health care providers

HIT shortage can only get worse

Mon, 21 Apr 2008 06:59:59 -0400

IT is a complex profession in and of itself, and health IT management even more so. While I'm not an IT recruiter, I'd wager that you wouldn't want anyone with less than a decade of hard-core experience under their belt to take a top position in your organization (with most, if not all, directly in health organization). The problem is, there's just not enough of such people to fuel the great health IT revolution we're seeing today.

As the study outlined in today's issue suggests, we'll need more than the 40,000 professionals we've got on duty within a short stretch--say, three to five years max--or the whole EMR adoption movement will stumble badly.

Sure, some folks in Congress have begun to notice the big professional shortage their pro-EMR policies will create. For example, Rep. David Wu (D-OR) is backing the "10,000 trained by 2010 Act," which helps fund health IT education. While that falls far short of the 40,000 or so HIT staffers we'll need, it's at least a start. However, those 10,000 will include at least some very green folks, which doesn't quite fit the bill.

What's even scarier about this is that not only are we going to need HIT pros to keep the EMR ship on course, we'll need more such pros with deep clinical skills. If it's hard to recruit a seasoned health IT expert, recruiting physician or nurse IT specialists will be even more costly and difficult. My guess is that there will be an even more painful shortage in this job category. Unfortunately, healthcare just isn't an industry that can easily hand off high-profile jobs to junior people in the 20s. Sure, they'll do some of the work, as they do in every IT organization. But given the depth of skills and experience HIT leadership requires--even for middle management, much less C-level jobs--it's pretty risky to promote talented young folks too quickly.

I wish I could tell you I had suggestions for solving problem, but I don't--other than, perhaps aggressively retraining top pros from other industries. I do know that if providers don't want their plans to grind to a halt for lack of support, they're going to have to get creative, and fast. Maybe your health system isn't rolling out an EMR today, but if you don't do anything to address the HIT talent shortage, good luck getting it implemented in 2010.- Anne

ALSO NOTED: SC hospitals to get EDIS makeovers; Alliance's Wallace steps down; and much more...

Mon, 31 Mar 2008 07:59:50 -0400

> Perlegen Sciences' plans to work with an EMR vendor to use patient data for genetics research have made some in the medical community upset. So what does Perlegen have to say? Article

> EDIS's at two South Carolina hospitals are about to get a makeover. Article

> Alliance CEO Wallace steps down to pursue 'new health technology ventures.' Article

> Governor Edward G. Rendell announced today that he has signed an executive order creating the Pennsylvania Health Information Exchange, which is a framework that will give health care providers improved access to clinical data and lead to safer and more efficient patient-centered care. Release

And Finally... Bringing the pharmacy to you. Article

BCBS of MA plan requires hospitals to use CPOE

Tue, 19 Feb 2008 06:59:55 -0500

Hospitals participating in Blue Cross Blue Shield of Massachusetts will soon be required to used computerized physician order entry under the insurer's new incentive plan. Under the health plan's Primary Care Physician Incentive Plan and Hospital Quality Improvement Plan, both providers and hospitals will get incentives if they meet certain quality guidelines. Now, participating providers will need to meet standards established by the Massachusetts Hospital CPOE Initiative by 2012 if they want to eligible for these incentives. The Massachusetts CPOE Initiative has projected that 26 months after implementation, using CPOE will save $2.7 million per hospital, and a total $170 million per year for the state as a whole.

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

Related Articles:
Mass. BCBS to "tier" hospitals, MD. Report
Massachusetts e-prescribing volume hits 10.8 million scripts. Report
BCBS of MA plans reimbursement changes. Report
BCBS of MA begins physicians analysis program. Report

Trend: E-prescribing top HIT issue for 2008

Tue, 22 Jan 2008 06:59:58 -0500

It's looking like e-prescribing is going to be the hottest health IT issue under discussion in 2008, according to a growing list of observers and stakeholders in the industry. For one thing, much could happen if a recent bill requiring Medicare physicians to adopt e-prescribing by 2011 gets passed. The bill, sponsored by Sen. John Kerry (D-MA) is stalled in committee, but the idea is a popular one, observers note. Not only that, HHS head Mike Leavitt is encouraging private payers to push providers in this direction, too. Then, consider that the DEA appears to be ready to let providers prescribe controlled substances electronically, and it begins to look like e-prescribing is getting more practical than it had been, too.

All told, it seems almost a foregone conclusion that this year will be an e-prescribing turning point. The main question, now, will be how long it will take to get the systems in place and the physicians actually using the technology.

To learn more about this trend:
- read this iHealthBeat piece

Related Articles:
Momentum growing for requiring Medicare e-prescribing. Report
HHS head encourages payers to demand e-prescribing. Report
DEA may allow e-prescribing of controlled substances. Report
E-prescribing: What's holding it back? Editorial
E-prescribing highlights barriers to data sharing. Editorial

ALSO NOTED: Maine providers ready statewide EHR; FCC offers U of Wyoming telemedicine grant; and much more...

Tue, 22 Jan 2008 06:59:50 -0500

> A group of Maine health care providers have raised $4 million to begin building a statewide electronic health record system. Article

> The FCC has provided the University of Wyoming with an $800,000 grant to create a high-speed telemedicine network to serve the state. Article

> Trend: Physicians are providing care via e-mail at a growing rate, though some say that they're missing out on a lot when they're not actually seeing patients, experts say. Article

> This Pennsylvania community will soon serve as a testbed for a U.S. Department of Defense health data sharing project. Article

And Finally... Can physicians who use robots to make beside rounds remotely do as good a job as their hands-on brethren? Article

HHS head encourages payers to demand e-prescribing

Mon, 26 Nov 2007 06:59:57 -0500

It's just a blog--but look who's blogging! In a recent post, HHS Secretary Mike Leavitt has suggested that not only Medicare and Medicaid, but also private payers, should demand that providers use e-prescribing technology. "E-prescribing needs faster implementation," Dr. Leavitt writes. "...Large health care providers, including Medicare and Medicaid, need to move toward making it a mandatory part of medical practice soon."

In his post, Leavitt compared the problem in promoting e-prescribing use to the issue faced by the state police department when he was governor of Utah. After finding out that key data was being buried in paperwork, he required officers to learn to use a laptop to transmit key reports, despite the fact that some barely knew how to use a keyboard. He's now suggesting that similar pushiness is called for with physicians.

Leavitt made his comments after meeting with the American Health Information Community last week, where he serves as chairman. AHIC has just begun drafting a recommendation to the Secretary's office on making e-prescribing mandatory for Medicare.

To learn more about Leavitt's comments:
- read this Government Health IT article

Related Articles:
SPOTLIGHT: Physician IT adoption still poor--so what next? Report
Leavitt adds teeth to HIPAA enforcement. Report
HHS promotes international EMR standards. Report
HHS asks employers to push shared HIT standards. Report

A big moment for physician IT

Mon, 29 Oct 2007 07:59:59 -0400

Today and tomorrow, I'll be at the Medical Group Management Association meeting in Philadelphia getting a reality check on physician practice issues. I'm excited to be here. I think we've arrived at a big moment for the business of medicine, particularly where IT issues are concerned.

Sure, there's always been IT management issues for medical group practice managers to consider, but it's probably been decades since so many disruptive technologies have been on the table. We're talking not only EMRs, which pose probably the biggest challenge to physician practice patterns, budgets and business operations, but also e-prescribing, 'virtual visit' approaches, portals and new, healthcare-specific mobile applications. It's a heady mix.

With any luck, I'll pick up success stories on how medical practices are implementing some of these emerging tools. I'm particularly hoping that I can find people from of the one- to nine-physician practice to discuss their IT issues, as everyone agrees that such practices face the toughest time going forward with IT adoption. But I'll be happy to hear about any instance in which a medical group large or small improved care, improved patient satisfaction or (naturally) made more money.

In the process, I'm fully expecting to hear some venting. After all, I'm sure many physicians are irritated by mounting pressure to use these technologies--hey, I would be if someone gave me a new, expensive, unfamiliar gadget and forced me to write FierceHealthIT with it.

With any luck, though, attendees will find the support they need to survive this big technology moment without enduring too much pain. After all, once the difficult transition period is over, I think there's going to be some exciting new possibilities not only for the business of medicine, but the practice of it as well. (I'll share more on these possibilities in future FHIT issues, so stay tuned.) - Anne

The medical group in the middle

Mon, 20 Aug 2007 06:59:59 -0400

I don't know about you, but I couldn't survive without the basic IT tools I use to run my day. From given--but powerful--tools like email for communication (I'm a Thunderbird fan), Web browsers for research, commerce and networking (think Plaxo and LinkedIn) and calendaring/contact management software (Palm desktop), I need them all. I'd probably be pounded into a pancake by my schedule and obligations if I didn't have access to them. These are the types of tools deployed by your newly emerging micropractice, the one-man or one-woman show depending on modern technology.

I'm also a big fan of the conveniences provided by large companies' IT infrastructure. When I worked at a $100M data firm, I got corporate security, information management tools, shared storage, virus updates and more. Once you get used to having powerful databases available, 24/7 tech support, a Web dev team to work with you rather than a single person going it alone or as a consultant, you get hooked. And the corporate managers depend on big iron to scale their operation. Think the Cleveland or Mayo Clinic and you have the picture.

On the other hand, when you work at a smallish company (let's say, 30-50 employees), you're sort of stuck in the middle. You don't have access to high-end corporate IT perks like a large dedicated support staff. Sometimes it's one guy who's doing all the network administration and development too, or even an outsider who comes only once a week! And I can well understand why these middling size companies don't invest more in IT. They have what they need, and maybe just a bit less, but they're getting by, and they're just short of the need for costly big-enterprise IT. Now, consider the medium-sized medical group, whose name is little known but represents a legion across the U.S. That's the position they're in, too.

Such mid-sized practices (which, as it happens, are the fastest-growing practice category) certainly have computers and practice management software in place, they're probably working with billing technology in some form if it isn't integrated into the PM package, and they're generally pretty satisfied with what they've got. They're just big enough to be deathly afraid of change, as they're not as flexible as the little guys nor as well-funded as the giants.

Now, how are you going to get the practice in the middle to invest in emerging tech like EMRs and eprescribing? For one thing, let's admit this niche is the problem. General statements that smaller practices aren't adopting such technology are too vague. Second, let's make sure it's this mid-market niche that gets the first infusion of support and cash. It's funny how government programs and the like often end up supporting giants rather than smaller players.

So how are we going to push this process along? Let's roll up our sleeves and toss out some solutions. Readers, what do you think? - Anne

Case study: EMR paid for itself in 16 months

Mon, 16 Jul 2007 06:59:54 -0400

Sure, this study might be worth taking with a grain of salt, as the vendor behind the project profiled is taking a large hand in promoting the case. But it's still worthy to note that the University of Rochester Medical Center, N.Y., seems to have made a significant financial success of its ambulatory EMR system. The system, which was installed by Allscripts, was used in five ambulatory offices representing 28 health care providers. The study, which was published in the Journal of the American College of Surgeons, looked at the costs of conducting several standard functions, including chart pulls, creating new charts, time to file charts, as well support staff salary. Researchers compared numbers from the third quarter of 2005, after the system as installed, to costs in the third quarter of 2003 when tasks were still being doing by hand.

The new system seems to have been able to reduce costs by nearly $394,000 per year, with almost two-thirds of those savings coming from a speedup in the time needed to manually pull charts. Because the EMR system cost $484,577 to install an operate in the first year, that meant that the medical center recouped its costs within 16 months. Over the longer haul, the system cost about $114,000 per year to operate, a savings of more than $279,500 for the medical center.

To learn more about the EMR installation:
- read this MedicineNet.com item

Related Articles:
Study: Physicians at EMR "tipping point." Report
Money is not the problem. Editorial
Study: E-health offers 2:1 return on investment. Report
Leapfrog Group seeks to measure P4P benefits. Report

ALSO NOTED: House considering rural HIT grants; CDC brings infection data to Web; and much more...

Sun, 01 Jul 2007 20:01:30 -0400

> Several members of the U.S. House of Representatives have filed a bill which would offer $20 million to $30 million in grants to foster the development of rural health IT. Article

>The CDC has made its Web-based infection reporting network available to all U.S. healthcare facilities. Release

> A new study suggests that almost half of Tennessee health care providers have broadband connections, including 68 percent of urban physicians and 17 percent of rural physicians. Article

> Kansas City, Missouri-based St. Luke's Health System is adding teleneurology to its growing telehealth program. The program already offers cardiology, pulmonology and psychiatry services. Article

And Finally... Here's 42 questions HHS might ask when it audits your HIPAA compliance program. A must-read. Article