Year-end thoughts

Ah, another long delay between posts. Some people blog for fun. When you write for a living, you do other stuff when you need to take a break. Like sleep in or watch too much TV.

I have just a couple of things to say before the end of the year. So here goes.

Everyone’s offering a personal health record. Few are using them. I’ve written about that plenty this year. I’m now declaring a personal moratorium on PHR stories until someone gives me evidence that patients and physicians are actually using PHRs. There, I said it. Hopefully I’ve just saved myself from a dozen more HIMSS meeting requests. But not likely.

Secondly, I thought it was remarkable that HHS Secretary Mike Leavitt wrote to members of Congress, asking that any legislation to address the 10 percent Medicare fee cut for 2008 include incentives for EHRs and give CMS the authority to require e-prescribing in the future. Could it be that a the Bush administration was asking Congress for something close to a mandate? Not exactly, but it sure got my attention. (Unfortunately, I could not find a copy of it online, but I have a paper copy around here somewhere that perhaps I’ll scan and post as soon as I find it.)

As it turned out, the impetus for the letter came from the American Health Information Community, as detailed in my Digital HealthCare & Productivity story from a couple weeks ago. I had an interview with AHIC member Lillee Gelinas, chief nursing officer of VHA, who gave me a nice play-by-play of the surprisingly quick process.

And as it turned out, the letter didn’t do much on Capitol Hill. Congress postponed the Medicare day of reckoning for six months, offering yet another year-end Medicare Band-Aid and setting up the possibility of a midyear Band-Aid next summer. That legislation didn’t have any health IT provisions, which isn’t surprising, given that Congress already has denied a funding increase for the Office of the National Coordinator for Health Information Technology in 2008.

Is it me, or did 2007 actually mark a regression in health IT on the federal level?

I’ve observed that Washington seems to gather the political will for serious Medicare reform about once a decade, and it already happened this decade, with the 2003 Medicare Prescription Drug Improvement and Modernization Act. Meanwhile, 2008 is a presidential election year, so don’t expect any major revisions to the Medicare payment structure next year either. That means there won’t be any incentive money for EHRs beyond the small-scale demonstration projects already in place, as authorized by the 2003 MMA.

Pessimistic? Perhaps. Realistic? I think so.

Health IT might get some lip service in the presidential campaign, but as I wrote in November, it hasn’t been a top-tier issue for the candidates.

As I post this entry, I see that the odometer has just turned over to 30,000 visitors to this site since I started tracking more than three years ago. Thanks for reading, and happy new year.