As the Obama administration works to garner support for healthcare reform, about $1.2 billion in grants were announced on Friday to help hospitals and healthcare providers implement and use electronic health records.

Announcing the grants in Chicago, US Vice President Joe Biden said the $1.2 billion would be funded by the $787 billion economic stimulus plan.

“With electronic health records, we are making health care safer; we are making it more efficient; we are making you healthier; and we are saving money along the way. These are four necessities we need for healthcare in the 21st-century,” Biden said during an appearance at a hospital with Health and Human Services secretary Kathleen Sebelius.

Expanding the use of electronic health records is fundamental to reforming the country’s healthcare system, Sebelius said, adding that electronic health records would help reduce medical errors, make healthcare more efficient and improve the quality of medical care for all Americans.

“You are going to be able to save a lot more lives and save tens of billions of dollars,” Biden told about 100 medical professionals.

Of the total money, $598 million would be used to establish 70 health information technology regional extension centers, which would help hospitals select and implement electronic health record systems.

Grants totalling $564 million would go to States and Qualified State Designated Entities to support the development of mechanisms for information sharing within an emerging nationwide system of networks.

The grants would be awarded beginning fiscal year 2010. Biden also expressed confidence that the healthcare legislation would be passed.

“Soon we are all going to get much better health care at a more rationale price…We are not taking the system that works away from any American. We are making the stuff that doesnt work, work better,” he added.

Pointing out that the economic stimulus package is working to improve the economy, Biden said, “We stopped the free fall. Now we are beginning to ascend again”.

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President Obama held a town hall meeting in New Hampshire today, Tuesday, August 11, in an effort to calm fears over the Democrats’ legislative initiatives to reform healthcare in this country. The meeting was structured, and no visible emotional outbursts were seen as in other meetings with lawmakers across the country.

Obama answered questions posed by attendees, emphatically telling the audience that the current healthcare system solely benefits the insurance industry. With 46 million in the country without health insurance, he tried to reassure his audience that they would be able to keep their current coverage and doctor and that the government would not be “in charge”. Obama hammered on the fact that the government and insurance bureaucrats should not be meddling, that pre-existing conditions will be covered and that insurance companies would not be able to drop or deny coverage or water down coverage. Many of the questions on voter’s minds that were expected to be answered, especially with respect to employers and small businesses, were not addressed.

Numerous recent polls show support for healthcare reform is eroding, and the President’s numbers are dropping as well over fears that a government takeover of our healthcare system in the U.S. will lead to a Canadian style system with long waits for treatments and referrals.

The President’s message today was supposed to address people who already have insurance through their employers and highlight how his proposals would affect them. HAI monitored the town hall meeting and didn’t find the retool of the White House message to have answered those questions. Another town hall meeting with Obama is scheduled for Bozeman, Montana on Friday, and on Saturday, Obama will be in Grand Junction, Colorado.

Meanwhile, the White House has opened a Reality Check website with a viral tool aimed at online healthcare combat on everything from rationing to euthanasia. The website incorporates lessons learned from the Obama presidential campaign, and shows the White House is becoming more aggressive in dispelling what they call misinformation in the healthcare debates.

The August Congressional Recess is not even half over, and Democratic lawmakers are very much at risk of losing control of the public debate over healthcare reform, facing wary constituents and facing a barrage of accusations and criticism over their writing of the legislation prior to leaving Washington. Powerful groups on both sides of the debate are using the August recess to hammer home to lawmakers that there are very serious political consequences to the healthcare issue.

Senators working on a yet to be released draft bill said earlier this week that President Obama would like to get something passed for healthcare reform and then start negotiating in a House-Senate conference committee. Some Democrats support the public option, but it will be a tough sell for Republicans if they want to get a bill through the Senate. The flashpoint in the debate has become the question of whether a healthcare overhaul should include a public option. As the debate rolls on, Americans are questioning what the shape and size of the government’s role in the economy should be, especially on the heels of Congress passing three massive economic stimulus bills.

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State governments around the country are working to facilitate, and in some cases, enhance, Washington’s stimulus-funded incentives for doctors and hospitals that adopt new health information technology. “A group of the nation’s governors and state officials has released a guide for state implementation of the Health Information Technology for Economic and Clinical Health Act,” the formal name for the portion of the stimulus bill, McKnight’s Long-Term Care News reports. A key recommendation is that state leaders create health information exchanges so providers can readily share information to improve coordination of care (8/7).

Meanwhile, members of the National Lieutenant Governors Association called for support of “advance interoperable health IT and its adoption among providers” in a resolution this week, Modern Healthcare reports. They call on states to adopt systems with the stamp of approval of the Certification Commission for Health Information Technology, a group affiliated with an e-health industry association (DerGurahian, 8/6).

Louisiana went a step further with “a bill that would create a loan program for physicians and hospitals hoping to buy an electronic health record system,” American Medical News reports. The state health department will seek other stimulus funding to seed the loans. The bill also will create the Louisiana Rural Health Information Exchange (Dolan, 8/6). (Other states, such as Maryland, have taken similar action in recent weeks).

At the local level, Florida officials are reviving two e-health projects in the Miami and Palm Beach areas to pursue the stimulus funding, the Sun-Sentinel reports. One project, run by the South Florida Health Information Exchange, had succeeded in digitizing the records for dozens of clinics and setting up protocols to share them with a local hospital, before funding dried up and the program became dormant (LaMendola, 8/6).

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August/07/Health-IT-Fri.aspx

DENIS STAUNTON in Washington

US PRESIDENT Barack Obama has promised to overhaul the American healthcare system by the end of this year – without Republican support if necessary.

Speaking in Indiana after a town hall meeting to promote his economic policies, the president said he would prefer to sign a bipartisan healthcare Bill but it was not yet clear if negotiations with Republicans would prove fruitful.

“Sometime in September we’re going to have to make an assessment,” he told MSNBC. “I promise you, we will pass reform by the end of this year because the American people need it.”

Mr Obama told his audience in Elkhart, which experienced the sharpest unemployment rise in the US last year, that he would issue $2.4 billion in taxpayer grants to create electric cars and tens of thousands of jobs.

“For too long, we failed to invest in this kind of innovative work, even as countries like China and Japan were racing ahead,” he said.

“That’s why this announcement is so important – this represents the largest investment in this kind of technology in American history.”

Mr Obama identified energy, innovation, healthcare and education as the pillars of the new US economy he wants to build from the wreckage of the recession.

“Now, there are a lot of people out there who are looking to defend the status quo. There are those who want to seek political advantage. They want to oppose these efforts.

“Some of them caused the problems that we got now in the first place, and then suddenly they’re blaming other folks for it. They don’t want to be constructive. They don’t want to be constructive; they just want to get in the usual political fights back and forth,” he said to applause.

“But you and I know the truth. We know that even in the hardest times, against the toughest odds, we have never surrendered. We don’t give up. We don’t surrender our fates to chance. We have always endured. We have worked hard, and we have fought for our future.

“Our parents had to fight for their future; our grandparents had to fight for their future. That’s the tradition of America.

“This country wasn’t built just by griping and complaining. It was built by hard work and taking risks. And that’s what we have to do today.”

Republicans, who have opposed all Mr Obama’s key proposals, from the economic stimulus package to healthcare reform, see in the president’s declining popularity an opportunity to make gains in next year’s congressional elections.

“President Obama is now looking like a mere mortal, as opposed to someone who previously exceeded gravity,” said John Cornyn, chairman of the National Republican Senatorial Committee.

“I think there will be a significant number of voters who, leading up to 2010, will wonder if they voted for someone they didn’t get.”

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http://www.irishtimes.com/newspaper/world/2009/0806/1224252080737.html

As President Obama continued his push to reform the U.S. health care system, he highlighted the Cleveland Clinic as a model for how effective health IT systems can improve care and lower costs, Healthcare IT News reports.

Obama visited the Cleveland Clinic on Thursday and viewed a presentation on the center’s health IT initiatives.

Cleveland Clinic executives also spoke with the president about patient-centered health IT projects involving Microsoft HealthVault, Google Health and MyChart. MyChart currently connects 202,000 patients to an online portal for appointment scheduling, prescription management, preventive health reminders and test results.

C. Martin Harris, Cleveland Clinic’s CIO and a member of HHS’ Health IT Standards Committee, said the center “is developing health IT that gives patients the power to better manage their health care.”

Harris added that the Cleveland Clinic is “focused on helping lead the nation toward a comprehensive electronic medical records system that will reduce medical errors, improve quality and lower costs.”

During a town-hall meeting later that day, Obama said the Cleveland Clinic has “one of the best health IT systems in the country.” He said the center’s electronic health technology allows it to:

• Boost patient care;
• Coordinate with other health workers in the community;
• Improve chronic disease management;
• Monitor treatment efficacy;
• Reduce duplicate testing; and
• Track patient health and progress.

Obama said, “And here’s the remarkable thing: They actually have some of the lowest costs for the best care” (Monegain, Healthcare IT News, 7/24).

Ezekiel Emanuel, a physician and health policy adviser to the Obama administration, said the Cleveland Clinic has a “fantastic health IT system, which is a necessary component of changing the game” in health care reform (Brown, Washington Post, 7/23).

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-To-Tout-Health-IT-as-a-Key-to-Health-Reform.aspx

By Matthew DoBias

President Barack Obama moved to stem growing criticism of his blueprint to overhaul the U.S. healthcare system, warning a national audience not to “become consumed in the game of politics” and underscoring the potential benefits everyday individuals could reap under a wholly reformed system.

In a news briefing that focused almost entirely on healthcare, the president tried to put the focus on the personal rather than the political.

“My hope is, and I’m confident that, when people look at the cost of doing nothing, they’re going to say, ‘We can make this happen. We’ve made big changes before that resulted in a better life for the American people,’” Obama said.

Over the past three weeks, Obama’s push to fundamentally change how care is provided and paid for has come under attack from a bloc of fiscally conservative Democrats, stalwart Republicans and both right- and left-leaning interest groups.

Longtime policy shapers have begun to tie the president’s upstart reform efforts to one that failed spectacularly in the early 1990s. Such comparisons could prove to be as damaging as any legislative setback or missed deadline.

The president reiterated a pledge not to support any new taxes that would hit the middle class. His steadfast opposition to a tax on health benefits has rankled some lawmakers who had hopes of using such a levy to help defray the expected $1 trillion overhaul price tag.

“If I see a proposal that is primarily funded through taxing middle-class families, I’m going to be opposed to it,” he said. But, he added that he’s open to other tax proposals now being hashed out by congressional leaders.

And Obama also backed a measure that would give the Medicare Payment Advisory Commission expanded powers to enact many of its payment recommendations with limited chances for Congress to alter such proposals

Above article published on http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20090722/
REG/307229963&AssignSessionID=173353830933946

The AP reports President Obama “returned to campaign-style rhetoric on Thursday,” saying at two New Jersey events that “inaction is not an option” as he urged supporters “to push for his overhaul of the nation’s health care system.” ABC World News, which opened with the story, called the President “a man on a mission. Everywhere he goes these days, he’s pushing healthcare reform.” The AP reports Vice President Biden was also touting reform, joining Health and Human Services Secretary Kathleen Sebelius at a forum in Virginia.

The Politico reports, “On the defensive over the economy and health care, the White House is shooting back with a double-barreled message for its critics and skeptics. To Republicans who say the stimulus isn’t working: Back off. To moderate Democrats wary of health care reform: We’re watching you.” Bloomberg News, however, reports Senate Finance Chairman Max Baucus “complained…Obama is ‘making it difficult’” to create a bipartisan compromise in the Senate. Baucus said Obama’s “opposition to the idea of taxing health-care benefits is ‘not helping us.’” The Hill reports Baucus and other senators emerged from “another intense day of closed-door negotiations” to “admit they had not reached the finish line.” Baucus said, “We’re very close to reaching agreement. By close, I mean it’s a matter of couple, three or four days, maybe.”

Sen. John McCain said on Fox News’ Your World, “The President has reiterated time and again his commitment to getting through before the recess. This thing is like a fish in the sun. If you leave it out there very long, it’s going to begin to smell very, very badly to the American people. That is why they are in such a rush to fundamentally affect one-sixth of our gross national product.”

USA Today reports that three tax increases “proposed by President Obama and House Democrats on the richest Americans could produce the highest tax rates in a quarter-century.” About 500,000 taxpayers earning $1 million or more would pay a full 5.4 surtax under one plan; surtaxes at lower rates would impact anyone earning more than $350,000 per year. Obama’s February budget “calls for letting tax cuts for top earners enacted at the beginning of the decade expire in 2011,” and during the presidential campaign, Obama “favored bolstering Social Security by subjecting family income above $250,000 to the 12.4% payroll tax.”

The New York Times reports Congressional Budget Office Director Douglas Elmendorf told the Senate that healthcare legislation proposed so far “would not curb the federal government’s runaway spending on medical care, and that lawmakers would need to take more forceful action to meet President Obama’s goal of controlling costs.” His testimony “drew criticism from Democratic leaders” and “provided ammunition to Republican critics.” The Wall Street Journal reports Senate Majority Leader Harry Reid “quipped that Mr. Elmendorf should consider running for Congress,” while Senate Majority Whip Richard Durbin “admitted that Senate Democrats were frustrated with the CBO’s various pronouncements over their efforts to push through health-care overhaul.”

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Ever since the government announced it would offer financial rewards of $44,000 to $64,000 to each physician who could show “meaningful use” of a qualified electronic health record, doctors have been wondering what meaningful use means. Today the Health IT Policy Committee, which advises the U.S. Department of Health and Human Services, took a major step toward providing a definition of this term.

The recommendations released by the HIT Policy Committee are not the final word. In fact, they are simply the product of a workgroup, and the committee’s discussion today made it clear that the provisions are subject to change and will be tweaked over the next couple of months. After the committee adopts a definition, it will be submitted to CMS, which will put the definition through its formal rule making process. Even when that’s completed, probably by the end of the year, it will apply only to 2011 and 2012 requests for government subsidies. In 2013 and 2015, the requirements will be significantly expanded.

To what end? The HIT Policy Committee has very grand ambitions. As it states in the preamble to its report, “We recommend that the ultimate goal of meaningful use of an Electronic Health Record is to enable significant and measurable improvements in population health through a transformed health care delivery system.” In other words, the committee members are not just trying to make sure that physicians are using the EHRs for which they’re seeking subsidies; they want to make sure they’re using them to “transform healthcare.”

The pertinent questions are whether what the committee is considering bears any resemblance to 1) the EMRs currently on the market; and 2) the environment in which physicians and hospitals (which will also be subject to the definition) operate. The answer to the first question is Maybe: most of the requirements for 2011 can be satisfied by the leading certified EMRs, but it’s unclear whether more than a handful of them will be able to keep up with future requirements. As for the second question, the ability of physicians to exchange information with providers that use different systems is very limited right now, and some of the other requirements in the future may discourage physicians from acquiring EMRs.

During the discussion period at the committee meeting today, committee member Neil Calman, of the Institute for Family Health, noted that it takes a while for physicians to get up to speed on EHRs and begin to use various components of them. “You can’t open up a patient portal on the day your EMR goes live,” he pointed out. So if the meaningful use criteria for 2013 are too advanced, he said, “A non-adopter will look at those criteria and say, ‘This is not achievable.’”

Calman suggested that as the bar is raised for meaningful use, first-year applicants for government subsidies be allowed to meet the original criteria in that year, and then go through the process of using their EMRs to reach higher goals. David Blumenthal, the national coordinator of health IT, said, “That’s more realistic in some ways.” But a CMS official stepped in and said the law doesn’t allow it. “The meaningful use criteria in 2013 have to be the same whether you’re a first-year or third-year user,” he stated.

That strikes me as a way to guarantee the program will fail. If the law doesn’t make sense, Congress should amend it.

Other committee members expressed reservations about the report. Gayle Harrell, a committee member and former Florida state legislator, pointed out that “this is a very aggressive model.” Some hospitals are taking a long time to roll out health IT to their physicians, she pointed out, and the degree of interoperability varies dramatically from one region to another. “Are we setting goals that are not achievable?” she asked. “I’m afraid we will set ourselves up for failure if we’re not specific and take smaller bites of the apple.”

After the meeting, Blumenthal announced he was asking the workgroup to revise their recommendations over the next month. I just hope that the HIT Policy Committee–perhaps with some input from practicing physicians–considers the issues raised by its members today before it issues its final definition of meaningful use.

Above article published on

http://industry.bnet.com/healthcare/1000806/is-
government-health-it-program-overreaching/

Molly Merrill, Associate Editor

ANNANDALE, VA – President Obama called for fixing the broken healthcare system by building upon investments made in electronic medical records in a town hall meeting held Wednesday.

The town hall was held at Northern Virginia Community College in Annandale, Va., where the president took questions the public 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.”

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The Healthcare Information and Management Systems Society predicts that hospitals will spend $14.4 billion on IT systems through 2014 but that capital spending will remain relatively flat until funding from the federal stimulus package kicks in, Government Health IT reports.

On Tuesday, HIMSS officials discussed their hospital health IT spending projections, which are based on the group’s tracking of more than 5,000 U.S. hospitals.

According to HIMSS, spending on systems — such as electronic health records, computerized physician order entry and clinical decision support — is expected to reach $1.7 billion this year. Hospitals’ IT spending later will increase because of the effect of the federal stimulus package, HIMSS predicts.

Funding Constraints

Mike Davis, executive vice president of HIMSS Analytics, said that hospitals face funding challenges in the near term.

He said that banks are not lending to the hospitals he has talked to, including those that have submitted business plans based on the federal stimulus package. He added that hospital endowment funds have lost 20% to 30% of their value in some cases.

Davis said he hopes to see signs of improvement by the end of the year.

Davis also noted that some IT vendors have begun to offer financial assistance to hospitals. For example, GE announced earlier this week that it plans to offer interest-free loans to hospitals and health care providers, he said.

Conflicting Priorities

Davis said that as funding becomes more available, hospitals will face conflicting investment priorities.

He said that as hospitals continue to pursue EHR projects, they face a January 2012 compliance deadline for HIPAA 5101 transactions and an October 2013 deadline for ICD-10 coding compliance (Moore, Government Health IT, 6/17).

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-Health-IT-Through-2014-HIMSS-Says.aspx