In This Issue: May 2009

• In Their Own Words |
• By the Numbers |
• Tools and Resources |
• Congressional News |
• In the News |
• State News |
• Calendar of Events|

>> Congressional News

Health Reform Update
Last week, the Department of Health and Human Services (HHS) released the Operational Plan for funding provided by the American Recovery and Reinvestment Act of 2009 (ARRA).  In addition, Congress left town for the Memorial Day holiday with healthcare reform as a leading legislative priority. In the House, Speaker Nancy Pelosi (D-CA) would like to have the House pass healthcare reform legislation prior to the August congressional recess. A leader of healthcare reform efforts in the Senate, Chairman Max Baucus (D-MT), hopes to hold a mark-up of healthcare reform legislation in June.  Members of the GOP, Congressmen Paul Ryan (R-WI) and Devin Nunes (R-CA), along with Senators Tom Coburn (R-OK) and Richard Burr (R-NC), introduced their healthcare reform legislation, which is an alternative to legislation developing within the prominent congressional committees.  Read more

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Chopra Outlines IT Views before Senate
Virginia Secretary of Technology Aneesh Chopra,  a HIMSS member, who President Barack Obama nominated to be associate director of the White House Office of Science and Technology Policy, outlined his views in his confirmation hearing before the Senate Commerce, Science and Transportation Committee on May 19th.  “We will apply the most innovative technologies to our most important challenges -- bending the healthcare cost curve, optimizing the energy grid to reduce our dependence on foreign oil, delivering an educational system focused on student excellence with special emphasis on science, technology, engineering and mathematics, protecting our nation’s critical infrastructure, and building the high-wage, high-growth jobs in all corners of our country,” Chopra testified.   As Virginia’s secretary of technology under Gov. Tim Kaine (D) since 2005, Chopra promoted health IT projects in Virginia, including developing a secure online registry for advanced health care directives, which will also serve as a future platform for clinical exchange among public health clinicians.  Prior to joining Kaine’s administration, Chopra was managing director with the Advisory Board Co., a health care think tank.

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Senate Finance Committee Roundtable on Financing Healthcare
The Senate Finance Committee has hosted three roundtable discussions on healthcare reform.   During the May 12th session on finance reform, Committee Chairman Max Baucus explained, “This one thinks about money. With any luck, we’ll have a great deal of it.”  Americans spend $4.5 million on healthcare every minute of every day or $2.5 trillion a year.  Without reform, over the next 10 years, America will spend more than $33 trillion on healthcare.  The committee’s May 5th roundtable discussion focused on expanding healthcare coverage.  The first roundtable was held on April 21 and addressed reforming the nation’s healthcare delivery system.

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GOP Seeks 'common ground' on Healthcare
House Republican leaders wrote to President Barack Obama on May 13th to say that they see “areas for potential common ground on health care reform” that they would like to discuss. “We write to you today to express our sincere desire to work with you and find common ground on the issue of health care reform,” says the letter signed by House Republican Leader John Boehner of Ohio, House Republican Whip Eric Cantor of Virginia, House Republican Conference Chairman Mike Pence of Indiana, and others. The letter uses the phrase “common ground” four times in eight paragraphs, and calls for “open and constructive dialogue across party lines.” “Our hope is that such a dialogue will lay the groundwork for an honest debate and open process that will culminate in enactment this year of significant and truly bipartisan health care reform legislation,” the letter says.

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Finance Committee Discuss Public Plan Options
The Senate Finance Committee will met to discuss the inclusion of a public insurance plan in its healthcare reform legislation.  The Finance Committee will consider a plan similar to Medicare but that would feature slightly higher reimbursement rates for providers. The plan would either be operated by the government or government-contracted private firms. Another option would allow each state to develop and oversee its own public coverage plan. The committee also will consider a proposal from Sen. Charles Schumer (D-NY) that would allow a new public plan to compete with private insurers by requiring that the public plan be financed by premiums rather than tax dollars, that it follow the same solvency rules that apply to private firms and that it keep a reserve fund to cover liabilities. The public plan also would be required to follow the same consumer protection rules as private firms.  The panel also is expected to discuss employer or individual mandates.  Committee ranking member Chuck Grassley (R-IA) has said he believes a public plan would eventually eliminate private insurance and force U.S. residents out of their employer-sponsored plans, said the committee meeting will reveal the likelihood of Republicans uniting against a public option.

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House Considering Public Healthcare Plan
The House Energy and Commerce Committee met to discuss a public healthcare plan, including potential state-run options, CongressDaily reports. Energy and Commerce Oversight and Investigations Subcommittee Chair Bart Stupak (D-MI) said a potential state- or region-based plan would address geographic variations that affect health care delivery and costs. However, he said that he is waiting for more details, especially on the cost of such an option, before supporting any specific public plan.  A former aide to a committee member said a public plan could include a federal exchange that featured public and private coverage options that meet certain coverage minimums. The aide said that states could opt out of the federal exchange in favor of creating their own exchange, which still would feature plans that meet the minimum coverage standards.  Committee leaders also said Democratic health care negotiators are considering a public plan that allows consumers to choose from three levels of coverage.

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Rep. Kind Introduces Voluntary Insurance Legislation
Rep. Ron Kind (D-WI) is proposing a bill (HR 2360) that would establish voluntary insurance pools to help businesses, farmers and ranchers find affordable health coverage. The bill, which Rep. Kind hopes will be folded into a comprehensive overhaul bill, would offer private health plans within state or nationwide pools. Small-business owners would receive a tax credit of as much as $1,000 per worker or $2,000 per family if they cover 60% of premiums and a bonus if they pay a larger portion. Self-employed people would be eligible for an $1,800 annual tax credit, or $3,600 for families, with which to buy insurance. The bill also would ban the rating of premiums based on health status and claims experience in these pools.

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>> In the News

ONC to Develop Web Site on PHRs
The Office of the National Coordinator for Health Information Technology (ONC) has proposed developing a Web site containing facts about personal health record (PHR) systems and the privacy policies related their use to help consumers make informed decisions.  In a notice in the Federal Register on May 22nd, the national coordinator’s office described a project to develop an online model or template in which PHR providers would present the facts and key information about privacy, security and information management policies.  ONC said it will test consumer understanding about the model through October in six locations across the nation and revise the template as it gets more feedback. Testing will include 90-minute, one-on-one, cognitive usability interviews with six to seven participants at each of six sites.  The Federal Register notice is available here.

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Report Issued on Failing Status Medicare Funds
The 2009 Medicare Trustees Report finds Medicare Trust Funds will be exhausted by 2017. Today, the fund spends more than it takes in and we make up the difference using assets from the fund, HHS Secretary Sebelius said in a statement. “But in 2017 – eight years from now – those assets will be exhausted if we don’t do something. Second, the Supplementary Medical Insurance Trust Fund helps pay for medical care and prescription drugs. This fund is solvent, but only because premiums and general revenue financing are reset every year, requiring seniors and the Federal budget to pay more for their care. If health care costs keep going up, our beneficiaries will continue to see their premiums rise at unsustainable rates.”

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Dr. Frieden Appointed Director of the CDC
President Barack Obama has appointed Dr. Thomas Frieden, currently Commissioner of the New York City Health Department, as Director of the Centers for Disease Control and Prevention (CDC). Dr. Frieden is an expert in preparedness and response to health emergencies, and has been at the forefront of the fight against heart disease, cancer and obesity, infectious diseases such as tuberculosis and AIDS, and in the establishment of electronic health records.

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FDA Post Health IT Pre-Solicitation
The Food and Drug Administration has issued a pre-solicitation with the intent to issue a Request for Quotations in June.  The scope of work and tasks are to:  provide technical expertise in pharmacoepidemiology and biostatistics to identify, develop, validate, and implement advance analytical and statistical methods related to signal detection, strengthening and validation; provide access and utilize data from disparate automated healthcare data systems including but not limited to electronic health record systems, administrative claims databases, and registries; develop data identification and access plans along with surveillance plans and study designs; test data model options and the effects on signal detection, strengthening and validation; implement standardized data elements in disparate automated healthcare data systems; and develop and propose a secure communication strategy to support the data access needs.  For more information, go to www.fbo.gov. If interested in the solicitation when released, email Tara R. Hobson, Contract Specialist Tara.Hobson@fda.hhs.gov or call 301-827-9691. The solicitation is scheduled to be available on or about June 1, 2009.

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AHRQ and DoD Release New Team Training Tool for Hospital Rapid Response Systems
A new team training tool on Rapid Response Systems has been released and is available from the Agency for Healthcare Research Quality (AHRQ) and the Department of Defense (DoD). Designed for use by hospital teams, the new training module complements the Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), which was published in 2006.  Research suggests that after implementing a Rapid Response System, hospitals experience a decrease in the number of cardiac arrests, deaths from cardiac arrest, the number of days in the intensive care unit and the hospital overall post arrest, and inpatient death rates. This evidence-based module, available in CD format, provides insight into the core concepts of teamwork as they are applied to the Rapid Response System. The curriculum can be customized to meet an institution's unique needs.  Free copies of the new Rapid Response System module CD are available at http://teamstepps.ahrq.gov/abouttoolsmaterials.htm or by calling AHRQ's publication clearinghouse at 800-358-9295.

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It’s Not Too Late……Win a Trip to Washington
Have you rubbed elbows with politicians, regulatory officials, advisors…or their staffs? If you answered ‘yes’ - you could already be a winner!  We're looking for digital pictures of HIMSS members with President Barack Obama, members of the Obama Administration, members of Congress, state and local elected officials and their staffs.  These are the people who can help us move closer to transforming healthcare through IT and management systems. Moreover, these pictures will inspire others to get involved in HIMSS Advocacy initiatives.  Email your pictures to advocacy@himss.org 

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NCVHS Issues Report on Meaningful Use Hearing
On May 18th, the National Committee on Vital Health Statistics (NCVHS) published the report of the hearing on the definition of “meaningful use” of certified EHR technology they held on April 28-29, 2009.  The report summarizes the main themes cited by the 100+ stakeholders who testified at the hearing.   It is divided into five broad categories of questions, which were outlined by the Office of the National Coordinator and Centers for Medicare and Medicaid.  The categories were:  vision for health and healthcare transformed, meaningful use capacity, paths to meaningful use, evaluation and ideal circumstances for product certification, and mechanisms for measuring meaningful use.  For all five categories, testifiers repeatedly cited the need for a patient-centered focus and quality measures.  The report of the hearing and the transcripts of the hearing can be found on the NCVHS website. 

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>> State News

Virginia Seeks to Become ‘Platinum Standard’ in Health IT
The Virginia HIMSS chapter assisted U.S. Senator Mark Warner’s office in the preparation and communication for a very exciting Health IT Conference in Richmond on May 18th.  The Conference brought some 700 people (500 in person and 200 via web cast) together, including state legislators, to learn how Virginians can access new federal funds and position the Commonwealth as a national leader in health IT.  Prominent speakers included Senator Warner; Dr. David Blumenthal, National Coordinator for Health IT; Dr. Robert Wah, Former Deputy National Health IT Coordinator; Virginia’s Secretary of Health and Human Resources Marilyn Tavenner; and Tony Trenkle, Director for E-Health Standards and Services, Centers for Medicare and Medicaid Services. Read more

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Health IT Advocacy Days Grow Across the Country
As the months go by, the enthusiasm and level of participation in the State Health IT Advocacy Days continue to grow. Four successful and well attended State Advocacy Days have already been held during the current month:  Pennsylvania (May 5), New York & California (May 12) and Alabama (May 15).  The California State Advocacy Day is a good example, where more than 90 Southern and Northern California HIMSS members attended the event. This was almost double the attendance from 2008. HIMSS members met with 64 state legislators and distributed information to 120 offices.   Speakers included: Herb Schulz, Senior Advisor to the Governor and Jonah Fhlrolich, Deputy Secretary of Health Information Technology, California Health & Human Services. Their presentation focused on the many facets of the Stimulus bill and included a 45 minute question and answer session.  In addition, Dave Roberts, the Vice President for Government Affairs, gave a presentation on HIMSS Legislative Principles, renamed the HIMSS Government Initiatives. The training session on “How to Prepare for Meetings with State Legislators” was conducted by Angela Taylor, the chapter advocacy advisor. This event was considered one of the most successful advocacy days for both chapters.  

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Michigan Legislation Makes Healthcare Affordable
Michiganders without health insurance would have a chance to buy an affordable health policy under measures introduced by State Sen. Tom George.  The bill creates Insure Michigan, which would offer affordable policies for people whose annual household income is 200 percent to 300 percent above federal poverty levels. That's $19,140 to $43,710 for a family of two, including the percentage increase. Michigan would subsidize the coverage, sold by commercial insurers and nonprofit health plans. Part of the money for the program would come from doctors, by reducing physician reimbursement paid by commercial insurers to lower Medicare reimbursement levels.  The legislation sets the stage for a debate about what to do about rising health insurance costs and Michigan's growing number of uninsured people. One in 11 state residents has no health coverage.

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Health IT Grants Available in New York
New York Governor David A. Paterson announced two grant programs under the Health Care Efficiency and Affordability Law of New York State (HEAL NY). The first grant program has $175 million available to support projects to help the state’s older adults and individuals with disabilities have increased access to person-centered high quality community-based services.  The second New York state grant announcement will provide $175 million in funding to further restructure the New York healthcare system. This funding will help hospitals transition to a new model of care by consolidating excess hospital beds, eliminate duplicative services, support more outpatient care, and provide better support for ambulatory and outpatient care.  Grant applications are due on July 14, 2009. The RGA can be viewed at www.nyhealth.gov.

The second New York state grant applications for Phase 11 of HEAL NY are due on July 1, 2009 and the RGA can be viewed on www.nyhealth.gov.

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Funding Available for Small Practice EHRS
The California HealthCare Foundation is funding a two year $1.5 million initiative called “Small Practice eDesign” to develop a prototype community infrastructure and tools. The funding will support the adoption, integration, and meaningful use of EHRs for small practices.  The project will develop, refine, and test a model to support EHR implementation in up to 20 primary care practices in Tulare County a federally designated primary care shortage area. Applicants that intend to submit a proposal must submit an “Intent to Apply” by May 29th. The submission of an “Intent to Apply” is optional and if not submitted does not disqualify applicants from submitting a full proposal in June.  Proposals must be received by June 17, 2009. For more information on proposal submissions, contact Faith Wu at fwu@chef.org.

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Southeastern Center to Develop Medical Technology
Georgia Governor Sonny Perdue announced last week that four of Georgia’s leading research and healthcare organizations have joined together to create an innovative new center that will accelerate the development and commercialization of next-generation medical devices and medical technology.  The first of its kind in the Southeast, the Global Center for Medical Innovation (GCMI) will include a comprehensive medical device prototyping center. Supported by the Georgia Institute of Technology, Saint Joseph’s Translational Research Institute (SJTRI), Piedmont Healthcare and the Georgia Research Alliance (GRA), the new center will bring together a complete medical device marketplace – which includes universities, research centers and clinicians; established drug and device companies; investors, and early-stage companies. The new center will be located adjacent to the Georgia Tech campus in Technology Enterprise Park.

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New Mexico Creates ARRA Team
Governor Bill Richardson has signed an Executive Order to create the “Competitive Grant Advisory Team” to assist local communities in New Mexico compete for funds under the American Reinvestment and Recovery Act (ARRA).  “Most of the formula recovery funds are designated for specific existing programs with very little local discretion. The competitive grant process is the best way for many New Mexico communities, especially rural areas, to access funding for qualified projects that will create jobs and boost the economy,” said Governor Richardson.  The advisory team will meet with the local communities to let them know about the competitive grant opportunities under ARRA and then help the communities navigate the grant process. The group will also look for local partners in state applications for broadband and health information technology funding.  Also, the Executive Order establishes the New Mexico Office of Recovery and Reinvestment to be headed by former New Mexico Governor Toney Anaya to ensure that stimulus funds spur economic activity, create and retain jobs, and promote long-term economic prosperity.

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Nebraska to Create Statewide HIE
The Nebraska Health Information Initiative (NeHII) plans to create a statewide electronic health record network with economic stimulus funding.  Deb Bass, NeHII interim executive director, said the group will request several million dollars in stimulus funding but has not yet determined the exact amount.  The public-private NeHII has been working on developing the EHR system for three years. “When we go statewide in the next couple of months, the process will be working and we will bring in the next hospital,” said Lt. Gov. Rick Sheehy.  “It’s going to be a growing health information exchange.   Physicians and medical practices are used to competing and now they are coming together.”

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In Their Own Words

“Any reform legislation must take steps to improve patient safety and the quality of care in America. Our country is home to some of the finest, most advanced medicine in the world. But today, healthcare associated infections – infections caught in a hospital or other settings -- are one of the leading causes of death in our nation. 98,000 Americans die each year as a result of these and other medical errors -- more than car accidents, breast cancer, or AIDS. These numbers are not acceptable for the world’s richest nation. We must sharply reduce the number of medical errors, keep patients safe and ensure all Americans receive high-quality care.”

Source:  Statement by Kathleen Sebelius, Secretary, U.S. Department of Health and Human Services before the House Committee on Ways and Means on May 06, 2009.

By the Numbers

$30.8 Billion:  Hospitals spent $30.8 billion on 4.4 million hospital admissions that might have been avoidable. Medicare patients accounted for $20.1 billion of the full amount spent on possibly preventable admissions, while privately-insured patients were responsible for $4.7 billion of the $30.8 billion total.  Congestive heart failure and bacterial pneumonia were the two most common reasons for inpatient stays, mounting up $15.6 billion in costs. 

Source:  Agency for Healthcare Research and Quality 

Tools & Resources

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® also gives you direct access to the best in the industry.

Member Only Benefit: GRANTS OFFICE  -- HIMSS Grants Advantage subscription service provides information on identifying funding initiatives, 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 the funding resources in categories that include, but are not limited to:

• Health IT
• Facility planning and construction
• Health services planning
• Specialized health research
• Education
• Veteran's health

Learn more about the benefits of subscribing to HIMSS Grants Advantage

Member Only Benefit: CONGRESSIONAL RESEARCH SERVICE REPORTS

Healthcare Reform in the 111th Congress

Fiscal Year 2010 Medicare Budget Issues

To access other CRS Reports, visit HIMSS Member Center (Click HIMSS PULSE on the left column)

Calendar of Events

Register Now for June Government Health IT Conference
The annual Government Health IT Conference & Exhibition is set for June 4-5, at the Ronald Reagan Building in Washington DC.  The conference’s theme is Government Health IT: Driving Transformation, and features two educational tracks: Demonstrating the Value of Interoperability and Strategy and Policy: From Legislation to Action. A third track—the Industry Solutions Showcase—is complimentary for all attendees. Attendees also will have an opportunity to browse the Exhibit Hall, while networking with attendees.
In addition, HIMSS is offering complimentary eSeminars on various topics of interest to the government sector. Register for the conference and review the agenda online.

HIMSS Virtual Conference & Expo
June 9-10, 2008
Economic stimulus and the technologies to achieve the healthcare reform agenda set forth by President Obama are on the minds of all health IT professionals. HIMSS’ fifth Virtual Conference & Expo on June 9-10 will provide attendees with an 18-session educational program focused the future of health IT.  Free to qualified registrants, HIMSS Virtual Conference & Expo features two educational tracks: Health Policy and the New Administration and Transforming Healthcare Through Practice.  Led by industry thought leaders and designed to keep healthcare professionals informed, the following educational sessions will address healthcare reform:

• Opening Keynote: Congressman Michael C. Burgess, MD (R- Texas)
• Outcomes and Lessons Learned from 5010 Testing Project Collaboration
• The Federal Government's Gateway Solution to the NHIN
• Ensuring Compliance with FTC's Red Flags Rules on Identify Theft Prevention

HISPC Seminar Series
The HISPC Seminar Series will be held throughout the month of June on Tuesdays and Thursdays and will include eight 90-minute online seminars.  Each seminar will highlight the work and results of the seven HISPC multi-state collaboratives as well as follow-up analysis on state law variation completed by Georgetown University.  The HISPC Collaborative presentations will focus on the tools and processes developed and how they can be used by individual, local, regional, and state-level stakeholders.  The schedule and registration information for each seminar is available at http://hispc-events.webex.com/.  Each session will be held at 2:00 pm Eastern Time on Tuesday and Thursday afternoons, beginning June 4th.    Registration is required no later than 24 hours prior to each session and space is limited. 

A Must Attend Event for Health IT Professionals
Based on high demand, the CONNECT seminar has been changed to June 29-30, 2009 at the J.W. Marriott, 1331 Pennsylvania Avenue, Washington, DC.  Upon taking office, President Obama called for all Americans to have an EHR by 2014.  Understanding and participating in HIEs at a local and national level will be central to the long-term success of health reform, and the federal government has released a new open source solution called CONNECT to support efforts to achieve health information exchange. CONNECT was built to become the platform for widespread participation in health information exchanges while also laying the foundation for innovation.  Registration is available online.

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visit www.HIMSS.org/advocacy