Edition Six (3/10/09)

Making Smart Investments In HIT
Life As a Healthcare CIO, 3/10/09
John D. Halamka, MD, MS, Chief Information Officer of the CareGroup Health System, wrote an article highlighting five guiding principles for spending stimulus funds wisely. Additionally, check out his daily posts on his blog, which include information on the economic stimulus plan.

Report Questions Stimulus Bill Health I.T. money
AP/Yahoo News, 3/10/09
Billions of stimulus dollars meant to spur doctors to switch to electronic record-keeping may not be enough to do the job, according to a study by Avalere Health, an information company serving government and the health care industry. The stimulus bill signed by President Obama contained $19 billion for health information technology, including $17 billion for incentives and penalties to encourage doctors and hospitals to abandon paper record-keeping and go high-tech beginning in 2011. But particularly for doctors in small practices, the high cost of installing electronic records systems could outweigh the incentives and penalties for failing to comply, the analysis said.

Stimulus Money + EHR + Medical Home = Reform
HealthLeaders, 3/10/09
There are five areas the United States has to concentrate on in order to improve health care: coverage for all, payment incentive reform and realignment, wellness initiatives, quality improvement, and health information technology. That is what American Hospital Association President Richard Umbdenstock told key stakeholders last week during President Obama's White House health care summit.

Comparing U.S., Canada I.T. Efforts
Health Data Management, 3/6/09
Sierra Systems, a British Columbia-based consulting firm, has released a brief report comparing the national health care information technology initiatives of Canada and the United States. The report also notes lessons learned in Canada for U.S. policymakers. The firm has experience implementing electronic health records systems across Canada, where the government is helping fund EHRs.

Stimulus Package Boosts Medical Document Scanning
PRWeb, 3/6/09
President Obama has given doctors a $19 billion incentive to convert their paper records to digital files. Medical record scanning was marked as a high priority initiative in the $800 billion stimulus package. The president is clearly sending a message to medical practices and hospitals that it is time to convert their paper files to Electronic Medical Records (EMR).

Revisiting the EMR Stimulus Math
HealthLeaders, 3/5/09
Sometime in the not-too-distant future, the vast majority of health records will be electronic. I am sold on the benefits of EMR systems and I am a proponent of physician adoption when possible. Even if I weren't, however, I'd recognize that forces are pushing health care in that direction and physicians can only lag behind for so long.

DeParle’s Industry Ties a Non-Issue
The Hill, 3/5/09
White House Office of Health Reform Director Nancy-Ann DeParle’s professional ties to health care companies may have prompted questions from the media, but government ethics watchdogs say they don’t see a problem. DeParle brings stellar credentials to her new job, having served in several high-level federal and state government health care positions. She also can boast of a top-tier educational background that includes a Harvard law degree, degrees from Oxford University and a Rhodes scholarship. But since 2001, DeParle has worked in the private equity field, advising on deals between health care companies and serving on the boards of directors of a handful of health care firms.

Electronic Medical Records: Will They Really Cut Costs?
Time Magazine, 3/5/09
Expanding the use of EHRs, touted by President Obama and many others as a means to improve health care and control costs, would provide doctors with "advantages" but many physicians are concerned that "the greatest cost will be in the quality of medicine [they] practice," Time Magazine reports. While U.S. physicians have "not been enemies of the digital revolution," many are "forced to use computerized orders" or risk being barred from hospitals.

The Nation’s New Chief Information Officer Speaks
The New York Times, 3/5/09
Reforming the entire health care system may be easier than doing everything Vivek Kundra says he wants to do when it comes to reforming the government’s computer systems. Mr. Kundra, the 34-year-old former chief technology officer of the District of Columbia, was named by President Obama to the new position of chief information officer of the United States. That’s a different job than the chief technology officer, a White House position that Mr. Obama said he would create but has yet to define. The chief information officer, however, will be part of the Office of Management and Budget. He will oversee $71 billion in annual technology spending across the government and set standards for the design of federal systems.

AMIA Defines Clinical Informatics Subspecialty
Modern Healthcare, subscription needed 3/5/09
The American Medial Informatics Association released details of its clinical informatics subspecialty that it says will enhance physicians’ ability to use health information technology to provide safe, effective, and efficient patient care. The content has been in development for two years, when AMIA first received a $300,000 grant from the Robert Wood Johnson Foundation to establish a base for defining the clinical informatics subspecialty and establishing medical training requirements for it. The organization this week released two white papers in the Journal of the American Medical Informatics Association defining the subspecialty’s core content and detailing the requirements of a clinical informatics fellowship program. AMIA said it is now reaching out to the American Board of Medical Specialties to formally establish the subspecialty.

White House Czars' Power Stirs Criticism
Chicago Tribune, 3/5/09
President Obama named two women this week to lead his effort to overhaul the nation's health care system. One of them, Gov. Kathleen Sebelius of Kansas, began preparing for confirmation hearings. But the other woman, Nancy-Ann DeParle, can begin work right away, without outside review of her abilities or opinions. That is because DeParle holds the newly created post of "health czar"—one of several new "czar" positions that are within the White House and require no Senate review. Now, with the number of czars growing, some lawmakers and outside experts fear that Obama is concentrating too much on policymaking and power within the White House—and also setting up the potential for conflict among his many advisers.

In Health Plan, Industry Sees Good Business
The Washington Post, 3/5/09
President Obama's attempt to dramatically expand the health care system has attracted support from insurers, hospitals, and other players in the powerful medical lobby who are set to participate in an unusual White House summit on the issue. The lure for the industry is the prospect of tens of millions of new customers: If Obama succeeds in fulfilling his pledge to cover many more Americans, those newly insured people will get checkups, purchase medicine, undergo physical therapy, and get surgeries they cannot afford today.

New HRSA Chief Brings Nurse's Perspective
HealthLeaders, 3/4/09
Newly appointed Health Resources Services Administration Administrator Mary Wakefield says her background as a registered nurse will be as valuable to her new job as her years of experience and expertise in the health care policy arena. Wakefield starts at HRSA on March 10, where she will lead an organization with 1,400 employees in six bureaus and 13 offices, and an annual budget of about $6.85 billion—90% of which is doled out to provide grants that directly affect about 23 million people in urban and rural areas in every state and territory. HRSA grants are targeted to improve health care access, quality, and outcomes to vulnerable populations that include the poor, uninsured, people with HIV/AIDS, pregnant women, and mothers and children.

Google Says New Privacy Rules Don’t Affect its PHR
Modern Healthcare, subscription needed 3/4/09
If Congress thought it had roped in the personal health record services of Google and Microsoft Corp. under federal privacy and security rules with the recently passed American Recovery and Reinvestment Act, according to a top Google health official, the lasso missed. A 22-page subtitle of the act was devoted to updating the privacy and security measures of the Health Insurance Portability and Accountability Act of 1996.

Free Course Covers I.T. in Stimulus
Health Data Management, 3/4/09
Washington-based Health I.T. Certification, a training firm for information technology professionals, is offering a complimentary on-line course on the health I.T. provisions in the American Recovery and Reinvestment Act. The 69-page course is designed for those who need to quickly come up to speed on the law and how it affects health I.T. The course has separate sections covering the law and its overall health care spending; funding specific to health I.T., including explanations of Medicare and Medicaid incentives; new federal policies in the Health Information Technology for Economic and Clinical Health Act within the law; and new privacy and security requirements.

Community Hospitals and Stimulus I.T.
Lead Time, a leadership blog for HealthLeaders, 3/3/09
It seems to me that the real impact of the I.T. funds available under the Stimulus Package will be felt at the community hospital level: those hospitals that for a variety of reasons are not as far along in clinical documentation as they want to be. I asked Tom Stephenson, President and CEO of Healthcare Management Systems, Inc., which has 600 community hospital clients, how they see the law playing out.

A Do-it-Yourself Board Presentation
Life As a Healthcare CIO, 3/3/09
Here's a post on the nomination of Kansas Governor Kathleen Sebelius as HHS Secretary from blogger John Halamka. Halamka points out that now that healthcare leadership is imminent, the entire industry is anticipating action on the next steps outlined by the American Recovery and Reinvestment Act. Every I.T. professional in the land is being asked to present an overview to their Board summarizing the possibilities, Halamka says, and he puts a sample presentation together for readers.

Time to Move Beyond The Stimulus Hype And Get to Work
HealthLeaders, 3/3/09
The United States health care system is going to become digitized. By allotting nearly $20 billion for health information technology, President Obama has set in motion a fundamental change to our entire health care system which many experts agree has been a long time coming. The period we're in now is that nebulous time after a bill has become law, but before any tangible change takes place when all the blogs and message boards come alive with opinions, hypotheses, and predictions about what this infusion of cash will mean in practical terms for the country's hospitals and physician practices.

Obama Taps Health Aide With Links to Industry
The New York Times, 3/2/09
In picking Nancy-Ann DeParle to champion an overhaul of the nation’s health system, President Obama selected someone with deep roots in the Washington bureaucracy, an intimate familiarity with health policy, and respect on both sides of the political aisle—not to mention degrees from Harvard Law School and Oxford University. But in putting Ms. DeParle in charge of an issue that has bedeviled presidents for decades, Mr. Obama also chose to overlook Ms. DeParle’s business ties to companies that have a direct stake in the health care debate.

Stimulus Package May Allow Hospitals to "Dust Off" Stalled I.T. Projects
HealthImaging.com, 3/2/09
Bradley Erickson, MD, PhD, from the Mayo Clinic discusses how some providers are reexamining health care I.T. projects which have been deferred now that the economic stimulus has been passed. He also says now is the time to get to begin evaluating how many jobs I.T. projects create, assessing the health care quality impact, and totaling costs in anticipation of government requests for grant applications.

Industry Coalition Launches Health I.T. Security Plan
Reuters, 3/2/09
A coalition of more than 50 health care companies and technology vendors unveiled a common security framework designed to be a benchmark for safeguarding the privacy of electronic medical records. The Obama administration is encouraging broader use of electronic records in the United States with the aim of reducing medical errors, eliminating redundant testing and saving money overall. But patient privacy concerns, a rise in security breaches in information technology and a lack of widely accepted security standards have been stumbling blocks.

Innovation May Fuel Economic Recovery
Boston Globe, 3/9/09
When the economy finally snaps back, technology is expected be the catalyst that pulls Massachusetts out of its doldrums, just as it has done in the past. It may not be computers or the Internet this time, but according to analysts, entrepreneurs are likely to ride to the rescue in fields like cell phones, medical gear, and the batteries that power the cars of the future. With the state jobless rate now topping 7 percent for the first time in nearly 16 years, the economy looks to be sliding to levels not seen since the late 1980s and early 1990s, when unemployment in Massachusetts peaked at 9 percent. That period was followed by a technology boom fueled by the personal computer revolution.

Wisconsin Hospitals Move Toward Wristband Standardization
Modern Healthcare, subscription needed 3/5/09
Nearly 80% of hospitals in the state of Wisconsin have standardized the use of color-coded wristbands, falling short of the Wisconsin Hospital Association’s goal of 100% standardization by March 1. Despite not meeting that goal, the association said the high number of hospitals that are now using the same colors on wristbands to identify different medical conditions means they recognize the need to standardize to improve patient safety.

Communications Networks Connect, Divide Iowa Hospitals
Des Moines Register, 3/1/09
The federal government is spending nearly $18 million to hook every Iowa hospital to fiber-optic communications networks, but there's no guarantee that the hospitals all will be able to talk to each other easily. The projects are part of a national push to increase the use of electronic medical records. Supporters say the networks will allow staff members at one hospital to rush medical scans and other vital patient records to their counterparts at a different hospital.



AMA to White House: Don't Dictate Care
HealthLeaders, 3/9/09
President Obama is calling for flexibility and compromise from stakeholders in the health care reform debate, but the nation's largest physicians' organization warns that any attempts by the federal government to use evidence-based medicine to dictate how physicians provide individualized care would be a deal breaker. In an interview with HealthLeaders Media, American Medical Association President Nancy Nielsen, MD, says she's already made that clear in her two summit meetings with the president in the last two weeks.

Cough, Cough. Is There a Doctor in the Mouse?
The Wall Street Journal, 3/5/09
The doctor will see you now ... electronically. Some new low-cost services have popped up on the Internet with the aim of providing basic health care consultations more cheaply and easily. The services are the next step in "telehealth," or the delivery of health care through the telephone, Web, or other telecommunications technologies. While some doctors communicate with their patients electronically, medical providers, and insurance companies generally provide on-line services that allow patients only to manage personal health records, schedule appointments, refill prescriptions, and request referrals.

Adding Up Obama’s Plan to Save $300 Billion in Medicare, Medicaid
The Wall Street Journals' Health Blog, 2/27/09
We all know by know that the $630 billion health care “reserve fund” described in President Obama’s budget relies on a combination of tax increases and savings in Medicare and Medicaid spending. But just what do those spending cuts look like? We found a pretty clear answer in Table S-6, on p. 127 of the budget outline.

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