Posted on July 29, 2008 by Helen Oscislawski

Think Tank Thinks ONC's Plan will Tank

Heartland Institute, a Chicago-based think tank published a "scathing critique of the government's efforts to promote healthcare information technology," reports Healthcare IT News.
In its August 2008 edition of Health Care News, Heartland's analysts call the ONC- Coordinated Federal Health Information Technology Strategic Plan 2008-2012 "poorly conceived" and argue that "any plan for changing the healthcare system is better coming from the private sector rather than government . . ."

Greg Scandlen, Director of Consumers for Health Care Choices at the Heartland Institute, further claims that "[a]ny system that is imposed today will be obsolete in five years," and that "[t]he federal government is woefully incapable of changing or eliminating outdated rules and regulations. So we will be stuck for all time with whatever they come up with today."

However, I think that Heartland does not address the fact that the myriad of incompatible standards that have been developed for HIT, privacy, and agreements in connection with health information exchange has also slowed progress.  And, as hundreds and maybe thousands of entrepreneurs and innovators across America "roll out new approaches, try them out, refine them based on experience, and repeat the process," we continue to be left with disjointed systems and vacuums for emerging standards. 

In short, we might not have the time and luxury of allowing market forces to reach their final determinations when the economic and clinical benefits of implementing coordinated systems for health information exchange are needed now.   As such, a centralized coordinator and gatekeeper, such as ONC, may potentially optimize the process -- if done right -- and so, cooperation between the private and public sector could be key to quicker progress.

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Posted on July 23, 2008 by Helen Oscislawski

Wikipedia for Health Care? It's Coming . . .

The Los Angeles Times reported today about MEDPEDIA.com,  the website currently being developed by Internet entrepreneurs, together with doctors, researchers, and other medical professionals in order to create what is hoped (by them) will be largest body of health information on the Internet.  The information being gathered for the website is of the nature typically confined to academic circles.  The team working on Medpedia hopes to make that information understandable and available to consumers.  The LA Times indicates that Medpedia is "[m]odeled on the on-line encyclopedia Wikipedia, but [will be] written and edited only by trained professionals." 

The website lists Harvard Medical School, Stanford School of Medicine, and the [University of California] Berkeley School of Public Health as some of the organizations that will be assisting in building Medpedia's comprehensive medical clearinghouse.  The official launch of www.medpedia.com is scheduled for the end of 2008, but the website currently contains additional information about what is to come.    

Medpedia is just another example of how health care providers and Internet companies are experimenting with unique and helpful on-line tools to respond to the health IT momentum and a push to use such technology to empower patients.

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Posted on July 9, 2008 by Helen Oscislawski

Horizon BC/BS Grants a Limited EHR Subsidy to New Jersey Health Care Providers

Health Data Management reported yesterday that Horizon Blue Cross Blue Shield of New Jersey will commit up to $500,000 to help select hospitals in its New Jersey network adopt electronic medication history technology.  This would give physicians real-time medication histories when patients check into a hospital or emergency department.  Under the program, Horizon will pay for 85% of the costs of the technology up to $40,000 for each hospital.  Horizon expects up to eight hospitals to join its subsidy program by the end of the year.

I would assume that the Horizon's subsidy program for hospitals would need to comply with the requirements under the EHR safeharbor to assure that the arrangement is not found as potentially violating the federal Anti-kickback Statute.  Under the safeharbor, a health plan is a protected donor, and a hospital a protected recipient, but several additional requirements must be met in addition to the hospital paying for 15% of the cost of the technology.  It does not appear that the subsidy program would need to meet the equivalent Stark Exception where the recipients of the technology will be limited to hospitals, and so the Stark prohibition on physicians' self-referrals should not be triggered. 

More information on Horizon's subsidy program, see drfirst.com and horizonblue.com.


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Posted on June 3, 2008 by Helen Oscislawski

ONC releases its Comprehensive HIT Plan

Today, the Office of the National Coordinator for Health Information Technology (ONC) released a comprehensive Strategic Plan for advancing health information technology (HIT). The Strategic Plan is intended to serve as a guide to coordinate the federal government’s health IT efforts to achieve nationwide implementation of an interoperable health IT infrastructure throughout both the public and private sector. 

Dr. Robert Kolodner, National Coordinator for HIT, stated that the Strategic Plan "[e]stablishes the next generation of HIT milestones to harness the power of information technology to help transform health care in this country.’’ ONC also notes that objectives, strategies, and milestones have been established for each goal and portray the totality of what must be done across the federal government to:

  • address privacy and security concerns;
  • achieve an interoperable health IT architecture to ensure reliable data exchange;
  • accelerate IT adoption; and
  • foster collaborative governance. 
ONC has posted a Full Report of the 115-page Strategic Plan as well as a shorter Synopsis on its website.

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