Cures Act also requires ONC to address the
burden of time physicians spend on EHR documentation, another topic to watch this year. The Centers for Medicare and
Medicaid Services (CMS) will weigh in on that too, as well as
providers, vendors, and other stakeholders. This could have an
impact on areas directly related to HIM, such as clinical documentation improvement and data quality. ¢
1. DeRusha, Jason. “Good Question: Does Numerology
Work?” WCCO-TV CBS Minnesota. January 12, 2011.
2. Brigit. “ 12 Tarot Tips for the Tarot Beginner.” Biddy Tarot
Blog. February 4, 2015. www.biddytarot.com/12-tarot-
3. Emily Gems. “The Art of Crystal Ball Gazing.” https://crys-
Mary Butler ( firstname.lastname@example.org) is associate editor at the Journal of AHIMA.