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That was fast

Barack Obama has been president for just about three hours now, and already the White House Web site has been completely made over. Here’s Obama’s healthcare agenda. Notice that it contains not a word about technology on this page.

However, healthcare is mentioned as part of the technology agenda. This part looks unchanged from the campaign, at least so far: “Use health information technology to lower the cost of health care. Invest $10 billion a year over the next five years to move the U.S. health care system to broad adoption of standards-based electronic health information systems, including electronic health records.”

Note, though, House Appropriations Committee Chairman David Obey (D-Wis.) said last week that the economic stimulus plan would include $20 billion for health IT. I’m not entirely clear whether this money would be spent this year or even if it “counts” toward the $50 billion Obama wants over the next five years.

Toast the new president today, but tomorrow will be time to get to work.

What can’t wait for tomorrow is Chilmark Research‘s offer of free downloads of the executive summary of its May 2008 “iPHR Market Report.” Chilmark said yesterday that the document will be free for 24 hours. The post does not say when the clock started ticking, but I’m going to guess and say you’d better get your downloading in before close of business on the east coast, since Chilmark is in Cambridge, Mass.

January 20, 2009 I Written By

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

An inaugural first

Let the record show that new President Barack Obama mentioned health IT in his inaugural address today. It had become a point of pride in health IT circles that President George W. Bush had mentioned the need for technology to improve healthcare in the last four State of the Union addresses, but today marks the first time it’s been the part of a presidential inauguration.

From the text of Obama’s speech as he actually delivered it, according to the AP/Yahoo transcription:

The state of the economy calls for action, bold and swift, and we will act — not only to create new jobs, but to lay a new foundation for growth. We will build the roads and bridges, the electric grids and digital lines that feed our commerce and bind us together. We will restore science to its rightful place, and wield technology’s wonders to raise health care’s quality and lower its cost. We will harness the sun and the winds and the soil to fuel our cars and run our factories. And we will transform our schools and colleges and universities to meet the demands of a new age.

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 Affairs on Obama HIT plans

We don’t know all the details yet, but a lot of people are excited about the fact that President-elect Barack Obama has made a point of including health IT in his forthcoming economic agenda. He did this as recently as Saturday.

Yesterday, in a Health Affairs blog post, Health Affairs Executive Publisher Jane Hiebert-White summarized Obama’s statements and other various reactions to his plans. She also indicated that the venerable policy journal will devote its March issue to health IT.

I’m reserving judgment until Obama not only fills in some of the details, but also chooses the new heads of CMS and the Veterans Health Administration.

January 6, 2009 I Written By

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

More commentary

Barack Obama doesn’t take office for nearly four more weeks, but already we’re seeing some pushback against his campaign proposal to ask for $50 billion over five years for health IT.

The federal checkbook, er, money-printing machine, has been busy of late. If the Wall Street and Detroit bailouts have shown anything so far, it’s that a billion dollars just ain’t what it used to be. There are some who are making the case that throwing more money at the healthcare problem might not be the wisest move.

Notably, Bill Yasnoff, M.D., Ph.D., had an op-ed published at BusinessWeek Online last Friday, in which he says electronic medical records must be part of any economic stimulus plan Obama introduces in 2009. Yasnoff pushes for his brainchild, the “health record bank” and calls for greater privacy protection than HIPAA currently affords.

The last point is not surprising, considering Yasnoff is allied with privacy guru Deborah Peel, M.D. For her part, Peel, founder of the Patient Privacy Rights Foundation, sent a letter to Congressional leaders this week complaining of the lack of regulation in recent health IT policy as well as accountability problems with the financial industry’s bailout.

Both Yasnoff and Peel suggest that any funding for health IT must include accountability measures and provisions to ensure sustainability.

C. Peter Waegemann, CEO of the Medical Records Institute also argues against simply throwing money at the problem. In an “HIT Status Report”, posted Dec. 9, cautions that nobody has yet proved that EMRs alone can save money.

“Cost savings can be achieved through a restructuring of healthcare, and EMRs may well be tools in the restructuring process, but they should not be perceived as the main tool or goal and we should not have such unrealistic expectations of them,” Waegemann writes. He also contends that recent federal efforts to promote health IT have failed.

Over at The Health Care Blog, Rick Peters, M.D., argues that the health IT industry is similar to the auto industry of the 1970s, and thus not suitable for a government “bailout.”

And from the Department of Negativity at Any Cost, the Cato Institute‘s Michael Cannon has a blog post entitled, “Blocking Obama’s Health Plan Is Key to the GOP’s Survival.” If so, we’re in for several more years of politics as usual.

December 26, 2008 I Written By

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

Daschle’s looking better already

From Paragraph 93 of the federal criminal complaint against Illinois Gov. Rod Blagojevich unsealed this morning:

On November 5, 2008, ROD BLAGOJEVICH spoke with Deputy Governor A regarding positions that ROD BLAGOJEVICH might be able to obtain in exchange for the soon-to-be vacated Senate seat. Among the potential positions discussed were Secretary of Health and Human Services and various ambassadorships.

Paragraph 98 alleges:

On November 7, 2008, ROD BLAGOJEVICH talked with Advisor A about the Senate seat. ROD BLAGOJEVICH stated that he is willing to “trade” the Senate seat to Senate Candidate 1 in exchange for the position of Secretary of Health and Human Services in the President-elect’s cabinet.

That’s right, Blagojevich allegedly saw himself as the right person to fix America’s healthcare woes. Well, there is a precedent for Midwestern governors taking over HHS—Wisconsin’s Tommy Thompson—but it seems so far like President-elect Barack Obama made a wise choice in picking Tom Daschle over Captain Hairdo. Particularly in light of this gem from Paragraph 101(c):

ROD BLAGOJEVICH said that the consultants (Advisor B and another consultant are believed to be on the call at that time) are telling him that he has to “suck it up” for two years and do nothing and give this “motherfucker [the President-elect] his senator. Fuck him. For nothing? Fuck him.”

Ah, the joys of Chicago politics!

December 9, 2008 I Written By

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

Breaking news: Daschle is HHS pick

The news today is that former Senate Majority Leader Tom Daschle (D-S.D.) will be President-elect Obama’s choice for secretary of Health and Human Services. Politico reports that Daschle was picked for his ability to work through the intricacies of the legislative process, something that is particularly helpful in the complicated world of healthcare reform.

Daschle’s definitely a partisan type, but he seems to have respect from both sides of the aisle, a trait that seemed to serve current HHS Secretary Mike Leavitt, a former Utah governor, very well. One thing I do not know is if Daschle is as much of an IT advocate as self-described “techno-geek” Leavitt is. That said, I’m sure Daschle knows about Obama’s desire to seek $50 billion in federal money over five years to promote electronic health records. I’m also pretty sure Rob Kolodner will want a meeting with Daschle as soon as possible.

November 19, 2008 I Written By

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

More on health reform proposals

Here’s some video from the California HealthCare Foundation

In a Sept. 16 event at the Commonwealth Club of California in San Francisco, McCain health policy advisor Daniel Kessler and Obama advisor E. Richard Brown explained and debated their respective candidates’ positions. It should come as no surprise that IT is but a small part of the discussion.

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If you don’t want to watch all 66 minutes of this video, it’s broken into 13 chapters. Click on “Open Tools” in the video window to select.

October 11, 2008 I Written By

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

Did you notice?

Both John McCain and Barack Obama mentioned electronic health records during last night’s presidential debate. Notably, this was the one debate held in a town-hall format, where the candidates ostensibly spoke directly to undecided voters.

October 8, 2008 I Written By

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

Catching up

I’m slowly recovering from a tragic last few days, in which the Chicago Cubs, the best team in the National League this season, failed to show up for their three playoff games. I was among the more than 42,000–a number that surely had to violate some section of the fire code–jammed into Wrigley Field for Game 2 on Thursday night to watch a stinker for the ages. I suppose this doesn’t hurt as much as 2003, but maybe it will when it sinks in.

Alas, life goes on, and so does the backlog in my inbox. Baseball season may be nearing a close in Chicago (the White Sox are on the brink, but still alive), but the never-ending political season still has a month to go. It was brought to my attention recently that Hollywood may have anticipated the McCain-Obama matchup in a 2006 episode of The West Wing. The debate between Matthew Santos (Jimmy Smits) and Arnold Vinick (Alan Alda) even strikes a familiar chord.

A discussion of healthcare policy starts around 3:20.

Back in the real world, I’ve seen a bunch of commentaries of late on the health IT policies of the Obama and McCain campaigns, in part because I had to write summaries for both the Physician Office Technology Report of Part B News and for my British client, E-Health Insider. The most interesting analysis I’ve seen so far is from David Merritt, a longtime aide to Newt Gingrich who also is advising the McCain campaign. Despite this built-in bias, Merritt actually gives a mostly unbiased assessment of the plans. Mostly.

If you want to know more, check out the Kaiser Family Foundation’s health issues comparison tool on 15 areas of health policy, including IT.

I still think both candidates are really lacking in specificity when it comes to health IT. I am anxious to hear further details, though I don’t really expect to hear much before the actual election. More likely, the details will come when the new president names his secretary of Health and Human Services, and perhaps not until the full healthcare policy teams are in place.

Moving on, there’s a new professional certification program in health information exchange. It’s from the same people who developed programs to designate certified professionals in health information technology and certified professionals in electronic health records. I wrote about that in November 2004 and got one very pointed comment how certification courses like this were “a joke” because they convey a hoity-toity title after just a few days of training. Just like then, however, program has some highly respected names on its advisory board. Anyone know if this sort of thing is worth it?

While we’re talking about professional credentials, here’s a link to the newly redesigned EMR Jobs.com site (even though it defaults to a .net site). Now I have just set myself up for everyone with an IT-related Web site to demand a link. I’ve been good at ignoring e-mails in the past, and I can do it in the future.

I didn’t submit anything to the most recent Health Wonk Review, but host David Shafrin of the Healthcare Economist blog examines groups in need of bail-outs.

I figured it would be much ado about nothing when HIMSS circulated a letter it sent to Reps. Pete Stark (D-Calif.) and Dave Camp (R-Mich.) about the proposed “Health-e Information Technology Act of 2008.” Just a few weeks ago, I expressed my frustration with new legislation that stands almost zero chance of passing.

Apparently the response did strike a raw nerve with some people, including open-source advocate Fred Trotter, who accused HIMSS of being little more than a lobby group for vendors of proprietary systems. HIMSS subsequently published a “fact sheet” about its views on the Stark-Camp bill, including this statement: “HIMSS actively supports the industry’s exploration and utilization of open source software as one avenue for information technology solutions within the healthcare industry.”

Just how significant is this mini-spat anyway?

October 5, 2008 I Written By

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

It’s the quality, stupid.

At the risk of sounding partisan—and I do my best to be unbiased in my actual journalism—I have to call out Sen. John McCain for an ad that he’s been running about healthcare. “The problem with healthcare in America is not the quality of healthcare, it’s the availability and the affordability.”

Say what?

Someone had better brief him on the two Institute of Medicine reports, “To Err Is Human: Building a Safer Health System” (1999) and “Crossing the Quality Chasm: A New Health System for the 21st Century” (2001), not to mention the countless other academic studies that have followed in recent years questioning the adherence of physicians and hospitals to established quality metrics.

Watch for yourself.

This sounds like McCain is trying to play the patriotism card by insinuating that we have the best health system in the world simply because we’re the United States of America. Yes, cost and access are huge issues, but so is quality. Ask anyone who has ever been prescribed the wrong medication or acquired a MRSA infection in a hospital.

For his part, Sen. Barack Obama has not really run any commercials related to healthcare, but he does focus on cost in his discussion of quality on his campaign Web site.

Clearly, this issue is more esoteric and less sexy than, say, Hurricane Ike or the Wall Street crisis, but someone needs to explain to both candidates that quality really is a problem in American healthcare. Perhaps these two senators are part of the reason why Congress has done virtually nothing on health IT?

September 18, 2008 I Written By

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