August 2004

 Mission:  To examine issues and advocate for improvements in our health care delivery system to help foster a system that drives quality and efficiency in health care and develop an agenda to promote bipartisan solutions.

 

IN THIS ISSUE:

 

Secretarial Summit on Health Information Technology and 2004 NHII Conference.  Over 1200 attendees participated as HHS Secretary Tommy G. Thompson launched the Secretarial Summit on Health Information Technology on July 21st to accelerate progress toward electronic health records and other benefits of health information technology for Americans.  At the conference, he released a strategic plan which was mandated by President Bush in an April 27 executive order that also established the new Office of the National Coordinator for Health Information Technology at HHS. The executive order also required a report within 90 days on progress toward a national strategy for harnessing health information technology. The report outlined shared responsibilities of the public and private sectors in achieving the benefits of health information technology (HIT).

 In this "Framework for Strategic Action" report were four major goals:

·         Goal 1: Inform Clinical Practice: Incentivize EHR adoption and create tools that ensure successful EHR implementation and use.

 Copies of the report are available at: http://www.os.hhs.gov/news/press/2004pres/20040721.html

 

Josie King Act Introduced to Transform Healthcare System.  On July 21, Congressman Patrick J. Kennedy (D-RI), co-chair of the 21st Century Health Care Caucus, introduced the "Josie King Act of 2004" (also known as the "QUEST Act"), H.R. 4880, named for an 18-month old infant who died as a result of preventable medical errors. 

 

The bill would transform the technological backbone of the American healthcare industry by 2015, enabling higher quality, better patient safety, and increased efficiency.   It would create a series of interconnected regional health information networks, established and financed by public-private partnerships, to enable patients and providers to share information in a secure manner that safeguards privacy.  Building on interoperability standards, this mechanism would create a fully electronic health information system in a decade.  The Josie King Act also includes provisions providing for better measurement and reporting of provider quality and efficiency, new research into the cost-effectiveness of clinical interventions, and new market incentives to reward higher quality care.  

 

The announcement (http://www.house.gov/apps/list/press/ri01_kennedy/pr_040721.html)  coincided with the National Health Information Infrastructure conference and Secretarial summit.  A summary of Kennedy's legislation as well as his statement from the floor of the House are available upon request.  For more information on Josie King, please visit www.josieking.org.

 

Other Draft Legislation of Interest.  Caucus member Rep. Tim Murphy (R-PA) introduced H.R. 4805 to establish a demonstration program to offset the costs of electronic prescribing systems for Medicare healthcare providers. The grants in the legislation would help provide computer software and hardware, including handheld computer technologies for electronic prescribing systems, upgrades to systems, communications capabilities for clinical data access, storage, and exchange, and the grants would also provide education and training.

 

Another bill, H.R.4779, sponsored by Rep. Dave Weldon (R-FL) would provide for clinical research infrastructure grants that would go to academic centers. The funding would be used for developing the infrastructure that is necessary to process information discovered in the laboratories, funds to develop up-to-date information technology systems and address incompatible databases, plus funds to use to develop training and mentoring.

 

And S. 2710 was introduced by Senator Judd Gregg (R-NH) Chair of the Senate Health, Education, Labor and Pensions Committee. The legislation would establish an Office of Health Information Technology within the Office of the Secretary of Health and Human Services and would require the adoption of federal standards within 2 years of enactment. It would also provide federal funding for the creation of Local Health Information Infrastructures (LHII) using federal interoperable systems and federal loan guarantees for the purchase of interoperable health information technology systems including software and training, and would be available to institutions and individuals who can demonstrate the need for the funding.

 

CMS Releases Proposed Rule for Prescription Drug Benefit.   Responding to the Medicare Modernization Act, the Centers for Medicare and Medicaid Services have released a draft proposed rule for the Medicare Prescription Drug Benefit, to include provisions on electronic prescribing and data transmission.  Review the proposed rule at http://a257.g.akamaitech.net/7.257/2422/06jun20041800/edocket.access.gpo.gov/2004/04-1. 

 

Ways & Means Health Subcommittee Hearing on E-prescribing.  Congresswoman Nancy L. Johnson (R-CT), Chairman, Subcommittee on Health of the Committee on Ways and Means, held a hearing on electronic prescribing on Thursday, July 22, 2004.  Witnesses included:  Dave McLean, Chief Executive Office, RxHub, Saint Paul, Minnesota; Craig Fuller, President and Chief Executive Officer, National Association of Chain Drug Stores, Alexandria, Virginia; Thomas Sullivan, MD, Women's Health Center Cardiology, Danvers, Massachusetts; and Jonathan Teich, MD, Ph.D., Assistant Professor of Medicine, Harvard University, Cambridge, Massachusetts.

 

According to witnesses that testified, electronic prescribing could improve care, boost efficiency and translate into substantial savings and patient safety benefits. However, the panel identified several potential barriers to wider adoption of e-prescribing. 

Dr. Jonathan Teich of Harvard Medical School told the subcommittee that technology could save up to $27 billion. Teich said that doctors write more than 3 billion prescriptions annually. This results in more than 150 million phone calls each year from pharmacists to doctors to clarify illegible prescriptions, according to Craig Fuller of the National Association of Chain Drug Stores.  Fuller said that 30% of doctors write 80% of all prescriptions. "We're going after them first," he said.

"By far the greatest barrier for technology developers has been the lack of comprehensive, uniform, national standards under which interoperable systems could be developed and instituted," said David McLean, CEO of RxHub.  As noted above, CMS has now issued a proposed rule to begin the process of establishing national standards pursuant to the MMA.

Only about 15% of U.S. physicians have e-prescribing systems. Another barrier to adoption is the amount of time and lost productivity associated with implementing the systems. Fuller warned that systems shouldn't have too many features. "Doctors won't even take that first step," if the systems are too complicated, McLean said.

 

Committee Chair Nancy Johnson (R-CT) and Ranking Member Pete Stark (D-CA) said that e-prescribing should lead to more comprehensive electronic health records.

  

House Government Reform Subcommittee Holds Hearing on Health Informatics.  With the spotlight increasing on the field of health informatics the House Government Reform Subcommittee on Technology, Information Policy, Intergovernmental Relations, and the Census held a hearing to examine the progress and impediments to the development and implementation of an efficient, secure, and reliable health information sharing network.  Representatives of the Office of Management and Budget, Government Accounting Office, Centers for Disease Control and Prevention, and former Speaker of the House Newt Gingrich testified before the Subcommittee. 

 

Former Speaker Gingrich cited government reports that have shown that $100 billion a year is linked to medical errors and that 44,000 to 98,000 people die every year from medical errors in hospitals alone.  He called for the creation of a Public Health Service Reserve Corps, similar to the reserve and National Guard program that would include every doctor, nurse, pharmacist and pharmacist currently practicing or retired who could be called upon in the event of an emergency.  He also called for the interoperability of all federal databases, development of nationwide data standards and the alignment of the payment system to incentivize providers to invest in health informatics.  http://reform.house.gov/TIPRC/Hearings/EventSingle.aspx?EventID=1200

 

New Report Suggests Medical Errors may be Even More Widespread Than Earlier Thought.  A new study by a health-care consulting firm in Colorado estimated that preventable medical errors contributed to nearly 600,000 deaths in a three-year period, an average of 195,000 per year.  Earlier, the Institute of Medicine had made a widely cited estimate of 44,000 to 98,000 error-related deaths annually. 

 

The study by Health Grades Inc. was based on data from 37 million Medicare beneficiaries nationwide.  The authors stated that if the CDC counted hospital errors as a cause of death, they would rank sixth.  The report is available at http://www.healthgrades.com/media/english/pdf/HG_Patient_Safety_Study_Final.pdf.

 

Department of Defense Works to Help Achieve President's Goal of Electronic Medical Records.  The Department of Defense will be sharing its expertise in using electronic health care records in response to the President's call for the widespread use of electronic medical records within the next 10 years.  The DoD is working with the Department of Health and Human Services, and the Department of Veterans Affairs to develop usable standards for public-sector application of electronic storage and movement of medical information. The Department first started using electronic medical records twelve years ago.  The Military Healthcare System has 8.9 million beneficiaries and a budget of nearly $28 billion.  

 

See Healthcare IT Innovations Back Home.  There has been tremendous momentum in recent months to push health information technology into the national spotlight.  From the Executive Order handed down by the President to provide electronic health records for most Americans within a decade to the many localities working to develop healthcare information technology solutions, more Americans are taking a second look at the improvements needed to transform the current healthcare industry.  The Healthcare Information and Management System Society (HIMSS) has 42 local chapters across the United States, composed of  more than 15,000 individual members and some 240 member corporations that employ more than 1 million people, eager to work with everybody to increase the effectiveness of healthcare treatment while decreasing the cost. 

 

During the 2004 August District Work Period, HIMSS has invited Members of Congress and staff to experience first hand the innovations in healthcare information and management technology that are taking place in their home states.   HIMSS can help organize a tour of a local facility or arrange an opportunity to speak to local healthcare executives back home.  For more information, please contact Ms. Blair Hedgepeth at the HIMSS Washington, D.C. office to arrange a tour of a local facility or an opportunity to speak to healthcare information professionals in your home state.  Blair can be reached by phone (703) 299-9714 or email, bhedgepeth@himss.org