Feds release summary of HIT plan May 27, 2009
Posted by Obi Jo in E Health, EHR (electronic health records).Tags: American Recovery and Reinvestment Act, CMS, comparative effectiveness, Congress, E Health, EMR, health, health care reform, health information technology, health plans, health reform, healthcare, HHS, HIT, Hospitals, Medicaid, Medicare, Office of the National Coordinator for Health Information Technology, outcomes, patient care, PHR, Physicians, President, President of the United States, Recovery Act, Secretary of HHS
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The government has released it’s summary of funding and expenditures for the implementation of the HIT strategy included in the recent recovery act. The 8 page document is filled with information, mostly written in “beurocratese” with endless references to various legal frameworks. Hello . . . the key is the technology folks, not the legalese. What is also most interesting in the budgetary numbers is that the vast majority, as outlined below, is listed under the category of “unspecified”. As in $1.5 billion plus. That’s what we would call leaving quite a margin of error. We are most interested in meaningful adoption of electronic health records, which are secure, portable and confidential. We continue to argue that health insurance reform must go hand and hand with any HIT initiatives. The collecting of sensitive medical data, no matter the safeguards, could be used against patients (and in the past has). We must immediatly eliminate pre-existing condition exclusions, eliminate limitations on what constitutes a family member, eliminate health profiling to determine decisions to drop subscribers . . . these are the real safeguards needed much more than extensive HIPPA compliance regulations (which we do agree with by the way). We are hopeful, but continue to be cautious, about the data aggregation plans under this legislation and the nature of its and use and ultimate intent. Improving health, health care delivery and outcomes is something we all agree on . . . limiting options, rationing or restriction of access to technology we cannot accept . . . obi jo
Health Information Technology American Recovery and Reinvestment Act (Recovery Act) Implementation Plan Office of the National Coordinator for Health Information Technology
Funding Table
Total Appropriated (Dollars in Millions)
Privacy and Security* $ 24.285
National Institute of Standards and Technology (NIST) $ 20.000
Regional HIT Exchange $ 300.000
Unspecified $ 1,655.715
Total, Health Information Technology $ 2,000.000
*Note: This dollar figure, $24,285,000, includes an estimated $9.5 million for audits by the Office for Civil Rights and the Centers for Medicare & Medicaid Services. This estimate is subject to change. Updated Figures will be reported to Recovery.gov.
The Health Information Technology for Economic and Clinical Health (HITECH) Act provisions of the Recovery Act of 2009 create a historic opportunity to improve the health of Americans and the performance of the nation’s health system through an unprecedented investment in health information technology (HIT). This initiative will be an important part of health reform as health professionals and health care institutions, both public and private, will be enabled to harness the full potential of digital technology to prevent and treat illnesses and to improve health. This is a remarkable and far-sighted commitment that the Office of the National Coordinator for Health Information Technology (ONC) is honored to lead and support.
The ONC is acutely aware that to fulfill its obligations under the Recovery Act it must act swiftly but thoughtfully. It must meet tight deadlines created by statutory requirements of the law while assuring that ONC’s decisions and actions support the law’s fundamental, long-term purposes: improving health and health care through the best possible applications of HIT. Meeting the long-term goals of the Recovery Act will require careful thought and planning while delivering to the American people quick action and effective investment of committed funds.
http://www.hhs.gov/recovery/reports/plans/onc_hit.pdf
http://www.recovery.gov/
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Vermont targets payments to doctors by industry May 21, 2009
Posted by Obi Jo in Pharmaceuticals, Physicians.Tags: device manufacturers, devices, drugs, health, health care reform, health reform, healthcare, legislation, medical devices, NLARx, NY Times, outcomes, patient care, patients, Pharmaceutical Research and Manufacturers of America, Pharmaceuticals, PhRMA, physician behavior, physician education, physician payment, physician payments, Physicians, Vermont
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There is no doubt that there is misguided spending by drug and device companies, particularly in the arena of marketing. It seems clear that many legislatures are bent on limiting the ability of physicians to interact with the medical industry in any sort of normal manner. Not only are governmental agencies seeking to ban gifts, gratuities and perhaps even legitimate consulting and development relationships, they are now seeking to publicize these events and the amounts received in an attempt to publicly cast some sort of shame or implied wrong doing on physicians who have accepted “gifts”. This site seeks real health reform and many of the excesses of the past need to be curtailed and eliminated. However, to consider that a representative of a legitimate medical or device company is guilty of some evil deed by bringing pizza to a physicians office is a bit over the top. Common sense must always rule if we are to have real, meaningful reform. Physicians who are in legitimate research, consulting, and development work with drug and device companies should not be subjected to this type of public disclosure, lest their activities be confused with gratuitous payments by companies to unscrupulous providers. Real Health Reform is needed, along with legislation and common sense reform . . . obi jo
Vermont law targets medical industry payments to physicians, other providers
Cracking down on medical industry payments to doctors, the Vermont legislature has passed a law requiring drug and device makers to publicly disclose all money given to physicians and other healthcare providers, naming names and listing dollar amounts. The law would also ban nearly all industry gifts, including meals, to doctors, nurses, medical staff, pharmacists, health plan administrators, and healthcare facilities. The measure, scheduled to take effect on July 1, is believed to be the most stringent state effort to regulate the marketing of medical products to doctors, closing a loophole in previous regulations that had allowed companies to keep specific expenses private by claiming them as trade secrets.
Vermont Acts to Make Drug Makers’ Gifts Public -http://www.nytimes.com/2009/05/20/business/20vermont.html?_r=1&scp=1&sq=%2b%22Food+and+Drug+Administration%22&st=nyt
AS PASSED BY HOUSE AND SENATE – http://www.leg.state.vt.us/docs/2010/bills/Passed/S-048.pdf
CODE ON INTERACTIONS WITH HEALTHCARE PROFESSIONALS -http://www.phrma.org/code_on_interactions_with_healthcare_professionals/
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New Director of CDC Named May 15, 2009
Posted by Obi Jo in Public Health.Tags: CDC, disease control, disease prevention, health, health care, health care reform, health news, healthcare, Hospitals, outcomes, patient care, patients, politics, President of the United States, Public Health
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The new chief at CDC will have his hands full with many issues needing to be addressed. His history of no nonsense approaches to dealing with infectious diseases such as tuberculosis and HIV suggest he will be a true public health advocate free from “pc” bias, be that bias liberal or conservative. We can only wish the new director well . . . and watch his performance . . . jomaxx and obi jo
President Obama announced on Friday that he has chosen Dr. Thomas R. Frieden, the New York City health commissioner, as the next director of the Centers for Disease Control and Prevention.
http://www.nytimes.com/2009/05/16/health/policy/16cdc.html?hp
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Holding down costs or improving quality? Interest Groups Vow to Cut Costs May 13, 2009
Posted by Obi Jo in health reform.Tags: access, ACS, affordable health insurance, AHA, AHIP, AMA, CMS, Congress, health, health care reform, health information, health insurance, health insurance access, health insurance reform, health plans, health policy, health reform, health research, health savings, healthcare, HIT, Hospitals, Insurance, insurance benefits, Insurance Profits, Medicaid, medical care access, Medicare, Medicare Advantage, outcomes, patient care, patients, personal health responsibility, physician behavior, physician billing, physician education, physician payment, President, President of the United States, SEIU, sustainable growth rate, underinsured, uninsured
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Well, it is a great first step. One fueled by self-interest, concerns about “thrival” (thriving survival), true desire to evolve and change, and of course, concern for patients. So, yes this day brings many motives as well as players to the table of health reform. The focus for now is on cost containment. Laudable. But hardly the key first step needed. Over the next days, we will dissect this initiative and re-focus on details of “the plan” and which first steps the President and his team need to focus on to make the most happen the quickest . . . or to get the biggest bang for the buck. What is being offered today is really the willingness to work toward reform. In and of itself this is no small matter. Many of the entrenched interests have been unwilling to even consider taking a leading role in designing changes to the current health care system. Still, we are skeptical of any initiative that focuses SOLELY on holding down costs. Especially when one considers that no matter what is done, the 75 million plus baby boomers that are turning 60 between 2006 and 2024 will undoubtedly place new demands on health care. We have noted that item before. So cost containment alone, cannot work in isolation, lest it become rationing and mandated control on choices available for care. Again, a great first step . . . we will be watching . . . and stepping up our call for REAL HEALTH REFORM . . . obi jo
Industry Pledges to Control Health Care Costs
To achieve all of these goals, we have joined together in an unprecedented effort, as private sector stakeholders—physicians, hospitals, other health care workers, payors, suppliers, manufacturers, and organized labor—to offer concrete initiatives that will transform the health care system. As restructuring takes hold and the population’s health improves over the coming decade, we will do our part to achieve your Administration’s goal of decreasing by 1.5 percentage points the annual health care spending growth rate—saving $2 trillion or more. This represents more than a 20% reduction in the projected rate of growth. We believe this approach can be highly successful and can help the nation to achieve the reform goals we all share . . .
http://www.ama-assn.org/ama/pub/news-events/letters-editor/obama-11may2009.shtml
http://www.seiu.org/splash/
Obama Push to Cut Health Costs Faces Tough Odds -http://www.nytimes.com/2009/05/12/us/politics/12health.html?hp
Obama Praises ‘Historic’ $2 Trillion Health Care Savings Plan -http://www.foxnews.com/politics/2009/05/10/health-care-industry-reps-offer-trillion-savings-source-says/
Obama, Health Industry Pledge to Cut Health Spending Growth by $2 Trillion -http://www.cnsnews.com/public/content/article.aspx?RsrcID=47974
Major Stakeholders Vow to ‘Bend Healthcare Spending Growth Curve’ -http://www.medpagetoday.com/Washington-Watch/Washington-Watch/14153
Obama, interest groups to launch health reform plan -http://thehill.com/leading-the-news/obama-interest-groups-to-launch-health-reform-plan-2009-05-10.html
Obama: Health overhaul could save U.S. trillions – http://news.yahoo.com/s/nm/20090511/pl_nm/us_obama_healthcare
Obama Promised $2 Trillion Savings in 10 Years by Health Groups – http://www.bloomberg.com/apps/news?pid=20601103&sid=aXidEEmwiKhU&refer=us
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There is no substitute for a good doctor or nurse May 5, 2009
Posted by Obi Jo in Medicare.Tags: chronic illness, CMS, Congress, coordinated care, E Health, e-medicine, EMR, health, health information technology, health plans, health reform, healthcare, HIT, medical care access, Medicare, nursing care, outcomes, patient care, patients, Physicians
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After much study, it should not be surprising that the best way to manage ill seniors, is by communication – between patients, nurses and doctors. This communication essentially continues and reinforces the flow of information that patients need to help maintain effective care regimens. This is particularly true when the patient is older and may have multiple medical conditions, medications and health care providers. The models needed are not costly, bureaucratic, government driven programs to oversee this, but fundamental models of e-communication and voice communication, backed up by regular face to face interactions. In summary, traditional good patient care and followup. But this model requires that we have enough doctors and nurses to interact and both disciplines are stretched thin. It also will require a more robust integration of e-communication tools to allow patients tele-access to their care providers, thus reducing the need for excessive travel, which is often a physical and financial burden for the ill elderly. That is the best medicine for the economic concerns addressed in these articles and the simpler the system created the better and more useful it will be . . . jomaxx
Programs to coordinate care for chronically ill Medicare patients may not reduce hospitalizations, cut costs, researchers say.
An ambitious effort to cut costs and keep aging, sick Medicare patients out of the hospital mostly didn’t work, according to a study published in the Journal of the American Medical Association. These results show how tough it is to manage older patients with chronic diseases, who often take multiple prescriptions, see many different doctors and sometimes get conflicting medical advice.
Mathematica Policy Research Inc. in Princeton designed the “pilot project.” In their analysis, Mathematica looked at 15 care-coordination programs involving more than 18,000 fee-for-service Medicare patients with chronic problems such as congestive heart failure, coronary artery disease and diabetes. Only two programs were successful, and both had certain features in common, namely more contact between nurse-coordinators and patients and more contact between coordinators and physicians. The studies lead author said that both these programs had good relationships with local hospitals and with patients’ physicians.
For two programs — Mercy Medical Center in Des Moines, Iowa, and healthcare provider Health Quality Partners in Doylestown, Pa., — the treatment group did have lower expenditures than the control group, but the differences were not statistically significant, the researchers said. Those findings suggest that the potential exists for care coordination interventions to be cost-neutral and to improve patients’ well-being, according to the researchers.
Sobering results for cost-cutting Medicare project @ http://archives.chicagotribune.com/2009/feb/10/health/chi-ap-med-medicaredisappoi
Medicare Faces Challenges Caring for Chronically Ill @ http://www.healthday.com/Article.asp?AID=623921
Care Coordination Programs Do Not Meet Goals @ http://www.medpagetoday.com/Geriatrics/Medicare/12834
http://jama.ama-assn.org/cgi/content/full/301/6/603
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COMMENTARY: The Spectre of Specter May 1, 2009
Posted by Obi Jo in health reform.Tags: affordable health insurance, Congress, Democrat, health, health care reform, health insurance access, health Insurance exclusions, health insurance reform, healthcare, Insurance, Insurance Profits, patient care, personal health responsibility, politics, reform, Republican, Senate, Senator Arlen Specter, underinsured, uninsured
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Politics as Usual is the REAL Enemy of REAL HEALTH REFORM
specter |ˈspektər| ( Brit. spectre) – noun – a ghost – something widely feared as a possible unpleasant or dangerous occurrence (New Oxford American Dictionary)
It may strike some as unusual to link what on the surface would appear to be purely political to the quest for real health reform. However, there are moments, so called “teachable moments”, when one must point out the unseen obstacles to true reform in our republic. Politics as usual is one of them. Our new president has vowed to end that, as have many of his predecessors. Yet, the actions of Senator Arlen Specter this week speak volumes about the true nature of the reforms that must be undertaken in order to create in our great republic, truly a “more perfect union”.
Senator Specter is experienced in many ways. He is experienced in posturing to get elected. He did so in the past, when he switched from Democrat to Republican and he is doing so now in switching from Republican to Democrat. He is clearly experienced at getting elected since he has spent most of his life doing so. In fact for the past 30 years, Mr. Specter has been a senator from Pennsylvania . . . that is 5 terms . . . 5 senate elections . . . and 5 times the millions of dollars and thousands of promises needed to win those elections. So, in the end, his only reason for switching parties was to help ensure for himself (he hopes) another term in the senate. All this at age 79 and having survived multiple bouts with Hodgkin’s Disease, most recently in July 2008. Does Mr. Specter have no other interests? Is there no room for a new voice in the senate from Pennsylvania? Senator Specter apparently thinks not and sights his desire to complete unfinished business, more funding for NIH and research . . . but, we must point out, that there will always be “unfinished business”.
It is our belief that career politicians at all levels, local, state and federal, have stifled real reform and thwarted the true intent of the Founders of our American Republic. Our founders never imagined that any person would wish to leave their livelihood, be it farming, the law, medicine, teaching or business to pursue a lifetime in politics. How can real health reform proceed, indeed any real political or government reform, with career politicians of this type.
To be fair, Senator Specter has a record of accomplishment, and we commend him for that. He has voted in many cases to advance health care issues over the years without doubt. But we must ask, in the final analysis, what has he done for REAL health reform during his 30 years in the senatorial club?
Let us count the ways:
(1) Did he support, vote for or submit legislation that would require all citizens to have health insurance?
(2) Did he support, vote for or submit legislation that would require all citizens to provide proof of health insurance in order to get a license, enroll in school or get a job?
(3) Did he support, vote for or submit legislation that would prevent health insurers from discriminating against citizens with pre-existing conditions or who were ill?
(4) Did he support, vote for or submit legislation that would force health insurers to sell policies to all consumers, at market based rates, regardless of their health status?
(5) Did he support, vote for or submit legislation that would limit the profit margins that health insurers could obtain through premium hikes and claims denials?
To our knowledge he has not or if so, he has not been sufficiently effective. No doubt many of these issues have come up or been discussed behind the scenes, but it would appear with little effect or notice.
In the end, we wish Senator Specter well, however, we can only hope that the citizens of Pennsylvania will choose someone new . . . anyone . . . regardless of party. Since politicians seem to think their terms in office should be without limit, it is up to the electorate to impose term limits. We can only hope they have the wisdom to do so and thereby help us to achieve REAL reform . . . obi jo
http://en.wikipedia.org/wiki/Arlen_Specter
http://specter.senate.gov/public/
http://projects.washingtonpost.com/congress/members/s000709/
http://www.ontheissues.org/Senate/Arlen_Specter.htm
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