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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 fast $5000 loans-cash.net with bad credit, 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 fast $5000 loans-cash.net with bad credit, 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 fast $5000 loans-cash.net with bad credit, 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 fast $5000 loans-cash.net with bad credit, hospital/physician practice management and healthcare finance.

Filed Under: blogging  health IT  Health Wonk Review  HIMSS  Legislation
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Update

In my Dec. 27 post, I referenced a letter from HHS Secretary Mike Leavitt to members of Congress regarding EHRs and the planned 10.1% Medicare physician fee cut for 2008 that eventually was postponed for six months.

I said that the letter was not available online. I was wrong. Here it is.

It seems I confused that letter, from Leavitt to Senate Finance Committee leadership, with another one from members of the Senate regarding e-prescribing. In the latter correspondence, 19 senators asked Attorney General Michael Mukasey to push the Drug Enforcement Agency to revisit its ban on electronic prescribing of controlled substances.

Sen. Sheldon Whitehouse (D-R.I.) issued a press release about that Dec. 17 letter. The letter followed a Dec. 4 hearing on the topic in front of the Senate Judiciary Committee. In the interim, on Dec. 10, the Justice Department included electronic prescriptions for controlled substances on its semi-annual regulatory agenda (see page 70083). That means expect a proposed rule change within the next six months.

As the Washington regulatory machine plods along and the presidential primary season kicks into high gear, please don’t ask me to make any predictions on the EHR/Medicare issue, or, for that matter, on the Medicare fee debate now on hold for a few months.

I will say again, however, that I believe Congress seems to have the will to make major changes to Medicare about once a decade, and that already happened this decade with the Medicare Prescription Drug Improvement and Modernization Act of 2003. Call me cynical (and many have), but I don’t see anything big happening in a presidential election year.

Meanwhile, I’m trying to arrange something super cool: a ride-along in an all-digital ambulance. Hopefully not as a patient. Stay tuned.

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January 8, 2008 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality fast $5000 loans-cash.net with bad credit, hospital/physician practice management and healthcare finance.

Filed Under: e-prescribing  HHS  Legislation
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My dirty mind

When I first saw a news brief today about a statewide database for medical records in New York, I had to laugh. There was something about the name: Health Information Exchange of New York.

I thought there might be a reason that the state name came at the end, like perhaps to form an acronym. Then I realized that the initials, HIENY, might be pronounced as “hiney.” Talk about setting yourself up to be the butt of jokes (pun strongly intended)!

To my disappointment, I clicked on the link to the actual news story the brief came from and learned that the exchange is known as HIXNY.

Anyhoo …

Yet another health IT bill destined for inaction was introduced in Congress today, but at least this one seems to have some thought behind it. The proposed Independent Health Record Trust Act, from Rep. Dennis Moore (D-Kan.) and Rep. Paul Ryan (R-Wis.), calls for a national network of “trusts” to manage patient-owned health data.

“This forward-looking plan would utilize market forces to drive the creation of a fully interoperable, nationwide HIT network, while also taking additional steps to protect the privacy of sensitive medical information,” Moore said in a press release.

For those of you keeping score at home, Moore and Ryan had sponsored the Independent Health Record Bank Act in the last Congress, a bill that of course went nowhere. Perhaps there is greater political will this year. Perhaps not.

And speaking of National Health Information Network initiatives, there seems to be some opposition among RHIO leaders to the Office of the National Coordinator for Health Information Technology‘s NHIN contracting procedures, as this letter illustrates.

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July 11, 2007 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality fast $5000 loans-cash.net with bad credit, hospital/physician practice management and healthcare finance.

Filed Under: Legislation  RHIO
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