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CMS extends 2014 MU hospital attestation until end of year

Just days before the clock was to run out on hospitals, including Critical Access Hospitals, hoping to attest to Meaningful Use of EHRs for 2014, the Centers for Medicare and Medicaid Services has pushed back the attestation deadline by a month, until Dec. 31.

In an announcement posted yesterday on the CMS Meaningful Use registration and attestation login page, CMS said: “CMS is extending the deadline for Eligible Hospitals and Critical Access Hospitals (CAHs) to attest to meaningful use for the Medicare Electronic Health Record (EHR) Incentive Program 2014 reporting year from 11:59 pm EST on November 30, 2014 to 11:59 pm EST on December 31, 2014.”

Just don’t expect to do so online during a short period in a couple of weeks, as CMS says the site will be down for maintenance from Friday, Dec. 12 at 10 a.m. EST to Saturday, Dec. 13 at 12:30 p.m. EST. CMS also says people “may experience intermittent connectivity” Nov. 30 between 12:01 and 5 a.m. EST.

This extension “will allow more time for hospitals to submit their meaningful use data and receive an incentive payment for the 2014 program year, as well as avoid the 2016 Medicare payment adjustment,” CMS says.

 

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.

All my HIMSS coverage in one place

The last of my 10 MedCity News stories from HIMSS14 has been posted. It’s a nice mix of news, features, analysis and commentary. Here are links to all of them, in chronological order.
NantHealth launches Clinical Operating System – biggest of big data startups – with $1B (Feb. 25)

Body + biology + behavior: Intel exec explains how technology is making N=1 care possible (Feb. 26)

Tavenner: 2014 is your last chance for a hardship exemption for Meaningful Use 2 (Feb. 27)

HIMSS crowd skeptical of promise for flexibility on MU2 hardship requests (Feb. 27)

Google Glass startup expecting third healthcare client in less than 6 months (Feb. 27)

DeSalvo: True EHR interoperability – and a national HIE – is possible by 2017 (Feb. 28)

DeSalvo meets and greets – briefly – while Tavenner keeps her distance at HIMSS (March 3)

HIMSS Intelligent Hospital tracks patients, pills and clinicians in completely connected loop (March 5)

Interoperability Showcase uses car crash to show how connected data really can improve patient care (March 5)

Athenahealth’s first inpatient product isn’t quite an EHR, but a ‘Trojan horse’ into hospitals (March 10)

 

March 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.

CMS clarifies MU2 hardship exemptions

As I reported for MedCity News at HIMSS14 nearly two weeks ago, CMS Administrator Marilyn Tavenner announced plans to provide unspecified flexibility in claims for Meaningful Use Stage 2 hardship exemptions this year. Tavenner then left without speaking to the media.

The news left a lot of people scratching their heads and waiting for some details. Today, CMS issued some clarification, confirming that there would be exemptions for healthcare providers unable to have EHRs certified to 2014 standards in place for the 2014 reporting year. This is particularly important now because Medicare penalties for not achieving Meaningful Use take effect next year, but they are based on the 2014 reporting year (Oct. 1, 2013-Sept. 30, 2014 for hospitals, the 2014 calendar year for physicians and other individual “eligible providers.”)

The guidance confirms that CMS is aware of the problems caused by the slow pace of certification to the new, 2014 standards that Stage 2 requires. As of today, according to the ONC Certified Health IT Products List (CHPL), there are 3,736 ambulatory and 1,200 EHRs and EHR modules certified to 2011 standards, but just 899 total that meet 2014 certification.

Here’s the one-page CMS guidance for hospitals/critical access hospitals and the one for eligible providers.

March 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.

CMS proposes MU2 extension, MU3 start date of 2017

Less than three weeks ago, I reported from the American Medical Informatics Association Annual Symposium in Washington that officials from the Office of the National Coordinator for Healthcare Information Technology were publicly saying it was unlikely there would be a delay to Stage 2 of Meaningful Use.

In October, noting that the federal rule-making process can be arduous, former national health IT coordinator Dr. Farzad Mostashari said, “I think folks should assume that the timelines stick.” He was speaking to the College of Healthcare Information Management Executives a week after leaving government service.

Today, we find out that they knew something we didn’t. The Centers for Medicare and Medicaid Services proposed extending Stage 2 to 2016 and delaying the start of Stage 3 to 2017.

Per ONC:

Under the revised timeline, Stage 2 will be extended through 2016 and Stage 3 will begin in 2017 for those providers that have completed at least two years in Stage 2. The goal of this change is two-fold: first, to allow CMS and ONC to focus efforts on the successful implementation of the enhanced patient engagement, interoperability and health information exchange requirements in Stage 2; and second, to utilize data from Stage 2 participation to inform policy decisions for Stage 3.

The phased approach to program participation helps providers move from creating information in Stage 1, to exchanging health information in Stage 2, to focusing on improved outcomes in Stage 3. This approach has allowed us to support an aggressive yet smart transition for providers.

 

The delay to Stage 3 was likely. As I exclusively reported in June, ONC’s deputy national coordinator for programs and policy, Judy Murphy, dropped a strong hint that Stage 3 would not start until 2017, saying, “2016 would be a problem.” By pushing back the start of the third stage, we would automatically get an extension to Stage 2, making it a three-year program instead of two.

The start of Stage 2 already had been pushed back a year from the original plan of 2013. From my reading, what CMS is proposing today is not another delay to the beginning of Stage 2. Hospitals that have begun their attestation periods since Oct. 1 may continue and physicians are allowed to start Jan. 1.

CMS said to expect proposed Stage 3 regulations, as well as proposed ONC EHR certification rules for Stage 3, in the fall of 2014.

What strikes me as odd is that this announcement came late on a Friday afternoon. There is no time stamp on the ONC blog post, but CMS’ Travis Broome tweeted this at 4:05 pm EST:

Late Friday is typically when government agencies take steps they don’t want plastered all over the news. I don’t see anything here that is surprising or controversial, and it could be argued that ONC didn’t mislead people with earlier statements because the start dates for Stage 2 are not changing. Did I miss something?

UPDATE: CMS held a webcast about this that started at 1 p.m. EST. That’s still Friday afternoon, but not so late that it looks like they’re trying to bury the news.

 

December 6, 2013 I Written By

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

Follow-up from ATA Fall Forum

Last week, I joined Steve Dean of Falls Church, Va.-based Inova Health System’s Inova Telemedicine Program on stage at the American Telemedicine Association’s Fall Forum in Toronto for what turned out to be a very well-received session on mobile apps and devices finding their way into clinical workflows. It was either a Letterman-style top 10, or, as Dean described it, a Siskel and Ebert-style discussion and review of 10 popular and/or interesting apps.

In one example, Dean noted that Aetna’s iTriage consumer app had been downloaded more than 9.5 million times. One audience member questioned the relevance of that number, suggesting that many people download an app, try it once and decide not to use it again. She asked if we had any actual usership statistics. I said I would contact Aetna and find out, then post the answer here on this blog.

An Aetna spokeswoman didn’t have data on the number of iTriage users, but told me that iTriage has nearly 60 million user sessions per year. (For what it’s worth, the app also passed 10 million downloads last week, she added.)

Here are our slides from that presentation. We alternated, with Dean presenting AirStrip OB, AliveCor, Asthmapolis (which changed its name last week to Propeller Health), iTriage and Welldoc. I opened discussion on DrawMD, mym3, Walgreens, Fitbit and various apps from the VA and CMS. Download ATA Fall 2013 v3.pdf

I realize context might be missing from just looking at these slides, but the ATA tells me video will soon be available online through the ATA Learning Center. (For now, access is restricted to ATA members, but the site promises non-member access “soon.”)

 

September 18, 2013 I Written By

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

Sampling of opinions on meaningful use Stage 2

I’ve been an absentee blogger yet again the last few weeks. Here’s something to chew on while I get caught up, a sampling of all the statements I received regarding the Stage 2 final rules for meaningful use, in the order I received them. Most interesting are what the consumer groups had to say because CMS lowered the threshold for sharing records through a patient portal to a laughable 5 percent of patients, down from the proposed (and almost equally laughable) level of 10 percent. Patients need to speak up and demand access to their own records. Providers need to stop fighting the inevitable.

National Partnership for Women & Families

Leading Consumer Advocate Lauds Stage 2 Meaningful Use Final Rule for Promoting Better Communication Among Doctors, Fewer Medical Errors and Lower Health Costs

Statement of Christine Bechtel, Vice President, National Partnership for Women & Families

“The Stage 2 Final Rule released by the Centers for Medicare & Medicaid Services (CMS) this afternoon is a huge step forward.  It brings us closer to the days when fewer overwhelmed patients and their family caregivers struggle to keep track of tests, diagnoses and medications; beg their doctors to talk to one another; suffer avoidable medical errors; and pay for duplicative and unnecessary care.  The rule issued today offers the promise of better, more efficient care, improved safety and fewer hospital readmissions.

We are pleased that the new rule gives patients the ability to go online and view, download and transmit their health information from the Electronic Health Record (EHR) to secure places of their choosing.  A recent public opinion survey commissioned by the National Partnership for Women & Families found that this kind of feature helps consumers see great value in physicians’ use of EHRs, and helps them have more trust in electronic systems.  The fact that this is now a core requirement, and will apply to the hospital setting as well as to physicians, is key to finally recognizing the critical role patients play as partners in their own care. This is a huge advance that will allow patients to be more actively engaged in their care.  It helps realize the potential of health IT in ways the nation needs.

It is good that the new rule also recognizes the essential role that providers and their staff play in encouraging patients to use this online access.  It does that by holding physicians and hospitals accountable for ensuring that 5 percent of their patient population logs in once during the year.

In addition, enabling patients to download and transmit their health information electronically will help foster more of the kind of information sharing that is desperately needed to facilitate care coordination, improve safety and reduce costs.  Patients play a key role in information sharing, and this rule gives patients the tools they need to do just that.

The rule’s requirements that a summary of care document be sent from one provider to the next for at least one of every two transitions of care or referrals is a good step.  CMS is also requiring 10 percent of those transmissions to be electronic.  And providers will have to show they are capable of sending these documents to providers who have different EHRs.

Improving care coordination and patient engagement through these criteria (information sharing requirements and online access for patients) are cornerstones of building the foundation of interoperability that will support health system reform.  So many new models of care like Accountable Care Organizations and medical homes will crumble without this bedrock foundation.  This is a good day for consumers who urgently need a more efficient, safer, better coordinated health care system.”

Click the links below for:

  1. Interviews with physician leaders who have implemented patient portals (or online access for patients)
  2. A snapshot of the national HIT opinion survey results
  3. A full executive summary of the national HIT opinion survey results

 

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American Health Information Management Association

Meaningful Use Stage 2 Final Rule:

AHIMA Provides Initial Comments on CMS Ruling

 

CHICAGO – Aug. 23, 2012 Today the final rule on the Electronic Health Record Incentive Program Stage 2 Meaningful Use (MU2) was announced by the Centers for Medicare and Medicaid Services (CMS). This act focuses on incentive payments to eligible professionals, hospitals and critical access hospitals participating in this program that successfully demonstrate meaningful use of certified electronic health record (EHR) technology.

A full analysis of this complex ruling announced as part of the American Recovery and Reinvestment Act – Health Information Technology for Economic and Clinical Health (ARRA-HITECH) will be forthcoming from the American Health Information Management Association (AHIMA). AHIMA is the preeminent nonprofit association representing Health Information Management (HIM) professionals on the front lines for implementing the rule.

While AHIMA studies the complete text of the rule and its scope, the following points have been included:

  • Consistent with the proposed regulation, health information technology (HIT) measures will allow for patients to have the ability to view online, download, and transmit their health information within four business days of the information being available.
  • CMS continues to acknowledge and align Clinical Quality Measures with other reporting programs to reduce burden and duplication of efforts.
  • All HIT Menu Set measures have been transitioned to the Core Set of measures with the exception of electronic syndromic surveillance data and advance directives.

 “We are encouraged to see CMS’ continued push toward actively exchanging health information to improve coordination of care thus improving patient safety,” said AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, CAE, FACHE.  “We are also pleased to learn of CMS’ continued commitment toward engaging patients and families in their healthcare through the ability to view online, download and transmit their health information.  We believe patients must be partners and work side-by-side with their providers to achieve the best possible healthcare outcomes.”

According to Thomas Gordon, the 2014 compliance date CMS provided will enable the industry – providers, hospitals and vendors – the appropriate time to plan and implement the necessary changes.

“As HIM professionals, we are a critical component to the reporting of clinical and HIT quality measures in achieving meaningful use,” said Allison Viola, MBA, RHIA, senior director of federal relations at AHIMA. “We are pleased to see that CMS has heard our calls for increased alignment of quality reporting programs and acknowledgement of making an effort to reduce the reporting burden and duplication of reporting.  We also stand ready to support patients and their ability to have online access to their health information to ensure its privacy, integrity, and timeliness for their continued care.”

Live webinars to discuss the rule’s provisions will be available free for AHIMA members and for $59 for non-members. Visit ahima.org for the schedule and registration information.

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Society for Participatory Medicine

Statement of Sarah Krug, president of the Society for Participatory Medicine:

“Although we’re disappointed this final rule does not give patients next-day access to their electronic medical record after they leave the hospital, we believe that on balance the Stage 2 Meaningful Use requirements go a long ways towards patient empowerment and feature a number of important patient-centered innovations. Patients must be full partners in access to their health information so they can be full partners in their care. For that reason, the Society for Participatory Medicine intends to keep a sharp eye on how the new Meaningful Use rules are actually implemented.”

 

Healthcare Information and Management Systems Society

HIMSS Statement on Release of Meaningful Use Stage 2 and Standards & Certification Criteria Final Rules

August 24, 2012 – (Washington, DC) – HIMSS appreciates the release of the Meaningful Use Stage 2 and Standards & Certification Criteria final rules by the U.S. Department of Health and Human Services. The Stage 2 regulations allow the healthcare community to continue the necessary steps to ensure health information technology will support the transformation of healthcare delivery in the United States.

In our initial review of the Medicare and Medicaid Programs; Electronic Health Record Incentive Program–Stage 2 Final Rule from the Centers for Medicare and Medicaid, HIMSS has identified several significant policy decisions, including:

  • Setting the Meaningful Use Stage 2 start date as 2014, which will maximize the number of eligible professionals (EPs), eligible hospitals (EHs), and critical access hospitals (CAHs) prepared to meet Stage 2 requirements
  • Allowing a 90-day reporting period in Year 1 of Stage 2, which is consistent with HIMSS’ recommendations on the proposed rule
  • Accepting 2013 as the attestation deadline for EPs, EHs, and CAHs to avoid a Medicare payment adjustment, and allowing for exceptions, including limited availability of information technology
  • Finalizing Clinical Quality Measure submission specifications for EPs, EHs, and CAHs

ONC’s efforts in the Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition  appear to streamline the administrative process of certifying EHR products.  We note that the Final Rule both adopts and concurs with a number of HIMSS recommendations. The HIMSS response to the proposed rule had requested several points of clarity and additional specification around certain criterion, and we commend the government’s thorough review and inclusion of additional information to clarify many topics.

We are assessing impacts of each Final Rule regarding Clinical Quality Measurement, reporting options, standards specifications, and alignment with other federal quality reporting and performance improvement programs.

We look forward to continuing to work with the federal government and our members to ensure that the EHR Incentive Program makes impactful improvements to the quality of healthcare delivery in the United States.

Stay tuned for in-depth analysis on HIMSS’ Meaningful Use OneSource; a webinar series in September; and a full slate of Meaningful Use education and exhibition activities at HIMSS13, including a new Meaningful Use Experience.

MGMA-ACMPE

Statement from Susan Turney, MD, MS, president and CEO of MGMA-ACMPE

“MGMA is pleased that the Centers for Medicare & Medicaid Services (CMS) responded to our concerns regarding several of the proposed Stage 2 meaningful use requirements. Extending the start for stage 2 until 2014 was a necessary step to permit medical groups sufficient time to implement new software. Permitting group reporting will reduce administrative burden, as will lowering the thresholds for achieving certain measures such as mandatory online access and electronic exchange of summary of care documents. MGMA supports the rule’s expanded list of exclusions and believes it will allow physicians to achieve meaningful use with fewer hurdles.”

 

Health IT Now Coalition

Health IT Now Coalition Expresses Concern over Meaningful Use Stage 2 Final Rule
Stresses clinical exchange measures are insufficient

WASHINGTON – The Centers for Medicare and Medicaid Services (CMS) today issued its final rule detailing criteria for Stage 2 of the federal electronic health-record system incentive program. The following should be attributed to Joel White, executive director of the Health IT Now Coalition<http://www.healthitnow.org>:

“While we are encouraged that ONC and CMS have recognized that care coordination cannot be achieved exclusively through directed exchange, the rule still fails to adequately address the core issue of interoperability.  Providers, developers, and state health information exchanges have already adopted and implemented more mature and scalable standards that are functioning well in the market today.

“More could and should have been done to support the interoperability requirements necessary for advanced payment and delivery reforms to operate optimally.  The measures for clinical exchange laid out in the Stage 2 final rule will likely not be sufficient.”

Health IT Now is a coalition to promote the rapid deployment of heath information technology (health IT). Health IT will benefit patients and health care consumers while supporting health practitioners to make smart decisions about patient care and save money. For more information, visit www.healthitnow.org<http://www.healthitnow.org>.

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College of Healthcare Information Management Executives

The College of Healthcare Information Management Executives (CHIME) today issued a statement in response to final rules on Stage 2 of the EHR Incentive Payments program, also known as Meaningful Use:

“CHIME applauds efforts made by officials at the Department of Health and Human Services in working diligently to prepare final rules on Stage 2 of the EHR Incentive Payments program,” said CHIME President and CEO Richard A. Correll.

“We commend the Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health IT for seeing the wisdom and practicality of heeding many of CHIME’s recommendations, filed during the spring public comment period. By allowing providers to demonstrate Meaningful Use through a 90-day EHR reporting period for 2014, government rule-makers have ensured greater levels of program success. And by including additional measures to the menu set, providers have a better chance of receiving funds for meeting Stage 2.

“However, we also recognize that these points are conciliatory and that many details may need further clarification. The final rule still puts providers at risk of not demonstrating meaningful use based on measures that are outside their control, such as requiring 5 percent of patients to view, download or transmit their health information during a 3-month period. Some areas of clarification include some of the exclusionary language as well as nuances around health information exchange provisions, clinical quality measures and accessing images through a certified EHR.

“CHIME will continue to delve into this sizable and weighty effort, including the technical specifications and certification criteria,” Correll added.

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September 5, 2012 I Written By

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

ACA decision is a beginning, not an end, to health reform

I’ve spent a lot of time on social media since Thursday morning debating the meaning of the Supreme Court’s rather stunning decision on the Patient Protection and Affordable Care Act. It was stunning in that Chief Justice John Roberts, a George W. Bush appointee, sided with the four liberal-minded justices, but also stunning in that the court went against conventional wisdom by upholding the individual mandate on the grounds that it was a legal exercise of Congress’ constitutional right to levy taxes.

I had to remind a lot of people that this decision neither solves the crisis, as supporters have claimed, or turns us into the Soviet Union, as some on the lunatic fringe have suggested. Expanding insurance only throws more money at the same problem. This was my first tweet after I learned of the decision:

Breaking news: American #healthcare still sucks. It's quality, stupid. #ACA #hcr #SCOTUS #Obamacare
@nversel
Neil Versel

The cynic in me likes to point out that the individual mandate was an idea first conceived by the conservative Heritage Foundation and championed in Massachusetts by Mitt Romney. Both somehow now oppose the idea. The law that ultimately passed Congress was written by Liz Fowler, a top legal counsel to Max Baucus’ Senate Finance Committee who previously was a lobbyist for WellPoint. Her reward for doing the bidding of the insurance industry was for Obama to appoint her deputy director of the Office of Consumer Information and Oversight at HHS. This was insider dealing at its finest, as much a gift to insurers as the 2003 Medicare Prescription Drug, Improvement and Modernization Act was a gift to Big Pharma.

Of course, I initially was misinformed about the Supreme Court ruling because CNN jumped the gun (as did Fox News) and erroneously reported that the court had struck down the individual mandate on the grounds that it violated the Interstate Commerce clause of the Constitution. But so were millions of others.

I suppose that was fitting, since the national media have for more than two years been misinforming the public about what is really in the law. There are small but real elements of actual care reform — not just an insurance expansion — in there, but very few have been reported. The actual reform has been drowned out by ideologues on both sides. Here’s a handy explanation of most of what’s really there (it’s a good list but not exhaustive). The insurance expansion, the only thing people are talking about, really is just throwing more money at the problem. There is a lot more work to be done to fix our broken system.

What I consider real reform in the ACA includes accountable care organizations and the creation of the Center for Medicare and Medicaid Innovation. Along with the innovation center, CMS also gets the power to expand pilot programs that are successful at saving money or producing better outcomes. In the past, successful “demonstrations” would need specific authorization from Congress, which could take years.

Notice that there isn’t a whole lot specific to IT. That’s because the “meaningful use” incentive program for EHRs was authorized by the 2009 American Recovery and Reinvestment Act. Another key element of real reform that also is not part of the ACA is Medicare’s new policy of not reimbursing for certain preventable hospital readmissions within 30 days of discharge.

We need more attention to quality of care. Many have argued that tort reform needs to be part of the equation, too, because defensive medicine leads to duplicative and often unnecessary care. Perhaps, but lawsuits are a small issue compared to the problem of medical errors. Cut down on mistakes and you cut down on malpractice suits. Properly implemented EHRs and health information exchange — and I do mean properly implemented — will help by improving communication between providers so everybody involved with a patient’s care knows exactly what’s going on at all times.

All of these facts lead me to conclude that true healthcare reform hasn’t really happened yet. Look at this Supreme Court ruling as a beginning, not an end, to reform.

 

June 29, 2012 I Written By

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

A dubious honor from Health Wonk Review

For the very first time, I captured the top spot on the biweekly Health Wonk Review blog carnival, this time hosted by Dr. Jaan Sidorov of the Disease Management Care Blog. Unfortunately, I had to endure my dad’s untimely death after a miserable hospital experience in order to write the piece in question. But if it brings more traffic to that post and, more importantly, more awareness of multiple system atrophy (MSA) and the problem of poorly coordinated care and broken processes in hospitals, I’ll take it.

Since you’re here primarily for health IT, I’ll point you to a couple of relevant items that Sidorov summarizes. In a post actually written back in February, Martin Gaynor, chairman of the Health Care Cost Institute, discusses the organization on the Wing of Zock (the name is explained here) blog. The institute is aggregating claims information from the likes of Aetna, Humana, Kaiser Permanente, UnitedHealthcare and CMS to provide researchers with rich data sets related to healthcare costs and utilization.

“At its most basic, HCCI was formed because a better understanding of health spending can improve the quality of care and save money. If we generate information that makes a difference, then we will be a success,” Gaynor says.

Also, consultant Joanna Relth makes it known on the Healthcare Talent Transformation blog that she is no fan of ICD-10. “I’m sure that the intent of making this massive change to the codes is to improve the accuracy of diagnosis coding so providers will bill more accurately and insurance companies will pay providers and insureds in a more timely fashion. Seriously?? Did anyone ask a learning professional about how large a list is reasonable and at what point does the number of data points become impossible to follow?” she wonders in what comes off a little as an anti-government screed.

But I prefer to end this post on a happy note. In the comment section, Relth links to a video from EHR vendor Nuesoft Technologies that parodies Jay-Z’s “99 Problems.” Enjoy.

May 25, 2012 I Written By

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

HIMSS12 notes

I’ve just returned home from HIMSS12. As usual, it was a grueling week, made more grueling by the fact that I arrived a day earlier than usual. But I do have to say that this was the least stressful HIMSS I have been to in years.

Maybe it’s because the conference layout within the massive Venetian-Palazzo-Sands Expo complex was surprisingly compact for my purposes, and I didn’t have to do as much walking as normal. Maybe it was because I only set foot on the show floor once, thanks, in part, to the announcement of the Stage 2 “meaningful use” proposed rules on Wednesday, which caused me to cancel one vendor meeting (in the exhibit hall) and cut another one (in the media interview room) short so I could knock out my story for InformationWeek. Or maybe it’s because I spent too much time in the casinos. Let’s go with the first two, OK?

HIMSS12 broke all kinds of records, drawing 37,032 attendees, beating last year’s former record of 31,500 by nearly 18 percent. The final exhibitor count was 1,123, also the most ever. After I tweeted the attendance figure, at least one person thought this rapid growth was an indication that the conference was “jumping the shark”:

jumping the shark? RT @: #HIMSS12 draws record 37,032 attendees, crushing last year's mark of 31,500. http://t.co/Mw1TDYSA #HealthIT
@apearson
Aaron Pearson

I have thought in recent years than HIMSS may be becoming too big for its own good. This time around, I heard mixed reviews.

Personally, like I said, it was less stressful than normal. It’s always good to catch up with old friends, particularly my media colleagues. This year, I also met up with a couple of friends from back home who happen to work for vendors. We kept the fun going all the way back to Chicago, since at least three other health IT reporters and a few others I know were on the same flight as me.

I also have to say I had a wonderful time on a “Meet the Bloggers” panel on Wednesday afternoon, where I joined Healthcare Scene capo John Lynn, fellow Healthcare Scene contributor Jennifer Dennard, Carissa Caramanis O’Brien of Aetna and moderator Brian Ahier for some lively dialogue about social media in health IT. I know that at least one audience member took some video, and I’ll link to that once it’s posted.

Later that evening, I saw nearly every one of the same people at Dell’s Healthcare Think Tank dinner, where I participated in a roundtable discussion about health IT with a bunch of supposed experts. It was streamed live, and I believe the video will be archived. Many of the participants, including myself, tweeted about it, using the hashtag #DoMoreHIT. I really am adamant about the public needing to be explained the difference between health insurance and healthcare.

Speaking about misunderstandings, I am in 100 percent agreement with something Dr. Wendy Sue Swanson, a.k.a. Seattle Mama Doc, said during an engaging presentation Monday at the HIMSS/CHIME CIO Forum. She made the astute observation that there needs to be better distinction between expertise and merely experience when it comes to celebrities being held up as “experts” in healthcare and medicine. Let’s just say that Swanson, as a pediatrician, is no fan of some of the things Jenny McCarthy and Dr. Mehmet Oz have told wide audiences.

There definitely were some people among the 37,000 who were not enamored with the cheerleading at HIMSS. There was talk around the press room that HHS really dropped the ball by not having the meaningful use Stage 2 proposal out a week earlier, before the conference started. In reality, blame the delay on the White House. Every federal rule-making has to be vetted by the bean counters and political operatives in the Office of Management and Budget, and it’s hard to tell how long the OMB review will take once an administrative agency, in this case, HHS, sends the text over.

I admit, I was wrong in expecting the plan to be out earlier, too. Instead, we got the news Wednesday morning and saw the text Thursday morning, forcing thousands of people to scramble to scour the proposed rules.

I know HIMSS had a team at the ready, who dropped everything to read the proposal and get a preliminary analysis out by the end of the day Thursday. Lots of consulting firms did the same. I’ll save some of the commentary I received for another post.

The wireless Internet in the Venetian’s meeting areas was truly terrible. Either that, or I need to replace my aging laptop. I’m thinking both.

I had no trouble getting my e-mail over the Wi-Fi network, but I really couldn’t do anything on the Web unless I was hard-wired to one of the limited number of Ethernet cords in the press room, and those workstations filled up fast. Bandwidth was particularly poor on Thursday, when I presume thousands of people were downloading the Stage 2 PDF. CMS officials said the Federal Register site crashed from the heavy demand, and I’m sure a lot of it came from inside the Venetian and the Sands Expo.

There didn’t seem to be enough attention paid to safety of EHRs, at least according to Dr. Scot Silverstein of the Health Care Renewal blog, who wrote this scathing critique of the sideshow the exhibit hall has become, making Las Vegas perhaps “fitting for people who gamble with people’s lives to make a buck.”

Personally, I thought ONC and CMS took the recent Institute of Medicine report on EHR-related adverse events pretty seriously. Plus, one of the IOM report authors, Dr. David Classen, presented about the study findings at the physician symposium on Monday and again during the main conference.

Mobile may also have gotten a bit of a short shrift, despite the recent launch of mHIMSS and last’s week’s news that HIMSS had taken over the mHealth Summit from the NIH Foundation. The mobile pavilion was relegated to the lower level of the Sands, the area with low ceilings and support pillars every 30 feet or so. (I called that hall “the dungeon.”) I have a feeling you will like Brian Dolan’s commentary in MobiHealthNews next week. I’m still figuring out what I will write for that publication, but I have to say I did hear some positive things about mobile health this week.

I still don’t know what GE and Microsoft are doing with Caradigm, their joint venture in healthcare connectivity and health information exchange that didn’t have a name until a couple of weeks ago. The name and the introductory reception they held Tuesday evening at HIMSS seemed a bit rushed, IMHO. The Web address the venture reserved, www.caradigm.com, currently redirects to a GE page. Other than the fact that Microsoft is shifting its Amalga assets to Caradigm, I’m at a loss.

Popular topics this year were the expected meaningful use and ICD-10, plus the buzzwords of the moment, business analytics and big data. I’d be happy I never hear the word “solution” as a synonym for “product” or “service” again. To me, that represents lazy marketing. Get yourself a thesaurus.

 

February 24, 2012 I Written By

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

Berwick, after the fact

The tragedy of Dr. Don Berwick’s short tenure as head of the Centers for Medicare and Medicaid Services has been well-documented, including right here on this blog. Berwick got in by a controversial recess appointment because President Obama didn’t have the political courage to fight for his nominee and allow Berwick to face the Democratic-controlled Senate. Berwick, of course, quit late last year when it became clear Obama would not renominate Berwick for the job he is uniquely qualified for.

There have been a number of postmortems in the press, where Berwick discussed his experience running CMS, including the challenges of implementing both the HITECH Act and the Patient Protection and Affordable Care Act and his. continuing efforts to improve the quality of care in this country. But I haven’t seen one quite as good as what Dan Rather just produced.

The former CBS News anchor has been toiling in relative obscurity at HDNet, a hard-to-find cable network run by billionaire Mark Cuban. Fortunately, Rather took to the far more popular Huffington Post this week to share his thoughts on a recent interview he conducted with Berwick.

“Dr. Don Berwick, a pediatrician by training, came to Washington with a sterling reputation among people who actually know something about health care. He had helped pioneer the Institute for Healthcare Improvement, which may sound like another pointy-headed D.C. think tank, but really is a Cambridge, Massachusetts-based organization lauded the world over for helping make health care systems better. For example, they have worked with hospitals on common sense techniques to reduce hospital infections. These are serious people who are welcomed in hospitals and clinics across the country and around the world,” Rather wrote on HuffPo.

That’s right, Rather understood Berwick’s background, unlike, say Dr. Scott Barbour of a crackpot group called  Docs4PatientCare. “Utilizing quotes from Dr. Berwick, Dr. Barbour exposed that, ‘He is not interested in better health care. He is only concerned about implementing his socialist agenda,’” read a pitch I received from that organization last year.

I’ve been over this before. Berwick has probably done more to improve the quality of care and save lives than anybody else on the planet today. Some of the people who publicly opposed his nomination privately knew this, as Rather’s interview with Berwick demonstrates:


Yes, most of the opposition was an elaborate lie perpetrated for political gain. In today’s Washington, is anybody surprised? The losers once again are the American people and anybody who comes to this country for healthcare.

February 16, 2012 I Written By

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