Edition Two (2/10/09)

Comparison of Economic Stimulus Plans
Boston Globe, 2/10/09
The Boston Globe compared the Senate and House economic stimulus plans, and laid out how the health care funding will be spent. In the Senate bill: $20 billion to subsidize health care insurance for the unemployed under the COBRA program; $87 billion to help states with Medicaid; $22 billion to modernize health information technology systems; and $10 billion for health research and construction of National Institutes of Health facilities. In the House bill: $40 billion for more generous COBRA subsidies and to provide health care through Medicaid; $87 billion to help states with Medicaid; $20 billion to modernize health information technology systems; $4 billion for preventative care; $1.5 billion for community health centers; $420 million to combat avian flu; and $335 million for programs that combat AIDS, sexually transmitted diseases and tuberculosis.

Lawmakers differ on EMR privacy
Washington Post, 2/10/09
House and Senate lawmakers are at odds over language in the stimulus bill covering privacy of electronic medical records. House members support tougher protections, while the Senate has opted for more limited protections in its version of the bill. Health care providers and insurers have expressed concern that proposed provisions could interfere with efforts to improve care quality and efficiency.

The Stimulus Bill Will Change How I.T. Data is Used in Health Care
HIStalk, 2/10/09
Dr. Peter Sanderson, a family physician and Director of Medical Informatics and Operations and Executive Sponsor, EHR Program, at Ministry Health Care, made a guest appearance on HIStalk to comment on how the economic stimulus bill will effect health care I.T.

Revised Bill Retains Most I.T. Funds
Health Data Management, 2/9/09
The compromise reached in the U.S. Senate the evening of Feb. 6 on the economic stimulus bill retains most of the funding that was originally proposed for health information technology initiatives. The Senate expects to vote on the revised stimulus bill Tuesday, Feb. 10. The compromise retains the original Senate bill's nearly $20 billion to fund Medicare and Medicaid incentive payments for the use of I.T. and $3 billion in "jump start" funds allocated to the Office of the National Coordinator for Health Information Technology. The original Senate bill allocated $5 billion to ONC; the bill approved earlier by the House included $2 billion.

Kansas Gov. Sebelius Among Top Choices for HHS Secretary, Obama Administration Officials Say
Kaiser Daily Health Policy Report, 2/9/09
Kansas Gov. Kathleen Sebelius (D) has emerged as "the leading contender" for HHS secretary, with Tennessee Gov. Phil Bredesen (D) also under consideration, according to Obama administration officials. According to the AP/Baltimore Sun, Sebelius has had a "long and close working relationship" with Obama, and she "worked tirelessly for Obama's bid and was a top surrogate to women's groups." In addition, advocacy groups believe that her former role as Kansas insurance commissioner benefits her candidacy for the position. Bredesen also remains under consideration for the position, although some advocacy groups have raised concerns about his former role as an executive with a managed care company, as well as his continued financial ties to the health insurance industry.

Stimulus Would Boost Digitizing Health Records
San Francisco Chronicle, 2/9/09
Both the House and Senate versions of the economic stimulus package include $20 billion for electronic medical records, a sum expected to spur the conversion to save costs, improve the quality of care and add information technology jobs, especially in the San Franciso area. While a relatively small part of President Obama's roughly $900 billion plan to jump-start the economy, the funds amount to the largest infusion of cash the health I.T. industry has ever seen.

Lawmakers Endorse Dean
The Hill, 2/8/09
Sen. Bernie Sanders (I-Vt.) became the latest of several lawmakers to endorse former Democratic National Committee Chair and former Vermont Gov. Howard Dean (D) as the nominee for HHS secretary. In a letter sent to Obama, Sanders wrote that Dean, a physician, is "eminently qualified" for the position. He wrote, "Gov. Dean understands, as you do, that all Americans are entitled to health care as a right of citizenship, and that we must pay far more attention to the needs of our children if we are to have a healthy and prosperous society."

Bipartisan Deal Eases Way for Stimulus Bill in Senate
Washington Post, 2/6/09
Against a backdrop of rising unemployment, Senate Democrats struck a hard-won deal yesterday with a handful of Republican moderates to scale back spending in a massive economic stimulus bill, virtually guaranteeing Senate passage of the legislation but also ensuring arduous final negotiations with the House. The bipartisan deal was cut after two days of talks and would cut more than $100 billion from the $920 billion bill, dropping its cost to about $820 billion, if amendments added on the Senate floor are retained. Moments after Reid announced the deal on the Senate floor, GOP lawmakers said that they will seek to delay a final vote through procedural objections, which could push debate to as late as Monday. The compromise cut $2 billion from a plan to help critical-access hospitals computerize medical records.

Senators Reach Deal on Stimulus Plan as Jobs Vanish
New York Times, 2/6/09
Just hours after the Labor Department announced that 598,000 jobs were lost in January, Democrats reached an agreement with Republican moderates on Friday to pare a huge economic recovery measure, clearing the way for approval of a package that President Obama said was urgently needed in light of mounting job losses. The contraction in jobs is already steeper than in any other recession since at least the early 1980s. And economists warn that several more shoes are about to drop, a message that added urgency to the Senate deliberations.

Baucus and Kennedy Vow Action on Health Care
Wall Street Journal, 2/6/09
Two key congressional players on health care vowed their commitment to moving forward with reform legislation in a letter to President Barack Obama. "We are writing to affirm our continuing commitment to enacting comprehensive health care reform this year, and to express our confidence that you will swiftly choose an exceptionally qualified and dedicated alternate nominee for Secretary of Health and Human Services to assist in our efforts. As you have emphasized, we must act now," wrote Senate Finance Chairman Max Baucus of Montana and Health Education Labor and Pensions Committee Secretary Edward Kennedy of Massachusetts.

Obama's Plans for Health Care I.T.: Too Much Money Too Soon?
Computerworld, 2/5/09
President Barack Obama's plan to inject $25 billion into the health care industry (Health Information Technology for Economic and Clinical Health Act) could create a technological divide between large and small health care organizations, according to doctors and health care professionals. And some worry that his efforts to create a national electronic health records (EHR) system could affect the quality of health care in the U.S. Those were among the concerns to emerge at the Massachusetts Health Data Consortium's 2009 Health Information Technology (HIT) Conference where several hundred health care professionals attended the day-long conference.

Observers Speculate on Whom Obama Might Nominate as HHS Secretary, Director of White House Office of Health Reform
Kaiser Daily Health Policy Report, 2/5/09
According to observers, possible replacements for Senate Majority Leader Tom Daschle (D-S.D.) could include Kansas Gov. Kathleen Sebelius (D); Pennsylvania Gov. Ed Rendell (D); Michigan Gov. Jennifer Granholm (D); former Oregon Gov. John Kitzhaber (D); former Democratic National Committee Chair and former Vermont Gov. Howard Dean (D); CIA Director Leon Panetta, who served as director of the White House Office of Management and Budget under former President Bill Clinton; Massachusetts Gov. Deval Patrick (D), who implemented the state's health insurance law and has addressed unexpected problems with the law, is a possible replacement; or former Massachusetts Gov. Mitt Romney (R), who drafted the Massachusetts health insurance law.

Senator: Don't Strip I.T. from Bill
Health Data Management, 2/5/09
Sen. Sheldon Whitehouse (D-R.I.) on Feb. 4 spoke on the Senate floor amid rumors of support for an amendment to strip health information technology funding from the economic stimulus bill. Whitehouse argued that infrastructure improvements, beyond traditional brick and mortar projects, would create immediate jobs and long-lasting economic growth. Full speech, located here.

Docs Say I.T. Critical to Health Care Reform
Healthcare IT News, 2/4/09
Two physician organizations are weighing in on the health care piece of the economic stimulus package, calling on the president and Congress to support health care information technology, additional funding for primary care training, Medicaid funding for states, and comparative effectiveness research. The American Academy of Family Physicians and the American College of Physicians, which represents 126,000 internal medicine physicians, separately called for action on health care reform.

Health I.T. Amendments Expected in Senate Economic Stimulus Bill
iHealthbeat, 2/4/09
Several changes to health I.T. language in the Senate economic stimulus bill are expected as lawmakers continue to debate the legislation. Health care disparities, quality initiatives, health privacy violations, and data breach notification were discussed among the changes.

As Nominee Trips, Health Care Drive Suffers a Setback
New York Times, 2/4/09
The abrupt collapse of Tom Daschle’s cabinet nomination undercut President Obama’s mission to expand health care by depriving him of an unusually well positioned architect for a big legislative campaign and leaving him without a backup plan. Mr. Daschle’s decision to withdraw his candidacy for secretary of health and human services could slow the president’s drive to reshape the nation’s health care system as the White House searches for a replacement, and it could allow Congress to step into the vacuum during that delay, analysts said.

IBM, Google Partner on On-line Health Records
Silicon Valley/San Jose Business Journal, 02/02/09
Google Inc. and International Business Machines Corp. have teamed up to help get personal health data on-line. The companies said people who use Google Health can now automatically stream data from medical devices into their personal health records. The new feature uses software IBM developed based on guidelines from Continua Health Alliance, an organization that supports interoperable health care technology products. It is also based in part on open-source software available now from Eclipse and Open Health Tools, two open-source communities dedicated to supporting advancements in health care.

Survey: Recession Hits Georgia Hospitals Hard
Atlanta Journal-Constitution, 2/5/09
The economic downturn has caused 60% of Georgia's hospitals to cut staff or consider it, and more than one-third to reduce services or contemplate such a move, according to a survey of 63 hospitals and health systems by the Georgia Hospital Association. And about 60% of hospitals say the economy and low payments from the Medicaid insurance program have affected their ability to meet day-to-day operating expenses.

South Carolina Program Puts HAIs in the Crosshairs
HealthLeaders Media, 2/4/09
South Carolina is launching the South Carolina Healthcare Quality Trust (SCHQT), a statewide, voluntary hospital quality collaborative to reduce hospital-acquired infections and their associated costs. SCHQT creates a free information-sharing portal linking the state's 65 hospitals with one another and with the major academic and research medical facilities in the state, with an emphasis on using evidence-based practices that eliminate preventable HAIs.

Indiana Bill Aims to Increase Oversight of Retail Health Clinics
Kaiser Daily Health Policy Report, 2/4/09
A bill sponsored by Indiana state Sen. Patricia Miller (R) aims to increase government oversight of and set new standards for retail health clinics in the state. There are about 300 retail health clinics in the state. Under Miller's proposal, the clinics would have to install entrances that are separate from the store entrance; train all staff in cardiopulmonary resuscitation; display fees outside of the examination rooms; and provide a detailed report of patients' visits to their primary care physicians, among other measures.

Penn Study Shows How Electronic Medical Records Can Be Used to Test Drug Efficacy
Insciences.org, 2/6/09
Researchers at the University of Pennsylvania School of Medicine have discovered a way to get another bonus from the implementation of electronic medical records: testing the efficacy of treatments for disease. In the first study of its kind, Richard Tannen, M.D., Professor of Medicine at the University of Pennsylvania School of Medicine, led a team of researchers to find out if patient data, as captured by EMR databases, could be used to obtain vital information as effectively as randomized clinical trials, when evaluating drug therapies. Tannen warns the ability to use EMR databases from the United States to measure the efficacy of therapies will take more than 10 years of national data, but the results should serve as a catalyst for more researchers to explore the accuracy of the information that can be obtained using EMR database studies.

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