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| September 2006 |
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Top RHIO News | Advocacy and Public Policy | RHIO Spotlight | Technology Corner | Calendar of Events |
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Louisiana RHIO Workgroups Encourage Use of IT The Louisiana Health Care Redesign Collaborative received a formal briefing on September 1 regarding of an initial plan to redesign health care for the poor and uninsured in the Greater New Orleans region. The plan is based on the use if health information technology and a model of a ‘medical home’ where citizens will have ready access to neighborhood clinics instead of having to seek care in hospital emergency rooms. According to Dr. Fred Cerise, the plan is the result of six weeks of intensive work by six teams of healthcare experts and the full Collaborative. “This is not the finished plan, but an initial step that builds upon the ideas expressed by each of the workgroups,” Cerise said. “Over the next two weeks, we will work to add the details of how the plan will be financed and what information technology will be needed to support the plan. We will also more fully develop the specific components of the medical home.” San Diego CIOs Discuss Establishing a RHIO Last month, information officers from local hospitals and officials from the San Diego County Medical Society met with Cindy Ehnes, director of the California Department of Managed Care, which oversees the state’s HMOs, to tell her of local efforts to create an electronic RHIO. The system would link health records among medical professionals. However, Medical Society President Tom Gehring told the San Diego Business Journal his group did not make any official requests to Ehnes and called the meeting a “fact-finding session.” Tampa Bay RHIO Embarking on Fundraising Campaign The Tampa Bay RHIO has decided to begin an aggressive campaign to raise money and in-kind support for its projects. "We're going to reach out to private-sector employers," said Russell Thomas, chief executive officer of Gold Standard in Tampa, who presented the organization’s progress report to Governor Jeb Bush. "They need to step up and volunteer both dollars and time to help us." Sponsored by the Tampa Bay Partnership, the RHIO was organized last year and got its first state grant in January, $450,000 for a six-month pilot project. For the state fiscal year that began July 1, however, the local RHIO received just $360,000 from the state, far short of its $2.2 million budget for expansion. RHIO organizers said they plan to raise $350,000 in cash from the community and make up the balance through in-kind contributions of executives' time, supplies and other needs. Employers that have donated substantial amounts of executive time to the RHIO this year include University of South Florida; Pepin Distributing Co.; three local hospitals: Tampa General, Moffitt Cancer Center and All Children's Hospital in St. Petersburg; USMD Inc., an electronic medical record company founded by Tampa physician and philanthropist Kiran Patel; and Gold Standard, an online drug-information supplier.
Executive Order Highlights Role of Regional Health Collaboratives CMS Administrator Resigns On September 5, Centers for Medicare and Medicaid Services Administrator Mark McClellan formally announced his resignation from the agency, effective in October. "Dr. McClellan has been a leading voice on the important role that health information technology (HIT) and management systems can have in transforming the delivery of healthcare in the U.S.," said HIMSS Director of Federal Affairs Tom Leary. "During his tenure as Administrator, CMS has taken a very practical approach to ensuring initiatives and regulatory reforms are part of an overall strategy to have HIT available where care is provided, whether the setting is the local hospital or provider's office. His visionary leadership has stimulated policy change through a pay-for-performance pilot program, Stark Physician Self-Referral reform, and a Doctor's Office Quality-IT program that lay the groundwork for improving the quality and efficiency of healthcare delivery in the U.S. Dr. McClellan has been a good friend to HIMSS by working collaboratively and speaking on multiple occasions to our diverse membership." HIMSS Letter to Congress Outlines Important Provisions in HIT Legislation HIMSS released a letter to the U.S. Congress stating its position on what provisions should be included in the reconciliation of H.R. 4157 and S. 1418. HIMSS Government Relations Department worked collaboratively with the Steering Committees, EHRVA, and AFEHCT Advisory Council to ensure the letter was inclusive. Prior to sending the letter, the Government Relations team sponsored a teleconference for HIMSS members to discuss the proposed legislation. "We are continuing discussions with House and Senate staff that may be named conferees,” said HIMSS Vice President of Government Relations. “It is our best guess that conferees will be named within the next two weeks and a reconciled HIT bill will be completed before the Congress adjourns on October 6. We have also been working closely with Rich Corel at CHIME on this topic." HIMSS needs your help in sharing this letter and your personal comments with your members of the House and Senate. Please go to http://capwiz.com/himss/home/ and tell Congress to Pass HIT Legislation Now! GAO Testimony Characterizes HIT Efforts in Progress The Government Accountability Office (GAO) released testimony on September 1, 2006 that reviews the Office of the National Coordinator for Health IT (ONC) and efforts to define a strategic direction for HIT implementation. The testimony provides an excellent overview of the contracts and other initiatives that ONC has initiated to advance the adoption of interoperable electronic health records and a Nationwide Health Information Network. The testimony commends ONC for their efforts to date. However, GAO raises concerns that if ONC and other HHS agencies do not complete a strategic plan with specific milestones, they may fall short of "the President's goal for HIT." HHS Released Report on QIO Program On September 1, Secretary of Health and Human Services Michael O. Leavitt released a report to Congress outlining his response to a March 9 study from the Institute of Medicine, which called for maximizing the potential of the Quality Improvement Organization (QIO) program. Many of the Secretary’s recommendations are aligned with H.R. 5866 introduced in July by Rep. Michael Burgess (R-TX) to strengthen the QIO program and modernize it for the future. CMS Releases New Service for Medicare FFS Contractors The Centers for Medicare & Medicaid Services has created a new listserv for clearinghouses, software vendors, and billing services involved with submitting electronic transactions to, or receiving transactions from, Medicare fee-for-service (FFS) contractors. Messages sent on the listserv will inform subscribers when new CMS instructions are released that affect changes to electronic billing software or services. If you have a clearinghouse, billing service or software vendor involved in your Medicare FFS billing, go to the CMS Mailing Lists website and sign up for the “CLEARINGHOUSE” listserv located in the “Available Mailing Lists” menu.Santa Cruz RHIO Reaping Tremendous ROI
Today, it’s grown to more than 700 users in the community and about a third of those are doctors and the other two-thirds are staff, explained Bill Beighe, CIO, Physicians Medical Group, IPA, Santa Cruz. “We’ve been looking at numbers pretty closely since 2002. We’ve grown from about 200,000 page views a month to more than one million in a month over the last four years. It’s pretty dramatic.” The Santa Cruz RHIO extends outward from the city itself, a northern California coastal community of 40,000, to several agricultural towns which dot the area and bring the total regional population to 280,000. An advantage at the outset was that the IPA had good relationships with the two hospitals in the community: Dominican Santa Cruz (part of Catholic Healthcare West) and Watsonville, a for-profit 100-bed hospital. Today, its members include more than 70 independent physician groups, laboratories, community health clinics, Planned Parenthood, the county healthcare department. Once the RHIO is in place there is a tremendous return on investment (ROI) for data providers, Keet added. “The people feeding the data have a much more efficient way of accessing information. The physician has the advantage of being more efficient. We also have the ability to graph information over a couple of years. For many doctors, we are using it as the primary data source for the patient. We have a dual electronic paper record but the electronic is the primary source. I’m a practicing physician and I receive 100 percent of my information electronically.” Interoperability was part of the network from the beginning. Beighe noted that whenever possible data is obtained in an HL7 format using standards and link coding so that things can be standardized. However, some things don’t fit into discrete data coding. For example, the Sleep Study Center issues reports that are word documents and cannot be graphed but it’s securely delivered to the physician, avoiding paper, faxing, and things being lost. Once it is delivered it’s always linked to the patient. A receiving physician can look back next year and see what was recommended.Language-Analysis Software on the Horizon New software is being developed to protect and selectively disclose to physicians and other officials private information contained in electronic documents, according to Technology Review. The software, which is being developed by Xerox, analyzes words and phrases, taken in context, to determine who should have access to the information. Each document is revealed based on the level of authorization of the person trying to access the information. The software will not create multiple versions of documents and it will use less memory than encryption programs. Xerox anticipates the software will be ready for commercialization in two to five years. 4th Annual HIMSS Public Policy Forum
Space is limited. Key Topics for Discussion
The Public Policy Forum has been approved by HIMSS for up to 7.0 contact hours of continuing education credit towards renewal of the CPHIMS credential. Please complete the Continuing Education Tracking Form. Should you have any questions, please feel free to contact Julianna Kazragys@himss.org. For more information, please contact Tom Leary, HIMSS director of Federal Affairs, at tleary@himss.org.
3rd Annual Nursing RHIOS AND NURSING: INFORMATION AT THE CENTER OF CARE Join the AMIA Nursing Informatics Working Group and HIMSS for the 3rd Annual Nursing Informatics Symposium at AMIA 2006 on Saturday, November 11, 2006, 8 a.m. to 5 p.m. at the Hilton Washington and Towers in Washington, DC. National initiatives are prompting the development of RHIOs. In order for these RHIOs to support the practice and delivery of nursing care by the 2.8 million nurses in multiple care settings in the US, nurses must be more involved in the development, governance and technology management related to these RHIOs. HIMSS Vice President of Informatics Joyce Sensmeier, CPHIMS, FHIMSS, RN is a keynote speaker.
Register Now for HIMSS07 Get ready for HIMSS07 in New Orleans on February 25-March 1. Online registration is available and hotel reservations are now open at http://himss07.org/travel/travel.aspx. Take a look at the confirmed keynote speakers and visit the web site for information on the conference and New Orleans.
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More than 10 years ago, as Medical Director of an independent practice association (IPA), Physicians’ Medical Group of Santa Cruz County, Robert Keet, MD, FACP sought to improve overall clinical efficiency and quality and led the charge to build a RHIO. “In 1993, our IPA had about 120 to 130 physicians that contracted with hospitals and major outpatient laboratories and radiology services. The IPA spearheaded the entire process, bringing all of those groups together in a common electronic network, started with taking all of the clinical data and turning it into electronic messages sort of like email but electronic. We evolved from there building tools to manage that data, manage the flow, the receipt of data and how doctors deal with the data.” 
Keynote Speaker: Steven A. Ballmer is Chief Executive Officer of Microsoft Corporation, the world's leading manufacturer of software for personal and business computing. Ballmer joined Microsoft in 1980 and was the first business manager hired by Bill Gates. Since then, Ballmer's leadership and passion have become hallmarks of his tenure at the company.
Keynote Speaker: General Colin L. Powell, USA (Ret.) became the 65th Secretary of State on Jan. 20, 2001. Before becoming Secretary of State, Colin Powell served as a key aide to the Secretary of Defense and as National Security Advisor to President Reagan. He also served 35 years in the United States Army, rising to the rank of Four-Star General and serving as Chairman of the Joint Chiefs of Staff (1989 – 1993).
Keynote Speaker: Dr. Stephen R. Covey is co-founder/vice-chairman of Franklin Covey Company, a leading global professional services firm. Franklin Covey offers learning and performance solutions to assist professionals and organizations in significantly increasing their effectiveness in productivity, leadership, communications and sales.