Posts Tagged ‘HIT’
Tuesday, May 26th, 2009
The Office of the National Coordinator for Health IT (ONCHIT) has released its operating plan for implementing the health IT provisions included in the federal stimulus package. But don’t get your hopes up. The plan is disappointingly brief and lacking in detail . . . more along the lines of “here’s what we’re going to do once we get started.” C’mon people! The clock is ticking!! Get with it.
Sadly, it’s looking more and more like the HIT provisions of ARRA will not have their intended effect: stimulating the economy. By the time ONCHIT releases its rules and guidelines, the absence of which has frozen EHR implementations, the U.S. economy will be well on its way to recovery. Sadder still, legislation that was designed to create spending has actually slowed spending.
Once again, the best laid plans of governement have gotten sidetracked in bureaucracy. Maybe we should save these EHR incentive dollars until a more considered plan can be developed.
You can view ONCHIT’s Operating Plan here.
Tags:ARRA, Certification, EHR, EHR Incentives, EHR Reimbursements, Emr, EMR Reimbursements, HIT, HIT Incentives, HIT Stimulus Package, Meaningful Use, ONC, ONC Operating Plan, ONCHIT, ONCHIT Operating Plan, Operating Plan, Stimulus Package
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Tuesday, March 31st, 2009
Interesting post by David C. Kibbe over at The Health Care Blog entitled “Why Clinical Groupware May Be the Next Big Thing in Health IT”. You can view the post here.
Could the Clinical Groupware movement produce meaningful small scale optimization of health information (less expensive, easier to use, rich portability) that would replace today’s large scale mayhem (prohibitively expensive, difficult to use and maintain, no portability)?
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Tags:Clinical Groupware, HIT, HIT Trends, Trends
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Monday, March 30th, 2009
The California HealthCare Foundation and Forrester Group have just released the following issues brief: “Lessons from Amazon for Health Care and Social Service Agencies”.
In my opinion, if we’re going to make any rapid progress toward meaningful exchange of health care information, including interoperability considerations, we need to continue to think along these lines. What do you think?
You can view the document here.
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Tags:Amazon, EHR Interoperability, EMR Interoperability, Health Care Information, Health Care Service Oriented Architecutre, Health Care SOA, HIT, HIT Interoperability, Service Oriented Architecture, Sharing, Sharing of Health Care Information, SOA, SOA Health Care
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Friday, March 6th, 2009
Sierra Systems (British Columbia) has issued a white paper comparing the national health care information technology initiatives of Canada and the United States. Worth a read.
You can view the white paper here.
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Tags:Approach To EHR, Approach To EMR, Canada, EHR, EHR Lessons Learned, EHR Policies, Electronic Health Record, Electronic Medical Record, Emr, EMR Lessons Learned, EMR Policies, Health Information Technology, HIT, HIT Policy, United States
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Monday, February 9th, 2009
View the February 20, 2009 UPDATE to this post here.
Despite a vote to occur within the Senate in less than 24 hours, the text of consolidated Senate revisions to HR1 is not yet available. However, this from the United States Senate website, updated February 9, 2009. Presumably, this is the most recent (current) version of the Senate amendment affecting incentives available to EHR adopters.
Senate Amendment 570 to HR1 (scroll down to S.A.570) still contains the following language, verbatim, from HR1 regarding incentives for provider adoption of EHR:
“(B) LIMITATIONS ON AMOUNTS OF INCENTIVE PAYMENTS.–
“(i) IN GENERAL.–In no case shall the amount of the incentive payment provided under this paragraph for an eligible professional for a payment year exceed the applicable amount specified under this subparagraph with respect to such eligible professional and such year.
“(ii) AMOUNT.–Subject to clauses (iii) through (v), the applicable amount specified in this subparagraph for an eligible professional is as follows:
“(I) For the first payment year for such professional, $15,000 (or, if the first payment year for such eligible professional is 2011 or 2012, $18,000).
“(II) For the second payment year for such professional, $12,000.
“(III) For the third payment year for such professional, $8,000.
“(IV) For the fourth payment year for such professional, $4,000.
“(V) For the fifth payment year for such professional, $2,000.
“(VI) For any succeeding payment year for such professional, $0.
So, despite the headlines depicting broad HIT spending cuts by the Senate, it appears this little chunk of spending will be carried forward into the compromise bill.
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Tags:2009 Senate Stimulus Bill, Differences Between House And Senate Stimulus Bill, Economic Stimulus Bill Text, EHR, Emr, HIT, Incentives, Politics News, Read Senate Stimulus Bill, Senate Bill, Senate Bill - s. 336, Senate Bills, Senate Stimulus, Senate Stimulus 2009, Senate Stimulus Bill, Senate Stimulus Bill 2009, Senate Stimulus Bill Full Text, Senate Stimulus Bill Text, Stimulus, Stimulus Bill, Stimulus Bill Full Text, Stimulus Bill List, Stimulus Bill Text, Stimulus Bills, Stimulus Package, Stimulus Package Full Text, Stimulus Package Text, Text Of Senate Stimulus Bill, Text Of Stimulus Bill, Us Senate Stimulus, Us Senate Stimulus Bill
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Friday, February 6th, 2009
Last month, AHRQ issued a solicitation for proposals for multiple IDIQ/Task Order contracts through which individual Task Orders will be awarded to maintain, serve, and support the AHRQ National Resource Center for Health Information Technology.
Today, AHRQ announced that it has modified the ceiling amount for all contracts (including options) to $300 Million instead of the previously stated $75 Million. Individual ceiling amounts will be established for each base contract awarded based on the anticipated level of work required under each of the following four domain areas:
1. Support for HIT Program Management, Guidance, Assessment and Planning
2. HIT Technical Assistance, Content Development, Program Related Projects and Studies
3. HIT Dissemination, Communication and Marketing
4. HIT Portal Infrastructure Management and Website Design and Usability Support
In addition, AHRQ has extended the due date for receipt of proposals to February 26, 2009, at 12:00 PM EST. Also listed in the amended solicitation are responses to questions that have been received as a result of the Requests for Proposal. View the amended solicitation.
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Tags:Agency for Healthcare Research and Quality, AHRQ, Bid Solicitation, Bids, HIT, HIT Communication and Marketing, HIT Content Development, HIT Dissemination, HIT Portal Infrastructure Management, HIT RFP, HIT Website Design and Usability Support, IDIQ/Task Order ontracts, Open HIT RFP, Open HIT RFPs, Support for HIT Program Management
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Thursday, February 5th, 2009
View the February 20, 2009 UPDATE to this post here.
ASP EMR To Gain Preference? – According to Bloomberg News, the economic stimulus bill approved by the House last week favors health IT firms that operate on an application service provider model over software vendors.
ASP Less Expensive Up Front – The House’s $819 billion economic stimulus package includes $20+ billion for health IT. The bill would provide financial incentives to physicians over time, rather than upfront, lump sum payments. This means doc’s and hospitals will likely opt for a less-expensive ASP EMR solution, versus investing in a locally-installed software package that is relatively more expensive to buy. Or so Bloomberg’s logic goes.
I Don’t Necessarily Agree – On the surface Bloomberg’s logic seems sound, but let’s face it. There’s a lot more to an EMR buying decision than initial cost.
Internet Interruptions – If I’m a doc’, and I’m about to make the leap to managing my practice electronically, I’m certainly going to think about the reliability of the sytem I choose. What if my internet connection goes down, or the speed of my connection bogs down to a snail’s pace? Am I supposed to stop seeing and scheduling patients, and stop prescribing their med’s, until my connectivity is restored?
Security – With all of the state and federal onus placed on practitioners and healthcare facilities to protect and secure patient health information, is it wise to allow such information to vaporize into the web cloud? I would love to see the indemnification provisions contained in an ASP EMR license agreement and the ASP’s terms of service. If anyone has an example, please do forward it on.
Long-Term Value – The fee basis for many ASP EMR arrangements is tied to revenue. Is it better to make a somewhat larger investment upfront, depreciate it over several years, and own it outright? Or, better to make the smaller upfront investment and share revenue indefinitely? I think many EMR buyers will opt for ownership and control of their EMR system.
Initial Costs – Lastly, another flaw in the Bloomberg analysis is the fact that locally-installed EMR systems (software versus ASP) are just not that expensive. You license the software, maybe buy some additional hardware, and it’s off to the races. For a small office practice, initial cost estimates for an EMR system vary from $3,000 to over $40,000. Certainly, wise buyers will do just fine with investing at the smaller end of this range. In the current House bill, independent (not hospital-based) providers can receive up to $15,000 in 2009, and a lesser amount each year thereafter, during a total incentive period of five (5) years. In my mind, the current incentive figures are more than adequate to support purchase of a locally-installed EMR system.
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Tags:ASP EHR, ASP EMR, ASP EMR Better Than EMR Software, ASP EMR Security, Economic Stimulus Package, EHR, Emr, EMR Software Versus ASP, Health Information Technology, HIT, Stimulus Package Favors ASP EMR Solutions
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Wednesday, February 4th, 2009
View the February 20, 2009 UPDATE to this post here.
UPDATE – See the February 9, 2009 UPDATE to this post here.
As the Senate works on its version of the Economic Stimulus Bill, CongressDaily is reporting the following amendments to the House version of the bill.
Reduce HIT Spending – So far, a reduction of the amount of HIT spending and incentives has not been attacked in the Senate. Good news for those of us who work within and touch HIT.
Health Care Disparities – In an effort to eliminate healthcare disparites, this amendment would require that electronic health records collect information on race, ethnicity and gender.
Health Privacy Violations – Changes would allow state attorneys general to file class-action lawsuits against violators of federal health privacy laws, and prohibit states from hiring outside lawyers on a contingency basis to ensure that damages collected are returned to taxpayers.
Data Breach Notification – Changes are aimed at closing loopholes that would in many cases prevent consumers from knowing if their medical information has been improperly accessed.
Quality Initiatives – An amendment that would exempt quality initiatives, such as disease management and care coordination efforts, from a provision that requires the HHS secretary to issue new health care operations rules.
So, thus far, all good news in terms of maintaining substantial funding for HIT. This happens to be the objective that I care about most right now–a good chunk of HIT spending that is cemented into the final bill. We can worry about the peskier of details later, in my opinion.
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Tags:Economic Stimulus Bill, Economic Stimulus HIT, EHR, Emr, HIT, HIT Incentives, HIT Spending, Medicare HIT Incentives, Reduce HIT Spending, Senate Amendments, Senate Version Of Bill
Posted in Healthcare IT | 1 Comment »
Thursday, January 29th, 2009
View the February 20, 2009 UPDATE to this post here.
UPDATE – See the February 9, 2009 UPDATE to this post here.
The House version of the Stimulus Bill passed on January 28, 2009 and is worth some $819 Billion. The Senate will vote on its version of the bill next week, which is worth close to $900 Billion and includes an additional $3 Billion for HIT.
Funding That Will Become Available
The bill creates the “Health Information Technology for Economic and Clinical Health Act” or the “HITECH Act”. You can view the approved House version of the HITECH Act here (scroll down to Page 30).
Independent Professionals
Under the HITECH Act, “eligible professionals” (which does not include “hospital-based professionals”) who are “meaningful EHR users” can receive up to $41,000 over five (5) years. (Section 4311)
Hospital-Based Professionals
“Hospital-based professionals” are not excluded from incentive payments, but their eligibility and maximum incentives will be extablished through subsequent rulemaking. (Section 4311)
Hospitals
“Eligible hospitals” that are “meaningful EHR users” will receive a “base amount” ($2 Million) plus a “discharge amount” (based on annual Mecidare discharges), times a “transition factor” applied over five (5) years. The transition factor starts at unity (1) for the first year, and declines to zero (0) in the fifth year. (Section 4312)
Positive Effect
There will always be naysayers and detractors, but to me these are substantial sums, and they demonstrate the federal government’s commitment to HIT (though mixed with its commitment to economic stimulus). These monies will no doubt save many HIT jobs–not just within hospitals and clinics, but across HIT vendors and consultancies–and in the best of worlds, the dollars may be sufficient to create new HIT jobs over time.
NOTE: The figures above are based on my quick read of the House version of the HITECH Act, which has not yet been enacted. My interpretation of this version may not be accurate, and in all events, all of its provisions are subject to further revision and amendment prior to enactment.
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Tags:4311, 4312, Economic Stimulus, EHR, Eligible Hospitals, Eligible Professionals, Emr, Health Information Technology, HIT, Meaningful EHR User, Meaningful EMR User, Medicare, Stimulus Bill
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Thursday, January 22nd, 2009
View the February 20, 2009 UPDATE to this post here.
UPDATE – See the February 9, 2009 UPDATE to this post here.
The House Appropriations Committee approved a $358 billion portion of an economic stimulus package that includes funds for healthcare IT. Of this total amount, roughly $20 Billion has been earmarked for IT-related healthcare spending.
Earlier announcements tied a good portion of the the $20 Billion to Medicare and Medicaid providers to improve their EMR platforms. Regardless of how these dollars are ultimately targeted and spent, this is good news for HIT professionals.
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Tags:Economic Stimulus Package, Emr, Healthcare IT, Healthcare IT Spending, HIT, HIT Job Market, HIT Spending, House Appropriations Committee, Medicaid, Medicaid Providers, Medicare, Medicare And Medicaid, Medicare Medicaid, Medicare Providers, Plan House, Platforms, Stimulus Plan
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