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Another view on reform—from Oz

I just read another report on healthcare reform. It pointed out some things you probably already know:

  • Healthcare represents a huge and rapidly expanding portion of the economy, and spending continues to outpace inflation.
  • Healthcare is not as safe as it can and should be.
  • Many of the adverse events that result in injury or death are the result of systemic failure rather than human error.
  • Either way, many are entirely preventable.
  • Information technology likely will be a major force for healthcare transformation and improvement.
  • IT can help empower consumers to make better choices about their own care.

The report makes a key point by quoting former HHS Secretary Tommy Thompson, who said in 2004: “The most remarkable feature of about 21st-century medicine is that we hold it together with 19th-century paperwork.” The thing is, most people reading it have never heard of Thompson, a four-term governor of Wisconsin and a longtime Amtrak board member, since the intended audience is Australian.

“It’s an American problem requiring an American solution,” is how one TV commercial on the cable news channels goes right now. OK, but don’t discount an idea just because it came from beyond our shores.

The report, “A Pebble in the Pond: A Vision for E-Health Enabled Healthcare Transformation,” written by Louise Schaper for Australian health IT research firm CHIK Services contains some interesting arguments that seem relevant to the U.S. market right now, including engagement of public and private stakeholders, capable leadership, defragmentation of information, and, yes, substantial financial investment.

And Schaper even has the wisdom to quote from a story I wrote from MedInfo 2007 in Brisbane, Australia.

January 14, 2009 I Written By

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

COO Charlene Frizzera to head CMS in short term

The news out of Washington is that current Chief Operating Officer Charlene Frizzera will serve as interim head of the Centers for Medicare & Medicaid Services after acting CMS boss Kerry Weems steps down one week from today. This news comes to us from The Pink Sheet Daily, via the ISPE Blog, and reportedly based on an internal e-mail sent Friday by HHS Chief of Staff Rich McKeown.

The thing is, I know nothing at all about Frizzera, and could not find a bio online. She did win an intragovernmental award in 2006, though. Anyone care to help fill in some details?

The report also has Assistant HHS Secretary Charlie Johnson becoming acting HHS secretary “between January 20 at noon and the time when Secretary-designate Daschle is sworn in.” That might not be for long. In past transitions, the Senate generally went to work on confirming Cabinet secretaries almost as soon as the new president’s inaugural address ended, and swearings-in happened in short order following confirmation.

We still do not know who will be the permanent CMS boss.

January 13, 2009 I Written By

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

MGMA wants standard patient IDs within a year

As promised at its annual meeting back in October, the Medical Group Management Association on Monday introduced a plan to standardize patient ID cards—on a very aggressive timeline.

The program, called SwipeIT, is an effort to convince health plans—Medicare included—as well as vendors and care providers to create standardized, machine-readable IDs by the beginning of 2010. Here is a sample.

MGMA estimates that this plan could reduce administrative waste by $1 billion a year. Magnetic-stripe cards following standards set by the Workgroup for Electronic Data Interchange would cost 50 cents each to replace the more than 100 million health insurance cards currently in circulation. In other words, a $50 million investment would realize $1 billion in annual savings.

A big question is whether some might see this as a move toward a national patient ID number, even though that is not what MGMA is proposing. The perception alone might cause some to balk. And then there’s the tricky issue of achieving consensus on something—anything at all—in healthcare administration.

I Written By

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

AHIC Successor now National eHealth Collaborative—sans nurses

The group once known informally as AHIC 2.0 and later AHIC Successor finally has a name of its own: the National eHealth Collaborative. This completes the privatization of the American Health Information Community (AHIC), a public-private advisory board to the secretary of Health & Human Services.

Leadership positions for 2009 remain as announced a month ago:

Other board members include:

The panel also includes three federal liaisons, National HIT Coordinator Robert Kolodner, M.D., and representatives of the HHS and VA secretaries. Obviously, the latter two will change on Jan. 20.

That seems like a pretty impressive roster, but remember the controversy about the Google Health Advisory Council a year and a half ago? The Internet giant came under fire for not including any nurses, medical librarians and even radiologists. While it’s nice to see a behavioral health specialist on the National eHealth Collaborative, there are no nurses or medical librarians anywhere to be found here, either. I didn’t bother to look up the specialties of the many doctors on this panel, but isn’t it incongruous to overlook nurses and librarians?

For what it’s worth, several board members were to meet today with the Obama transition team. Perhaps someone has an inkling of who might be appointed to head CMS or the Veterans Health Administration? That’s what I’m waiting for.

UPDATE, Jan 11: I’ve just been informed that nurses are in fact on this board. I’m told that Laura Adams is a nurse, though her bio does not seem to reflect that. Also, Linda Fischetti, who I know is an RN, is the non-voting liaison to NeHC from the VA. Still, it does seem like nursing might be a little under-represented, given the field’s overall importance in healthcare.

January 9, 2009 I Written By

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

‘Modest’ feedback

A couple of months ago, I posted, “A modest proposal,” my observations about a session on clinical decision support from the American Medical Informatics Association annual meeting. In it, I argued that medical informatics needed a rock star of sorts to help humanize the issue of clinical decision support and communicate the benefits of such technology to the general public.

I got three comments on that post—actually pretty high for this blog—as well as several e-mails. One correspondent said we need more than a rock star, we need the whole band. I passed that comment on to Dr. Bill Bria, CMIO of Shriners Hospitals for Children, who was part of the panel at the AMIA meeting, who told me that he once led an all-physician rock band called the Straight Caths. It still may take the Rolling Stones or perhaps an entire Woodstock to make some of the changes American healthcare needs. Then again, Thursday is Elvis’ birthday.

One non-physician wrote: “That was terrific. Thanks! Except, while I don’t disagree, maybe if they learned to speak English, too, it would help.” Actually, Joan Ash of the Department of Medical Informatics and Clinical Epidemiology at Oregon Health and Science University made a similar point in said AMIA session.

CareGroup Healthcare System CIO Dr. John Halamka, himself a rock star in health IT circles for his incredible ability to juggle so many responsibilities (and perhaps for his Johnny Cash wardrobe), pointed me to one of his blog posts about his idea for ASP-style “decision support service providers”

One vendor executive wrote: “Its a shame that these guys seem to believe that CDS just means medication decision support when there are many other steps that use and benefit from DS.” This writer said there should be more of a focus on diagnosis decision support. The e-mail also included a quote from Dr. Donald Berwick: “Genius diagnosticians make great stories, but they don’t make great health care. The idea is to make accuracy reliable, not heroic”

Just think, a well-implemented clinical decision support system could finally give Cuddy a reason to fire House. I think about that every time I watch that show. It’s sad that trial and error can produce such great television.

January 6, 2009 I Written By

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

Health Affairs on Obama HIT plans

We don’t know all the details yet, but a lot of people are excited about the fact that President-elect Barack Obama has made a point of including health IT in his forthcoming economic agenda. He did this as recently as Saturday.

Yesterday, in a Health Affairs blog post, Health Affairs Executive Publisher Jane Hiebert-White summarized Obama’s statements and other various reactions to his plans. She also indicated that the venerable policy journal will devote its March issue to health IT.

I’m reserving judgment until Obama not only fills in some of the details, but also chooses the new heads of CMS and the Veterans Health Administration.

I Written By

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

Audio and transcript of meeting on identity theft

In case, as I did, you missed the Office of the National Coordinator for Health Information Technology‘s Oct. 15 town hall on medical identity theft, you can download an MP3 audio recording and a transcript (Microsoft Word document) of the proceedings.

Warning: the MP3 file is a whopping 286 MB. It took me about 7 minutes to download on a typical residential cable Internet connection. It will take you 5 hours and 12 minutes to listen to the whole thing if you’re so inclined.

More details of the ONC-sponsored assessment on medical identity theft are at http://www.hhs.gov/healthit/privacy/identytheft.html

ONC promises a full report sometime this winter on issues related to health IT and identity theft, as well as a recommended roadmap for addressing these issues.

January 5, 2009 I Written By

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

HIMSS buys Government Health IT

Already a major investor in Healthcare IT News publisher MedTech Publishing Co., HIMSS announced today that it has purchased another key industry magazine, Government Health IT. HIMSS also acquired the Government Health IT Conference and other related educational products from the previous publisher, 1105 Media, of Falls Church, Va.

Financial terms were not disclosed. As of this writing, the Government Health IT site was down.

According to a HIMSS FAQ page, the wants to “expand its reach and further its educational initiatives with the federal health sector.” HIMSS VP for communications Fran Perveiler will manage the print and online magazine in coordination with HIMSS government relations staff in Arlington, Va.

HIMSS says Government Health IT will have editorial independence, and any HIMSS-related content will be identified as coming from the organization. Paul McCloskey will continue as editor of Government Health IT, and he is the only staffer moving to the HIMSS payroll. Reporter Nancy Ferris retired at the end of 2008. HIMSS says additional hires are possible.

This development might open the door for yours truly to freelance for Government Health IT. I’ve talked to Ferris in the past about exactly that, but never really followed through because I had plenty of work already. But with the recent demise of Digital HealthCare & Productivity, I’m definitely looking for new assignments. In this case, a lot will depend on whether the new Government Health IT truly is an independent publication and does not turn into a HIMSS house organ.

Come to think of it, the entire credibility of the publication will depend on that.

I Written By

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