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Patients Overwhelmingly want their Physicians to Use Electronic Medical Records

August 11, 2008

Analysis of:Majority of Patients Want Doc to use EHRs: Study | www.modernhealthcare.com

Nearly 90% (86%) of over 1000 adults recently surveyed by Harris Interactive stated that they wanted their physicians to move to an all-electronic format for medical records.  Another 71% want their physicians to prescribe electronically.  A total of 44% said that they would access their records on the internet and 48% said that they would book appointments electronically and e-mail their physicians. Patients also want physicians and hospitals to move away from traditional fee for service reimbursement and toward a system which rewards them for high quality, patient-centered care.  They also want incentives to seek out those types of physicians and hospitals who deliver high quality, patient-centered care.   They also want regulatory changes so that physicians and other caregivers can more readily share patient data electronically.

Nationwide Electronic Health Record Network Pegged at $150 Billion

August 1, 2008

Analysis of:Nationwide EHR Implementation Price Tag Estimated at $150 billion | www.govhealthit.com

The most recent estimate of the costs to establish the nationwide system of electronic health records (EHR) which President Bush envisioned by 2014 came out of a conference by the prestigious Institute of Medicine (IOM) yesterday.  That figure was $150 billion for full implementation of networked e-health records in U.S. physicians' offices and hospitals spread over an eight year period.

Could the Congress Have an Election Year Surprise for the Health IT Industry?

July 25, 2008

Analysis of:Bill would mark $560 million for Health IT Grants, Loans | www.modernhealthcare.com

For at least the past five years, the U.S. Congress has toyed with the healthcare industry about getting serious with some real money commitments for health IT.  Finally, there seems to be legislation that has a really good shot at being passed even in this Presidential Election Year.    The current bill, called the Protecting Records, Optimizing Treatment and Easing Communication through Healthcare Technology Act, or PRO(TECH)T Act comes up with $560 million.  Although this sum pales in comparison to the many billions of dollars the governments of other industrialized nations have invested in health IT, it's lots more than what had been available previously from the U.S. government to finance loans and grants to physicians and hospitals to install health IT.   

Getting Even Less than What We're Paying for in Healthcare

July 18, 2008

Analysis of:While the U.S. Spends Heavily on Health Care, a Study Faults the Quality | www.nytimes.com

The second national scorecard shows that the U.S. spends more than twice as much on each person as most other industrialized countries.  But it has fallen to last place (out of 19) among major industrialized nations in preventing deaths through the use of timely and effective care, according to a report just released by the Commonwealth Fund, a nonprofit research group in New York.

Electronic Prescribing Bonus Surprise in the Legislation to Halt Medicare Pay Cuts

July 14, 2008

Analysis of:Medicare Bil Includes e-Prescribing Bonus | www.modernhealthcare.com

Lurking within the legislation which the U.S. Senate passed this week by a veto-proof margin to prevent the 10.6% Medicare pay reduction to physicians was a provision for a "stepped down" system of bonus payments for physicians who electronically prescribe.  Senator John Kerry was the primary author of this provision, which covers a reporting initiative, and is part of a broader Medicare bill that cleared the U.S. House (also by a veto-proof margin) in June. 

Microsoft and Google Join with Consumer Groups to Address Health Privacy Concerns

July 2, 2008

Analysis of:Microsoft, Google, Consumers Endorse Health Privacy Standards | www.bloomberg.com

Beyond their cost, the other major stumbling block to more widespread adoption of electronic health records has been the matter of protecting consumers' health privacy.   Microsoft, Google and dozens of other organizations promoting the adoption of electronic personal health records last week agreed for the first time to a comprehensive set of privacy standards.

Ranking Hospitals Based on Their Demonstrable Value

June 30, 2008

Analysis of:Ranking Hospitals on Bang for the Buck | blogs.wsj.com

There is yet another ranking methodology for hospitals out there now.  Unlike earlier ones, however, this one at least tries to combine in one index both quality and affordability/efficiency (as well as patient satisfaction) simultaneously.  Doing this creates an otherwise elusive "Value Index" for purchasers and patients of care to help them to determine where to get the best bang for their health care buck.

Healthcare Reform Beckons Again: This Time the Stars may be in Even Better Alignment

June 17, 2008

Analysis of:Writing New Prescriptions for Change--Policymakers' Interest in Health Care Intensifies | www.washingtonpost.com

The pressure is building from virtually all stakeholders of the $2.3 trillion healthcare industry for major reform in 2009, regardless of who may be the new occupant of the Oval Office.  Even the Chairman of the Federal Reserve Board (arguably the most powerful person in the world at least when it comes to being able to influence the movement of trillions of dollars on but the particular words he uses in a sentence or two) has weighed in on the topic with his own proposal this week.

Prospering under Pay for Performance will Require Clearing an Ever Higher Quality Bar

June 16, 2008

Analysis of:Good is Never Enough for P4P | www.hhnmag.com

The Premier (Hospital Purchasing Alliance) and Center for Medicare and Medicaid Services (CMS in the U.S. Dept. of HHS) have undertaken the nation's highest profile pay for performance program for about five years now.  Those 250 plus hospitals participating are finding that the longer they do the more difficult it is and will be for them to rank sufficiently high to receive bonus payments for superior quality.

Feds Finally Publish a Strategic Plan for Widespread Health IT Adoption

June 6, 2008

Analysis of:ONC-Coordinated Strategic Plan Released Setting Health IT Milestones Across Federal Agencies | www.hhs.gov

The federal government, through its HHS Office of the National Coordinator for Health Information Technology (ONC), has finally published its much anticipated (and delayed) strategic plan for spreading health IT throughout the country.  The feds are still trying to reach the increasingly more elusive goal that President Bush articulated more than four years ago that most Americans have access to electronic health records by the year 2014.  The head of ONC, in fact, reiterated that goal in his Introductory Message to the Plan. 

CMS Raises the Kimono on Medicare Part D Claims to Improve Patient Safety

May 30, 2008

Analysis of:Part D Claims Data to be used in Patient-Safety Initiatives | www.modernhealthcare.com

The Center for Medicare and Medicaid Services (CMS), the financier for the Medicare and Medicaid Programs, has decided in final regulations to permit access of its vast and rapidly growing Part D data stores to the Food and Drug Administration , other government agencies and academic researchers to promote patient safety.

How to Make Two Hospitals as Good as One

May 23, 2008

Analysis of:Like Night and Day--Shedding Light on Off-Hours Care | content.nejm.org

Although sharing the same address, the hospital from 7 a.m. to 7 p.m. Monday through Friday is a very different hospital during the other 108 hours of the week.  The weekday hospital has a full administrative team, department chairs and service chiefs, experienced nurse managers, and a full complement of professional staff.  The off-hours hospital, rarely, if ever, has senior managers present.  Nurse to patient ratios are significantly lower, as are the number of resident physicians due to work hour restrictions imposed since 2003.  Although fewer staff might result in a calmer environment in the off-hours, there are real dangers, especially for the severely ill.

Giving Credit Where Credit's Due for Hospital Tech Spending

May 19, 2008

Analysis of:S&P to Watch Hospital Tech Spending | www.modernhealthcare.com

The Standard and Poor's Credit Rating Agency has just made a compelling case why nonprofit hospitals need to spend more on advanced technology (both to improve patient care directly through better diagnosis and treatment and through information technology to enhance safety).  The credit rating agency has pronounced that the extent to which such hospitals can spend enough on technology will continue to drive their credit quality ratings and the gap between the "haves" and the "have nots".

The Feds Get Personal with your Medical Records

May 12, 2008

Analysis of:Medicare PHR Pilot is Underway in South Carolina | www.govhealthit.com

Medicare has launched a pilot online personal health records program in South Carolina.  This programs provides thousands of Medicare beneficiaries access to personal health records (PHRs) containing their hospital and physician claims information.  Although information on their prescription drugs will not be automatically included, beneficiaries can enter this information as well as that for nonprescription medicines.   In addition, those who use the PHR will find links to web sites with information concerning their conditions.   This constitutes a major advance on both keeping track of this information for Seniors and also providing them with relevant information to help them to take better care of themselves.

So Maybe there wll be a National Health Information Network (NHIN) after All

May 2, 2008

Analysis of:Federal Healthcare Agencies Gear Up for NHIN Trials | www.healthcareitnews.com

For decades, the Holy Grail for those pushing electronic health information technologies has been the ability to produce for physicians and other caregivers at the point of care complete information about patients from all sources to facilitate intelligent decision making.  There had been several largely unsuccessful attempts at achieving this over the years and decades.  So there were many skeptics when the federal government unveiled its most recent variation of this, the NHIN,  shortly after the Presidential appointment almost exactly four years ago of the first National Coordinator for Health Information Technology in the Office of the Secretary of HHS.  The recent predicted demise of regional health information organizations (RHIOs) touted by many as the necessary precursor components of the NHIN, seemed to confirm the predictions of the naysayers that yet another stillbirth of the Holy Grail was in the offing.

Waste not Want not: Will this Ever Apply to U.S. Healthcare?

April 28, 2008

Analysis of:The Price of Excess--Identifying Waste in Healthcare Spending | www.pwc.com

For the first time a major comprehensive authoritative national study (by PricewaterhouseCoopers, LLP) has concluded that over one half of the nation's $2.2 trillion in annual health spending (fully $1.2 trillion) is wasted.  Other studies have put this percentage in the 25 to 40% range.  This is the first to conclude that more than half is wasted. With all the talk about how to find the money to cover the 47 million uninsured and to help the twice that number that are underinsured because of the skyrocketing cost of health insurance, this is a staggering finding.  Even eliminating half of this waste (or $600 billion) would suffice to cover the uninsured and to bring premiums down sufficiently to drastically cut the number of underinsured.

Feds Now Won't Pay for 9 Additional Conditions in Medicare Patients Starting in October

April 21, 2008

Analysis of:Feds Try to Cut the Costs of Hospital Errors | www.forbes.com

The Medicare Program stunned much of the hospital world last year when they stated that beginning in October, 2008 (Federal Fiscal Year 2009) it would no longer pay for the costs Medicare patients generated for their treatment of eight conditions not present on admission which were likely the result of preventable medical errors, while hospitalized.  This past week the feds added nine additional conditions  to this list of "No Pay for No Performance".  Now the list is at 17 (with no guarantee that it won't go even higher by October).  Most private payers and states are following the example of the feds in this financial policy area of "No Pay for No Performance".

Hospitalized Children at 450% Greater Risk of Harmful Medication Errors than Thought

April 14, 2008

Analysis of:Medical Errors Threatan One in 15 Hospitalized Children | www.healthcareitnews.com

In the latest study released on Monday (April 7) in the journal "Pediatrics", researchers found a rate of 11 drug-related harmful events for every 100 hospitalized children.  That new number compares with an earlier estimate of only two per 100 hospitalized children based on traditional detection methods.

Apocalypse Now: Physicians and Insurers Agree on Performance Measurement Principles

April 8, 2008

Analysis of:Consumers, Health Care Purchasers, Physicians, and Health Insurers Announce Agreement on Principles to Guide Physician Performance Reporting | www.cyperus.com

Leading consumer, employer and labor organizations have agreed with the top medical and health insurance groups on principles to govern the development of physician performance measures.  The "Patient Charter for Physician Performance Measurement, Reporting and Tiering Programs" creates a national set of principles to guide measuring and reporting to consumers about physicians' performance. If nothing else, this has to represent a major concession (call it a "wake up call") among the leading physician groups that major consumer, purchaser and insurer groups were going to go ahead and develop these measures without physician input if the major medical groups did not participate in this effort. 

"Ask Not for Whom the Bell Tolls...It Tolls for Medicare"

March 31, 2008

Analysis of:Outlook Remains Bleak for 2 Programs | www.nytimes.com

The Bush Administration's  most recent report on the future of the Medicare and Social Security Programs released this week is at least not worse than it was a year ago.  That's the good news.  However, the bad news is that it is no better.  The Medicare Hospital Trust Fund is expected to be exhausted by 2019, scarcely more than a decade from now.  Even Social Security's reserve funds are not expected to last much more than a couple of decades longer--until 2041. This, far more than the Global War on Terror, is the most urgent issue facing American voters in this Presidential Election Year.

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