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Looking forward from Katrina

Tuesday, of course, was the anniversary of Hurricane Katrina. Of all the news coverage examining what went wrong and how bad things still are in the Gulf Coast region, I haven’t seen anything forward-looking, at least in terms of healthcare.

Wait, I take that back. I did see one story: my own. And it wasn’t even published in the United States.

I wrote a fairly detailed commentary on post-Katrina rebuilding of healthcare for London-based E-Health Insider this week.

I hope every U.S. publication that passed on my services is embarrassed for missing this important side of the story. But it’s not too late. I have plenty more material from my five-day tour of Louisiana and Mississippi last month, pertaining to much more than just IT. Editors, I await your call.

I’m also slowly putting together a podcast with the hours worth of compelling audio I have from my trip. Most likely, you will only hear it right here on this blog.

August 31, 2006 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Blog updates, plus a useful link

This is just a quick note to say that I have made some changes to the right-hand column, separating the blogroll from the list of online health news sites, adding a couple of blogs and updating the list of conferences for the fall and into the winter.

And for those of you still interested in seeing the health IT discussion on CNBC last week, here is video of one of the segments.

August 29, 2006 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

That CNBC segment

A bunch of people have been finding this site while searching for what was said on CNBC’s “Squawk Box” yesterday morning, which featured athenahealth chief Jonathan Bush as a guest host, plus Piper Jaffray senior analyst Sean Wieland and Intel e-health executive Louis Burns talking about health information technology. Health and Human Services Secretary Mike Leavitt apparently had been invited but did not appear.

Bush actually was at the anchor desk for an hour, but the dialog on health IT only took up about 10 minutes or so. Bush (whom regular anchor Carl Quintanilla at one point inadvertently said was founder and chairman of “Aetna Health”) praised the new Stark/Medicare anti-kickback exemptions for health IT and commented on quarterly results from Medtronic and news about Bausch & Lomb during his stint, but there were more mentions of Tom Cruise jumping on Oprah’s couch than there were of health IT until late in the hour. Such is the nature of TV news.

When they finally got down to things, Wieland recommended investment in companies focused on IT for the 80 percent of healthcare services delivered outside of hospitals, specifically plugging Allscripts (MDRX) and Quality Systems (QSII), parent company of NextGen Healthcare Information Systems. He also praised Eclipsys (ECLP) for changing its pricing model to emphasize delivering results to customers rather than selling software—much as Bush’s company does.

Burns said that Intel was focused on delivering “the right information at the point of decision” in healthcare, but also said it was “too early to talk about” how much business Intel was doing in the healthcare sector. Burns did, however, show a prototype Sensitron tablet PC with integrated barcode reader and RFID capability, designed specifically for nurses. He said the product should hit the market early next year.

August 24, 2006 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Executive order on HIT interoperability

Here’s the full text of President Bush’s executive order on interoperability and transparency of health information, signed Tuesday afternoon in Minnetonka, Minn.:

EXECUTIVE ORDER

- – - – - – -

PROMOTING QUALITY AND EFFICIENT HEALTH CARE IN FEDERAL GOVERNMENT ADMINISTERED OR SPONSORED HEALTH CARE PROGRAMS

By the authority vested in me as President by the Constitution and the laws of the United States, and in order to promote federally led efforts to implement more transparent and high-quality health care, it is hereby ordered as follows:

Section 1. Purpose. It is the purpose of this order to ensure that health care programs administered or sponsored by the Federal Government promote quality and efficient delivery of health care through the use of health information technology, transparency regarding health care quality and price, and better incentives for program beneficiaries, enrollees, and providers. It is the further purpose of this order to make relevant information available to these beneficiaries, enrollees, and providers in a readily useable manner and in collaboration with similar initiatives in the private sector and non-Federal public sector. Consistent with the purpose of improving the quality and efficiency of health care, the actions and steps taken by Federal Government agencies should not incur additional costs for the Federal Government.

Sec. 2. Definitions. For purposes of this order:

(a) “Agency” means an agency of the Federal Government that administers or sponsors a Federal health care program.

(b) “Federal health care program” means the Federal Employees Health Benefit Program, the Medicare program, programs operated directly by the Indian Health Service, the TRICARE program for the Department of Defense and other uniformed services, and the health care program operated by the Department of Veterans Affairs. For purposes of this order, “Federal health care program” does not include State operated or funded federally subsidized programs such as Medicaid, the State Children’s Health Insurance Program, or services provided to Department of Veterans’ Affairs beneficiaries under 38 U.S.C. 1703.

(c) “Interoperability” means the ability to communicate and exchange data accurately, effectively, securely, and consistently with different information technology systems, software applications, and networks in various settings, and exchange data such that clinical or operational purpose and meaning of the data are preserved and unaltered.

(d) “Recognized interoperability standards” means interoperability standards recognized by the Secretary of Health and Human Services (the “Secretary”), in accordance with guidance developed by the Secretary, as existing on the date of the implementation, acquisition, or upgrade of health information technology systems under subsections (1) or (2) of section 3(a) of this order.

Sec. 3. Directives for Agencies. Agencies shall perform the following functions:

(a) Health Information Technology.

(1) For Federal Agencies. As each agency implements, acquires, or upgrades health information technology systems used for the direct exchange of health information between agencies and with non-Federal entities, it shall utilize, where available, health information technology systems and products that meet recognized interoperability standards.

(2) For Contracting Purposes. Each agency shall require in contracts or agreements with health care providers, health plans, or health insurance issuers that as each provider, plan, or issuer implements, acquires, or upgrades health information technology systems, it shall utilize, where available, health information technology systems and products that meet recognized interoperability standards.

(b) Transparency of Quality Measurements.

(1) In General. Each agency shall implement programs measuring the quality of services supplied by health care providers to the beneficiaries or enrollees of a Federal health care program. Such programs shall be based upon standards established by multi-stakeholder entities identified by the Secretary or by another agency subject to this order. Each agency shall develop its quality measurements in collaboration with similar initiatives in the private and non-Federal public sectors.

(2) Facilitation. An agency satisfies the requirements of this subsection if it participates in the aggregation of claims and other appropriate data for the purposes of quality measurement. Such aggregation shall be based upon standards established by multi-stakeholder entities identified by the Secretary or by another agency subject to this order.

(c) Transparency of Pricing Information. Each agency shall make available (or provide for the availability) to the beneficiaries or enrollees of a Federal health care program (and, at the option of the agency, to the public) the prices that it, its health insurance issuers, or its health insurance plans pay for procedures to providers in the health care program with which the agency, issuer, or plan contracts. Each agency shall also, in collaboration with multi-stakeholder groups such as those described in subsection (b)(1), participate in the development of information regarding the overall costs of services for common episodes of care and the treatment of common chronic diseases.

(d) Promoting Quality and Efficiency of Care. Each agency shall develop and identify, for beneficiaries, enrollees, and providers, approaches that encourage and facilitate the provision and receipt of high-quality and efficient health care. Such approaches may include pay-for-performance models of reimbursement consistent with current law. An agency will satisfy the requirements of this subsection if it makes available to beneficiaries or enrollees consumer-directed health care insurance products.

Sec. 4. Implementation Date. Agencies shall comply with the requirements of this order by January 1, 2007.

Sec. 5. Administration and Judicial Review.

(a) This order does not assume or rely upon additional Federal resources or spending to promote quality and efficient health care. Further, the actions directed by this order shall be carried out subject to the availability of appropriations and to the maximum extent permitted by law.

(b) This order shall be implemented in new contracts or new contract cycles as they may be renewed from time to time. Renegotiation outside of the normal contract cycle processes should be avoided.

(c) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.

GEORGE W. BUSH
THE WHITE HOUSE,
August 22, 2006.

August 23, 2006 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Health IT on CNBC

According to an e-mail I received from his publicist, Jonathan Bush, CEO of athenahealth, will be a guest host of “Squawk Box” on CNBC this Wednesday from 7 to 8 a.m. EDT. (That’s the middle hour of the three-hour live show, which begins bright and early at 6 a.m. in the East, or 3 a.m. for you West Coast insomniacs out there.)

Bush will lead a discussion on health information technology, among a panel that’s also scheduled to include Health and Human Services Secretary Mike Leavitt, Piper Jaffray senior analyst Sean Wieland and Intel Digital Health Group boss Louis Burns.

Set your alarms early. Or better yet, record it and get a full night’s sleep.

August 21, 2006 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Blogging en español and other international affairs

Well, OK, it’s not me who’s blogging in Spanish. I studied French. But someone who reads this blog does write in Spanish. I got a mention this week in the blog entitled “Noticias seleccionadas por Sanitic” concerning my July 26 post on open-source software.

Muchas gracias for the mention. You are officially added to my blogroll on the right side of the screen.

From what I can gather, “sanitic” essentially means “health IT” in Spanish, at least in Castillian Spanish because this seems like a European site, which helps me segue nicely into my next thought.

I really do want to attend and cover the first World of Health IT conference in Geneva in October. As a freelancer, I usually have to cover my own travel expenses, so I make sure I have enough work to make any work-related trip worthwhile. This, of course would be an expensive trip.

I’m not begging for a sponsor here (I’ll do that privately with some of my clients), just fishing for names of English-language publications around the world that might be interested in my services for that conference, which is focusing on health IT in Europe, the Middle East and Africa. Any suggestions would be much appreciated.

Muchas gracias.

August 16, 2006 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Skype for customer service?

Maybe I’m a little behind the cutting edge because I’d never seen it before, but I just saw something I thought was totally cool: a Skype link to contact a vendor directly.

The link is on the Contact page of the Web site of BrunMed, a small EMR and practice management software vendor in eastern Canada.

Is this the future of customer service? If it means you get to talk to a live person right away, I’m all for it.

I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Communication issues

I wanted to call your attention to a couple of recent stories illustrating problems with health information.

Reader’s Digest has something this month about errors in pathology and radiology, often related to lack of communication. I wonder how much this story will scare the public, especially given the perception that Reader’s Digest attracts a lot of retirees? Of course, fear often is a good motivator.

Meanwhile, the Chicago Tribune wrote last week about an interesting conundrum for patients. With all the talk about consumer-directed health plans and transparency in health information, healthcare providers are unable to tell people what various procedures actually cost.

One of the sidebars to this story reported that five of six local hospitals contacted about pricing either would not or could not provide the requested information.

As someone with a high-deductible health plan, I had a similar experience earlier this summer. I asked a PA about the price of an injection she recommended for me, and she decided it was easier to give me the service gratis than to find out what it would cost. I was billed only for the office visit.

I guess it pays to ask questions.

August 14, 2006 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.