Category — Economic Stimulus

By Neil Versel,

Until HHS officially publishes proposed regulations near the end of this year, Dr. David Blumenthal can’t talk publicly yet about what “meaningful use” EMRs will look like, but the national coordinator for health information technology continues to discuss his vision for various components of federal health IT policy. His latest, communicated in an open letter released Thursday, is about health information exchange and what the Health Information Technology for Economic and Clinical Health (HITECH) Act–the health IT portion of the American Recovery and Reinvestment Act–says about the subject.

“A key premise: information should follow the patient, and artificial obstacles–technical, business related, bureaucratic–should not get in the way,” Blumenthal writes. “Exchange within business groups will not be sufficient–the goal is to have information flow seamlessly and effortlessly to every nook and cranny of our health system, when and where it is needed, just like the blood within our arteries and veins meets our bodies’ vital needs.”

Blumenthal noted that the HITECH Act is specific about eliminating commercial, economic and technical barriers to health information exchange and that it provides “building blocks” for HIE across state lines, partly in the form of $564 million in grant money. He said that HHS will begin awarding grants this winter.

Blumenthal also promised another letter about strengthening privacy and security safeguards for personal health information. He is due to address the American Medical Informatics Association’s annual symposium in San Francisco Monday afternoon. FierceHealthIT will be there to cover the speech.

Above article published on http://www.fiercehealthit.com/story/blumenthal-stimulus-provides-strong-foundation-hie/2009-11-16

By Mary Mosquera

Wednesday, October 14, 2009

The Health IT Standards Committee today said today it would bring together experts from outside the healthcare field to share ideas about best ways to apply new workflow and information sharing standards across organizations.

Aneesh Chopra, the White House’s chief technology officer and chairman of the panel’s newly formed standards implementation group, said he wants to mine the lessons of other industries in using information handling standards successfully and then apply them broadly to healthcare.

“There is an interest in how other industries have adopted standards, and I think we’re going to take that feedback to heart,” Chopra said after the meeting. The panel will host a hearing on Oct. 29 to share best practices, Chopra said.

Additionally, Chopra will open a two-week online forum to seek feedback from a wider audience on a series of structured questions and information posts on standards usage. The implementation workgroup will report on its findings at the next standards committee meeting Nov. 19

Dr. David Blumenthal, the national health IT coordinator, cautioned against confusing the adoption of standards with the adoption of electronic health record technologies.

“This is not about the adoption of technology but the adoption of standards,” he said. Health IT vendors will be able to solve most of the technology problems, he said.

Standards are at the heart of healthcare reform, Blumenthal noted, as reform will depend on standards and infrastructure being available to exchange health information anytime.

“Congress might not know it or realize it, but you are at the center of their effort to improve the healthcare system,” Blumenthal said in praising the standards committee’s work.

Blumenthal also said the Nationwide Health Information Network project, a public-private sector project that has been in progress for years, is essentially a set of standards.

“The goal has always been not to develop a thing or a network that is closed or a physical representation of a network, but to create a resource in the form of protocols, standards and specifications that are available in the public domain, he said.

“They are available to anyone who wishes to use the Internet to exchange information in a private and secure and effective way.”

Blumenthal said his office has also been considering how to accelerate the availability of the standards, protocols and specifications that comprise the NHIN as well as how to provide consumers and small practices access to the NHIN toolset.

“We think [that] is a laudatory goal just as we think that individual physicians and small physician groups should” have access. Blumenthal said. “This is a public resource whose broadest use is our goal.”

In other areas, the Committee’s clinical quality workgroup said it would create a sub-group to focus on gaps in the transition of vocabulary standards along the health IT adoption path.

For instance, providers will have to migrate from using ICD-9 to ICD-10 to SNOMED CT by 2015 to record physician’s clinical observations in an electronic health record.

“We need to enable that conversion to the adoption process, and that’s where these gaps are,” said Jamie Ferguson, co-chairman of the work group and executive director of Kaiser Permanente’s health IT strategy and policy.

Above article published on http://www.govhealthit.com/newsitem.aspx?nid=72210

By Mary Mosquera

The National Institutes of Health awarded Kaiser Permanente $54 million in grants for projects that will tap clinical information from the provider’s mammoth electronic health record database to study links between genes and conditions such as heart disease, obesity, diabetes and aging.

The NIH funding originated with the HITECH Act, which allocated $400 million to NIH to support comparative effectiveness research.

The largest of the 22 awards provides $24.8 million to study the influence of genes and the environment on health, disease and longevity over time and across diverse groups of people. The grants will fund genotyping of 100,000 Kaiser members in Northern California. The University of California in San Francisco is also a partner in the research.

The analysis will link genetic information with historical clinical data taken from health surveys and Kaiser’s electronic health record database, according to Raymond Baxter, senior vice president for Kaiser. Researchers will add to the study environmental information, such as air and water quality and proximity to parks and healthy foods.

Dr. Richard Hodes, NIA director of the National Institute on Aging, said genetic information generated by the project may help researchers discover genetic factors that explain differences between people in response to medications.

“This would help doctors provide patients with the best medicines for them individually,” he said.

The grant package included $7.2 million in funding to develop a cardiovascular surveillance system for a collaborative of 14 different health plans across the U.S.

A $3.3 million grant will create a National Research Database to organize Kaiser Permanente’s electronic health records.

A $1,005,372 portion of the funding will be used to integrate the Kaiser Permanente electronic medical record to measure rehabilitation outcomes for stroke patients. Another $99,971 was allocated to study the use of natural language processing to extract data from the electronic medical record.

Above article published on

http://www.govhealthit.com/newsitem.aspx?tid=10&nid=72202

By John Moore

New York State has awarded about $60 million in grants for localized health information technology projects, one of three rounds of grants recently issued under the state’s Health Care Efficiency and Affordability Law for New Yorkers (HEAL NY) initiative.

Gov. David Paterson announced grants totaling $436 million on Sept. 25. In addition to health IT, the grants will fund collaborative projects among hospitals and improvements to long-term care.

The state will allocate the funds through its Department of Health and the Dormitory Authority of the State of New York.

The health IT portion of the grants, HEAL NY Phase 10, targets community-based projects focused on information sharing. Examples include a $6.7 million grant to the Fort Drum Regional Health Planning Organization to help launch electronic health records and health information exchange to “improve coordination of care for adult patients with chronic pulmonary disease,” according to the health department.

HEAL NY Phase 11, meanwhile, provides more than $174 million in grants that aim to promote collaborative arrangements among hospitals in an effort to boost the quality and efficiency of care delivery. In HEAL NY Phase 12, more than $172 million in grants will be issued to 19 applicants for long-term care related projects.

Above article published on

http://www.govhealthit.com/newsitem.aspx?nid=72149

Health and Human Services Secretary Kathleen Sebelius released a report Thursday on how information technology can improve healthcare for Americans living in rural communities.

The report examines how the Columbia Basin Health Association in Othello, Wash., uses IT to improve healthcare quality and patient safety as well as promote care coordination and continuity.

“The Columbia Basin Health Association is just one place in America where health information technology and electronic health records have helped ensure patients get better care,” said Sebelius. “Health information technology can reduce paperwork, make care more efficient and let doctors spend more time practicing medicine and less time filling out forms.”

The CBHA provides 25,000 patients with access to a variety of medical, dental, prescription and other services at four sites and was one of the first health centers in the United States to fully transition from paper-based charts to an electronic health record system.

In response to the growing prevalence of diabetes in rural communities, the CBHA used its EHR system to track 1,302 diabetic patients, monitoring whether they received recommended exams and providing feedback to healthcare providers on their performance.

In January 2008, 31 percent of patients at the CBHA had received a foot exam and 37 percent had received an eye exam during the previous year. By June 2008, 86 percent of patients had received a foot exam and 63 percent had received an eye exam over the previous year.

According to the report, since the CBHA’s implementation of EHRs, the community health center has consistently ranked above the 95th percentile nationally in total medical and dental team productivity.

Approximately 65 million Americans live in communities with shortages of primary care providers and nearly 50 million live in rural areas. Sebelius said health information technology, and specifically EHRs, can improve care for patients and assist in clinical decision-making and the use of evidence-based guidelines. EHRs can also decrease administrative hassle, increasing workplace satisfaction and productivity.

The American Recovery and Reinvestment Act encourages greater use of health information technology through significant new investments, Sebelius said. Through incentive payments to providers and hospitals, she said, the ARRA will accelerate the adoption of health information technology and creation of an interoperable, nationwide network, and health insurance reform will build on this investment by simplifying and streamlining administrative procedures, investing in telehealth and improving the quality of healthcare.

Above article published on

http://www.healthcareitnews.com/news/hhs-secretary-speaks-power-healthcare-it-rural-communities

HHS Secretary Kathleen Sebelius today announced awards totaling $27.8 million to health center-controlled networks and large multi-site health centers to implement electronic health records (EHR) and other health information technology (HIT) innovations. The funds are part of the $2 billion allotted to HHS’ Health Resources and Services Administration (HRSA) under the American Recovery and Reinvestment Act of 2009 (ARRA) to expand health care services to low-income and uninsured individuals through its health center program.

“The increased use of health information technology is a key focus of our reform efforts because it will help to improve the safety and quality of health care generally while also cutting waste out of the system,” said Secretary Sebelius.

“These funds to expand and upgrade electronic health records systems will make a huge difference for health centers struggling to provide health care to the growing number of people in need,” said HRSA Administrator Mary Wakefield, Ph.D., R.N.

“Broad use of health information technology has the potential to improve health care quality, prevent medical errors, and increase the efficiency of care provision,” added David Blumenthal, National Coordinator for Health Information Technology. “This program supports the Department’s overall efforts to assist physicians and hospitals in adopting and becoming meaningful users of health information technology.”

Eighteen grants totaling more than $22.6 million will support EHR implementation. Grants totaling more than $2.6 million will help four grantees implement a variety of HIT innovations, including the creation of health information exchanges among different providers and the incorporation of HIT at dental delivery sites. Another five grants totaling over $2.5 million will help health centers devise plans to use existing EHRs to improve patient health outcomes.

HRSA received $2 billion through the Recovery Act to expand health care services to low-income and uninsured individuals through its health center program. To date, more than $1.3 billion of these funds have been awarded to community-based organizations across the country. HRSA-supported health centers treated 17 million patients in 2008, 40 percent of whom have no health insurance.

In addition, HRSA received $500 million in Recovery Act workforce funds—$300 million to expand the National Health Service Corps (NHSC) and another $200 million for other health care workforce programs. The NHSC funds will pay for student loan repayments for primary care medical, dental, and mental health clinicians who will practice for a minimum of two years in NHSC sites that treat underserved and uninsured people. Recently, awards totaling $33 million—part of the $200 million total—were announced to expand the training of health care professionals.

The list of grant recipients follows:

alth Resources and Services Administration (HRSA), part of the U. S. Department of Health and Human Services, is the primary Federal agency for improving access to health care services for people who are uninsured, isolated, or medically vulnerable.  For more information about HRSA and its programs, visit www.hrsa.gov.

Above article published on

http://www.hhs.gov/news/press/2009pres/09/20090929a.html

JMolly Merrill, Associate Editor

First Lady Michelle Obama announced the release of $851 million in grants to Community Health Centers on Monday.

The Recovery Act Capital Improvement Program (CIP) grants will support the construction, repair and renovation of more than 1,500 health center sites nationwide. More than 650 centers will use the funds to purchase new equipment or health information technology systems, and nearly 400 health centers will adopt and expand the use of electronic health records.

“For centers around the country, these Recovery Act grants will mean new diagnostic equipment, renovation of facilities that need repair, expanding computer centers to help manage electronic medical records, adding on new staff (and) expanding programs that work. And over the next two years, Recovery Act dollars for community health centers will expand desperately-needed services to more than 2.8 million people,” said Obama, who made the announcement while visiting Unity’s Upper Cardozo Health Center in Washington.

The CIP grant awards are the third set of health center grants provided through the American Recovery and Reinvestment Act.

“And there’s another part of this equation beyond health,” continued Obama. “When Unity builds those 20 new exam rooms, they’ll be creating jobs and putting people to work in construction and renovation. When a health center in rural Illinois purchases a new computer center, it’s going to keep a programmer in the Silicon Valley on the job. So as we provide quality healthcare to more people, there will be this multiplier effect that will also provide more jobs to more workers.”

“Just think about the impact of all these Recovery Act grants all over the entire country. Every single health center that applied for a grant will receive at the very least $200,000. And every dollar of every grant is going to make a difference in the life of someone in need,” Obama said

Above article published on

http://www.healthcareitnews.com/news/first-lady-announces-851m-grants-community-health-centers

In a Federal Computer Week opinion piece, John Loonsk — chief medical officer of CGI, and former director of interoperability and standards at the Office of the National Coordinator for Health IT and former associate director of informatics at CDC — argues that federal stimulus funding should be directed specifically to the Nationwide Health Information Network.

He writes that “without any specific stimulus funding for NHIN, we run the risk of having more than 50 separate jurisdictional networks, a separate quality reporting network, many separate lab results networks, a separate e-prescribing network, many separate public health networks, separate claims networks and others.”

Loonsk adds, “Trial implementations have demonstrated NHIN’s viability and utility” but “none of the more than $36 billion for health IT in the American Recovery and Reinvestment Act is dedicated to advancing any common health information network or ensuring that common network services are available.”

He concludes, “As with the Internet, a clear commitment to common network services is necessary to open opportunities for the next steps in health information exchange that can attract health care providers into the technology rather than pushing it on them” (Loonsk, Federal Computer Week, 9/10).

Above article published on

http://www.ihealthbeat.org/Articles/2009/9/11/Opinion-Some-Stimulus-Funding-Should-Be-Directed-Toward-NHIN.aspx

Diana Manos, Senior Editor

The HIT Policy Committee is holding a hearing today in Washington, D.C. to discuss the privacy aspects of healthcare IT found in the American Recovery and Reinvestment Act (ARRA).

Jodi Daniel, director of the Office of Policy and Research at the Office of the National Coordinator for Health IT (ONC), who opened the meeting this morning, said privacy and security are fundamental building blocks for meaningful use of healthcare IT.

“The success of health information technology and exchange rests on consumer and provider confidence in privacy and security protections,” she said.

Daniel outlined the key privacy aspects found in ARRA. The HIT Policy Committee is responsible for advising the federal government on:

• Technologies that protect the privacy of health information and promote security in an electronic health record;
• Segmentation and protection from disclosure of specific and sensitive individually identifiable health information with the goal of minimizing the reluctance of patients to seek care;
• Use and disclosure of limited data sets;
• Infrastructure that allows for accurate exchange;
• Technologies for an accounting of TPO (treatment, payment and health operations) disclosures;
• Technologies that allow IIHI to be rendered unusable, unreadable or indecipherable to unauthorized individuals; and
• Methods to facilitate secure access to personal health information by an individual or person assisting in care.

ONC officials proposed a breach notification rule in April, with a final rule out in August. The rule will be effective Sept. 23 with a comment period closing Oct. 23, Daniel said.

Deborah Peel, a national expert on patient healthcare IT privacy, was the first to testify today on patient privacy. “Millions of Americans are concerned about the control of their personal data,” she said. She said ensuring data privacy and security is the only way that healthcare IT can move forward successfully.

Peel said privacy should have been established before policy on healthcare IT.

Above article published on

http://www.healthcareitnews.com/news/hit-policy-committee-holds-privacy-hearing-today

By Gregg Blesch

The White House announced $25 million in grants for states and health systems that carry out and evaluate evidence-based patient-safety and medical-liability demonstrations, following up on President Barack Obama’s nod to malpractice reform in his speech to Congress last week.

In a memorandum, Obama directed HHS to make the funding available for “the development, implementation and evaluation of alternatives to our current medical liability system.” Obama said in the memo that such alternatives should reduce preventable injuries; improve communication between physicians and patients; ensure fair and timely compensation for injured patients; reduce frivolous lawsuits; and reduce liability premiums.

Grants of up to $3 million and three years will go to applicants that implement and evaluate demonstrations, and one-year grants of up to $300,000 and technical assistance will go to applicants that want to plan projects, the White House said in a news release. Decisions are expected in early 2010.

The American Medical Association called the news “a welcome step” toward liability reform. “The AMA supports federal funding for state-based pilot projects on medical liability reform alternatives such as health courts, early disclosure and compensation programs and expert witness qualifications,” AMA President J. James Rohack said in a written statement

Above article published on

http://www.modernhealthcare.com/article/20090917/REG/309179979/-1