Medicaid | Meaningful HIT News

Patients with complex cases don’t want multiple provider portals, Rady CIO says

How about some real, original content for a change? Yeah, that’s why you started coming to my blog in the first place, isn’t it? You’re tired of nothing but video embeds from others and short, offbeat attempts at humor.

I recently interviewed Albert Oriol, CIO of Rady Children’s Hospital-San Diego, for a story that will appear elsewhere (read: a paying client) soon, but I had a lot of material I left out of that story. I get to use some of the rest here in a little experiment to see what it does to this site’s traffic.

Obviously, pediatric hospitals aren’t eligible for the Medicare side of meaningful use, which is why the threshold is lower for qualifying for Medicaid bonuses. Pediatricians and children’s hospitals only need to have 20 percent of their visits with Medicaid patients, compared to 3o percent for other providers. Rady meets that standard and already has attested to Stage 1.

Oriol, however, does not like the way the rules are written, calling some of them “well-intentioned mandates with unintended consequences.” For example, providers must offer portals for some of their patients – 10% in Stage 1, rising to 50% in Stage 2. But patients with complex conditions go to multiple providers, each of which may have unique portals. “It’s inconvenient for them to go to many different portals,” he says.

He also is frustrated with having to build reports knowing that many of the items will not apply to pediatric subspecialties. “It’s not the best use of resources,” Oriol says.

The two things at the top of mind for Oriol these days are telemedicine and advanced analytics. Rady is expanding its telemedicine program to support rural areas in Imperial County, a poor, isolated jurisdiction east of San Diego County along the Mexican border. He believes this will provide value and convenience to primary care physicians and patients alike.

On the analytics front, Rady is working on a demonstration project with California Children’s Services (CCS), a managed care program for children in the state’s MediCal system with certain diseases. “We’re going to bring in data from other providers,” Oriol says.

The hospital also is “taking a big step forward” in innovation and discovery by partnering with industry to research technology and the analytics of technology, according to Oriol.

Guest podcast: Deborah Gordon of Network Health talks reform with Sivad Solutions

Last September, I was a guest on a podcast hosted by Todd Schnick and Charles Davis of Sivad Business Solutions. Afterwards, we decided to share content if and when it made sense. That hasn’t happened until now (actually last month — I’m just getting around to posting now).

Schnick and Davis interviewed Deborah Gordon, chief marketing officer of Network Health, a health insurer in Massachusetts, to discuss healthcare reform. I wouldn’t be posting this if it didn’t have a focus on real reform of health care, and not just insurance expansion, with a strong element of patient safety and attention to outcomes.

From Sivad:

An honor to welcome Deborah Gordon, the Chief Marketing Officer for Network Health. Debbie joins us to talk about one of the more innovative non-profit health plans one can find across the US. You can learn more about Network Health here, the number three health plan for Medicaid health plans.

Discussion topics included:

1. The challenges of serving a very diverse population and customer base, along with lower income customers as a result of income or job situation.

2. Network Health, and states like Massachusetts, have lead the nation in Medicaid health care. How can that trend, and how can the reforms found in Massachusetts, spread across the land?

3. The creation of the Health Insurance Exchange is the key to success…which brings competition and market forces to bear in health care. “It is like Expedia for health insurance…”

4. A focus on quality patient care going forward…

5. What are the challenges going forward, and how does the heated national debate impact the work they are doing.

6. The innovation that’s possible when market forces are at play… “Regulators spawning innovation…”

7. More technology is available and serving the health care markets, which is exciting. But, will access to that technology be accessible to the low income markets?

8. The e-discharge program…

9. The utilization of analytics…

10. Exposing more information to the consumer makes them better patients, healthier, and more compliant to health recommendations…

11. The patient should be the center of the health care system… not the doctor.

12. Debbie was recently named a 2013 USA Eisenhower Fellow, a prestigious fellowship which recognizes emerging leaders who are making momentous contributions to society. In 2013, she will travel to Singapore and Australia where she will explore how these countries have successfully established systems and supports that allow consumers to make good decisions about their health care. The goal is to gather insights and best practices that can be applied here in the U.S.

Chart: Current state telemedicine legislation

Here’s a handy chart from the American Telemedicine Association showing the current status of telemedicine legislation in all 50 states plus D.C. Specifically, it shows which states have already mandated private and Medicaid insurance coverage for telemedicine services, as well as which states are considering such a law. (Medicare policy of course is set at the federal level.) This information is current as of this month.

Podcast: This time, I’m the interviewee

In a rare turn of events, I’m the one being asked the questions on a podcast by Sivad Business Solutions, which hosts regular audio discussions on a variety of business topics. I give kind of a high-level view of health IT and offer my very strong opinions on patient safety and healthcare reform. There’s an interesting discussion about EHRs being designed to maximize reimbursements rather than assure safety.

Interestingly, we recorded this via Skype. I like the audio quality, if not the nasal quality of my own voice, more than usual that day.

Hopefully the embedded audio works. If not, click here.

Here’s the rule for meaningful use

Here’s the CMS proposal for meaningful use: http://www.federalregister.gov/OFRUpload/OFRData/2009-31217_PI.pdf

There is a companion interim final rule related to standards and certification: http://www.federalregister.gov/OFRUpload/OFRData/2009-31216_PI.pdf

There’s a public conference call at 5:15 p.m. EST.
From ONC:

On Wednesday, Dec. 30, 2009, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) will announce two regulations that lay a foundation for improving quality, efficiency, and safety through meaningful use of electronic health record (EHR) technology.

The regulations will help implement the EHR incentive programs enacted under the Health Information Technology for Clinical and Economic Health (HITECH) Act, which was part of the American Recovery and Reinvestment Act of 2009. Public comments on both regulations are encouraged.

WHO: David Blumenthal, M.D., M.P.P., national coordinator for health information technology
Jonathan Blum, director, Center for Medicare Management
Cindy Mann, director, Center for Medicaid and State Operations

WHAT: Briefing for HITECH Partners and Stakeholders – Providers, HIT Industry Organizations

WHEN: Wednesday, Dec. 30, 2009
5:15 p.m. – 6:00 p.m. Eastern Time

WHERE: Toll-Free Dial: (800) 837-1935
Conference ID: 49047605
Pass Code: HITECH

Money matters

A post last month that listed the salary range for a job opening at the Office of the National Coordinator for Health Information Technology resulted in a comment that the $109,808 to $165,200 salary won’t make anybody rich in the pricey Washington area. OK, fair enough. The job as deputy coordinator does not require a medical degree, but a physician with informatics training certainly could make a lot more money in the private sector. Case in point is this entry on the Physician Salaries USA blog from last week.

Good stuff, right? Well, if you read either For The Record or Health Executive, you would have known that chief medical information officers tend to be well-compensated for their high-level expertise and long hours. I mention these publications purely in a self-serving manner, as I wrote recent pieces on the role of the CMIO in each of these magazines. My Health Executive story is in the January 2007 issue. In the case of For The Record, check the Sept. 18, 2006 edition.

Now that I’ve dispensed with the gratuitous self-promotion, some other money-related news caught my eye last week: the $103.6 million in federal grants awarded to 27 state Medicaid programs. Nearly every project funded in this Medicaid Transformation Grants initiative is related to information technology. Connecticut will receive $5 million for e-prescribing and health information exchange. Hawaii has been granted nearly $3.2 million to implement an OpenVista ASP network. Michigan and Massachusetts each are getting several million dollars to automate vital records. For details on the grants, click here.

From what I can gather, this is the first large-scale, nationwide push for IT in Medicaid.

HHS says it will award an additional $46.4 million later this year to complete the $150 million program authorized by the 2005 Deficit Reduction Act. The solicitation has not gone out yet.

Patients with complex cases don’t want multiple provider portals, Rady CIO says

Guest podcast: Deborah Gordon of Network Health talks reform with Sivad Solutions

Chart: Current state telemedicine legislation

Podcast: This time, I’m the interviewee

Here’s the rule for meaningful use

Money matters

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