December 2004

 Mission:  To expand the use of information, information technology, management systems, and incentives to foster a health care delivery system that produces the safest, highest-quality health care possible at the lowest possible cost.

 

IN THIS ISSUE:

Congress Rejects Funding for Health Information Technology

 

Mike Leavitt Nominated as next Secretary of Health and Human Services

 

National Health Information Technology Coordinator Addresses Industry Questions

 

New National Health Plan Learning Collaborative Announced

 

MedPAC Looks at Healthcare Information Technology

 

Vendors Meet with CMS on Healthcare Technology Adoption

 

AMA reports on pay for performance initiatives

 

Comparative Effectiveness Research Receives Initial Funding

 

IHI's Promising Practice of the Month

 

New Jersey Hospital Wins Malcolm Baldridge National Quality Award

 

Institute of Medicine Issues Report on Improving Rural Health Care Quality

 

HHS To Publish HIPAA Rules, E-Prescribing Standards

 

 

 

1.  Congress Rejects Funding for Health Information Technology

In his fiscal 2005 budget request, President Bush requested $50 million for David Brailer's Office of the National Coordinator for Health Information Technology at HHS.  The massive omnibus spending bill recently passed by Congress did not include this funding.  While the operations of Brailer's office will continue to be funded from departmental discretionary funds, the decision was disappointing to advocates of health IT.  Not only will Brailer's office not have funds expected to be used to support the development of regional initiatives, but the funding decision raises questions about the Administration's and Congress's commitment to health IT.

 

In the wake of the omnibus, outside commentators such as former Speaker Newt Gingrich have challenged the Administration to put political muscle behind its supportive rhetoric (see, for example, this New York Times article), and House 21st Century Health Care Caucus co-chairs Reps. Kennedy and Murphy have encouraged a more concerted, robust campaign by health care IT advocates to educate Congress about the importance of these initiatives.

 

2.  Mike Leavitt Nominated as next Secretary of Health and Human Services

President Bush has nominated Environmental Protection Agency (EPA) Administrator Michael O. Leavitt as the 8th Secretary of the Department of Health and Human Services, replacing retiring Secretary Tommy G. Thompson.  A former three-term governor of Utah, Mr. Leavitt has had extensive executive level experience in many of the issues that will face the Department over the next few years, including healthcare, national preparedness, and administrative reform. 

 

Mr. Leavitt's nomination will be submitted to the Senate and a hearing will be conducted in late January by the Health, Education, Labor and Pensions Committee under the new chairmanship of Senator Michael B. Enzi (R-Wyoming).  Committee passage of the nomination will precede a full Senate vote prior to Mr. Leavitt's confirmation when he officially takes over at HHS, a Department created in 1979 with over 60,000 employees and a $500 billion dollar annual budget. 

 

Leavitt's bio can be found at http://www.epa.gov/adminweb/leavitt/biography.htm. 

 

3.  National Health Information Technology Coordinator Addresses Industry Questions
The Office of the National Coordinator for Health Information Technology (ONCHIT) held a conference call on December 6th to address questions related to the Request For Information (RFI) released on November 15th seeking public comment regarding how widespread interoperability of health information technologies and health information exchange can be achieved through a National Health Information Network.  Dr. David Brailer, National Coordinator for Health Information Technology, provided a brief overview of the intent and context of the RFI. Dr. Brailer stated that this is the opportunity for all interested to influence the government's development of public policy related to health information technology.  Following the overview, callers were able to ask specific questions.  Many of the questions related to who in the government would be reviewing the submissions and what level of privacy would be afforded to the response. All information submitted is discoverable under the Freedom of Information Act. While ONCHIT does not intend to release the responses publicly they will be providing a summary of the lessons learned after all responses are reviewed. 

 

4.  New National Health Plan Learning Collaborative Announced

The Agency for Healthcare Research and Quality has announced a new public-private partnership, the National Health Plan Learning Collaborative to Reduce Disparities and Improve Quality.  The collaborative is designed to help reduce disparities in health care for people with diabetes and other conditions.  Nationally, only one-fifth of patients with diabetes receive routinely recommended health care services, including eye exams, flu shots, blood sugar (hemoglobin A1c) tests, foot exams and cholesterol screening, according to AHRQ's National Healthcare Quality Report released in December 2003. And  minority groups who live in poor neighborhoods suffer even lower rates of receiving the proper care.  http://www.ahrq.gov/news/press/pr2004/dispcolpr.htm

 

5.  MedPAC Looks at Healthcare Information Technology

The Medicare Payment Advisory Commission (MedPAC) has approved draft recommendations that Congress authorize rewards for providers using certain information technologies and establish a loan program to help community-based providers build interoperable IT systems, according to Modern Healthcare. Among the issues considered by MedPAC were: financial incentives for the adoption of health information technology including pay for performance, loans, and grants, supporting a certification process for IT products, and promoting standards development. MedPAC is an independent federal body established by the Balanced Budget Act of 1997 (P.L. 105-33) to advise the U.S. Congress on issues affecting the Medicare program.  http://www.medpac.gov/public_meetings/transcripts/1204_HealthIT_CW_cov.pdf

 

6.  Vendors Meet with CMS on Healthcare Technology Adoption
Health care information technology companies met recently with CMS Administrator Mark McClellan to preview a RAND study on how much the health care system could save if the industry increased its IT use.  RAND researchers have suggested policy changes that could improve healthcare IT adoption.  Cerner, General Electric, Hewlett-Packard and several other major companies financed the study. The study shows that payers, employers and the government gain the most benefits from IT use and should help pay for its implementation.   The study was released in October and found that physicians are reluctant to buy clinical IT systems because the benefits of such systems do not accrue to them. The study showed that other organizations, such as health plans and payers, benefit from IT adoption.

 

7.  AMA reports on pay for performance initiatives

The American Medical Association has issued a special report to it members to educate them on the growing trend of pay for performance programs for physicians. While a large percentage of the population would likely value information of a health care provider's quality, many physicians are concerned that pay for performance programs could interfere in the delivery of healthcare and aren't necessarily tied to outcomes.  Most pay for performance programs reward physicians for how well they hold to established methods of care and not necessarily on the final outcome of the patient.   www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=27254 

 

8.  Comparative Effectiveness Research Receives Initial Funding

While the omnibus appropriations bill contained bad news for health IT funding, it did provide initial funding for outcomes research authorized in last year's Medicare Modernization Act.  The research is intended to better inform medical decisions by comparing the effectiveness of different drugs and other interventions in treating given conditions.  This research, to be funded through the Agency for Healthcare Research and Quality, received $15 million.

9.  IHI's Promising Practice of the Month
"You can't get there from here" - is exactly what the leaders of the Veteran's Administration Healthcare System in Connecticut found themselves saying when they embarked on a journey to reduce appointment backlogs and improve the health of patients caught in a system that wasn't working . Now, a program called "advanced acess" has changed everything for the better. Read about it: http://www.ihi.org/IHI/Topics/OfficePractices/Access/ImprovementStories/QualityandAccessGoHandinHandattheVAinConnecticut.htm

10.  New Jersey Hospital Wins Malcolm Baldridge National Quality Award

The Robert Wood Johnson University Hospital Hamilton, New Jersey's fastest growing hospital, won the 2004 Malcolm Baldridge National Quality Award for its initiatives to improve health care quality.  Among the hospitals accomplishments include guaranteeing that emergency room visitors will see a nurse within 15 minutes and a doctor within 30 minutes.   For more information, see the press release from the National Institute of Standards and Technology: http://www.nist.gov/public_affairs/releases/2004baldrigewinners.htm.

 

11.  Institute of Medicine Issues Report on Improving Rural Health Care Quality

This month, the Institute of Medicine at the National Academies of Science released a report entitled Quality Through Collaboration: The Future of Rural Health.  The publication makes recommendations concerning provider shortages in rural communities, financial and reimbursement issues, and the tailoring of practice guidelines and performance measurements to a rural setting. 

  

12.  HHS To Publish HIPAA Rules, E-Prescribing Standards

HHS is working on four HIPAA rules, Health Data Management reported this week. HHS also plans to publish a proposed rule to adopt initial electronic prescribing standards.

The proposed rules include:


However, rules publication is subject to delay, as "HHS often fails to meet its own schedule for rules promulgation," and leadership changes within the agency also could slow publication, Health Data Management reports.

 

 

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 2-8)

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 9-11)

___________________________
Michael S. Zamore
Policy Advisor
Congressman Patrick J. Kennedy
407 Cannon House Office Building
Washington, DC 20515
(202) 225.4911
(202) 225.3290 fax