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HHS HIT Website

Posted on April 27, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Today I came across what someone called a new Health and Human Services (HHS) health information technology (HIT) website. Unfortunately, they didn’t get the same graphic designer and web developer that have been doing such a fine job with the various websites that Obama has been putting up.

I find the first page interesting since it has HHS asserting the following:
Health information technology (Health IT) allows comprehensive management of medical information and its secure exchange between health care consumers and providers. Broad use of health IT will:

  • Improve health care quality
  • Prevent medical errors
  • Reduce health care costs
  • Increase administrative efficiencies
  • Decrease paperwork
  • Expand access to affordable care

Interoperable health IT will improve individual patient care. It will also bring many public health benefits including:

  • Early detection of infectious disease outbreaks around the country
  • Improved tracking of chronic disease management
  • Evaluation of health care based on value enabled by the collection of de-identified price and quality information that can be compared.

I wish that each of these bullet points had links to all of the research that shows these are indeed the outcomes of HIT. This should include the research that argues against HIT being able to solve these problems. That would turn the list into an invaluable resource on the benefits and challenges of HIT.

I’m going to need to take some time to look at the rest of the site. However, the link that said “Standards and Certifications” certainly caught my eye and is guaranteed to be a future blog post.

Kathleen Sebelius as Obama’s HHS Secretary

Posted on March 2, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

An AP report is announcing that Kathleen Sebelius will be announced as Barack Obams’s new nominee for HHS secretary tomorrow. The article says the following about Kathleen Sebelius as HHS secretary:

Sebelius, 60, is seen as a steady hand, an experienced public official who knows how to work across political lines. As a former state insurance commissioner, she is unfazed by the complexities of health care and insurance issues.

Of course, Sebelius will still have to gain confirmation from the Senate which could be interesting because Sebelius has clashed with abortion opponents in Kansas and the fight might head to Washington.

Another delay in the nomination of the HHS secretary could mean even more delays in the HITECH act and EHR adoption. I for one hope that health care doesn’t have to wait even longer for the HHS secretary to start getting down to business. There’s just far too much to do for us to be without a leader.

UPDATE: It’s now official that Kathleen Sebelius has been named as Obama’s HHS secretary. Check out the Huffington Post report and the Washington Post.

HITECH Act Gives HHS $2 Billion of Discretionary Funds

Posted on February 20, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The HITECH Act gives Health and Human Services (HHS) 90 days to develop a plan to allocate $2 Billion of discretionary funds. Talk about a nice infusion of funding for HHS. HHS does have a set of core areas of focus for the money (per an Allscripts presentation on HITECH).

The area of focus that interests me most is the “Regional Health IT Resource Centers.” Seriously, what is a regional health IT resource center? Can any of you imagine a doctor visiting a health IT resource center? I don’t understand how this will work at all.

I have a better idea. Why not take a cool million and give it to me? I’ll create a killer online platform for sharing of health care IT resources where people can share information nationally or within their region. Could be a killer application for sharing information quickly and could be available to every state in the country (and for that matter the world). Unless you think that training health care IT staff is better done without using IT.

Here’s a look at the full list of core areas of focus:

  • Standards requirements due before the end of this year
  • HIE Infastructure, National Health Information Network (NHIN)
  • Regional Health IT Resource Centers
  • Federal grants through AHRQ, HRSA, CMS
  • Grants to the states in 2010
  • Promote advanced EHR

Big Winners from Obama EHR Stimulus HITECH

Posted on February 19, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

UPDATE: Check out this post I did updating the Big Winners from the HITECH EHR Stimulus Incentive Program.

Whenever government decides to spend $20 billion, there are bound to be a lot of winners. The money has to go somewhere. I previously posted how I think that EHR adoption won’t significantly increase because of HITECH. However, there will be some BIG winners from this legislation. Lets’s take a quick look at a few of them.

  • EHR Vendors – I don’t think there’s any doubt that vendors will benefit from $18 billion of investment in EHR.  The legislation was signed yesterday, and I’ve already seen ads for Allscripts talking about learning about the EHR stimulus.  Marketers for every “certified” EHR are going to beat this stimulus like a dead horse.
  • Health Care IT Consultants (ohhh…maybe I should become one) – Business should be just fine for EHR and health care IT consultants despite the current economic crisis.  I didn’t think there were enough before.  Even a small increase in EHR adoption will mean higher demand for health care IT consultants.
  • Existing EHR Users – Despite my feeling that this stimulus won’t stimulate EHR adoption, I do think that already implemented EHR users should benefit from this EHR stimulus.  I didn’t read any “first time home buyer” provision in this legislation.  This could mean a bit of free (minus a little paperwork) cash for those who find themselves already using a certified EHR.
  • CCHIT (if they get chosen) – This is a big IF, but I believe that CCHIT’s survival hinges on them being chosen as the certification required to receive stimulus.  It would say a lot if they weren’t chosen.  Let’s hope HHS has the guts to not choose them despite the incredible lobbying efforts I’m sure they’ll receive.
  • Hospital Systems – I’m familiar with one hospital system that has over 100 multi specialty clinics with many of them using a centralized EHR.  Seems like a great investment to pay someone to make sure they meet the required standards.  100 clinics X number of doctors in a clinic X $40k = a lot of money
  • Health and Human Services (HHS) – Even just the $2 billion in discretionary funding is a huge boost to that organization.
  • Obama’s HIT Donors

Anyone else I should add to the list?

Meaningful EHR User

Posted on February 18, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I predict that “meaningful EHR user” will become the most overused term in EHR and Healthcare IT adoption over the next year.  Since the term seems to be the cornerstone of receiving a part of the $20 billion EMR stimulus package, then I thought it might be a good idea to understand how HHS might define what a “meaningful EHR user” will need to do.

Luckily Patricia King, a health care attorney in Illinois, posted the criteria for being a meaningful EHR user on NetDoc as follows.

To be a “meaningful EHR user”, the physician must satisfy three criteria:

  • The physician must use “certified EHR technology” in a meaningful manner, including electronic prescribing. The law calls for creation of a health information technology (HIT) Policy Committee, and an HIT Standards Committee. The HIT Policy Committee will focus on development of a nationwide health information infrastructure, while the HIT Standards Committee will recommend standards, implementation specifications and certification criteria. The Office of the National Coordinator for Health Information Technology (ONCHIT) is to adopt an initial set of standards, implementation specifications and certification criteria before December 31, 2009.
  • The physician must demonstrate that the certified EHR technology is connected in a manner that provides for the electronic exchange of health information to improve the quality of health care, such as promoting care coordination.
  • The physician must submit information on clinical quality measures specified by HHS.

Sound confusing enough?  Well, it’s going to be confusing until HHS is able to define what a certified EHR will look like (let’s all hope that it’s not synonymous with CCHIT certification) along with defining how the EHR should be able to exchange information.

I’ll be very interested to watch how HHS plans to implement these things.  I wonder if the frenetic pace that President Obama is basically requireing will end up being good or bad for health care IT and EHR adoption.

One thing we know for sure is that we’re in for an interesting ride.

HHS Secretary Mike Leavitt Blogs About EHR Adoption

Posted on May 26, 2008 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Today I came across the HHS Secretary Mike Leavitt’s blog. To be honest, I saw Mike Leavitt’s picture on the blog and I felt like I was meeting an old friend. No, I don’t really know Mike Leavitt from the next person on the street. We have never met before and the closest I’ve been to him is probably when I watched him pass by in numerous 24th of July parades in Utah. However, he was the governor of Utah for many of the years I lived in Utah and so I feel like I kind of know the man.

Reminiscing aside, I find Mike Leavitt’s blog completely captivating. He currently has been writing about his trip to China. For some reason I’ve always had an inner itch whenever I heard about China. I don’t know what it is, but I find the place completely fascinating. So, you can imagine my fascination with the HHS secretary’s interaction with the Chinese government. Plus, these posts about HHS and China give Mike a real personal quality that I find real and interesting.

Of course, I couldn’t begin to read the HHS Secretary’s blog without making sure to find some post about EHR or EMR. I quickly found a post entitled Value-Driven Health Care Interoperability which I think could more aptly be entitled “Electronic Health Records (EHR) Progress Report.” Of course, he is in government so that explains the title.

I’m grateful that the HHS Secretary is willing to engage the public in a discussion about EHR and EHR adoption, but unfortunately the post I found is so filled with political rhetoric. It sounds really good, but really has very little substance.

First, I’ll start with the good.

Three years ago, there were 200 vendors selling electronic health record systems but there was no assurance that the systems would ever be able to share privacy protected data in interoperable formats.

I think the concept of a certification for interoperability is good. It just makes sense that every EMR software vendor should be able to interact with another. Establishing a quality standard for this interoperability is valuable and even worth certifying.

Unfortunately, I think the HHS Secretary has been getting bad information when he says the following:

Since then, we have made remarkable progress.

An EHR standards process is now in place, and we are marching steadily towards interoperability. We created the CCHIT process to certify products using the national standards and it is functioning well. More than 75% of the products being sold today carry the certification.

Where to begin? First, Mike has suggested that there were 200 vendors selling EHR systems 3 years ago (It’s probably a few more than 200 EHR, but we’ll let this one slide). Mike asserts that “75% of the products being sold today carry the certification.” If that’s the case, then simple math tells us that there should be 150 certified EHR software, no?

If you look at the 2006 CCHIT Certified Ambulatory EHR list I count 92 EHR software products. Let’s see, that’s only 46% of EHR products that are certified. Plus, my count of 92 EHR counts some of the software multiple times since a number of the EHR software vendors certified multiple versions of their product. That sounds like less than 75% of EHR products sold to me.

Of course, Mike Leavitt certainly could say that 75% represents a percentage of actual products sold. Certainly the certified eMD’s has a lot more installs than any of the free open source EMR products out there. However, I think it’s a bit deceptive to say 200 EHR and then 75% of products sold if they aren’t the same thing.

I also love how it says 75% of products sold. I think we’re all aware of the outrageous failure rates of so many of the EHR products out there. It’s unfortunate that we don’t have a percentage of products installed. Then, you’d have a much better idea of how many doctor’s offices really have the possibility of interoperability.

Wait a minute! I was being extra generous above when I said that there were 92 Ambulatory EHR CCHIT certified. Why? Because it was 92 EHR certified with the 2006 CCHIT Certification. Correct me if I’m wrong, but I think that interoperability was taken out of the 2006 CCHIT Certification (along with the joke of the pediatric requirements). I’m pretty confident about this, because I work on one of the 2006 CCHIT Certified EHR and I have no way of sending a chart to another clinic other than manually going through the product and printing out the chart.

What does all this mean? That means that instead of 92 interoperable CCHIT certified EHR, there are only 31 EHR CCHIT certified in 2007. That represents 15.5% (not 75%) of the 200 EHR products on the market today are interoperable according to number of certified EHR.

I’m not really blaming Mike Leavitt for this. I’m sure him or his office was given a nice executive report with a bunch of data and they made it look as nice as possible. Reminds me a lot of what I call EMR sales miscommunications. Sometimes the data just gets lost in translation. Let’s just hope my trackback to Mike Leavitt’s blog gets read.

You thought I was done. Nope. Still plenty more to say and I’m just hitting the major points.

In addition, a National Health Information Network will start testing data exchange by the end of the year and go into production with real data transmission the year after.

This concept I really find intriguing. I look forward to seeing this go public and I’m glad it’s on the agenda. However, I fear that this isn’t more than political hyperbole. I’d love to see how they plan to address any of the following: unique identifier, the ultimate hacker’s health information paradise, economic model, motivational model and that’s just the list off the top of my head.

The primary reasons for low adoption rates among small practices are predictable: economics and the burden of change.

I’m glad you pointed out the obvious. If this was so obvious, then why did you support the implementation of a certification that costs so much money that EHR will inevitably raise the cost a small practice pays for an EHR? That doesn’t make much economic sense. Not to mention you missed what I think is the biggest factor in lack of implementation: fear. Not fear of change. Not fear of the expense. Certainly those are two major factors, but I believe that adoption rates by small practices are so low because most doctors have seen too many of their colleagues fail at implementing an EHR.

Let’s start waving the CCHIT certification flag again. Many will be willing to make the case that CCHIT certification helps supplant a doctor’s fear that their EHR implementation will fail. It may even supplant some fear, but what it doesn’t do is decrease the number of failed EHR implementations. It’s a problem I’ve discussed many times on this blog. Certifications don’t certify usability. They never have and never will.

I actually have a thought about what should have been done instead of CCHIT, but I think I’ll save that for a future post.

Thanks Mike for opening up the lines of communication with your blog. Now it will be interesting to see if Mike Leavitt and HHS have really embraced new social media and participate in the discussion they started. I’m certain that Mike’s blog is going to become one of my favorite reads.