Health IT Special Issue of The American Journal of Managed Care: Dec 2010

AJMC Publishes Health Information Technology Special Issue Online Dec 20, 2010
“Featuring scholarly articles and perspectives from policymakers, payers, providers, pharmaceutical companies, health IT vendors, health services researchers, patients, and medical educators, this [December 2010 special] issue of  The American Journal of Managed Care is a reflection” of  “the  dramatic growth of interest in the potential for HIT to improve health and healthcare delivery,” writes Sachin H. Jain, MD, MBA and David Blumenthal, MD, MPP in their introductory article titled “Health Information Technology Is Leading Multisector Health System Transformation.”  Both Jain and Blumenthal are with the Office of the National Coordinator for Health Information Technology.

Authors of 23 Articles in Special Issue
Sachin H. Jain, MD, MBA; and, David Blumenthal, MD, MPP; Cynthia L. Bero, MPH; and Thomas H. Lee, MD; Aaron McKethan, PhD; and Craig Brammer; John Glaser, PhD; Pete Stark; Newt Gingrich, PhD, MA; and Malik Hasan, MD; James N. Ciriello, MS; and Nalin Kulatilaka, PhD, MS; Seth B. Cohen, MBA, MPA; Kurt D. Grote, MD; Wayne E. Pietraszek, MBA; and Francois Laflamme, MBA; Amol S. Navathe, MD, PhD; and Patrick H. Conway, MD, MSc; Reed V. Tuckson, MD; Denenn Vojta, MD; and Andrew M. Slavitt, MBA; Marc M. Triola, MD; Erica Friedman, MD; Christopher Cimino, MD; Enid M. Geyer, MLS, MBA; Jo Wiederhorn, MSW; and Crystal Mainiero; Nancy L. Davis, PhD; Lloyd Myers, RPh; and Zachary E. Myers; Bryant A. Adibe, BS; and Sachin H. Jain, MD, MBA; Spencer S. Jones, PhD; John L. Adams, PhD; Eric C. Schneider, MD; Jeanne S. Ringel, PhD; and Elizabeth A. McGlynn, PhD; Jeffrey L. Schnipper, MD, MPH; Jeffrey A. Linder, MD, MPH; Matvey B. Palchuk, MD, MS; D. Tony Yu, MD; Kerry E. McColgan, BA; Lynn A. Volk, MHS; Ruslana Tsurikova, MA; Andrea J. Melnikas, BA; Jonathan S. Einbinder, MD, MBA; and Blackford Middleton, MD, MPH, MS;Alexander S. Misono, BA; Sarah L. Cutrona, MD, MPH; Niteesh K. Choudhry, MD, PhD; Michael A. Fischer, MD, MS; Margaret R. Stedman, PhD; Joshua N. Liberman, PhD; Troyen A. Brennan, MD, JD; Sachin H. Jain, MD, MBA; and William H. Shrank, MD, MSHS; Amir Dan Rubin, MBA, MHSA; and Virginia A. McFerran, MA; Fredric E. Blavin, MS; Melinda J. Beeuwkes Buntin, PhD; and Charles P. Friedman, PhD Robert D. Hill, PhD; Marilyn K. Luptak, PhD, MSW; Randall W. Rupper, MD, MPH; Byron Bair, MD; Cherie Peterson, RN, MS; Nancy Dailey, MSN, RN-BC; and Bret L. Hicken, PhD, MSPH; Jeffrey A. Linder, MD, MPH; Jeffrey L. Schnipper, MD, MPH; Ruslana Tsurikova, Msc, MA; D. Tony Yu, MD, MPH; Lynn A. Volk, MHS; Andrea J. Melnikas, MPH; Matvey B. Palchuk, MD, MS; Maya Olsha-Yehiav, MS; and Blackford Middleton, MD, MPH, MSc; Emily Ruth Maxson, BS; Melinda J. Beeuwkes Buntin, PhD; and Farzad Mostashari, MD, ScM; Daniel C. Armijo, MHSA; Eric J. Lammers, MPP; and Dean G. Smith, PhD; Katlyn L. Nemani, BA.

Look for an upcoming post on e-Healthcare Marketing reviewing this special issue of AJMC.

Data in EMRs to be Health Industry’s Most Valuable Asset: PriceWaterhouseCoopers Study

EMR Data–Health Industry’s Most Valuable Asset: PwC Study
“Transforming healthcare through secondary use of health data”

In a report issued on October 1, 2009 by PriceWaterhouseCoopers, 3/4 of healthcare executives surveyed “agree that the secondary use of this information (from electronic medical records) will be their organization’s greatest asset over the next five years. The data that could be mined from the health system can improve patient care, predict public health trends and reduce healthcare costs, but PricewaterhouseCoopers finds lack of standards, privacy concerns and technology limitations are holding back progress.”

“PricewaterhouseCoopers calls for public-private collaboration and a role for government in creating incentives for the private sector to collect, share and use health data; to establish standards; and to redefine technical architecture to allow interoperability.”

This report is based on a round-table discussion PwC held with IT and strategy leaders from payer, provider, and pharmaceutical companies, and  a related national survey conducted in the spring of 2009.

Five case studies for using secondary health data are highlighted:
1. Integrated, member focused healthcare: Aetna
2. Evidence-based, quality improvement program: American Heart Association/American Stroke Association (AHA/ASA)
3. Promoting healthcare research: Geisinger Health System
4. Post-market surveillance of drugs: Partners HealthCare
5. An integrated health record: WellPoint

PwC Press Release
PwC Report Web Page
PwC Report (pdf) : “Transforming healthcare through secondary use of health data”

NY Times: Tech Companies Push to Digitize Patients’ Records

Tech Companies Push to Digitize Patients’ Records
In a major story fronting New York Times business section (Sept 10, 2009), Steve Lohr reports “On one proposal for health care reform at least, there is a rare bipartisan consensus: the push to computerize patient records.” Article starts with Dell’s new partnerships with hospital groups, gives a sampling of seven companies involved with EHR implementation in a sidebar,  looks at Verizon’s initiative to build supporting data centers, and captures the EHR experience of Dr. Allen Gee, a sole practioner in Cody, Wyoming.

Kaiser’s Long and Winding Road

Health Data Management  Reviews Kaiser’s EHR Lessons
In August 1, 2009 issue of Health Data Management Magazine, Executive Editor Howard J. Anderson reports extensively on lessons learned as “Kaiser Permanente is entering the home stretch in what’s turned out to be a seven-year drive to implement comprehensive EHRs, personal health records and related systems at all of its hospitals and clinics.” Lessons focus on cost centers, training, deployment, and ongoing process.
Learned of story from daily AHIP Solutions SmartBrief e-newsletter published July 28, 2009.  AHIP is America’s Health Insurance Plans association.

Physicians: Prepare to meet “meaningful use”

Advice to Physicians: Prepare to meet “meaningful use” EMR requirement
Pamela Lewis Dolan, of
American Medical News, reporting June 15, 2009 on the experts’ answer to whether physicians should wait until all the rules have been clarified. The experts told her “Don’t wait to buy or upgrade just for want of a definition. There are enough clues in the legislation to estimate the definition of ‘meaningful use.’”

Scenario: How do you keep the patient at the center of the medical interview?
On the American Medical News site on June 8, 2009, Frederic W. Platt, MD, answered the question: “Given the high-tech trend in patient encounters, how do you conduct the medical interview in a way that does not interfere with the patient relationship?” Dr. Platt is clinical professor of medicine, University of Colorado, Denver, School of Medicine, and regional consultant for the Institute for Healthcare Communication. The post is part of’s Ethics Forum.
Dr. Platt’s quide to the essence of physician-patient communications:
Field Guide to the Difficult Patient Interview, 2nd Edition. Co-authored with Geoffrey H. Gordon.’s Current and Archived Articles on EMRs
Ready source of articles written for physicians about Electronic Medical Records

Health Information Security and Privacy Collaboration (HISPC): States Explain Privacy & Security Agreements

HISPC releases Action and Implementation Manual
Joseph Goedert of HealthData Management reported on June 5, 2009
 that “The Health Information Security and Privacy Collaboration (HISPC) has released a how-to guide for state cooperation in health care privacy and security issues.” Referred to as AIM (Action and Implementation Manual), it’s the result of collaborative work between 42 states and territories.  According to HISPC site, the ”AIM serves as a how-to guide for each of the seven multistate collaboratives’ tools and templates.”

AIM was prepared for Jodi Daniel, JD, MPH, Director and Steven Posnack, MHS, MS, Policy Analyst of the Office of Policy and Research of the Office of the National Coordinator for Health IT.  AIM was prepared by Linda L. Dimitropoulos, PhD of RTI International, Chicago and released in June 2009.

Action and Implementation Manual 45-page pdf:
HISPC Phase 3 Executive Summary (Background on AIM) pdf:

HISPC June 2009 Seminar Series
“The 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.”

HISPC Provider Education Toolkit Video
The HISPC Toolkit for physicians and other healthcare providers  ”video {page down on the Press Kit and Tools Web page} was presented at the National HISPC Conference in Bethesda MD in March 2009 and provides a powerful message about electronic health information technology and exchange and the related privacy and security aspects. Please feel free to use this video at any event where health care providers would benefit from awareness of these issues and how to tap in to the Provider Education Toolkit websites and resources.”

Health Information Security & Privacy Provider Education Toolkit This Web site (including the video featured above) and its resources, built as one of the seven collaborative projects of HISPC, is a treasure and roadmap for educating providers and consumers. “Welcome to the Health Information Security & Privacy Provider Education Toolkit designed especially for physicians and the healthcare community. We invite you to explore our Web site, learn more about electronic health information exchange, related privacy and security implications, earn free CME credits, ask questions, and get the tools and resources you need to safely and securely get connected! ”

Thanks to Fred Pennic of Healthcare IT Consultant Blog
Today’s email update from Healthcare IT Consultant Blog, produced by Fred Pennic, and his brief on the HISPC release of AIM, brought the program to my attention and led me down the path of discovery of these resources. Thank you Fred Pennic.

HISPC National Conference: March 4-6, 2009 Bethesda, MD
Presentations from ”conference showcased the common, replicable solutions
developed by seven multi-state collaboratives to the privacy and security challenges presented by the implementation of electronic health information exchange at the state and organizational level.”
HISPC site with relevant working documents:

ONC Proposes Regional IT Extension Centers

US Seeks Input for Establishing Regional IT Extension Centers
Reported by Helen Pfister of Manatt Health Solutions for California HealthLine.  “In addition to well-publicized incentives to get doctors to start using electronic health records, the federal stimulus package also dangles financial carrots to encourage the establishment of what will amount to a new mini-industry involved with helping those doctors choose and use EHRs.

“Applicants identifying viable sources of matching funds, including but not limited to grants from states and not-for-profit foundations, and payment for services from providers. “

ONC Proposes Health Information Technology Regional Extension Centers

Healthcare Technology News reports on Regional Extension Centers
HTN reported
 on June 2, 2009 that the ONC has proposed Health Information Technology Regional Extension Centers to help providers achieve meaningful use.  Funding between $1 and $10 million.  Comments due back by June 11, 2009.

Based on Federal Register May 28, 2009 notice:
Office of the National Coordinator for Health Information Technology (ONC), HHS;
Notice of Availability: Secretarial Recognition of Certain Healthcare
Information Technology Standard Panel (HITSP) Interoperability
Specifications and the Standards They Contain as Interoperability Standards for Health Information Technology
Excerpt: “We propose that the goals of the regional center program should be to:
–Encourage adoption of electronic health records by clinicians and
–Assist clinicians and hospitals to become meaningful users of
electronic health records; and
–Increase the probability that adopters of electronic health record
systems will become meaningful users of the technology.”

Excerpt: “We propose to give preference to proposed regional center
organizational plans and implementation strategies incorporating multi-
stakeholder collaborations that leverage local resources. The local
stakeholders and resources that applicants may wish to consider
including in some combination, though not limited to, the following:
Public and/or private universities with health professions,
informatics, and allied health programs; state or regional medical/
professional societies and other provider organizations; federally
recognized state primary care associations; state or regional hospital
organizations; large health centers and networks of rural and/or
community health centers; other relevant health professional
organizations; the regionally relevant state Area Health Education
Center(s); health information exchange organizations serving providers
in the region; the Medicare Quality Improvement Organization(s)(QIO(s) serving
providers that the proposed regional center aims to serve; state and
tribal government entities in the center’s geographic service area
including, but not limited to, public health agencies; libraries and
information centers with health professional and community outreach
programs; and consumer/patient organizations.”

“As noted below, we propose to give preference to
applicants identifying viable sources of matching funds. Viable sources
could include grants from states, non-profit foundations, and payment
for services from providers able to make such payment. For example,
Medicaid providers could choose to contract with a regional center in
lieu of a corporate vendor for implementation and meaningful use
support services, for which costs are reimbursable under Section 1903
of the Social Security Act, as amended by the HITECH Act. A regional
center could also, theoretically, seek to establish itself as a first-
choice source of assistance that would realize net retained earnings on
service to non-prioritized providers and use those retained earnings as
a source of matching funds for its grant-funded activities.

Additional News Sources on EHR/EMRs

iHealthBeat: Reporting Technology’s Impact on Health Care
EHRs and PHRs Coverage from the California HealthCare Foundation
A place to focus on this slice of the Health IT world.

iHealthBeat covers the wider world of Healthcare IT, as it explains:
is a free, daily news digest reporting on technology’s impact on health care. iHealthBeat is part of the California HealthCare Foundation’s commitment to important issues affecting health care policy, delivery and financing.”

“The Advisory Board Company is a national health care research service and publisher. It independently publishes iHealthBeat for the California HealthCare Foundation and is responsible for the editorial content of the publication. iHealthBeat editors review more than 300 newspapers, journals, and trade publications to produce daily news summaries.”