primary care

MN lawmakers approve e-prescribing measure

Tue, 27 May 2008 06:59:55 -0400

The Minnesota state legislature has approved a broad healthcare bill that would, among other things, require physicians, pharmacists and others who prescribe or dispense medication in the state to use electronic prescribing as of 2011.

The bill also creates new rules intended to boost quality and price transparency and tie payment to care coordination and performance. For example, the state would create a "healthcare home" certification by July 2009; clinics earning the designation would encourage primary care use, develop comprehensive care plans and focus on those who have or are at risk of developing chronic conditions.

To learn more about the state's e-Rx initiative:
- read this Modern Healthcare article (reg. req.)

Related Articles:
Coalition wants e-prescribing included in Medicare reform
HHS head encourages payers to demand e-prescribing
Group says controlled-substance rules block e-prescribing
E-prescribing: What's holding it back?

ALSO NOTED: Telemedicine system links India, Ethiopia;KY county lets EMTs send patient data wirelessly; and much more...

Mon, 07 Apr 2008 06:59:50 -0400

> Here's an interesting telehealth project; a new pilot has linked hospitals in rural Ethiopia with India's leading cardiac institute. Article

> Officials in Louisville-Jefferson County, KY have bought a $2.1 million electronic patient care recording system that allows its EMTs to capture patient info digitally and wirelessly transmit the data to hospitals. Article

> A California medical practice is rolling out an EMR system with help from the National Committee for Quality Assurance. Article

> A California multi-site primary care and specialist network has set plans to offer patients a set of online administrative tools, including a PHR. Article

And Finally... Want to see what an EMR looked like circa 1961? Check this out. Video

Report: Gov't should remove telemedicine barriers

Mon, 10 Mar 2008 07:59:55 -0400

A new paper issued by a think tank promoting HIT use suggests that for telemedicine to come into wider U.S. use, the government will have to lend a hand. The paper, by the Center for Health Transformation, argues that telephone-based medical consults alone can make a big difference in promoting affordable healthcare access. The research contained within the paper focused consults provided by TelaDoc Medical Services, which has an estimated 1.2 million members.

Having studied what worked in that population, researchers concluded that the key features of successful telemedical consulting included rapid access to a primary care doctor by phone, cross-coverage via phone to handle acute illness, portable EMRs for patients and doctors and a standardized data structure. While the paper didn't specify what the government needs to do to foster these conditions, it emphasized that officials, as well as corporate policymakers, should bear these principles in mind in their health purchasing and reform efforts.

To learn more about the report:
- read this Healthcare IT News piece
- read the CHT paper (.pdf)

Related Articles:
Study: Telemedicine could save $4.2 billion annually. Report
California may spend $400M on telemedicine programs. Report
Study: Telemedicine offers clinical, cost benefits for chronic disease care. Report
USDA offers $128M for rural telemedicine. Report

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

SPOTLIGHT: Groups say HIT plans should include primary care

Mon, 14 Jan 2008 06:59:52 -0500

While it's fine to put greater emphasis on the adoption of EMRs, planners aren't paying enough attention to primary care issues, according to the American Academy of Family Physicians. For one thing, these systems may not be suitable for providing patients with a medical home. To do so, EMR systems would need to provide a complete picture of a patient's health, and many under discussion do not, the group says. Article

Study: EMRs alone can't improve diabetes care

Sun, 10 Jun 2007 20:01:35 -0400

EMRs have long been held out as a key tool in the fight to better manage chronic disease. Given their capacity to review records automatically--and let physicians know when standard steps weren't taken--the idea seemed like a no-brainer. In reality, though, EMRs in and of themselves may not help much when it comes to improving diabetes care, a new study suggests. The study, which was published in the Annals of Family Medicine, looked the care diabetics got in 50 primary care practices. Researchers concluded that the care diabetics got in the 37 offices that weren't using an EMR was actually better than patients seen in offices that did have EMRs. On the other hand, researchers did also note that most of the 13 offices using an EMR had underpowered systems which might not have been up to the job. Regardless, EMRs are more likely to improve care when used as part of an overall quality improvement initiative, researchers said.

To find out more about the study:
- read this HealthDay News item

Related Articles:
California RHIO targets diabetics. Report
Vendor trials cellphone-based diabetes monitoring. Report
RFID chip reads blood glucose levels. Report

HHS grants improve Medicaid data management

Sun, 28 Jan 2007 19:01:38 -0500

HHS has awarded $103 million to 27 states, supporting programs a range of programs--including health IT initiatives--designed to improve the way Medicaid dollars are used. Congress has approved a total of $150 million for these "transformation grants," which will distributed over fiscal '07 and '08. While the states will be able to use the funds for a variety of purposes, key themes include the development of programs to encourage EMR use, clinical decision support tools or e-prescribing. Other areas include increasing utilization of generic drugs, implementation of a medication risk management programs and improving access to primary care and specialty physicians using integrated university-based hospitals and clinics. Interesting IT projects that were funded, included a health information exchange/e-prescribing initiative in Connecticut, which got $5 million, an $11.8 million Medicaid HIE in Arizona, an "open Vista ASP Network" in Hawaii, which got $3.2 million, and a $1.5 million grant integrating EHRs with clinical decision making. What I'd like to see added to this list, personally, is a grant which is explicitly designed to speed up how quickly at which Medicaid physicians get paid. Now there's an IT initiative everyone would love.

To learn more about the grant program:
- read this press release from HHS, which lists state by state awards
- get more background on the grant application guidelines

Case study: Nurses drive MSHA EMR project

Sun, 10 Dec 2006 19:01:36 -0500

While it wasn't always the case in the past, nurses are playing an increasingly large role in shaping and rolling out EMR systems. That was definitely the case at Mountain States Health Alliance (MSHA), which was aggressive enough to begin moving from paper records to EMR in 2001. MSHA's network includes 11 hospitals with 1,462 beds, 21 primary care centers and 13 outpatient clinics.

While physicians often run EMR deployments, this time chief nursing executive Kathryn Wilhoit oversaw the EMR rollout. In addition, 32 other nurses, including some involved in direct patient care, helped to select the vendor. Because the hands-on patient care nurses were paired with nurse IT specialists, clinical issues and IT issues got equal time, resulting in the consensus choice of a fully-integrated Web-based product from Siemens Medical Solutions.

For more information on the MSHA EMR implementation:
- read this article from Digital HealthCare & Productivity

SPOTLIGHT: RHIOs as ASPs?

Sun, 12 Nov 2006 19:01:32 -0500

Many health providers believe that, in theory, they could get a great deal of benefit out of participating in a regional health information organization (RHIO). Unfortunately, however, few small primary care practices are like to invest the time and money needed to link up with a RHIO. Writer Matthew Holt suggests that RHIOs might stand a better chance of attracting providers if they host and manage the data networking application themselves. About 20 percent of RHIOs are already considering becoming ASPs, according to one expert cited by Holt. The question is, will this approach work for most RHIOs, or is there a better way to attract providers to RHIO network? Column