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Daschle = Hitler? The Washington Times thinks so

Say what you like about the tax problems that forced former Senate Majority Leader Tom Daschle to withdraw from consideration for HHS secretary and criticize his policies all you want, but the Washington Times has officially gone too far. In an editorial today, the favorite paper of the lunatic fringe on the far right compares Daschle’s proposals for increasing the efficiency of healthcare through IT to a Nazi program.

“This notion is fully in the spirit of the partisans of efficiency but came from a program instituted in Hitler’s Germany called Aktion T-4. Under this program, elderly people with incurable diseases, young children who were critically disabled, and others who were deemed non-productive, were euthanized. This was the Nazi version of efficiency, a pitiless expulsion of the ‘unproductive’ members of society in the most expeditious way possible,” the Times says.

The article is accompanied by a photo of Adolf Hitler.

There almost was a cogent argument here. “One provision causing increasing concern is the future role of the National Coordinator of Health Information Technology, who will be in charge of collecting and monitoring the health care being provided to every American,” the Times says, before launching into its Coulteresque polemic. There are legitimate concerns about privacy in the health IT portion of the economic stimulus plan.

Yes, I know the far right likes to shock, particularly in this new era of full Democratic control of the federal government, but come on. The fact that the current national coordinator, Dr. Robert Kolodner, is Jewish, makes this extra offensive.

February 11, 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 on Allscripts—and the fight over data

Earlier today, I posted news about Allscripts-Misys Healthcare Solutions intending to sell its Medication Services division to an unnamed purchaser for an unspecified amount. I’ve since gotten clarification via e-mail from company spokesman Todd Stein:

“The release is earlier than we would normally have liked because we’re required to reveal all material non-public information about the company prior to undertaking a share repurchase program like the one we also announced yesterday. That’s to ensure that shareholders know everything about the company that they need to know in order to make an informed buy-or-sell decision.”

Indeed, Allscripts announced yesterday a $150 million buyback program and related $150 million increase in its credit commitments.

The company also was named in a Bloomberg story today as one of three firms leading the fight over whether to include greater privacy protections than HIPAA currently affords in the $20 billion health IT section of the economic stimulus legislation. Privacy advocates, including Dr. Deborah Peel’s Patient Privacy Rights Foundation and the American Civil Liberties Union, favor the House version. Business groups, including IT vendors, pharmacy benefit managers and the pharmaceutical industry, prefer the Senate version that allows data mining and direct-to-consumer marketing to continue.

For the record, the other companies named as possible major beneficiaries of the legislation are athenahealth and Quality Systems, the publicly traded parent company of NextGen Healthcare Information Systems.

How do I know this story is a Big Deal? Peel and her cohorts have been very active in keeping the media up to date on developments on Capitol Hill the last couple of weeks, knowing that this could be the last chance for another decade or more to change existing healthcare privacy laws and practices.

I Written By

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

HIT stimulus apparently leaves out mental health

According to the National Council for Community Behavioral Healthcare, both the House and Senate versions of the economic stimulus bill exclude mental health providers from the $20 billion in funding for health IT.

“The National Council is deeply concerned about the lack of direct support for persons with addiction disorders and mental illnesses in the stimulus bill, formally known as the American Recovery and Reinvestment Act. In particular, the economic recovery measure contains no new federal investments for the Substance Abuse and Mental Health Services Administration (SAMHSA). In fact, it appears that SAMHSA is the only operating division within the United States Public Health Service that did not receive emergency funding in either the House or Senate version of the stimulus legislation,” National Council President and CEO Linda Rosenberg, MSW, says in a statement e-mailed to reporters today.

“Also, while privacy protections in the Health Information Technology (HIT) for Rconomic and Clinical Health Act have wide support in the addictions and mental health communities, we were dismayed to learn that the vast majority of our nation’s residential, community-based and individual providers of addiction and mental health services are not eligible to receive Medicaid and Medicare financing or direct grant support under this new HIT initiative. Without the additional resources included in the bill, the goal of community behavioral health organizations to help people with mental illnesses and addiction disorders recover and lead productive lives will be compromised. The community organizations will face many barriers to receiving the Medicare and Medicaid incentive payments for the adoption of HIT technology and will likely be excluded from the grant/loan programs, infrastructure funding, and other HIT provisions of the bill,” Rosenberg continues.

“Let us be clear: parity does not stop at private health insurance coverage. Mental health and addiction providers, both those that receive SAMHSA funding and those that do not, are as much a part of America’s healthcare safety net as physicians and hospitals. Indeed, we confront the same economic conditions including a significant spike in average caseloads combined with successive rounds of state budget cuts.

“The National Council urges Congress to include community behavioral health organizations as eligible entities in the economic recovery bill.”

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 as pork?

The lead editorial in today’s Chicago Tribune talks about a proposed “expansion of health-care entitlements” in the economic stimulus blll.

According to the Trib: “The House version of the stimulus package would … shower $20 billion on computer experts to help doctors convert to electronic medical records. That will create jobs but probably not quickly enough to make a difference in this struggling economy.”

To me, the word “shower” suggests an undeserved windfall. Yes, there are risks of wasting $20 billion on a poor implementation of health IT, but are people really seeing this as a giveaway simply meant to create work? This is about reining in runaway healthcare spending and, ultimately, saving lives, right?

Right?

February 10, 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.

NYT calls for EHR privacy

Electronic health records have made it to the editorial page of the Sunday New York Times. Today, the paper praises the legislation passed by the House last week and facing the full Senate this week for not watering down privacy protections, at least so far.

Read the editorial here.

February 1, 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.

Clancy likely to stay at AHRQ

I’ve just learned that staff at the Agency for Healthcare Research and Quality is operating under the assumption that President Obama will choose to retain Dr. Carolyn Clancy as agency director. As a non-political federal employee, Clancy stayed on past Inauguration day, unlike the heads of many other HHS agencies. Although the new president has a right to bring in his own people, the word I’m hearing is that Obama will not change leadership at AHRQ.

Clancy struck me as one of the first people within the federal government to understand the link between IT and quality, and I think it would be foolish to replace her now.

Incidentally, AHRQ stands to be in line for a pretty big expansion. The entire agency’s current budget estimate for fiscal year 2009 is $327.7 million, down from $334.6 million in 2008. But the economic stimulus legislation that the House passed last night gives $1.1 billion to AHRQ, at least according to the version of the bill introduced Monday. The AHRQ language starts on page 134. (As of this writing, the final text of the bill that passed was not online.)

The Senate companion bill, which is pending, calls for the same $1.1 billion appropriation (page 129).

January 29, 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.

Google denies lobbying to kill privacy provision

Google today denied a claim by a group called Consumer Watchdog that it was lobbying to kill consumer privacy protections in proposed health IT legislation.

From the Google Public Policy Blog:

Consumer Watchdog wrong on medical records claim
Tuesday, January 27, 2009 at 3:12 PM
Posted by Pablo Chavez, Senior Policy Counsel

Earlier today a group called Consumer Watchdog put out a press release alleging a “rumored lobbying effort” by Google “aimed at allowing the sale of electronic medical records.”

This claim — based on no evidence whatsoever — is 100 percent false and unfounded.

Google does not sell health data. In fact, one of our most steadfast privacy principles is that we don’t sell our users’ personal data, whether it’s stored in Google Health, Gmail, or in any of our products. And from a policy perspective, we oppose the sale of medical information in the health care industry.

We are supportive of strong privacy protections for medical records. Consumers own their electronic medical data and should have the right to easily access their information and control who gets to see it. We also believe in data portability, and we support open standards that enable consumers to control their data and take it wherever they’d like.

We have corresponded with Consumer Watchdog several times over the past few months to hear and address their concerns. It’s unfortunate that they did not contact us before making today’s unfounded statements, because we could have told them that their claims were patently false.

At last year’s HIMSS conference, Google CEO Eric Schmidt said that the company would not attempt to monetize its health product, other than by driving people to the company’s regular search engine.

January 27, 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.

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.

Networking, socially

You may have noticed, since the Digital HealthCare & Productivity gig dried up for me a few weeks ago, I’ve been posting more often to this blog. The posts also have been reasonably short. I’m kind of experimenting to see what kind of traffic I get with regular posts.

Now here’s something to get people talking: A collection of Facebook groups for HIT and healthcare quality that I’ve come across recently. All these are open groups; I can’t get into the invitation-only ones anyway. This is by no means exhaustive.

In no particular order:

AMIA – American Medical Informatics Association
American Medical Informatics Association (AMIA) 10×10
Asia Pacific Association for Medical Informatics (APAMI)
IMIA (International Medical Informatics Association)
AHIMA
Canadian Health Information Management Association (CHIMA)
Health Informatics
Health2.0–User Generated Healthcare
Health 2.0
Medicine 2.0
HIMSS
Evidence-based medicine
La Télémédecine mérite mieux. Telemedicine deserves a future.
Medbloggers
Medical Informatics
Empower Patients
Institute for Healthcare Improvement
Bioinformatica en Español

And because Dr. Bill Hersh of Oregon Health and Science University asked nicely, here’s the fan page for the OHSU-AMIA 10×10 Program.

Dr. Hersh also had a letter to the editor published in The Oregonian on Sunday, in which he promoted health IT as a job-creation engine for any economic stimulus that the new Congress might consider in 2009.

December 16, 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.