Digital Medical Records Get Five Year Deadline

Posted by AMS at 6 SEP 10:07 am

Next year, docs’ offices, hospitals can get federal money to help with cost.

WASHINGTON — The Obama administration on Tuesday rolled out an ambitious five-year plan for moving doctors and hospitals to computerized medical records, promising greater safety for patients and lower costs.

Starting next year, doctors’ offices and hospitals can get federal money to help defray the costs of the systems, which can run to millions of dollars for hospitals. Providers who don’t comply by 2015 will face cuts in Medicare payments.

Federal incentive payments for doctors and hospitals to buy computerized systems could reach $27 billion over 10 years, and that’s only a fraction of what technology vendors stand to take in. It’s hoped the investment will streamline the delivery of medical care, yielding long-run savings.

Patients get the benefit of systems that can warn doctors before they make a mistake — prescribing a drug that could cause a severe reaction, for example. And there’s also the convenience of being able to access records online.

The move by the Health and Human Services Department came with the release of two regulations hundreds of pages long. The main one described how doctors and hospitals can qualify for federal money by acquiring systems that meet certain “meaningful use” standards. A companion rule outlined how the systems will be certified.

Initial reaction from key interest groups was guarded. As lawyers pored over the text of the regulations, the American Medical Association said it was withholding judgment.

Federal officials said they tried to address doctors’ concerns that the initial draft of the rule asked them to do too much, too quickly. More than half of family doctors practice in groups of four or fewer. A majority of small and medium offices have opted not to adopt electronic records because of costs and unresolved questions, according to the American Academy of Family Physicians.

David Kibbe, an adviser to the group, said that may start to change. “This is pretty good news,” he said. “It will almost certainly translate into more physicians becoming participants in the electronic health records incentive program.”

Money for electronic records was included in the 2009 economic stimulus bill.

Administration officials said they lowered the number of initial, “core” capabilities that the systems have to demonstrate in order for providers to get federal money, and allowed a longer period of time to achieve others.

They also lowered several additional requirements. Only 40 percent of medications will have to be electronically prescribed, as opposed to 75 percent as the government initially proposed.

The result “strikes the balance that was needed,” said Steven Findlay, a policy expert with Consumers Union. “They give doctors the financial support to promote electronic records adoption without undue burdens. But they also hold doctors accountable for actually improving care and the health status of their patients.”

The top government official overseeing the transition program says that reflects what happened to him in a previous stage of his career, when as a middle-age primary care doctor he was forced to learn to use electronic medical records.

David Blumenthal, now national coordinator for electronic health records, said the computer once saved him from prescribing a drug to a patient who was allergic to the medication. On many other occasions, he was able to avoid ordering duplicative tests, because earlier results stored in the system told him what he needed to know.

“I watched it make my care better before my eyes,” said Blumenthal, formerly a prominent Boston area physician and Harvard professor.

Doctors’ offices can receive as much as $44,000 through Medicare and $63,750 through Medicaid for installing computer systems that meet federal standards. Hospitals can receive millions.

MSN – updated 7/13/2010 3:29:24 PM ET

Pros And Cons To Converting To Electronic Medical Records

Posted by AMS at 30 AUG 8:23 pm

The Department of Health and Human Services recently released rules for creating electronic health records. These rules came days after HHS issued regulations to safeguard the privacy of medical records.

This digital revolution could dramatically improve medical care. The RAND Corporation estimates America could save $77 billion a year with health information technology (HIT).

But policymakers must remember the interests of doctors and patients. If they don’t, HIT could increase costs, hurt medical care and infringe on the doctor-patient relationship.

Health care providers have slowly digitized their medical records. According to HHS Secretary Kathleen Sebelius, “only 20 percent of doctors and 10 percent of hospitals use even basic electronic health records,” although according to some studies, the numbers may be double that.

Last year’s stimulus package offered $27 billion in incentives for doctors and hospitals to improve their technology, and the new health law offers funding. But the funds won’t be released until doctors meet a list of “meaningful use requirements.”

Those requirements initially were so onerous few providers could meet them.

Kaiser Permanent, an early adopter of electronic record-keeping, couldn’t meet the requirements. President Barack Obama often praises Utah’s Intermountain Healthcare for its integrated information systems, but even Intermountain couldn’t meet 75 percent of the criteria.

HHS has since amended its requirements to make it easier to comply. But how will others fare with the newly relaxed rules?

Providers must meet the HIT requirements by 2015. Those that miss the deadline will lose subsidies and face financial penalties.

The government is essentially forcing doctors and hospitals to upgrade their technology systems without providing financial support. Consumers will likely pay for the upgrade.

Providing doctors with more easily accessible data could help them make better decisions for their patients. But this is the key: Doctors must still be the ones making the decisions.

Unfortunately, access to “meaningful use” information may allow government officials to steer doctors toward cost-effective — instead of health-conscious — treatments or practices.

This has already happened in California’s Medicaid program. State officials limit physicians’ ability to prescribe drugs, often forcing them to prescribe cheaper medicines before moving to newer, more expensive ones.

Doctors must wade through paperwork to get clearance to prescribe drugs that may not be on the state’s approved list.

Federal officials may also urge doctors to skip certain tests. This has already happened. In late 2009, an HHS task force revised its guidelines for mammograms. The panel said most women should wait until age 50, and then only get a screening every other year rather than the current practice of starting annual exams at 40. Only after a public outcry did the government soften this position.

Embracing HIT could improve medical care. But doctors, not government officials, must use the information to plan the best treatment for their patients. As our health sector moves into the Information Age, it’s crucial that we remember the central importance of the doctor-patient relationship.

Turner is president of the Galen Institute.

BY GRACE-MARIE TURNER Oklahoman

Published: August 28, 2010

FCC’s broadband critical to health IT

Posted by AMS at 13 APR 7:37 am

WASHINGTON – Healthcare IT champions are applauding the broadband plan the government released Tuesday as a boon for health information technology.”We hope the National Broadband Plan serves as a driver for both innovation and connectivity, which are two key elements to lowering costs and improving patient care,” said Joel White, executive director of the Health IT Now! Coalition. “Millions of Americans have discovered the life-saving benefits of their doctor's use of electronic medical records. We know health information technology will not reach its true potential without full access to broadband services. This is a critical patient priority.”The Health IT Now! Coalition hosted a panel discussion with the Federal Communications Commission and a panel of experts Wednesday to discuss the FCC's National Broadband Plan and its proposals to develop affordable access to broadband and healthcare.

The broadband plan was released on March 16.”We believe that the National Broadband Plan will make it easier for doctors and hospitals to utilize electronic medical records, which will ultimately lead to improved care and better outcomes for patients,” said Mohit Kaushal, MD, director of connected health at the FCC. “The plan focuses on the growing need for greater connectivity and innovation.”"We need to continue momentum towards universal Health IT by ensuring doctors and hospitals have access to nationwide high-speed broadband, and the National Broadband Plan is a major step in the right direction,” said White.In addition to Kaushal, the panel included John Santelli of UnitedHealth Group; Karen S. Rheuban, MD, medical director of the Office of Telemedicine, professor of pediatrics and senior associate dean for CME and external affairs at the University of Virginia and president of the American Telemedicine Association; Hank Fanberg of CHRISTUS Health and Jim Bialick of Genetic Alliance.Continua Health Alliance, a nonprofit coalition of 230 healthcare and technology companies, commended the FCC for putting forth a plan that supports health information technologies, including: reimbursement, modernizing regulations, increasing data capture and utilization, and providing sufficient connectivity to better enable the provision of healthcare.”In the coming decades, broadband will play an increasingly important role in supporting health care delivery in America,” said Chuck Parker, executive director, Continua Health Alliance.

“The FCC plan would close the broadband connectivity gap for health care providers while aligning the commission's efforts with the emerging meaningful use criteria.”"The need for policy reform and leadership to usher in the era of connected health is clear,” said Rick Cnossen, president and board chair, Continua Health Alliance. “More than 100 million Americans lack access to basic broadband services, highlighting an urgent need for deployment of fixed and mobile broadband solutions nationwide for both patients and providers.”The plan includes 11 recommendations for using broadband networks to spur greater use of electronic health records, health data exchanges and telemedicine.

Create appropriate incentives for e-care utilization.

• Congress and the Secretary of Health and Human Services (HHS) should consider developing a strategy that documents the proven value of e-care technologies, proposes reimbursement reforms that incent their meaningful use and charts a path for their widespread adoption.
• Modernize regulation to enable health IT adoption.
• Congress, states and the Centers for Medicare & Medicaid Services (CMS) should consider reducing regulatory barriers that inhibit adoption of health IT solutions.
• The FCC and the Food and Drug Administration (FDA) should clarify regulatory requirements and the approval process for converged communications and health care devices.

Unlock the value of data.

• The Office of the National Coordinator for Health Information Technology (ONC) should establish common standards and protocols for sharing administrative, research and clinical data, and provide incentives for their use.
• Congress should consider providing consumers access to – and control over – all their digital health care data in machine-readable formats in a timely manner and at a reasonable cost.

Ensure sufficient connectivity for health care delivery locations.

• The FCC should replace the existing Internet Access Fund with a Health Care Broadband Access Fund.
• The FCC should establish a Health Care Broadband Infrastructure Fund to subsidize network deployment to health care delivery locations where existing networks are insufficient.
• The FCC should authorize participation in the Health Care Broadband Funds by long-term care facilities, off-site administrative offices, data centers and other similar locations. Congress should consider providing support for for-profit institutions that serve particularly vulnerable populations.
• To protect against waste, fraud and abuse in the Rural Health Care Program, the FCC should require participating institutions to meet outcomes-based performance measures to qualify for Universal Service Fund (USF) subsidies, such as HHS’s meaningful use criteria.
• Congress should consider authorizing an incremental sum (up to $29 million per year) for the Indian Health Service (IHS) for the purpose of upgrading its broadband service to meet connectivity requirements.
• The FCC should periodically publish a Health Care Broadband Status Report.

via FCC’s broadband plan lauded as critical to health IT | Healthcare IT News.

Department of Health & Human Services Recovery Information

Posted by AMS at 23 MAR 1:31 pm

The American Recovery and Reinvestment Act of 2009 (PDF – 1.07 MB) was signed into law by President Obama on February 17th, 2009. It is an unprecedented effort to jumpstart our economy, create or save millions of jobs, and put a down payment on addressing long-neglected challenges so our country can thrive in the 21st century. The Act is an extraordinary response to a crisis unlike any since the Great Depression, and includes measures to modernize our nation’s infrastructure, enhance energy independence, expand educational opportunities, preserve and improve affordable health care, provide tax relief, and protect those in greatest need.

HHS Marks the first Anniversary of the Recovery and Reinvestment Act

On February 16, 2010, President Obama marks the first Anniversary of the American Recovery and Reinvestment Act. The US Department of Health and Human Services has led several initiatives to help spur new economic growth in direct response to the worst economic crisis since the great depression.

The Recovery Act is a combination of tax relief, financial assistance and infrastructure projects designed to cushion the impact of the downturn and lay a foundation for economic recovery. Public and private forecasters estimate the program is already responsible for about 2 million jobs – putting it on-target to support more than 3.5 million jobs by the end of 2010.

• See HHS Recovery Act Accomplishments

Successful Commitment to Increasing Access to Health Care for People across the Country

Goal: Enable 1,129 Health Centers in 50 States and Eight Territories to Provide Expanded Service to Approximately 300,000 Patients

Why? As the cost of health care goes up and more people are losing coverage or even worse, losing their jobs, a growing number of people are turning to government sponsored health care for themselves and their families.

Results: 500,000 patients served!

Learn more about how this commitment was accomplished.

200-Days Milestone Report

HHS exceeds its 200-Day 300,000 patient goal, serving 500,000 patients in Community Health Centers!

Read the Vice President’s remarks on the 200 Days of the Recovery Act

Learn how Recovery Act funding successfully increased access to health care.

Implementation

HHS is committed to a timely implementation. Plans for spending, reporting, auditing, and investigation of fraud and abuse of Recovery funds are being developed and will be made available here.

Total Obligated HHS Funds: $71.4 Billion (as of 3/5/10)

Total Gross Outlays: $53.5 Billion (as of 3/5/10)

List of Programs for Which Funding Has Been Announced:

• Adoption Assistance and Foster Care Programs
• American Indians and Alaska Natives (AI/AN) Health Care Construction and Information Technology Funding
• Child Care and Development Fund
• Child Support Incentives
• Community Health Center Program
• Community Services Block Grant Program
• Comparative Effectiveness Research Funding
• Early Head Start and Head Start Expansion
• Immunization Grants Program
• Medicaid and Prescription Drug Funding
• National Health Service Corps
• NIH Medical Research and Construction Funding
• Senior Nutrition Programs
• State Health Information Technology Grants
• Strengthening Communities Fund
• Temporary Assistance for Needy Families (TANF) Programs

Major Activities

As of February 12, 2010:

• Cumulative Recovery Act Medicaid FMAP State draw downs total about $ 48.5 billion.
• Secretary Sebelius announced the availability of $10 million in cooperative agreements for national public or private nonprofit organizations to help communities decrease smoking and obesity, increase physical activity and improve nutrition. The funding opportunity, under the Communities Putting Prevention to Work, will be for national organizations to provide expert guidance to communities and foster a national movement toward prevention. This part of the initiative is being lead by the Office of Public Health and Science in partnership with the Centers for Disease Control and Prevention. (March 5)

Source: http://www.hhs.gov/about/