Again there has been just a heap of stuff arrive this week.
First we have:
- By Peter Buxbaum
- Jun 16, 2009
Most members of the Health and Human Services Department’s Health Information Technology Policy Committee favor an aggressive timetable for the adoption of health IT to qualify providers for Medicare and Medicaid incentive payments.
The American Recovery and Reinvestment Act of 2009 allows such bonuses to be paid to medical providers and organizations that make meaningful use of health IT.
The committee heard a presentation by its Meaningful Use Workgroup today as a first step toward defining that term.
David Blumenthal, the committee’s chairman and national health IT coordinator at HHS, took note of several members’ suggestions that requirements for health IT adoption be moved up from 2013 to 2011. He termed the shorter timeline “perfectly reasonable.”
The workgroup’s presentation took as its starting point a vision of the U.S. health system in 2015 that includes the achievement of certain goals, such as preventing 1 million heart attacks and strokes; halving medication errors, preventable hospitalizations and ethnic disparities in diabetes control; and giving patients access to electronic health information.
The workgroup then described a trajectory for achieving that vision through three sets of criteria: data capture and sharing, which should be ready for implementation in 2011; advanced clinical processes, required in 2013; and improved outcomes, to be demonstrated by 2015.
The 2011 objectives include capturing data such as medication lists, allergies, and vital signs in coded format and electronically prescribing drugs. Performance measures at this stage would include the achievement of unspecified percentages of lab results captured in electronic records in coded format and computerized physician order entries entered by physicians.
The 2013 objectives include access to clinical decision support at the point of care and receiving electronic public health alerts.
“Decision support would be derived from clinical data and would be standardized,” said Dr. Paul Tang, the workgroup’s co-chairman and vice president and chief medical information officer at the Palo Alto Medical Foundation. “These objectives are pushing more toward outcome improvements.”
There is little doubt this is pushing very hard indeed. I suspect it will take a good bit longer than initially planned if experience all over the world is to be believed.
Second we have:
Tuesday, June 23, 2009
by Protima Advani
Ever since former President George W. Bush put forth a goal for every American to have an electronic health record by 2013, hospitals and health systems across the country have spent millions of dollars purchasing a variety of EHR applications.
What's Happened Until Now
Although the inpatient EHR journey is nowhere near completion, the relaxation of the Stark laws in 2006 has fueled investment in IT, as hospitals began offering subsidized EHRs to community physicians. Almost every hospital seemed to be moving full steam ahead to achieve its digital ambition until the economic downturn of 2008 forced most hospitals to cut back on all capital expenditures and, in many cases, delay previously approved health IT implementations.
In the midst, President Obama signed into law the American Recovery and Reinvestment Act, allocating more than $19 billion to accelerate the adoption of EHR technologies and facilitating nationwide health information exchanges to improve the quality and coordination of care among health care providers, thereby reducing medical errors and duplicative care. Most of the funds -- approximately $17 billion -- will be made available to hospitals and physicians as Medicare and Medicaid incentives for meaningful use of health IT. The remainder of the funding, approximately $2 billion, will be available through competitive grants and loans to support the development of health IT standards, build the infrastructure for health information exchanges, as well as to enhance patient privacy and information security guidelines
Much more here:
This an interesting article discussing to topic of Vendor Financing of Health IT. Worth a browse.
Third we have:
BY CAROLYNE PARK
Posted on Sunday, June 21, 2009
MENA - Lying in an emergency-room bed at Mena Regional Health System on June 1, Iva Mae Sikes did her best to answer the questions asked by the male voice coming from the computer in front of her.
The entire left half of her body was paralyzed. The 89-year-old's usually clear, direct speech was slurred and the muscles in the left side of her face slackened. She'd had a stroke, and the voice from the computer was a neurologist evaluating Sikes' symptoms from 145 miles away in Little Rock.
Sikes is one of about 35 ruralhospital patients who've been reviewed from afar via videoconferencing technology as part of the Arkansas Stroke Assistance Through Virtual Emergency Support program, known as Arkansas SAVES.
The program started Nov. 1, with a one-year $6.1 million Medicaid contract with the Arkansas Department of Human Services.
It began as a partnership between the state Medicaid program, the Mena hospital, the University of Arkansas for Medical Sciences' Center for Distance Health in Little Rock, Sparks Health System in Fort Smith, Booneville Community Hospital, Johnson Regional Medical Center and the Arkansas Department of Health.
Since it began, hospitals in McGehee, DeWitt, Helena-West Helena, Mountain Home, Batesville and Arkadelphia have also joined SAVES.
The program provides rural hospitals access to neurologists at UAMS and Sparks 24 hours a day, with the goal of quickly identifying the type of stroke suffered. Doctors then see if patients can be given a potentially lifesaving medicine that must be administered within three hours of a stroke to dissolve blood clots.
A stroke is a sudden loss of brain function caused by a blockage or rupture of a blood vessel in the brain. Nationwide, it's the leading cause of serious long-term disability and the third-leading cause of death in the United States.
There are about 795,000 strokes in the country each year, according to the federal Centers for Disease Control and Prevention. Arkansas has the country's third-highest rate of deaths from stroke.
In 2005, 58.6 of every 100,000 deaths among Arkansas adults were due to stroke, for a total of 1,847 stroke deaths. That's compared with a national average of 46.6 of every 100,000 adult deaths, or 143,579 total stroke deaths, according to the latest CDC statistics.
Alabama had the highest rate, with stroke deaths making up 60.9 of every 100,000 adult deaths that year, followed by Tennessee with 60.7 of every 100,000.
Arkansas' high rates of obesity, smoking, diabetes, high cholesterol and untreated high blood pressure all contribute to the state's high stroke death rate, said Dr. Margaret Tremwel, neurologist at Sparks Regional Medical Center and director of the hospital's Early Intervention and Treatment Program.
"In every treatable risk factor we exceed the national average," she said. "We have a real problem here in Arkansas."
Telemedicine that takes specialty care to rural hospitals and community education about the signs of stroke and importance of getting immediate medical care are key to reducing strokerelated deaths and disabilities, Tremwel said.
Very full reporting continues here:
This is a good grass roots article on the place of telemedicine in stroke care.
Fourth we have:
Despite $1.576-billion spent between 2001 and March of this year, just 17 per cent of Canadians obtained electronic health records
Gloria Galloway and Daniel Leblanc
Ottawa — Tuesday, Jun. 23, 2009 03:37AM EDT
The effort to move Canadian medical records from paper to computer has been slow, and after eight years, the country is just a third of the way to its goal of having 50 per cent of those records available electronically by the end of 2010.
Canada Health Infoway, the non-profit organization charged with accelerating access to electronic records, released its annual report Monday. It shows that $1.576-billion was spent between 2001 and March of this year to bring Canadian health records into the computer age.
But, during that same period, just 17 per cent of Canadians obtained health records that could be accessed electronically. That's far below the goal of 50 per cent that has been set for next year.
Initially, Infoway had aimed to reach 50 per cent this year. But a federal review undertaken in 2006 stated that that goal was problematic.
“It is a very blunt target for a complex undertaking,” said the review, which was released under the Access to Information Act. “The definition of this target is broadly misunderstood, the target itself is likely to be missed, and is not a strong indicator of success.”
Health professionals believe that making the records available electronically will reduce errors, track patient care, and ultimately save lives.
A similar project, Ontario's eHealth initiative, is mired in a spending scandal replete with lucrative contracts awarded without competitive tenders and nickel-and-dime spending on snacks by consultants.
Dan Strasbourg, Infoway's director of communications, said it's too early to assume the new target will not be met.
Much more here:
This is a useful review of the overall progress in Canada. No doubt real progress has been made – but inevitably it has taken longer than one might have hoped.
Fifth we have:
By Aliya Sternstein 06/22/2009
The debate on health care reform is heating up through informal online channels such as blogs, social networking sites and e-mail campaigns, rendering official White House Web sites created to foster the policy discussions nearly inconsequential, some nongovernmental health specialists say.
A concept of a public health insurance plan under debate in Washington is stirring up online disputes, as is the push to adopt health care information technology. Health IT provisions in the economic stimulus package -- a marker for the wider health care revamp -- give doctors and hospitals incentives to buy into using certified electronic records systems by 2014. The Recovery Act appropriates about $20 billion to encourage the use of e-health records.
These discussions would seem to advance President Obama's ambition to overhaul the health care system in a manner that benefits all Americans. "The President has vowed that the health reform process will be different in his administration -- an open, inclusive, and transparent process where all ideas are encouraged and all parties work together to find a solution to the health care crisis," the White House Web site states. "Please visit www.HealthReform.gov to learn more about the president's commitment to enacting comprehensive health reform this year."
Much more here:
It is interesting just how we see the Web 2.0 technologies influencing major policy debates both here and in the US.
Sixth we have:
June 19, 2009
Queen's Park Bureau
Dr. Alan Hudson is devastated by the eHealth Ontario debacle and says he stepped aside so the project to bring health records online could move forward.
Breaking the public silence he has maintained since the eHealth Ontario spending scandal broke a month ago, Hudson told the Star he is "very disappointed" and feels ultimately responsible for the crisis as the former board chair.
"I feel very upset at what happened. It was the opposite of what I was trying to do," he said in an interview at his Toronto condo.
Hudson, who headed the board as a volunteer, said he was shocked to hear some consultants at eHealth were making $2,700 to $3,000 a day and that one billed for a $1.65 tea at Tim Hortons and Choco Bites for $3.99.
"I was surprised," said the 71-year-old neurosurgeon. "The board has to be accountable in the end. The public have the right to know."
But Hudson, whose resignation was announced Wednesday by McGuinty, said it was the Liberal government, not the eHealth Ontario board, that decided the terms of former CEO Sarah Kramer's $380,000 annual contract and $114,000 bonus.
Much more here:
Seems that everyone other than the Health Minister have now gone! Hopefully they can now move on in the Province and make up some lost ground.
Seventh we have:
Ontario spends a bundle for disappointing results, experts say
June 20, 2009
It irks Dr. Ben Chan that he can do his banking anywhere in the world, but his medical records can't be instantly called up at a hospital.
The annual report of the Ontario Health Quality Council, released earlier this month, points out Ontario is woefully behind other jurisdictions in digitizing health records. In 2007, only 25 per cent of Ontario's family-practice doctors had electronic medical records compared to 50 per cent in Alberta, 98 per cent in the Netherlands and 89 per cent in the United Kingdom.
"I think we all need to acknowledge that we're not functioning near as well as we should be," says Chan, the CEO of the organization. The consequence isn't just less efficiency, it's poorer quality of health care, he added.
This week's resignation of eHealth Ontario chair Dr. Alan Hudson will inevitably set back the effort even more, with some observers estimating it could take upwards of a year to get back on track.
Charged with developing electronic health records for Ontario, the eHealth agency has been engulfed by a spending controversy involving high-priced consultants and untendered contracts.
Much more here:
This article really wraps the whole thing up and shows how much work now lies ahead.
Inevitably there will be the usual controversy as the Province moves on!
By Micheal Vonn, Special to the Sun
Depression, infertility, cancer, addiction, abortion, erectile dysfunction, HIV/AIDS -- whatever our health issues, Canadians value the right to choose who they share intimate health information with. This right is now under threat. "E-Health" is coming.
E-Health will create a giant system of electronic health records that will eventually be accessible across the entire country. These government repositories of citizens' health information are promoted as likely to make health care safer, cheaper and more efficient.
This also offers a good perspective:
André Picard's Second Opinion
Here also is another view with great links:
Thursday, June 25, 2009
by George Lauer, iHealthBeat Features Editor
Eighth we have:
News Sentinel staff
Originally published 03:31 p.m., June 22, 2009
Updated 03:31 p.m., June 22, 2009
WASHINGTON — Tennessee today was recognized as one of the top five most improved states in routing prescriptions electronically.
Surescripts, a health information network that operates one of the country’s largest electronic prescribing networks, announced that Tennessee ranked second behind Vermont and just ahead of Kansas, Illinois and Missouri on the top five list. Recognized as the country’s leading states in electronic prescribing were Massachusetts, Rhode Island, Michigan, Nevada and Delaware.
The state was recognized during an event held by Surescripts at Washington, D.C.’s National Press Club.
Full article here:
It is interesting to see how the North East of the USA dominates this ranking. Tennessee seems to be a tiny bit of an outlier here.
The full press release is found here:
Ninth we have:
By Sandun A Jayasekera
Sri Lanka is to go high–tech in treating patients with a novel patient centric ‘e-health solution programme,’ which is in its experimental stage right now, a Health Ministry source said yesterday.
The current treatment methods are doctor centered and communication between the doctor and the patient is lacking in most cases. Patients leave the consulting room dissatisfied on many occasions. This happens mostly in rural areas and people in remote parts of the country have to travel long distances to consult a specialist. The e-health solution will address these constraints in healthcare delivery. The e-health programme is patient centered and here the patient has a say in what type of treatment they get, Ministry spokesman W.M.D Wanninayaka said.
Interesting how far the thrust towards e-Health has spread!
Tenth we have:
Carrie Vaughan, for HealthLeaders Media, June 23, 2009
The initial reaction to the HIT Policy Committee's recommendations for the definition of "meaningful use" of electronic health records was shock and concern. I overheard phrases like:
- "It's more of a stimulus stick."
- "You have to walk before crawling."
- "It sets the bar so high; it forces us to game the system."
- "It doesn't show how the functionality required furthers quality goals."
Chief information officers were overwhelmed by the list of objectives for EHRs by 2011, which include
- Using computerized physician order entry systems for all order types including prescriptions in both outpatient and inpatient settings.
- Incorporating lab-test results into EHRs in both outpatient and inpatient settings.
- Generating lists of patients by specific condition to use for quality improvement initiatives, reducing disparities, and outreach in outpatient settings.
- Providing patients with an electronic copy of- or electronic access to- clinical information (including lab results, problem list, medication lists, allergies) in both outpatient and inpatient settings i.e. through a personal health record.
- Providing clinical summaries for patients for each encounter in outpatient and inpatient settings.
- Exchanging key clinical information with other care providers, such as problems, medications, allergies, test results in both outpatient and inpatient settings.
- Submitting immunization and laboratory data to public health agencies.
- Complying with HIPAA Privacy and Security Rules and state laws.
These objectives were centered around five desired health outcomes: Improving quality, safety, efficiency, and reducing health disparities; engaging patients and families; improving care coordination; improving population and public health; and ensuring privacy and security for personal health information.
Even though the policy committee was more aggressive in its first draft of recommendations than many healthcare executives expected—perhaps the committee was hoping to generate a lot of public comment—many healthcare leaders still applauded the goals of the committee.
"The healthcare industry is far behind other industries in this country. Therefore, the bar needs to be set very high in order to drive the industry to catch-up and get where we need to be," says Norm Mitry, CEO of Heritage Valley Health Systems, an integrated delivery network in southwestern Pennsylvania.
Peter Basch, MD, the medical director for ambulatory clinical systems at MedStar Health, an eight-hospital system based in Columbia, MD, agrees. "The HIT policy committee has to take a road where an incentive is an incentive," he says, explaining that it should put the goals within reach of early adopters or just outside of reach of average physicians and hospitals adopting HIT. "We don’t what to set the bar too low that the results of this massive investment by American tax payers in healthcare infrastructure goes to naught."
Still there is a real concern that the bar may be out of reach for many providers. "Hospitals will need significant clinical systems already in place to meet the proposed timeframes," says Catherine Bruno, vice president and chief information officer at Eastern Maine Healthcare Systems in Brewer, ME. "Even though these are health information technology objectives, they are really changing clinical practice," she says.
The discussion on what ‘Meaningful Use’ really means is certainly generating lots of discussion. This is a good summary of the key points.
Eleventh for the week we have:
24 Jun 2009
University Hospitals of Morecambe Bay NHS Trust has completed its roll-out of Lorenzo on a final pilot ward at Furness General Hospital.
Ward Two, which went live on Monday, was the third ward to go live with the iSoft system at the early adopter site.
Steve Fairclough, the trust’s head of health informatics, told E-Health Insider that the orthopaedic ward plus three additional departments - including the patient progression unit, elective orthopaedic unit and discharge unit - went live simultaneously.
“We are taking all the departments as one even though they are scattered across the hospital because of the workflow and processes involved,” he said during an EHI visit to Furness General.
“This means that all surgery wards excluding paediatrics and day surgery are now live with Lorenzo. We are also using a system in pre-assessment clinics to support elective surgery, so we are definitely growing.
More here :
This sounds encouraging!
Twelfth we have:
17 Jun 2009
Choose and Book is launching a major upgrade to its service at the end of this month.
Release 4.2 will go live on Monday 29 June and will enable GPs to find and refer patients using SNOMED terms.
The e-booking system is used for between 53% and 55% of referrals for first outpatient appointments every week, and the introduction of SNOMED terms is designed to make it easier and quicker for GPs.
Dr Stephen Miller, medical director for Choose and Book, said the software upgrade had been more than 18 months in the making.
He added: “GPs told us that they wanted to search using clinical terms, similar to those already in use in many other clinical systems, because they thought it would help patients get referred more quickly and more effectively to the right place for treatment.”
Currently GPs are able to search using ‘speciality and clinic type’, ‘named clinician’ and by key word. Release 4.2 will still enable referrers to use the specialty, clinic type and named clinician functionality, but the key word searches will be replaced by SNOMED terms.
Dr Miller told EHI Primary Care: “It will save you time if you don’t know where a service is located.
"The key word search is purely text–based, so you are relying on providers having used the exact same key words.
"If you make a spelling mistake or use a synonym you might not be able to find the service you want, whereas the SNOMED browser will make suggestions if there is a spelling mistake or come up with a synonym.”
The SNOMED browser will also enable GPs to search for services by symptom and is designed to create a level playing field under 'free choice', as all providers will be using the same terms.
Dr Miller said there are 32,000 services on Choose and Book of which more than 80% have so far been loaded with SNOMED terms. He said many of the remaining services were not necessarily relevant to GPs or could easily be found by referrers using the speciality and clinic type search functions.
This is an important step forward. It will be interesting to see how it works out operationally. The comments on the article are well worth a browse.
Thirteenth we have:
22 Jun 2009
Relying on online sources such as NHS Choices to deliver information to patients could lead the NHS to sustain or even increase health inequalities, a new report warns.
The authors says the government’s policy is to give patients better access to information but that the internet may not be the most effective way of doing so.
The report from Birmingham University’s Health Services Management Centre, Supporting patients to make informed choices in primary care: what works? , says that older people, ethnic minority communities and those on lower incomes are most likely to have literacy problems and least likely to use the internet.
Jo Ellins, the report’s author, added: “Evidence shows that alternative ways of delivering information are far more successful at reaching these groups. More effective alternatives include telephone helplines, digital television and community education programmes.”
This is an important point that proponents of the use of PHRs as a panacea for e-Health ills need to keep firmly in mind.
Fourteenth we have:
MyChart gives patientsaccess to health history,link with doctor’s office
By Stephen T. Watson
NEWS STAFF REPORTER
When you go in for your annual physical, the doctor sits by your side and scans a thick chart filled with a record of your office visits, test results and any medicine you’re taking.
It’s your entire medical history, but it has been kept in your doctor’s hands — until now.
The Buffalo Medical Group, the largest physician group practice in the area, has started a pilot program that provides patient access to health records and is believed to be the first of its kind locally.
Using MyChart, patients can see their medical records over the Internet, immediately get lab results, seek prescription refills, make appointments and quickly get questions answered.
“It’s kind of a peek into the secret little chart that you never get to see,” said Timothy M. Creenan, chief executive officer of Amherst Alarm and a medical group patient, who has used MyChart since last year.
Also, officials say, the MyChart system is useful during public health emergencies because they can contact patients electronically to swiftly get the best information to them.
“The technology is such that it’s an amazing new way to proactively reach out to patients, as well as to have them proactively reach out to us,” said Dr. Irene S. Snow, medical director of the Buffalo Medical Group.
MyChart-type systems build off the growing use of electronic medical records in this country.
Experts see a future of increased portability and accessibility, when patient and doctor will be able to view a medical history at any time, through the Web or a microchip on a card, but key questions must be addressed.
“We’ve got to give patients a lot of informational rights, and full confidentiality and privacy that they have now and control of their record,” said Pam Dixon, executive director of the World Privacy Forum.
Much more here:
There is no doubt this is a trend we will see accelerate over time. Far better than having the provider keep one record and the patient keep another.
Fifteenth we have:
By Fawn Johnson
Of DOW JONES NEWSWIRES
WASHINGTON (Dow Jones)--Medical device makers are forging a new partnership with the cell-phone industry to allow doctors to remotely monitor their patients' heart rhythms, body temperature and breathing rates, with the goal of saving billions in hospitalization costs.
The newly formed San Diego-based West Wireless Health Institute is set to announce this week that it has joined forces with Corventis Inc. to conduct the first of its kind clinical trial of a remote heart monitor.
The Band Aid-like heart patch from Corventis sends patient readings through a Bluetooth wireless connection to the person's smart phone - an iPhone or a BlackBerry. The data is then transmitted to a doctor's office. Physicians are alerted if their patient shows irregularities.
Other device makers are waiting in the wings for similar trials, hoping to win over the people who ultimately would pay for their products - doctors, private insurance companies, and the government.
"The goal is to get it used in medicine, to get [government] reimbursement, to shake up how medicine is practiced," said Dr. Eric Topol, the wireless institute's chief medical officer.
More here (Subscription Required):
This is inevitable and welcome conversion of technologies.
Sixteenth we have:
June 23, 2009 | Bernie Monegain, Editor
WASHINGTON – The decision by CMS to discontinue reimbursement for hospital-acquired infections, the rise of statewide infection reporting initiatives and tougher standards from insurance companies are driving rapid growth for infection control surveillance software, according to a new report from research firm KLAS.
Infection control surveillance software offers a potentially powerful way to battle healthcare acquired infections, but until recently, adoption has been slow, the report notes. Now, new financial and regulatory changes have opened the door for rapid growth in this emerging market.
The KLAS report, Infection Control: Improving Patient Care and Reimbursements, highlights the recent growth and leading vendors in the market for infection control software, which analyzes data from various hospital departments to identify potential infections.
While KLAS estimates that these systems enjoy only 10 to 15 percent market penetration today, many vendors are experiencing rapid sales growth, researchers say.
"The decision by CMS to discontinue reimbursement for hospital-acquired infections has obviously had a direct impact on the adoption of infection control systems," said Steve VanWagenen, KLAS research director and author of the report. "Couple that with initiatives in many states requiring hospitals to report infection control data to the CDC, as well as tougher standards from insurance companies, and these solutions are poised for real growth."
Much more here (registration required):
The old ‘follow the money’ adage seems to be working again!
Fourth last we have:
By LARRY NEUMEISTER – 1 day ago
NEW YORK (AP) — So-called data-mining companies that collect information about the drugs doctors prescribe asked an appeals court Tuesday to stop Vermont from enacting a law next week restricting their work.
Attorney Thomas Julin told a three-judge panel of the 2nd U.S. Circuit Court of Appeals that it would violate the First Amendment rights of the companies if the law is enacted on July 1.
He asked the appeals court to block implementation of the law until it decides whether to uphold a lower court ruling that concluded the law did not violate the Constitution. Both sides were expected to submit written arguments in the wider appeal case within two months.
The court did not immediately rule, but Judge Barrington Parker called it a fascinating case.
Much more here:
It seems to me if this marketing information that is being gathered was not valuable there would not be an issue. The fact it is means drug companies are maximising profits using it – to the disadvantage of the consumer. Game, set and match to the states one would have thought.
Third last we have:
24 Jun 2009
A high profile coalition of patient advocates, US doctors, software vendors and bloggers have launched a Declaration of Rights for health data, HealthDataRights.org.
The new site aims to use social media to build support for increasing patient access to electronic health records. Although launched in the US, HealthDataRights appears universal in its aspirations.
The main objective of the site is to promote a ‘Declaration of Health Data Rights’, that, in emulation of the 1776 US Declaration of Independence states, “we the people”:
- Have the right to our own health data;
- Have the right to know the source of each health data element;
- Have the right to take possession of a complete copy of our individual health data, without delay, at minimal or no cost; if data exist in computable form, they must be made available in that form;
- Have the right to share our health data with others as we see fit;
The site goes on to add, “These principles express basic human rights as well as essential elements of health care that is participatory, appropriate and in the interests of each patient. No law or policy should abridge these rights.”
Much more here:
Sounds good to me!
Second last for the week we have:
Posted: June 24, 2009 - 10:45 am EDT
National Healthcare Information Technology Coordinator David Blumenthal said a work group of the federal Health Information Technology Policy Committee will be looking to add more immediate efficiency measures to its next draft definition of “meaningful use” under the American Recovery and Reinvestment Act of 2009.
Blumenthal’s comment came during a presentation Tuesday before the newly formed and Republicans-only Congressional Health Care Caucus, which is led by fellow physician Rep. Michael Burgess of Texas. Burgess is a member of the House Energy and Commerce Committee and its Healthcare Subcommittee.
At an HIT Policy Committee meeting last week, the work group issued its first draft of a set of definitions of “meaningful use,” a requirement that hospitals and office-based physicians must meet to receive billions of dollars in Medicare or Medicaid subsidy payments to purchase electronic health-record systems.
The discussion at the June 16 meeting included some criticism that the work group had not called for measurable improvements in claims processing and other cost-cutting activities involving use of an EHR until 2015, not in 2011 when other clinical performance metrics are proposed by the work group to be required and when the initial subsidy payments under the law will come due.
Blumenthal said the insurance industry, in a letter to President Barack Obama, called for the president and Congress to create a uniform, national billing system. He said that EHRs should lead to a more efficient billing and payment process. Blumenthal noted the work group is to report back with a revised draft of its “meaningful use” definitions in mid-July and should have the efficiency issue revisited by then.
“The committee is going to go back to the drawing board,” Blumenthal said. “We can, I think, do better than we did and they’re going to try.”
More here (registration required):
See the next article to understand why this question is so important!
Last, and very usefully, we have:
The federal government is about to spend big on health-care IT. Too bad the medical industry has a vested interest in inefficiency.
By Andy Kessler
Technology is once again being touted as a cure-all, this time for what ails the American health-care industry. The Obama administration's $787 billion stimulus plan includes $19 billion for health-care IT spending that provides incentives for doctors and hospitals to adopt electronic health records. Starting in 2011, stimulus funds will provide additional Medicare and Medicaid reimbursements for health-care providers using such systems.
These federal funding programs assume that the critical hurdle to widespread adoption of electronic medical records is cost. Indeed, hospitals surveyed in a study published last year in the Journal of the American Medical Association reported cost as the major barrier. Yet compared with other businesses, the health-care industry has been unmoved by the logic of lowering costs to increase profits. The truth is that these folks could have digitized the whole industry ages ago. The technology has been around for a long time: Wall Street began phasing out physical stock certificates over 35 years ago. Even the cash-strapped airline industry has gone ticketless, removing huge labor and overhead costs. These industries started using electronic records because they believed it would save money. The health-care industry simply has not followed suit.
The reason lies neither with cost nor with inadequate technology. Rather, the health-care industry's reluctance to digitize its records is rooted in a desire to keep medicine's lucrative business model hidden. Dangling $19 billion in front of a $2.4 trillion industry is not nearly enough to get it to reveal the financial secrets that electronic health records are likely to uncover--and upon which its huge profits depend. In those medical records lie the ugly truth about the business of medicine: sickness is profitable. The greater the number of treatments, procedures, and hospital stays, the larger the profit. There is little incentive for doctors and hospitals to identify or reduce wasteful spending in medicine.
The amount of unnecessary spending is huge. In a project that analyzed 4,000 hospitals, the Dartmouth College Institute for Health Policy and Clinical Practice estimated that eliminating 30 percent of Medicare spending would not change either access to health care or the quality of the care itself. The Congressional Budget Office then suggested that $700 billion of the approximately $2.3 trillion spent on health care in 2008 was wasted on treatments that did not improve health outcomes. This excessive spending has kept the entire health-care industry growing faster than the population, and faster than inflation, for decades.
While electronic medical records do have sizable up-front costs, they also have the potential to save big, in part by streamlining administrative costs. According to a 2003 article by Dr. Steffie Woolhandler in the New England Journal of Medicine, administration accounts for 31 percent of expenses in the U.S. health-care industry, or more than $500 billion per year. (To put that in perspective, Google has spent well under 10 percent of that on all its R&D.) Richard Hillestad of the Rand Corporation wrote in Health Affairs, in 2005, that health-care information technology could save physicians' offices and hospitals more than $500 billion over 15 years thanks to improvements in safety and efficiency.
Much more here:
This is a great article and a must read. Be assured it is all true!
There is an amazing amount happening. Enjoy!