Wednesday, January 26, 2011

Conference Ushers in New Era

The eHealth Initiative’s two day Annual Conference “Turning Policy Into Action” held in Washington D.C., wrapped up on January 20th with keynote speeches by Dr. David Blumenthal, the National Coordinator for Health IT, and Cokie Roberts, ABC Congressional Correspondent and Senior News Analyst for National Public Radio.

Registration for Meaningful Use incentives opened on January 3rd and as Dr. Blumenthal told the attendees, “The era of meaningful use is not the end of the journey—just the beginning. There is still an enormous amount of work and education to do.”

He continued to say, “ I think the Meaningful Use era and Meaningful Use concept provides a device for reaching consensus on the optimal use of information for healthcare improvement, both in quality and efficiency, but at the same time, it provides a process for us to hold ourselves accountable.” On January 14th, Dr. Blumenthal’s office released a new survey that showed that 81 percent of hospitals and 41 percent of practices plan to apply for Meaningful Use incentive payments.

Cokie Roberts followed Dr. Blumenthal and speaking as a journalist, a family caregiver, and a cancer survivor, assured attendees that despite the news coverage of Republican opposition to health reform, the current repeal effort in Congress would not succeed. She noted that among Democrats and Republicans now debating the issues, the only thing they can agree on is to support health IT.

Several interesting panels tackled coordinated care. According to Robert Fortini, MD, Chief Clinical Officer, Bon Secours Medical Group, his group has growth plans to include 500 doctors which will necessitate the maintenance of a coordinated system.

He reports that 400 people every hour turn 65, so the need to see more patients and improve patient compliance is essential and can only be accomplished by standardizing care as much as possible. This means that practices will have to analyze and assess their practices thoroughly to be able to perform a clinical redesign of the practice.

Dr. Fortini suggests that one of the first steps is to form a healthcare support team. For example, the physicians in the practice would handle new acute complaints and preventive medicine interventions with medical assistants handling point-of-care testing.

Practices would have case managers embedded in the care of the patients needing coordinated care. They would handle medication refills, monitor patients with chronic diseases, and provide patients with test results. Patients with acute mental health problems, or chronic disease compliance barriers would be helped by other team members perhaps specializing in behavioral health, medical nutrition therapy, and diabetes education.

Dr. Bruce Hamory, M.D, Executive Vice President, Chief Research Officer, Geisinger Health System, noted that new ideas and innovations are a must and we must develop new care management models. For example, we can put more effort into using kiosks to assist patients, and we can also encourage patients and caregivers to enter and check more of their own clinical information as it appears in the system.

Charles Kennedy, M.D., Vice President for Health Information Technology at WellPoint addressed the fact that since most electronic clinical data uses the HL-7 application level standard, a single WellPoint patient may have thousands of HL-7 messages over the course of one disease exacerbation. Each HL-7 message may have coded data, free text, and/or custom codes. Converting this extremely heterogeneous data stream into structured, coded data suitable for interoperability, analytics, and other purposes remains an unresolved challenge.

The Conference concluded with Jennifer Covich Bordenick, CEO, eHealth Initiative, saying “Legislation has passed, the first regulations have been issued, and now we turn to the same issue that we have been grappling with for the last decade—the adoption and use of health IT to improve the quality, safety, and efficiency of healthcare in the U.S. I am reassured after spending two days talking to leading experts and implementers in this country, that if money, expertise, and commitment are adequate inputs, we will certainly succeed in creating a nationwide system of HIT and information exchange.”

For more information on the Conference, go to