The Politics of Health Care : Technology

Preparing for a Hurricane That May Blow Over

Frank Irving — Tue, 24 Nov 2009 01:50:00 GMT

Physicians must be educated on proper documentation to meet ICD-10 code-set specificity and payer-coverage policies. Guest commentary from Holly Louie, RN, CHBME, PCS, corporate compliance officer at Practice Management, Inc., in Boise, Idaho The reimbursement...(read more)

Achieving Meaningful Use

Frank Irving — Tue, 17 Nov 2009 16:33:00 GMT

Guest commentary from Celwyn C. Evans, a senior partner at Greencastle Associates Consulting in Malvern, Pa. With the passage of the American Recovery and Reinvestment Act (ARRA) and the Health Information Technology for Economic and Clinical Health (HITECH)...(read more)

Building a Foundation for Health Care Transformation

Frank Irving — Thu, 12 Nov 2009 15:56:00 GMT

Evidence-based medicine will improve the quality of care and impact of each health care dollar spent. Guest commentary from Marc Perlman, g lobal vice president, Healthcare and Life Sciences Industry, Oracle The U.S. health care industry is challenged...(read more)

MGMA Pleased with House Vote on Health Reform

Frank Irving — Mon, 09 Nov 2009 17:56:00 GMT

Guest commentary from William F. Jessee, MD, FACMPE, president and CEO of the Medical Group Management Association The Medical Group Management Association (MGMA) is pleased that the House has voted favorably on H.R. 3962 (The Affordable Health Care for...(read more)

'More is Better' Only Applies to Technology

Frank Irving — Mon, 21 Sep 2009 15:28:00 GMT

Guest commentary by Andrew Schuyler, chief medical officer at MEDecision. In a recent article on the San Francisco Chronicle 's Web site, Dr. Deepak Chopra speculates that a lot of what's wrong with health care today can be attributed to the false notion...(read more)

Health Care Reform

Frank Irving — Tue, 08 Sep 2009 16:10:00 GMT

Guest commentary by Ward Keever, executive director of executive services for CTG HealthCare Solutions. Mr. Keever serves on ADVANCE's editorial advisory board. The hot topic for this summer has been health care reform. It has consumed our Congress as...(read more)

Patient Safety: Getting the Name Wrong May be Fatal

Frank Irving — Thu, 13 Aug 2009 14:48:00 GMT

Guest commentary by Dr. Bruce Lambert, University of Illinois at Chicago professor, Department of Pharmacy Administration, and president, Pharm I. R., Inc.; and Dr. Leonard A Shaefer, IBM chief scientist, Global Name Recognition After taking Flomax, used...(read more)

E-prescribers Pass 100,000 Milestone

Frank Irving — Fri, 24 Apr 2009 17:46:00 GMT

Surecripts, operator of the nation's largest electronic prescribing network, reported on April 22 that more than 100,000 prescribers are now routing prescriptions electronically in the United States. Surescripts made the announcement in conjunction with...(read more)

Keeping Digital Medical Records Secure

Frank Irving — Fri, 17 Apr 2009 20:27:00 GMT

By now, just about everyone in the industry knows that the American Recovery and Reinvestment Act (ARRA)'s provisions include more than $20 billion in funding for technology investments by health care organizations. However, some of the deeper implications...(read more)

Will the Weight of EMRs Break IT?

Frank Irving — Thu, 09 Apr 2009 20:53:00 GMT

Guest commentary from Alex Adamopoulos, executive vice president and COO of Exigen Services Pulling together as a nation to overhaul an aging, often paper-based medical records system is long overdue. We can all agree it will create jobs, pump money into...(read more)

For EHR Implementation, the Time to Act is Now

Frank Irving — Thu, 26 Mar 2009 18:37:00 GMT

Guest commentary from Thomas L. Pettibone, founder and managing partner of Transition Partners. President Obama's economic recovery package allows for billions of dollars for health care IT investment. As the recovery package begins to be distributed,...(read more)

EHR Rework Ahead

Frank Irving — Wed, 25 Mar 2009 15:27:00 GMT

A large majority of readers -- 65 percent -- who answered ADVANCE 's online opinion poll during the past month said they need to rework their existing EHR plans in light of the HIT provisions of the recently enacted American Recovery and Reinvestment...(read more)

Change Can’t Happen with Technology Alone

Frank Irving — Tue, 03 Mar 2009 16:39:00 GMT

Guest commentary by Michael L. Cowan, MD, chief medical officer at BearingPoint and former surgeon general of the U.S. Navy

It's official. The economic recovery package has been signed and $19 billion is marked for health information technology. But, before we can fix anything or facilitate technology adoption, we need to understand the major shifts and changes that are occurring in health care today.

Since President Bush's call to action in 2004, the government has made some progress with electronic health records and regional health information exchanges. These are good first steps, but advances in technology and changing values in our society mean our industry must become more agile to accomplish the radical transformation the industry needs to undergo. The rapid increase in consumer uses of Web 2.0 for health care information and community-building has changed the nature of the doctor-patient relationship and the way health care is consumed today. At the same time, the increasing amounts, depths and accessibility of medical knowledge have necessitated a change in thinking about the way medicine is taught and will be delivered in the future.

From a consumer perspective, the Internet has democratized health care. Access to vast quantities of vetted, actionable and reliable health care information has shifted the "power of knowledge" from the doctor to the patient. In earlier generations, only doctors had the latest medical information or experience managing disease. Now, people are constantly "plugged-in" and can easily search online for health care information. They also can access social networks of people with similar ailments with whom they can share their collective wisdom. This has irrevocably changed the nature of a doctor's relationship with patients. As part of health care reform, the new Secretary of Health and Human Services will need to think about how we can change the structure and policies of health care to acknowledge this and monetize the automated, online or virtual service models that consumers are demanding.

Furthermore, unlike past generations, today's patients have become more empowered and active in managing their own wellness. Web-focused, techno-savvy health care consumers are more willing to store personal or private information online in the hope of speeding progress for cures. Many now create and manage their own personal health records online. Hopefully, the new Secretary will work with President Obama to help cultivate this consumer grassroots movement to personal health records with the right incentives, standards and economic policies.

From a medical perspective, the recent completion of the Human Genome project will enable a new frontier in personalized medicine. The study of genomics has progressed to the point where experts can not only identify more than 20,000 individual genes in a human's DNA, but also how they relate to drug treatment. This advanced medical knowledge, combined with improved information access, will enable preventative and diagnostic care to match unique personal genetic characteristics. The impact of this is that future drugs will be tailored to an individual's genetic composition and history, making them more effective in treating diseases in each individual. However, before we achieve this goal, personalized health care will require many factors -- both diagnostically and therapeutically -- to be managed in a completely different way from the past.

With these trends in mind, I hope the new administration understands people are increasingly thinking of health care as a consumer service. Today's patients comparison shop and have become "prosumers." They not only choose their own care, but also produce vital information in the process. As a result of this health care consumerism and the rise of the Web, doctors will act more and more like consultants as the main mode of doctor/patient communication transitions to the Internet instead of a visit to the doctor's office. Thus, virtual management of patient conditions will become increasingly common. I hope the administration keeps these trends in mind and works toward enabling a future in which personalized healthcare and mass customization of treatments becomes a reality.

I am hopeful the administration will approach health care reform with an open mind, listening to alternative views, embracing current realities and facilitating positive change. If so, we will all benefit from a new frontier in health care in 2009 and beyond.

Consumers Need All of the Facts in the Privacy Debate

Frank Irving — Thu, 26 Feb 2009 18:06:00 GMT

Guest commentary by David St. Clair, founder and CEO, MEDecision

The economic stimulus package that President Obama has signed contains upwards of $20 billion to create electronic health records for most Americans within five years. The president has been very outspoken in his belief that EHRs are essential to health care reform and that the subsequent savings they'll generate will help to strengthen the larger overall economy.

Whenever the subject of proliferating EHRs catches the national spotlight, you can bet that debates about privacy aren't far behind. Indeed the privacy issue has already started to gain some traction in the media. In this video clip, CNN's Campbell Brown and Elizabeth Cohen examine how easy it is for someone to obtain private medical information online by simply using someone's Social Security number and date of birth.

While this assessment may be accurate, it's a bit light on the fairness scale. Brown and Cohen only make brief mention of facts like President Obama's plan to appoint a chief privacy officer and to implement unprecedented privacy controls to safeguard the EHR transformation. Instead they emphasize the more sensational angle implying that electronic health information just isn't safe. They also seem to downplay the fact that a simple thing like creating a password can protect one's private information.

I suspect the privacy issue is going to reach a crescendo in the coming months, and it's very important that Americans have all of the facts. There are unfortunately people in the world who are going to try to illegally obtain and misuse private health information. But that doesn't mean we should just write off EHRs as a bad idea. We simply need to be vigilant and proactive in incorporating the highest security measures into the planning process -- which the president has done. To borrow an analogy from a close colleague: We don't stop building roads because some people drive drunk. We punish the drunk drivers and continue building roads because of the tremendous benefits they bring to the rest of our law-abiding society. There is too much at stake for the health care system and the nation's economy to allow over-dramatized and misperceived weaknesses in EHR security to thwart progress.

Additionally, to make the privacy debate a fair one, we must ask what's more dangerous: the potential misuse of information or simply not using information at all? Should we put the privacy of an overwhelming minority of people ahead of safer, more efficient, more affordable and potentially life-saving health care for the overwhelming majority? In reality, the only people who stand to be harmed by an unlikely EHR privacy breach are celebrities and other high-profile individuals. Even if someone were to gain access to the average person's health information, there isn't much they could do with it, other than cause that person some personal embarrassment. In a very real sense, the question then becomes whether we value the privacy of information more than its potential to help us lead healthier lives.

Without question we must make ensuring privacy a top priority in any plans to implement EHRs. I'm confident that the Obama plan does so and, in fact, I think we'll see even stronger controls than we may have previously imagined. No EHR is going to come with guaranteed safety, but I would argue that the risk level is the same or less than that associated with online retail and banking transactions. The public needs to understand this. It is up to those of us in the industry to ensure that the facts are clear and readily available. Hopefully the media will choose to report all of them so that Americans can form opinions based on complete information.

States Tripled Number of HIT Bills Enacted in 2007-08

Frank Irving — Wed, 17 Dec 2008 18:21:00 GMT

According to a report released last week by the bipartisan National Conference of State Legislatures (NCSL), lawmakers around the country introduced more than 370 bills relating to health information technology (HIT) during an 18-month period between 2007 and 2008.

The report noted that 132 bills containing HIT provisions were enacted in 44 states and the District of Columbia during the 2007-08 period studied by NCSL. That was a three-fold increased in bills enacted compared to the same period from 2005 to 2006, NCSL researchers said.

The only states that did not enact bills with HIT provisions during the 2007-08 period were Arkansas, Kentucky, Mississippi, Nebraska, South Dakota and Wyoming, according to the report.

The majority of the bills relate to financing and planning efforts, NCSL noted.

Six states enacted comprehensive measures aimed at protecting patient privacy while facilitating the exchange of health data:

Indiana SB 511 (enacted 5/2/07)
Massachusetts SB 2863 (enacted 8/10/08)
Minnesota HB 1078 (enacted 5/25/07)
Rhode Island HB 7409 (enacted 7/10/08)
Texas HB 1066 (enacted 6/15/07)
Vermont HB 229 (enacted 6/5/07)

Click here to access the entire report.