It was an event anticipated-and dreaded-for more than a year. IT staffs prepped, contingency plans were mapped, and it was all hands on deck when the first of the month rolled around.

Actually, it was the first day of the new millennium. Y2K. And it wasn't just healthcare organizations that were getting ready for the worst. From police departments to power companies to publishers, no one knew precisely what would happen to computer systems once the calendar rolled over to Jan. 1, 2000. It turned out not much happened-reprogramming of existing systems had headed off any potential issues, and life went on. Y2K became the butt of jokes because of perceived overreaction to a potential worst-case scenario.

It's nostalgic to recall the frenzy surrounding Y2K. As I write this column in mid-September, I can't help but compare Y2K with what's awaiting the industry on October 1, when the transition to ICD-10 becomes official. Just like Y2K, this shift has been anticipated for years. But ICD-10 is an entirely different animal; it's a far-reaching change that will affect all facets of operations, and one the healthcare system will be working through for many months to come.

There's a strange mix of optimism and dire foreboding about how the industry will absorb this change. All healthcare organizations are preparing for the ICD-10 transition in these final days, writes Joseph Goedert in this month's cover story (page 14). Some providers have made steady progress, and they report they're ready. Others are scrambling to complete last-minute tasks, sprinting to make the switchover.

In addition, organizations are taking steps such as reducing expenses, setting aside money to cover payment shortfalls and talking to major payers to ensure contingency plans are in place in case problems arise.

Revenues also can suffer when organizations rip out and replace an existing electronic health records system. It's another hard, costly transition, Elliot Kass reports on page 24. He highlights the experiences of a couple of large organizations that anticipated the revenue hit, and also used the opportunity to sensitize staff to their role in maximizing charge capture.

Another transition under way in the industry is the shift to population health. Elizabeth Gardner writes on page 18 about how organizations embarking on a population health strategy are counting on IT to better track data, to enable them to reduce costs and improve the care they deliver.

Finally, on page 27, experts discuss the challenges in trying to standardize terminology across an enterprise. Given the growing reliance on integrated delivery systems, use of different terminology makes it tougher to gather and analyze information; it also introduces risks to patient safety and hampers efforts to increase organizational efficiency.

Many changes lie ahead; please let us know about the challenges you're facing.

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