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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?

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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.

Filed Under: health IT  Legislation  media

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.

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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.

Filed Under: Legislation  media
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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).

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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.

Filed Under: Legislation
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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.

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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.

Filed Under: Google  Legislation  privacy

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.

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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.

Filed Under: Barack Obama  health IT  Legislation  PHR
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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.

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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.

Filed Under: health IT  Legislation
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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?

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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.

Filed Under: Barack Obama  Health Wonk Review  HIMSS  Legislation  RHIO
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Enough with the new bills

Yesterday, Health Data Management had a story about some new health IT legislation coming from Rep. Pete Stark (D-Calif.). I see lots of stories like it every time some member of Congress introduces a bill or even thinks about doing so, and I see just as many stories every time one subcommittee or another holds a hearing or takes a vote on health IT legislation.

The one thing I’m not seeing is actual enactment of health IT legislation, with one notable exception: the Medicare e-prescribing incentive program. That one, of course, was part of a broader bill “rescuing” providers from a 10 percent Medicare fee cut at the 11th hour—and setting up a 20 percent cut on Jan. 1, 2010, unless Congress acts again. But how many health IT bills have we heard hyped over the past four or five years, only to see them die before coming to a vote before the full House or Senate?

I sweated out a midday outdoor press conference in stifling, 95-degree heat on Capitol Hill back in June, listening to politician after politician offer great praise for National Health IT Week and call for various forms of incentives to promote EHRs, PHRs, the NHIN and all the other acronyms we’ve become so familiar with. Most reporters who were there ate that up. But not I.

I pulled aside Rep. Patrick Kennedy (D-R.I.) and Rep. Tim Murphy (R-Pa.) after their speeches, and asked each of them one-on-one about the chance of passing any meaningful health IT bills during a presidential election year. Both laughed and said it was slim to none.

So there you have it, some refreshing honesty from members of Congress. And yet people still seem to get excited whenever someone important utters a word about health IT. My guess is that the majority of Congress still doesn’t grasp the issues. Until that happens, don’t expect anything to reach the president’s desk—no matter who happens to be sitting in the Oval Office.

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September 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.

Filed Under: Legislation

Congress includes eRx in Medicare bill

Finally Congress has paid more than lip service to health IT. Late yesterday afternoon, the Senate approved the Medicare Improvements for Patients and Providers Act of 2008, halting the planned 10.6 percent physician fee rollback and, significantly, including financial incentives for physicians to move to electronic prescribing.

Reportedly, Sen. Edward M. Kennedy (D-Mass.), a strong advocate of health IT, surprised a lot of his colleagues by returning to the Senate in time for the vote, his first appearance there since his cancer surgery last month.

According to the eHealth Initiative, calls for bonuses of up to 2 percent for providers who use “qualified” e-prescribing systems for five years, beginning in 2009. Starting in 2012, providers would be subject to 2 percent penalties for not writing electronic scripts. The Department of Health and Human Services would have the option of adding a hardship exemption for certain providers.

This is not a done deal, however, as President Bush has threatened to veto the legislation over its proposed Medicare Advantage cuts. The bill passed the Senate by unanimous consent, but the eHealth Initiative says 69 senators voted in favor, making the margin veto-proof. The House vote on June 24 was 355-59, also enough to override a veto.

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July 10, 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.

Filed Under: e-prescribing  Legislation
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Health Wonk Review

This week’s Health Wonk Review is up, over at David Williams’ Health Business Blog.

My favorite item there is from Fard Johnmar, who writes in his Health Care Vox blog that technology, marketing and social media are more likely to transform healthcare than any politician.

I see I’m not the only one who noticed that we’re now on our third Congress since the Bush administration challenge of 2004, and I recall exactly one significant health IT bill passed, the one that formalized the Office of the National Coordinator for Health Information Technology. Am I forgetting anything else?

Meanwhile—and this is not from Health Wonk Review—new Leapfrog Group CEO Leah Binder has been added as a keynote speaker for the Integrated Healthcare Association‘s 2008 National Pay for Performance Summit. That event is set for Feb. 27-29 in Los Angeles. You know, right during the HIMSS conference in Orlando, where I and the rest of the health IT universe will be. Nice planning.

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February 7, 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.

Filed Under: blogging  health IT  Health Wonk Review  HIMSS  Legislation
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