So, today's big question is: What were you doing in that happening decade, the 1970s?

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A lot has changed since the 1970s, including health care. Is it any wonder why we need to update our medical coding system? Running time: 3:42

Maybe you were mourning the breakup of the Beatles or the passing of The King, Elvis. Off to the movies to wait in line in the afternoon to see Star Wars so you could be home in time to watch that new program, M*A*S*H, on television?

Maybe you were reading all the news stories as the Watergate scandal devolved or watching television footage of President Nixon giving that big wave goodbye before stepping into the helicopter just after the announcement of his resignation. And there were the unforgettable pictures of the shootings at Kent State, U.S. troops pulling out of Vietnam, Jonestown.

Then again, maybe you went shopping for your first floppy disk, VCR or Walkman. How cool was that, eh, man?

Microsoft was founded and Steve Jobs and Steve Wosniak established Apple in the now legendary Jobs family garage.

If you were kicking around health care in the 1970s you might have been marveling about all the advances in radiology: first-generation CAT scans, PET scans, MRIs. Artificial hearts, new vaccines, test-tube babies — why, it's a whole new era of procedural and technological medical wonders.

You were probably trying to avoid conflict with the medical staff, and hoping those pesky trustees still liked you. (Some things never change.)

Or maybe you were fretting about rumors signaling the end of cost-based reimbursement. Maybe even, you were complaining about implementing that new coding system, ICD-9. "Why, what was wrong with the old one?" you ask.

Why am I reminiscing about the 1970s in the midst of these dynamic times? Because I wanted to show just how really, really long ago that was — culturally, politically and medically. And ICD-9 has been around for some 40-odd years. Look around. Has anything changed?

Essentially, ICD-9 must be replaced because it is simply tapped out. It no longer can accommodate all of the scientific progress and technological innovation that has occurred over the last 40 years.

Nor can ICD-9 simply be expanded, because it is limited by its numeric structure. ICD-10's new alphanumeric framework allows for concisely coding the many disease distinctions that have been classified and the new procedures and techniques that have been developed since 1975. ICD-10 accounts for existing technologies and also provides for future technological and procedural developments.

Yes, there are many more codes. The ICD-9 code set includes nearly 14,000 diagnostic codes compared with 69,000 in ICD-10. Not all of these will be commonly used, but that level of granularity is precisely the point.

A recent AHA survey showed 98 percent of CEOs agreed hospitals should investigate and implement population health management strategies. ICD-10 should be a data bonanza to advance those efforts.

When it comes to ICD-9's ability to further today's strategies, Elvis has definitely left the building.

— Let me know what you think. You can reach me at mgrayson@healthforum.com