September 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:

Health Information Technology News

Health Quality News

*        IHI's Promising Practice of the Month: Rapid Response Teams

 

1.  Appropriations Update.  The House of Representatives approved on September 9 an appropriations bill (H.R. 5006) for fiscal year 2005 that would designate $25 million for new grants through the office of the Secretary of HHS to support state and regional data exchange demonstration programs, half of the $50 million requested by the Administration.  The bill also included $84 million for patient safety and health IT efforts at the Agency for Healthcare Research and Quality, an increase of $4.5 million.

 

The following week, the Senate Appropriations Committee passed its version of the same spending bill.  The Senate bill did not fund the new health data exchange grants, but included the same $84 million at AHRQ for patient safety and health IT.  It also funded outcomes research authorized by the Medicare Modernization Act at $15 million.

 

Health Information Technology News

2.  Caucus Staff Meet with National Health Information Technology Coordinator David Brailer.  On September 15, staffers of members of the 21st Century Health Care Caucus met for an hour with Dr. David Brailer, the National Health Information Technology Coordinator appointed last spring pursuant to an executive order signed by President Bush.  Dr. Brailer briefed the caucus staff on the Department's new framework for strategic action on health IT and answered questions about the Administration's plans and outlook.  He sounded an optimistic note about the degree of cooperation from other agencies and departments but told caucus staff that he was still feeling out the degree of influence his office will have as it tries to streamline the Administration's health IT strategies.

3.  Survey: Electronic Health Record Implementation May Take Longer Than 10 Years.  Conversion to an electronic health record as a standard in the health care industry will take longer than 10 years, according to 42% of the respondents to a recently released HIMSS Vantage Point survey. The survey revealed that 50% of the 274 respondents felt that public sector reimbursement incentives for use of electronic health records is the policy option that would have the most impact on accelerating electronic health record implementation.  Other policy options cited in the survey included regional demonstration projects and grants (12%), clear legal safe harbors for hospital/physician IT collaboration (15%), and low interest rate loans for EHR purchases (6%). 

Over 50% of the respondents also indicated that lessons learned from the Department of Veterans Affairs and the Department of Defense will have the most impact on HIT implementation plans.  http://www.himss.org/asp/vantage_point.asp

4.  NCVHS Submits E-Prescribing Standards to HHS.   The National Committee on Vital and Health Statistics has submitted its draft of electronic prescription standards to The Department of Health and Human Services. HHS is looking for ways to accelerate the timeline for e-prescribing standards, for which Medicare legislation calls for tests by 2006.  The NCVHS, an advisory body to HHS, hopes the initial set of recommendations will give standards development organizations and vendors time to include additional capabilities for testing, said Jeff Blair, vice chair of the subcommittee on standards and security for NCVHS.  The NCVHS developed 18 major observations with associated recommendations. Once HHS reviews the draft standards, it will plan a series of hearings and create an implementation work plan, an HHS spokesperson said. The NCVHS plans to complete a second set of recommendations in March 2005.  

5.  GAO Report on Legal Barriers to Healthcare IT Adoption.  The Government Accountability Office has released a briefing on the Department of Health and Human Services' efforts to promote health information technology and the legal barriers to its adoption.  The briefing states that there is little known about the nature and extent of the legal barriers to the adoption of healthcare IT.  While it did not address the barriers associated with privacy and security issues the report does look at the impact of fraud and abuse, antitrust, federal income tax, intellectual property, malpractice, and state licensing laws on the adoption of information technology in the healthcare arena.  http://www.gao.gov/cgi-bin/getrpt?GAO-04-991R

6.  VA Uses IT to Help Patients Make Informed Decisions.  The Department of Veterans' Affairs is adopting a new computer program to help patients make more informed decisions about their care.  The Electronic Support for Patient Decisions initiative uses customized software to provide patients with information about treatment options and standardized procedures among clinicians.  The program takes physicians through the informed consent process step by step, displays educational materials about risks and benefits of procedures, generates and stores consent forms, and imports information from patient records.  http://www1.va.gov/opa/pressrel/PressArtInternet.cfm?id=852

7.  Private Sector Launches Certification Commission for HIT and Names Inaugural Slate of Commissioners.  The Certification Commission for Healthcare Information Technology (CCHIT), formed by three leading healthcare organizations to create an efficient, impartial and trusted mechanism to certify ambulatory electronic health records and other healthcare information technology (IT) products, was launched and has appointed its initial slate of commissioners.

 

The commissioners, who will serve one-year terms, represent three primary stakeholders: providers that purchase healthcare IT products; vendors that develop, market, install and support these systems; and purchasers or payers that are prepared to offer incentives and support for healthcare IT adoption.

 

To encourage the adoption of healthcare IT for improving care and efficiency, the American Health Information Management Association (AHIMA), Healthcare Information and Management Systems Society (HIMSS), and The National Alliance for Health Information Technology (Alliance) formed the certification commission in July and are providing the initial funding and staff. Through voluntary certification of products, the commission aims to reduce the risk of IT investment by healthcare providers while ensuring interoperability of healthcare IT products with emerging local and national health information infrastructures.

 

"Certification will go a long way towards ensuring that healthcare IT systems deliver the benefits that providers need and expect," says Dr. Mark Leavitt, the commission's chairman.  "At the same time, certification will provide the clear definition of product capabilities and compatibilities that payers, healthcare purchasers and government officials will demand as a prerequisite to large-scale investments in these systems."

 

The commission's goal is to have initial certification requirements and processes ready for testing by summer 2005.  http://www.ahima.org/press/press_releases/04.0901.cfm.

 

 

Health Quality News

 

8.  IHI's Promising Practice of the Month: Rapid Response Teams.  Mortality rates have been slowly but steadily dropping at Baptist Memorial Hospital in Memphis, Tennessee, due in part to the implementation of a new process that empowers nurses and other staff members to call upon a Rapid Response Team to assist before the patient's condition seriously worsens. Read Baptist Memorial's success story:

http://www.ihi.org/IHI/Topics/Improvement/MoveYourDot/ImprovementStories/RapidResponseTeamsHeadingOffMedicalCrisesatBaptistMemorialHospitalinMemphis.htm.

 

The "IHI Promising Practice of the Month" will be a regular feature of this newsletter, supplied by the Institute for Healthcare Improvement.

  

9.  New Report from the Institute of Medicine on Health Care Quality.  On January 6 and 7, 2004, the Institute of medicine (IOM) hosted the 1st Annual Crossing the Quality Chasm Summit, to pool knowledge and resources on improving care  for five chronic illnesses: asthma, depression, diabetes, heart failure, and pain control in advanced cancer. The new IOM report, 1st Annual Crossing the Quality Chasm Summit: A Focus on Communities synthesizes the strategies and action plans developed at the summit. To read the report or obtain copies, go to http://iom.edu/report.asp?id=22344.

 

10.  NECON to Host Conference to Address "The Science of Prevention."   On October 8, 2004 NECON, the New England Governors' Conference, Inc., and Region I, US Department of Health & Human Services will convene their annual region-wide forum of policymakers and legislators at the Westin in Providence, RI. The conference will gather government officials, academics and health promotion advocates throughout New England to address how creating evidence-based prevention strategies can help solve the escalating cost and burdens of preventable diseases facing our nation. The presentations will focus on actions we can take and models of successful evidence-based programs in the areas of:

To view the agenda for this one-day event and register online, please go to www.NECONinfo.org.

 

11.  Steering Committee on Telehealth and Healthcare Informatics to hold session on Patient Safety.  The Steering Committee on Telehealth and Healthcare Informatics will be holding its next lunch session on Wednesday, September 22nd from 12:00 - 1:45 pm, in Room SD-138, of the Dirksen Senate Office Building.  A complementary box lunch will be available.  The session will focus on promoting patient safety using information technology. 

 

Evidence demonstrates that an investment in interoperable health care information technology will lead to a reduction in medical errors and marked improvements in health care quality. Presentations will provide information on ways that health care technologies can be used to improve patient safety and to ensure providers have the most up-to-date information at the point of care. A discussion on computerizing medical records and the challenges in accomplishing this goal will be included. Finally, panelists will explore federal policy initiatives that may assist in diffusing information technologies toward improved quality care.  Included among invited panelists are representatives of: the federal Agency for Healthcare Quality and Research (AHRQ); the eHealth Initiative (eHI); and, the American Health Quality Association (AHQA).

Honorary Steering Committee Co-chairs are: Mike Crapo (R-ID); and Senators Kent Conrad (D-N.D.); along with Representatives Charlie Norwood (R-GA); and Rick Boucher (D-VA).

 

The House 21st Century Health Care Caucus thanks the following organizations for their contributions to this newsletter:

HIMSS (Healthcare Information and Management Systems Society) is the healthcare industry's membership organization exclusively focused on providing leadership for the optimal use of healthcare information technology and management systems for the betterment of human health.  HIMSS frames and leads healthcare public policy and industry practices through its advocacy, educational and professional development initiatives designed to promote information and management systems' contributions to ensuring quality patient care.  On the web at www.himss.org. (Items 3-7)

The Institute for Healthcare Improvement (IHI) is a not-for-profit organization leading the improvement of health care throughout the world.  Founded in 1991 and based in Boston, MA, IHI is a catalyst for change, cultivating innovative concepts for improving patient care and implementing programs for putting those ideas into action.  Thousands of health care providers participate in IHI's groundbreaking work. To find out more, go to www.ihi.org. (Items 8-9)