Healthcare IT News - January 2009 - (Page 7) www.HealthcareITNews.com January 2009 n Healthcare IT news EMR as opportunity BY NOW most people in healthcare recognize the benefits of an electronic medical record systems to patient safety and care quality. Historically the costs (both hard and soft) of acquiring and implementing these solutions have limited widespread adoption in the physician office setting. Without financial support, only a small percentage of physicians are likely to acquire or upgrade to an EMR solution. In the past five years, most of the work on clinical process automation has been within the walls of hospitals. However as adoption of EMR and related clinical automation becomes the new standard in healthcare, it will become more strategically important for hospitals to facilitate the deployment in the physician office setting as well. Providing integrated solutions to community-based physicians serves to tighten relationships with doctors, protect ancillary hospital revenues, and enhance quality of care overall. Developing a clear and effective EMR deployment program will become a crucial strategic advantage for hospitals and health systems in the next few years. Thanks to clarifications made by Health and Human Services in October 2006, many of the concerns about violating Stark and anti-kickback rules have been allayed. O M M N T R Y NEwsMakER iNtERviEw What is the main takeaway from the NHIN Phase 2 trial? The demonstrations at the NHIN Forum confirmed the optimism of the participants in the potential for real progress to improve quality, efficiency and access to care through the use of information technology. What is the top challenge facing NCHICA? With a stressed economy, the challenge will be adapting to the change in administrations at the state and national levels so that the focus and momentum is maintained and that communicating the progress of the NCHICA’s efforts over the 15 years since our founding in 1994 is beginning to have a real impact on health and care in our state. “Without financial support, only a small percentage of physicians are likely to acquire or upgrade to an EMR solution.” Hospitals can now safely make these “donations” to their medical staff members under a defined set of criteria. However, nearly two years after these legal clarifications, only a few organizations are taking advantage of the opportunity. A big reason for this hesitancy has been cost – ambulatory EMR solutions can be expensive, especially when one considers associated hardware and implementation costs. Another issue has been a lack of enthusiasm on the part of most medical staff members to radically change the way they operate their offices. As a result, hospital leaders have avoided making investments in a technology program that is not embraced and could possibly damage relations with their physicians. Why rock the boat? However in the last few months, many hospital leaders have noticed an increased interest on the part of their medical staff to discuss EMR implementation. This recent interest may be a result of the federal government’s July approval of the Medicare Improvements for Patients and Providers Act of 2008 (H.R. 6331), a law that provides financial incentives to physicians who adopt e-prescribing. The act provides increased professional fee payments of up to 2 percent for practitioners who use e-prescribing in 2009 and 2010 with possible penalties coming in 2011. This interest is enhanced by a growing sense of inevitability among physicians about clinical automation Further, generational changes in medicine are creating a growing interest in automation as younger physicians leave residency and move into private practice. These providers have grown up with computers and the Internet, and expect to practice medicine this way too. When community-based physicians DavID begin to reach the point of acceptance, vreelaND they often prefer to work with their Cumberland preferred hospital’s technology group Consulting to get advice about vendors and discuss Group opportunities to integrate their computers with the hospital’s network and systems. As hospital leaders consider responding to their medical staff members, they should proceed with caution. 1. Engage the general counsel early to help interpret the clarifications and come up with a legal position that right for your organization. 2. Establish an overall strategy for providing EMRs to physicians. 3. Build the pricing model to include “skin in the game” for physicians. 4. Develop a rigorous communication plan. 5. Offer more than one solution. Be clear about how the solutions will integrate with hospital information systems. 6. Avoid focusing only on the technology aspects of the initiative; sponsor the program at the CEO, COO, or CMO level. By making these solutions available to their medical staff, hospitals and health systems enable tighter relationships, making it easier to order tests and receive results, improving the quality of care offered to patients, and potentially increasing ancillary service revenues to the institution. n Holt anderson Executive Director of the North Carolina Healthcare information & Communications alliance, inc steering Committee for the NC immunization Registry and the advisory Council for the North Carolina Center for Nursing. What role can personal health records play in health data exchange? Personal Health Records will provide new tools to meet the expressed needs of many consumers to have control over health information and basic registration information to facilitate visits to healthcare facilities for themselves, a spouse or perhaps chronically ill children or elderly parents. What is the most valuable benefit reaped from NCHICA? Members comment that NCHICA provides a trusted and neutral forum where they can participate with their peers, suppliers, government agencies, professional associations in the development of model policies, standards-based approaches to implementation of new regulations, education and professional development of staff through the various work groups and task forces. What is your best advice to other HIEs? Build trust in their “community” and understand that the sociology and policy are the most difficult challenges. Once the trust factor is established, then it is much easier to reach consensus on technology approaches that will benefit the greatest number of participants. More at HealthcareITNews.com e Connect: anderson 0109 More at HealthcareITNews.com e Connect: Vreeland 0109 ● ● leTTers Continued from page 6 Most critical element missing from payer list Missing from BCBS’ list of what is needed for healthcare reform is the SINGLE MOST IMPORTANT element of HIT systems: consumer control over personal health information. Patient Privacy Rights is not surprised. This is the same corporation that aggregates and sells the health and claims records of 79 million enrollees without their knowledge or consent via its Blue Health Intelligence business unit. Patient Privacy Rights’ response to BCBS’ five initiatives for reform: We will never know what “procedures, drugs, and devices work best” because so much health data is NEVER entered into electronic systems that are designed for data mining. Today, according to HHS, 600K people refuse early diagnosis for cancer, 2M refuse treatment for mental health, and RAND found that 150K Iraqi vets with PTSD refuse treatment because of the lack of privacy, leading to the highest rate of suicide among active duty military in 30 years. The lack of privacy kills. We will never know what “performance” is best because there is no privacy. Today, vast amounts of treatment information about many sensitive illnesses is simply NOT recorded electronically, it is off-the-grid. Nor will data about alternative treatments, diet, exercise, and all the other ways Americans address health and wellness ever be added to HIT systems that are designed for data mining. The lack of privacy means we will never have the complete and detailed research data we need for research to figure out what treatments are best. The lack of privacy means too much data is off-the-grid. Deborah C. Peel, MD Founder and Chair Patient Privacy Rights More at HealthcareITNews.com e Connect: letters 0109 Readers give thumbs up to picks NO “I doubt that Mr. Daschle has any real experience in the way that hospitals are run. Mr. Orzag I have never even heard of so I would imagine he is another bean counter with no idea what he is doing. Boy, do I ever hope I am wrong!”utilization of the technology. More inadequate records are not what we need.” - David Devine Tampa General Hospitals HEaltHcaRE it NEWSMONitOR NEWS Q 80% 60% 40% 20% 0% Do President-elect Obama’s choices of former Sen.Tom Daschle for HHS secretary and Congressional budget chief Peter Orszag to run the Office of Management and Budget bode well for healthcare IT? MoNitoR 138 reader responses 0% 30% NO YES YES “Both are selected because of their commitment to IT in advancing knowledge management and solving difficult healthcare problems.” - Anonymous ● To take future surveys, subscribe to our enewsletter, HealthcareITNewsWeek, or visit us daily on the Web at HealthcareITNews.com. http://www.HealthcareITNews.com http://www.HealthcareITNews.com http://www.HealthcareITNews.com http://www.healthcareitnews.com/news/emr-opportunity http://www.healthcareitnews.com/news/newsmaker-interview-2 http://www.HealthcareITNews.com http://www.HealthcareITNews.com http://www.healthcareitnews.com/news/letters-editor-8
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