HIMSS Pulse on Public Policy

November 2009 SUBSCRIBE

>> Congressional News

House Passes Healthcare Reform
On November 7, the House passed H.R. 3962 , the Affordable Health Care for America Act, on a slim margin of 220-215. Among many things, the legislation would establish a public health insurance option, require individuals to have health insurance, expand Medicaid, and leverage health IT in such activities as care coordination and home-based care. A full listing of the legislation’s health IT related provisions can be accessed on the HIMSS Web site.

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Senate Begins Debate on Healthcare Reform Legislation
Democratic leaders in the Senate have reiterated their intention to pass healthcare reform legislation by the end of the year. Majority Leader Harry Reid (D-NV) released long-awaited healthcare reform legislation, the Patient Protection and Affordable Health Care Act, a product of legislation approved by the Senate Health, Education, Labor, and Pensions (HELP) and Finance Committees. Totaling $849 billion over 10 years and reducing the deficit by $138 billion over that same period, according to the Congressional Budget Office, the bill includes an opt-out approach for states in regard to the public option and aims to insure 31 million Americans.  By a close 60-39 vote, the Senate invoked cloture on Saturday night, and will proceed to debate the legislation after Thanksgiving break.

In regard to health IT, the bill retains such provisions as extension of the PQRI (Physician Quality Reporting Initiative) program, leveraging electronic health records (EHRs) to report quality measures, administrative simplification, and leveraging health IT in care coordination activities. For more information, click here. 

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House Passes Medicare Payment Reform Bill
In an effort to address the Medicare cost-control formula—known as the Sustainable Growth Rate—and inhibit a 21 percent cut to physician payments next year, the House passed H.R. 3961, the Medicare Physician Payment Reform Act of 2009, which would replace the formula with payment updates based on inflation. An effort to consider similar legislation, S. 1776, failed in the Senate last month. The Senate is expected to readdress the issue of Medicare physician payments after consideration of healthcare reform legislation.

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HIT Financing Act Passes House of Representatives
H.R. 3014, the Small Business Health Information Technology Financing Act, passed the House by voice vote this month.  Introduced by Rep. Kathleen Dahlkemper (D-PA), the language was also included in the larger H.R. 3854, the Small Business Financing and Investment Act of 2009, which also passed the House in late October by a large margin. In the aftermath of the American Recovery and Reinvestment Act of 2009 (ARRA), the legislation addresses the need by many providers for financial assistance to adopt health IT.  The bills would authorize the Small Business Administration to guarantee loans of up to $350,000 for a small business health professional and $2,000,000 for groups of affiliated professionals for the acquisition of health information technology, defined as computer hardware, software and related technology to aid in the provision of health care and supports the requirements for being treated as a meaningful use EHR user.  The bills expressly state that no loan may be guaranteed until meaningful EHR use has been determined by HHS.  Senator John Kerry (D-MA) has introduced companion legislation, S. 2765. That bill and the two House bills have been referred to the Senate Committee on Small Business and Entrepreneurship.

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House to Review NIST EMR Standards Research
At the November 19 Congressional Luncheon Seminar Series briefing sponsored by the Institute for e-Health Policy, Representative David Wu (D-OR) indicated that the House Science and Technology Committee will hold an oversight hearing in early 2010 to review the standards research that the National Institute of Standards and Technology is conducting. ARRA requires that NIST receive $20 million in funding from ONC to support standards-related research that supports the security and interoperability of electronic medical records to reduce healthcare costs and improve the quality of care.  More details are expected in the coming months.

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>> In the News

Blumenthal Added to HIMSS10 Keynoter Lineup
National Coordinator for Health Information Technology David Blumenthal, MD, MPP, will present the keynote address, Becoming a Meaningful User of Health IT: Moving Toward a New Level of Professionalism in Healthcare, on Wednesday, March 3 during the 2010 Annual HIMSS Conference & Exhibition in Atlanta. Dr. Blumenthal will share his thoughts about ONC’s strategic efforts to advance rapid adoption and the meaningful use of health IT.  Go online for more details on the HIMSS10 keynoters’ lineup, as well as the latest information on HIMSS10 education, the exhibition and networking events.  Early bird registration ends December 14. 

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HHS Announces HIT Workforce Grants
The Department of Health & Human Services announced plans to make available $80 million to enhance the health IT workforce.  Grant opportunities include $70 million for non-degree community college training programs, and $10 million for the development of educational materials.  Said Dr. David Blumenthal, National Coordinator for Health IT, “Critical to achieving the goal of the Heath Information Technology for Economic and Clinical Health (HITECH) Act and supporting meaningful use of health IT is the availability of a skilled workforce that understands the unique technology and management needs within a clinical setting.”  More information on the grants will be available online shortly.   

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HIT Standards Committee Focused on Simplicity
The Implementation Workgroup of the HIT Standards Committee summarized its public hearing with ten recommendations, centered on keeping the process simple and understandable for the entire healthcare community—patient, provider, and big and small companies.  White House Chief Technology Officer, Aneesh Chopra, applauded the public dialogue on standards and meaningful use that has been ongoing on the federal government blog and personal blogs for the past three weeks.  He encouraged additional participation before the online forum is concluded on December 1.  Secretary Chopra opened the session on cyber security by stating that cyber security is an issue of great interest to President Obama, and made reference to the President's decision to launch an initiative in May, 2009, and the relevance to healthcare delivery. As part of the cyber security panel, Lisa Gallagher, HIMSS Sr. Director for Privacy and Security, presented testimony on the 2009 HIMSS Security Survey. Read more about the meeting here. 

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Blumenthal Addresses HIT Advisory Committee Meetings
In his opening remarks to the HIT Standards Committee November meeting, Dr. David Blumenthal of the Office of the National Coordinator for Health IT reported that the ONC is hard at work to ensure the interim final rule is released by the December 31, 2009 deadline that was identified in ARRA.  Similarly, the Centers for Medicare and Medicaid Services is eager to complete the notice of proposed rule making on meaningful use.  Dr. Blumenthal anticipates that both will be issued in the next four to six weeks.

Both the HIT Policy Committee and the HIT Standards Committee Implementation Workgroup met in late October. Speaking at the Policy Committee, Dr. David Blumenthal of the Office of the National Coordinator (ONC) noted that meaningful use, standards, and certification regulations are "in advanced stages of drafting," and proceeded to identify areas where ONC would like the Policy Committee to focus: privacy and security; recommendations for meaningful use for specialty providers in 2013 and 2015; health IT adoption with an emphasis on EHRs; standards development and harmonization (with the possibility of federal resources to support closing gaps in current standards and developing new standards); a rethinking of the "network of networks" model for the Nationwide Health Information Network; coordinating meaningful use efforts between state Medicaid and federal Medicare; and advising ONC on updates to its strategic plan.  Dr. Blumenthal identified privacy & security, the NHIN, and state HIEs as "time-sensitive topics."

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Blumenthal Emphasizes “Patient-Centric” Care in HITECH Implementation
Health Information Exchange is the topic of Dr. Blumenthal's latest in his series of messages on the implementation of the HITECH provisions of the American Recovery and Reinvestment Act (ARRA).  Dr. Blumenthal’s reminder that patient-centered healthcare is the central goal of the HITECH provisions comes at an important time before the release of the Certification Criteria Interim Final Rule and the Meaningful Use Proposed Rule.  The pending federal regulations will not be effective without the removal of three specific barriers to information exchange:

• Commercial barriers: The development of a Nationwide Health Information Network that encourages competition and ensures consumer choice;
• Economic barriers: Medicare and Medicaid incentive payments for the adoption and meaningful use of electronic health records that includes information exchange; and
• Technical barriers: The standards harmonization process promotes common interpretation and use of standards that prepare a foundation for information exchange.

The ONC cooperative agreements with state HIE activities that will be announced by the early part of December will provide $564 million to continue NHIN infrastructure development. 

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ONC Launches “Health IT Buzz” Blog
In an online announcement this week, Dr. David Blumenthal of the Office of the National Coordinator for Health IT (ONC) kicked off a new ONC blog, the Health IT Buzz Blog, to share information and solicit ideas and opinions.  Said Dr. Blumenthal, “We plan to report on progress, and create an open dialogue among members of the health IT community. …We want to hear from citizens, patients, health professionals, managers, policymakers, technology enthusiasts and technology skeptics.”

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ONC Plans Public Survey on Attitudes Toward EHRs
The Office of the National Coordinator for Health Information Technology (ONC) has filed a notice in the Federal Register that it is proposing to conduct a nationwide survey “to better understand individuals’ attitudes toward electronic health information exchange and its associated privacy and security aspects as well as inform policy and programmatic objectives.”  HHS is currently seeking public comment on its proposal.

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ONC Introduces Advisory Committee Blog
ONC has launched a blog for its two federal advisory committees – the HIT Policy Committee and the HIT Standards Committee.  “In the spirit of transparency and collaboration, this blog will help ONC’s FACAs open a broader dialogue with you. In the months to come, we will use this blog to let you know about key FACA activities.”  The public is invited to post comments on blog entries.

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HRSA to Release Additional Grant Funds
The Health Resources and Services Administration is preparing to release an additional $80 million in EHR implementation and health IT implementation grants, to be awarded to community health centers in the coming weeks. The $80 million is part of $2 billion appropriated to HRSA through ARRA.  These funds are in addition to the $27.8 million in EHR grants that were awarded to community health centers on September 29.

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Dr. Regina Benjamin confirmed as U.S. Surgeon General
Dr. Regina Benjamin has been confirmed as Surgeon General of the United States.  Dr. Benjamin has experience converting to a paperless environment under extreme circumstances following Hurricane Katrina, and is a strong advocate for rural and underserved populations.  HIMSS congratulates Dr. Benjamin and looks forward to working with her team to ensure health IT can be optimally leveraged to achieve our nation's strategic healthcare objectives.

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SSA and VA to Begin Sharing EHRs
Beginning in 2010, the Social Security Administration will share electronic health information with the Veteran’s Administration and Department of Defense in order to speed claims processing.  “VA has been exchanging information with Social Security for years, but it has been digital paper, like PDFs,” said Jim Borland, SSA’s Special Advisor for Health IT. 

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AHRQ Releases Reports on EHR Usability
Concerns regarding the usability of electronic health records have recently been getting more attention. The Agency for Healthcare Research and Quality commissioned two reports on the usability of Electronic Health Records that were released this month: EHR Usability: Evaluation and Use Case Framework and EHR Usability: Interface Design Considerations.  HIMSS has been at the forefront of the usability discussion; the HIMSS Usability Workgroup released a paper in July titled Defining and Testing EHR Usability, and HIMSS is currently seeking opportunities to collaborate with AHRQ on future usability publications.

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AHRQ Launches HospitalCompare.hhs.gov
AHRQ Director Dr. Carolyn Clancy released a new advice column on AHRQ's website discussing how consumers of healthcare can determine if their hospital is "doing a good job." To aide in that research, Dr. Clancy announced the launch of HospitalCompare.hhs.gov. HospitalCompare is a web-tool designed to show users how effectively hospitals treat patients regarding specific illnesses and surgical procedures, with a specific focus on readmission rates.

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Federal Broadband Efforts Streamlined to Get Funding Out
The Department of Commerce National Telecommunications and Information Administration (NTIA) and the Department of Agriculture Rural Utilities Service (RUS) announced that they are merging the final two rounds of ARRA Broadband Initiatives funding to increase efficiency, better accommodate applicants, and bring Broadband access and the jobs broadband access creates to more Americans. RUS and NTIA expect to award over $4 billion dollars in funding during this cycle, which is expected to begin in December, 2009. Both agencies have released a joint Request for Information requesting public comments on streamlining the BroadbandUSA initiative. Comments are due November 30, 2009.

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HIMSS Launches Diversity Business Roundtable for Health IT
HIMSS has created a Diversity Business Roundtable for Health IT to enable businesses owned by minorities, women and veterans the opportunity to advocate, collaborate, network and grow as the health IT market prepares for rapid expansion over the next decade.  The Roundtable will be co-chaired by Peggy McShane of Net New Growth (woman-owned), Rick Blake of Strategic Health Resources (minority-owned), and Keith Moore from Martin-Blanck (veteran-owned).  For more information and to join, please contact HIMSS staff liaison Arnol Simmons.

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HIMSS Federal Health Community
The HIMSS Federal Health Community is a complimentary networking platform and community of professionals for HIMSS members who are also federal government employees. The Community works to foster cross-agency information sharing and enable members to network, share ideas on how health IT can be used to improve healthcare delivery by the federal government, and provide leadership, guidance and domain expertise to HIMSS activities and industry initiatives. The Community meets bi-monthly via teleconference focused on collaborating on activities and HIMSS updates, coupled with networking events at HIMSS Annual Conference and the Annual Government Health IT Conference in Washington DC. The Community will also utilize HIMSS Connect Social Networking Technology so members can network with each other to discuss issues of interest.  For more information, please contact Jonathan French , HIMSS Manager of Federal Affairs.

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>> State News

How to Host a State HIT Day – Free Webinar
The HIMSS Government Relations Team will host a free webinar, How to Host a State HIT Day on Capitol Hill, on December 16, 2009 from noon to 1:00 P.M.  Contact the Member Services Team if you would like to participate and they will send you the call-in information.

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Florida to Offer Online PHRs for Medicaid Recipients
Florida’s Agency for Heath Care Administration (AHCA) is introducing a free, Internet-based personal health record, My Florida Health eBook and My Florida eBaby Book.  When the system goes live in the next few weeks, State Medicaid recipients will be able to access their personal health record at www.FloridaHealthFinder.gov by using their Medicaid ID number.  They will then be able to track information about their health care visits, procedures, medications, immunizations, allergies and more.  “We applaud the Florida Agency for Health Care Administration for offering 2.6 million Medicaid recipients access to their personal health records, putting Florida at the forefront of providing consumers online tools to manage their own health information,” said Tom Keefe, HIMSS Sr. Director of State Government Relations.

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Kansas Moves Forward on Plan for Statewide HIE
The Kansas Department of Health and Environment has convened an e-Health Advisory Council, made up of more than 30 stakeholders and divided into five working groups, to guide in the planning and implementation of a statewide health information exchange.  Kansas expects to get word in December that it will receive $9 million in funding from the federal government to support the state’s transition to HIEs. The goal is to have a complete electronic health record by 2014.  The next meeting of the Council will be held December 16, 2009. 

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HIMSS Launches San Antonio Chapter
The HIMSS San Antonio Chapter has been formally approved by HIMSS Board of Directors. It will cover San Antonio and Southwest Texas.  To become a member of the chapter, visit the HIMSS Member Center and scroll down to “Manage Chapter” to update. Be sure to update your contact details and demographics. E-mail the HIMSS Membership Department with any questions.

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In Their Own Words

“Information exchange must cross institutional and business boundaries. Because that is what patients need. Exchange within business groups will not be sufficient – the goal is to have information flow seamlessly and effortlessly to every nook and cranny of our health system, when and where it is needed, just like the blood within our arteries and veins meets our bodies’ vital needs.

- David Blumenthal, MD, MPP
National Coordinator for Health Information Technology
U.S. Department of Health & Human Services
November 12, 2009

HIMSS Government Relations Tools Keep You In the Know
The HIMSS  Public Policy Center provides HIMSS members with a number of tools to keep up with health IT, stimulus funding, and healthcare reform activities on Capitol Hill and at the White House, including updates on the American Recovery and Reinvestment Act, HIMSS Fact Sheets, the Legislative Action Center, and the complimentary monthly e-newsletter, HIMSS Pulse on Public Policy, for timely insight into HIT policy in Washington and around the nation and how it might affect you. If you have plans to be in Washington, DC, the HIMSS Government Relations staff would be happy to help you arrange meetings with your elected officials; please visit the HIMSS Government Relations Toolkit. If you would like to become more involved with HIMSS public policy activities, contact the HIMSS Government Relations team.

By the Numbers

HIMSS Security Survey Says Health Orgs Not Ready for Security Challenges
With ARRA underway, healthcare organizations face new challenges to maintain privacy and security of patient health data. However, data gathered from healthcare IT and security professionals indicate that many organizations may not be ready to meet some of the HITECH components of the ARRA legislation and other security challenges, according to the results of the 2009 HIMSS Security Survey, sponsored by Symantec Corp.

HIMSS Analytics Survey: Healthcare "Business Associates" Unprepared for Data Breach
In a national survey of hospitals and business associates to check the state of healthcare vulnerability to data breach, HIMSS Analytics found that approximately one-third of business associates surveyed were not aware that they need to adhere to federal Health Insurance Portability and Accountability Act (HIPAA) privacy and security requirements, compared to 87 percent of health providers. 

BLS Predicts Rise in HIT Employment
The Bureau of Labor Statistics predicts a nearly 18 percent employment increase for medical records and health information technicians between 2006 and 2016, from 170,000 to 200,000 in that 10-year-period.

EHRs May Improve Quality in Hospitals that Care for the Poor
The findings of a national survey “suggest that adopting EHRs should be a major policy goal of health reform measures targeting hospitals that serve large populations of poor patients.”  The study, “Evidence Of An Emerging Digital Divide Among Hospitals That Care For The Poor,” showed that hospitals that provide care for large numbers of poor patients had minimal use of EHRs and also lagged in quality; however, those with EHRs appear to have eliminated the quality gap. 

On HealthReform.Gov
A Success Story in American Health Care: Using Health Information Technology to Improve Patient Care in a Community Health Center in Washington, examines how the Columbia Basin Health Association in Othello, WA uses health information technology to improve health care quality and patient safety as well as promote care coordination and continuity.

Tools & Resources

Member Only Benefit: Congressional Research Service Reports
CRS Report for Congress: Medicare Program Changes in H.R. 3962, Affordable Health Care for America Act (November 2009)

CRS Report for Congress: The Market Structure of the Health Insurance Industry (October 2009)

To access other CRS Reports, visit HIMSS PULSE in the HIMSS Member Center (scroll down).

HIMSS Introduces
New RSS Feeds
Making it even easier to stay current with easily accessible and updated information, HIMSS introduces two new RSS feeds - Ambulatory Information Systems and Clinical Informatics.  Other available feeds include HIMSS News, Healthcare Reform Updates, Physician Community Podcasts, and Government Health IT.  These feeds offer another way to get HIMSS content; subscribe to get the latest news, announcements and multimedia - delivered directly to your favorite feed reader and updated regularly. The HIMSS Web site offers step-by-step instructions on how to sign up.

Member Only Benefit: HIMSS Grants Advantage 
HIMSS Grants Advantage subscription service provides information on identifying funding initiatives and the steps needed to apply and succeed in the entire grants life cycle, including identification, submission, award receipt, reporting and closure. Grants Advantage can help you find funding resources in categories that include health IT; facility planning and construction; health services planning; specialized health research; education; and veterans’ health.  Learn more about the benefits of subscribing to HIMSS Grants Advantage.

Make Good Decisions for EMR Strategies with Guidelines from HIMSS Analytics
As the nation continues its journey toward adoption of the electronic medical record, hospitals must understand and meet the funding requirements established by the American Recovery and Reinvestment Act.  A new HIMSS Analytics white paper, The State of US Hospitals Relative to Achieving Meaningful Use Measurements, offers an overview of market gaps that must be addressed to achieve ARRA compliance.

Tool Measures Your Organization’s EMR Adoption Progress
Find out your EMR Adoption ModelSM score and optimize ARRA funding. By knowing your score you will have a valuable tool to measure yourself against your peers’ progress in adopting EMR and other healthcare technologies. This number will help you more effectively plan and execute your EMR strategies—and chart your path for achieving "meaningful use" dollars as part of ARRA funding. To find out your EMRAM score, all you need to do is participate in the HIMSS Analytics annual study. To get started, contact Patti Harris at 312-638-9460. Or visit the HIMSS Analytics Web site for more information.

HIMSS JobMine®
Whether you're actively looking for a new position or simply waiting to be approached with a great opportunity, HIMSS JobMine® helps you stay focused on the healthcare industry. And if you’re looking for high quality candidates, HIMSS JobMine® gives you direct access to the best in the industry.

Calendar of Events

Taking HIT To The Streets
Join other healthcare decision makers at The ARRA Era, one-day regional conferences designed to help hospitals and health systems identify and qualify for funding opportunities from the American Recovery and Reinvestment Act.  Registration is now open for the December 4, 2009 conference in Dallas/Ft. Worth, and the January 15, 2010 event in Chicago.

ARRA and Beyond: Outcomes Driven HIE – Free Webinar
Learn the various emerging business approaches to health information exchange, how those approaches might be sustainable beyond ARRA funding, and about available options for technical solutions to health information exchange and how various technology approaches can solve problems and deliver improved outcomes. Click here to register for the December 10, 2009 free HIMSS webinar.

HIMSS10 Early Bird Registration Ends December 14th!
Registration is now open for the 2010 Annual HIMSS Conference & Exhibition, the industry’s biggest health IT event, March 1-4, 2010 in Atlanta. Early-bird registration rates are available now through December 14, 2009.

How to Host a State HIT Day – Free Webinar
The HIMSS Government Relations Team will host a free webinar, How to Host a State HIT Day on Capitol Hill, on December 16, 2009.  Contact the Member Services Team for details

Northern California HIMSS Chapter - Meaningful Use
Join the Northern California HIMSS Chapter on January 28, 2010 for an update on Meaningful Use - A State and National Goal. Gain insights into what organizations need to do to achieve Meaningful Use. Find how EHRs are being implemented and accepted as well as learn the status of the statewide collaboration in the development and deployment of secure and practical HIEs.

HIMSS State Chapters Plan 2010 Advocacy Days
The Virginia HIMSS Chapter is planning its annual State Advocacy Day for February 4, 2010.  The Maryland Chapter has scheduled its State Advocacy Day for February 17, 2010.  To schedule an Advocacy Day in your state, contact Tom Keefe, HIMSS Senior Director of State Government Relations.

Save the Date for HIMSS 9th Annual Policy Summit!
With the continuing emphasis on the role of information technology in healthcare transformation and the American Recovery and Reinvestment Act of 2009, it’s more important than ever to become better educated on health IT policy and engage with your elected officials. The HIMSS 9th Annual Policy Summit will be held June 16-17, 2010, in Washington DC.

 

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