By Neil Versel

Vice President Joe Biden, HHS Secretary Kathleen Sebelius and national health IT coordinator Dr. David Blumenthal are in Chicago today to announce $1.2 billion in federal grants to promote EMR use and interoperability. The money represents the bulk of the $2 billion in stimulus funds allocated to the Office of the National Coordinator for Health Information Technology.

Of the $1.2 billion, the administration plans to spend $589 million on health IT extension centers to assist hospitals physician practices in selecting and implementing EMRs. The other $564 million will go to encourage health information exchanges and help build the Nationwide Health Information Network. “Electronic health records can help reduce medical errors, make healthcare more efficient and improve the quality of medical care for all Americans. These grants will help ensure more doctors and hospitals have the tools they need to use this critical technology,” Sebelius says.

The administration officials are speaking at Mount Sinai Hospital, an aging facility in an impoverished West Side neighborhood, where just 7 percent of patients have commercial insurance. Biden is leading a roundtable discussion on comprehensive healthcare reform, focusing, in part, on health IT infrastructure, his office says.

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http://www.fierceemr.com/story/biden-sebelius-blumenthal-announce-funding-emr-extension-centers-hie/2009-08-20

By Jim Dawson

Inside Science News Service

WASHINGTON (ISNS) –The progress and problems in developing a national system of electronic medical records topped the agenda Thursday as the Obama Administration’s “best and brightest” from the world of science, medicine and technology gathered in Washington for the inaugural meeting of the President’s Council of Advisors on Science and Technology (PCAST).

David Blumenthal, the national coordinator for health information technology, said there was an “appalling lack of use of technology” in the U.S. medical record-keeping system. “Only 20 percent of physicians and 10 percent of hospitals have meaningful electronic records,” he told the 21-member panel. The transition from the paper-based medical record-keeping system to an electronic one is a priority in President Barack Obama’s push for health care reform, Blumenthal said, as a way to save money over the long run and improve the quality of health care.

In February, Obama signed the American Recovery and Reinvestment Act, which would put $20 billion toward what Blumenthal called a “completely revised, interoperable, integrated health information system.” The system, which is supposed to be functional by 2014, will actually be many different electronic records systems developed by private companies that meet a host of federal standards and requirements that are currently being developed.

“Paper records put us in a suboptimal position [to improve health care],” said Eric Lander, a co-chair of PCAST and the director of the Broad Institute, a medical genetics research program in Cambridge, Mass., run by both Harvard University and the Massachusetts Institute of Technology. An electronic records system, in addition to allowing a patient’s medical records to be shared among doctors, could allow medical researchers to “mine data and combine data” to do faster, more sophisticated medical studies, he said.

Blumenthal said the point of the system isn’t the technology itself, but how that technology is used. “There is very little about the health care system that doesn’t concern us or that we can’t affect in some way,” he said. “We are enabling information to be more accurate and available at the point of care.”

“Use” is one of three area of concern for the scientists and others developing the records system. The other areas focus on getting doctors and hospitals to adopt the electronic system, and, once they have it, how to use it to efficiently exchange information.

The “adoption” issue addresses the difficult question of “which technology should be used, which [computer] platforms are mostly likely to support innovation and change,” Blumenthal told the committee. “And we have to realize that anything that is adopted now will be primitive by the time this entire system is put into place.”

The “exchange” issue involves a host of questions and problems, he said. Should the records system be centralized? How can the system make medical records easy to study and share among doctors, but at the same time guard the privacy of patients and make them secure? “Privacy and security must be assured,” Blumenthal said.

PCAST member Eric Schmidt, the Chairman of Google, in Mountain View, Calif., asked if patients would own their electronic medical records. Aneesh Chopra, the chief technology officer at the administration’s Office of Science and Technology Policy, replied that patients would be given summaries of their records. Schmidt shook his head and said, “that isn’t the same.”

In describing ways an electronic system could benefit medical research, Chopra noted that 40 percent of the U.S. population will at some point be diagnosed with cancer, “but today less than 5 percent of cancer patients have their information in a shareable form that is suitable for research. Why can’t every cancer patient be treated like someone in a clinical trial?” he asked. With electronic medical records, they could be, he said.

John Glaser, a doctor and advisor to the national coordinator for health information technology, detailed a list of benefits in patient treatment that would come from an electronic records system. The system would allow small hospitals and medical practices to have access to patient information on a more sophisticated, interconnected level, he said.

Patients typically see several doctors and they often assume the doctors are talking to each other. They usually aren’t, he said, but with the new records system they would be. Drug interactions would be more apparent, and treatments and procedures done by one doctor could create patterns that reveal a disease like diabetes to another physician working with the records.

The trick, Blumenthal said, is “structuring the [health] market to use the system and allow for innovation, but also maintain order. And we have to assure privacy and integrity in the system. If someone is talking to their doctor about STDs (sexually transmitted diseases), they want to know their records are secure,” he said.

He concluded by noting that while Denmark and other Scandinavian countries are far ahead of the U.S. in the use of electronic records, “nobody has developed an exchange system [of electronic medical records] in a country that is anything like the U.S. in size, population, cultural value differences, and economic structure.”

“We have to live in the world we have,” he said to the scientists and others working to establish the new system.

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http://www.aip.org/isns/reports/2009/090807_pcast.html

By Adriel Bettelheim

President Obama plans to huddle with his Cabinet and top advisers on Friday and Saturday to review lessons learned from his first six months in office. There’s bound to be some gnashing of teeth over the pace of the health care overhaul, and also some satisfaction over signs the economy is staggering back.

But based on his remarks at Wednesday’s town halls in Raleigh, N.C. and Bristol, Va., don’t expect a major recalibration of the administration’s message.

Obama continued to strenuously defend economic relief efforts launched in the aftermath of last fall’s financial crisis and lay some blame at the feet of former President George W. Bush. And he eagerly portrayed himself as a responsible steward of taxpayers’ money, to deflect persistent Republican charges that he’s incapable of controlling federal spending.

“I know that some critics in Washington think we’ve been slow to get these projects started,” Obama said in Raleigh, referring to work funded by the $787 billion economic stimulus package (PL 111-5). “They are saying we should have broken ground on all our highway projects on the first day. But everyone knows that’s impossible, especially because I wanted to be sure we did our homework and invested tax dollars only in those projects that actually created new jobs and jumpstarted our economy.”

Speaking in a state where the jobless rate is 11 percent, Obama said while there’s still much work left to be done to assure a complete recovery, “there is little debate that these steps, taken together, have helped stop our economic freefall.”

Obama also fired back at critics who blame him for running up the federal deficit, saying he inherited a $1.3 trillion shortfall. Without mentioning Bush by name, Obama said the staggering deficit was “a debt that is partially a result of two tax cuts that went primarily to the wealthiest few and a Medicare drug program, none of which was paid for.”

Finally, Obama continued to subtly recalibrate his health care message, casting the debate as one that revolves around curbing insurance companies’ less-savory business practices.

He outlined a series of consumer-protection measures aimed at preventing health plans from denying coverage to individuals who have preexisting medical conditions, dropping coverage for individuals who become seriously ill or charging unlimited out-of-pocket expenses. He also said the health overhaul would force the plans to pay for preventive care and routine checkups and remove arbitrary caps on the amount of coverage individuals can receive in a given year or in a lifetime.

Of course, many of these proposals aren’t major sticking points in the current debate. But talk about contentious stuff like public insurance options and how to pay for the overhaul should probably best be left to staff retreats and closed-door negotiating sessions on Capitol Hill.

Above article published on

http://blogs.cqpolitics.com/balance_of_power/2009/07/
obama-defends-stimulus-health.html

Greater access to health information technology, like bar code administration systems and computerized prescriber order entry systems, is just one of the benefits that pharmacists in hospitals and health systems will reap from the newly enacted economic stimulus package signed by President Obama.

In an analysis of the $787 billion American Recovery and Reinvestment Act, ASHP found more than $100 billion allocated for issues important to the Society, including ensuring the widespread adoption of health information technology, supporting comparative effectiveness research, and alleviating shortages of primary care providers.

Nineteen billion dollars will be set aside to allow hospitals to take advantage of loans and grants to implement health information technology systems throughout their facilities. The stimulus also includes $1.1 billion for comparative effectiveness research to evaluate the clinical outcomes of a variety of treatments, including drug therapy.

Two of ASHP’s top priorities, funding for pharmacy residency programs and pharmacist inclusion in loan forgiveness programs were left out of the stimulus package. ASHP will keep these issues on the front burner as dialogue on health-care reform proposals begins later this year. Both are featured in ASHP’s Principles for Health-Care Reform.

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http://www.ashp.org/import/news/NewsCapsules/article.aspx?id=262