Edition Ten (4/7/09)

HHS Updates HIMSS Crowd on I.T.
Health Data Management, 4/6/09
The health information technology funding and policy provisions in the American Recovery and Reinvestment Act are a "game-changer" for the industry, says Robert Kolodner, the national coordinator for health information technology in the Department of Health and Human Services. Still, Kolodner does not anticipate his successor, David Blumenthal, M.D., will make wholesale policy changes when he becomes the national coordinator in late April. The Secretary of Health will decide in what form the rules for meaningful use come out. Whatever the form, the rules, and much more information, will be on a new government health I.T. Web site.

HIMSS Estimates Stimulus Impact
Health Data Management, 4/6/09
A 250-bed hospital could receive a maximum of $5.7 million in Medicare incentive payments for using electronic health records under the economic stimulus package. That’s the latest estimate prepared by HIMSS.

Doctor Calls for EHR Action
Health Data Management, 4/6/09
Physicians need to stop “whining and crying” about the cost of electronic health records and jump on the bandwagon, a physician who has had electronic records for more than 10 years says. James Morrow, M.D. of North Fulton Family Medicine in Cumming, Ga., says his 14-physician practice cut its expenses by more than a third when it adopted electronic records, thanks to improved efficiency.

Is EHR Vendor Consolidation Ahead?
Health Data Management, 4/6/09
Funding for electronic health records in the economic stimulus package will hasten the consolidation of EHR vendors who cater to physician groups, the leader of one consulting firm predicts. Deward Watts, group president, health care sector, at Computer Sciences Corp., predicts many of the larger outpatient records vendors will merge and smaller ones won’t survive.

Push for Digital Health Records Sparks Debate
USA Today, 4/6/09
The government has set a goal for every American to have an electronic health record by 2014, and Kathleen Sebelius, the White House nominee for Health and Human Services secretary, calls the move to computerization "one of the linchpins" of overhauling the nation's health care system. But naysayers suggest health information technology is full of false promise. Digital records can lead to better care and fewer medical mistakes, they say, but the costly transformation could waste money if the doctors and hospitals buy systems that can't be connected to share information.

Kolodner to Retire From Federal Government
Government Health IT, 4/6/09
Dr. Robert Kolodner, national coordinator of heath I.T., said he would retire from federal service after a 30-year career during which he led the effort to build a working foundation for national health information sharing. Kolodner said in an interview that he would retire once his successor, Dr. David Blumenthal, was ready to take over the office. He will explore a range of opportunities for working in health I.T. after leaving government, he said.

GAO Official Names First 13 Members of HIT Policy Advisory Committee
Kaiser Network, 4/6/09
Government Accountability Office acting Comptroller General Gene Dodaro last week named 13 members to a policy committee on health care information technology established under the federal economic stimulus package. The HHS secretary and members of Congress will name the other members to complete the 20-member committee. President Obama can appoint additional members to represent other relevant federal agencies. The committee will make recommendations on developing a policy framework for the implementation and adoption of a national health I.T. system, including the standards for sharing electronic patient information. The stimulus package also established a standards committee, but does not specify a deadline for HHS to make appointments to that committee.

Trend Shows More Spending: Health I.T. Survey
Modern Healthcare, subscription needed 4/5/09
By Congressional Budget Office estimates, the federal government is poised to pour as much as $38.3 billion into health care information technology support through 2015 under the American Recovery and Reinvestment Act of 2009. The following trends, based on data from the 19th annual Modern Healthcare/Modern Physician Survey of Executive Opinions on Key Information Technology Issues, reflect the impact the legislation might have on the industry.

Health Care Industry Moves Slowly Onto the Internet
The New York Times, 4/5/09
The health care industry, a well-known laggard in information technology, is where most of corporate America was a decade or more ago in adopting Internet-style computing. There are innovators, intriguing experiments and lots of interest, but the technology hasn’t yet gone mainstream. Still, the direction is now clear, and only the pace of the shift is in question. The Obama administration’s plan to spend $19 billion to hasten the adoption of electronic health records that can share data across networks will only give more impetus to the shift toward Internet-style computing.

Quaid Emphasizes Need for Health I.T. to Avoid Errors
Modern Healthcare, subscription needed 4/5/09
Health information technology has its place in reducing medical errors, according to medical professionals and safety advocates speaking at HIMSS. Dennis Quaid delivered the show's first keynote address, retelling the story about the medication error that nearly cost his 10-day-old twins their lives last year.

Halamka: HIEs Before EHRs
Health Data Management, 4/4/09
With passage of the American Recovery and Reinvestment Act, a big health care issue in Washington now is the definition of “meaningful use” of electronic health records as a condition for receiving government Medicare and Medicaid incentives. That’s the view of John Halamka, M.D., CIO of CareGroup Health System in Boston and chair of the Health Information Technology Standards Panel, who spoke during HIMSS. Halamka challenged a common belief that comprehensive, interoperable EHRs are needed to support HIE development. He interprets ARRA’s definition of what constitutes meaningful use “as suggesting we should build HIEs before EHRs. We build the connection points to link the EHRs to HIEs.”

Survey Tracks HIE Practices
Health Data Management, 4/4/09
Sixty-one percent of 21 health information exchanges recently surveyed expect to depend on grants and contracts to maintain long-term sustainability, according a recent study. A task force of the Healthcare Information and Management Systems Society in Chicago conducted the survey in late 2008.

Senator: Industry Faces Tsunami of Costs
Health Data Management, 4/4/09
America’s health care industry is headed toward a financial cliff, with “a tsunami of health care costs sweeping toward us,” said U.S. Sen. Sheldon Whitehouse (D-R.I.), who spoke during HIMSS. Whitehouse acknowledged the political difficulties of fundamental reform and wide use of health I.T. are formidable.

Experts Say Usability Absent from ‘Adolescent’ EHRs
Modern Healthcare, subscription needed 4/4/09
The federal government is rushing to spend billions of dollars to encourage providers to adopt health care information technology, but the audience intended to be galvanized by that money says that I.T. usability is still a missing link. Dr. David Butler, a physician with Texas Children’s Pediatric Associates, says until ease of use—like addressing what a provider sees on the screen, how quickly they can get started and how intuitively the applications are structured—can be applied to EHRs, adoption will continue to be slow.

Stimulus Money Heightens Urgency for Health I.T. Guidance
Federal Computer Week, 4/3/09
Imagine what would have happened in the early 20th century if the federal government had decided to give the automobile industry a boost with billions of dollars for manufacturers and buyers, even though the industry was just starting to figure out what it was doing. The $19.5 billion in funding for health information technology in the American Recovery and Reinvestment Act is expected to save the government $12 billion in the coming years.

Debate Continues on Hospital EHRs
Health Data Management, 4/3/09
Two-thirds of U.S. hospitals have made significant progress toward implementing comprehensive electronic health records, HIMSS Analytics contends. The assertion comes in reaction to a recent report in the New England Journal of Medicine that claimed only 1.5% of hospitals have a comprehensive EHR in place.

HITSP to Turn Focus on EHR Stimulus Requirements
Modern Healthcare, subscription needed 4/3/09
Electronic health record systems are often called a disruptive technology. Not surprisingly, the American Recovery and Reinvestment Act is having a disruptive influence on the status quo of the national health care information technology policy apparatus. During a conference call with HITSP members, the HITSP’s leadership announced it will be taking a 90-day hiatus from its scheduled business to focus on the needs outlined in the recovery act.

Fast Vote Is Unlikely on Health Department Pick
The New York Times, 4/2/09
Gov. Kathleen Sebelius of Kansas appeared Thursday to be headed for confirmation as health and human services secretary, but several Republican senators objected to an immediate vote, so the Senate is unlikely to take up the nomination until later this month. Ms. Sebelius sailed through a hearing of the Senate Finance Committee on Thursday without encountering any difficult questions about her income taxes or her views on abortion.

Sebelius, Mikulski Tout Value of HIT Interoperability
Modern Healthcare, subscription needed 4/2/09
A long-serving senator has warned of a “techno-Katrina” if unsettled issues over the interoperability of health care information technology aren’t addressed in short order. Sen. Barbara Mikulski (D-Md.), a senior member of the Health, Education, Labor and Pensions committee, lauded the promise of health I.T. for its ability to reduce errors and streamline care, but said that slow-to-develop guidelines that would allow different computer systems to work together could quell momentum for broad-scale health care reform.

AMA Offers E-Prescribing Info
Health Data Management, 4/1/09
The American Medical Association is offering a free on-line learning center to provide physicians with information about electronic prescribing. The Chicago-based association’s learning center includes information on vendors’ products, including prices and features; calculators to estimate time savings and determine potential Medicare e-Prescribing incentive payments; updates on federal and state incentive programs; and resources doctors can use to create an implementation plan.

HHS Nominee Sebelius Amends Tax Returns
Wall Street Journal, 4/1/09
Health and Human Services nominee Kathleen Sebelius amended three years' worth of tax returns to correct errors, paying back taxes and interest totaling just under $8,000. She is the fifth nominee to run into tax problems, though Senate Finance Committee Chairman Max Baucus said in a statement that the errors were "minor [and] unintentional" and expressed strong support for her confirmation.

Sebelius Confirmation Hearings Start
The New York Times, 3/31/09
The first of two hearings began on the confirmation of Gov. Kathleen Sebelius to become the Obama administration's secretary of health and human services. The Democratic governor of Kansas faced a largely friendly audience from the Senate Health, Education, Labor and Pensions Committee. Sebelius appears before the Finance Committee on April 2.

Stimulus Funds Can Lead to Health Information Exchange Networks
HealthLeaders, 3/31/09
With the announcement that the federal government's plans to spend $19 billion to spur the use of computerized patient records, the industry has a renewed interest in how and when hospitals should begin to adopt electronic health records. But what about hospitals already entrenched in EHR? What's next for them?

Bundling: Is What's Good for the Consumer Good for You?
HealthLeaders, 3/30/09
When I wrote about the "bundling" aspect of President Obama's budget a couple of weeks ago, a man I greatly respect took the time to respond. Francois de Brantes, chief executive officer of Bridges to Excellence, who has dedicated his career to improving the efficiency of health care, thinks the Obama budget proposal "needs some important refinements," but "it is on the right track."

Critics Say Louisiana Proposal to Penalize Doctors Not Meeting Standards Provides Wrong Type of Incentive
Kaiser Daily Health Policy Report, 4/3/09
A Louisiana Department of Health and Hospitals proposal to implement performance standards for physicians who care for low-income residents has come under criticism from child care advocates who say the program will lead doctors to stop participating in the state's CommunityCARE program.

Critics Say Rell's Proposed Cuts to Medicaid Go Against Spirit of Federal Stimulus
The Hartford Courant, 4/2/09
To accept $1.3 billion in federal Medicaid stimulus money, Gov. M. Jodi Rell will have to scrap $22.1 million worth of proposed Medicaid cuts—including a plan to charge premiums to more Medicaid recipients. But advocates for Medicaid recipients say the governor needs to do more to avoid violating the intent, if not the strict terms, of the stimulus. Other proposed Medicaid cuts, which Rell is not expected to withdraw, target safety net programs at a time when more residents need them, something the stimulus program was intended to avoid, they say.

CalRHIO Approved for Federal Tax-Exempt Status
Modern Healthcare, subscription needed 4/1/09
Statewide health information exchange organization CalRHIO said it has received a notice March 31 from the Internal Revenue Service that the group was accorded federal, tax-exempt status. In a news release, CalRHIO said it first filed for 501(c)(3) status in early 2006, shortly after it became an independent, not-for-profit organization. “Because RHIOs are a new entity, the IRS has been slow to determine status,” the group said.

China Says It Will Have Health Care for All by 2020
AP/Yahoo News, 4/6/09
China has announced it will extend medical services to all its citizens by 2020, taking aim at a health care system long derided as creaking and inadequate. The reforms aim to boost funding and oversight to provide "safe, effective, convenient and affordable" health services for all 1.3 billion citizens, according to a plan approved by the State Council, China's Cabinet. Under the reforms, hospitals and clinics in the poor countryside and less developed cities would be improved and the price of essential medicines used by public hospitals and clinics would be capped.

Hospitals Can Save by Doing Less
Reuters, 4/5/09
Hospitals in the United States can help patients by doing less and could save at least $4 billion in the process, Thomson Reuters says. The international professional information provider, parent company to Reuters news, says its comparative analysis can help hospital chief executives lower needless costs by looking for their weak spots when compared to similar hospitals.

The Slow Boat to Electronic Payment
Health Data Management, 4/4/09
The industry’s slow pace to electronic payments was discussed in excruciating detail on April 4 during the Financial Systems Symposium at the HIMSS Conference in Chicago. Panelists representing the entire food chain of claims payment—provider, payer, and clearinghouse—acknowledged their world is not easy to understand, nor easy to fix. HIPAA has helped, they say, but much work remains to be done in digitizing payments, the final step of the revenue cycle.

Study Finds Many on Medicare Return to Hospital
The New York Times, 4/1/09
The nation spends billions of dollars a year on patients’ return visits to the hospital—many of which are readmissions that could be prevented with better follow-up care, according to a study published in the New England Journal of Medicine. As many as a fifth of all Medicare patients are readmitted within a month of being discharged, according to the study, and a third are rehospitalized within 90 days.

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