And for the new year, more of the same: “The most important advancement in healthcare in the coming year will not come from physician offices and hospitals across the nation, but from Washington D.C.,” says Jim Lacy, CFO of ZirMed, a Louisville, Ky., revenue cycle management company. “Despite the intended positive impact and the potential monies associated, the Act created more questions over what what type of EMR would qualify and what the real value was of the EMR.”

Against the background of a continued shaky economy and a “Darwinian” survival-of-the-fittest environment as hospitals and other providers consolidate, Mary Grealy, president of the Healthcare Leadership Council, a healthcare policy advocacy group, says that “2010 will be a year of trial and error for physician practices as small group and solo practices will be particularly challenged to make the right decisions about which products to purchase.”

Other key trends and challenges for the coming year:

· A Bigger Dose of E-Prescribing: Still a standalone application, e-prescribing has languished from poor adoption rates, but Brian O’Neill, president of Office Ally, a Vancouver, Washington medical claims clearinghouse, says e-prescribing will accelerate. Under the current legislation, physicians will be penalized 2 percent in reimbursements if not e-prescribing by 2012. “Physicians are now really scrambling to find programs that are affordable, easy-to-use, and easy-to-learn,” says O’Neill.

· Mobile Devices On the Move: “The mobile device market exploded in 2009, thanks to the availability of new devices with lower price points and greater computing power, as well as the availability of more applications,” says Michelle Snyder, senior vice president at Epocrates, a PDA medical software company based in San Mateo, Calif. Snyder anticipates smartphone adoption to continue to spike in 2010.

· Privacy Protection Ramps Up: HITECH provisions are forcing providers to take HIPAA privacy rules very seriously, especially as state attorney generals have been empowered to enforce HIPAA, with levying of fines for violations. “So far, at least two large six-figure fines have already been assessed in California alone,” says Scott Finlay, CEO of MaxMD, a provider of encryption technology. “With all states hungry for new revenue sources, it only makes sense that they’ll be looking at HIPAA audits as a potential cash cow for empty state coffers,” adds Finlay, of the Jersey City, N.J. firm.

· PHR (Personal Health Records) Mature: From Microsoft’s HealthVault to Google Health, PHRs are significantly maturing and have the ability to provide secure functionality and value that will help drive adoption, says Dr. Tom Stevenson, a Grand Rapids, Mich., physician and Chief Medical Officer for Compuware Covisint, a provider of business automation services. “Consumers will play a greater role in their own care and decision making process.”

· EDI (Electronic Data Interchange) a Must: Currently about 30 percent of small physician practices still submit bills via paper – but this equates to payment delays and possible non-compliance with state and health plan regulations. “There will be an ongoing effort to increase the use of clearinghouses and EDI,” says O’Neill of Office Ally. “More states and health plans will began mandating the use of EDI, meaning physicians will need to find solutions that work for their practices.”

As “meaningful use” is defined in 2010, “the hope is that it will help many of the small practices – which includes the majority of physicians in the U.S. – take the leap toward paperless offices and electronic medical record implementation,” says Snyder of Epocrates. “The road to healthcare IT adoption has been challenging for small practice physicians, due to high costs and resource constraints. But in 2010, these practices will be incentivized and supported by the government, and HIV vendors will develop technologies that require minimal training and support.”

Our final prediction? 2010 will be anything but a boring year. Just wait and see.