Edition Five (3/3/09)

Congress Eyes I.T. to Fund ER Pay Bump
Modern Healthcare, subscription needed 3/3/09
Lawmakers who want to offer a 10% Medicare reimbursement increase for emergency department care are looking to health information technology adoption to offset that pay bump. Last week, a bipartisan group of senators and congressmen reintroduced the Access to Emergency Medical Services Act, which calls for the creation of a national bipartisan commission to examine factors that affect the delivery of care in emergency departments, and asks the CMS to develop standards, guidelines, and measures to address boarding—keeping patients in ER exam rooms or in the hallways when inpatient rooms aren’t available—and ambulance diversion.

On Health, President Takes Team Approach
The New York Times, 3/3/09
In separating the roles of health czar and health secretary, President Obama is adding to an already large stable of experts who will help him in his effort to overhaul the health care system. But it was not immediately clear who would dominate, or who would corral members of the ever-growing team, with their varying viewpoints. While all the players agree that the goal is providing affordable health insurance to all, they have expressed different ideas about how to get there.

Obama Taps Sebelius, DeParle for Health Posts
CNN.com, 3/2/09
President Obama announced the nomination of Kansas Gov. Kathleen Sebelius for the position of health and human services secretary. Sebelius— whom Obama seriously considered as his vice presidential nominee, according to administration officials—was rumored for weeks to be a top contender for the job. Obama also announced Nancy Ann Min DeParle will be his new director of the White House office on health reform. DeParle's position, also referred to as the White House health care czar, was conceived by Obama's initial HHS pick, former Senator Tom Daschle. DeParle would work with Sebelius as the president's point person to coordinate the administration's outreach to Congress regarding health care reform.

Obama Pick Gets a 2nd Chance on Health Care
The New York Times, 3/2/09
In Kansas, Gov. Kathleen Sebelius is known as a Democrat who can deal with Republicans, a necessity in a state where the opposition party dominates both houses of the Legislature. But on matters of health policy, Ms. Sebelius’s efforts to forge bipartisan consensus have rarely succeeded. She recently observed that the greatest frustration of her six years in office had been her inability to persuade lawmakers to raise tobacco taxes for a modest expansion of government health coverage.

Obama's Health Plan, Ambitious in Any Economy, Is Tougher in This One
The New York Times, 3/1/09
President Obama's goal of remaking the health care system was always going to be difficult to reach, but the ailing economy has complicated his task. Obama is proposing a major expansion of the federal commitment to health care even though the government can barely afford the health insurance programs it has. The financial condition of Medicare is deteriorating because of the recession, and the Medicare trust fund could be depleted several years sooner than expected. But Obama hopes to turn the economic crisis to his advantage by citing the burden of health costs and the growing ranks of the uninsured, now at 46 million people, to justify a shake-up.

How to Make Electronic Medical Records a Reality
The New York Times, 2/28/09
Only about 17% of the nation's physicians are using computerized patient records, according to a government-sponsored survey published last year in The New England Journal of Medicine. That market failure is a principal target of the Obama administration’s plan: A main feature of the legislation calls for incentive payments of more than $40,000 spread over a few years for a physician who buys and uses electronic health records. A crucial bridge to success, according to experts, will be how local organizations help doctors in small offices adopt and use electronic records.

Waxman Details Agenda To Track Health Care Spending in Stimulus Package
Kaiser Daily Health Policy Report, 2/26/09
House Energy and Commerce Committee Chair Henry Waxman (D-Calif.) has outlined a detailed plan to oversee health spending in the recently enacted economic stimulus package, including the $19 billion for health information technology and $87 billion in increased Medicaid funding to states.

Alliance Report Offers Three HIE Organizational Models
Modern Healthcare, subscription needed 2/26/09
As states consider ways to develop and expand health information technology, a new report conducted by the University of Massachusetts Medical School outlines three public-governance models that could lead to sustainable health information exchange. The report was prepared for the State Alliance for e-Health, a consensus-based, executive-level body of state elected and appointed officials who are responsible for reviewing the health I.T. and electronic HIE issues of state governments.

AMA Officials Applaud Health Reform Goals
Temple Daily Telegram, 2/26/09
The cost of medical care is escalating and out of reach for many. According to President Obama, by the end of 2009, it could cause 1.5 million American to lose their homes. In his address to Congress, Obama said the “crushing cost of health care” needs to be addressed. The recovery plan will include investing in electronic health care records and new technologies that will reduce errors, bring down costs, ensure privacy and save lives, Obama said.

Obama's e-Health Plan: Three Heavyweight Health I.T. Leaders Weigh In
Computerworld, 2/26/09
President Obama, in his address to Congress this week, emphasized that he wants electronic health records to be established for all Americans over the next five years. His recently passed American Recovery and Reinvestment Act earmarked $19 billion for health information technology spending, $17 billion of which is designated for incentive payments for EHR use beginning in 2011. To date, only about 25% of the nation's 5,000 hospitals have rolled out EHR systems, and only a small fraction of physician practices have done the same. Computerworld spoke with three health technology experts from private corporations and the I.T. vendor side to get their take on the new bill and whether the billions being spent will succeed in establishing EHRs.

Gartner: I.T. Spending to Grow 2.6%
Health Data Management, 2/24/09
The U.S. health care industry will increase spending on information technology by 2.6% to $28.4 billion in 2009, according to Gartner Inc., a Stamford, Conn.-based research and consulting firm. Because of the recession, the rate of growth will be down substantially from 2008, when health I.T. spending grew 6.6%, and 2007, when it grew 7%. Nevertheless, I.T. spending will grow more in health care during 2009, than any other sector of the U.S. economy because of the federal financial incentives for electronic health records under the economic stimulus package.



Health Care Systems Could Get Help with Electronic Records
Charlotte Business Journal, 2/27/09
Local medical providers which already have electronic health records systems could still benefit from $19 billion in federal economic stimulus money. The government will provide grants and incentive payments for existing systems, says Blair Childs, senior vice president for Premier Inc., a health care alliance with key operations in Charlotte. The money can be used to offset system upgrades and maintenance expenses as well as startup costs. However, those grants for existing systems aren’t slated to start until October 2010.

National Health I.T. Network Ready for First Exchanges
Modern Healthcare, subscription needed 2/27/09
The first practical data exchange begins tomorrow for some participants in the national health information network after more than a year of testing and demonstrations. The Social Security Administration on February 28 will begin receiving medical records of patients at Bon Secours Richmond Health System from MedVirginia, the regional health information organization serving central Virginia, so it can more quickly determine disability benefits. The go-LIVE comes after basic exchange and specific data testing began in September 2007, when nine RHIOs first began to implement the national network using a $22.5 million federal award.

Hospitals Seek Help for Electronic Medical Records Challenge
Pittsburgh Business Times, 2/27/09
Hospitals and doctors are on a deadline to invest serious money in computerized medical records at a time when charity care is up and reimbursement is down, a problem that’s stinging community hospitals. The economic stimulus package contains $17.2 billion for health information technology for hospitals nationwide. For hospitals just starting to shop for the equipment, it may be too late: Fewer than half of Pennsylvania hospitals are expected to qualify for grant money to buy the gear. Instead, doctors and most other hospitals will be rewarded with government incentive payments for getting on-line by 2011.

Johns Hopkins Medicine, Erickson Retirement Communities Lead e-Medical Records Push
Baltimore Business Journal, 2/24/09
Health industry leaders have submitted a plan to create a statewide health information exchange that would enable hospitals to share electronic medical records. Erickson Retirement Communities, Johns Hopkins Medicine, University of Maryland Medical System, and more than a dozen companies and health care institutions submitted their plan this month to the state’s health care commission.



Tools to Standardize Security Launched
Health Data Management, 3/2/09
The Health Information Trust Alliance, an industry consortium, has unveiled its Common Security Framework for electronic health information. The framework is an attempt to standardize health I.T. security practices. The framework includes a best-practices security implementation manual, a standards and regulations cross-reference matrix, and a readiness assessment toolkit, among other services.

Stimulus Broadens Privacy Disclosure Accounting
Modern Healthcare, subscription needed 3/2/09
Patient-privacy advocates have plenty to cheer about in the American Recovery and Reinvestment Act of 2009. Hospitals, physician offices, health plans, pharmacies, claims clearinghouses, and other so-called “covered entities” under HIPAA, as well as their business associates—if they use electronic health record systems—will be required to provide patients with a much broader accounting of the disclosures they make of a patient’s protected health care information. Robert Gellman, a Washington lawyer and privacy consultant, wrote an 18-page analysis (PDF) of the privacy provisions of the new law.

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