$1.2 Billion Slated for HITECH Priority Grant Programs

By News Staff

Nearly $1.2 billion soon will be available to help the nation’s hospitals, physicians and other health care professionals purchase and use electronic health records, or EHRs, according to an Aug. 20 announcement from Vice President Joe Biden. Money from the Health Information Technology for Economic and Clinical Health, or HITECH, Act priority grant programs, which are funded by the American Recovery and Reinvestment Act of 2009, will start flowing in 2010.

“With electronic health records, we are making health care safer, we’re making it more efficient, we’re making you healthier, and we’re saving money along the way,” said Biden in the announcement. “These are four necessities we need for health care in the 21st century.”

The money will be divided between two programs.

• $598 million has been set aside to establish the Health Information Technology Extension Program, which will allow about 70 health IT regional extension centers to offer technical assistance and guidance to support health care professionals using EHRs.
• $564 million will fund the State Health Information Exchange Cooperative Agreement Program, an initiative designed to help states and other entities establish health information exchange capacity among hospitals and health care professionals.

According to David Blumenthal, M.D., M.P.P., the national coordinator for health IT, the rollout of the programs “represents a critical step forward in laying the groundwork for meaningful use of EHRs.”

“Together, the grants will offer much-needed local and regional assistance and technical support to providers while enabling coordination and alignment within and among states, ultimately allowing information to follow patients anywhere within the health care system,” Blumenthal said in an Aug. 20 update e-mailed to health IT stakeholders and posted on the HHS Web site.

Information about the HITECH priority grants program and application requirements is available online from HHS

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By Anne Zieger

The Agency for Healthcare Research and Quality has announced that it will provide a series of grants totaling $48 million that can be used to develop national patient registries for comparative effectiveness research. Clinical registries are one of a number of approaches to helping providers identify the long-term effects of treatments, along with clinical data networks and other forms of health IT networking.

This is part of a larger $300 million grant and contract package designed to fund comparative effectiveness projects funded by the federal stimulus package. The AHRQ will offer grants to study treatment benefits focused on 14 common conditions, including diabetes, obesity and heart and blood vessel problems.

AHRQ will also seek $74 million in contracts for analyzing and generating evidence, along with $19.5 million to establish an infrastructure for identifying the right treatment issues to focus on as part of comparative effectiveness reviews.

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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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http://www.kaiserhealthnews.org/Daily-Reports/2009/
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

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.

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http://blogs.cqpolitics.com/balance_of_power/2009/07/
obama-defends-stimulus-health.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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http://www.ihealthbeat.org/Articles/2009/7/24/Obama-Continues
-To-Tout-Health-IT-as-a-Key-to-Health-Reform.aspx

Although the federal economic stimulus package allocates billions of dollars to support health IT implementation, it remains to be seen whether the funding will improve health care quality or simply boost sales for health IT vendors, the Dallas Morning News reports.

Under the stimulus law, hospitals and physicians who demonstrate “meaningful use” of electronic health records can qualify for federal incentive payments.

The Obama administration contends that EHRs will allow physicians to better coordinate patient care, reduce medical errors and avoid duplicate testing. Medical errors alone cost the U.S. about $37.6 billion annually, according to the Institute of Medicine.

However, some advocates are concerned that health care providers will be unable to achieve the administration’s goals if meaningful use criteria tie stimulus funding to simply purchasing software.

They caution that such action could benefit health IT software companies at the expense of achieving interoperability and improved patient outcomes.

Conflict of Interest?

The federal stimulus package requires health care providers to purchase certified EHR systems to qualify for incentive payments.

In the past, certification responsibilities fell to the Certification Commission for Healthcare IT, which was founded by the trade group Healthcare Information and Management Systems Society.

Some critics argue that CCHIT is too closely linked with the health IT industry to be designated as the sole certifying body for EHRs.

However, leaders of the commission say CCHIT maintains its independence from health IT firms.

Although commission officials acknowledged that certification thus far has failed to promote EHR interoperability, they said the group is working to support system compatibility. In addition, CCHIT leaders say the commission is beginning to focus on alternative health IT systems and not just those developed by large software vendors (Michaels/Roberson, Dallas Morning News, 7/14).

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http://www.ihealthbeat.org/Articles/2009/7/15/
Questions-Raised-About-Stimulus-Law-Benefits-for-Health-IT-Vendors.aspx

Annie Reyes of Merizo said the Southern Regional Community Health Center has been a lifesaver for her family for decades.

“They’re good people; they do a good job here,” she said yesterday in the waiting room of the Department of Public Health and Social Services center in Inarajan after a doctor’s visit.

Not only are the staff friendly and competent, it saves the family from a long — and expensive — drive to see a doctor, added her husband, Joe Reyes.

More families will be able to be seen at the health center daily after an expansion project breaks ground next week.

An infusion of $718,000 through President Obama’s economic stimulus plan, announced, will help fund the expansion, said Dr. Tony Stupski, medical director and acting administrator for Public Health’s community medical centers in Inarajan and Dededo.

The stimulus plan, signed into law in February, set aside $1.5 billion to fund construction, renovation and equipment purchases at community health centers around the nation.

On Guam, it will help along a project to build a larger lab and pharmacy, more exam rooms, isolation rooms and storage at the 40-year-old Inarajan center, Stupski said.

“The whole idea of it is to increase access,” he said. “If you’ve ever been to the regional medical centers, you know sometimes it’s hard to get in. We’re just trying to expand the number of appointments we have and to see more people.”

The Inarajan center also will expand its emergency services offerings, Stupski added.

“It’s going to be set up so it can be used as an emergency center, so during typhoons people can go there,” he said.

The center provides services such as immunizations, women’s care, minor surgeries and wound repair, tuberculosis testing and therapy, STD and cancer screening, communicable and chronic disease care and community outreach.

During the renovation, the center won’t close, but some services, such as assistance programs, have been moved to other Public Health facilities, Stupski said.

The economic downturn and the rising cost of health care mean many more people around the country are depending on community health centers, Obama said earlier this year.

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http://www.guampdn.com/article/20090701/NEWS01/907010318/1002/
Accessible-health-care–Stimulus-funds-will-expand-health-center

Pulmonary Care of Central Florida is installing a new electronic medical records system — a move that may help it land some of the $19 billion in federal stimulus funds earmarked for health information technology.

The Winter Park medical group, which has one doctor and two nurse practitioners, decided to do so to reduce the amount of space needed for records storage and to save time, said MaryAnn Simmons, the practice’s administrator.

She estimated such systems cost $50,000-$70,000, take about a month to install and up to eight months to master.

It’s unknown how many local doctors use electronic medical records, but Melanie Boscan, executive director of the Orange County Medical Society, estimated at least 20 percent have them — and the rest may be waiting to see how the federal stimulus incentives shake out. “Doctors are a little leery. Until they are all mandated to have a system, you’re not going to see a rush.”

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http://orlando.bizjournals.com/orlando/stories/2009/06/29/story8.html

WASHINGTON – President Barack Obama’s expanded fiscal year 2010 budget signals continued commitment to advancing healthcare IT as a way to cut healthcare costs and save lives.

Obama’s $3.4 trillion federal budget, released May 8, expanded the outline he presented to Congress at the end of February. It includes $879 billion for the Department of Health and Human Services, an estimated $63 billion increase over fiscal year 2009.

The Agency for Healthcare Research and Quality (AHRQ) is expected to receive $372 million to conduct research on comparative effectiveness, prevention and care management, value research, health information technology and patient safety. In addition, the AHRQ will use the funding to support research it conducts with other agencies.
The president’s budget for AHRQ will be in addition to the $1.1 billion allotted for comparative effectiveness research under the stimulus package.

Obama’s plan calls for $635 billion over 10 years as a “down payment” toward health reform. Health and Human Services Secretary Kathleen Sebelius called it “a smart investment.”

“No one should underestimate President Obama’s commitment to getting healthcare reform this year,” she said. “This budget sends a clear message that we can’t afford to wait any longer if we want to get healthcare costs under control and improve our fiscal outlook,” she added. The president has made it clear that he considers health IT as a major aspect of containing costs into the future.

David Blumenthal, MD, National Coordinator for Health Information Technology, said his office is “totally focused” on President Obama’s initiatives to establish healthcare IT. He called health IT “a critical pillar” in the plan to build more quality into American healthcare. Obama’s goal calls for every American to have electronic health records by 2014.

Though Obama clearly has much support, some are not sold. At a Senate Finance Committee hearing May 11, Ranking Member Chuck Grassley (R-Iowa) was skeptical about spending a lot on health reform, including health IT.

“It will be some time before this fairy dust turns to gold,” he said. Grassley did say that President Obama’s leadership would be “essential” in figuring out how to pay for health reform.

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