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More on health reform proposals

Here’s some video from the California HealthCare Foundation

In a Sept. 16 event at the Commonwealth Club of California in San Francisco, McCain health policy advisor Daniel Kessler and Obama advisor E. Richard Brown explained and debated their respective candidates’ positions. It should come as no surprise that IT is but a small part of the discussion.


If you don’t want to watch all 66 minutes of this video, it’s broken into 13 chapters. Click on “Open Tools” in the video window to select.

October 11, 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.

Did you notice?

Both John McCain and Barack Obama mentioned electronic health records during last night’s presidential debate. Notably, this was the one debate held in a town-hall format, where the candidates ostensibly spoke directly to undecided voters.

October 8, 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.

Catching up

I’m slowly recovering from a tragic last few days, in which the Chicago Cubs, the best team in the National League this season, failed to show up for their three playoff games. I was among the more than 42,000–a number that surely had to violate some section of the fire code–jammed into Wrigley Field for Game 2 on Thursday night to watch a stinker for the ages. I suppose this doesn’t hurt as much as 2003, but maybe it will when it sinks in.

Alas, life goes on, and so does the backlog in my inbox. Baseball season may be nearing a close in Chicago (the White Sox are on the brink, but still alive), but the never-ending political season still has a month to go. It was brought to my attention recently that Hollywood may have anticipated the McCain-Obama matchup in a 2006 episode of The West Wing. The debate between Matthew Santos (Jimmy Smits) and Arnold Vinick (Alan Alda) even strikes a familiar chord.

A discussion of healthcare policy starts around 3:20.

Back in the real world, I’ve seen a bunch of commentaries of late on the health IT policies of the Obama and McCain campaigns, in part because I had to write summaries for both the Physician Office Technology Report of Part B News and for my British client, E-Health Insider. The most interesting analysis I’ve seen so far is from David Merritt, a longtime aide to Newt Gingrich who also is advising the McCain campaign. Despite this built-in bias, Merritt actually gives a mostly unbiased assessment of the plans. Mostly.

If you want to know more, check out the Kaiser Family Foundation’s health issues comparison tool on 15 areas of health policy, including IT.

I still think both candidates are really lacking in specificity when it comes to health IT. I am anxious to hear further details, though I don’t really expect to hear much before the actual election. More likely, the details will come when the new president names his secretary of Health and Human Services, and perhaps not until the full healthcare policy teams are in place.

Moving on, there’s a new professional certification program in health information exchange. It’s from the same people who developed programs to designate certified professionals in health information technology and certified professionals in electronic health records. I wrote about that in November 2004 and got one very pointed comment how certification courses like this were “a joke” because they convey a hoity-toity title after just a few days of training. Just like then, however, program has some highly respected names on its advisory board. Anyone know if this sort of thing is worth it?

While we’re talking about professional credentials, here’s a link to the newly redesigned EMR site (even though it defaults to a .net site). Now I have just set myself up for everyone with an IT-related Web site to demand a link. I’ve been good at ignoring e-mails in the past, and I can do it in the future.

I didn’t submit anything to the most recent Health Wonk Review, but host David Shafrin of the Healthcare Economist blog examines groups in need of bail-outs.

I figured it would be much ado about nothing when HIMSS circulated a letter it sent to Reps. Pete Stark (D-Calif.) and Dave Camp (R-Mich.) about the proposed “Health-e Information Technology Act of 2008.” Just a few weeks ago, I expressed my frustration with new legislation that stands almost zero chance of passing.

Apparently the response did strike a raw nerve with some people, including open-source advocate Fred Trotter, who accused HIMSS of being little more than a lobby group for vendors of proprietary systems. HIMSS subsequently published a “fact sheet” about its views on the Stark-Camp bill, including this statement: “HIMSS actively supports the industry’s exploration and utilization of open source software as one avenue for information technology solutions within the healthcare industry.”

Just how significant is this mini-spat anyway?

October 5, 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: HIMSS CEO Steve Lieber

ORLANDO, Fla.—Here’s a podcast that’s been a year in the making. Actually, it was a year plus an hour and a half. Last year in New Orleans, I had a lively, hour-long conversation with HIMSS President and CEO Steve Lieber that was supposed to be for a podcast, but the recording didn’t work.

On Saturday, I showed up at the appointed hour for another sit-down with Lieber, and realized I’d forgotten my recorder back at my hotel, so we rescheduled for about 90 minutes later. Well, the third time was a charm, and the result is this podcast, a lively, half-hour-long conversation with Steve Lieber, just ahead of the opening of the annual HIMSS conference.

Podcast details: Interview with Steve Lieber at HIMSS ’08. MP3, mono, 64kbps, 13.8 MB. Running time 30:10.

0:30 Expected attendance of 27,000+
1:15 Greater attention on technology in healthcare
1:45 Growth on clinical side
2:50 More interest from non-IT executives
4:00 E-prescribing as an example of IT crossing disciplines
5:45 Multiple opportunites for improvements in prescribing and medication administration
6:30 Continuing problems with access to capital
8:50 Prospects for Medicare payment reform
10:07 Health IT in the presidential campaign
11:15 Health IT debate remains largely nonpartisan.
12:40 Progress among private payers in reimbursement for quality
14:00 More focus on disease management than quality per se
14:40 Slow adoption of personal health records
15:42 Suitability of PHRs for chronically ill
17:30 Kids may be first major PHR constituency in general population.
18:05 Google, Microsoft and Revolution Health in healthcare and HIMSS keynotes from Eric Schmidt and Steve Case
20:00 Movement toward home health
20:40 HIMSS strategic interest in medical devices
21:40 HIMSS branching out as an association
22:30 Interoperability of financial and administrative information
23:10 Working for universal set of quality measures
23:35 Globalization of HIMSS
26:00 Standardization beyond the U.S., e.g., Snomed
27:00 Highlights of HIMSS conference: Interoperability Showcase
28:00 Public meetings at HIMSS, including AHIC
29:03 International registration

February 24, 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.


What would my blog be without a random item from weeks ago? On Tuesday I discovered a news story from Dec. 31 about an e-health strategy in Rwanda. The U.S. Centers for Disease Control and Prevention reportedly is helping to fund the installation of Internet links between the three major hospitals in the Central African country, known in these parts mostly for its brutal, 1990s civil war.

According to the story, lack of high-speed Internet is holding back a national e-health strategy, “meant to help Rwandan medical experts exchange health information with their overseas counterparts.” Those overseas counterparts included “two U.S. universities of George Washington and New Jersey.” So George Washington University in Washington, and, I presume, the University of Medicine and Dentistry of New Jersey? (Anyone know for sure? I’m too tired to hunt down that information.)

So, basically, U.S. taxpayers are financing international interoperability testing in a country with limited health infrastructure of any kind, but we can’t find more than $100 million or so (counting various HHS offices) in a $3 trillion federal budget for health IT at home? Interesting.

Yes, President Bush did discuss electronic health records in his State of the Union again this year, and yes, Sen. Hillary Clinton did give a pretty lengthy argument in favor of EHRs during last week’s Democratic presidential debate in Los Angeles, but are we really getting more than empty election-year posturing? Prove me wrong, politicians, prove me wrong.

And while we’re pondering interoperability conundrums, here’s a good one from Tim Dotson, my editor at Inside Healthcare Computing. In the Feb. 4 issue of that newsletter, he asks: “Why can’t somebody figure out a way for hospitals to share clinical decision support rules that will work on any vendor’s system instead of letting those systems go to waste because hospitals never develop their own rules?”

Good question. I suppose that’s why Cerner sold off Zynx Health a couple of years ago, but the issue is a lot deeper than one set of rules being tied to one vendor. Collaboration sure is hard, isn’t it?

P.S. Is anyone arriving at HIMSS early? I may come in as early as the Friday, Feb. 22, just because I hate 6 a.m. flights. Drop me a line if you’ll be in Orlando before Sunday.

February 5, 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.

A new gig!

Ladies and Gentlereaders,

I am proud to announce that I have a new gig. I am writing a monthly supplement to the weekly Part B News called Physician Office Technology Report. It’s published by Decision Health of Rockville, Md.

The title pretty much speaks for itself, and the audience is primarily physician practice managers, similar to my last full-time job at a publication that shall remain nameless because I don’t want them to have the publicity.

So yeah, there was a good reason why I was in Philadelphia last week for the Medical Group Management Association‘s annual conference and yet another reason why my blogging has been rather spotty of late.

The first issue of the Part B News Physician Office Technology Report came out this week. Look for it the first week of each month.

Speaking of conferences I’m covering, I will be at the American Medical Informatics Association confab here in Chicago next week. The last time I saw Don Detmer’s crew was in Australia for MedInfo in August. Let’s see, 17 hours of flying vs. 25 minutes on the bus. Discuss.

The AMIA meeting at the Sheraton overlaps with the AHIP Business Forum, which is at the Renaissance Chicago about five blocks away, so it’s unlikely I’ll spend much time with the health insurers.

I did go to the AHIP annual meeting in Las Vegas in June (much warmer than Chicago in November, or, for that matter, Chicago in October 1871), but I’m not sure how much I’d get out of next week’s meeting.

A poll question in an AHIP “SmartBrief” last week asked which of the following trends was most significant in 2007:

1. CMS ruling not to reimburse costs for preventable errors.
2. Expansion of walk-in clinics in retail health settings.
3. Efforts to provide more insurance options for young people.
4. Obesity epidemic continuing.

Notice that health IT didn’t register. It’s not a top-tier issue on the national healthcare scene at the moment, a point further driven home at another event I dropped in on last week: the 25th anniversary celebration for Health Affairs. There, representatives from nine or 10 presidential campaigns participated in a roundtable discussion of healthcare issues.

The way it sounded to me was: “Access. Cost. Access. Cost. Medicare reform. Access. Cost. Health savings accounts. Access. Cost. Access Cost.” John McCain’s representative did mention health IT and, at the very end, Barack Obama’s guy alluded to quality. And you wonder why national HIT legislation hasn’t gone anywhere?

Want another sign that physicians are lagging on the IT front? I’m going to scrape the very bottom of the barrel for some evidence contained in a spam e-mail. Yeah, I know.

Someone trying to sell physician mailing lists said there were 788,974 total licensed physicians in the U.S. That sounds about right. This particular outfit claimed to have e-mail addresses for 17,042 of them. That works out to about 2 percent. Even if you consider only the 600,000 or so practicing docs, you’re only taking about 3 percent.

OK, enough with the spam. Here’s a public service for some people I’ve worked with, either directly or indirectly: Job listings.

First, blogger Matthew Holt is looking for 2-3 unpaid interns for the next health 2.0 conference, scheduled for San Diego next March. He’s based in San Francisco, and I assume most of the work is too. (Maybe I shouldn’t mention that the current issue of another pub I contribute to, Inside Healthcare Computing, has a commentary headlined “Our Take: Health 2.0 Is Really Advertising 2.0.”)

Also, E-Health Media in the UK, publisher of E-Health Insider, is putting on a healthcare IT careers forum in London on Nov. 30.

If you go to the latter, bring me back some British pounds. They’re worth about $2.11 as of this writing. Heck, I’d settle for Canadian or Aussie dollars, euros, yen, whatever.

November 5, 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.