Tag Archives: stimulus

CPI investigation details health information technology sector’s lobbying efforts

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Writing for The Center for Public Integrity’s iWatch News, Josh Israel reports that, with billions of stimulus dollars still at stake, the number of health information technology lobbyists taking advantage of the lucrative “revolving door” between Capitol Hill and the private sector is sky-high, even by D.C. standards.

The Obama administration is still working to iron out the details of the “meaningful use” mandate expressed in the recovery act, and the big players in health IT are pulling out all the stops to ensure the rules are written to their advantage.

Healthcare Informatics magazine publishes an annual ranking of the 100 largest health IT companies by annual revenue. According to the Senate Office of Public Records, 15 of the companies in the 2010 ranking — most of them ranked in the top third by revenue — reported health IT-related lobbying activity in the first quarter of 2011 or the last quarter of 2010. Of the 90 lobbyists listed as having done health IT lobbying for those firms, at least 63 were former Congressional and/or executive branch staffers, many of whom worked for health-related agencies or committees.

For those interested in additional details on HIT’s lobbying efforts, Israel also included two sidebars:

Report explains doctors’ reluctance to adopt EMRs

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Writing for the Center for Public Integrity’s iWatch News, Susan Jaffe spent time in the trenches to better understand how government incentives toward the adoption of electronic medical records are (or aren’t) working. She spent time with Cleveland-area small practices and government agencies to understand the real obstacles faced by physicians on the ground. It offers a picture of the reality of EMR today. Some of my favorite tidbits:

  • “570 different electronic health systems certified by private organizations for non-hospital settings may be used to qualify for the bonus.”
  • “The systems are priced in a way that does not make comparison shopping ‘easy or necessarily valid,’ said Dottie Howe, a spokeswoman for the Ohio regional extension center. There is no basic price because each company offers different components, features, options, and level of technical support.”
  • EMR systems can include more than a thousand sometimes-customizeable details, and that’s not including the myriad warnings and cross-checks.
  • Compatibility with the systems in the area’s large hospitals is tough to guarantee, yet factors as a major concern for many small practices.
  • How early adopters in the field were burned and are wary of getting fooled again.
  • When practices adopt EMRs, they typically have to go through a “learning curve,” a period of weeks or months during which they can only see about half as many patients.
  • Many major HIT companies don’t guarantee that physicians who adopt their systems will meet the standards for a government HIT bonus.
  • The VA’s proven HIT system is available for free, but can’t handle billing and insurance.
  • To get the maximum bonus payment, practices must adopt EMRs this year or next.
  • Only certified systems can earn bonus payments, yet the second and third stages of certification haven’t even been finalized yet.

An accompanying piece by Emma Schwartz looks at one physician’s concerns.

NEHI maps out future of comparative effectiveness

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

NEHI,  a nonprofit research group that was known as the New England Healthcare Institute, has released a white paper mapping out a potential near future for comparative effectiveness research in the United States. We first noticed the report on the Kaiser Family Foundation’s Health Reform Source site.

The white paper’s authors, Tom Hubbard, Shin Daimyo and Karan Desai, make a strong case that proper dissemination will be the real key to the success of CER. Their argument hinges on the observation that, even today, good medical research rarely makes it into clinical practice without a hefty nudge. cer_white_paperWhen it comes to delivering this nudge to all that stimulus-funded comparative effectiveness research, the paper’s authors have singled out the newly created Patient-Centered Outcomes Research Institute. PCORI’s stated role is to help all stakeholders make informed health care decisions. It’s also, the authors write, uniquely positioned to become a key force in CER dissemination alongside the AHRQ’s Office of Communications and Knowledge Transfer. Unlike AHRQ, PCORI is an independent organization that’s free to form relationships and build consensus across the spectrum.

All in all, the report’s a quick and handy read. There are only 9 pages of text, and you’ll come out with a better understanding of the practical problems facing those who seek to apply comparative effectiveness research. If you’re  looking for examples of successful implementation programs, head to pages 8 through 10.

Health IT moves forward, regulation doesn’t

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Fred Schulte and Emma Schwartz report that while the Obama administration plans to create a digital medical file for every American by 2014, “the administration has established no national mandatory monitoring procedure for the new devices and software. That no process exists to report and track errors, pinpoint their causes and prevent them from recurring is largely the result of two decades of resistance by the technology industry, a review of government records and interviews by the Huffington Post Investigative Fund shows.”

Major HIT malfunctions continue – they focus on one of 10 hospitals in the Trinity Health System in the upper Midwest – and nobody has a grip on their location or frequency. Meanwhile, the administration has issued regulations for HIT implementation that make no mention of safety and quality standards, standards the FDA has been considering for some time.

FDA to regulate health information technology?

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Fred Schulte and Emma Schwartz, the Huffington Post Investigative Fund duo who have made it their business to stay in front of all stories related to the federal push for the adoption of health information technology, now look at the possibility of federal regulation of health IT.

Schulte and Schwartz write that “In the past two years, the agency has received reports of six patient deaths and several dozen injuries linked to malfunctions in the systems,” and officials say those voluntary reports represent just the tip of the iceberg. In case you’re interested, here are the transcripts from the relevant government hearing.

hit
Photo by brianjmatis via Flickr.

… digital medical systems are not risk-free. Over the past two years, the FDA’s voluntary notification system logged a total of 260 reports of “malfunctions with the potential for patient harm,” including 44 injuries and the six deaths. Among other things the systems have mixed up patients, put test results in the wrong person’s file and lost vital medical information.

Schulte and Scwartz summarize the three possible regulatory approaches outlined by officials:

  • Option 1: FDA requires HIT makers to register, submit safety reports and correct problems.
  • Option 2: FDA requires HIT makers to report safety concerns and sets minimum quality guidelines.
  • Option 3: FDA makes HIT “subject to the broader regulatory actions that new medical products must face before they ever reach the market.”

Many manufacturers argue that such regulation could be counterproductive.

The manufacturers of the systems generally have opposed regulation by the FDA, arguing in part that imposing strict controls would slow down the government’s campaign to spur widespread adoption of the technology.

Regulation will not necessarily create a “safer” electronic medical record “and might actually limit innovation and responsiveness when it is needed most,” Carl Dvorak, executive vice president of Epic Systems Corporation, a Wisconsin-based company that builds the systems mainly for hospitals and large medical practices, said in his prepared testimony for Thursday’s hearing. The hearing is being held by an advisory group created by the stimulus law.

Government Health IT also is following the issue and points to some problems the Veterans Health Administration has run into and how it dealt with the lapses.

FCC’s broadband plan includes wireless health tech

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

The Federal Communications Commission will release a report next month outlining a national broadband plan that is expected to include measures for promoting and facilitating the use of mobile devices in health care, Mary Mosquera of Goverment Health IT reports. The plan was mandated as part of the stimulus package.

celltower
Photo by Jeff Kubina via Flickr.

The FCC plan will describe “where government has a role to reduce some of the hurdles to these technologies both in connectivity and to promote innovation in applications,” said Dr. Mohit Kaushal, digital healthcare director of the FCC’s Omnibus Broadband Initiative.

The American Recovery and Reinvestment Act called for the FCC to develop a plan for establishing broadband connections to the Internet as a way to spur business development, job creation and improvements in healthcare.

To demonstrate a few possible uses of such technology, Mosquera also talks to organizations, hospitals and doctors who are taking advantage of current resources.