Sunday, November 22, 2009

HIT Progress Discussed

The “e-Health Policy Congressional Luncheon Seminar” took place on Capitol Hill November 19th, to discuss the Administration’s activities relating to health information technology. The speakers focused on legislation affecting the field, HIT workforce development, HRSA’s grant programs, HIT Policy Committee and Standards Committee’s plans, funding for community health centers, and in general, discussions centered on what is ahead for the health technology community.

Neal Neuberger, Executive Director of the Institute for e-Health Policy and moderator, reported that since 1993, the Congressional Steering Committee has held more than 130 briefings plus technology demonstrations to discuss telemedicine, eHealth, and HIT. As Neuberger said, “The sponsoring senators and representatives and their staffs have played an important role in enabling the seminars to continue and to keep providing invaluable information.”

He mentioned several bills presently under consideration. One of the bills introduced by Senator Tom Udall (D-NM) is the “Rural TECH Act of 2009” to improve community health. The bill would establish three telehealth pilot projects in place to analyze clinical health outcomes and the cost effectiveness of telehealth systems in medically underserved and tribal areas.

In addition, the bill would expand access to stroke telehealth services under the Medicare program, improve access to “store and forward” telehealth services in IHS and federally qualified health centers, and reimburse IHS facilities as originating sites.

Other bills mentioned at the briefing would help healthcare providers purchase electronic health records. The House just passed the Small Business Health IT Financing Act (H.R 3014). A similar bill was also introduced by Senator John Kerry (D-MA) to enable SBA to make loans to help providers to purchase hardware, software, and other technology to support EHRs. Both bills would allow $350,000 for any single qualified eligible professional and $2,000,000 for a single group of affiliated qualified eligible professionals.

In another recent legislative move, the “Small Business Early Stage Investment Act” (H.R. 3738) that passed would provide grants to help finance early stage small businesses in targeted industries such as information technology, life sciences, and digital media. The grants are not to exceed 100,000,000.

Several members of Congress stopped by the briefing. Representative Patrick Kennedy (D-RI) reports that in Rhode Island there is a high rate for e-prescribing usage with 70 percent of healthcare providers in the state on the way to adopting electronic records.

Representative Kennedy continued to say, “Consumers are beginning to realize that they have a tremendous stake is seeing their EHRs and PHRs integrated. Today if everyone had a PHR it would really be beneficial and help the country deal with the current flu pandemic. To deal effectively with this worldwide health issue, we need to be interconnected and have readily available information on the ever changing flu situation. Interconnecting EMRs and PHRs would make it possible for everyone to be interconnected not only nationally but globally.

Representative David Wu (D-OR) Chair of the House Science Committee’s Subcommittee on Technology and Innovation, has been a strong leader and proponent along with other groups to bring HIT workforce training to the forefront. It is estimated that 40,000 rural health workers will be needed in the near future with others in the field making higher estimates.

He also pointed out the important role that standards play. The National Institute for Standards and Technology (NIST) is working full force on developing the standards needed with the $20 million they received from HHS.

According to Johanna Barraza-Cannon, Director, Division of Health IT Policy, Office of Health IT, at HRSA, HRSA is working very hard to expand the use of HIT. Recently, $27.8 million went to health center-controlled networks and large multi-site health centers to implement electronic health records and other health information technology innovations.

Specifically, funding is supporting EHR implementation and grants totaling more than $2.6 million and to help grantees implement a variety of HIT innovations, including the creation of health information exchanges. Another five grants totaling over $2.5 million will help health centers use EHRs.

Barraza-Cannon reported that HRSA provides assistance to help healthcare professionals by providing technical assist tools, conducting workshops and webinars, helping others to select EHRs, educating consumers, and providing a web site at to help interested parties find a network.

Christine Bechtel, Vice President for the National Partnership for Women & Families, explained how she is sometimes questioned as to how her organization relates specifically to health issues. She pointed out that her organization’s major effort is to help women and families in difficult circumstances provide economic security for their families. This means that it is very important for all women and families to have access to quality and affordable healthcare.

Bechtel, as a member of the HIT Policy Committee put in place to advise the Office of the National Coordinator (ONC) explained how the committee relates to the ONC and to the Standards Committee. She emphasized that the HIT Policy Committee makes recommendations to ONC on developing and adopting a nationwide health information infrastructure including standards for the exchange of patient medical information. Following that action, ONC then delivers the information to the Standards Committee.

She told the audience that the goal is to have a definition of “meaningful use” in place by 2011 with a proposed rule scheduled to be published by December 31. Request for public comments will follow with the final rule to be published.

Michael R. Lardiere, LCSW, Director, Health IT and Senior Advisor, Behavioral Health, National Association of Community Health Centers, informed the luncheon crowd that Community Health Centers serve 20 million people at more than 7,000 sites located throughout all 50 states and U.S. territories. In addition the Health Centers serve 20 percent of low income uninsured people, provide comprehensive care, and save the national healthcare system between $9.9 billion and $17.6 billion a year.

As Lardiere mentioned, health center-controlled networks are very important. For example, it was recently announced by HHS Secretary Sebelius that over $2 million alone would go to Colorado to fund health center-controlled networks and large multi-site health centers to implement EHRs and other HIT innovations. These funds are part of the $2 billion allotted to HRSA under ARRA to expand healthcare services to low income and uninsured individuals through the health center program.

He continued to say the plan is to use $1.5 billion for Community Health Center Capital Programs available from Recovery Act funding. So far, Capital Improvement Program Grants have funded 2,614 projects totaling $455,754,510 to provide construction repair, renovations, and equipment purchases including HIT.

Brian Wagner, Senior Director of Policy and Public Affairs, eHealth Initiative, oversees policy, government relations, and media efforts for the organization. He sees government successfully driving health technology, sees the benefits of using technology to outweighing the costs, but he also knows that it is essential for the user to be able to master the technology.

He looks to 2010 for a time when things in the field will start happening. For starters, the eHealth Initiative is going to hold their annual conference on January 25-26, 2010 at the Omni Shoreham Hotel in Washington D.C. to discuss and debate how to deal with the rapidly changing world of HIT. Discussions will be held on policies as to what is possible and what is practical.

The Conference will highlight how eHealth is being implemented across the country, and the plan for the country to move towards the universal “meaningful use” of health information technology by 2014.