Wednesday, July 14, 2010

The USA Shows How Leadership Really Matters in e-Health.

This appeared overnight – and I would suggest is the most important step for e-Health taken anywhere in the world since the release in the UK of its ‘Information for Health’ Strategy about 8 years ago.

What is described here is the outcome that can be worked towards when some real smarts, some real leadership and some real money are used to address an obvious problem.

Australia compares so poorly in all three areas right now it is really very sad I believe.

The “Meaningful Use” Regulation for Electronic Health Records

Posted by NEJM • July 13th, 2010 • Printer-friendly

David Blumenthal, M.D., M.P.P., and Marilyn Tavenner, R.N., M.H.A.

The widespread use of electronic health records (EHRs) in the United States is inevitable. EHRs will improve caregivers’ decisions and patients’ outcomes. Once patients experience the benefits of this technology, they will demand nothing less from their providers. Hundreds of thousands of physicians have already seen these benefits in their clinical practice.

But inevitability does not mean easy transition. We have years of professional agreement and bipartisan consensus regarding the potential value of EHRs. Yet we have not moved significantly to extend the availability of EHRs from a few large institutions to the smaller clinics and practices where most Americans receive their health care.

Last year, Congress and the Obama administration provided the health care community with a transformational opportunity to break through the barriers to progress. The Health Information Technology for Economic and Clinical Health Act (HITECH) authorized incentive payments through Medicare and Medicaid to clinicians and hospitals when they use EHRs privately and securely to achieve specified improvements in care delivery.

Through HITECH, the federal government will commit unprecedented resources to supporting the adoption and use of EHRs. It will make available incentive payments totaling up to $27 billion over 10 years, or as much as $44,000 (through Medicare) and $63,750 (through Medicaid) per clinician. This funding will provide important support to achieve liftoff for the creation of a nationwide system of EHRs.

Equally important, HITECH’s goal is not adoption alone but “meaningful use” of EHRs — that is, their use by providers to achieve significant improvements in care. The legislation ties payments specifically to the achievement of advances in health care processes and outcomes.

HITECH calls on the secretary of health and human services to develop specific “meaningful use” objectives. With the Centers for Medicare and Medicaid Services (CMS) in the lead, the Department of Health and Human Services (DHHS) has used an inclusive and open process to develop these criteria, providing an extensive opportunity for public and professional input. The department published proposed meaningful use requirements on January 16, 2010. The proposal prompted some 2000 comments. This week, the DHHS is releasing a final regulation for the first 2 years (2011 and 2012) of this multiyear incentive program. Subsequent rules will govern later phases.

The full article is here:

A .pdf can be downloaded from the bottom of the article. This is worth doing to read the contents of just what is required to receive the $27 Billion in incentive payments.

The Journal has also published an amusing story on one doctor’s trip to the EHR!

Finding My Way to Electronic Health Records

Posted by NEJM • July 13th, 2010 • Printer-friendly

Regina Benjamin, M.D., M.B.A.

The recent oil spill off the Gulf Coast may prove to be one of the great environmental challenges of our lifetime. It is yet another devastating blow to the Gulf region, a place I call home. My heart goes out to the people there who are concerned about how this latest disaster will affect their livelihood and their health. Though the full effects of the spill remain to be seen, already the health needs of Gulf Coast inhabitants are increasing during this time of crisis. Physicians in the area will need to adapt and find innovative ways to efficiently deliver health care for an already underserved population. I recall my experiences as a physician during the crises of Hurricanes Georges and Katrina and try to remember how I adapted.

Full tale here:

For another take on all this it is worth reading John Halamka’s blog.

Tuesday, July 13, 2010

Meaningful Use and the Standards are Finalized

Today at 10am, CMS and ONC released the final rules that will guide electronic health record rollouts for the next 5 years. Key resources include:

New England Journal of Medicine overview. The table provides a detailed list of final meaningful use requirements.

Federal Register publication of the Meaningful Use regulation

Federal Register publication of the Standards regulation


Overall, a very good day for ONC, HHS and stakeholders. The final rule means Meaningful Use will be achievable by many. The Standards and the process to certify their use are sufficiently specific. I'm impressed.

John Halamka

Read and take heart. Good things are possible I believe but lacking the leadership and governance frameworks I am not at all confident they will come to pass.


1 comment:

Anonymous said...

The US has the knack of identifying, appointing and then trusting folks with actual expertise in a domain to lead such enterprises.

In Australia we run from experts (part of our cultural cringe) and instead either do it try to handle programs like e-healht via a government bureaucracy, or the consultancy houses, or those who manage to curry political favour to get plumb jobs.

If we want excellence we need to find and support individuals of excellence. The job is hard enough even if you do that. Lets see who the new DOHA CIO will be - that will be interesting.