Ask Dory! integrates data from www.clinicaltrials.gov. My Cancer Genome provides “therapeutic options based on the individual patient’s tumor gene mutations, making use of National Cancer Institute’s physician data query clinical trial registry data set and information on genes being evaluated in therapeutic clinical trials,” according to a statement.
The two apps are part of the rapidly growing field of mHealth — or use of mobile devices for health purposes. Some are calling it an “mHealth bubble,” as thousands of groups large and small are rushing to develop the next great app for diabetes, cancer, infectious diseases, weight management, addictions, and more.
Seeing the potential benefit for patients and providers, federal officials are providing incentives, and funding initiatives as simple as free text messaging reminders for pregnant women and new moms, to apps like Ask Dory!
The Obama administration really, really wants doctors to start using electronic health records (EHRs). For the past few years, they have been out urging physicians to invest in the systems and offering a pretty big carrot for adoption. Under the 2009 HITECH (Health Information Technology for Economic and Clinical Health) Act, physicians who meet certain quality metrics through the use of certified health IT systems can qualify for incentive payments from Medicare and Medicaid. Under the Medicare program, the maximum incentive is $44,000 over 5 years. Under Medicaid, it’s nearly 64,000 over 6.
HHS officials want to make paper medical records a thing of the past. Courtesy Wikimedia Commons/U.S. Navy Photo by Rod Duren/ Public Domain.
Now officials at the Health and Human Services department are trying to drive up adoption by removing a potential barrier to early participation in the program. HHS recently announced that physicians can begin participating in the incentive program this year and not have to meet quality standards until 2014. Previously, if a provider reported to HHS that he or she was using health IT as part of the incentive program in 2011, they would have to meet the quality standards starting in 2013. But those that started sometime in 2012 wouldn’t have to meet the standards until 2014 and would still qualify for the maximum incentive payments. It can get a little complicated, but essentially HHS is trying to take away reasons for people to hold off on adopting EHRs.
It’s hard to tell if this latest policy change will make a big difference to physicians considering an EHR. But the incentive program as a whole does seem to have physicians interested. A new survey from the Centers for Disease Control and Prevention found that 52% of office-based physicians report that they plan to take advantage of the new incentive payments. As for doctors who have already adopted some type of “basic” EHR, that number has climbed from 17% in 2008 to 34% this year.
Tell us what’s driving your decision to adopt an EHR in your practice? Take our poll:
Dr. Blumenthal left his government post earlier this year after 2 years overseeing the federal government’s policy of expanding health IT use by physicians and hospitals. During his tenure, he presided over the implementation of the Health Information Technology Economic and Clinical Health (HITECH) Act, which offers incentive payments for physicians and hospitals to use health IT to improve quality of care; the program began this year. We conducted a Q&A interview with Dr. Blumenthal at the beginning of his time as national coordinator. Check it out here. And learn more about meaningful use incentives here and here.
Now that he is back in the private sector, he has signed on to chair the Commonwealth Fund’s Commission on a High Performance Health System. The commission has been in operation since 2005 and has produced a number of reports that lay out payment and system reforms aimed at improving the quality, safety, and efficiency of the health care system. Dr. Blumenthal takes over as chair from Dr. James J. Mongan, who died in May.
Dr. Blumenthal, who is a primary care physician, will have plenty of other doctors to keep him company on the commission. Among the commission’s 17 members are several physicians, including Dr. Christine K. Cassel of the American Board of Internal Medicine; Dr. Patricia A. Gabow, CEO and medical director of Denver Health, Dr. Neil R. Powe, vice-chair of medicine at the University of California, San Francisco; Dr. Martín-J. Sepúlveda, vice president of Integrated Health Services at IBM; Dr. David A. Share of Blue Cross Blue Shield of Michigan; and Dr. Glenn D. Steele Jr., CEO of the Geisinger Health System.
Stay tuned to see how Dr. Blumenthal puts his stamp on the commission.
Starting today, physicians can begin submitting data to the Medicare program to qualify for thousands of dollars in bonus payments under the federal government’s new electronic health record incentive program. Physicians can attest to their use of EHRs through a new online portal set up by the Centers for Medicare and Medicaid Services.
The program, which was created under the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 and officially launched in January of this year, gives doctors a chance to earn up to $44,000 over five years through the so-called meaningful use of EHRs. In their first year of participation, they can earn $18,000 for successfully reporting that they have complied with the government’s standards for using EHRs. Physicians have until the end of 2012 to report on 90 days of meaningful use and still get the full first-year incentive. After that, they must report on a full year of data.
Image via iStock.
Since April 18 is the first day that physicians are able to report to CMS, it’s something of an early test of the incentive program. The program has been touted by the administration as a way to finally close the gap in physician adoption of EHRs, but it’s unclear if the incentives will be enough to motivate a large number of doctors to make the switch from paper records. Interest in the program is high, but many doctors still have their doubts.
While $44,000 is a lot of money, health information technology experts say it’s unlikely to cover the cost of a new EHR system. Even if it did, the CMS payments come only after physicians have made the up-front investment of purchasing and implementing the EHR systems.
And cost isn’t the only factor. There’s also the hassle of switching over to a new system, which may or may not have the functionality necessary to make the office workflow any better. This a concern often voiced by certain subspecialists, who say that most EHRs on the market are geared toward primary care.
What’s your view on the new EHR incentive program? Take our poll and share your thoughts.
Check back with Notes from the Road in the coming months as we follow the progress of the EHR incentive program.
Image via Flickr user southerntabitha by Creative Commons License.
Many electronic health records are equipped with alerts and other safety features, designed specifically to prevent the type of human errors that too often put patients at risk for injury. But the reality is that health information technology (HIT) has its own problems when it comes to patient safety. The Health Information Technology Policy Committee, which advises the federal government’s health IT czar, met earlier today to talk about some of the unique safety risks presented by HIT.
It turns out that only a small part of the problem is caused by faulty technology, said Paul Egerman, who co-chairs the Certification/ Adoption Workgroup for the HIT Policy Committee. While some problems do occur because of software bugs, those are generally easily fixed, provided they are discovered. Instead, the bulk of the problem comes from the complex interactions between people and technology, known as issues of usability. In other words, the technology can be working fine, but if the staff isn’t trained to use it or if using it makes their lives so miserable that they develop workarounds, bad things can happen.
This problem could become magnified as more physicians and hospitals adopt electronic health records with an eye on cashing in on government incentives for the use of the technology. These incentives begin in 2011. Mr. Egerman and his group put out preliminary recommendations for how to solve some of these potential patient safety issues. For starters, they suggest that all training and implementation for HIT devote some time to patient safety as well as how to report patient safety risks. They also want to focus on the near misses and potential hazards to try to prevent unsafe conditions before an error is made. They also called for establishing a national database where providers could report problems and the information could be rapidly disseminated to other institutions that might be doing something similarly risky.
Has health IT helped or hurt patient safety efforts in your institution? Let us know.
The audience sat rapt as the oracle of Intel, chairman Craig Barrett, pontificated on how the U.S. health system could deliver more and better care at a lower cost. Not surprisingly, given CTIA’s sponsorship and his company’s products, his solution is to rig every corner of America with broadband.
Waving a touchscreen-enabled wireless device the size of a small laptop, Mr. Barrett suggested that Americans could use such technology to monitor their own blood pressure or pulse rate, enter it into their own personal health record and send the data back to their physicians.
Credit: Flickr Creative Commons user aeu04117
He attempted to demonstrate that promise by attaching a pulse oximeter to his fingertip and then connecting it to the device. The two pieces of technology never synchronized — a bitter irony, given that the biggest complaint physicians and hospitals have about the promise of health IT is that there are no interoperability standards.
Mr. Barrett said the health industry needs a revolution similar to the one technology underwent 30 years ago. A hospital’s just like the old mainframes that used to take 24 hours to process information, he said. The advent of the personal computer not only sped up information processing but brought technology into the home. “Why don’t we personalize medicine so you don’t have to go to the mainframe?” he asked.
The job of the health care system should be to keep people out of the hospital, “not give them better service in the hospital,” Mr. Barrett said.
Not that his is a radical notion. But perhaps when Mr. Barrett speaks, many, many others will listen and follow.