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How the Government's Spending Spree on Electronic Medical Records will Reshape the Industry

June 5, 2009

Analysis of:Electronic Patient Records will Force Consolidation in Health Care | bits.blogs.nytimes.com

The unprecedented spending by the federal government to support the implementation of electronic medical records (by some estimates as much as $36 billion in total federal outlays over a five year period starting at the end of 2010--a hundred fold increase over previous governmental subsidies) will also have profound effects on the industry itself, the shape of physician practices and the delivery and financing of healthcare.

How Physicians Can Lead Healthcare Reform (and Help Save the World in the Process)

May 22, 2009

Analysis of:Achieving Health Care Reform--How Physicians Can Help | content.nejm.org

Despite all the skepticism surrounding the claim of being able to cut costs by over $2 trillion in the next decade coming out of the meeting in the White House last week involving six major healthcare organizations which (other than patients) may have the largest stake in healthcare reform, achieving that goal may not be nearly so difficult as many have said.  That's the conclusion of three of the most respected leaders in healthcare in a feature article for the "New England Journal of Medicine" published this week.

And...The Race is on to Get Comprehensive National Healthcare Reform Legislation Passed

May 14, 2009

Analysis of:Obama Calls for Urgency in Passing Healthcare Bill | online.wsj.com

President Obama and Democratic Congressional Leaders met at the White House on Wednesday, May 12, promising the creation and passage of comprehensive national healthcare reform legislation by the end of the year.  To do that both Houses are shooting to vote on bills before their month long August recess.   If both chambers meet their timetable, the goal would then be to hammer out the differences in their respectively passed bills to give the President a bill to sign before the end of 2009.

GE Brings Good Things to Life (and Health)

May 8, 2009

Analysis of:GE Launches 'Healthymagination'; Will Commit $6 Billion to Enable Better Health | www.fiercehealthcare.com

GE announced this week tht it will spend $3 billion over the next six years on healthcare innovation to deliver better care to more people at lower cost.  In addition, the company will commit $2 billion of financing and another $1 billion in related GE technology and content to drive health care information technology and health in rural and other underserved areas.  This is all part of its "Healthymagination" Initiative.

Value Based Purchasing of Medicare Services Takes another Leap Forward

May 1, 2009

Analysis of:Medicare System Overhaul Proposed by Two Senators | www.nytimes.com

The two Senators from both major political parties with arguably the most clout over the shape of national healthcare reform this year--Max Baucus (D-Montana) and Chuck Grassley (R-Iowa), Chairman and Ranking Minority Member of the U.S. Senate Finance Committee, respectively--have proposed a significantly different way of compensating physicians and hospitals under the Medicare Program.  Payment for demonstrable quality and clinical outcomes or value-based purchasing is making another major leap forward.

The Tables May be Turned on Healthcare Reform Opponents

April 24, 2009

Analysis of:Reconciliation: This Changes Everything | blogs.tnr

Both the Obama Administration and now the U.S. House of Representatives are in favor of passing healthcare reform this year through the reconciliation process.  The Senate also is starting to lean that way.  If the Senate goes that route, which even a lot of Republicans believe is increasingly likely, that will change everything over the next few months in the healthcare reform debate.

Comparative Effectiveness Research Panel Hits the Ground Running

April 17, 2009

Analysis of:Federal Panel Hears Advice, Concerns about Comparative Effectiveness Research Efforts | www.healthleadersmedia.com

The Federal Coordinating Council for Comparative Effectiveness Research had its inaugural meeting in the main HHS headquarters building in Washington, D.C. this past Tuesday.  Its 15 members are charged with determining by this Summer how to prioritize the spending of some $1.1 billion for this type of research.

Positioning for the New Age of Health Information Technology

April 13, 2009

Analysis of:Stimulating the Adoption of Health Information Technology | content.nejm.org

The unprecedented investment of the federal government in funding health IT will create a new age for the industry.  By some estimates, the actual amount of federal outlays could be almost double (to arouind $36 billion) the number of $19 billion most bandied about (since this latter amount has already taken into account about $17 billion in expected savings).

Congressional Passage of the President's Budget Bodes Well for Large Scale Healthcare Reform this Year

April 3, 2009

Analysis of:Congress Approves Budget | www.washingtonpost.com

Congress passed the President's $3.5 trillion Budget last night paving the way for large scale healthcare reform this year.  The work of the Joint Confererence Committee begins now to try to reconcile the measures passed by each of the chambers.  Although there will certainly be some give and take, all indications are that the President will have at least a clear shot at achieving his goals to pass national healthcare reform legislation deriving from this budget package later this year--probably by the early Fall.

U.S. Hospital Electronic Records Adoption Rate Even Worse than Thought

March 27, 2009

Analysis of:U.S. Hospitals Slow to Adopt E-Records | online.wsj.com

Only 9% of U.S. hospitals have electronic health records according to a new survey published in this week's issue of the "New England Journal of Medicine".  This contrasts with rates of adoption of over 90% in some European countries.  Even more significantly, only a paltry 1.5% of non-federal hospitals have in place what could be called "fully functional" comprehensive hospital-wide systems (which requires that 24 features be in place)

Federal Council for Comparative Effectiveness Research Goes to Work

March 20, 2009

Analysis of:Stimulus Funds will Boost 'Comparative' Health Research | online.wsj.com

The Department of Health and Human Services on March 19 established the Federal Council for Comparative Effectiveness Research to set national priorities for comparative studies on the relative effectiveness of different medical treatments for the same or similar conditions.  The 15 member council will oversee the use of $1.1 billion set aside for "comparative effectiveness" research under the recently passed economic-stimulus plan.

From the People who Brought You $4 Prescriptions: Discount Electronic Medical Records!

March 16, 2009

Analysis of:Wal-Mart Plans to Market Digital Health Records System | www.nytimes.com

Wal-Mart is seeking to bring Electronic Medical Records to the most difficult physicians to reach--those in the smallest offices.  They are seeking to charge under $25,000 for the first physician in a practice and then only about $10,000 for each additional doctor. Of course, it certainly remains to be seen whether this strategy can really work--much less that these physicians will use this technology in ways which will improve quality, safety and efficiency. Nevertheless, if the smallest physician offices are penetrated (where most of American Medicine is still practiced), then this move could potentially make the dream of near universal electronic medical records in the next decade, if not sooner, an actual probability.

Healthcare Reform 2.0: The Stars Seem to be in Better Alignment this Time

March 6, 2009

Analysis of:360-Degree Health Care Forum has Rousing Start | www.usatoday.com

President Obama kicked off his healthcare reform campaign at the White House yesterday with 150 industry leaders and stakeholders, including an assortment of so-called "ordinary people".  The President left no doubt that it is his highest priority to sign healthcare reform legislation this year.  Those leading the charge in Congress (Senators Baucus, Grassley, Kennedy and Representatives Waxman and Rangel) have promised a bill by this Summer.

Global Hospital IT Market Poised for Significant Growth in Next Five Years

February 27, 2009

Analysis of:Global Market for Hospital IT Systems Pegged at $35B by 2015 | www.healthcareitnews.com

Even before the passage of the American Recovery and Reinvestment Act of 2009 guaranteeing (depending on who's doing the estimating) somewhere between $20 and $25 billion in new health IT spending by 2015 in this country alone, Global Industry Analysts had already projected that the worldwide hospital information systems segment, itself, would exceed $35 billion by 2015.   The U.S. hospital information system market is experiencing an increase in acceptance of customized technology such as laboratory information systems and radiology information systems, the report notes.  That market is also a promising ground for electronic medical record systems (especially now after the passage of the Economic Stimulus Package).  

Could Electronic Health Record Databases Make Clinical Trials Unnecessary?

February 20, 2009

Analysis of:EHRs Can be Used to Test Rx Drug Efficacy, Researchers Say | www.ihealthbeat.org

Randomized controlled clinical trials have long been considered the gold standard for determining what types of medications work best for specific conditions in large populations of similarly afflicted patients.  However, such trials are very time consuming and expensive.  This study makes the case that at least for some trials, the use of electronic health records (EHRs) could supplant the need for these trials in accomplishing the same ends.

Christmas in February: President Obama Likely to Approve $19 billion for Health IT

February 12, 2009

Analysis of:Congress Strikes $789 Billion Stimulus Deal | online.wsj.com

Yesterday U.S. House and Senate conferees agreed to a slimmed down $789 billion Economic Stimulus Package driven to a significant extent by the views of three Republican Senators (Senators Snow, Collins and Spector).   These three Senators' support for this compromise legislation and votes now will ensure its passage into law in the next few days.  The American Recovery and Revinvestment Act of 2009 (H.R. 1) is intended to create and/or save at least 3.5 million jobs in the next two years.  That constitutes approximately as many as have been lost since the current Recession began in December, 2007.

Study Showing the Positive Impact of Health IT Timed Very Auspiciously

February 6, 2009

Analysis of:Health Info Technology Saves Lists, Costs: Study | news.yahoo.com

Just as the Congress was determining whether to include between $20 and $23 billion in new investments in health IT as part of President Obama's Economic Stimulus Package, a breakthrough study was published in the "Archives of Internal Medicine" (Amarasingham, R, Plantinga, L, Diener-West, MR, Gaskin, DJ, Powe, NR, Clinical Information Technologies and Inpatient Outcomes; Arch. Intern. Med. 2009; 169(2):108-114).  This January 26 reported study concluded from a study of 41 hospitals that the greater the use of health IT (including order entry, electronic test ordering and result retrieval and clinical decision support), the greater the drop in the adjusted odds of fatal hospitalizations, complication rates, and costs, in general, and for specific conditions (e.g. heart attack, bypass graft procedures).  In fact, the co-author from Johns Hopkins projected that if all hospitals had fully effective use of computerized records and notes, at least 100,000 lives could be saved annually.

Health IT has its own Quality Chasm to Close

January 23, 2009

Analysis of:HIT Initiatives not Adequate for Reaching IOM Goals: Report | www.modernhealthcare.com

The landmark reports by the Institute of Medicine of the National Academy of Sciences in 1999 and 2001, respectively, concluded that up to 98,000 Americans may die annually in hospitals due to preventable errors and that there were not just gaps, but veritable chasms, between the care provided and what would constitute optimal delivery in hospitals and physicians offices across the country. Recently, one of the country's foremost physician informaticists, Dr. William Stead, CIO of the Vanderbilt Medical Center, reported as Chair of a Committee under the auspices of the National Research Council (part of the National Academies) that health IT systems currently used by several major health centers (including his own institution) almost universally thought to be the best in using such technologies, in fact, were falling well short of utilizing them in such a manner to meet the Institute of Medicine's main quality goals as set forth in its 2001 "Crossing the Quality Chasm" report.  

$144.4 Billion for Healthcare in Economic Stimulus Package

January 16, 2009

Analysis of:More than $100 billion Marked for Healthcare | www.modernhealthcare.com

The just released $825 billion Economic Stimulus Package has allocated $144.4 billion for healthcare--$87 billion to help the states fund Medicaid and $27.1 billion for a raft of other healthcare provisions.  There was also put aside $30.3 billion to provide greater health insurance coverage under the COBRA Program.  Although these significant investments will not reform the healthcare system in and of themselves, they will set the stage for doing so subsequently.  They will create and/or save potentially hundreds of thousands of jobs.   They will create a new type of environment in which the quality, safety and efficiency of care may be improved to an unprecedented extent.  

No Recession for the Electronic Medical Records Market

January 9, 2009

Analysis of:Kalorama: EMR Market to Grow by 14 Percent Annually through 2012 | www.fiercehealthit.com

Despite all the dire talk in healthcare circles about the impact of the recession on capital spending, since health IT has been identified by the incoming Obama Administration as a key component of its economic stimulus plan, that sector is poised for unprecedented growth.

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