News

Medicare law offers IT incentives

Anne Zieger — Sun, 20 Jul 2008 15:30:23 -0400

Last week, physicians sighed with relief as the threatened 10.6 percent Medicare cut was put on hold for 18 months despite a presidential veto. The bill didn't just protect physician reimbursement levels, however. It also included incentives for doctors to get more wired. Critics remain skeptical that such incentives will get physicians off the fence, but this is at least a start. Until now, no one on the Hill seemed to be able to agree on an approach.

The new law offers Medicare incentives for doctors who adopt healthcare IT as well as those who use e-prescriptions--a move proponents said could ultimately help cut medication errors and healthcare costs generally. The bill also expanded the list of telehealth originating sites (sites qualified to get paid for initiating a telehealth transaction) to include hospital-based renal dialysis centers, skilled nursing facilities and community mental health centers.

To learn more about the legislation:
- read this Healthcare IT News piece

Related Article:
Bill halting MD Medicare cuts approved by Congress

Case study: Kaiser rethinks IT in building new hospital

Anne Zieger — Sun, 20 Jul 2008 15:19:35 -0400

Kaiser Permanente is well along the way on its plans to build a new, 314-bed hospital in Fontana, CA--but this time, it hopes to do something different. Not only is Kaiser focused on building a green building, it's also taking this chance to rethink how it handles its entire IT infrastructure. The new project will cost $700 million overall, including building, green modifications and new IT options. While Kaiser hasn't broken out the numbers, it's likely that this figure will include substantial money for IT investment, as Kaiser has pretty expansive plans.

The new hospital, of course, will be hooked up with Kaiser's Epic EMR installation, dubbed Health Connect. Health Connect terminals will be available at the bedside through computers with cards connected wirelessly to the network. But it plans to go well beyond that. For one thing, Fontana Medical Center will include a digital OR communication system offering real-time access to clinical data and images from varied system. Kaiser is also including digital radiology rooms, whose digital images will be available on demand to physicians, a patient monitoring system allowing for easier information sharing between teams, and many other upgrades.

To learn more about this project:
- read this Healthcare IT News article

Related Articles:
Kaiser IT controversy fells top exec
Kaiser's EMR facing state investigation

VT funds EMR adoption with health plan tax

Anne Zieger — Sun, 20 Jul 2008 13:26:33 -0400

In a move that may be the first of its kind in the country, Vermont legislators have created a trust--funded by a quarterly tax on health plans--that will provide support for healthcare providers who want to implement EMRs. The fund will also support the further development of a statewide HIE and kickoff of a new medical home project. Over the next five years, the fund is expected to help physicians boost EMR use from 13 percent to 50 percent.

Health plans, which will be required to submit their first payment on October 1, will choose between paying two-tenths of a percent on all healthcare of the previous quarter's claims for their Vermont members, or a fee based on proportion of last year's overall claims. All told, this should raise $32 million over the next seven years, state officials project.

Leaders of Vermont Information Technology Leaders, the non-profit public-private partnership that runs the state's HIE, will manage the trust. Physicians will be able to apply to VITL or state government to get funding. State leaders are particularly focused on getting funding to about 300 independent physicians who aren't affiliated with a hospital or large group practice and tend to get lower reimbursements.

To learn more about the fund:
- read this Government Health IT News piece

Study: U.S. behind other countries in EMR use

Anne Zieger — Sat, 19 Jul 2008 23:24:23 -0400

A new study suggests that the U.S. isn't just adopting EMRs slowly, but we're doing it more slowly than other countries. The study by the Commonwealth Fund concluded that at current adoption rates, it will take more than 30 years to get clinical-support tools to all U.S. doctors. While EMR use in the U.S. grew to 28 percent in 2006 vs. 17 percent in 2001, that's still well behind other countries. For example, 98 percent of practices in the Netherlands are using EMRs that are more likely to have advanced clinical functions allowing for HIE connectivity, while New Zealand has an EMR adoption rate of 92 percent.

The same study concluded that the U.S. healthcare system's problems haven't improved since 2006, when the group's first National Scorecard was released. For example, it notes that 42 percent of U.S. adults, or more than 75 million citizens, were uninsured or underinsured during 2007. That's up from 35 percent in 2003.

To learn more about the study:
- read this Modern Healthcare article
- read this Commonwealth Fund analysis

Related Articles:
California MDs lead in EMR adoption
CMS to offer EMR adoption incentives
Want shared EMRs? Drop the technology debates
NY gives free EMRs to some physicians

Seattle system will pay $100K HIPAA fine after repeated breaches

Anne Zieger — Sat, 19 Jul 2008 22:56:35 -0400

A Seattle-based health system has agreed to pay a $100,000 HIPAA fine to HHS--as well as improve its medical data security--after failing to properly secure data backup tapes, disks and laptops. This marks the first time HHS has agreed to a Resolution Agreement. During 2005 and 2006, medical data was stolen from Providence Health & Services several times, with backup tapes, optical disks and laptops being lost or stolen repeatedly. All told, the unencrypted personal health information of more than 386,000 patients was compromised.

In light of these incidents, the health system will now revise its policy on transporting patient records outside of company buildings, and it will improve employee training. It will also undergo security monitoring by the feds, and turn in report on data security measures for three years.

The fine that will be paid by Providence is actually fairly unusual, as very few HIPAA fines have actually been imposed to date. However, its security issues are also unique. While many health organizations have lost a single laptop or backup tape to theft or disorganization in recent years, I haven't encountered any that have actually had to report multiple losses. That might explain why federal monitors took a particular interest in this organization's troubles.

To learn more about the HIPAA settlement:
- read this Seattle Post-Intelligencer piece
- read this Briefings on HIPAA article

Related Articles:
IT staffer fired after data theft, sues hospital
Tenet warns of potential data theft
VA pledges better data security
Johns Hopkins investigates data breach

SPOTLIGHT: CBO: Medicare pay, health IT use should be linked

Anne Zieger — Sat, 19 Jul 2008 01:17:58 -0400

Much of the discussion on Capitol Hill on how to foster health IT adoption has focused on using tax credits or federal subsidies to entice doctors. But according to at least one powerful Hill player, these aren't the government's best options. This week, Congressional Budget Office director Peter Orszag told members of the House that linking health IT use to Medicare reimbursements would work much better, arguing that subsidies only nudge along physicians who are already close to investing. Article

Hospital dev continues on Second Life; Senate discuss health IT's role in reform;

Anne Zieger — Sat, 19 Jul 2008 01:00:29 -0400

> Palomar Pomerado Health of San Diego, CA, which plans to open a new high-tech hospital in 2011, is getting a lot of mileage from its virtual model of the new hospital on Second Life. Article

> This week the Senate Finance Committee held another hearing on the subject of preparing for health reform--including a discussion of the role health IT will play. Article

> Boston's Brigham and Women's Hospital has signed a deal with LodgeNet Healthcare that will provide educational videos, movies, music to patients at the bedside. Article

> A new poll by Harris Interactive has found that 9 million Americans believe that their health data has been lost or stolen at some point. Article

And Finally... I told you that baby was holding out on us. Article

Study: Top health IT initiatives listed

Anne Zieger — Sun, 13 Jul 2008 12:15:52 -0400

According to a new study sponsored by healthcare IT company Logicalis, data storage is the top driver for many hospital and healthcare IT projects underway right now. However, when it comes to the projects themselves, predictably, EMRs are in the lead, according to the study, which names the top 10 IT initiatives being undertaken by healthcare organizations. The remainder of the list includes disaster recovery; medical archiving systems; storage consolidation/virtualization; backup; business intelligence; PACS; health IT infrastructure; compliance and the security of personal health information.

What's interesting about these conclusions is that they differ in some respects from those drawn by a status released by HIMSS in April. For one thing, HIMSS respondents said that improving safety and reducing errors were key drivers of IT investment. Also, it's worth bearing in mind that according to HIMSS results, security breaches still seem to be rather common within healthcare organizations, with 18 percent of respondents having seen a breach within the past six months. If patient safety and security are key drivers, that takes one down a different road than projects driven by storage. I'm not sure how to reconcile these results--readers, what do you think?

To learn more about the study:
- read this Healthcare IT News piece
- read the Logicalis press release

Related Articles:
HIMSS: Patient safety top reason for IT investment
Study: Hospital execs stress IT investment for coming years
Study: Nursing point-of-care IT can interfere with workflow
Study: Better health IT could give nurses more patient time

NJ Blue plan invests $500K in med history tech for hospitals

Anne Zieger — Sun, 13 Jul 2008 11:48:34 -0400

Horizon Blue Cross Blue Shield of New Jersey has set aside $500,000 to help some of the hospitals in its network bring up electronic medical history technology. Early registrants for the program include Chilton Memorial Hospital of Pompton Plains, NJ, which will receive 85 percent of the costs of the technology--up to $40,000--for participating in the network. To roll out its part of the effort, Chilton will use technology vendor DrFirst's RcopiaAC system. During the remainder of 2008, as many as eight hospitals are expected to join the Blue plan's program. Amounts given to the various hospitals will vary.

Horizon believes that it is the first health plan in the U.S. to offer such a program. Even if that's true, however, it's unlikely to be alone for long. Health plans have a tremendous incentive to help hospitals avoid medication errors, which are costly, damaging and frequently, avoidable.

To learn more about this project:
- read this Healthcare IT News piece

Related Articles:
Study: Bar codes may not fix medication mistakes
Study: E-prescribing cuts med errors 66%
Nursing home drug errors remain hidden
Joint Commission issues warning on child med errors

SC plans to launch Medicaid HIE

Anne Zieger — Sun, 13 Jul 2008 09:28:30 -0400

South Carolina officials have set plans to launch a health information exchange for the state's 700,000 Medicaid patients. The South Carolina Health Information Exchange, known as SCIEx, will connect hospitals, doctors, clinics and other healthcare providers with access to Medicaid beneficiaries' medical records. It was paid for by HHS, which contributed $250,000 to implement the system. It's also backed by the South Carolina Hospital Association, the South Carolina Primary Care Association and several state agencies.

The SCIEx system includes a records locator service along with a system that links disparate health databases. Providers will now have access to a broad medical history on patients, including diagnoses, medications and test results. Officials say this will be particularly helpful for beneficiaries who live in rural areas and may only get sporadic care or see varied doctors, as it will make sure that their histories travel with them. They also note that the new HIE should save money for the state, since it will avoid a wide range of paper, printing and storage costs.

To learn more about the HIE:
- read this article from The Greenville News

Related Articles:
Study: RHIOs/HIEs backed by states will win
Study: 75 percent of states developing HIEs
NJ set to move ahead with statewide HIE plans
Minnesota backs statewide HIE

CA bill proposes prescription drug tracking requirement

Anne Zieger — Sun, 13 Jul 2008 02:18:34 -0400

A bill that would require cradle-to-grave drug tracking in California has sparked extensive debate in the state, with critics contending that the new requirements could impose tens of millions in new costs on pharmacies annually. Drugmakers including Pfizer, Bristol-Myers Squibb and Teva Pharmaceuticals, along with pharmacy chain Rite-Aid, have all voiced opposition to the bill--and drugmakers have asked to be excluded from its requirements

The bill would require providers and pharmacies to track drugs with electronic technology or bar codes from when they are manufactured from when they are sold in a pharmacy. The concept, known as "e-pedigree," was originally sponsored by the California Board of Pharmacy. Now, Board's parent agency, the Consumer Services Agency, actually opposes the bill as it is currently written. The CSA wants to see it amended to delay the deadline for deploying e-pedigree technologies from 2011 to 2015.

Vendors are clearly ready to support this approach, however. For example, IBM announced a offering last year allowing pharmaceutical companies to create electronic certificates of authenticity (the basis for e-pedigree approaches) as part of its WebSphere RFID Information Center, a data repository allowing users to manage and share information with trading partners.

To learn more about this bill:
- read this iHealthBeat item

E-prescribing rules for controlled meds include strict monitoring

Anne Zieger — Sun, 13 Jul 2008 01:22:05 -0400

While the Drug Enforcement Administration has finally proposed a rule allowing e-prescribing for controlled drugs, everyone involved will be required to comply with a boatload of regulations if they want to participate. The rules, which allow physicians to e-prescribe drugs like OxyContin and Vicodin, impose new regulations on doctors, hospitals and pharmacies that want to participate. Not only would doctors have to register in person with law-enforcement officials, but they'd also have to allow routine audits of their prescription records. Pharmacists, meanwhile, would have to verify weekly that doctors doing the prescribing remain licensed and in good standing, keep digital records of the controlled drug e-prescriptions and notify the DEA within 24 hours if a security violation occurs.

The DEA's rules are still in draft form for the time being, however. At the moment, federal rules now ban the e-prescription of controlled drugs, which make up about 10 percent of all prescriptions written by doctors.

To learn more about the rules:
- read this Modern Healthcare article (reg. req.)

Related Articles:
DEA eases painkiller prescription rules
DEA may allow e-prescribing of controlled substances
DEA allows e-prescriptions for controlled drugs

FDA improves Intel-made home monitoring device; House members debate EMR privacy;

Anne Zieger — Sat, 12 Jul 2008 13:16:49 -0400

> The FDA has approved a new system from Intel designed to support home monitoring of chronically-ill patients. Article

> House members continue to debate a bill creating a national electronic medical record system, with privacy protections being the biggest sticking point to date. Article

> The costs involved in implementing and maintaining an EMR rank among the top concerns of physician groups, according to a recent study by the Medical Group Management Association. Article

> A new Harris Interactive poll has found that the more aware patients are of medical data breaches, the more likely they are to believe that EMRs are less secure than paper records. Article

And Finally... Heaven only knows how this gentleman would have gotten through airport security! Article

SPOTLIGHT: Website allows consumers to talk to MDs live

Anne Zieger — Sat, 12 Jul 2008 13:04:02 -0400

Consumers often want to talk to doctors at inconvenient times--in the middle of the night, particularly--but can't do so unless they wake their PCP up or head to the emergency department of their local hospital. However, a new website may offer an alternative. The site, TalktoaDoc.org, allows patients to talk to local physicians live, through text, voice or video. Article

Cigna rolls out Second Life community

Anne Zieger — Sun, 06 Jul 2008 00:10:29 -0400

In an interesting case of an insurance company doing something (moderately) cutting-edge, Cigna has launched a pilot project that includes a virtual healthcare community based on virtual world Second Life. Previous companies with an interest promoting healthcare interests on SL include IBM, which debuted its own healthcare island promoting its HIE architecture at this year's HIMSS conference. As FierceHealthIT users are likely to know, SL is a 3-D virtual world where users interact in a realistic landscape using avatars to represent them. Cigna's SL community, which is being promoted in both the U.K. and the U.S., will offer virtual health seminars, educational games focused on preventative care and programs designed to improve and sustain health behaviors. Cigna hasn't yet decided whether the SL content will be provided to employers as a standard part of health plans, or as a free option for plan members.

To learn more about Cigna's offering:
- read this Healthcare IT News article