In February 2009, President Obama and the Congress launched a vast, ambitious program to improve the health of Americans, and the performance of their health system, by building a nationwide, interoperable, private and secure, electronic health information system. This vision – of health care empowered by a modern information system, serving each and every American according to their needs and preferences – reflects decades of study and thinking by health care experts, health professionals, and average citizens. Typical of the consensus underlying the nation’s new health information technology (HIT) program is this recommendation by the Institute of Medicine from its seminal 2001 report, Crossing the Quality Chasm:

“Congress, the executive branch, leaders of health care organizations, public and private purchasers…should make a renewed national commitment to building an information infrastructure to support health care delivery, consumer health, quality measurement and improvement, public accountability, clinical and health services research, and clinical education. This commitment should lead to the elimination of most handwritten clinical data by the end of the decade.”

Similar recommendations have come from many other non-partisan, independent authoritative sources such as the Commonwealth Fund, the Markle Foundation, and the Robert Wood Johnson Foundation. These recommendations reflect not only academic studies showing the benefits of HIT, but also experience and common sense. We live in a digital age. We have seen technology improve virtually every facet of our lives. But medicine still relies on cumbersome paper charts. We manage information the same way Hippocrates did 2400 years ago. It’s time to move medicine into the 21st century.

Many health care organizations, big and small, public and private, have installed electronic health record systems and are reaping their benefits daily. Examples include not only national systems like the Veterans Administration and Kaiser Permanente, but regional groups like Geisinger Health System, and individual hospitals like the Beth Israel Deaconess Hospital in Boston, and Lakeland Hospital, a 77-bed facility outside of Omaha Nebraska. These organizations show that the vision is feasible – health care can be made higher in quality and lower in cost through the best existing HIT.

From a common sense perspective, it is impossible to imagine a 21st century American health system deprived of the electronic methods of collecting, managing, and moving data that have revolutionized virtually every other area of human endeavor. Information is the lifeblood of medicine. HIT is its circulatory system. A health care system without an electronic health information system simply cannot achieve its potential, anymore than an Olympic athlete could compete with a failing heart. This is the vision that President Obama and the Congress embraced in February 2009.

Nevertheless, any bold new goal has to be reduced to practice, and skeptics are now asking appropriately whether the HIT program can succeed. A few recent studies have raised questions about whether health care organizations that have installed electronic health records are actually realizing the expected benefits. Perhaps existing examples of success are atypical, and can’t be reproduced in the rest of our health system? Perhaps we are moving too fast? Perhaps the risks are too great?

As a scientist myself, I take the academic literature very seriously. I believe that policy should be based on the best available information, carefully analyzed and considered. However, recent studies raising questions about the benefits of EHRs are informative, but limited in their applicability to our HIT program. To the extent that they accurately capture past experience with EHRs, these studies illustrate something that the Congress and the President understand and have allowed for: namely, that having an EHR alone is not sufficient. Doctors and hospitals have to use this technology effectively, have to employ its extraordinary power to improve clinical decisions, in order to achieve its potential benefits. The federal government’s new programs of incentives and penalties are totally focused on encouraging the meaningful use of EHRs. The resources set aside by the Congress to encourage the adoption of EHRs will go only to physicians, hospitals, and other providers who meet carefully designed new requirements for the use of EHRs that will translate into health improvements and cost reductions for the American people. And the plan passed by Congress includes new resources and support that will help make it possible for providers and hospitals to meet these requirements. We have already announced the availability of grants that will help providers adopt and use EHRs, and we will be making additional announcements in the weeks and months ahead.

Sometimes bold steps are required to improve the human condition. Among the most successful health and social programs in American history are Social Security, Medicare, Medicaid, the Community Health Center Program, and the State Children’s Health Insurance Program. It would have been a tragic mistake, costing untold thousands of lives and enormous suffering, if we had foregone or delayed these programs. I believe the HIT initiative will rank with these huge successes in the value it will bring to the American people over the years to come.

Above article published on http://www.healthcareitnews.com/blog/evidence-hit

On Friday, Kentucky Gov. Steve Beshear (D) announced the creation of a new office designed to serve as a single point of contact for state and federal agencies working on health IT initiatives, the AP/Lexington Herald-Leader reports (AP/Lexington Herald-Leader, 8/17).

The Governor’s Office of Electronic Health Information will be housed within the Kentucky Cabinet for Health and Family Services. The federal stimulus package requires states to create such a department to receive stimulus funding designated for health IT.

According to an Office of the Governor release, the new office will help facilitate the development of a statewide electronic health record system. It also will work with the state’s three regional health information organizations, as well as health care providers, consumers, insurers and other groups involved in the electronic exchange of health data (Business First of Louisville, 8/14).

Above article published on

http://www.ihealthbeat.org/Articles/2009/8/17/Kentucky-Creates-Electronic-Health-Information-Office.aspx

Molly Merrill, Associate Editor

President Barack Obama called for fixing the broken healthcare system by building upon investments made in electronic medical records in a town hall meeting held last month.

The town hall was held at Northern Virginia Community College in Annandale, Va., where the president took questions the public had submitted online regarding healthcare reform.

I know that people say the costs of fixing our problems are great and in some cases, they are, Obama said. The costs of inaction, of not doing anything, are even greater. They’re unacceptable. And that’s why this town hall and this debate that we’re having around healthcare is so important.

The president highlighted the continued use of electronic medical records as one way to help drive down costs.

We already made those investments in the Recovery Act because when everything is digitalized, all your records your privacy is protected, but all your records on a digital form that reduces medical errors. It means that nurses don’t have to read the scrawl of doctors when they are trying to figure out what treatments to apply. That saves lives; that saves money; and it will still ensure privacy, the president said.

Obama said the government has already identified $950 billion over 10 years that will be used to pay for healthcare reform. He said this doesn’t even include the savings that we’re going to get from prevention, or the savings that we’re going to get from health IT because in using congressional jargon, which I’m never supposed to do because nobody understands it, it’s not scorable.

And what that means is, is that the Congressional Budget Office can’t identify exactly how much you would save - even though everybody believes that it will end up saving a lot of money, we can’t put a hard number on it, Obama said.

The president ended his speech by calling for the American people to stand up and say now is the time.

We can create a healthcare system that gives you choice, allows you to keep your doctor, drives down costs, makes sure that every American doesn’t have to worry if they lose or change their jobs. That’s our aim. That’s our goal. We’re going to make it happen this year.

Above article published on

http://www.healthcareitnews.com/news/obama-stresses-it-key-health-reform

Diana Manos, Senior Editor

The Centers for Medicare and Medicaid Services is now releasing healthcare IT funding from the stimulus package to state Medicaid programs.

According to a CMS letter mailed Wednesday to state Medicaid directors, the American Recovery and Reinvestment Act enables the government to pay a 100 percent federal financial participation (FFP) match to states that help Medicaid providers adopt, implement or upgrade certified electronic health record technology to demonstrate meaningful use.

It will also pay a 90 percent FFP match to cover a state’s administrative costs for running an HIT Medicaid incentive program. States may now request the 90 percent FFP match for administrative planning activities, according to the letter.

Medicaid directors should contact their CMS regional office for further guidance and maintain ongoing communication while initiating planning activities. State health IT incentive programs should be part of larger statewide efforts to promote healthcare IT use and exchange.

CMS advised states who plan to apply for a FFP match to plan how they will audit their healthcare IT incentive payment programs for errors.

CMS is working on a final rule, due by the end of the year, with more information on how Medicaid providers will have to show meaningful use to qualify for health IT incentive payments.

Above article published on

http://www.healthcareitnews.com/news/states-can-now-apply-health-it-medicaid-funding-cms-says

Source: US National Governors’ Association

As the national dialogue on health care reform continues, health information technology (IT) and health information exchange (HIE) have emerged as critical means to ensuring a health care system that is affordable, effective, safe and transparent. A new report from the State Alliance for e-Health, Preparing to Implement HITECH: A State Guide for Electronic Health Information Exchange, aims to help states lead the way in using health IT and HIE and guide them as they begin instituting the federal Health Information Technology for Economic and Clinical Health (HITECH) Act.

The State Alliance for e-Health, a consensus-based, executive-level body composed of governors, state legislators, attorney generals and state commissioners, was created by the NGA Center for Best Practices in 2006 to address the unique role states can play in facilitating adoption of health IT and HIE. The HITECH Act, enacted as part of the 2009 American Recovery and Reinvestment Act, expands the role of states in fostering health information exchange and adoption of electronic health records over the next five years.

“Governors understand that swift and thoughtful action is needed at the state level to plan and implement a national system of health information exchange, “said Tennessee Gov. Phil Bredesen, co-chair of the State Alliance. “Widespread adoption and use of electronic health records provide a critical foundation for improving health outcomes and cost-effectiveness.”

The report recommends actions states should begin undertaking now to successfully implement the HITECH Act, including:

• Preparing or updating the state plan for HIE adoption;
• Engaging stakeholders;
• Establishing a state leadership office to manage the different phases of HIE implementation;
• Preparing state agencies to participate; implementing privacy strategies and reforms;
• Determining the HIE business model;
• Creating a communications strategy; and
• Establishing opportunities for health IT training and education.

“States already have taken the lead in modernizing the health care system by advancing the use of health IT, electronic health records, e-prescribing and electronic exchange of health information,” said Vermont Gov. Jim Douglas, NGA Chair and co-chair of the State Alliance. “We now have an opportunity to accelerate adoption of health IT across the states and create a truly comprehensive health care system that is effective, affordable and accountable.”

The report and state initiatives to implement health IT and electronic HIE will provide a central focus for the State Alliance for e-Health’s semi-annual conference, to be held August 7 in Burlington Vermont.

The State Alliance – supported by funding from the U.S. Department of Health and Human Services – provides a nationwide forum through which governors, state policymakers and other stakeholders can work together to identify effective HIT policies and best practices and explore solutions to challenges related to the exchange of health information.

Above article published on

http://www.egovmonitor.com/node/27565

Looks like Big Brother is finally coming to the Bluegrass State. Governor Steve Beshear announced last week that state government would begin compiling the health records of all Kentuckians in a central computer data base. What could possibly go wrong?

To coincide with the Obama administration’s plan to implement a system of health information technology (HIT), Gov. Beshear has created the Governor’s Office of Electronic Health Information within the Cabinet for Health and Family Services (CHFS), to serve as single point of contact on Kentucky’s health information technology efforts

In anticipation of congressional action on proposals to establish a national health care system, Obama’s administration is calling for universal adoption of electronic health records by 2014. To access stimulus funds to support HIT, states are being forced to have the technology and other infrastructure in place to support electronic health records (EHR) and HIT. “President Obama has made health care reform one of his top priorities, and health information exchange is a cornerstone of a national goal to improve health care quality,” Gov. Beshear said. “Many of our health care providers practice independently or in small groups and are located in rural areas. Our challenge is to bring together Kentucky’s stakeholders to assure that the development and use of health information exchange meets federally defined standards for privacy and security and to assure stakeholders that health information exchange is interoperable, sustainable and dependable.”

hose “stakeholders” include the state’s three regional health information organizations (RHIOs), hospitals, physicians, heath care practitioners and other providers, consumers, private insurance companies, and all others who participate in the exchange of health information. In other words, the state will control access to the medical records of every man, woman, and child in the Commonwealth.

The Kentucky E-Health Network Board (EHNB), which is administratively attached to the Cabinet for Health and Family Services, will also serve as an integral resource to the Office as it moves forward. The EHNB will compile a central database of all physician, hospital, pharmacy and medical insurance records, and will control access to this database. As yet, the EHNB will have no authority over distribution of medical services, or eligibility determination. Nothing in the Governor’s proposal empowers the EHNB to limit end-of-life health care services.

“The Governor’s action will allow the Commonwealth to be in a position to apply for federal stimulus funds for planning and implementation of health information exchange to support infrastructure and build resource capacity, particularly for underserved communities, said CHFS Secretary Janie Miller. “Initially, the office will be created by assigning existing resources within the Cabinet. Once efforts are underway it is expected that all states will receive federal stimulus dollars to expand our activities to fully plan and implement health information technology.”

“Kentucky has established a strong vision for the future of e-health in our state. The new Governor’s Office of Electronic Health Information can effectively take that vision to reality,” Gov. Beshear said. “We will respond quickly to opportunities that will afford our important health industry to take full advantage of incentive funds available under ARRA.”

Naturally, the Cabinet for Health and Family Services and the Kentucky E-Health Network Board, will limit access to the confidential information in this database; just as the FBI and the IRS closely guard their databases. After all, these files will contain detailed information about the health of each Kentuckian; along with everything a citizen tells his physician or psychiatrist, and everything the doctor tells his patients.

Above article published on

http://www.examiner.com/x-3747-Louisville-City-Hall-Examiner~y2009m8d16-Kentucky-government-to-compile-citizens-health-records

By Anne Zieger

If the state’s governor gets his way, Kentucky will soon be home to a statewide electronic health records system. To foster that goal, State Gov. Steve Beshear (D) has created the Governor’s Office of Electronic Health Information.

The state is creating the office to make sure it gets its share of the Obama administration’s stimulus funding package for EHRs, which goes to states who adopt them by 2014.

To get those funds, states are required to create a department that oversees its EMR project. These state offices serve as single points-of-contact for federal and state agencies helping to get the EMR ball rolling. In this case, the office will also work with the state’s three regional health information organizations, healthcare providers, consumers, insurers and the whole kit and kaboodle involved in sharing health data.

It will be interesting to see if any of this comes to fruition. Despite some big talk, RHIOs aren’t going great guns, and getting a state’s worth of EMRs in place by 2014 sounds a tad optimistic at best. But hey, press releases wouldn’t exist if people weren’t optimistic!

Above article published on

http://www.fierceemr.com/story/kentucky-launches-initiative-designed-foster-statewide-emr-system/2009-08-20