However, there are challenges.

1.  Clinicians are not broadly trained in the use of SNOMED-CT. It may be that SNOMED-CT should be used for internal storage of structured data but only friendly plain text descriptions are displayed to users.

2.  Will CMS, the Joint Commission, and malpractice insurers accept the concept of jointly authored care team notes?

3.  Implementing all 5 applications/modules at once may be too much change too quickly, making the overall project high risk

4.  Will SNOMED-CT map to ICD-10 cleanly enough to ensure neither upcoding nor downcoding, but "right coding"

5.  Will companies be willing to create such modules/services at a time when few EHRs are likely to interface to them? As Meaningful Use Stage 3 is finalized, I expect some of this functionality to be required

We have 22 months before ICD-10 compliance is required and complete documentation in support of the new codes must be available. We need to work fast.   Tomorrow we have an internal conference call to plan next steps - what module or modules do we work on first? We have companies interested in partnering with us on Modules 2 and 3. The National Library of Medicine's VSAC is developing module 4.

I welcome your advice -- have you discovered emerging products that might be useful for our exploration?

Have you considered how to take your clinical documentation to the next level?

I look forward to the adventure ahead.