I already reported the results of the annual HIMSS healthcare CIO survey in a story I wrote for InformationWeek the other day. Since everybody seems to love infographics these days, HIMSS produced one visualizing some of the highlights, including the finding that two-thirds of U.S. hospitals already have met Stage 1 meaningful use. Based on this, I’m guessing that close to 90 percent should be there by the end of the year, which means that CMS and ONC will have achieved their objectives for Stage 1, at least on the hospital side. (Of course, the physician part is proving to be much more difficult.) Someone in the know at ONC told me last night that people in that office are expecting 80 percent hospital success by the time fiscal year 2013 closes Sept. 30.
NEW ORLEANS—I made my debut for the new Health Innovation Broadcast Consortium last night with a live webcast interview with Athenahealth CEO Jonathan Bush. As usual, I didn’t need to prepare much for the interview because Bush almost interviews himself, so I just decided to wing it. Also as usual, we kept it light, as each of us had a beer in our hand, since we were at the House of Blues in the French Quarter, where Athenahealth had its annual HIMSS party. (This year featured a jazz funeral marking the “death of software.”) But we did discuss some topics actually relevant to health IT, including meaningful use and Athenahealth’s recent acquisition of Epocrates. Enjoy.
Once again, as has become custom, I sat down with HIMSS CEO Steve Lieber at the organization’s Chicago headquarters the week before the annual HIMSS conference to discuss the conference as well as important trends and issues in the health IT industry. I did the interview Monday.
Here it is late Friday and I’m finally getting around to posting the interview, but it’s still in plenty of time for you to listen before you get on your flight to New Orleans for HIMSS13, which starts Monday but which really gets going with pre-conference activities on Sunday. At the very least, you have time to download the podcast and listen on the plane or even in the car on the way to the airport. As a bonus, the audio quality is better than usual.
Podcast details: Interview with HIMSS CEO Steve Lieber about HIMSS13 and the state of health IT. Recorded Feb. 25, 2013, at HIMSS HQ in Chicago. MP3, stereo, 128 kbps, 46.0 MB. Running time: 50:17.
1:00 Industry growth and industry consolidation
3:45 Why Dr. Eric Topol is keynoting
6:00 New Orleans as a HIMSS venue
6:50 Changes at HIMSS13, including integration of HIT X.0 into the main conference
8:55 Focus on the patient experience
9:35 Global Health Forum and other “conferences within a conference”
13:00 Criticisms of meaningful use, EHRs and health IT in general
17:00 Progress in the last five years
20:45 Healthcare reform, including payment reform
22:30 Why private payers haven’t demanded EHR usage since meaningful use came along
23:50 Payers and data
26:28 Potential for delay of 2015 penalties for not meeting meaningful use
29:15 Benefits of EHRs
30:40 Progress on interoperability between EHRs and medical devices
32:52 Efficiency gains from health IT
35:27 Home-based monitoring in the framework of accountable care
36:55 Consumerism in healthcare
39:40 Accelerating pace of change
41:10 Entrepreneurs, free markets and the economics of healthcare
43:25 Informed, empowered patients and consumer outreach
46:30 Fundamental change in care delivery
Here’s a quick travel update for those of you still making plans for HIMSS13 in New Orleans next month. Today, OnPeak, the travel service that HIMSS has contracted with, seems to have released a number of hotel rooms for the week of the conference.
I had been waiting to book for a few weeks since I first heard that rooms would open on Jan. 30 or so after vendors, which apparently claimed big blocks of rooms months ago, had to give their final numbers. That didn’t happen, and I was starting to sweat a bit. But I made my reservation today, and am near enough to the Morial Convention Center that I don’t have to worry if I miss the last shuttle of the evening, which I’ve done plenty of times in past years. I feel bad for anyone staying out by the airport in Metairie or Kenner, because that’s a good 10-13 miles away. From my experience in other HIMSS cities, those bus trips can easily take 45 minutes to an hour during rush hour, and the buses don’t run all that frequently. HIMSS won’t be going back to San Diego anytime soon because so many people had to stay out by La Jolla the last time the conference was there in 2006, and that is closer to the San Diego Convention Center than the airport hotels are in New Orleans.
Back then, seven years ago, attendance had swelled to a then-record 25,000, and stayed in that range for a couple of years. But then came the HITECH Act and meaningful use in 2009, and interest in health IT has soared. Last year, more than 37,000 people came to HIMSS12 in Las Vegas, where hotels are plentiful. The Big Easy might not be as big a draw as Sin City, but it might be for some people who prefer authentic culture to the manufactured kind. (For the record, I like both places.) I’ve heard registration was slower this year than last, but I didn’t get that directly from HIMSS.
If you do find yourself stuck, I did notice in the last couple of weeks that there are a good number of hotels with vacancies across the Mississippi River in Gretna and Marrero and points east, such as Chalmette and New Orleans East. But there is no HIMSS shuttle to those places, and good luck finding a car to rent unless you’re willing to spend $90 a day. Go ahead, search for a car rental with airport pickup and try to find one for less during the week of March 3. (You can get one from an off-airport location for about $31 a day if you’re willing to take a taxi into town first to pick it up.)
This leads me to wonder if this might be the last time for a while that HIMSS meets in New Orleans. I think a couple of extra shuttle routes could fix the problem. And if attendance does level off or even drop a bit since we’ve probably passed the peak of the Gartner Hype Cycle, then it’s all good. Given some of the recent pushback against the direction of meaningful use and the efficacy of current EHR technology, I think it’s safe to say we are in or headed to the trough of disillusionment this year.
I’ll have more later this week about HIMSS, including what I’m trying to get from the conference. Vendors, please pay attention. I’m finally about to start working on my schedule, but I will have specific objectives.
The last edition of Health Wonk Review prior to the Nov. 6 presidential election falls into the familiar big-media trap of portraying the Patient Protection and Affordable Care Act, a.k.a. Obamacare, as being only about health insurance and of effectively equating health insurance to healthcare. Let me repeat: insurance is not the same thing as care, and having “good” insurance does not guarantee good care.
This installment of HWR is awfully heavy on the insurance aspects of the ACA in the context of politics the election, which is not surprising, though host Maggie Mahar of the HealthBeat blog does at least consider comparative-effectiveness research, thanks to a contribution on the esteemed Health Affairs Blog.
My post, which includes the infographic from the movie “Escape Fire” showing how medical harm essentially is the No. 3 cause of death in the U.S., is almost an afterthought, but at least Mahar also includes an entry from Dr. Roy Poses about medical harm in clinical trials.
There’s nary a word on health IT, which really is a shame in the context of the election, especially given that several Republican members of Congress, including Sen. Tom Coburn, M.D. (R-Okla.), have publicly questioned whether “meaningful use” so far has led to higher utilization of diagnostic testing and thus higher Medicare expenses.
By the way, Healthcare IT News is currently running a poll that asks: “With four GOP senators calling on HHS to suspend MU payments, would health IT remain bipartisan if Romney became president?” The poll is on the home page, but even after voting, I couldn’t find the results. In any case, I personally believe health IT has enough bipartisan support for MU to continue.
I also believe that no matter who wins the presidency, Congress probably will remain divided for the next two years, with Democrats holding onto the Senate and the GOP retaining control of the House, so I don’t expect any controversial legislation to pass. A Romney administration possibly could put a hold on future MU payments or revise the Stage 2 rules, but never underestimate the power of the hospital and physician lobby.
I’ve been an absentee blogger yet again the last few weeks. Here’s something to chew on while I get caught up, a sampling of all the statements I received regarding the Stage 2 final rules for meaningful use, in the order I received them. Most interesting are what the consumer groups had to say because CMS lowered the threshold for sharing records through a patient portal to a laughable 5 percent of patients, down from the proposed (and almost equally laughable) level of 10 percent. Patients need to speak up and demand access to their own records. Providers need to stop fighting the inevitable.
National Partnership for Women & Families
Leading Consumer Advocate Lauds Stage 2 Meaningful Use Final Rule for Promoting Better Communication Among Doctors, Fewer Medical Errors and Lower Health Costs
Statement of Christine Bechtel, Vice President, National Partnership for Women & Families
“The Stage 2 Final Rule released by the Centers for Medicare & Medicaid Services (CMS) this afternoon is a huge step forward. It brings us closer to the days when fewer overwhelmed patients and their family caregivers struggle to keep track of tests, diagnoses and medications; beg their doctors to talk to one another; suffer avoidable medical errors; and pay for duplicative and unnecessary care. The rule issued today offers the promise of better, more efficient care, improved safety and fewer hospital readmissions.
We are pleased that the new rule gives patients the ability to go online and view, download and transmit their health information from the Electronic Health Record (EHR) to secure places of their choosing. A recent public opinion survey commissioned by the National Partnership for Women & Families found that this kind of feature helps consumers see great value in physicians’ use of EHRs, and helps them have more trust in electronic systems. The fact that this is now a core requirement, and will apply to the hospital setting as well as to physicians, is key to finally recognizing the critical role patients play as partners in their own care. This is a huge advance that will allow patients to be more actively engaged in their care. It helps realize the potential of health IT in ways the nation needs.
It is good that the new rule also recognizes the essential role that providers and their staff play in encouraging patients to use this online access. It does that by holding physicians and hospitals accountable for ensuring that 5 percent of their patient population logs in once during the year.
In addition, enabling patients to download and transmit their health information electronically will help foster more of the kind of information sharing that is desperately needed to facilitate care coordination, improve safety and reduce costs. Patients play a key role in information sharing, and this rule gives patients the tools they need to do just that.
The rule’s requirements that a summary of care document be sent from one provider to the next for at least one of every two transitions of care or referrals is a good step. CMS is also requiring 10 percent of those transmissions to be electronic. And providers will have to show they are capable of sending these documents to providers who have different EHRs.
Improving care coordination and patient engagement through these criteria (information sharing requirements and online access for patients) are cornerstones of building the foundation of interoperability that will support health system reform. So many new models of care like Accountable Care Organizations and medical homes will crumble without this bedrock foundation. This is a good day for consumers who urgently need a more efficient, safer, better coordinated health care system.”
Click the links below for:
- Interviews with physician leaders who have implemented patient portals (or online access for patients)
- A snapshot of the national HIT opinion survey results
- A full executive summary of the national HIT opinion survey results
American Health Information Management Association
Meaningful Use Stage 2 Final Rule:
AHIMA Provides Initial Comments on CMS Ruling
CHICAGO – Aug. 23, 2012 – Today the final rule on the Electronic Health Record Incentive Program Stage 2 Meaningful Use (MU2) was announced by the Centers for Medicare and Medicaid Services (CMS). This act focuses on incentive payments to eligible professionals, hospitals and critical access hospitals participating in this program that successfully demonstrate meaningful use of certified electronic health record (EHR) technology.
A full analysis of this complex ruling announced as part of the American Recovery and Reinvestment Act – Health Information Technology for Economic and Clinical Health (ARRA-HITECH) will be forthcoming from the American Health Information Management Association (AHIMA). AHIMA is the preeminent nonprofit association representing Health Information Management (HIM) professionals on the front lines for implementing the rule.
While AHIMA studies the complete text of the rule and its scope, the following points have been included:
- Consistent with the proposed regulation, health information technology (HIT) measures will allow for patients to have the ability to view online, download, and transmit their health information within four business days of the information being available.
- CMS continues to acknowledge and align Clinical Quality Measures with other reporting programs to reduce burden and duplication of efforts.
- All HIT Menu Set measures have been transitioned to the Core Set of measures with the exception of electronic syndromic surveillance data and advance directives.
“We are encouraged to see CMS’ continued push toward actively exchanging health information to improve coordination of care thus improving patient safety,” said AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, CAE, FACHE. “We are also pleased to learn of CMS’ continued commitment toward engaging patients and families in their healthcare through the ability to view online, download and transmit their health information. We believe patients must be partners and work side-by-side with their providers to achieve the best possible healthcare outcomes.”
According to Thomas Gordon, the 2014 compliance date CMS provided will enable the industry – providers, hospitals and vendors – the appropriate time to plan and implement the necessary changes.
“As HIM professionals, we are a critical component to the reporting of clinical and HIT quality measures in achieving meaningful use,” said Allison Viola, MBA, RHIA, senior director of federal relations at AHIMA. “We are pleased to see that CMS has heard our calls for increased alignment of quality reporting programs and acknowledgement of making an effort to reduce the reporting burden and duplication of reporting. We also stand ready to support patients and their ability to have online access to their health information to ensure its privacy, integrity, and timeliness for their continued care.”
Live webinars to discuss the rule’s provisions will be available free for AHIMA members and for $59 for non-members. Visit ahima.org for the schedule and registration information.
Society for Participatory Medicine
Statement of Sarah Krug, president of the Society for Participatory Medicine:
“Although we’re disappointed this final rule does not give patients next-day access to their electronic medical record after they leave the hospital, we believe that on balance the Stage 2 Meaningful Use requirements go a long ways towards patient empowerment and feature a number of important patient-centered innovations. Patients must be full partners in access to their health information so they can be full partners in their care. For that reason, the Society for Participatory Medicine intends to keep a sharp eye on how the new Meaningful Use rules are actually implemented.”
Healthcare Information and Management Systems Society
HIMSS Statement on Release of Meaningful Use Stage 2 and Standards & Certification Criteria Final Rules
August 24, 2012 – (Washington, DC) – HIMSS appreciates the release of the Meaningful Use Stage 2 and Standards & Certification Criteria final rules by the U.S. Department of Health and Human Services. The Stage 2 regulations allow the healthcare community to continue the necessary steps to ensure health information technology will support the transformation of healthcare delivery in the United States.
In our initial review of the Medicare and Medicaid Programs; Electronic Health Record Incentive Program–Stage 2 Final Rule from the Centers for Medicare and Medicaid, HIMSS has identified several significant policy decisions, including:
- Setting the Meaningful Use Stage 2 start date as 2014, which will maximize the number of eligible professionals (EPs), eligible hospitals (EHs), and critical access hospitals (CAHs) prepared to meet Stage 2 requirements
- Allowing a 90-day reporting period in Year 1 of Stage 2, which is consistent with HIMSS’ recommendations on the proposed rule
- Accepting 2013 as the attestation deadline for EPs, EHs, and CAHs to avoid a Medicare payment adjustment, and allowing for exceptions, including limited availability of information technology
- Finalizing Clinical Quality Measure submission specifications for EPs, EHs, and CAHs
ONC’s efforts in the Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition appear to streamline the administrative process of certifying EHR products. We note that the Final Rule both adopts and concurs with a number of HIMSS recommendations. The HIMSS response to the proposed rule had requested several points of clarity and additional specification around certain criterion, and we commend the government’s thorough review and inclusion of additional information to clarify many topics.
We are assessing impacts of each Final Rule regarding Clinical Quality Measurement, reporting options, standards specifications, and alignment with other federal quality reporting and performance improvement programs.
We look forward to continuing to work with the federal government and our members to ensure that the EHR Incentive Program makes impactful improvements to the quality of healthcare delivery in the United States.
Stay tuned for in-depth analysis on HIMSS’ Meaningful Use OneSource; a webinar series in September; and a full slate of Meaningful Use education and exhibition activities at HIMSS13, including a new Meaningful Use Experience.
Statement from Susan Turney, MD, MS, president and CEO of MGMA-ACMPE
“MGMA is pleased that the Centers for Medicare & Medicaid Services (CMS) responded to our concerns regarding several of the proposed Stage 2 meaningful use requirements. Extending the start for stage 2 until 2014 was a necessary step to permit medical groups sufficient time to implement new software. Permitting group reporting will reduce administrative burden, as will lowering the thresholds for achieving certain measures such as mandatory online access and electronic exchange of summary of care documents. MGMA supports the rule’s expanded list of exclusions and believes it will allow physicians to achieve meaningful use with fewer hurdles.”
Health IT Now Coalition
Health IT Now Coalition Expresses Concern over Meaningful Use Stage 2 Final Rule
Stresses clinical exchange measures are insufficient
WASHINGTON – The Centers for Medicare and Medicaid Services (CMS) today issued its final rule detailing criteria for Stage 2 of the federal electronic health-record system incentive program. The following should be attributed to Joel White, executive director of the Health IT Now Coalition<http://www.healthitnow.org>:
“While we are encouraged that ONC and CMS have recognized that care coordination cannot be achieved exclusively through directed exchange, the rule still fails to adequately address the core issue of interoperability. Providers, developers, and state health information exchanges have already adopted and implemented more mature and scalable standards that are functioning well in the market today.
“More could and should have been done to support the interoperability requirements necessary for advanced payment and delivery reforms to operate optimally. The measures for clinical exchange laid out in the Stage 2 final rule will likely not be sufficient.”
Health IT Now is a coalition to promote the rapid deployment of heath information technology (health IT). Health IT will benefit patients and health care consumers while supporting health practitioners to make smart decisions about patient care and save money. For more information, visit www.healthitnow.org<http://www.healthitnow.org>.
College of Healthcare Information Management Executives
The College of Healthcare Information Management Executives (CHIME) today issued a statement in response to final rules on Stage 2 of the EHR Incentive Payments program, also known as Meaningful Use:
“CHIME applauds efforts made by officials at the Department of Health and Human Services in working diligently to prepare final rules on Stage 2 of the EHR Incentive Payments program,” said CHIME President and CEO Richard A. Correll.
“We commend the Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health IT for seeing the wisdom and practicality of heeding many of CHIME’s recommendations, filed during the spring public comment period. By allowing providers to demonstrate Meaningful Use through a 90-day EHR reporting period for 2014, government rule-makers have ensured greater levels of program success. And by including additional measures to the menu set, providers have a better chance of receiving funds for meeting Stage 2.
“However, we also recognize that these points are conciliatory and that many details may need further clarification. The final rule still puts providers at risk of not demonstrating meaningful use based on measures that are outside their control, such as requiring 5 percent of patients to view, download or transmit their health information during a 3-month period. Some areas of clarification include some of the exclusionary language as well as nuances around health information exchange provisions, clinical quality measures and accessing images through a certified EHR.
“CHIME will continue to delve into this sizable and weighty effort, including the technical specifications and certification criteria,” Correll added.
I’ve spent a lot of time on social media since Thursday morning debating the meaning of the Supreme Court’s rather stunning decision on the Patient Protection and Affordable Care Act. It was stunning in that Chief Justice John Roberts, a George W. Bush appointee, sided with the four liberal-minded justices, but also stunning in that the court went against conventional wisdom by upholding the individual mandate on the grounds that it was a legal exercise of Congress’ constitutional right to levy taxes.
I had to remind a lot of people that this decision neither solves the crisis, as supporters have claimed, or turns us into the Soviet Union, as some on the lunatic fringe have suggested. Expanding insurance only throws more money at the same problem. This was my first tweet after I learned of the decision:
The cynic in me likes to point out that the individual mandate was an idea first conceived by the conservative Heritage Foundation and championed in Massachusetts by Mitt Romney. Both somehow now oppose the idea. The law that ultimately passed Congress was written by Liz Fowler, a top legal counsel to Max Baucus’ Senate Finance Committee who previously was a lobbyist for WellPoint. Her reward for doing the bidding of the insurance industry was for Obama to appoint her deputy director of the Office of Consumer Information and Oversight at HHS. This was insider dealing at its finest, as much a gift to insurers as the 2003 Medicare Prescription Drug, Improvement and Modernization Act was a gift to Big Pharma.
Of course, I initially was misinformed about the Supreme Court ruling because CNN jumped the gun (as did Fox News) and erroneously reported that the court had struck down the individual mandate on the grounds that it violated the Interstate Commerce clause of the Constitution. But so were millions of others.
I suppose that was fitting, since the national media have for more than two years been misinforming the public about what is really in the law. There are small but real elements of actual care reform — not just an insurance expansion — in there, but very few have been reported. The actual reform has been drowned out by ideologues on both sides. Here’s a handy explanation of most of what’s really there (it’s a good list but not exhaustive). The insurance expansion, the only thing people are talking about, really is just throwing more money at the problem. There is a lot more work to be done to fix our broken system.
What I consider real reform in the ACA includes accountable care organizations and the creation of the Center for Medicare and Medicaid Innovation. Along with the innovation center, CMS also gets the power to expand pilot programs that are successful at saving money or producing better outcomes. In the past, successful “demonstrations” would need specific authorization from Congress, which could take years.
Notice that there isn’t a whole lot specific to IT. That’s because the “meaningful use” incentive program for EHRs was authorized by the 2009 American Recovery and Reinvestment Act. Another key element of real reform that also is not part of the ACA is Medicare’s new policy of not reimbursing for certain preventable hospital readmissions within 30 days of discharge.
We need more attention to quality of care. Many have argued that tort reform needs to be part of the equation, too, because defensive medicine leads to duplicative and often unnecessary care. Perhaps, but lawsuits are a small issue compared to the problem of medical errors. Cut down on mistakes and you cut down on malpractice suits. Properly implemented EHRs and health information exchange — and I do mean properly implemented — will help by improving communication between providers so everybody involved with a patient’s care knows exactly what’s going on at all times.
All of these facts lead me to conclude that true healthcare reform hasn’t really happened yet. Look at this Supreme Court ruling as a beginning, not an end, to reform.
The headline above shouldn’t surprise regular readers or anyone who knows me. I’ve been saying for a couple of years to anyone who asks me about “Obamacare” or any other aspect of healthcare reform—and many people who haven’t asked—that the public debate and media coverage have been about insurance reform, not care reform, and health insurance is not the same thing as healthcare. I’ve publicly chided the national media, too.
Maybe that is changing. Last month, attorney Philip K. Howard, chairman of advocacy group Common Good (an organization working to “fill the substance void in the 2012 election by offering new solutions to fix broken government”), wrote in The Atlantic that no matter what the Supreme Court does with the Patient Protection and Affordable Care Act, healthcare still will remain inefficient and expensive. “The Affordable Care Act, aka Obamacare, strives for universal coverage. While it encourages pilots for more efficient delivery systems, the overall effect is to exacerbate the unaffordability of American health care. In this sense, the upcoming Supreme Court decision on constitutionality is just a side skirmish,” Howard said.
In other words, as I’ve been arguing for two years, the insurance expansion of this supposed comprehensive “healthcare reform” legislation is simply throwing more money at the same problem. Having insurance doesn’t assure you good care, nor will it by itself even reduce overall costs. It just shifts costs. There was more reform in the HITECH section of the 2009 American Recovery and Reinvestment Act, in the form of the $27 billion incentive program for “meaningful use” of electronic health records than there is in the part of the ACA being widely debated in this election year.
That’s why, as I pointed out Friday, I was happy to see that investigative journalism organization ProPublica has started a Facebook community for people to share stories of patient harm. And today, the New York Times discussed actual healthcare quality in one of its Sunday editorials (h/t Jane Sarasohn-Kahn). The Times highlighted efforts at Virginia Mason Medical Center in Seattle, Cincinnati Children’s Hospital Medical Center and hospital alliance Premier, saying, “It is a measure of how dysfunctional the system has become that these successful experiments — based on medical sense, sound research and efficiencies — seem so revolutionary.” Indeed.
By the way, my recent, controversial post arguing that faxing should be considered malpractice isn’t a new thought I’ve had. I just rediscovered my January 2011 commentary in Columbia Journalism Review about media coverage of telephone-based “telemedicine.” I ended the piece by advising fellow journalists to “start asking the health-care organizations you cover why they still rely on old-fashioned telephones and fax machines.” Malpractice or not, legal or not, it’s more than a decade into the 21st century, yet we still view healthcare through a 20th-century lens.
Or, as I also like to say, it’s quality, stupid.
I have railed more often than I can count against politicians and the national media for misleading or at least failing to inform the public on what health reform is all about. For me, it was quite refreshing to see an interview in the Washington Post with Sen. Sheldon Whitehouse (D-R.I.), attempting to shed some light on the parts of reform that have nothing to do with insurance.
“The Affordable Care Act is mostly known as an insurance expansion, expected to extend coverage to more than 30 million Americans,” started the post by Sarah Kliff. “But … a big chunk of the law is dedicated something arguably more ambitious: an overhaul of the American business model for medicine. ‘This is a very significant piece of the bill that has received virtually no attention because it’s so non-controversial,’ Sen. Sheldon Whitehouse (D-R.I.) told me in a recent interview.”
On Thursday, Whitehouse released a 52-page document outlining what he sees as the 47 changes the Patient Protection and Affordable Care Act is making to how care is delivered. That doesn’t even count the reforms in the HITECH section of the American Recovery and Reinvestment Act from a year earlier, by the way.
Health IT, of course, is a big part of reform.”The HITECH Act took important steps to restructure financial incentives to shift the pattern of health IT adoption. The HITECH Act’s Medicare and Medicaid incentive payments are encouraging doctors and hospitals to adopt and “meaningfully use” certified
electronic health records,” Whitehouse noted.
Also from that report:
Health information technology (IT) will radically transform the health care industry, and is the essential, underlying framework for health care delivery system reform. The ACA’s payment reforms, pilot projects, and other delivery system reforms are built with the expectation of having IT-enabled providers. In particular, the shift to new models of care, like ACOs, will rely heavily on information exchange and reporting quality outcomes. Indeed, the formation of ACOs is contingent on having providers “online” to transfer information and patient records, and report quality measures.
Whitehouse did discuss ACOs with the Washington Post, but there’s a reason why the interview appears on a page called the WonkBlog. This stuff is too complicated and wonky for the average person.
What isn’t complicated is explaining that throwing more money at a broken system, as the insurance expansion does, will not lower the cost of care. It also isn’t complicated to explain that tens of thousands of Americans needlessly die each year due to medical errors or low-quality care. Yet, more than a few defenders of the ACA have said that the insurance mandate would help guarantee “quality care” for millions.
The insurance expansion guarantees insurance coverage. It does not guarantee quality care. Whoever wins Friday’s Mega Millions drawing wouldn’t necessarily be able to buy quality care, either. Nor would Bill Gates, for that matter. You can’t get quality care unless you’re willing to address the causes of errors and adverse events. Period.
Sen. Whitehouse seems to understand that. I doubt too many other members of Congress do, despite the fact that a former colleague, the late Rep. John Murtha (D-Pa.), who had the “Cadillac” coverage so many people covet, died as a result of a medical error.