Dr. Farzad Mostashari Appointment as National Coordinator for Health IT

Here's a press release from HIMSS about the new appointment at the ONC:

08 April 2011
HIMSS Statement on Dr. Farzad Mostashari Appointment as National Coordinator for Health IT

We are pleased that Dr. Farzad Mostashari has been appointed as the new National Coordinator for Health IT, replacing Dr. David Blumenthal who is returning to academia. HIMSS notes Dr. Mostashari’s leadership on a number of issues, including provider adoption and associated certification requirements, interoperability and health information exchange, and efforts to engage all communities in driving the innovation that is necessary for transforming healthcare, and we are very comfortable with the directions he advocates. The announcement of his elevation to National Coordinator is timely, given the recent release of the Federal Health IT Strategic Plan: 2011-2015. We look forward to continuing to work with Dr. Mostashari and the entire ONC team to leverage the goals and objectives identified in the Strategic Plan to address the ongoing transformation of healthcare using information technology.

Thoughts about the final "meaningful use" rules

The final "meaningful use" rules came out yesterday. I'm still reading through the 800 page document and thinking about the amount of time it must have taken to come up with all these rules. The New England Journal of Medicine (NEJM) published a perspective article yesterday titled, "The “Meaningful Use” Regulation for Electronic Health Records." David Blumenthal, M.D., M.P.P., and Marilyn Tavenner, R.N., M.H.A. start the article with this paragraph:

The widespread use of electronic health records (EHRs) in the United States is inevitable. EHRs will improve caregivers’ decisions and patients’ outcomes. Once patients experience the benefits of this technology, they will demand nothing less from their providers. Hundreds of thousands of physicians have already seen these benefits in their clinical practice. 

They then remind the readers that:

Through HITECH, the federal government will commit unprecedented  resources to supporting the adoption and use of EHRs. It will  make available incentive payments totaling up to $27 billion  over 10 years, or as much as $44,000 (through Medicare) and $63,750 (through Medicaid) per clinician. This funding will provide important support to achieve liftoff for the creation of a nationwide system of EHRs.

That's a lot of money, but will it be adequate to ensure that hospitals and physicians are equipped with the support staff and the IT infrastructure to achieve "meaningful use" within their organizations?

Healthcare IT News is reporting that "Overall, AHA leaders said they remain concerned that the requirements may be out of reach for many hospitals. "Unfortunately, CMS continues to place some barriers in the way of achieving widespread IT adoption," AHA said in its statement."

Health 2.0 Goes to Washington

This Health 2.0 conference is the leading showcase of cutting-edge social media, web and mobile technologies engaging consumers and providers in transforming healthcare.

Here's some information about the upcoming conference (this is from an e-mail message):

For our first conference in DC, we've worked closely with the Office of the National Coordinator for Health IT (ONC) on a unique forum for leading innovators from the Health 2.0 community to meet with government leaders, trade associations and policy makers to share visions and practical solutions that will shape the future of health care.

On the Main Stage: David Blumenthal, National Coordinator for Health Information Technology, Todd Park, Chief Technology Officer, US Health and Human Services, Aneesh Chopra, Chief Technology Officer of the United States, AND more than 30 demonstrations from leading Health 2.0 companies.

Patients 2.0: Join Gilles Frydman, ACOR, as he hosts a panel of 7 vocal ePatients who will share their personal journeys navigating the healthcare system and the world of Health 2.0. Stay tuned for the launch of a very special documentary project as well. And in addition to this session, in a first for a Health 2.0 conference, there will be a patient on every main-stage panel!

Learn more here: http://www.health2con.com/dc-2010/

Health IT "Meaningful Use" Defined?

The phrase "meaningful use" is a critical part of the health IT or HITECH provisions within ARRA (American Recovery and Reinvestment Act). The Office of the National Coordinator for Health Information Technology (ONC) health IT policy committee voted last week and approved the proposed meaning of "meaningful use." Based on the HITECH provisions, Medicare reimbursement incentives for physicians will begin as early as 2011 and penalties for those not engaging in the "meaningful use" of electronic health records or EHRs will start in 2017.

Now, the recommendations will need to be approved by David Blumenthal, MD, National Coordinator for Health IT before they go to CMS (Centers for Medicare and Medicaid Services).

So have we fully defined the phrase "meaningful use"? How many physicians will be using EHRs by 2017? If you think about it, 2011 really isn't that far away. I'd like to think that by 2017, most physician offices will be utilizing EHRs, but I also remember thinking that 10 years ago when I thought that health IT uptake was going to soar. Now that we have a major carrot and stick, we should see significant change over the next several years. Let's wait and see.

Stimulus 103: Real World Perspectives

If you missed the AMA webinar titled, "Stimulus 103: Real World Perspectives," then you may be glad to know that you can view the archived session here: www.ama-assn.org/go/hit and then look under "Health IT webinars." Or, you can click on this direct link: https://cc.readytalk.com/play?id=8qo7xu

This is the 3rd part to the American Recovery and Reinvestment Act (ARRA) webinar series by the AMA. The presenters include:

• Amanda Ervin, Director of Health Information Technology Initiatives, AMA
• Gary S. Schenk, Sr., MD, Gaston Family Care, Gastonia, NC

The agenda includes the following topics:

• Update on meaningful use
• Small practice perception of meaningful use as it pertains to utilization of an EHR

Seems like we're getting closer to really understanding and defining "meaningful use." The Health IT Policy Committee's "meaningful use" work group will meet today in Washington to submit revised recommendations to Dr. David Blumenthal, the National Coordinator for Health Information Technology. The next HIT policy committee meeting is scheduled for August 14.

Health IT will be central to the practice of medicine

If you're a healthcare professional, what type of role does health information technology (Health IT, HIT, or HITECH) play in your practice? Do you use an electronic health record (EHR)? Do you have computers in your office/hospital (if you can't imagine not having computers everywhere, try visiting some remote health clinics in Montana and Wyoming). You may have a very old computer and if you're not connected to the Internet, then it really may be a worthless paperweight. I don't know how you'd be reading this if that were the case.

Anyways, with all this talk about healthcare reform, we now see people like Dr. David Blumenthal really pushing for health IT. At the HIT Symposium at MIT, Dr. Blumenthal gave an opening keynote where he shared how health IT will transform healthcare in the U.S. Given that somewhere between $31 billion and $46 billion will be channeled towards health IT, this is a huge amount that will result in more than simple incremental changes. Physicians will be expected to use health IT resources heavily. They must demonstrate meaningful use, otherwise they will not see the incentives that are outlined within the HITECH (health IT) provisions outlined within ARRA (American Recovery and Reinvestment Act).

So, should health IT play a more integral role during medical training?

Defining "Meaningful Use" Begins Today

We've all been waiting for today. Today (June 16), those in the health information technology (Health IT, HIT, or HITECH) industry began getting glimpses of the definition of "meaningful use" from government leaders. If physicians use an electronic health record (EHR), they must use it in a meaningful way if they are to reap the benefits and avoid the punishments stated in the ARRA. Who gets to decide if you're using an EHR in a meaningful way? The government.

Today is just the beginning of a long conversation, according to Dr. David Blumenthal, National Coordinator for Health Information Technology. Today, the HIT Policy Committee met and highlighted some of the essential components that outlines this mysterious phrase, "meaningful use." We won't see physicians meaningfully using an EHR overnight. This will happen in three stages (although many things will also be happening simultaneously):

1. Data capture and sharing by 2011
   
2. Advanced clinical processes by 2013
   
3. Improved outcomes by 2015

Here are some key points of data capture and sharing:

• Physicians must actually document outpatient progress notes using an EHR (so can you still dictate your note and have it manually transcribed into the EHR?)
  
• They must use computerized physician order entry (CPOE) for all order types, including e-prescribing
• They must improve care coordination (that's a bit nebulous if you ask me, but I'm sure they will eventually iron out the critiera for this)
• Submit electronic data to registries and other databases to improve public health and assist with disease surveillance
  
• Comply with HIPAA Rules and state laws (isn't this obvious?)

So, this is just the beginning of a long conversation. Any surprises here, or have we simply stated the obvious?

Is MIT a Leader in Health IT?

It's great to see a school like MIT getting heavily involved in the world of health information technology (health IT, HIT, or HITECH). I don't think many people would argue with me if I say that MIT is a leading technology institute in this country.

MIT is holding a HIT Symposium next month (called the HIT Symposium at the Massachusetts Institute of Technology) and I'm seriously thinking about attending (either in-person or virtually via online webinars, etc.). I really miss those days in Boston when I was a care-free college student at MIT. I would trade anything to go back to those days.

You may be interested to know who will be providing special keynote addresses:

• David Blumenthal, MD, MPH; National Coordinator for Health Information Technology, Department of Health and Human Services, Former Director, Institute for Health Policy, Massachusetts General Hospital, Samuel O. Thier Professor of Medicine, Harvard Medical School, Washington, DC
• Clayton M. Christensen, MBA, DBA; Robert and Jane Cizik Professor of Business Administration, Harvard Business School, Co author, Innovator's Prescription: A Disruptive Solution for Health Care, Author, The Innovator's Dilemma and Disrupting Class: How Disruptive Innovation Will Change the Way the World Learns, Cambridge, MA

Health IT Policy Committee Appoints 3

The United States Department of Health and Human Services (HHS) has appointed three people to the Health Information Technology Policy Committee:

1. David Blumenthal, MD, MPP; head of the Office of the National Coordinator for Health Information Technology
   
2. Michael J. Klag, MD, dean of Johns Hopkins Bloomberg School of Public Health
   
3. Deven McGraw, director of the Health Privacy Project at the Center for Democracy and Technology

Exciting news! Let's see what this committee comes up with over the next few months.

Defining "Meaningful Use"

The new HITECH bill is calling hospitals and physicians to demonstrate "meaningful use" with electronic health records (EHRs) so they can receive higher Medicare reimbursements. How do you define this phrase? I'm sure that Dr. Blumenthal and his team will come up with some measurable definitions of the phrase "meaningful use."

Blumenthal and HITECH in the NEJM

If you get the New England Journal of Medicine (NEJM), you may have seen David Blumenthal's article about Health IT (or HITECH) in the April 9, 2009 edition. It's a Perspective titled, "Simulating the Adoption of Health Information Technology." If you have any interest in health IT, then you should read this article. It's a short article - just a few pages long.

Health IT and the NEJM

I don't think I've ever seen so much content related to health IT in the New England Journal of Medicine (NEJM). I'm sure more and more universities are offering programs in medical informatics and health informatics. The March 25, 2009 issue of the NEJM had an article titled, "Use of Electronic Health Records in U.S. Hospitals." The issue that I got today has an article on health IT by David Blumenthal, MD, MPP.