News from Rhode Island

Providence, RI —July 30, 2007—Rhode Island is now one step closer to implementing a health information system that will allow physicians, with their patient’s permission, to access important patient health data from a variety of sources when and where it is needed. The State has chosen Electronic Data Systems Corporation (EDS), and its subcontractor InterSystems Corporation, to build and integrate the necessary technology and software.
National and local efforts have been underway for the last several years to computerize medical records and develop secure methods to share records electronically. Governor Carcieri has prioritized making health information electronic for the majority of Rhode Islanders by 2010. “Anywhere, Anytime Health Care Information” is one of five elements that make up the Governor’s health care agenda.
“We can now begin the important work of building a secure Health Information Exchange, which will result in a more cost-effective health care system by reducing unnecessary tests and potential medical errors,” said Governor Carcieri.
The Rhode Island Department of Health (HEALTH), working closely with community partners, providers, and other key stakeholders, will oversee the development of this interconnected, interoperable system. HEALTH has engaged a wide range of consumer advocacy groups, health care attorneys, and others to ensure the system protects patients’ privacy and addresses the needs of both health care consumers and clinicians.
“With the creation of a statewide Health Information Exchange, doctors will be able to look up their patient’s critical health information, giving them a more complete understanding of their patients and allowing them to provide higher quality, safer, more coordinated care,” said Director of Health, David R.Gifford, MD, MPH.
Following an RFP process, HEALTH selected EDS as the technical vendor to build the system’s technology. EDS will subcontract with InterSystems Corporation for its HealthShare software. Through a three year, federally funded, $1.71 million dollar contract, EDS and InterSystems will build the core components of the system, including giving authorized health care providers access to comprehensive lab results and medication history for their patients. Initially these data will come from Lifespan, East Side Clinical Labs, the Department of Health State Laboratories, and SureScripts (a national company that administers the network connecting physician offices and pharmacies for e-prescribing). During the course of the contract, the system may be enhanced to include additional data sources and types.
EDS is a leading global technology services company, with a local office in Warwick. The company has extensive experience working for the State of Rhode Island, such as serving as Medicaid’s fiscal agent. For more information about EDS, visit www.eds.com
InterSystems Corporation, a software company headquartered in Cambridge, Massachusetts, provides software for connecting healthcare information. For more information about InterSystems Corporation, visit www.Intersystems.com.
Editorial Contact:

Read more »

One Step Forward Two steps Back

Report: Health IT Bills Will Not Affect U.S. Health Care
Congressional measures to boost health IT adoption would not go far enough to make a significant difference in U.S. health care, according to a Commonwealth Fund report released Thursday, Government Health IT reports.The report, which analyzed major health IT and other health-related bills introduced between 2005 and 2007, found that none of the bills "would commit the funds and central leadership required to realize the potential benefits of a health information system.""There's just not enough funding to get us to a paperless health system in five to 10 years, in my judgment," Commonwealth Fund President Karen Davis said, adding, "If the U.S. is to close the health information technology gap with other leading countries, it will need a strategy and commitment of requisite funds to achieve its promise."Davis said the federal government should subsidize health IT adoption for safety-net providers and the development of regional health information organizations. "The basic problem (with the legislation) is that giving small amounts of money -- compared to the $3 trillion in U.S. health care spending -- and setting standards is not going to be enough to accelerate the adoption of health IT," she said.Davis said the report's findings are applicable to the Wired for Health Quality Act of 2007.The bipartisan Wired for Health Care Quality Act of 2007 has won committee approval and is awaiting action from the full Senate. There is not yet a companion House bill, but Rep. Patrick Kennedy (D-R.I.) is planning to introduce a comprehensive health IT bill after Labor Day, according to his policy aide, Michael Zamore (Ferris, Government Health IT, 7/26).

Despite this bleak appraisal of federal mandates and lack of follow through we see progress in private entrepenurial ventures to fund HIE. Local initiatives and buy in by stakeholders remains the elemental ingredient for success. One has only to look at the success of Healthbridge in Ohio, which has been operational for almost a decade. The key ingredient is focus and dedication by those involved over the long term.

Read more »

Curing Healthcare: Knowledge, Standards and the Healthcare Crisis: Part 10

Curing Healthcare: Knowledge, Standards and the Healthcare Crisis: Part 10

Read more »

The Train Coming Down the Track

Is your information technology structure from the ‘90s? 1890??

In the next five years we will see a catalytic innovation take hold, and I don’t just mean electronic medical records, personal health records, or web 2.0 applications.
In the past several months we have seen several states release morbidity and mortality statistics from hospitals performing certain procedures. Most of these were selected based upon their high per capita cost. The figures are prominently announced and displayed on easily found web sites. This of course is quite controversial and is resulting in angst of both hospital administrators and physicians alike. Payers want the most “bang” for their “bucks”, that is to say the best possible outcomes for beneficiaries. (i.e., they are not going to pay for “bad results”.
Providers and hospitals have seen this coming for quite some time, but the impact of seeing this data displayed publicly is immeasurable. For those providers and hospitals on the top tier, this gives them a significant advantage when contract talks begin.
Internal quality assurance, outcome measurements and daily updates will be necessary to stay even with
Change management is one key for successful transition to healthcare 2.0. The significance of the paradigm shift in the early 1990s is not lost on health care institutions or the establishment of the RVU for determining reimbursements for services by providers. The lag in understanding the “strategic” shifts which occurred then caused thousands of practice business failures and also hospital shut downs. Even the sea-change of practice management firms could not stave off bankruptcy and/or operational demise. The drive toward multiple levels of management, i.e., IPA, MSO, and HMO with all it’s subsets of responsibility between patient, provider and hospital serves as a rationing method. The new system will not allow for this paradigm.

Consumer advocacy groups have arisen, and are and will be playing significant roles in “health change”.

Perhaps California was the “poster child” for bad things, the emigration of thousands of providers to other states, the cacophony of IPA closures, health plan demise, and the changing nameplates of groups, hospitals and others in the health industry.
It is a fairly simple analysis. (The have’s and the have not’s) The have not’s will not be providing health care in five years.

Not only will having EMR be critical but also additional systems that will enable chronic disease management by “remote control’ and telemedicine. Leveraging the capability of the medical staff to care for SNF patients, and at home chronic patients will enable providers. Payers must come to terms with reimbursements for these modalities, since the ultimate outcome will be to reduce hospital in patient and readmissions as well as needless office calls. Remote telemedicine is here with devices that can provide audio visual contact using dial up technology. Remote sensing of BP, Pulse, and Glucometers is already available, and many more are in development. Other peripheral include the Prothrombin time Micro coagulation System, telephonic stethoscope, digital scale, and pulse oximeter.

Payers have been reluctant to share in the development costs of these systems. Change management must analyze the short term ROI, rather than long term ROIs. Most businesses want to see results in three months ( a business quarter).Successful transition therefore will require carefully focused change implementation in limited areas and progress as each gains ROI. (Randy Moore, American Telehealthcare)

Read more »

Reality Check

I recently navigated over to the "TOP 100 HEALTHCARE BLOGS" ranking, and found that my blog was down in the 300s. The top 3 were "Random Acts of Reality" "Medgadget" and "Bad Science"
I also noted that technorati seemed to play a significant role in popularity of the "winners"

In the past I have written a great deal about health information exchange and RHIOs. From what I learned in the past three years I have altered my course and given up on the idea of "warp speed" and will depend upon "Impulse engines".

There certainly appears to be no impuslivity as it pertains to EMRs nor HIEs.

I sent out letters this past week regarding the "NEW PLAN" to bring EMR and HIE to our region of Southern California. Today is a clear day and I can look out over most of it and see all the way from Mt Wilson to Mt San Gorgonio and San Jacinto. As an aviator I can say
"CAVU". A properly paced mirror or antenna on anyone of these peaks would serve as a "beacon" for the hub of a health information exchange. If TV and Radio stations can do that then why not health information? Would this be a "disruptive technology" or a "catalytic innovation"

Funding seems to be a barrier to implementation of EMR and HIE. Why not an excise tax like the 911 excise tax on phone bills to provide emergency services? Certainly health care is important enough to our society that there lies a real basis for this to fund EMR and health IT. It spreads out the fiancial support to almost everyone evenly.

For those of you in our local region who read this I hope you will respond to my letter and email regarding the HHS grant for HIE. Hopefully your administrative assistant did not file it in the round file. Personally I tire of the voicemail trees and the voicemail...

On another note. one of my colleagues wanted to test the capacity of his servers. He posted a comment about "Daniel Radcliffe Naked". Within one day Google had picked up this post and his site hits went up by 10000 hits/day.

The name of my new post shall be "Daniel Radcliffe Naked" in the Health Information Age.
BTW for those of you over age 40 Daniel is the actor who plays Harry Potter.

From the desert to the sea

Your willing sevant.

Read more »

Google me

Google Health (GH) could be the event of the decade in advancing health care reform — not just healthcare information technology (HIT) reform,
The "ultimate" PHR????
Google Health (GH) could be the event of the decade in advancing health care reform — not just healthcare information technology (HIT) reform, but health care system reform. GH promises simultaneously to create AND dominate the market for next generation personal health records (PHRs). There is nothing else in our solar system or in the entire universe like it.
II. GH’s Anticipated Technology Model
We’ve been provided a number of clues about the technology model that GH is likely to develop:
Patient centric
A personal health URL
Automated data mechanisms to gather and store PHI
Interoperable technical standards: XML and the Continuity of Care Record (CCR) standard
A user interface
Appropriate security and confidentiality measures
Value added functionality (over time)
What do you think???

Read more »

Posted in: public social engineering,rhio