September 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. RAND Study Estimates that Widespread Adoption of Health Information Technology Could Save $162 Billion per Year
2. Crash Program Uses Technology to Reconstitute Katrina Victims' Records
3. Leavitt Announces Health IT Advisory Panel Members
4. CMS Announces Quality Improvement Demonstration
5. National Conference of State Legislatures Calls for IT as Part of Medicaid Reform
6. Arizona, Kentucky Advance E-Health
7. Report Calls for VA to Centralize IT Operations
8. In Fits and Starts, HHS Inches Free EHR Forward
9. Caucus Launches New Website
10. IHI's Promising Practice of the Month: Perfect Heart Attack Care Every Time

 

RAND Study Estimates that Widespread Adoption of Health Information Technology Could Save $162 Billion per Year
On September 14, the RAND Corporation released a study concluding that widespread adoption and effective use of electronic medical record systems (EMRs) and other health information technology (HIT) improvements could save the U.S. health system as much as $162 billion annually.  Nearly half of the estimated savings - over $77 billion annually --  derive from improved efficiencies and reductions in duplication, preventable medical errors, and streamlined administration.  Greater potential savings are forecast from lower death rates, fewer complications, and fewer employee sick days from chronic diseases, presuming the technology is accompanied by changes in practice that become possible with technology.  The study puts the maintenance costs to the system at $10 billion per year.

The study, about which the Caucus sponsored a Capitol Hill briefing on September 15, is the first of its kind to project both the savings and health benefits that could result from nationwide adoption of HIT.  Because there is limited direct evidence of the benefits at this early stage of adoption, the RAND team used computer models to show the potential benefits if EMR systems were adopted widely, interconnected, and used effectively.

The study noted that barriers to wider adoption of HIT include:

• High initial acquisition and implementation costs;
• Slow and uncertain financial payoffs for health care providers;
• Disruptive effects on physician practices during implementation; and
• Payment systems that result in most HIT-enabled savings going to insurers, patients, and government payers like Medicare, while most adoption and care improvement costs are borne by providers.

To accelerate HIT adoption, the study recommended that the government act more aggressively in the early stages of adoption to ensure widespread use of:

• EMR systems that conform to a national set of standards;
• Information-exchange networks sharing approved data among providers and patients; and
• Programs to measure, report and reward the provision of high-quality, efficient care.

A number of bills have been introduced in Congress that begin addressing these recommendations, including Caucus Co-Chairmen Murphy and Kennedy's 21st Century Health Information Act (H.R. 2234).  For more information on health IT bills, visit the Legislation link on the Caucus website, www.patrickkennedy.house.gov/21stcenturyhealth.

 Crash Program Uses Technology to Reconstitute Katrina Victims' Records
A broad coalition of pharmacy benefit managers, pharmacies, labs, IT vendors, and Medicaid contractors, convened by Dr. David Brailer, the National Coordinator for Health Information Technology, has begun using health IT to reconstruct the medical histories of Katrina victims.  The project, now online at www.katrinahealth.org, began by making prescription drug information from 150 hard-hit zip codes available to clinicians in 8 emergency shelters.  The emergency records will allow health care workers in shelters to see prescriptions that patients have been on in recent months.  The system may be expanded to include some lab data as well and discussions are underway with the personal health record service iHealthRecord to make the service available to evacuees.

On September 9, the HHS Office for Civil Rights (OCR) published a second bulletin pertaining to compliance with the HIPAA Privacy Rule in the wake of Hurricane Katrina.  The bulletin provided guidance to health plans, health care providers, and others with prescription and other health information regarding how to share that information and modifying business associate agreements to get necessary information about evacuees to clinicians at shelters without running afoul of HIPAA.

 Leavitt Announces Health IT Advisory Panel Members
The Department of Health and Human Services (HHS) has officially announced the 16 commissioners for the American Health Information Community (AHIC).  The public-private commission, chaired by HHS Secretary Mike Leavitt, will advise HHS on specific actions necessary to achieve a common interoperable framework and serve as a forum for a wide range of healthcare industry constituencies.  AHIC will have an integral role in developing the work products from the four RFPs addressing standards harmonization, certification of EHRs, prototypes for a NHIN, and processes for overcoming limitations to interoperability that are created by  state-level privacy and security legislation and regulation.

CMS Announces Quality Improvement Demonstration
The Centers for Medicare & Medicaid Services (CMS) has announced that it is seeking proposals for the Medicare Health Care Quality Demonstration.  The CMS press release, dated September 9, gives highlights on CMS's interest in conducting a five-year project to find and develop approaches to identify, develop, test, and disseminate major and multifaceted improvements to healthcare systems at the area or regional level.  The demonstration will incorporate modified payment and incentives to providers who incorporate quality measures to improve care delivery and control the healthcare costs for the patient and Medicare.  Medicare is encouraging physician groups, integrated delivery systems, and regional coalitions to submit projects and strategies that are consistent with the Institute of Medicine's six aims for improving quality.  Applications will be considered in two groups with due dates of January 30, 2006 and September 29, 2006, respectively.

National Conference of State Legislatures Calls for IT as Part of Medicaid Reform
The NCSL Health Committee issued a principle for Medicaid reform, including the need for health IT to improve Medicaid.  By adopting this principle, members of NCSL, who are elected state legislators and legislative staff, have both recognized and embraced the vital role that HIT plays in improving healthcare delivery in the U.S.

The principle reads as follows: "NCSL urges the Administration and Congress to support efforts to increase the use of health information technology in the Medicaid program to: (1) improve safety and quality; (2) to control costs; (3) to simplify program administration; and (4) to improve efforts to collect data to evaluate program effectiveness. Medicaid service funds should not be reduced to support these activities. NCSL urges Congress to provide an enhanced administrative match for information technology services."

Arizona, Kentucky Advance E-Health Agendas
With the goal of accelerating the state's use of electronic medical records (EMRs), Arizona Gov. Janet Napolitano signed an executive order recently creating the Arizona Health-e Connection, a 39-member board charged with developing a plan to build the state's HIT infrastructure.  Over the next six months, the panel will work to ensure patient privacy, identify possible funding sources, and develop technical standards. Its members include the leaders of hospitals, medical associations, insurance companies and the state's major employers.  "An interoperable electronic health system will improve the quality and reduce the cost of healthcare in Arizona," Napolitano said in a statement. Her goal is to get widespread adoption of EMRs by -2010-four years earlier than the federal goal set by President Bush.

Across the country, on August 22 Kentucky Gov. Ernie Fletcher, M.D., announced appointments to a new e-health panel. The Kentucky e-Health Network Board was created by state legislation signed into law on March 8 by Fletcher. Its purpose is to develop a secure statewide electronic network to access and transfer healthcare information.

Report Calls for VA to Centralize IT Operations
The House Veterans' Affairs Committee held a hearing on Wednesday, September 14, and Chairman Steve Buyer (R-IN) announced that he and Ranking Member Lane Evans (D-IL) will introduce legislation to give the VA's chief information officer control of resources, budget and personnel related to IT.  The move to reform the VA's IT operations and centralize it within the CIO's office will affect the VA's entire IT budget, including HealtheVet and the VA's electronic health records system.   This recommendation is a result of a study conducted by Gartner Consulting for the VA to analyze the VA's IT management structure and make recommendations for improvement. 

In Fits and Starts, HHS Inches Free EHR Forward
On September 12, an HHS official announced that the release of free electronic health record software for physicians has been delayed indefinitely according to an article published in Government Health IT.  VistA-Office, which is based on the EHR system used in VA hospitals and clinics, was scheduled to be released in July and then postponed until August.  Eight days later, CMS announced that it was releasing an "evaluation version" of VisatA-Office, to be distributed through qualified vendors.  The limited release is intended to provide feedback on the program's usability, effectiveness, implementation, and potential for interoperability.  Vendors will then be able to improve the software.  The evaluation version will not be entirely free to providers, as licensing fees will be required for certain functionality and most providers will need to pay for vendor support for installation and maintenance.  Interested providers can get more information at www.vista-office.org.

Caucus Launches New Website
To inform Members of Congress and the public about efforts to transform health care, the Caucus has launched a new website, at www.patrickkennedy.house.gov/21stcenturyhealth.  The site provides information about relevant legislation, reports, and links, as well as back copies of the monthly newsletter and a list of Caucus members and their staff contacts. 

IHI's Promising Practice of the Month: Perfect Heart Attack Care Every Time
Improving care for patients experiencing a heart attack is key to new efforts at Medicare to track how well hospitals do at delivering the right care, quickly. The series of steps necessary, including prompt use of drugs such as aspirin, beta blockers and ACE inhibitors, is also at the centerpiece of the Institute for Improvement's 100,000 Lives Campaign. McLeod Regional Medical Center in South Carolina used to deliver perfect care 80% of the time but now consistently delivers perfect care nearly 100% of the time.  Click here to learn more about how McLeod raised the bar on care. 

 

 

The House 21^st 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 1-2, 4-8)

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. (Item 10)