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Podcast (but not mine): I discuss ACA, HIPAA, consumerism in healthcare

Longtime readers know how I’ve railed against how the mainstream media’s coverage of healthcare reform in general and the Affordable Care Act in particular, notably the fact that Obamacare addresses a lot more than just insurance coverage. I’ve also railed against how hospitals have used HIPAA as an excuse not to give patients copies of their medical records, when, in fact, the privacy rule says the exact opposite, something HHS finally saw need to provide guidance on just this month.

Those of you who have followed me to MedCity News know that I’ve also been covering the Get My Health Data effort since the beginning last summer — and its roots in the HHS decision to water down “patient engagement” requirements in the Meaningful Use EHR incentive program nearly a year ago.

With this in mind, I knew exactly what I was going to talk about when an old college friend, Missouri lawyer and published novelist Dale Wiley, asked me to be one of the first guests on his new podcast, the Dale Wiley Show. We talked for a good half hour, and probably could have gone on for longer, and I am especially grateful he let me talk about multiple system atrophy, the rare disease that took my dad’s life in 2012.

I do have to take Dale to task for picking a photo of me with my face bandaged from my injury at the 2011 HIMSS conference. He told me he picked more for pixel size than for aesthetic quality. Ah, well. I’m probably due for a new professional headshot anyway.

Click here for the iTunes link to the Dale Wiley Show. Music fans will especially like it, as Dale formerly ran an indie record label and knows a lot of people in the business.

January 18, 2016 I Written By

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

CMS publishes Stage 3 Meaningful Use proposal

The rumor I heard this morning was true. CMS has published its proposed rules for Stage 3 of Meaningful Use, once again waiting until late on a Friday to release a major document. Stage 3 will start no earlier than 2017.

Simultaneously, ONC released its proposed update to EHR certification regulations, to be known as the 2015 edition.

Both documents will appear in the Federal Register March 30, triggering a public comment period. CMS will take comments on the MU rule through May 29, while ONC will do so on the certification plan through June 30. Expect to see final rules before the end of the year.

From an HHS e-mail announcement:

Together, these proposed rules will give providers additional flexibility, make the program simpler and reduce burden, drive interoperability among electronic health records, and increase the focus on patient outcomes to improve care.

The proposed rules are one part of a larger effort across HHS to deliver better care, spend health dollars more wisely, and have healthier people and communities by working in three core areas: to improve the way providers are paid, improving the way care is delivered, and improving the way information is shared; to support transparency for consumers, health care providers, and researchers; and to strengthen decision-making.

“The flow of information is fundamental to achieving a health system that delivers better care, smarter spending, and healthier people. The steps we are taking today will help to create more transparency on cost and quality information, bring electronic health information to inform care and decision making, and support population health,” said HHS Secretary Sylvia M. Burwell.

The Meaningful Use Stage 3 proposed rule issued by CMS specifies new criteria that eligible professionals, eligible hospitals, and critical access hospitals must meet to qualify for Medicaid EHR incentive payments (Medicare incentive payments end in 2016). The rule also proposes criteria that providers must meet to avoid Medicare payment adjustments (Medicaid has no payment adjustments) based on program performance beginning in payment year 2018.

The 2015 Edition Health IT Certification Criteria proposed rule aligns with the path toward interoperability – the secure, efficient, and effective sharing and use of health information – identified in ONC’s draft shared Nationwide Interoperability Roadmap. The proposed rule builds on past editions of adopted health IT certification criteria, and includes new and updated IT functionality and provisions that support the EHR Incentive Programs care improvement, cost reduction, and patient safety across the health system.

The Stage 3 proposed rule’s scope is generally limited to the requirements and criteria for meaningful use in 2017 and subsequent years. CMS is considering additional changes to meaningful use beginning in 2015 through separate rulemaking.

Enjoy perusing the 301 pages of the Stage 3 proposal and 431 pages of the certification proposal this weekend!

March 20, 2015 I Written By

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

Cameras in operating rooms?

As you know, I’ve become rather obsessed with patient safety ever since I watched bad things happen to my dying father nearly three years ago, so I wanted to pass along a petition and gauge people’s opinions. Should cameras be mandatory in operating rooms? Some people think so. There’s obviously a growing movement in the U.S. to equip police officers with body cameras, in the name of protecting police and the public alike. There just might be a parallel for surgery teams and patients.

A petition went online late last month as Causes.com, calling on legislators to require OR cameras “to reduce harm, and learn from errors.” I learned about it from John James, founder of Patient Safety America. In an e-mail, James explained, “There are many reasons to do this: educational tool, improve performance of surgeons, document skills, have an unbiased record if an adverse occurs, and reduce misstatements in medical records.”
What do you think? Vote here, and if you are so inclined, leave a comment below.

January 12, 2015 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 Wonk Review for the holidays

The final Health Wonk Review of 2014 is up (actually, it’s been up for five days, but I’ve been buried with deadlines until this morning), courtesy of Julie Ferguson  and the Lynch Ryan Workers’ Comp Insider blog. My Forbes.com post on the recent reality checks for healthcare wearables makes this biweekly review of the best of the healthcare blogosphere. (I also did a follow-up, featuring an ESPN “Sport Science” segment sponsored by Fitbit.) FWIW, the comments have been closed on the LinkedIn Digital Health Group item about my original post.

There isn’t much else in the realm of health IT in this edition of HWR, but there are some interesting discussions about the Patient Protection and Affordable Care Act, including an important question from Peggy Salvatore: To whom is accountable care actually accountable to? Yep, ACOs are right there in the Affordable Care Act, lest you think the Obamacare law is only about health insurance coverage.

Enjoy the recap, and enjoy the holidays, whichever ones you celebrate. I’ll see you in January.

December 23, 2014 I Written By

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

Join the discussion about wearable technology

The thing about the Internet is that you never know when something is going to go viral or spark heated debate. (Actually, it’s a fairly sure bet that anything involving politics, religion or sports will lead to heated debate, generally of the lowbrow variety.)

Less common is informed, intelligent discussion on the Internet. Something I wrote early yesterday for Forbes.com has, happily, fallen into this category.

My post, “Hype Around Healthcare Wearables Runs Into Reality,” is far from the most inflammatory piece I’ve written about overblown hype in healthcare innovation, or, as Dr. Joseph Kvedar called it, “irrational exuberance,” borrowing a line from former Federal Reserve Chairman Alan Greenspan.

It’s also far from the most-viewed item I’ve had on the Forbes.com platform since I started about six months ago. However, it’s generating a lot of discussion on Paul Sonnier’s Digital Health group on LinkedIn. As of this writing, there are 28 comments, or more than one per hour since the original post went up at 9:54 am EST Wednesday.

If you’re one of the more than 30,000 members of that group, I encourage you to join the discussion. If not, you might want to join the group, or comment on the original post at Forbes.com.

I haven’t decided yet if I’ll throw in an additional two cents, since I did, you know, already give my opinion in the actual post.

December 11, 2014 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 Wonk Review talks turkey

I’ve been a bit remiss the last few days, in that the latest Health Wonk Review came out Thursday, and I’m  just getting around to sharing it now.( Blog carnivals work best when contributors link back to the compilation.) But, better late than never, right?

In that spirit, and in the spirit of Thanksgiving, I invite you to check out Health Wonk Review: The Turkey Edition, hosted by David Harlow on his HealthBlawg. The big stories this time around are all about insurance coverage under the Patient Protection and Affordable Care Act, a.k.a., Obamacare, but there is also an interesting posts about “wrist slaps” given to pharmaceutical executives for allegedly violating drug-marketing laws.

My post at Forbes.com about the American Medical Association belatedly but predictably fighting the impending Medicare penalties for not meeting Meaningful Use makes the cut. I’m particularly proud of the line, “Ruthlessly Defending the Status Quo Since 1847. :)

Check it out, and for those of us here in the United States, have a happy Thanksgiving. I’ll see you after the long weekend.

November 25, 2014 I Written By

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

Infographics: Health IT leadership and salaries

It’s infographic time! In fact, it’s time for two infographics.

The first is from HIMSS, celebrating 25 years of the organization’s annual health IT leadership survey. Some interesting findings, as pointed out by a HIMSS publicist:

  • 1991- 75 percent say their institution’s financial health is helped by computers
  • 1994 – 14 percent predict that digital patient information will be shared nationwide in 1-3 years
  • 2000 – 70 percent of respondents say HIPAA is a top business issue.

 

The second infographic comes from HealthITJobs.com. Not surprisingly, the most lucrative jobs are in consulting, and those with experience get paid significantly more than newbies.

September 18, 2014 I Written By

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

Podcast: Greenway Health CEO Tee Green on interoperability, consumerism and more

Health IT vendor Greenway Health recently finished its rollout of a cloud-based EHR to all 8,200 Walgreens stores in the U.S. When I was offered the chance to interview CEO Wyche T. “Tee” Green III about this, I decided to take it a step further.

In all my years of covering health IT, I’ve never met nor even spoken to Green, so I figured a podcast was in order. After all, I had written a piece for Health Data Management earlier this year about how pharmacies are reshaping themselves as true healthcare companies. (This interview also comes in the wake of CVS Caremark ending its sale of tobacco products and changing its name to CVS Health.)

I also had a lot of questions about interoperability issues in health IT and the many criticisms that lately have been heaped on both EHR vendors for perceived usability problems and the federal Meaningful Use EHR incentive program. The timing couldn’t have been better.

Podcast details: Interview with Greenway Health CEO Tee Green, recorded Sept. 8, 2014. MP3, mono, 128 kbps, 25.5 MB. Running time 27:51

1:00 Walgreens rollout and EHRs for “retail health”
3:20 Future expansion to Walgreens Healthcare Clinic locations
4:15 My own experience with lack of interoperability at a CVS MinuteClinic
5:30 Achieving EHR interoperability
7:30 Frustration with slow progress on Meaningful Use
10:30 Data liquidity
12:30 Update on CommonWell Health Alliance
14:25 Addressing criticisms that vendors are hindering interoperability
16:30 EHR usability
18:10 Greenway Marketplace app store
22:15 Patient engagement and slow start to Stage 2 Meaningful Use
24:10 Dealing with the rise of consumerism in healthcare

I’ve been kicking around in my mind the idea of hosting a regular podcast, perhaps as frequently as weekly. If so, what day of the week would you prefer to hear a new episode?

September 12, 2014 I Written By

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

EHRs and patient safety

If you wonder where I’ve been, I’ve, for one thing, been blogging a bit for (very little) pay over at Forbes.com and writing a lengthy cover story for the September issue of Healthcare IT News.

The Healthcare IT News piece actually breaks down into a fairly short lead story and several sidebars, which aren’t all that evident from the traditional Web version. (The digital edition has everything.) For the sake of convenience, here are links to all elements of the cover package:

Main story: “Patient safety in the balance: Questions mount about EHRs and a wide range of patient safety concerns”

Sidebars:

The issue also contains a reprint of my May 2012 blog post, written just a week after my father’s death: “Medical errors hit home.”

Happy reading, and happy Labor Day weekend.

August 29, 2014 I Written By

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

Adelphi U ad spreads health reform fallacy

The following ad has popped up several times on my mobile Facebook app recently:

Adelphi Facebook ad
That’s from Adelphi University in Garden City, N.Y., and the first sentence of that ad is absolutely false, not to mention poorly written. There is no government mandate for any healthcare facility to go paperless at all, much less by 2015.

As people in health IT and in healthcare management probably know, the federal Meaningful Use EHR incentive program calls for Medicare penalties starting next year for any provider that hasn’t achieved at least Stage 1 of Meaningful Use. But that’s not a mandate; hospitals and other providers still have the option of participating. Those who don’t see Medicare patients don’t face penalties anyway.

Even those that are able to meet all the Meaningful Use requirements still don’t have to be paperless, at least not according to the Stage 1 and Stage 2 rules. Nor have I seen any evidence that Stage 3 would contain such language, and even if it does, that phase does not start until 2017.

There are plenty of reasons why those who start work on a master’s in health informatics this year will be very much in demand next year. Why does Adelphi need to mislead people in an apparent attempt to create demand for its program?

June 29, 2014 I Written By

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