News

Short EHR implementation timeline could lead to errors

Neil Versel — Mon, 08 Feb 2010 14:44:53 -0500

If there is such a thing as a general consensus about the proposed rules for "meaningful use" of health IT, it's that the current HHS plan is fairly solid, but in need of some tweaking. It's fairly certain there will be some changes before HHS finalizes its definition this spring; CMS officials have said as much. How much change, and what kind, is up in the air, but it appears that the most common criticism of the Dec. 30 proposal is that the timetable is too short--even though CMS said providers would only have to demonstrate meaningful use for 90 consecutive days to earn the full incentive payment for 2011.

Some of that criticism is starting to show up in academic journals. "[The] extremely aggressive timeline in the American Recovery and Reinvestment Act (ARRA) of 2009 stimulus package places enormous pressure on healthcare practitioners and their organizations to rapidly implement EHRs," often forcing them to install technology without taking the time to tailor systems to organizational realities, Memorial Hermann Health System informatics specialist Dean Sittig and University of Utah health IT guru (and CSC consultant) Dr. David Classen write in the Journal of the American Medical Association.

"Such rapid implementations could lead to significant patient safety events," they add.

To prevent errors, Sitting and Classes propose a five-stage plan to monitor and evaluate EHR systems, including annual self-assessment by EHR users. They also would like to see oversight by the Joint Commission or local health departments and the creation of a national board to investigate "adverse events" related to EHRs.

For details on their plan:
- read this CMIO story about their commentary

Obama budget calls for more funding for ONC, comparative effectiveness

Neil Versel — Mon, 08 Feb 2010 14:08:56 -0500

The Office of the National Coordinator for Health Information Technology would get a $17 million funding boost, to a total of $78 million, under the Obama administration's budget proposal for fiscal year 2011. This includes $4 million for ONC to "to identify consumer perspectives on consumer e-health tools and the development of patient decision aids; anticipate and mitigate unintended consequences of the electronic exchange of health information; and support state governments as they implement their HITECH grants," InformationWeek reports.

In total, the White House is asking Congress for $110 million in funding to bolster health IT policy coordination and research across federal agencies as part of an $81.3 billion budget request for the Department of Health and Human Services. Other proposed HHS funding for health IT includes $32 million for the Agency for Healthcare Research and Quality for patient safety initiatives, $1.6 million in the Office for Civil Rights to establish "regional privacy advisors" and $1 million "for independent evaluation of EHR adoption and economic factors influencing health IT" within the Office of the Assistant Secretary for Planning and Evaluation.

Also included in the proposed HHS budget is an additional $286 million for comparative effectiveness research, on top of the $1.1 billion allocated over three years as part of the American Recovery and Reinvestment Act, which Obama signed into law a year ago next week.

Meanwhile, the departments of Defense and Veterans Affairs stand to receive $2.8 billion for health IT next fiscal year under the proposed federal budget.

For more:
- read this Healthcare IT News story
- see InformationWeek's take on this news
- check out this NextGov piece on DoD and VA health IT funding
- have a look at this Computerworld article on general federal health IT spending

HIT vendor contracts must be aligned with meaningful use rules

Neil Versel — Mon, 08 Feb 2010 13:42:22 -0500

We're still waiting for a final definition of "meaningful use" of electronic health records, but with a proposed rule out there for more than a month now and a good sense of where the industry is headed, it's probably not a bad time for healthcare organizations to review their IT strategies and contracts.

Jeffery Daigrepont, senior VP at health IT consulting firm Coker Group, suggests that providers need to take this time to make sure vendor contracts are aligned with the proposed rules for meaningful use so they stay on the right path toward earning federal stimulus money. "Many vendors offer a money-back guarantee if their product does not comply with stimulus," Daigrepont says in an interview with Healthcare IT News. "Every contract should have a warranty that requires a vendor to correct defects at their expenses and under NO circumstances should you ever sign a contract without being entitled to future upgrades and new releases."

Daigrepont also offers a list of five health IT decisions to avoid: buying defective software; buying software that isn't certified for meaningful use or otherwise doesn't meet national standards; not seeing "the writing on the wall" that a vendor is discontinuing or refusing to upgrade a product; buying a "one-off" solution to mollify a specific individual or department; and implementing a system that hasn't been fully developed, tested and validated.

"Not acting or refusing to accept the obvious is only delaying the unavoidable reality of having to rip out and replace your system," Daigrepont says.

To read the complete list:
- see this Healthcare IT News story

IBM to purchase Initiate Systems

Neil Versel — Mon, 08 Feb 2010 13:16:16 -0500

IBM, which long ago abandoned plans to develop an electronic medical record, is making a deeper push into health information exchange by agreeing to acquire Initiate Systems. Privately held Initiate produces software to manage data integrity and create master patient indices for the purpose of sharing electronic health information.

Terms of the deal were not disclosed, though the two companies say they have been collaborating for about five years.

"This is all about growth and synergy," Arvind Krishna, general manager of information management at IBM, said, according to the Chicago Sun-Times. Initiate's president and CEO, Bill Conroy, said that "IBM's vision meets ours to get to [a global] scale quickly."

A master patient index is a subset of a general IT function called master data management, and InfoWeek reports that several IBM competitors have been beefing up their MDM offerings recently. Initiate Systems offers a "strong and proven" platform for data integration and "best-in-class data de-duplication, security and privacy," one analyst wrote, according to InfoWeek.

For details:
- read this IBM press release
- see this InfoWorld story for a broader perspective
- take a look at this Chicago Sun-Times piece for a local angle on Initiate Systems

'Stories of Success!' highlight 16 organizations using HIT to improve quality

Neil Versel — Mon, 08 Feb 2010 12:52:39 -0500

Last fall, HIMSS and the American Society for Quality solicited case studies of healthcare organizations that have successfully employed IT to improve patient safety and the quality, effectiveness and efficiency of care. Now, the two groups have introduced the first 16 peer-reviewed case studies for the "Stories of Success! Leveraging HIT, Improving Quality & Safety" program.

Six organizations--including some that might not be so obvious--achieved "Tier 1" designation, meaning they aligned most closely with the goals of the program, while 10 more were listed as "Tier 2" by virtue of their "impressive success stories," according to HIMSS. The second tier contains some big names, notably Brigham and Women's Hospital in Boston, Kaiser Permanente's Southern California Region, Marshfield (Wis.) Clinic and Memorial Hermann Health System in Houston.

The case studies are "real-world examples for those endeavoring to become 'meaningful users'" of health IT, Dr. Joseph Fortuna, chair-elect of ASQ's healthcare division, says in a joint HIMSS-ASQ press release.

"With the provisions of the American Recovery and Reinvestment Act now underway, the information gathered in these case studies will help the industry understand how valuable health IT as a tool can be to improving patient safety and quality," adds David A. Collins, HIMSS' director of healthcare information systems. "By sharing notable quality improvement scenarios, we hope these best-practice examples will serve as guidance to others for improved healthcare delivery and demonstrate the benefits of health IT adoption."

The two organizations will issue another call for submissions for the program next month.

To learn more about "Stories of Success!":
- check out this Health Data Management story
- see the HIMSS/ASQ press release
- read the 16 case studies

Don't forget that HIMSS is more than a vendor show

Neil Versel — Mon, 08 Feb 2010 12:21:08 -0500

We're just three weeks away from the annual HIMSS conference in Atlanta, and if you're going, by now your schedule likely is pretty full for the duration of the meeting. Personally, I'm still filling out my calendar and trying to balance all the meeting requests with the sessions I'd like to cover and the parties I'd like to go to--including FierceHealthIT's own MixIT! networking party on Tuesday, March 2 at the World of Coca-Cola.

As is usual with the largest health IT gathering of the year, the meeting requests keep on coming, perhaps even more so than in the past now that I have this rather high-profile gig as editor of all three of Fierce's health IT publications. I know that most vendors appreciate the fact there will be something like 900 exhibitors at the trade show part of HIMSS and that it's impossible for every reporter to hit more than a few of them.

Notice how I hesitate to call HIMSS10 a "show," and that I just use that word for the portion of the event that takes place in the massive exhibit hall. That's because HIMSS is much more than a vendor show. In fact, I tend to get more story ideas out of the many educational sessions than I do out of some vendor meetings.

I'm not putting down the vendors here. Without them, there wouldn't be much of a health IT industry now, would there? I'm just making the point that the educational sessions are pretty valuable to a reporter like me. Which is exactly why I generally don't schedule vendor meetings that conflict with such sessions--and why the exhibit hall is closed during much of the session hours.

To the vendors out there: If you have any openings in your tight schedules--and I understand that you try to spend as much time as possible schmoozing prospective clients--I recommend that you have some of your executives avail themselves of the sessions, or at the very least try to get to the keynote addresses. Often, when I do sit down with vendors and their clients, they say something that one of the speakers touched on. It would be nice to be able to have something in common to talk about.

See you in Atlanta. - Neil

HHS promises transparency, but only after getting caught

Neil Versel — Mon, 01 Feb 2010 13:56:51 -0500

A lot has been made about President Obama's repeated promises to run the most transparent administration this country has ever seen. Obviously, the administration still has a lot of work to do.

The Office of the National Coordinator for Health Information Technology last week announced that it would be making public the deliberations of the various workgroups of the Health IT Policy Committee and the Health IT Standards Committee. In a press release, ONC said it would webcast all workgroup meetings at http://healthit.hhs.gov. "In addition, audio files [.mp3] of [HIT Policy Committee and HIT Standards Committee] meetings and the workgroup meetings will be available on the ONC website within 24 to 48 hours following the conclusion of each meeting. A draft transcript of the meetings will be available within 5 to 8 business days," ONC says.

Meanwhile, CMS announced that it would make public the comments it receives about the proposed rules for "meaningful use" of health IT. (CMIO has a nice summary of comments through last Wednesday.)

Great stuff, right? Open government is good. The problem is, this sudden transparency seems to be a direct response to the Policy Committee's workgroup on privacy and security being caught by another publication holding a closed-door meeting Dec. 8, the very same day the White House issued a directive on open government. For weeks, the administration stonewalled the reporter in his attempts to find out why the meetings were closed.

A follow-up story about federal officials standing firm ran on Dec. 23. That happened to be the same day ONC chief Dr. David Blumenthal, who oversees the committees in question, wrote on his blog about a "commitment to transparency." Ah, the irony.

Let's hope last week's announcements really mean the process of awarding some $20 billion in federal subsidies for health IT really will be transparent and not just empty political rhetoric. Let's also hope that HHS isn't hiding anything else from us. And let's celebrate the power of the press to keep politicians honest. - Neil

HHS looks for unintended consequences of EMR stimulus

Neil Versel — Mon, 01 Feb 2010 13:24:02 -0500

We love this headline from Government Health IT: "HHS takes Hippocratic oath on health IT stimulus."

"First, do no harm" is the mantra of a new group HHS is forming to identify and prevent any "potentially harmful unintended consequences" of the federal EMR stimulus plan."While we expect for these programs to help achieve the many desirable outcomes envisioned by Congress, a sense of responsibility for activities we support, historical experience, as well as mounting evidence of unexpected problems, demand that we consider potential downsides," HHS says in a presolicitation notice, in which the department announces its intention to award a contract to set up the panel.

HHS doesn't specify the types of unintended consequences it anticipates, though it says some side effects actually could have a positive impact toward the goals of making healthcare more efficient and effective.

Responses to the notice are due Feb. 26.

To learn more:
- have a look at this Government Health IT story
- read the HHS presolicitation notice

Report: More physicians communicating online with patients

Neil Versel — Mon, 01 Feb 2010 13:00:14 -0500

While the majority of doctors still do not communicate with patients via email, secure messaging portals or instant messaging, online patient-physician communication is no longer a rarity, according to a new report from Manhattan Research. About 39 percent of physicians now have electronic communications with their patients, a 14-point increase since 2006, the healthcare market research company says.

This embrace of technology could bode well for the coming push to adopt electronic medical records. "We find that those physicians connecting with their patients online are more likely to be accessing the Internet during patient consultations and using various forms of health IT across the board," Manhattan Research's director of research, Erika S. Fishman, says in a company statement. "As we work to remove the barriers to physician adoption of online communication with patients, and each party becomes more comfortable with exchanging health information online, we could see a parallel movement in use of electronic medical records and personal health records."

Among specialty physicians, dermatologists and medical oncologists are the most likely to communicate online with patients. Neurologists, endocrinologists and specialists in infectious diseases also have relatively high rates of electronic communication.

To learn more:
- read this Manhattan Research press release

Revolution Health kills its PHR

Neil Versel — Mon, 01 Feb 2010 12:18:17 -0500

So much for the Revolution.

Revolution Health, a much-hyped venture of AOL co-founder Steve Case, is terminating one of its signature products, an online personal health record for the masses. In an email to users, the company said: "Thank you for being a loyal user of the Revolution Health Personal Health Record. Unfortunately we will be discontinuing this service as of the end of February 2010 and removing all records, information, and data from the Revolution Health website." No further explanation was given.

The company recommended that users print out or download the contents in a PDF file so they don't lose their records. That likely means that the data can't simply be imported into another PHR product, providing yet another example of siloed electronic health information.

The news follows a Jan. 24 filing by Revolution Health parent company Everyday Health for an initial public offering of about $100 million. Everyday Health, formerly known as Waterfront Media, purchased Revolution Health in October 2008 after Case's start-up failed to live up to pre-launch expectations.

For more:
- see this Healthcare IT News story
- read the Revolution Health email at Dr. Ted Eytan's blog

SPOTLIGHT: Tougher penalties for HIPAA violations

Neil Versel — Mon, 01 Feb 2010 11:30:55 -0500

Federal civil monetary penalties for HIPAA privacy and security breaches are about to go up, to as high as $1.5 million, thanks to provisions in the HITECH section of the American Recovery and Reinvestment Act. The new rules take effect Feb. 17, the first anniversary of the passage of the stimulus legislation. Under the new rules, penalties will vary based on whether or not the violation was willful. Fines for willful neglect will start at $10,000, compared to $100 for more benign cases. FierceHealthcare

New phishing scams target doctors and their data

Neil Versel — Mon, 01 Feb 2010 11:01:50 -0500

Physicians tend to have a good deal of money--recent med school grads with mountains of debt notwithstanding. Increasingly, physicians also are the gatekeepers of rich storehouses of valuable data. And thus they are becoming inviting targets for a sophisticated bunch of scam artists who practice a technique known as "spearphishing."

Spearphishing is similar to phishing, except it's aimed at a specific population and the bogus emails are cloaked as messages from someone the target might actually interact with, such as an employer, insurance company or government agency. American Medical News reports that one recent scam sent emails that looked as if they came from the Centers for Disease Control and Prevention, asking doctors and patients to register for an H1N1 vaccine database. Last fall, a physician at the University of California, San Francisco, Medical Center exposed personal data of more than 600 patients by responding to a spearphishing message that looked like it had come from the hospital's IT department.

Though it may be tough to discern a scam email from a real one, security experts say there are some clear red flags. Check the originating email address and the URL it asks you to click on for clues. If you don't know the sender personally, don't click on any links. And be alert for file attachments ending in ".exe," which often contain viruses.

For more safety tips:
- read this AMNews article

Grassley: Vendor 'gag orders' prevent HIT issues from being reported and resolved

Dan Bowman — Mon, 25 Jan 2010 13:25:15 -0500

Concerns from healthcare providers about errors and complications associated with using healthcare information technology have prompted Sen. Charles Grassley (R-Iowa) to send a lengthy list of questions to 31 hospitals nationwide. The questions focus on how the organizations report, analyze and track HIT-related issues and concerns, among other things.

The letter stems from a growing number of reports about interoperability problems between HIT programs; administrative complications related to implementation, formatting and usability issues; and actual computer errors stemming from the programs themselves.

For example, one problem brought to Grassley's attention involves "faulty software" that provides the wrong medication dosages for patients due to a glitch that interchanges kilograms and pounds.

Particularly troublesome, he says, is that such concerns are often ignored or dismissed due to "gag order" clauses in many vendor contracts. These nondisclosure agreements "prohibit health care providers and their facilities from sharing information outside of their facilities regarding product defects and other HIT product-related concerns," Grassley writes.

He points out the need for a national system for reporting product errors and HIT-related adverse events, such as the FDA has for regulated medical devices.

"Given the taxpayer investment and the investment of the healthcare system overall in the information technology industry, the more Congress and others overseeing implementation of this program dig into the problems and work to get them sorted out now, the better," Grassley writes.

Grassley penned a similar letter to HIT vendors such as 3M, Allscripts-Misys and Cerner last fall, also citing complaints about the devices used. At the time, Dr. David Blumenthal, national health IT coordinator, said that Grassley was "doing what entrepreneurial senators do."

To learn more about Grassley's efforts:
- read this press release
- read his letter to the hospitals
- see this CMIO story

Pentagon calls for longitudinal EHRs in five-year HIT plan

Neil Versel — Mon, 25 Jan 2010 13:15:27 -0500

The Military Health System will redesign its IT infrastructure and beef up its electronic health records to become more comprehensive and longitudinal, according to a newly released strategic plan. It is the first time since 1999 that the MHS has had a formal strategy for information technology and information management.

The five-year plan calls for more collaboration between the three branches of the armed forces, the Joint Chiefs of Staff, the MHS IT division and Tricare, the military's managed care group.

"Our architecture must enable responsive and reliable solutions and rapid delivery of new capabilities," the plan says, according to Government Health IT. "Our EHR needs to be intuitive, aggregate data for each patient over time and across providers, operate in all care settings, and allow sharing of information with our health partners."

Secondary goals of the strategy include a "Personal Health Agenda" to give patients electronic access to their own medical records, conduct virtual visits with clinicians and request appointments and medication refills online. Military brass also want to emphasize "enterprise intelligence" to share knowledge and disseminate best practices.

The plan is intended to mesh with a 2008 strategy to adopt service-oriented architecture, which, in part, facilitates interoperability between the MHS and the Department of Veterans Affairs.

For more:
- read this Government Health IT story
- download the Military Health System strategic plan (.pdf)

Microsoft's Ballmer: Focus on the patient for long-term gains

Neil Versel — Mon, 25 Jan 2010 12:53:11 -0500

It's not exactly a secret that various technology companies stand to profit handsomely from the estimated $20 billion infusion of federal dollars into electronic medical records. In jockeying for some of that cash, vendor executives are making the rounds to convince business and general IT interests that the time has never been better to get involved in healthcare. "I'm optimistic. The money is coming. The national debate has been engaged. And now is the time where our industry may be able to step up with some enabling factors and make an even bigger difference," Microsoft CEO Steve Ballmer said at a Nashville Health Care Council meeting in Tennessee last week.

"We look at the healthcare industry and say, 'It's not working.' Yet more than most industries, it is all about information--getting the right information to the right person at the right time," Ballmer said, the Nashville Business Journal reports.

The Microsoft honcho was joined on a panel by several health IT vendor executives, notably Allscripts-Misys Healthcare Solutions CEO Glen Tullman and George Lazenby, CEO of Nashville-based Emdeon. Both companies report that their e-prescribing businesses have more than doubled in the past year. "We think it's just the beginning of this industry in terms of growth," Tullman said.

Ballmer advised tech companies in Nashville, the unofficial capital of for-profit medicine, to focus on the patient if they want to make a difference in healthcare. "Start the dialogue with the physician with the patient's perspective and the patient's information in mind. It may not be the most rewarding in the short-term, but it's the most transformational thing you'll be able to do in the long run," he said.

For further details:
- check out this Nashville Business Journal story

Healthcare may help IT industry reverse job losses

Neil Versel — Mon, 25 Jan 2010 12:10:55 -0500

The IT industry has been reeling, having cut a net 175,000 jobs in 2009, or about 13.2 percent of all announced U.S. job cuts across all industries last year. The decline is more than 12 percent greater than the 155,000 tech jobs shed in 2008. But there are some bright spots. Forrester Research recently forecast that U.S. IT spending would grow by 6.6 percent in 2010, reversing an 8.2 percent reduction last year. And then there is the health IT sector.

The push to convert to electronic medical records in time to capture federal stimulus money in 2011 already is having a positive impact on health IT hiring, InformationWeek reports. MEDecision, maker of care management software and payer-centric tools for business intelligence, added 50 employees in 2009 and expects to grow its payroll by another 100 people this year. As we report in the Also Noted section of FierceHealthIT today, Cerner has big expansion plans, including a new campus in Kansas to house an expected 4,000 new hires by 2016.

For more on the state of the health IT job market:
- take a look at this InformationWeek blog post

Cisco leading telemed project at 15 underserved sites in California

Neil Versel — Mon, 25 Jan 2010 11:40:47 -0500

Cisco Systems kept a relatively low profile in healthcare, even as it provided telemedicine equipment to numerous hospitals and remote care sites nationwide. That will change this month, as the San Jose, Calif.-based networking giant joins up with the State of California and Medicare/Medicaid managed care firm Molina Healthcare to launch a 15-site telemedicine pilot program for low-income residents of Southern California.

Cisco will contribute $10 million to the California Telemedicine Pilot Project, which will rely on Cisco HealthPresence teleconferencing technology to deliver a "patient care experience similar to the common medical encounter when patients visit their healthcare providers," Healthcare IT News reports. The project will target medically underserved communities in Southern California, including at two Molina Healthcare sites in San Diego--Mountain Health and Community Services and La Maestra Community Health Centers. Later plans call for bringing in the University of California, Davis, a longtime leader in telemedicine in the northern part of the state.

For more information:
- see this Healthcare IT News story

SPOTLIGHT: CIOs pressured by short deadline, standards requirements of meaningful use

Neil Versel — Mon, 25 Jan 2010 11:16:15 -0500

A recent survey from the College of Health Information Management Executives indicated that CIOs increasingly are feeling under the gun, thanks to the short timeline to implement electronic health records and achieve "meaningful use" of such technology to earn bonus Medicare payments. Much of the concern stems from the fact that CIOs will have to adhere to standards that still aren't clearly defined. Vendor readiness also has quite a few tech execs on edge, says Pam McNutt, senior VP and CIO of Methodist Health System in Dallas. Hospital Impact

Panel raps CMS for not requiring MD progress notes

Neil Versel — Tue, 19 Jan 2010 04:09:35 -0500

Perhaps the biggest surprise in the proposed rules for meaningful use of health IT was the fact that physicians will not have to keep electronic progress notes to earn Medicare or Medicaid bonus payments in 2011. Now, some members of the Health IT Policy Committee, an HHS advisory panel, are second-guessing the plan.

At last week's Policy Committee meeting in Washington, Dr. Paul Tang, who co-chairs the workgroup on meaningful use, and Dr. George Hripcsak, the workgroup's other co-chairman, called the omission one of the most important "missed opportunities" for the stimulus to support better and more efficient care. They also said HHS passed on the chance to include guidelines on the substitution of generic drugs and for ordering some high-cost diagnostic tests, Federal Computer Week reports.

For details:
- check out this Federal Computer Week story

Committee wants to recast NHIN as set of policies

Neil Versel — Tue, 19 Jan 2010 03:55:17 -0500

The Nationwide Health Information Network should be recast as a set of policies and standards to facilitate exchange of health data rather than a physical network connecting databases, a federal advisory committee says.

The Health IT Policy Committee is pushing for the new definition and focus to help healthcare providers meet the short deadlines for achieving meaningful use of health IT. Instead of serving as a "medical Internet" of sorts--as former national health IT coordinator Dr. David Brailer said nearly six years ago--the NHIN should describe a basic set of services that facilitate meaningful use, the committee said last week. Such services should concentrate on electronic directories, policies for authenticating information and users, moving data in a secure manner over the public Internet, authentication and on simple "push" transactions that send messages to specific users, Government Health IT reports.

"There are hundreds of thousands of people who need to be accessible to this information exchange process, and we don't know where they all are," David Lansky, chairman of the HIT Policy Committee's NHIN workgroup, said Wednesday at a public meeting. "We don't know how to talk with their EHRs and find them with confidence."

For more on this significant policy change:
- read this Government Health IT story

McKesson CIO: Health reform impossible without better information

Neil Versel — Tue, 19 Jan 2010 03:19:14 -0500

Expanding access to care and holding down insurance costs are nice, but, as we've been saying for months, there can't be real healthcare reform in America without addressing the problems of inconsistent quality and rampant inefficiency. It can be argued that health IT vendors have already gotten their piece of the pie with the passage of the American Recovery and Reinvestment Act nearly a year ago, but some companies are still out their trying to spread the message.

"Health information is a very, very significant opportunity to improve the healthcare system of the United States," McKesson CIO and CTO Randy Spratt said at a meeting of the Pittsburgh Technology Council last week. "This is an opportunity like we've never had," he said, according to the Pittsburgh Business Times.

Though the sentiment isn't new, it's refreshing to hear it come from a McKesson executive, since IT makes up less than 5 percent of the mega-corporation's revenue, and that the company stands to lose sales from its core businesses as a medical supplier and drug distributor if the health system were to become more efficient.

Spratt also noted that information about the quality of providers is hard to come by. "Until consumers have access to information and begin to change spending habits, healthcare reform will not be possible," he said.

Congress, are you listening?

To learn more:
- take a look at this Pittsburgh Business Times story

NIST awards EHR testing contract, ONC seeks to re-identify HIPAA data

Neil Versel — Tue, 19 Jan 2010 02:53:55 -0500

As work continues to implement the American Recovery and Reinvestment Act, the Office of the National Coordinator for Health Information Technology is looking for a contractor to re-attach identifiers from supposedly de-identified information from a HIPAA data set. HHS, as directed by the ARRA legislation, is developing tougher HIPAA privacy standards, and it seems that this research on how clearly one can match de-identified data with an actual individual will help determine whether current HIPAA data sets are adequate to safeguard privacy.

Meantime, Booz Allen Hamilton has won a $400,000 contract from the National Institute of Standards and Technology to develop a framework for testing electronic health records and a process for certifying EHRs and other health IT products. The contract is part of a $20 million ARRA appropriation for NIST to help ONC create a "testing infrastructure that supports the security and interoperability of EHR systems," the institute says.

ARRA allows for multiple certification bodies, and national health IT coordinator Dr. David Blumenthal has advocated in favor of such. Currently, only the Certification Commission for Healthcare Information Technology, a private organization that got off the ground in 2005 with the help of a $7.5 million ONC contract, is in the EHR certification business. But at least one other organization, the Austin, Texas-based Drummond Group, has expressed interest in certifying EHRs. Providers will have to use certified EHRs to earn Medicare and Medicaid incentives under ARRA.

To learn more:
- read this CMIO story on the re-identification contract
- take a look at this Government Health IT article on the NIST award

'Emotional networking' seeks to improve health through virtual contact

Neil Versel — Tue, 19 Jan 2010 02:22:03 -0500

Even as they have drawn more people closer together, technologies like email, texting and social networking have in many ways depersonalized communication. A new wave of software known as emotional networking technology seeks to harness the power of electronic communication without losing the human element of face-to-face contact.

"Communication often has practical considerations--I have a reason and need to talk to you, so I'll pick up the phone or email you," Paul To, CEO and founder of Emota.net, a Menlo Park, Calif.-based technology company, tells Advance for Health Information Executives. "But the kind of communications that carry more emotional values are often more subtle and peripheral in nature. In the past, if you were thinking of someone, you might walk over to their house and drop a basket of flowers on their doorstep. That kind of subtle gesture helped people feel emotionally connected," To explains.

Emota.net is part of a new generation of companies building technology on the principle that emotional connections can have a positive impact on physical health, particularly among the elderly. Such technology could underpin efforts to create patient-centered medical homes and humanize the experience of long-term care. One example is a tree changing color on a computer screen to signify to an elderly person that a family member has sat down near a connected device or another tree waving in the wind as a reminder to call the doctor back.

"We know there is direct correlation between loneliness and healthcare cost," To adds. "Older adults with loneliness-related issues visit [the] doctor and emergency room more often, use more medications, incur higher outpatient charges and stay in [the] hospital longer."

To learn more about this technology:
- read this Advance for Health Information Executives feature

SPOTLIGHT: Health Net data breach brings first state HIPAA enforcement

Neil Versel — Mon, 18 Jan 2010 21:25:31 -0500

In the first case of a state attorney general enforcing general HIPAA regulations under the American Recovery and Reinvestment Act, Connecticut Attorney General Richard Blumenthal last week sued Health Net of Connecticut for misplacing the medical and financial information of nearly 450,000 enrollees and failing to notify those affected in a timely manner. The lawsuit comes nearly eight months after the insurer discovered that a portable computer disk drive with unencrypted information disappeared from Health Net's Shelton office. Although the missing data included protected health information and Social Security and bank account numbers, it took Health Net six months to notify appropriate authorities and the affected enrollees, Blumenthal said. FierceHealthcare

FierceHealthIT is observing MLK Day

Dan Bowman — Fri, 15 Jan 2010 16:43:07 -0500

In observance of Martin Luther King Day, FierceHealthIT will not publish a newsletter on Monday, Jan. 18. We instead will publish on Tuesday, Jan. 19.

ONC to outsource HIT program assessment and management

Neil Versel — Mon, 11 Jan 2010 12:59:25 -0500

While HHS was releasing its proposed "meaningful use" rules to much fanfare and many people had already checked out for the year, the Office of the National Coordinator for Health Information Technology rather quietly announced its intentions to hire contractors to assess and manage several grant programs and regional health IT extension centers.

In a series of four notices posted Dec. 30 and 31 on the Federal Business Opportunities website, ONC indicates its intention to outsource assessment of progress toward meeting the health IT goals of the American Recovery and Reinvestment Act, including programs for state health information exchange, regional extension centers, "beacon" communities and health IT workforce training. ONC also seeks technical assistance for governance, accountability and business processes for state HIE grantees, as well as customer-relationship management software for the extension centers.

In a separate action, ONC said that potential applicants for $60 million in previously announced Strategic Health IT Advanced Research Projects (SHARP) grants for "breakthrough" health IT research should fund activities that can be put to practical use in a short period of time.

For more:
- check out this Government Health IT story on the contract opportunities
- read this Government Health IT piece about the breakthrough grants

HHS hints at possible 'meaningful use' changes

Neil Versel — Mon, 11 Jan 2010 12:39:55 -0500

With the first full week of 2010 now behind us, it's becoming clear that the proposed "meaningful use" regulations published Dec. 30 indeed merely represent a proposal, and that the final rules certainly could change. On Friday, a workgroup of the federal Health IT Policy Committee indicated a willingness to consider the effect of the regulations on physicians trying to earn Medicare and Medicaid bonus payments starting in 2011.

Notably, CMS is considering dialing back the number of quality measures physicians will be required to report on. "We would certainly try to reduce them as we get the comments back in," Tony Trenkle, director of the CMS Office of e-Health Standards, said at the meeting, Government Health IT reports. "The idea was to report out a suite of specialty measures and then invite comments for that. We are going to be looking at what they say about the measures--their operational readiness and their appropriateness and how they relate to health outcomes."

But the workgroup indicated it was more likely to consider "philosophical" comments from the public rather than on making specific changes to the proposal. The Health IT Policy Committee will make recommendations to CMS and to national health IT coordinator Dr. David Blumenthal, but the final regulations on meaningful use will come from CMS. The Office of the National Coordinator is responsible for related rules on data standards and certification of health IT products. The full committee next meets on Wednesday.

Meanwhile, the private sector continues to weigh in on the proposal. The College of Healthcare Information Management Executives, ahem, chimed in by saying the reporting requirements, certification standards and tight deadlines could hinder compliance efforts. "Adequate time to understand the impact of these new systems and to implement them, are some of my secondary concerns," Baylor Health Care System CIO David Muntz says in a CHIME statement. "My primary concern is the time and effort required to achieve successful organizational change management."

Among vendors, NextGen Healthcare Information Systems says HHS needs to offer more guidance to providers, and the Horsham, Pa.-based developer of ambulatory EMRs announced the availability of various compliance-related resources. Competitor Allscripts-Misys Healthcare Solutions became the latest vendor to offer customers a guarantee of meaningful use, as well as some new financing options.

For more:
- read this Government Health IT story
- see this statement from CHIME
- check out this NextGen press release
- read the Allscripts announcement

Aging group awards first IT grants to support medication adherence

Neil Versel — Mon, 11 Jan 2010 12:11:03 -0500

The Center for Technology and Aging, an Oakland, Calif., organization dedicated to helping improve the quality of home- and community-based care for seniors, has, for the first time, awarded grants to support technology dissemination. In this case, five groups will receive a total of $477,000 to help boost medication adherence among older patients with chronic conditions via technology and better care coordination. The grants will be supported by $520,000 in matching funds from the recipients.

Caring Choices, a volunteer organization in Northern California, will bring the Philips Medication Dispensing Service to four home-health and senior-housing agencies with its grant. The VA's Central California Health Care System will deploy the Bosch Health Buddy monitoring system and related "smart" monitors and scales to five medically underserved counties. The Visiting Nurse Service of New York will use its grant to expand EMR, counseling support and medication algorithm technology at the point of care. Another grantee, the Connecticut Pharmacists Foundation, will tie together pharmacists in three states to provide remote, culturally relevant medication management services to Cambodian-American communities. And the American Society of Consultant Pharmacists Foundation will acquire a web-based medication assessment system called Monitor-Rx for a site in Irvine, Calif.

For more about these grants:
- take a look at this Center for Technology and Aging press release (.pdf)

Meaningful use may set off new round of vendor consolidation

Neil Versel — Mon, 11 Jan 2010 11:44:09 -0500

In our "Fierce Five of the Decade," we named mergers and acquisitions as the No. 4 story in health IT for 2000-09. Well, health IT still isn't a fully mature industry, so there's plenty of room for more consolidation. The publication of proposed standards for "meaningful use" of electronic medical records just might set off yet another round of M&A. "Vendors that offer standalone software that helps doctors manage the administrative and business side of their practices are scurrying to pair up with vendors of e-health record vendors that don't already offer practice management modules--and vice versa," reports InformationWeek.

Wouldn't you know, the year began with the news that practice management vendor AdvancedMD Software has acquired ambulatory EMR developer PracticeOne? (We mentioned this in FierceEMR last week.) According to InformationWeek, PracticeOne had a very small user base, but was attractive to AdvancedMD because it gave the acquiring company a foothold in the suddenly lucrative EMR market. "There's tremendous opportunity for us to cross sell to our existing clients," AdvancedMD CEO Eric Morgan told the magazine.

Meanwhile, we report today in the Also Noted section that Lawson Software has agreed to buy Healthvision. The consolidation continues.

For more on the AdvancedMD-PracticeOne deal:
- read this InformationWeek story

CalRHIO 'effectively shut down' after negotiations with state fail

Neil Versel — Mon, 11 Jan 2010 11:07:57 -0500

First, there was the failure of the Santa Barbara County Care Data Exchange. Now, it appears that California's Next Big Thing in health information exchange is falling apart.

iHealthBeat reports that the California Regional Health Information Organization (CalRHIO) has "effectively shut down" after failing to be named the lead health IT agency for the nation's most populous state. It now appears that the California eHealth Collaborative will be the organization to manage billions in federal dollars for health IT activities. CalRHIO and the California eHealth Collaborative had been the two finalists for that designation, but CalRHIO has published an undated letter saying that negotiations with the state had broken down.

iHealthBeat was unable to get anyone associated with CalRHIO for comment, but did obtain an email from CEO Dr. Molly Coye that acknowledged the inability to negotiate an agreement. "As a result, I will be taking the next four months to engage in a variety of activities, starting with some time off and then providing support for several federal and private advisory groups," Coye wrote.

As recently as last week, California's health IT secretary Jonah Frohlich said he expected to see a joint proposal from CalRHIO and CAeHC within the next two weeks, after which time the state would make an announcement regarding the designation. State officials are not commenting on the apparent disbanding of CalRHIO.

To learn more:
- take a look at this iHealthBeat story
- read the CalRHIO letter to stakeholders (.pdf)