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The Big Apple's $60 Million Electronic Medical Record Keeping Experiment

January 2, 2009

Analysis of:City to Pay Doctors to Contribute to Database | www.nytimes.com

No where else in the country has there been as great a dollar commitment by a single governmental entity to promote electronic medical records than in New York City.  To promote the public health through electronic surveillance of the incidence of high cost diseases and their responses to various therapies, the city's health department has ponied up $60 million to promote the use of electronic records especially among smaller medical practices in socioeconomically depressed areas. 

Widespread Health IT Gets "Thumbs Up" from the Green Eyeshade Guys at the CBO

December 23, 2008

Analysis of:Budget Office Highlights Health IT as Promising Proposal | www.ihealthbeat.org

The Congressional Budget Office (CBO) recently evaluated the cost savings potential of 115 healthcare proposals promoted by the incoming Obama Administration and Congressional Democrats.  Of all those, only health IT came out as a cost savings winner according to the CBO.  That may explain why health IT has been included as one of the cornerstones of the near trillion dollar Economic Stimulus package.   The Economic Stimulus Package will be considered for Congressional approval as early as January, 2009.   Broader, more controversial,  healthcare reform legislation may not be enacted until Democrats have a fillibuster-proof majority in the U.S. Senate, potentially after the 2010 midterm elections.

The Commonwealth Fund Jumps into the Hospital Quality Ratings Business

December 22, 2008

Analysis of:Commonwealth Fund Rates Hospitals Online to Spur Improvement | blogs.wsj.com

The Commonwealth Fund (one of the leading international healthcare philanthropies) has opened a new site--WhyNotTheBest.org. The Commonwealth Fund's new site relies on data from Medicare's Hospital Compare web site and from the Hospital Consumer Assessment of Healthcare Providers and Systems.  However, the new system fills a gap.  Existing hospital ratings systems  don't offer an easy way for them to compare their performance to each other or to obtain resources to help them improve, like this one does.

Congressional Leader Wants Major Upfront Governmental Health IT Investment

December 19, 2008

Analysis of:Baucus Wants SCHIP, Health IT in Stimulus | www.thehill.com

The conventional wisdom had become that healthcare reform would have to wait until the U.S. economy was stablized.  However, in the past couple of weeks, President-Elect Obama has made it clear that the U.S. economy cannot be stabilized in any sustainable way until and unless the healthcare system is reformed.   Healthcare, on the other hand, could not be reformed without saving a lot of money.  The question was how to save this money in a system where up to half of its $2.5 trillion of annual cost may be wasted.   

How Healthcare Reform Can Fuel Broader Economic Recovery in the U.S.

December 8, 2008

Analysis of:Medicine for the Job Market | www.nytimes.com

Many skeptics believe that the incoming Obama Administration will need to back burner major healthcare reform until it can strengthen the economy.  However, a growing minority is coming to believe that broader economic recovery (at least not of a sustainable nature) can occur in the absence of major healthcare reform.

Health IT is the Foundation of the Hospital of the Future according to the Joint Commission

November 27, 2008

Analysis of:Joint Commission Urges IT Adoption, Major Changes for Hospital of the Future | www.healthcareitnews.com

The Joint Commission has stated emphatically in a recent report that Health IT will be the foundation for the Hospital of the Future.  The report is the work of an expert panel comprising hospital executives and clinical leaders, as well as experts in technology, healthcare economics, hospital design and patient safety.

Group of 28 Healthcare Stakeholder Organizations Join Together to Promote Reform

November 24, 2008

Analysis of:Group Offers Fixes for Health Care System | www.startribune.com

A wide ranging coalition of 28 of the nation's leading organizations providing, purchasing, consuming and evaluating healthcare came together in Washington this week to launch an aggressive effort to transform the nation's healthcare system.  No less than the AMA, AHA, AARP, AFL-CIO, Joint Commission, Consumers Union and 20 other leading national private organizations and public sector agencies and financiers have come together around a set of six principles to guide the new Congress and Obama Administration toward achieving comprehensive healthcare reform in 2009

Hospitals' Electronic Records Adoption Rate Even Lower than Thought

November 17, 2008

Analysis of:Survey: Hospital EHR Adoption Rate is Below 12% | www.govhealthit.com

The same Harvard researchers who reported in the "New England Journal of Medicine" last July that only 4% of physicians had adopted "full functional" electronic health records reported this week to the HHS Secretary that only 1.7% of hospitals have adopted such records in all their departments.  "Fully functional" electronic health records (EHRs) are those which may facilitate the performance of 24 functions including computerized physician order entry, clinical decision support, clinical documentation and electronic laboratory, radiology and consultation requesting and results monitoring, among other things.  Fewer than 12% of hospitals had a minimal EHR (including approximately nine of these functions) in at least one institutional department.

President Obama Could be Santa Claus for Health IT Companies

November 10, 2008

Analysis of:Healthcare Tech Companies Could Benefit from Obama Plan | money.cnn.com

President-Elect Obama made reforming the U.S. healthcare system a central plank of his campaign.  A key initiative calls for spending $10 billion a year over the next five years ($50 billion total) to computerize health records and prescribe more treatments digitally. 

Health IT may be at Least Near the Front Burner in the new Congress in 2009

November 3, 2008

Analysis of:Congressional Democrats are Drafting a New Health IT Bill | www.govhealthit.com

Although dealing with the financial crisis will still occupy much of the time and focus of the new Congress and President early in 2009, the need to control the costs of healthcare will not be far behind.  Both candidates for President are pushing for much more health IT as critical to achieving that goal.  A President Obama, in particular, has pledged to invest $10 billion per year to support health IT for at least five consecutive years.

Health IT About to Become a Global Force for Change

October 27, 2008

Analysis of:Prescription for Change | online.wsj.com

The health care industry is on the brink of joining the 21st Century (or at least the late 20th Century).    Healthcare is about to undergo a global revolution that it can no longer resist with information technology as the fuel.  This transformation will occur because the previous barrier to more widespread adoption of health IT concerning the ability to assure adequate security and privacy for electronic patient information will soon be overcome.

Despite Bailout, Feds Still Have Cash Left for Physicians to Implement Electronic Records

October 20, 2008

Analysis of:Small Practices to get Financial Boost with new Health IT Incentive Program | www.healthimaging.com

Even after the trillion dollars which the federal government has had to spend to prop up the nation's financial system during the past month, it still has some real money left to subsidize the costs of physicians in smaller practices willing to implement electronic records.  With electronic records as a necessary ingredient in any healthcare reform package next year regardless of who occupies the Oval Office, these types of financial incentives can only be expected to increase next year and beyond.

Can E-Prescribing Pay for Itself?

October 13, 2008

Analysis of:CMS-eRX: Officals Lay out Cost-Benefit Analysis of E-Prescribing Bonuses | www.medpagetoday.com

Despite all the studies and reports touting hundreds of billions of dollars of savings from electronic medical records, the adoption rate especially by physicians in smaller practices remains woefully low.  The biggest barrier still remains costs.   Implementing electronic medical records may run in some practices (depending on the system) as high as $50,000 per physician. Sensing this impasse, there has been a significant shift in emphasis at the national level toward the much more economical step of electronic prescribing.  CMS is starting to pay this month up to $1 billion to the nation's physicians who electronically prescribe.

Will Fewer "Never Events" Translate to Lower Medical Liability Costs?

October 6, 2008

Analysis of:'Never Events' a Factor in Liability Costs | www.modernhealthcare.com

This week the federal government implemented its long awaited and often controversial policy not to reimburse hospitals for the extra costs of treating patients who experience during the admission one or more of 11 so-called "never events".  Dozens of states, insurers and others are following suit.  Although the cost savings from decreased reimbursements are not considered to be great (only about 0.02% savings), much greater savings may come from decreased liablity costs stemming from the decreased occurrence of these events.

Federal Government Value Based Purchasing of Healthcare Set to Grow

September 29, 2008

Analysis of:CMS Value-Based Purchasing Initiatives to Grow | modernhealthcare.com

Despite the mixed results of value-based purchasing of healthcare services (sometimes known as "Pay for Performance"), this new financing model is poised for significant growth in the years ahead.  The main reason for this is that based on current cost growth, the Medicare Part A trust fund financing hospitals for the treatment of government beneficiaries is on course for depletion in just a little over 10 years (2019)

New Health IT Bill Promises Big Bucks to Hospitals and Physicians for Electronic Records

September 19, 2008

Analysis of:Stark Offers Bill to Hasten e-record Adoption | modernhealthcare.com

A new Health IT bill from no less than Congressman Pete Stark, Chairman of the Health Subcommittee of the U.S. House's powerful Ways and Means Committee aims to provide substantial financial incentives for hospitals and physicians to adopt electronic health records.  The bill also provides disincentives for not adopting electronic records and strong penalties for violating patients' privacy. 

Health IT Legislation in Congress--Now or Later?

September 12, 2008

Analysis of:Health IT Now Renews Call for Action in Congress | www.govhealthit.com

The Health IT Now Coalition, (comprised of more than 175 business, associations, patient organizations and nonprofit groups), will soon deliver a letter to Congress urging it to act on longstanding bipartisan health IT legislation.  The coalition is pushing for passage of legislation championed by Edward M. Kennedy (D-Mass) and Mike Enzi (R-Wyo) in the U.S. Senate and John Dingell (D-Mich) and Joe Barton (R-Texas) in the U.S. House of Representatives. 

National Quality Forum Sets Health IT Standards

September 5, 2008

Analysis of:National Quality Forum Endorses National Consensus Standards for Health Information Technology | www.qualityforum.org

Health IT has been touted as a necessary component of transformational change for the healthcare industry for quite some time.  But until this past week, no highly respected  body had laid down the standards which health IT must achieve to fulfill its promise.  The National Quality Forum, considered the gold standard for the creation of consensus driven standards setting for the healthcare industry,  has now done just that.

Massachusetts Follows Up its Universal Coverage Law with Health IT Mandates

August 29, 2008

Analysis of:Mass. Law Requires some IT Systems in Hospitals | www.modernhealthcare.com

It used to be said that everything good (and bad) in this country started in California.  It seems that at least in health care that dubious honorific may now apply more to Massachusetts. Massachusetts Governor Deval Patrick signed a law last week, which, among other things mandates that hospitals and community health centers install computerized physician order entry systems (CPOE) by 2012 and electronic health record systems by 2015.   It is still unclear what the consequences may be for those institutions which, for whatever reason, either do not, or cannot, comply by those dates.

Hospital Death Rates No Longer a Secret

August 25, 2008

Analysis of:Hospital Death Rates Unveiled for First-Time Comparison | www.usatoday.com

This past week for the first time, the federal government posted on its  Hospital Compare web site the actual death rates for hospitals treating patients with three conditions:  heart attack, heart failure and pneumonia.  In the past, the feds had only indicated whether these death rates were higher, lower or about what could be expected given patients' pretreatment severity of illness   To prevent gaming the system, deaths were counted against a hospital if they occurred within 30 days.  This prevented them from improving their "scores" by shipping patients elsewhere.  However, some hospitals (most notably a Fort Worth, TX hospital in the Baylor System), noted that only 10 of 31 its deaths actually occurred in the hospital.  This indicated that hospitals also need to concern themselves with what happens to patients after they were discharged. 

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