The massive investment included in the stimulus funding raises a host of challenges but also many opportunities for stimulating health IT. There is great hope that the funding and reform will be able to deliver better health outcomes, according to Susan Dentzer, Editor-in-Chief, “Health Affairs”. She spoke at a briefing held in Washington D.C. on March 10th to release the publication’s March/April issue that has articles on health IT initiatives, healthcare from the industry perspective, privacy concerns, and public policy issues.
Louise Liang, Senor Consultant with Kaiser Permanente Health Affairs described how 8.7 million members have the benefit of a complete or partial KP HealthConnect record with outpatient EMRs available to all care teams. Today, 23 hospitals are working with the complete KP Health Connect suite, and almost 3 million members are actively using My Health Manager at www.kp.org. .
Kaiser has documented their system’s impact on patient visits and patient-physician e-mail messaging at KP Hawaii. Between 2004 and 2007, total office visits per member decreased by 26.2 percent, from about five visits per year, per member to about 3.7 visits per year per member, secure e-mail messaging increased six fold to 51,000 in 2007, and quality and satisfaction was maintained or slightly improved.
Peter Neupert, Corporate Vice President, Microsoft Health Solutions Group, looking at healthcare technology from the industry perspective, told the attendees that the U.S. has to encourage innovation in health IT by setting out objective goals and criteria. Innovation will not happen by mandating specific technologies or development models.
He further commented, “We need to reward innovative doctors who use the internet to provide for a patient-physician connection. At the same time, we need to remove barriers on data sharing and really provide incentives for data exchange. It is very important for the private sector to operate in the right environment so that an information infrastructure to connect data, systems, and people can be developed.” Neupert noted that although standards are very important to develop health IT, the focus should be on making data interoperable today and not wait for standards to develop tomorrow.
Colin Evans, as Vice President of Dossia Consortium an employer-led non-profit organization dedicated to improving health and healthcare, said “The recent passage of the 2009 Recovery Act is a huge step forward. The law expands the patient’s right to have data sent to a PHR or other entity of your choice.”
Dossia focuses on empowering individuals to have patient control and ownership of their health data to enable competition. Informed consumers can make smarter more cost efficient decisions and easily change their health plan or doctor. Real change will only come when every American healthcare consumer has the power and ability to participate as a true stakeholder in their own health.
Addressing community needs, Farzad Mostashari, M.D., Assistant Commissioner for the New York City Department of Health, stressed that community projects create the demand for improved EHR products. It is important to ensure that the implementation of electronic health records is focused on public benefits that might otherwise get overlooked. There is fear that an opportunity to achieve quality and efficiency gained through health IT expansion will be lost unless federal strategy is grounded in the proven success of the community extension model.
Concerning privacy issues Deven McGraw, Director of the Health Privacy Project at the Center for Democracy and Technology (CDT), reported that several specific recommendations were adopted in ARRA and the privacy language of the Act represents the most significant expansion of privacy protections in a decade. The Act includes better enforcement of HIPAA, expands the HIPAA privacy rule, covers electronic exchanges, tightens rules, limits the use of information for marketing purposes, examines HIPAA standards for de-identification, and ensures electronic access by consumers. However, there is still work to be done. There needs to be a reexamination of health care operations in HIPAA and protections are needed for information in PHRs.
McGraw continued to say that privacy is an important part of health reform. With ARRA enacted, the Administration is turning to privacy and the question of healthcare reform. CDT intends to keep working to make certain that effective privacy solutions are included in health reform.
In March 2008, CDT launched a major initiative to address the complex privacy issues associated with the growing use of IT to collect and exchange sensitive personal health information. As a result, the Health Privacy Project was created and led by McGraw brings together key stakeholders active in the health IT arena with the purpose to break the privacy “logjam” by developing pragmatic, effective solutions. In 2009, CDT has been asked to participate in the National Quality Forum’s efforts to provide for the effective and efficient capture of health data for quality purposes.
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