Kaiser Daily Health Policy Report Examines Recent Coverage Of Services, Projects Related To Health Care Information Technology

Main Category: IT / Internet / E-mail
Also Included In: Medical Practice Management;  Primary Care / General Practice;  Public Health
Article Date: 15 Apr 2009 - 4:00 PDT

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Several newspapers recently published stories related to health care information technology and services. Summaries appear below.

• Economic stimulus package: The Washington Post on Monday examined how it "can be daunting" for IT companies and professionals to enter the health care industry because physicians, hospitals, health insurance companies and patients "speak different languages and have vastly different needs." According to the Washington Post, it also is costly and time consuming for some physicians and hospitals to purchase, set up and manage health IT systems, while the lack of specifics for user and privacy protection standards may prompt others to delay using the new systems. However, the $19 billion included in the federal economic stimulus package to spur the creation and adoption of a national health IT system "has piqued the interest" of several technology companies "that have in the past shied away from the complex industry," the Washington Post reports. The funding also has created new opportunities for several IT companies to provide physicians and hospitals with the help they require to switch to the new technology. The article profiled some of the efforts by IT companies in the greater Washington, D.C., area to expand their businesses into health IT (Hart, Washington Post, 4/13).
  
  
• Google Health: The Boston Globe on Monday examined how Google's no-cost electronic health record service for patients has raised concerns from patients and physicians that incorrect data could prompt improper treatment. According to the Globe, Google Health and other similar Web-based personal health record services "say they are offering a revolutionary tool to help patients navigate a fragmented health care system." However, medical technology experts say that the insurance data that they use is "prone to inaccuracies, partly because of the clunky diagnostic coding language used for medical billing, or because doctors sometimes label a test with the disease they hope to rule out," the Globe reports. Roni Zeiger, a product manager at Google, said the system uses information and claims data provided by a number of sources, such as partner hospitals, pharmacies and laboratories. Zeiger noted that while the billing information can sometimes be inaccurate, he said that the overall benefit to patients is increased because having some information is better than not having any information. Experts have said that the accuracy of the information will eventually improve as better coding language used for it is adopted in the years ahead, the Globe reports (Wangsness, Boston Globe, 4/13).
  
  
• Health informatics specialists: The New York Times on Sunday examined how the "demand for health informatics specialists is skyrocketing" since the enactment of the federal economic stimulus package, which included $19 billion for health care IT. Don Detmer, president and CEO of the not-for-profit American Medical Informatics Association, said his "rough estimate is that we need about 70,000 health informaticians" to meet the demand. According to the New York Times, health informatics specialists are alternatively known as IT translators in the medical field because they typically have extensive knowledge about medical records and claims, clinical care and programming. Health informatics specialists, who typically have prior training as computer programmers, physicians, nurses, pharmacists or health record administrators, usually earn a graduate degree in health informatics before they are hired, the New York Times reports (Larson, New York Times, 4/12).
  
  
• Michigan hospitals: The Detroit News on Saturday examined how "[m]any Metro Detroit hospitals already are moving into the digital age" by switching to EHR systems. However, according to the News, "the conversion has been anything but seamless, costing some hospitals hundreds of millions of dollars." The News reports that "health experts acknowledge the industry has a long way to go before paper records can be abandoned." In addition, the "medical community still lacks a cohesive network that can allow doctors at one health system to exchange records with a cross-town rival or a doctor outside the hospital's network," the News reports (Rogers, Detroit News, 4/11).
  
  
• Virtual clinic: Blue Cross and Blue Shield of Minnesota this week will unveil a pilot project that would provide its 10,000 employees access to a Web site that would allow them to have a live 10-minute text- or video-based consultation with a general physician or specialist, the Minneapolis Star Tribune reports. The service is modeled after a similar initiative launched in January by Hawaii's BCBS affiliate, the Hawaii Medical Service Association. The project will use the same system used in Hawaii, which was designed by American Well Systems. It will match patients with the first-available participating physician that is licensed in Minnesota. BCBS Minnesota officials said the pilot project, which will begin this fall, is open only to the company's employees so that any issues with the system can been addressed before it is expanded to the public (Lerner, Minneapolis Star Tribune, 4/12).

Editorials

• Denver Post: President Obama's announcement last week that "his administration would create a seamless health care record link" between the networks maintained by the Department of Defense and the Department of Veterans Affairs is "an opportunity for the country to test drive the reform ideas the president sees as central to healing the nation's broken health care system," according to a Denver Post editorial. "A transition to e-health records will be a complicated and expensive task, but projected efficiencies and improvements in health care quality make the idea worthy of exploration," the editorial states. According to the editorial, "As the drive toward digitizing health care records has gained momentum in recent years, so too have concerns about patient privacy," adding, "Patients must retain control over the privacy of their records no matter how the system ultimately is configured and Congress must ensure measures are in place to offer privacy protections." The editorial also notes that "American hospitals and doctors' offices have been slow to go electronic, and the main holdup is money" as "[i]t is enormously expensive to buy such a system." The editorial concludes, "Even though the president has encouraged the development of an encompassing e-health care record system, it's clear such a reality is a long way off" (Denver Post, 4/11).
  
  
• Wall Street Journal: The $19 billion in funding for health IT in the stimulus package would allow the federal government to "create a health-tech monopoly," according to a Journal editorial. The editorial notes that the authors of an article recently published in the New England Journal of Medicine wrote that "'flexibility is critical' as Congress promotes electronic medical records" and that "[t]he ideal system would be an open platform for many developers to write applications that are allowed to succeed and fail," the editorial states. The editorial continues, "[The authors] argue that the key is 'allowing competition and "natural selection" for high-value, low-cost products. This approach contrasts sharply with design of a national system by committee.'" According to the Journal, it is "obvious" that the authors are implying that the money would give the Obama administration the ability to "define and approve 'certified' records," quashing competition. The editorial concludes, "With stimulus money being shoveled out as quickly as possible, doctors and hospitals may end up prematurely investing in the costly systems that happen to have the government seal of approval -- and in the process freezing out an innovative marketplace" (Wall Street Journal, 4/14).

Letters

• Kenneth Raske, New York Times: A recent New York Times editorial "is exactly right that money is the chief obstacle preventing more hospitals from adopting" EHRs, Raske, president of the Greater New York Hospital Association, writes in a New York Times letter to the editor. Raske continues, "Long before the severe economic downturn, America's hospitals were struggling with shrinking reimbursements, limited access to capital, soaring medical malpractice costs and the swelling ranks of the uninsured," and stimulus funds for EHRs "will not change that fiscal reality." In addition, some hospitals "have deep concerns about meeting the technical and functional requirements to become eligible for stimulus payments," Raske writes. Raske concludes that if EHRs "are to become the rule rather than the isolated exception," lawmakers "must demonstrate both patience and flexibility in helping hospitals overcome significant barriers to their adoption and use" (Raske, New York Times, 4/14).
  
  
• Rep. Bart Gordon (D-Tenn.), New York Times: "Establishing the standards for interoperability and security will be more effective if it's done on the front end, before all doctors' offices have systems in place that can't talk to one another," Gordon writes in a Times letter to the editor. According to Gordon, "In the current system, the patient is the record keeper." He writes, "Every appointment begins with questions about medical history," adding, "The quality of care the patient receives may depend on his (or his family's) ability to answer that question, including recalling detailed information about drug names and dosages." According to Gordon, "As our population ages and we see more specialists, this problem will grow." He writes, "Maintaining the status quo is not an option" (Gordon, New York Times, 4/14).

Opinion Piece
Over "the last decade," countries in Europe "have moved to require doctors and hospitals to use basic information technology tools that would be familiar to anyone with an ATM card," but the U.S. "has waited for the 'market' to carry its health system into the digital age," Maryland state Sen. Jim Rosapepe (D), chair of the state General Assembly's Joint Technology Oversight Committee, writes in a Washington Post opinion piece. Rosapepe continues, "But instead of the 'market' working to bring us into the 21st century, special interests have pointed fingers; argued that their system is better than any other; claimed that somebody else should pay for it; and blocked action," adding, "So today, hard as it is to believe, less than 20% of Maryland doctors' offices use electronic health records and less than half of hospital records in the state are digitized." To "break the logjam,"

Rosapepe writes, he and state Delegate Joseline Pena-Melnyk (D) have introduced a bill "for Maryland to lead the United States in meeting President Obama's goal of the digitization of medical records within five years." The bill would establish detailed goals for state physicians and hospitals and give the state Health Department the responsibility and authority to meet them by 2014; provide medical providers with financial assistance to switch to EHRs by increasing the reimbursements they receive from insurance companies; reduce the payments after five years to providers that have not switched to a digital system; maximize the funds that the state receives through the federal economic stimulus package; and enhance patient privacy protection standards to give consumers ownership of their own medical records, according to Rosapepe. Some countries in Europe "took this kind of step years ago" and "[i]t's time for Maryland to catch up," he concludes (Rosapepe, Washington Post, 4/12).

Broadcast Coverage
American Public Media's "Marketplace" on Friday examined how health IT is being used at New York-Presbyterian Hospital. The segment includes comments from a hospital patient; Ashley Katz, executive director of Patient Privacy Rights; and Richard Hillestad, a researcher at RAND (Herships, "Marketplace," American Public Media, 4/10).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

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