Edition Sixteen (5/19/09)

HIPAA, Meaningful Use on Busy HIT Docket
HealthLeaders, 5/19/09
The tight deadlines the Office of the National Coordinator for Health Information Technology must meet under the Health Information Technology for Economic and Clinical Health (HITECH) provisions of the stimulus law are spelled out in a new eight-page operating plan released May 18. Over the next several weeks, the national coordinator, David Blumenthal, MD, will hold hearings and meetings "to develop and vet plans and procedures."

Much of the Stimulus Money for Native American Care Will Replace Two Facilities
HealthLeaders, 5/18/09
About half of the $500 million in federal stimulus funds released to improve Native American health care last week will be used to replace two hospitals. The $227 million will build a hospital for a population of 9,300 American Indians in the Cheyenne River area of South Dakota as well as replace a 61-year-old hospital for the 10,000 population Norton Sound area in Alaska.

HIT Panel Looks to Define Standards, Specifications Before Tackling Meaningful Use
HealthLeaders, 5/18/09
Just one week after its members were appointed, the new Health Information Technology Standards Committee, which is advising the Office of the National Coordinator for Health Information Technology, hit the ground running May 15 with its first meeting in Washington. Another panel, the Policy Committee, which is advising the national coordinator on implementation issues, met four days earlier. Under an expedited process, the Department of HHS is requiring the standards group to publish an interim final rule with an initial set of standards, implementation specifications, and certification criteria for electronic use and exchange by Dec. 31, 2009.

The Machinery Behind Health Care Reform
The Washington Post, 5/16/09
When President Obama won approval for his $787 billion stimulus package in February, large sections of the 407-page bill focused on a push for new technology that would not stimulate the economy for years. The inclusion of as much as $36.5 billion in spending to create a nationwide network of electronic health records fulfilled one of Obama's key campaign promises—to launch the reform of America's costly health care system. But it was more than a political victory for the new administration. It also represented a triumph for an influential trade group (HIMSS) whose members now stand to gain billions in taxpayer dollars.

AMA Offers Stimulus Web Seminars
Health Data Management, 5/15/09
The American Medical Association will offer physicians three free Web seminars about the financial incentives for using electronic health records under the American Recovery and Reinvestment Act. The first session, focusing the basics of the provisions, will be held May 21. The second, featuring an update on the latest developments, will be offered June 9. The final event on July 15 will offer a “real world perspective.”

Two Studies Assess Cost of Doc-office Paperwork
Modern Healthcare, subscription needed 5/15/09
While how much of a medical practice’s administrative overhead can be classified as “waste” is still open to debate, two new studies posted on the Health Affairs Web site attempt to put a price tag on these clerical tasks and on how much a medical practice must spend before it can extract a check from an insurance company.

Bill Boosts Medicare-Paid Telemedicine
Health Data Management, 5/14/09
Legislation recently introduced in the House of Representatives would significantly increase Medicare reimbursement for telemedicine services. These services would include "telehealth" services that enable the remote monitoring of home-based chronically ill patients. Medicare presently has a limited telemedicine reimbursement policy targeting rural regions. The legislation, H.R. 2068, would expand Medicare reimbursement to urban and suburban areas, and expand the types of facilities eligible for payment.

Health Care Leaders Say Obama Overstated Their Promise to Control Costs
New York Times, 5/14/09
Hospitals and insurance companies said President Obama had substantially overstated their promise earlier this week to reduce the growth of health spending. Health care leaders who attended the meeting at the White House said they agreed to slow health spending in a more gradual way and did not pledge specific year-by-year cuts.

EHNAC, Data-exchange Work Group to Collaborate
Modern Healthcare, subscription needed 5/14/09
The Electronic Healthcare Network Accreditation Commission, a not-for-profit accrediting group for health care data and financial service companies launched by the industry in 1993, and the Workgroup for Electronic Data Interchange, a not-for-profit association pushing for health care data and data exchange standards, said they will collaborate to examine health care privacy and the financial services industry.

Privacy Belongs in Overall HIT Policy Work: McGraw
Modern Healthcare, subscription needed 5/14/09
David Blumenthal is now the third man to lead HHS' Office of the National Coordinator for Health Information Technology since the office was created five years ago. Not surprisingly, then, Blumenthal saw history repeating itself while chairing the first meeting of the Health Information Technology Policy Committee this week, even though that committee was created only recently by Congress.

Health Care Stakeholders Struggle to Define 'Meaningful Use'
AAFP, 5/13/09
Health care stakeholders are scrambling to help the federal government define key health information technology terms used in the American Recovery and Reinvestment Act of 2009, or ARRA, with a special focus on what constitutes "meaningful use" of health I.T. The distribution of $17 billion in incentive payments to America's health care institutions and physicians hangs in the balance, because after the language is finalized, health care providers must follow the government's blueprint to qualify for health I.T. funding.

Physician-Patient E-Mail Can Save Both Time and Cost
HealthLeaders, 5/13/09
Greater exchange of health information between physicians and patients through e-mail is the wave of the future, says Joe Scherger, MD, vice president for primary care at Eisenhower Medical Center, in the Coachella Valley near Palm Desert, CA. It's one of many easy ways to reduce unnecessary health costs for providers, health plans, and patients. In rural areas or places where transportation is a challenge, it can save hours of time for patients and avoid many hours of lost time from work or family responsibilities.

Senate Bill Targets Critical Care
Health Data Management, 5/13/09
Legislation introduced in the Senate would authorize millions of dollars to support specific programs to optimize the delivery of critical care and increase its workforce. The bill, for example, calls for spending $5 million annually from 2010 through 2015 to expand use of telemedicine technologies to enable clinicians in rural facilities to remotely consult with critical care specialists.

Is Stimulus Money Enough?
HealthLeaders, 5/12/09
Assume for a moment, there will be enough stimulus money to cover the cost of your electronic medical record system. Also assume that you receive the funds prior to your investment, so cost is not an issue. Will your EMR project succeed? Until hospitals address all of the barriers, they won't be successful.

Sweating the Details on Health Technology Policy
New York Times, 5/12/09
Some of the nation’s fine minds in medicine and technology have huddled, attended hearings, and produced position papers in the last few weeks that focus on the definition of “meaningful use.”The payments of the economic recovery package are based on “meaningful use” of electronic health records, although Congress left defining that term to the Department of Health and Human Services. It may seem arcane and nit-picky, but how the government defines and measures meaningful use will determine whether the $19 billion in incentives is a significant step in reforming American health care or a high-tech fiasco.

Data Encryption Just One Option Under Security Law
Modern Healthcare, subscription needed 5/12/09
For now, providers have two choices under a new health care data privacy and security law: data encryption or breach notification. But HHS also opened the door for future discussion of a possible third choice, using partial de-identification of patient data as a substitute for encryption. It is an alternative that privacy advocates say would take a hard-won legislative victory for privacy protection and turn it on its head. All of these options and controversies were set up in the mere 20 pages of “guidance” and request for comment on data breach requirements HHS issued April 17.

I.T. Cited as Component of Health Reform
Health Data Management, 5/11/09
Beating the drum for health care reform, two liberal think tanks claim the federal government could save $600 billion over the coming decade if it “modernized” the health care system. This “modernization,” the groups say, must include broader use of information technology. In a new report, the Center for American Progress Action Fund and the Democratic Leadership Council call for “investments in electronic medical records, research on comparative effectiveness and community- and employer-based prevention initiatives for problems such as obesity and smoking.”

HHS Lays Out Regulatory Schedule
Health Data Management, 5/11/09
The Department of HHS has published its semi-annual regulatory agenda, showing actions the department intends to take in coming months. Under the new agenda, a proposed rule to require electronic submission to the Food and Drug Administration of clinical trial data in standardized formats remains on track for September 2009. A publication date for the long-delayed final rule for adopting standard electronic claims attachments remains to be determined.

HHS Policy Panel Meets to Set Health I.T. Priorities
Government Health IT, 5/11/09
Stimulus law dictates tight schedule to determine standards for meaningful use, certification, and information exchange, Blumenthal says. A high-level committee advising the Office of the National Coordinator for Health I.T. recommended ONC focus its priorities in order to meet the tight timetable for carrying out the terms of the economic stimulus law. Members of the Health IT Policy Committee, in their first meeting since the panel was formed, agreed ONC should put the resolution of policies surrounding “meaningful use,” health I.T. certification, and health information exchange standards at the top of its agenda.

Cash for Computers
HealthLeaders, 5/11/09
With an 11-figure incentive to invest in information technology and electronic medical records, health care executives need to determine if this offer from Uncle Sam is the kind of help that they are prepared to accept. Be honest. The first two thoughts in any health care leader's mind upon seeing the billions being injected into health care information technology in the American Recovery and Reinvestment Act of 2009 were "How much?" and "Where do I get the check?" Now those leaders are into the tough questions about how to use that money in a way that maybe, just maybe, does some good for health care.

Obama Looks to Improve Rural Health
HealthLeaders, 5/8/09
Services Administration was cut by $44 million, the budget also includes many increases for rural health, according to the administration. In fact, the overall reduction from the 2009 budget of $125 million comes primarily because of the elimination of two programs, the $26 million Delta Heath Initiative in Mississippi and the $20 million Denali Project in Alaska.

Stimulus Cash Gives Health Care Records Technology a Boost
MetroWest Daily News, 5/12/09
The $4 billion in federal stimulus health care money headed to the Bay State over the next three years will help provide care for those who can't afford it and it is hoped help stem hemorrhaging costs by funding new technologies. The bulk of the health care stimulus funding—some $3.5 billion—will keep mostly safety-net programs afloat with Medicaid/Federal Medical Assistance Percentage funds. But a portion of federal stimulus money is targeted for cost-saving innovation. Massachusetts is expected to receive $1.3 billion in technology and research funds, with more than $500 million slated for initiatives to help create electronic patient records in the commonwealth.

Proposed Rule Could Affect Nursing Facilities Negatively
HealthLeaders, 5/18/09
A proposed Centers for Medicare and Medicaid Services rule could have a negative impact on reimbursement for skilled nursing facilities. The proposed rule, released on May 1, calls to implement a new case-mix classification model, known as Resource Utilization Group, Version Four, for FY 2011. Some of the changes incorporated into RUG-IV significantly deviate from the currently used model, RUG-III.

Diversity, Transparency Issues Raised at Comparative Effectiveness Hearing
HealthLeaders, 5/15/09
The Federal Coordinating Council for Comparative Effectiveness Research took its second listening session on the road from Washington. At the session in Chicago, the council, authorized under the American Recovery and Reinvestment Act (ARRA) to assist federal agencies in coordinating and comparing the effectiveness of health services research, heard requests for addressing disparities and creating better transparency for research.

Proposed Budget Increases Nursing Incentives
HealthLeaders, 5/13/09
President Barack Obama's proposed health care workforce development funding for fiscal year 2010 would bring incentives to nurses both in the field and in the classroom. Of $1 billion in the budget devoted toward strengthening health care professions, $125 million is allocated to the Nursing Education Loan Repayment Program—an $88 million increase from the 2009 budget. Funds for the Nurse Faculty Loan Program would increase by 40%.

Device Bills Indicate Excitement for Legislation
Modern Healthcare, subscription needed 5/13/09
Lawmakers will likely wait to see what the long-anticipated health care reform legislation package will include before moving on several high-profile bills that, if passed, would significantly affect how medical-device and drug companies develop, market, and manufacture their products, health care policy experts say. Hundreds of health care-related bills, at least eight of which would affect the medical-products industry, have seen little movement since their introduction to the Senate or House earlier this year.

10 Technologies for Hospital C-suites to Watch
HealthLeaders, 5/12/09
Hospital executives want to ensure their organizations are at the cutting edge of technology and investing their scarce dollars wisely. So which technologies are hot for 2009 and beyond? The ECRI Institute, an independent nonprofit organization that researches which medical procedures, devices, drugs, and processes are best equipped to improve patient care, released its top 10 list of technologies that hospital executives should keep an eye on. Number one on the list is Electronic Medical Records.

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