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Happy birthday, HITECH, and pre-HIMSS humor

Today is the fifth anniversary of the American Reinvestment and Recovery Act being signed into law, which also means today is the fifth anniversary of the Health Information Technology for Economic and Clinical Health (HITECH) Act, which was rolled into the $831 billion stimulus bill. HITECH introduced “meaningful use” into the lexicon, and for that, it has had a lasting effect.

Through the end of 2013, the program had paid out more than $19 billion in Medicare and Medicaid incentives for EHR usage, and healthcare is still a mess. However, all of that money is for Stage 1, and the goal for the first stage was mostly to get technology in place. Stage 2, which is just getting started, is about interoperability and data capture, while Stage 3, which will not start before 2017, will be focused on actually improving outcomes. It is not until the third stage where we are supposed to see real gains in healthcare quality, though we should start seeing some efficiency improvements in Stage 2.

Penalties for not achieving Meaningful Use kick in next year, though that could change. According to Medscape, the new bill to repeal the much-reviled Medicare sustainable growth rate calls for bringing Meaningful Use, the Physician Quality Reporting System (PQRS) and Medicare’s value-based payment modifier under a proposed new program called the Merit-Based Incentive Payment System (MIPS). This program would eliminate Meaningful Use penalties after 2017, but would base incentives and penalties on more factors than just EHR usage.

On a lighter note, MMRGlobal, the controversial PHR vendor that has been aggressive in defending its many patents but that also has, like every other vendor of untethered PHRs, had trouble landing many customers, has signed on actress and cancer survivor Fran Drescher as a spokesperson. There’s a video on the company’s Facebook page, with a teaser to “Watch For MMRGlobal on TV!” Draw your own conclusions.

On an even lighter note, digital media producer Gregg Masters has started the #HIMSSPickupLines hashtag on Twitter. A few samples:

 


 

Have fun.

February 17, 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.

A nurse speaks out against bad EMR software

Every Thursday, the Chicago Tribune’s “Play” section runs a little feature called “Love/Hate.” The paper picks three or four things that readers love and three or four things that readers hate. This week, EMRs entered the picture. This appeared in the “I hate …” category:

… being a slave to computer programs to document my care as a nurse. It’s so ridiculously time-consuming.

— Sheila Young, Orland Park

That must be one terrible EMR—or perhaps a hodgepodge of disconnected legacy systems—if Young not only considers herself a slave to the computer programs, but feels compelled to share her disdain for the technology with a light-hearted feature section of the local newspaper. That’s quite a statement against the quality of the system design?

On further inspection, it could be a function of not wanting to change old habits. According to Illinois state records, the only Sheila Young from Orland Park who’s a registered nurse (indeed, the only Sheila Young in the whole state with an active RN license) was first licensed in 1967. That means she’s been in nursing practice for at least 44 years. Old habits die hard.

Ms. Young, if you happen to read this, please contact me. I’d love to get the whole story.

May 27, 2011 I Written By

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

FierceHealthIT

Just a quick note: I’m the guest host, as it were, of FierceHealthIT this week. I wasn’t sure until it was too late if I was supposed to write a commentary, so I didn’t, but four of the top five story summaries this week carry my byline:

The one I didn’t write, “Top P4P hospitals to score $7m in bonuses from CMS,” ran in the daily FierceHealthcare last Thursday.

June 23, 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.

Podcast: Blogging hospital CEO Nick Jacobs

From the Department of Better Late Than Never comes this podcast with Nick Jacobs, CEO of Windber Medical Center in Windber, Pa., who’s well known in some circles for being perhaps the first hospital chief in the country to write his own blog.

Nick’s Blog has been around since May 2005, and Jacobs also contributes to Hospital Impact and to the World Health Care Blog. Paul Levy at Beth Israel Deaconess Medical Center in Boston has been writing his blog since August 2006. (I’ve got them both beat, as my blog dates to May 2004. But I am not going to brag until I get the kind of traffic that HIStalk does. That blog, which I’ve heard referred to as the “National Enquirer of health IT,” recently passed 1 million visitors. I’m still looking up at 30,000.)

Speaking of historical records, I’ve been sitting on this recording since September, when Jacobs was in Chicago for the third Healthcare Blogging & Social Media Summit. I’ve got an even older recording in the podcast pipeline, and who knows when I’ll get to that? I did write about Jacobs in Digital HealthCare & Productivity in early October, but now you can hear what he’s all about.

Podcast details: Interview with Nick Jacobs, CEO of Windber (Pa.) Medical Center. MP3, mono, 64 kbps, 9 MB. Running time 19:34.

0:49 Genesis of the blog
2:02 How blogging helps a small hospital compete with larger hospitals
2:50 His message
3:45 Early blog posts and how he started taking more risks
4:50 Motivating employees via the blog
5:40 Keeping local mass media honest
6:40 The global reach of the Internet: “You can never be a prophet in your own home town.”
8:00 Why other hospital CEOs don’t blog
9:20 Being the first to take the plunge
10:00 Why healthcare is so slow to turn to IT
10:40 Windber’s cancer research for the military
11:30 National recognition and local indifference: “reverse urban snobbery”
12:30 Transparency in healthcare
13:45 Flaws in public reporting requirements
15:30 High tech at small hospitals
16:20 Using the Internet to build a reputation
17:30 Market challenges for a small hospital
18:04 The future and his passion for change in healthcare

November 29, 2007 I Written By

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

Politics and healthcare

Here are just a couple of links for the politically minded.

First off, the Kaiser Family Foundation has put up a site with health-related news about the many, many candidates for president in 2008.

And the Healthcare Update News Service, mostly a compendium of press releases from various companies that also has weekly updates from Health Affairs, has posted video of a March 28 speech by the always-entertaining Bill “Dr. HIPAA” Braithwaite from the Fourth Health Information Technology Summit on privacy and security issues that may hold back health information exchange. I saw the speech live, and I think it’s worth the 33 minutes. Even if you don’t have that much time, you can skip to the “chapters” most of interest, much like watching a DVD.

Quick links:
KFF 2008 politics site
Braithwaite speech on privacy and security issues

July 16, 2007 I Written By

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

Podcast: HIT consultant Denise Silber on European initiatives

Last month, I blogged about the “personal” nature of electronic health records in France, based on a blog post by American-born, Paris-based health IT consultant Denise Silber. Well, Denise read my post and e-mailed me, or maybe it was I who sent the link to her. I’ve been in Vegas the last three days and the memory is a bit fuzzy at this stage. A few e-mails later, I had her on the phone for this podcast. Enjoy.

Podcast details: HIT consultant Denise Silber on European initiatives. MP3, mono, 64 kbps, 10.3 MB, running time 22:36.

1:00 Background on her e-health consulting and marketing work
2:40 France’s “personal medical record”
3:40 Fears of Big Brother on both sides of the Atlantic and French data privacy laws
4:25 Patient control of records in France
5:15 HIPAA confusion in the U.S.
6:00 Conflicts between French law and European standards for physicians, and patient concealment of personal health information
6:55 Usage and costs of French health system, including electronic insurance cards
8:25 Differences between French system and other European health systems
9:42 Physician use of EMRs and computers in France
10:25 Current status of French EMR projects
11:47 Standards
12:28 Purpose of the French PMR
13:05 Accuracy and quality of consumer health information
14:45 Physician shortage in France
15:47 HON Code
16:47 New organization for health information improvement in France
18:45 Consumerism in healthcare and transparency
21:10 Other forms of information accreditation

June 22, 2007 I Written By

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

Learning from others’ mistakes

I’ve had a theory for a while, that developing countries may have an easier time adopting IT in healthcare than rich nations that have a long history of inefficient, paper-based practice. It’s worked that way in telecommunications, in that many African countries had underdeveloped phone systems for decades, but quickly adopted mobile phones because it’s easier to put up some cell towers than to string wires to remote villages and urban slums.

Today, I came across this story about efforts to build electronic health systems. “Information technology is no longer a luxury purchased at the expense of other needs, but a basic tool, heard an annual pan-African government ministerial information technology summit last week,” the story says.

Would you believe that wireless, handheld computers are catching on with doctors in Uganda or that clinics in Mozambique have electronic scheduling systems to ensure that HIV/AIDS patients get regular care?

I’ve heard from World Health Organization officials that millions upon millions of people in places like India would rather have access to basic health services than advanced technology, so don’t expect EMRs to proliferate across the developing world any faster than they are in North America and Europe. But if you have a chance to build from the ground up, why not go with something modern and efficient instead of creating isolated silos of incomplete information?

Yes, I have an interest in Africa because my uncle has worked in economic development over there for years. I visited him in Senegal a couple of years ago and was fascinated by what I saw and experienced—though I had no real contact with what passes for a health system.

And Wednesday at the TEPR conference in Dallas, I heard a presentation from a Brazilian health official about some ambitious plans to wire her country’s health infrastructure. I’ll try to write about that another time.

May 23, 2007 I Written By

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

Podcast interview: Tennessee Gov. Phil Bredesen on health IT adoption

WASHINGTON—As co-chair of the State Alliance for e-Health, Tennessee Gov. Phil Bredesen has been heavily involved in the health IT policy debate. He’s also frustrated with the slow progress of technology adoption that’s holding back gains in quality and efficiency (read “cost savings” from a governor’s perspective). And Monday at the World Health Care Congress, he was not afraid to share his thoughts, as this short audio clip demonstrates.

Podcast details: Tennessee Gov. Phil Bredesen on health IT adoption, recorded April 23, 2007, in Washington, D.C. MP3, mono, 64 kbps, 2.1 MB, running time 4:31.

April 24, 2007 I Written By

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