May 2005

 Mission:  to transform the health care system through information and technology to improve patient safety and health care quality, lower costs, and coordinate care.

 

IN THIS ISSUE:

1. Murphy, Kennedy Introduce 21st Century Health Information Act
2. Brailer's Office Funded
3. HHS Releases Health Information Technology Report
4. 5 Years After To Err is Human, Medical Error Risks Remain Great
5. Compendium of Patient Safety Studies Released
6. Proposed Legislation Would Govern Outsourcing Data
7. Pay-for-Performance Demonstration a Success?
8. HHS Preparing Flurry of Health IT Initiatives
9. New Medicaid Commission
10. IHI's Promising Practice of the Month: Making Care Better by Making the Experience of Care Better

Murphy, Kennedy Introduce 21st Century Health Information Act 

Caucus Co-Chairmen Tim Murphy (R-PA) and Patrick J. Kennedy (D-RI), joined by Senator Hillary Rodham Clinton (D-NY) and former Speaker Newt Gingrich, introduced the first of its kind legislation, aimed at dramatically transforming the way healthcare is delivered in this country.   The 21st Century Health Information Act (H.R. 2234), unveiled on the Cannon Terrace on May 11, would promote the move towards secure, confidential electronic health records.

Clinton noted a commitment from Senate Majority Leader Bill Frist (R-TN) to work with her towards a Senate version of the Murphy-Kennedy legislation.  The Senators' goal is to introduce their bill in the near future.  

The 21st Century Health Information Act is a life-saving measure replacing the current paperwork system with secure, confidential electronic health information networks, ultimately saving lives and money by eliminating preventable medical errors, reducing unnecessary duplication of testing, and enhancing patients' health care experience.

The bill takes a regional approach, catalyzing a process that will bring together providers, patients, health plans, employers, and other health care stakeholders locally to do three things crucial to transforming health care: first, figure out how to collaborate on getting IT into physicians' hands; second, build a secure, confidential health information network to allow information to be shared as appropriate and authorized; and third, begin coming up with strategies to use the new information capabilities to make sure we get the right care to the right people at the right time as efficiently as possible.

Health information networks will allow the seamless transfer of health data while guaranteeing patient privacy and security. The process will help doctors streamline their practices by electronically linking medical records, catching conflicting prescriptions, and improving public health monitoring.

Sponsor letters in support of the bill are being received from across the health care spectrum, including the American College of Physicians, National Association of Manufacturers, Healthcare Information and Management and Systems Society (HIMSS), Families USA, and the American Academy of Family Physicians. 

 

The bill has been referred to committee and will need a strong demonstration of support to see action this year.  Call or email your Member of Congress and encourage them to cosponsor H.R. 2234.

 

Brailer's Office Funded

Healthcare IT News reports that Congressional appropriators have agreed to reprogram $32.8 billion to the Office of the National Coordinator for Health Information Technology this year.  The Administration had requested $50 million for FY2005 for the office, headed by Dr. David Brailer.  The omnibus appropriations bill passed last year by Congress shocked health IT observers by ignoring the request and providing no funding.  The funding will be used in part to fund the contracts and grants the Department is planning to issue soon (see item #_).  The Administration requested $125 million for Dr. Brailer's office for FY2006; the Appropriations Committees have yet to mark-up HHS spending bills for next year.

 

HHS Releases Health Information Technology Report

The Department of Health and Human Services has released the report, "Health Information Technology Leadership Panel: Final Report."  The Lewin Group, which produced the report, convened a panel of executives from major companies to examine strategies for health IT adoption.  The panel concluded that investment in information technology in healthcare as a high priority for the U.S. healthcare system.  It found a need for widespread adoption of interoperable health IT, for the federal government to use its healthcare buying power to drive provider adoption of IT, and for private sector purchasers and healthcare organizations to collaborate with the government.  It recommended speedy implementation of a series of incentives and steps to promote adoption.

 

5 Years After To Err is Human, Medical Error Risks Remain Great

From IHealthBeat:

As many as 98,000 patients still die annually as a result of medical mistakes, even though hospitals have made significant changes to improve safety in the past five years, according to an article in the Journal of the American Medical Association, USA Today reports (Weise, USA Today, 5/18). Even after a study by the Institute of Medicine in 1999 found that thousands of patients die because of medical errors, researchers have found that "[b]uilding a culture of safety is proving to be an immense task and the barriers are formidable" (Berwick/Leape, JAMA, 5/18).

Barriers to improving patient safety include the complexity of health care systems, lack of leadership, physicians' reluctance to admit mistakes and a flawed insurance reimbursement system, USA Today reports.

However, hospitals have taken steps to minimize medical errors, including implementing computerized prescribing (USA Today, 5/18). The researchers expect that the pace of change is likely to accelerate" as hospitals continue to adopt tools such as electronic health records and other practices. The article also urges the Agency for Healthcare Research and Quality to "bring together all stakeholders, including payers, to agree on a set of explicit and ambitious goals for patient safety to be reached by 2010" (JAMA, 5/18).

 

Compendium of Patient Safety Studies Released

The Agency for Healthcare Research and Quality and the Department of Defense have released a compendium of studies on the successes and challenges of efforts to improve patient safety and reduce medical errors.  The collection, Advances in Patient Safety: From Research to Implementation contains 140 peer-reviewed articles that represent an overview of patient safety studies.  It contains emerging lessons from clinical studies, presents cutting-edge technologies such as simulation tools for surgery training, the effects of change on dynamic systems of care and national and regulatory issues. 

 

Proposed Legislation Would Govern Outsourcing Data

On May 3, legislation was introduced in the House and Senate that would require businesses--including health care organizations--to receive consent from customers before sending their personally identifiable information outside the United States. The legislation from Sen. Hillary Clinton (D-NY) and Rep. Edward Markey (D-MA) is designed to regulate the growing practice of outsourcing financial and health care data processing work to overseas firms. Both bills, although not identical, are titled, "The Safeguarding Americans from Exporting Identification Data Act," or the "SAFE-ID Act." The Senate bill would authorize revisions to the HIPAA privacy rule to require an explanation in an organization's notice of privacy practices of outsourcing practices and consumer rights to object. Both bills would permit consumers to file civil lawsuits against violators. Text of the bills, S. 810 and H.R. 1653, are available at on the HIMSS Advocacy Center website.

 

Pay-for-Performance Demonstration a Success?

The Centers for Medicare and Medicaid Services pay-for-performance demonstration project is showing significant increases in quality of care at the hospitals participating in the program according to CMS reports. The 3-year demonstration program tracks hospital performance on 34 measures of processes and outcomes of care on five clinical conditions.  Initial reports show improvement in all five clinical areas.  The program, begun in October 2003, rewards high performers with bonuses totaling $7 million per year.  Poorly performing hospitals could potentially face penalties in the third year.  Each hospital is scored on measures for each condition and those in the top 10 percent for a given condition are given a 2 percent bonus on their Medicare payments for that condition. 

 

HHS Preparing Flurry of Health IT Initiatives

On May 12, the Department of Health and Human Services issued four pre-solicitation notices, related to four areas of improving health information technology:

RFP's are due out this summer with a thirty-day response period. Awards for all but the prototypes are expected before fiscal year-end (September 30, 2005).

 

New Medicaid Commission

On May 10, HHS Secretary Mike Leavitt signed a charter for the new Medicaid study commission, which was proposed in the FY 2006 Budget Resolution approved by Congress last month.  This commission will recommend ways to cut $10 billion from Medicaid over five years and propose longer-term solutions to slow the program's rising costs.  The commission will have as many as 15 voting members and 18 nonvoting members. Secretary Leavitt will appoint the commission's voting members and include Leavitt or his designee; federal Medicaid officials; current or former governors; current or former state Medicaid directors; three health care policy experts from public policy organizations; and other "individuals with expertise in health, finance or administration," according to the charter.  Four Republican and four Democratic legislators will be appointed by congressional leaders as nonvoting commission members. The commission also will be advised by 10 people involved in Medicaid, including state and local officials, consumer advocates and care providers.  The commission is expected to make cost-cutting recommendations by September 1. The charter states that by December 1, 2006, the commission must make "longer-term recommendations on the future of the Medicaid program."

IHI's Promising Practice of the Month: Making Care Better by Making the Experience of Care Better

Making it easier for patients to schedule medical appointments and cutting down on those long waits at the doctor's office, are the driving principles behind an approach to office practice called Open or Advanced Access. To achieve the best results, practitioners have to be vigilant and follow the rules. When they do, patients are more satisfied and receive better health care. Read about a successful Collaborative in North Carolina. http://www.ihi.org/IHI/Topics/OfficePractices/Access/Literature/TrimmingHealthCaresExcessWaitsandDelays.htm

 

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 1, 3, 5-9)

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. (Item 10)