Edition Fifteen (5/12/09)

‘Meaningful Use’ Site Launched
Health Data Management, 5/12/09
A new Web site provides a forum for health care professionals to discuss the “meaningful use” of electronic health records. Under the American Recovery and Reinvestment Act, hospitals and doctors can earn financial incentives if they meet yet-to-be-defined requirements for meaningful use of EHRs.

HIT Policy Committee Sets Agenda with Work Groups
Modern Healthcare, subscription needed 5/11/09
The Health Information Technology Policy Committee, a federal advisory panel created under the American Recovery and Reinvestment Act of 2009, met in Washington for the first time and boiled down its initial work activities to three areas. One work group will come up with an initial set of criteria for the “meaningful use” standard, a second work group will focus on requirements of I.T. system certification, and the final work group will address workforce development needs.

Survey: ICD-10 Can Fuel I.T. Advances
Health Data Management, 5/11/09
A survey of 100 health insurers shows many view the transition to the ICD-10 code sets as an opportunity to make strategic improvements in their use of information technologies. Some payers will use the migration as an opportunity to replace legacy core administrative systems. Others with newer systems plan to take advantage of better data analytics afforded through the more detailed code sets to improve business processes.

Stakeholders to Obama: We're Ready to Cut Costs
Health Data Management, 5/11/09
Five health care associations and a union have sent a letter to President Obama committing to support his effort to cut the annual health care spending growth rate to save at least $2 trillion over the next decade. Those savings would come by slowing the annual growth rate by an average of 1.5 precentage points during the next 10 years. But details are scarce. The associations, for instance, pledge to implement "common sense improvements in care delivery models, health information technology, workforce deployment and development, and regulatory reforms."

FDA Launches New Sentinel Initiative Web Site
Health Data Management, 5/11/09
The Food and Drug Administration rolled out a new Web site to house information regarding its Sentinel Initiative. The program aims to monitor health care safety issues in real time through the sentinel system. The FDA eventually wants to electronically link data from several sources about medication and other FDA-approved products to assess their safety.

Quality, Safety Champion Clancy Leads Doc-exec List
Modern Healthcare, subscription needed 5/11/09
If the promise of health information technology is to improve the quality, safety, and efficiency of health care, the Agency for Healthcare Research and Quality will probably have something to do with I.T. keeping that promise. As the person in charge of the agency tasked with such matters, AHRQ Director Carolyn Clancy can have a significant impact on health I.T. reaching its potential—even if she lacks the budget and regulatory power that would allow her to force it to happen.

HHS Will Release Guidance on 'Meaningful Use' of Health Information Technology This Summer, Blumenthal Says
Kaiser Daily Health Policy Report, 5/11/09
HHS soon will issue guidance and specifications on the definition of "meaningful use" of health information technology, National Coordinator for Health I.T. David Blumenthal said. "Meaningful use is very much on our mind," he said, adding, "We hope to provide a direction and some specifications in the late spring, early summer."

'Meaningful Use' No Mystery, Experts Contend
Healthcare IT News, 5/11/09
If providers delay their acquisition of an EHR until the federal government issues a definition of "meaningful use," they're wasting valuable time. That's the consensus of health care I.T. experts who regularly take the pulse of the Washington D.C. bureaucracy.

Modern Healthcare Opens I.T. Case Study Contest
Modern Healthcare, subscription needed 5/11/09
Modern Healthcare is now accepting submissions for its first-ever I.T. Case Study Contest. The program recognizes health care information technology implementation projects that have improved patient care and may also be eligible for funding from the American Recovery and Reinvestment Act of 2009. The contest submission deadline is June 1.

Digital Medical Records Push Exposes Potential Side Effects
Boston Globe, 5/11/09
The push for electronic medical records, fueled by $19 billion from the federal stimulus package, seems urgent and clear; such technology will cut costs and save lives, backers say. But a growing body of research illustrates the potential challenges—from getting doctors to use the safety-enhancing features the systems offer, to the patchwork of privacy regulations in different states.

Stimulating Times
Healthcare Informatics, 5/8/09
Like every other hospital CIO in the United States, Jennifer Laughlin has been in high gear ever since President Obama signed ARRA into law in February. The vice president and CIO of the 95-bed UW Health Partners-Watertown Regional Medical Center in rural Wisconsin hasn't even had time to compute exactly how much the Medicare incentives for meaningful EHR use will mean to her organization.

President Obama's Budget Request Includes $828B for HHS
Kaiser Daily Health Policy Report, 5/8/09
President Obama presented Congress with a detailed budget plan for the fiscal year beginning Oct. 1, which intends to reduce expenditures through changes to the Medicare program and improve federal food safety efforts. The plan would allocate $828 billion for HHS in FY 2010, including $78.3 billion in discretionary spending, which is slightly less than the $78.5 billion in discretionary spending granted to the agency in FY 2009. However, the economic stimulus package provides HHS an extra $22.4 billion for FY 2009 and FY 2010, and $109 billion extra in total.

Senators Ask for Loosening of e-Prescribing Reins
Modern Healthcare, subscription needed 5/8/09
A letter from a bipartisan group of senators has asked HHS Secretary Kathleen Sebelius and Attorney General Eric Holder to swiftly release federal regulations that would allow electronic prescribing for controlled substances. Currently, the Drug Enforcement Administration requires physicians to write paper prescriptions for controlled pharmaceuticals such as pain medications, antidepressants, and some pediatric asthma drugs.

HHS Names HIT Comittee Members
HealthLeaders, 5/8/09
HHS appointed members to two committees that will make recommendations to the national coordinator on developing a policy framework and standards for a national interoperable health information infrastructure. Three members were named to the HIT Policy Committee: David Blumenthal, the physician head of the Office of the National Coordinator for Health Information Technology; Michael Klag, a physician and dean of Johns Hopkins Bloomberg School of Public Health; and Deven McGraw, director of the Health Privacy Project at the Center for Democracy and Technology.

Privacy Watchdog Concerned Over Electronic Health Records
Computing, 5/7/09
The Information Commissioner has expressed concern that electronic patient records are not secure enough following the revelation that Lanarkshire NHS patient data was found on a hard drive purchased on eBay. Speaking to Channel 4 News, Information Commissioner Richard Thomas said the recent spate of data losses had prompted talks with the NHS on how to ensure adequate privacy practices are in place.

Higher P4P Rewards Equals Greater Participation
Healthcare IT News, 5/7/09
According to Bridges to Excellence, a national effort to recognize and reward high-performing physicians, pay-for-performance programs garner greater participation when the rewards are higher. Physician response rates to rewards were assessed using BTE’s Master Physician Lists from each of its four initial pilot sites—Louisville, Ky., Cincinnati, Albany, N.Y., and Boston. An analysis shows physician participation is largely a function of the size of the incentive for which they are eligible.

Sebelius: Interoperability is Imperative
Healthcare IT News, 5/7/09
HHS Secretary Kathleen Sebelius told members of the House Ways and Means Committee that health reform is not contingent merely upon health I.T. adoption, but on health I.T. interoperability. In her first appearance before a Congressional committee, Sebelius fielded questions on health reform legislation now brewing in Congress.

Non-Stimulus Fed I.T. Funds Flat for 2010
Health Data Management, 5/7/09
Funding for the Office of the National Coordinator for Health Information Technology and for I.T. initiatives in the Agency for Healthcare Research and Quality will remain at current levels next year under President Obama's fiscal 2010 budget proposal submitted to Congress. But the proposed $61 million for ONC for the third straight year does not include the "jump start" I.T. funds from the economic stimulus law. ONC will receive an estimated $432 million in jump start funds this year and $809 million in fiscal 2010.

ER Docs Say HHS Chief 'Uninformed'
HealthLeaders, 5/7/09
The nation's largest emergency physicians' group called newly appointed HHS Secretary Kathleen Sebelius "uninformed" and accused her of "perpetuating myths" about their role in delivering health care after she said this week that emergency room care presents the "least effective, most expensive" option. American College of Emergency Physicians President Nicolas J. Jouriles, MD, called on Sebelius and the Obama administration to "engage" emergency physicians and provide them with a speaking role in the ongoing health care reform discussion.

Questions Remain About Definition of 'Meaningful Use'
HealthLeaders, 5/7/09
Providers and vendors alike are anxiously waiting for HHS to establish a clear definition of "meaningful use" as a prerequisite for eligibility to tap into the $19 billion in EHR incentives available under the American Recovery and Reinvestment Act (ARRA) of 2009. What we know is that for hospitals, meaningful use will include the ability to exchange health information, provide decision support for physician order entry, and submit data related to clinical quality and other measures that HHS selects. For physicians, it will also include an electronic prescribing capability. One big unknown is the specific quality measures hospitals must report to be eligible for incentives.

Obama's Budget Targets Health Care Improvements
HealthLeaders, 5/7/09
In presenting his $3.4 trillion budget plan, which includes provisions that will cut the deficit in half by the end of his first term, President Barack Obama proposed cuts to Medicare Advantage payments to private insurers, expansion of health information technology, reduction of health care fraud, waste, and abuse, and improved health care quality. Obama said the government will save $22 billion annually starting in 2012 by eliminating Medicare payments to private health insurances "as a broader effort to reduce health care costs." The Medicare Advantage program is slated for payment cuts of between 4% and 4.5% in 2010.

I.T. Should Adapt to Clinician, Not Other Way Around
Modern Healthcare, subscription needed 5/7/09
Dr. Lyle Berkowitz’s commentary is the first insightful and coherent description of the true nature of our health information technology crisis that I have read in a very long time, and points to the greatest disincentive to implementation of information systems by hospitals and physicians. We have been inundated with software designed by engineers with no understanding as to how physicians think, work, and arrive at diagnoses and treatment plans. There has been very little insight by the vendors as to what the clinician really needs to enhance medical (and nursing) practice.

Sebelius: I.T. Underpins Health Reform
Government Health IT, 5/6/09
Health information technology can act as the foundation for moving the country’s health system in a new direction, said HHS Secretary Kathleen Sebelius in her first appearance before a congressional committee since becoming the Obama administration’s chief health care executive. Although she did not detail the administration’s plans for advancing health I.T., she indicated that it was essential to health care reform.

Senate Health Reform Hearings Focus on I.T.
Healthcare IT News, 5/6/09
Continued adoption of health care information technology is critical to health care reform, a spokesman for the nation's top corporations told the Senate Finance Committee. John Castellani, president of the Business Roundtable, which represents chief executives of the nation's top corporations, offered his comments during the second of three roundtables to discuss health care reform. The committee is chaired by Sen. Max Baucus.

Stimulus Gives Incentives for e-Health Records
Daily Press, 5/6/09
Health care providers across the country are moving to replace their old paper records with sleek new electronic systems, a process the Obama administration wants to speed along with over $17 billion in stimulus dollars. That's a tall order for doctors and hospitals, because an estimated 90 percent of health care offices still stack their records in floor-to-ceiling shelves crammed with manila folders.

Baucus Touts HIT as Key to Health Care Reform
Healthcare IT News, 5/5/09
Sen. Max Baucus (D-Mont.), chairman of the Senate Finance Committee and responsible for leading health care reform efforts, said that health I.T. will be key in containing costs to pay for reform. At a press meeting hosted by the American Progress Action Fund, Baucus said Congress wants to reduce costs internally through delivery system reform, and he highlighted health I.T. and comparative effectiveness as prime examples.

Industry Weighs in on Definition of Meaningful Use
HealthLeaders, 5/5/09
Health care providers are antsy to start working toward becoming "meaningful users" of electronic health record technology so that they can claim some of the American Recovery and Reinvestment Act's financial incentives when they become available in fiscal year 2011 and 2012. While providers wait for the government's definition of "meaningful use" of EHR technology, which ultimately is the only definition that matters, they did receive some guidance this past week as just about every association and industry group released their own definition of what meaningful use should include.

FTC Requiring Security Provisions for Electronic Heath Records
OhMyGov!, 5/4/09
In mid-April, the Federal Trade Commission (FTC) issued new breach notification requirements for personal health record (PHR) vendors and related entities. The new rule (now open for public comment through June 1, 2009) requires that PHR vendors and associated entities report any security breaches to the consumer/patient and to the FTC, which will then post security breaches on the Department of Heath and Human Services Web site.

HRSA Readies $850 Million in Grants
Health Data Management, 5/4/09
The Health Resources and Services Administration is preparing to offer $850 million in one-time grants under the economic stimulus law for capital improvements to federally funded community health centers. The improvements can include acquisition of health information systems.

Health Reform on Tap, But Doctors Must Wait Again
The Hill, 5/4/09
Congress may well enact a comprehensive health reform bill this year, but it does not appear that it will include a permanent new policy in the area that has driven health legislation for the better part of a decade: Medicare physician payments. Since 2002, physicians have engaged in an annual lobbying fight to prevent actual cuts in the fees they receive for treating Medicare patients.

U.S. Health Data Czar Sees Role for Government Hand
Reuters/Yahoo News, 5/1/09
Electronic health records need a nudge from the government if the technology is to become widespread, the nation's new health information technology czar said. "It is clear that this field has not advanced (enough) ... when left exclusively to the private sector so there is a public role," said David Blumenthal, MD, head of the Department of Health and Human Services' Office of the National Coordinator for Health Information Technology.

EHR Adoption Challenging, Worth the Effort—Says John Halamka, M.D.
Health Management Technology, May 2009
Addressing the sixth annual SAS Healthcare and Life Sciences Executive Conference, keynote speaker John Halamka, M.D., says transitioning to EHRs can potentially create as many as 50,000 new jobs, save the nation millions of dollars in health care costs, and simplify the health care delivery system. He also expects the transition to be difficult.

Defining Key ARRA Funding Clause
Health Management Technology, May 2009
As HHS attempts to clarify the details of the ARRA HITECH stimulus legislation and create a health I.T. incentive program, the National Council on Vital and Health Statistics held a hearing April 28th through 29th on “meaningful use” of health information technology. Under the American Recovery and Reinvestment Act, HHS must define that term before the end of 2009.

Consumers Need All of the Facts in the Electronic Health Record Privacy Debate
Health Management Technology, May 2009
If there was any lingering doubt about the importance of health care reform in President Obama’s plan to revive the American economy, it was swept away when he addressed congress in February. The president stated very clearly that he wants to see reform initiatives launched this year and that he believes electronic health records are central to those efforts.

EHR Enables Orthopedic Practice to Grow 25 Percent Annually
Health Management Technology, May 2009
Before implementing an electronic health record in mid-2006, the Center for Bone and Surgery of the Palm Beaches in West Palm Beach, Fla., was composed of nine orthopedic surgeons who saw about 300 patients daily at four locations. Since then, the EHR has become an indispensable tool in helping increase patient encounters by 25 percent annually while holding down administrative and clinical support cost increases to just 5 percent a year.



State Works to Create Electronic Health Information Exchange
Maryland Gazette, 5/8/09
Health care leaders statewide submitted a plan this year to the Maryland Health Care Commission to form a statewide health information exchange system to allow hospitals to share electronic medical records. The group, called the Chesapeake Regional Information System for our Patients, includes representatives from Johns Hopkins, MedStar Health, the University of Maryland Medical System, and Erickson Retirement Communities.

State Seeks to Revamp Way Doctors, Hospitals are Paid
Boston Globe, 5/7/09
Massachusetts soon may embark on another bold health care experiment, with a state commission poised to recommend this month that insurers radically change how they pay doctors and hospitals. Commission members said they will urge Governor Deval Patrick and the Legislature to replace the current system, in which insurers typically pay doctors and hospitals a negotiated fee for each individual procedure or visit, with a set payment for each patient that covers all that person's care for an entire year. Massachusetts would be the first state to broadly adopt such a system, which would essentially put doctors and hospitals on a budget in an effort to restrain health spending.

Highmark to Contribute $1M for Electronic Records Training
Pittsburgh Business Times, 5/7/09
Highmark will contribute $1 million to provide training and support for doctors who adopt electronic health records, the health insurer announced. The money is in addition to the $29 million the company has already offered doctors to do away with handwritten medical records and prescriptions by switching to a computerized system, said Augusta Kairys, vice president of provider relations at Highmark. The Pittsburgh Regional Healthcare Initiative and Jewish Healthcare Foundation are also helping pay the coaches to help physician practices adopt the technology.

Hospitals Embrace e-Pharmacy: Greater Efficiency, Lower Cost Heralded in Transition From Paper to Computers
Argus Leader, 5/6/09
Sioux Falls' two largest hospitals are early adopters of an electronic prescription effort that is simplifying how patient medications are filled. Sanford Health, which last November unveiled its docZ electronic health record system, has about half of its physicians using the program that allows the pharmacy to receive a prescription from a physician via computer rather than on paper. Doctors are submitting more than 9,000 e-prescriptions a week, or almost 40,000 a month.

Texas Medical Group to Help Docs Evaluate EHRs
Modern Healthcare, subscription needed 5/5/09
The Texas Medical Association launched an electronic health record evaluation tool for doctors who want to buy systems and don’t know what to look for. The on-line tool compares eight of the top 10 EHRs used by physicians in Texas based on responses to a survey conducted by the state medical association.

Wisconsin Group Expanding I.T. by Sharing EHR System: Part 2
Modern Healthcare, subscription needed 5/5/09
After Congress allocated upward of $19 billion in health information technology funding as part of the economic recovery package, the Sauk City-based Rural Wisconsin Health Cooperative of 35 free-standing hospitals said it would help its member hospitals and critical-access hospitals across the country understand how the legislation works. In addition to offering guidance to rural hospitals on health I.T. selection and implementation, the Rural Wisconsin Health Cooperative can serve as a model in another way: through the Rural Wisconsin Health Cooperative Information Technology Network, a collaboration among four member hospitals to share an electronic health record environment.

Connecting Stakeholders to Improve Care
Advance for Health Information Executives, 5/6/09
With each passing day, a concept formally called the "patient-centered medical home" is gaining momentum. Under this concept, a primary care practice would be the patient's regular source of care or "medical home," with teams composed of primary care physicians (PCPs), registered nurses, nurse practitioners, and physician assistants who coordinate services across the continuum of care. The goals are to improve outcomes and reduce overall costs by promoting preventive care; maintain patient health by leveraging information technology to foster clinical collaboration and data exchange; streamline follow-up visit requests and referrals to specialists, hospitals and other care settings; and empower patients to participate in and make better health care decisions.

New Effort Reopens a Medical Minefield
New York Times, 5/6/09
It was in the mid-1990s, when Dr. Deyo helped develop federal guidelines urging surgeons not to perform spinal fusions to treat acute pain. The reason was simple: There was little evidence that the fusions worked in many patients. Spine specialists quickly attacked the report, calling it flawed. Now, 15 years later, the Obama administration is entering this same medical minefield. And once again, opponents are gearing up for a fight.

Has the Time Come for Wireless I.T. in Health Care?
Computerworld, 5/4/09
Wireless medical apps are ready for broad usage and could transform patient care. That's what proponents say, at least. After years of talk about wireless technologies' potential for widespread use in medical applications, they appear to be ready for a takeoff in adoption within health care organizations. And some doctors and I.T. professionals think that wireless has the potential to transform health care in the U.S. by improving patient care and lowering costs.

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