Telehealth Monitor

So it looks as if the nation’s taxpayers are going to spend about $20 billion to accelerate the use of computerized medical records. In his press conference Monday night, President Obama went out of his way to explain why that money belonged in the economic stimulus package. It is, he said, a job-creating investment in both the present and the future that will improve the quality of care and save lives.

But in a letter delivered Tuesday to the White House and Congressional offices, 50 of the nation’s leading experts in electronic health records — most of them physicians themselves — warned that “an historic opportunity to achieve quality and efficiency gains through health information technology will be lost,” unless the government channels the spending carefully.

Just throwing money at doctors, they say, is not going to work. “The challenge is going to be all about implementation,” said Dr. Blackford Middleton, chairman of the Center for Information Technology Leadership, a research arm of Partners Healthcare, a big nonprofit medical group in Boston that includes Massachusetts General Hospital. “Where is the money going to flow and what is the mechanism of implementation?”

Dr. Middleton and others who signed the document say the answer lies in replicating a few standout community projects that have had success in offering installation help, technical support, buying power and training to small physician practices. The small group practices will be where the Obama administration’s push succeeds or fails because 75 percent of the nation’s physicians work in offices of 10 doctors or fewer.

via Electronic Health Records: How to Spend the Money Wisely – Bits Blog – NYTimes.com.

Former New York lieutenant governor Betsy McCaughey has caused a stir with a Bloomberg op-ed that raises questions about parts of the economic stimulus package concerning health care and the Department of Health and Human Services.

McCaughey writes that “One new bureaucracy, the National Coordinator of Health Information Technology, will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and ‘guide’ your doctor’s decisions.”

“Keeping doctors informed of the newest medical findings is important, but enforcing uniformity goes too far,” she writes, maintaining that the plan will limit growth and innovation in the health care industry.

via Stimulus Debate Shines Light on Health IT Job – Federal Eye – .

Short-circuiting a gradual move toward e-health records

Many physicians are moving toward electronic health records for reasons of their own, including market pressure, convenience, and efficiency. This happens as old systems are being replaced or upgraded, questions about security find better answers, and doctors and their staff become more familiar with the technology.

The Centers for Disease Control and Prevention found, in response to a mail survey last year that 38.4 percent of physicians reported using full or partial e-records system, not counting billing. This is up from 25 percent in 2005.

In the absence of the so-called stimulus bill, doctors and companies have been gradually moving in that direction, individually weighing the costs against the benefits and choosing the technology that best suits their needs.

This is the gradual process that the Democrats who wrote the legislation, and sent it the floor without the benefit of a single hearing, hope to short-circuit. The bill punishes physicians who are not “meaningful users” of a government-certified e-record database, and specifies certain procedures and information exchanges that will “satisfy” the requirement.

Starting in 2015, government reimbursements to physicians who are not participating in the federal e-record effort will begin to decline.

via U.S. stimulus bill pushes e-health records for all | Politics and Law – CNET News.