July 13, 2010
3:57 pm
An organization of health industry chief executives today applauded federal regulators for being responsive to the concerns of hospitals and physicians in constructing the final “meaningful use” regulations that will determine the allocation of health information technology (HIT) incentive funds. But, said the president of the Healthcare Leadership Council (HLC), the newly-released rules leave some critical issues still unaddressed.
HLC president Mary R. Grealy said that, even though her organization was still analyzing the regulations, “it’s clear that federal regulators paid close attention to the more than 2,000 comments they received on the proposed rule, and that they have been responsive to concerns that the initial regulations placed the “meaningful use” bar so unrealistically high that the health technology revolution would have been slowed instead of accelerated.”
The “meaningful use” regulations establish standards that health providers must meet in order to qualify for a share of the more than $27 billion authorized by Congress in last year’s economic stimulus legislation.
The Healthcare Leadership Council is a coalition of chief executives from all sectors of American healthcare.
Ms. Grealy said, “An example of this responsiveness is seen in the fact that the rules no longer require that, in the initial stage of implementation, all of a health provider’s administrative transactions must be included in an electronic health record. That simply wasn’t realistic. Those requirements are now in Phase 2 of implementation, which is achievable.”
She said, though, that legitimate concerns remain. For example, the regulations should consider each campus of a multi-campus hospital system as a separate entity in qualifying for HIT incentive payments. And, she said, health providers who have built and succeeded with their own information technology systems should be grandfathered into the universe of successful “meaningful use” qualifiers, but that doesn’t appear to be the case based on an initial review of the rules released today.
Nonetheless, Ms. Grealy said, “we’re seeing important progress with these regulations. Clearly, the administration saw there was a gap between the theoretical standards they initially wanted to apply and the real-world challenges that physicians and hospitals face in achieving HIT advancement. We all want the benefits that come from information technology – enhanced patient safety, more cost-efficient operations, greater use of evidence-based medicine – but to make strides forward, regulators and providers need to be moving at a coordinated pace.”
June 25, 2010
10:39 am
There is an interview well worth reading on Kaiser Health News today. Kate Lorig is the director of the Patient Education Research Center at Stanford University and is the creator of an initiative called the Chronic Disease Self-Management Program.
With eight out of every 10 over-65 adults having at least one chronic disease, and with chronic illnesses accounting for over 70 percent of our nation’s $2 trillion annual healthcare bill, Dr. Lorig’s program is a valuable one. The workshops and classes she initiated help chronic disease sufferers better communicate about their conditions engage in healthier lifestyles and do a more effective job handling their medication regimens.
The Kaiser interview caught my attention because Dr. Lorig makes an important point about the flaws in our healthcare system when it comes to treating many patients with chronic diseases. She said:
“Right now, it addresses diseases or even parts of diseases or small sub-parts of the body. It does not address the whole, complex person with multiple chronic diseases. So, right now, what happens, if you’re lucky, you go to a primary care doc who kind of does the day-to-day stuff and then you see four or five specialists each of which do their little specialty part — none of whom really talk to each other except maybe to look at your laboratory tests on an electronic medical record if you’re really lucky. It is totally uncoordinated. It’s chaotic. It serves pieces of people, not whole people.”
To be fair, there are a number of forward-thinking healthcare systems in the United States that have adopted coordinated care models and do an outstanding job bringing primary care physicians and specialists together to treat patients with a holistic approach. But, I can also attest personally, from overseeing my own father’s medical care, that there are too many cases where physicians aren’t communicating and don’t see the whole picture of a patient’s care when they recommend a new treatment or medication.
With over 50 percent of our senior population having multiple chronic diseases, it is clearly essential that coordinated care be the rule rather than the exception. And, as we move forward with the implementation of health reform, this has to be one of the most important priorities.
March 25, 2010
4:02 pm
The op-ed piece by Deborah Peel, who heads the Coalition for Patient Privacy, that appeared in The Wall Street Journal this week received an inordinate amount of attention. That’s because Matt Drudge of the popular Drudge Report website seized upon the Journal’s headline, “Your Medical Records Aren’t Secure” and listed it among several other stories critical of President Obama’s healthcare plan.
But Dr. Peel’s op-ed wasn’t criticizing the President. The targets of her op-ed included hospitals, pharmacies, employers and a litany of others who are out to plunder our personal medical records for financial gain. And, she alleges, these violations of confidentiality are even easier and more likely when health records are maintained electronically instead of on paper. She insists that the answer lies in giving patients the responsibility to decide what information they choose to share with medical professionals and what to keep secret.
Dr. Peel’s logic train goes off the tracks rather quickly. First of all, it’s simply not true that electronic records are less secure than paper ones. In her op-ed, she chooses to not acknowledge the role HIPAA privacy laws have played in keeping health information confidential. She ignores the new laws adopted earlier this year that strongly encourage encryption of electronic data and that impose new criminal and civil penalties for privacy violations. And you would never know from the op-ed in the Journal that hospitals, insurers and physicians throughout the country have taken extraordinary steps to safeguard patient data.
So we can see that any privacy “crisis” is overblown. The greater problem lies in the proposed solutions.
Giving patients the responsibility to decide which portions of their medical records should be open to healthcare professionals is, at best, unreasonable and, at worst, potentially deadly. It is highly unlikely that a patient without a medical background can make a sound decision on what information a physician might need to provide quality treatment.
But an even greater potential harm lies in the society-wide impact of ill-advised patient consent proposals. Enabling system-wide picking and choosing of what data enters the flow of essential information will have an impact on the many beneficial actions that are dependent upon information collection and analysis, such as:
• Reporting and tracking incidences of disease for public health purposes
• Monitoring the quality and safety of medical products
• Carrying out product recalls
• Medical research into lifesaving cures and treatments.
Our health system has dual objectives in this regard. We need to protect patient confidentiality while, at the same time, preserving the vital flow of information that protects, extends and saves lives. Some, as Dr. Peel’s op-ed demonstrates, lose sight of the need to maintain that balance. The fact is, though, that you should never have to choose between privacy and excellent healthcare, and we don’t have to.
January 12, 2010
5:20 pm
We hear it all the time. It’s a nonstop drumbeat. Healthcare in the United States is too expensive and too low in quality compared to other countries. Critics are constantly citing the World Health Organization which, in its most recent rankings, said the U.S. ranks 37th in overall healthcare performance.
In reality, though, what kind of healthcare do Americans receive? And would we really trade what we have for what is offered to citizens in other nations.
Dr. Mark Constantian, a reconstructive surgeon in New Hampshire, investigated that question and shared his conclusions in the Wall Street Journal last week. Dr. Constantian found that, when it comes to the factors that patients and healthcare consumers care about the most, healthcare in this country stacks up pretty well. Read more
November 25, 2009
11:44 am
Last week HLC participated in the Women in Technology roundtable event which gave their members an overview about the role of technology in health reform as it relates to electronic medical records, care management, and identity.
NextGenWeb blogger Shana Glickfield had this to say about the event:
“Women in Technology hosted a roundtable event to give their members a closer look at how healthcare policy intersects with technology. The presentations dove into where our government is heading when it comes to Health IT. Particularly when it comes to Electronic Health Records, the speakers focused on the recent progress in moving these life- (and money-) saving technologies forward.
Tina O. Grande, SVP for Policy at the Healthcare Leadership Council, noted that electronic health records were actually part of the economic stimulus bill (The American Recovery and Reinvestment Act). The bill provides many deadlines, standards and incentives. They include Medicare bonus payments to eligible physicians and hospitals using electronic health records as soon as 2011.”
HLC believes the nationwide use of health information technology, including the development of uniform standards for information-sharing and a national patient privacy standard will create quality improvements and greater patient safety. I would like to thank Shana for highlighting our efforts on health information technology.
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