Edition Eleven (4/14/09)

Electronic Health Records Raise Doubt
Boston Globe, 4/13/09
Google Health and others in the fast-growing personal health record business say they are offering a revolutionary tool to help patients navigate a fragmented health care system. Some doctors, however, fear that inaccurate information from billing data could lead to improper treatment.

EHR Incentives Available. Will Hospitals Take the Bait?
HealthLeaders, 4/13/09
If you've read the American Recovery and Reinvestment Act (ARRA) of 2009, you know that the money is in EHRs. But are hospitals really focused on implementation these days, and what are some of the major barriers?

HITECH Panic? Not Now, At Least
HealthLeaders, 4/13/09
New federal HIPAA laws are here. Anxiety at hospitals is not. That wasn’t the case in 2003, when providers scrambled for answers to comply with the new privacy and security rules of HIPAA. Here we are today, six years later, and with a Congress eager to move the industry to EHRs by 2014—and even more eager to protect patients’ privacy in the process.

As Medical Charts Go Electronic, Rural Doctor Sees Healthy Change
The New York Times, 4/11/09
In Washington, the Obama administration is promising to spend billions to make health care more efficient, but Jennifer Brull, a family doctor in rural Kansas, is already a step or two ahead. A year ago, she switched her 3,000 patients from paper charts to electronic health records, a core feature of most plans for healing the nation’s ailing health system. Now, working with computers and printouts, her staff of part-time nurses and shared front-office workers has more time to help her meet the needs of patients.

Stimulus Targets Struggling Families
The Washington Post, 4/10/09
Virginia, Maryland, and Washington, D.C., will receive more than $73 million in federal stimulus funds to expand and improve child-care and immunization programs for low-income families, the Obama administration announced. The money is part of a two-year, $2 billion initiative passed by Congress in February that gives states more money to help low-income families struggling with rising child-care costs.

Obama Pledges New Data System for Veterans
The Washington Post, 4/10/09
Military officials and lawmakers alike hailed President Barack Obama’s initiative to create a joint virtual lifetime electronic health record within U.S. military departments. Both Defense and Veterans Affairs departments plan to work together to streamline the transfer of their respective active-duty military and veterans' health records, to create this virtual EHR.

HITECH Gives HIPAA New Teeth
HealthLeaders, 4/9/09
At this point, you already know about the Obama administration's goals for widespread EHR adoption, about the $19 billion being invested in health care I.T., and about the carrots being offered to entice hospitals and physicians to play along. But is that all you know about the Health Information Technology for Economic and Clinical Health, or HITECH, Act? Did you catch the part about stricter HIPAA requirements and stiffer penalties for violations? Changes to HIPAA understandably haven't been getting as much attention. And while it makes sense for physicians to make EHR implementation a top priority, preparing for these new HIPAA requirements will be part of the process, and physicians should be aware of how they will affect their practices.

Stimulating the Adoption of Health Information Technology
The New England Journal of Medicine, 4/9/09
The recently enacted stimulus bill touches almost every aspect of the U.S. economy, and health care is no exception. In fact, the ARRA is historic health care legislation of the type rarely produced by our famously incremental federal government. The law prevents dramatic state cuts in Medicaid, expands funding for preventive health care services and health care research, and helps the unemployed buy health insurance. But perhaps its most profound effect on doctors and patients will result from its unprecedented $19 billion program to promote the adoption and use of health information technology and especially electronic health records.

Obama Makes Health Reform Office Official
The Washington Post, 4/9/09
One month after its director began work, President Obama has made it official that there is a new White House Office of Health Reform. Obama signed an executive order formally creating the new office assigned the task of pressing his goal of expanding and improving health coverage in America. As outlined in the order, the responsibilities include: coordinating with all relevant executive branch agencies, reaching out to state and local officials, working with Congress to enact health reform legislation, and overseeing implementation of any eventual policy changes.

Health I.T. Leaders Meet with Reform Chief DeParle
Modern Healthcare, subscription needed 4/9/09
After two hours of hearing from more than 30 health care industry leaders, Nancy-Ann DeParle, director of the White House Office of Health Reform, encouraged participants to “stay with us” as the federal government works to reform the nation’s ailing health care system. In the end, the discussion did not identify any clear next steps for DeParle’s office. Rather, it highlighted problems that have plagued health care for years—including high costs, chronic disease and coverage—and centered on a few solutions that have been mentioned before, such as health information technology, preventive care, comparative-effectiveness research, and integration of health care with the broader community.

Practical Tips for Incentive Prep
Health Data Management, 4/8/09
Health care provider organizations don't have to wait for final regulations to begin preparing a game plan for receiving economic stimulus payments. That's the clear message two attorneys offered attendees at the 2009 HIMSS Conference. Bruce Fried and Lauren Mack, with the law firm Sonnenschien, Nath & Rosenthal LLP, Chicago, offered numerous tips for action that providers can take now as they attempt to qualify for incentive payments tied to implementing electronic health records.

Health 2.0 on Back Burner, But PHRs are on 'Wish List'
Modern Healthcare, subscription needed 4/8/09
The 19th annual Modern Healthcare/Modern Physician Survey of Executive Opinions on Key Information Technology Issues shows that the buzz for the so-called “Health 2.0” applications such as information portals, patient messaging, home health applications, and personal health record systems has had little purchase with leaders of health care organizations participating in our survey. One happy note for Health 2.0 enthusiasts is that their ship may come in—sometime.

CIOs, CMIOs Want a New Focus
Health Data Management, 4/8/09
CIOs and CMIOs long for the day when they can focus most of their time and effort on health care quality improvement rather than technology implementation. Within five years, chief medical information officers and CIOs will be devoting much more time to using data mining and business intelligence to analyze data to support quality improvement, says Rick Schooler, CIO at Orlando (Fla.) Regional Healthcare. The executives will “go beyond just getting the right I.T. in place,” focusing instead on using data to change the practice of medicine.

Commentary: Why 'Quality' Care is Dangerous
Wall Street Journal, 4/8/09
The Obama administration is working with Congress to mandate that all Medicare payments be tied to "quality metrics," but an analysis of this drive for better health care reveals a fundamental flaw in how quality is defined and metrics applied, according to this opinion piece published in the Wall Street Journal. In too many cases, the quality measures have been hastily adopted, only to be proven wrong and even potentially dangerous to patients, the authors write.

Survey Details HIE Views of the Stimulus
Health Data Management, 4/7/09
Many health information exchanges are enthusiastic about the information technology funding available in the economic stimulus law, says a consultant who recently surveyed more than 30 stakeholders. That law includes $300 million in funds for HIEs and billions more dollars to incentivize physicians and hospitals to adopt electronic health records systems or enhance their existing systems.

Live From HIMSS: Don't Procrastinate on Developing I.T. Strategy
HealthLeaders, 4/7/09
The conference center in Chicago is buzzing about the American Recovery and Reinvestment Act. Just about every hand shot up when Howard Burde, JD, a partner and health law practice group leader with the law firm, Blank Rome, LLP, asked attendees, "How many of you have a new favorite hobby: researching the ARRA?" During a session on strategies to manage the opportunities and risks for health I.T. in the economic stimulus, Burde said the ARRA redefines government and private sector roles.

Live from HIMSS: Take Advantage of Stimulus Money
HealthLeaders, 4/7/09
The question of timing to get HITECH Act reimbursement is on everyone's mind for obvious reasons. On the one hand, the federal government is saying to hurry up to get the maximum reimbursement by Jan. 1, 2011. At the same time the government is also saying to wait until at least the end of the year before the regulations come to clarify what a "qualified EHR" or a "meaningful user" means. That has left many physician practices on the fence about when to make a move.

Feds Release Open-Source NHIN Gateway Software
Modern Healthcare, subscription needed 4/7/09
The open-source movement in health care was afforded significant federal affirmation this week as the software code to create a gateway between multiple federal organizations and the proposed national health information network has been made available for downloading and public use. The federally developed, free, and open-source software is called Connect. It was created under the auspices of the Federal Health Architecture initiative led by the Office of the National Coordinator at HHS.

More Linking of Quality Reporting, Payments: CMS
Modern Healthcare, subscription needed 4/7/09
Payments will be tied more and more to quality and value reporting, according to CMS officials. While payment reform is necessary, it will be “unequivocally linked” to quality reporting as electronic data capture continues to be refined, said Barry Straube, a physician who is director and chief clinical officer in the Office of Clinical Standards and Quality at the CMS. One of the agency’s goals is to get the health care industry to a point where it is reporting quality data from electronic health records.

Survey Shows Slow Start for More Capital I.T. Spending
Modern Healthcare, subscription needed 4/7/09
Early this year, as members of Congress heated up the debate on the merits and faults of the American Recovery and Reinvestment Act of 2009, our readers went to the “polls” themselves in a referendum of sorts on health care information technology and its role in their hospitals and physician office practices.

VIDEO: Mark Leavitt Discusses Future of CCHIT
Modern Healthcare, subscription needed 4/7/09
Mark Leavitt, M.D., chairman of the Certification Commission for Healthcare Information Technology, talks to Modern Healthcare and Health I.T. Strategist during the 2009 HIMSS conference about how the American Recovery and Reinvestment Act of 2009 will affect the federally funded organization.

MGMA: Clinics With EHRs Profit More
Health Data Management, 4/6/09
A new, small study by the Medical Group Management Association asserts that practices with electronic health records have higher profits than those that use paper records. The yet-to-be-published study by the Englewood, Colo-based association found that multi-specialty groups with records systems, on average, had $302,000 in revenue per physician after operating costs. This compares to $260,000 for those with paper records.

A Hospital Is Offering Digital Records
The New York Times, 4/5/09
Online personal health records—controlled by patients themselves, not by hospitals, doctors, insurers or employers—have been available for years. Yet only a small percentage of Americans have digital personal health records today, analysts estimate. A major obstacle to adoption has been getting useful medical and patient information into personal health records. Typing one’s personal health information into an on-line form is time-consuming, mind-numbing, and error-prone. To overcome that challenge, Microsoft and Google have announced partnerships in recent months with large health care providers to explore transferring patient data automatically into personal health records.

The Doctor Will See You - Log on Now
Star Tribune, 4/13/09
What would happen if patients could visit a doctor at the touch of a button, no waiting, without leaving their home or workplace? Starting this fall, Blue Cross and Blue Shield of Minnesota hopes to find out. Blue Cross & Blue Shield of Minnesota is preparing to roll out a virtual clinic for its own employees. It essentially allows patients and doctors to talk to one another in live-time, with a Web cam or by instant-messaging, for 10-minute "virtual visits."

Paterson Announces $60M in Health I.T. Financing Available
The Business Review (Albany), 4/10/09
New York Gov. David Paterson has released another round of HEAL NY financing available for health information technology projects. The $60 million is being offered to projects that promote the use of I.T. in patient-centered medical homes.

Oregon Senate Committee Passes Health Care I.T. Bills
OregonLive.com, 4/8/09
An Oregon Senate committee approved bills to establish a council to help health care providers convert to electronic patient records, bring together insurers and providers to develop and use evidenced-based clinical guidelines and best practices and establish a database on Oregon's health care workforce size and needs.

Doctors Receive Grant to Reine Patient-Safety Alliance
Modern Healthcare, subscription needed 4/8/09
Safety advocates are working to establish a patient-safety alliance akin to an aviation group credited with helping to reduce fatal accidents in that industry. Physician and patient-safety researcher Peter Pronovost is leading the effort to develop the Public Private Partnership to Promote Patient Safety, or P5S. Pronovost and other advocates, including physician and incoming head of the Office of the National Coordinator David Blumenthal, received a planning grant from the Robert Wood Johnson Foundation to refine how the alliance would be financed, operated, and governed.

Group Asks How to Spend $1.1 Billion
Health Data Management, 4/8/09
The Federal Coordinating Council for Comparative Effectiveness Research will hold a public "listening session" April 14 to get input on how to spend $1.1 billion appropriated in the economic stimulus law. The money is for assessing the strengths and weaknesses of various medical treatments. The 15-member council, made up of federal employees, will listen to three-minute presentations during the session in Washington. The session, from 2 p.m. to 5 p.m. EST on April 14, will be Webcast LIVE at hhs.gov/recovery.

Jobs Scarce, Even for Nurses
The Washington Post, 4/5/09
The economic downturn has put a Band-Aid on one of the most vexing problems in health care, a shortage of nurses that has slowed care at some hospitals and forced others to turn away the ill. With some nurses postponing retirement and others resuming their careers for financial reasons, many hospitals across the region and the nation say they have few, if any, openings. After more than a decade when hospitals struggled to maintain sufficient staffing and when nurses could have their pick of jobs, the want ads have virtually disappeared, and only acute-care and emergency-room nurses remain in great demand.

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