Sunday, February 24, 2008

Recent State Efforts

The Florida Legislature is considering bill (SB 1998) to create the Florida eHealth Initiative Act with grants for health information organizations and to establish the Electronic Medical Records System Adoption Loan Program. The bill would also create the Florida Health Information Exchange Advisory Council to help implement a plan to promote participation in regional and statewide health information exchanges.

Recently, Florida’s Governor Charlie Crist unveiled the prototype of a handheld case management device to help child and adult protection investigators as well as case managers better document their visits to homes of foster children and vulnerable adults.

This prototype device would enable case workers to respond quickly to the needs of children, be able to access information obtained during visits and interviews in real time, track critical dates for follow-ups and referrals, receive alerts, and be able to prioritize care based upon the severity of need. The Governor has proposed $9.8 million in the budget for 2008-2009 to purchase the “all-in-one” devices.

The Connecticut legislature is considering (HB 5542) to encourage the use of telemedicine to deliver health care services. Section 5 of the proposed legislation would enable the Department of Public Health to establish one or more two year pilot programs to study using telemedicine to treat congestive heart failure, diabetes, and COPD.

The proposed bill would enable the Department of Public Health to issue a Request for Proposal for one or more entities to operate the pilot program. Each proposal submitted would need to include a plan for administering the pilot program and the methods to be used for data collection and reporting. The patient’s medical condition, the patient’s need for high frequency urgent care, the patient’s cognitive ability, if the patient resides in a medically underserved area, if the patient has support from a relative or caregiver, and the patient’s access to telecommunications technology services would need to be considered in the proposal development.

Two new pieces of legislation (HB 2301 and SB 3194) introduced in Iowa would establish an Electronic Health Information Commission to develop a plan for statewide health IT by January 2009. One piece of the plan will need to address how telemedicine can be used to address workforce needs that will be generated by the increased use of health IT.

In Pennsylvania, the December Patient Safety Advisory reported that medical errors can sometimes cause drug overdoses when Smart Infusion Pump Technology is used. Even when computerized systems are used to reduce drug overdoses they can still occur. For example, this can happen when using intravenous high-alert medications like Heparin. The most common reason for the overdose is due to programming the infusion pump incorrectly.

The Advisory also reported that CT scans may affect pacemakers and other implantable electronic devices. Patients can experience a shock during a CT scan if they have an implantable electronic device. This may be due to new more powerful scanners being used to obtain faster scans.

The state of Minnesota recently published the report “Adverse Health Events in Minnesota” with information on activities in education, promoting organizational changes, sharing knowledge, and how to strengthen the reporting system.

According to the report, the web-based registry was modified to collect additional information on where events occur, to better enable analysis of the trends in adverse events by location or specific settings. In addition, the Minnesota Department of Health worked with hospitals to develop a better process for collecting additional follow-up information about reported events.

The Governor of New Jersey’s Commission on Rationalizing Healthcare Resources has delivered their final report. The 13 member Commission was led by Uwe E. Reinhardt, Ph.D an internationally recognized healthcare economist and Princeton’s James Madison Professor of Political Economy.

One section discusses how a full fledged 21st Century Health Information System should operate and gives recommendations on developing and sustaining a health information system. The report recommends that the healthcare information infrastructure be supported with public subsidies, and the state take a leading role in developing the system and financing the R&D. The development and maintenance of the system’s common data base should be heavily government funded even if the actual development and maintenance is delegated to a private entity.