government health

National EMR adoption could cost $150B

Anne Zieger — Sun, 03 Aug 2008 15:14:56 -0400

How much will it cost to roll out and fully implement EMRs in all U.S. physicians' offices and hospitals? A whopping $150 billion spread over the next eight years, according to one health economics professor. The professor, Robert Miller, of the University of California, San Francisco, actually considers the sum to be "manageable," given that it accounts for less than 1 percent increase per year in total U.S. healthcare spending.

Miller, who made his remarks at an Institute of Medicine workshop on the subject held last week, projects that hospitals are likely to spend $35 billion to buy and expand EMR systems, plus $55 billion on operating costs. In his view, large hospitals with the most beds are likely to be able to afford EMRs, but public and smaller hospitals--as well as troubled for-profits--may fall behind in the EMR arms race.

Meanwhile, the 96-odd percent of medical practices without EMRs would need to lay out about $15 billion in capital to acquire them, plus $24 billion to operate them over the next eight years, Miller says. Then there's $20 billion that should be spent for EMRs in nursing homes and other medical professional settings, Miller suggests.

To learn more about Miller's conclusions:
- read this Government Health IT piece

Related Articles:
CBO says EMRs won't save as much as hoped
California MDs lead in EMR adoption
CMS to offer EMR adoption incentives
The hidden side of EMR adoption

Should EMRs offer research capabilities?

Mon, 12 May 2008 06:59:59 -0400

Maybe it sounds like a crazy question, but how do you use your EMR system? Are you dedicating it entirely to supporting direct patient care, or do you expect to use it to conduct research, too?

I ask because some comments I've included in today's issue have me thinking. In it, a CDC researcher notes that the so-called "secondary" uses of EMR data--including disease surveillance, quality research and tracking of adverse drug reactions--are far too important to get second billing. Last week, he urged colleagues at at a DC seminar to rethink the whole raison d'etre for EMRs generally.

The question isn't just an academic one. Right now, commercial EMRs are being designed almost exclusively with patient care in mind. Whether that poses obstacles to quality data gathering, public health monitoring or academic research would, of course, depend on the product, but I'm sure it'd be easier to perform these tasks with software that anticipated research needs.

It seems to me that if an institution is going to spend all of the money it takes to bring up a robust EMR--at least $4 billion in Kaiser's case--it'd be crazy not to use it to track care, participate in national efforts to cure diseases and improve drug safety. On the other hand, I realize that there may be something I'm missing here from a design perspective.

OK, now it's over to you. Do you think it's important for EMRs to offer research capabilities, too, and if so how robust should they be? Do you share data with academic or government institutions now, and is it a strain on your systems? - Anne

Study: 75 percent of states developing HIEs

Mon, 28 Apr 2008 06:59:56 -0400

A new study has concluded that three-quarters of states have begun developing some form of HIE. The study, released by the State-Level HIE Consensus Project, found that while many projects are on the drawing board, some HIEs are almost ready to begin exchanging data. (The Consensus Project is supported by the Office of the National Coordinator for Health IT.) Why so much HIE activity? In large part, state health reform efforts are helping to fuel this trend, as many reformers believe that HIEs are central to improving the way care is delivered. In fact, many of the groups hope to serve, not only as conduits for data, but also to support quality measurement and pay-for-performance initiatives.

To find out more about the study:
- read this Government Health IT article

Related Articles:
RHIOs and HIEs backed by states will win
NJ set to move ahead with statewide HIE plans
Minnesota backs statewide HIE
Kentucky moves ahead with HIE plans

States show growing interest in health IT

Mon, 14 Apr 2008 06:59:56 -0400

A new study suggests that state interest in health IT investment has been mounting steadily in recent times. In fact, health IT projects are high on many state governors' agendas, according to a new report from government business research firm Input. So far this year, 27 percent of governors delivering state-of-the-state speeches mentioned health IT benefits, up from 14 percent last year, according to the firm. Governors are expressing strong support for EMRs, e-prescribing and health data interchanges, despite facing budget crunches and a faltering national economy, hopeful that these technologies can actually save money. And they're not just talking. For example, Minnesota has set aside $18.5 million for HIT projects in its 2008-09 budget, and Missouri $15 million.

To learn more about this study:
- read this Government Health IT article

Related Articles:
Louisiana may subsidize health IT adoption
Minnesota backs statewide HIE
Study: RHIOs/HIEs backed by states will win
NY kicks off final phase of RHIO funding

HIT terms becoming more defined

Mon, 31 Mar 2008 07:59:56 -0400

Do you know the difference between an e-medical record and an e-health record? Health IT professionals are banking on an answer of "no," which is why there now is more of a push to give more "precise definitions" to oft used HIT terms, according to an article in Government Health IT. For example, a health information exchange (HIE) should not be defined as any sort of organization, but rather the act of exchanging health information. Furthermore, a HIE org for, say, orthopedic surgeons nationwide, should not be referred to as a regional health information organization (RHIO) because it spans more than just a single region.

So what is the difference between an EMR and an EHR? According to project leaders at the National Alliance for Health IT, an EMR "is created and maintained by people from one organization, such as a hospital." An EHR, on the other hand, "is an aggregate of health records from more than one healthcare organization."

For more information:
- read the full article

CDC grants to help RHIOs share public health data

Mon, 17 Mar 2008 07:59:56 -0400

The CDC has awarded $38 million in contracts to help health information exchanges and regional health information organizations to create data sharing plans used to deliver information to public health authorities. The money will be used as a means of getting trial implementations of the National Health Information Network rolling. Recipients include the Indiana University School of Medicine, which received $10 million to continue work started by its Regenstrief Institute, the state health department, and the Marion County health Department to detect and monitor data outbreaks through the HIE. Other grantees include the Science Applications International Corp., which will receive up to $8 million over five years, and New York non-profit Health Research Inc., which works closely with the state health department.

To find out more about the grants:
- read this Government Health IT article

Related Articles:
HHS awards $22.5 M in NHIN contracts. Report
IBM tests tech for NHIN. Article
NHIN, RHIOs and all that. Article

Senate approves HIT fund

Mon, 10 Mar 2008 07:59:58 -0400

Last week, the Senate approved a budget amendment that would create a reserve fund for health IT legislation. Without getting too deep into procedural stuff, the net effect of the amendment will be that when a Senator wants to file an HIT-related bill, the money will be there to back it up. Otherwise, Senators might have to do gyrations explaining how each of their individual initiatives would fund themselves. While no dollar amount has been specified for the fund, Hill staffers expect that it will provide enough money to fund HIT bills for the next five years. The same bill will also fund further development of an interoperable EMR for the departments of Defense and Veteran's Affairs, an effort that has been all but stalled for a while.

To learn more about the fund:
- read this iHealthBeat item

HIMSS08: Kolodner expects increase in EMR use

Mon, 03 Mar 2008 06:59:56 -0500

Just in case you haven't had your fill, here's more optimism from the feds on HIT adoption. (As for me, it's getting a bit grating, as I don't see enough going on to actually make adoption happen.) At least in this case, the optimism is driven by the likelihood that hospitals will step up, which seems a bit more realistic.

In his HIMSS speech last week, Dr. Robert Kolodner, national coordinator of health information technology, said that he hopes that to see a 50 percent increase in the use of health information technology this year. He's also predicting that the Nationwide Health Information Network will become operational this year, and that EMR vendors will begin incorporating federal standards into their products. Dr. Kolodner contends that an increased use of EMRs will be driven partly by a growth in hospital donations of such software to physicians who practice at their facilities. Thanks to this and other trends, he says, by 2012 at the outside half of all doctors will use EMRs. My question is, how will everyone pay for this?

To get more of Kolodner's predictions:
- read this Government Health IT piece

Related Articles:
Groups say IT changes must be part of national reform. Article
CCHIT invites vendors to apply for EMR pilot. Article

Federal spending on health IT to shoot up

Mon, 25 Feb 2008 06:59:56 -0500

Federal spending on HIT is set for a boom over the next five years, according to a new report from a market research firm. The firm, Input, projects that federal HIT spending will rise 7.1 percent each year, to hit $4.5 billion by 2013. This spending will be driven in part by modernization projects by the Defense and Veterans Affairs departments, which, among other things, are working on huge EMR projects and extending their data reach into pharmacy and laboratory ops. Interestingly, Input is projecting that federal HIT budgets will climb, regardless of which political party takes over the White House in January, given the immensity of the needs involved.

To learn more about this report:
- read this Government Health IT article

Related Articles:
VA program slashes MRSA rates. Report
DoD, VA still struggling to share EMR data. Report
DoD makes progress in VA EMR integration. Report

Report: HIEs/RHIOs are states' top HIT priorities

Mon, 25 Feb 2008 06:59:54 -0500

States consider health information exchanges and RHIOs (pick your acronym) to be their top e-health priorities, according to a new Commonwealth Fund report. When surveyed in 2007, 25 of 41 of states said that HIE adoption was one of their top two e-health priorities, and 12 said HIE policy development was a key initiative. Meanwhile, states cited the other usual suspects in third, fourth and fifth place as priorities, namely EMRs, e-prescribing and addressing health data privacy and security issues.

States said that the biggest obstacle to jump-starting HIE development efforts were getting together funding for implementation and long-term operations. (Reading between the lines, it appears that state policy-makers aren't too confident that HIEs or RHIOs can be self-financing, as some advocates seem to be.) Many said they had difficulty building a business case for HIEs, lacked adequate standards and shared terminology to use.

To learn more about the study's results:
- read this Government Health IT article