Blumenthal: Meaningful use will make IT central to practicing medicine July 6, 2009
Posted by gonzalezloumiet in Blumenthal, Health Care IT.Tags: Blumenthal, Health IT
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June 30, 2009 | Chip Means, Web Editor
David Blumenthal, MD
CAMBRIDGE, MA – Electronic technology will soon be considered as fundamental to medicine as the stethoscope, according to National Coordinator for Health Information Technology David Blumenthal, MD.
Federal incentives for the meaningful use of such technology will propel the nation, Blumenthal told a crowd of providers, technologists, vendors and advocates during a Tuesday morning speech at the Massachusetts Institute of Technology in Cambridge.
"I found that (information technology) changed me as a physician. I thought it was going to change practice. That was 10 years ago," Blumenthal said. "I think that reality will be realized within a few years."
Blumenthal’s opening keynote at the HIT Symposium at MIT focused on the transformational potential of stimulus funds marked for healthcare IT initiatives. He emphasized the sheer size of the funding, which is between $31 billion and $46 billion depending on certain factors such as adoption levels and provider qualifications.
"The American Congress doesn’t produce more than incremental change very often, but the HITECH provision is discontinuous – it’s a leapfrog over the current state of affairs," he said. He qualified this statement with a reminder that President Barack Obama considers the funding a "downpayment" on healthcare improvement.
Despite attendees’ enthusiasm for the Obama administration’s focus on healthcare IT, some expressed anxiety over the short timeline for adoption and incentives. "If you look at the calendar and think about the institutions we need to create by 2011, it is a truly daunting prospect," Blumenthal said. "And in some ways, if we started a year ago, we’d still be late."
Blumenthal acknowledged other challenges facing the ONC, such as addressing the needs of small providers, privacy and security concerns and the lack of attention the current legislation pays to providers of long-term care, home care and hospices. ONC hopes to include those providers later, he said.
"We need that connection, but very frankly we don’t have the resources or the authority in this legislation to do what we need to do in that sector," he said.
Blumenthal said he’s optimistic about ONC’s ambitious agenda. "We will not be successful unless we think of this as something with the purpose of changing individual health, population health and the efficiency of our healthcare system," he said. "That’s the brilliance of the meaningful use concept: To set goals that are about healthcare, and not about information technology."
ONC’s 2009 objectives include holding further policy and standards committee meetings, holding open meetings on certification processes, releasing a concept for infrastructure programs and issuing an initial rule on "meaningful use" by the end of the calendar year.
Regarding the final definition of "meaningful use," Blumenthal said the initial rule would hit the federal register in December. A 60-day commenting period will follow, and in early- to mid-2010 there will be a final rule for 2011.
"(Meaningful use) is going to be an evolving concept," he said, noting that by Congressional intent, the definition will change to demand more of the nation’s healthcare system.
Confidence low that stimulus will drive health IT adoption July 4, 2009
Posted by gonzalezloumiet in Uncategorized.Tags: Health IT
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Survey respondents also say they aren’t interested in health information exchanges.
By Pamela Lewis Dolan, AMNews staff. Posted July 2.
More than half of health care workers, including physicians, interviewed for a recent survey say that the stimulus package will not help advance health information technology adoption.
The June report, published as a white paper by IVANS, a Stamford, Conn.-based network solutions provider, found that 52% of health care workers thought the stimulus package would have little or no success encouraging health IT adoption.
Meanwhile, the survey also found nearly 39% have plans to adopt an electronic medical records system within the next 12 months.
Clare DeNicola, president and CEO of IVANS, said that although finances are a major barrier — 82.3% included budget in their top two challenges to health IT adoption — the stimulus is not expected to be a driver for adoption, because it does little to address up-front costs.
The money allocated by the stimulus will be distributed by way of incentives for practices that already have a system up and running. The practices and health care facilities that have plans to adopt are doing so mostly because of quality and safety issues, DeNicola said.
The Web-based survey of more than 500 U.S health care workers on which the report was based was conducted in April. While participants included physician practices and hospitals, 58% of respondents were home health care workers and nursing homes.
But there were similarities in what each reported. For example, of the nursing homes and home health care respondents, 52% said the stimulus would do little or nothing to promote health IT adoption. And, 47% of respondents from private medical practices and hospitals said the same.
In addition, 83% of survey respondents said they have no plans to participate in a health information exchange, which could also explain their skepticism that the stimulus will be a driver, DeNicola said. To qualify for the incentive money, health IT users will have to meet “meaningful use” requirements that are bound to include participation in a health information exchange, she said.
“A lot of them are interested in implementing electronic health records, far less interested in the exchange of that information outside the four walls of the practice, whatever that practice may be,” DeNicola said.
Source: http://www.ama-assn.org/amednews/2009/06/29/bisf0702.htm
Can contractors be part of health IT reform? June 27, 2009
Posted by gonzalezloumiet in Health IT.Tags: Contractors, Health IT
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June 26th, 2009
Posted by Dana Blankenhorn @ 6:02 am ZDNET
In covering efforts to reform health IT based on open standards most reformers I have spoken with have reserved a special disdain for federal contractors.
Contractors got us into this mess, they sneer, with proprietary models and cost overruns.
John Loonsk is trying to change that.
A longtime advocate for a national healthcare network while at the Department of Health and Human Services, Loonsk joined CGI Group, a major federal contractor based in Montreal in April, and wrote at Government Health IT this week as an advocate of standards-based reform.
But what kind of reform? Carefully-engineered reform, he says.
Now that there are funds, the national health IT agenda is no longer emphasizing proactive engineering. Instead, the focus is more narrowly on getting electronic medical records into practice settings, supporting the general idea of health information exchange, and hoping that the organic growth of the two solves the many needs of a nationwide infrastructure.
The administration should reconsider this plan.
Instead, he suggests, standards need to be engineered that all vendors would meet and connect to.
Doubtless, a contractor such as CGI Group could be hired to engineer those standards. But would that speed or slow the pace of health IT reform?
Loonsk argues his case based partly on the development of Internet standards. But those standards were negotiated, not imposed. And they developed organically along with the network, in an open, transparent process.
Of course, while the Internet standards door was always open, few other than engineers walked in for nearly a quarter century. The Web was overlain on a set of standards that were engineered, but also negotiated, and existed before it was spun.
Is that possible with health IT, given the large number of vendors already serving the market and the urgency of the task?
