I participated in a conference call this morning with David Blumenthal, M.D. National Coordinator for Health Information Technology where he dicussed of the HIT Standards and Policy Committees and named the members of these important groups. I even was able to ask Dr. Blumenthal a question regarding the work of the HIT Standards Committee and how much influence the previous work of groups like NeHAC and HITSP would have on thei efforts. He indicated that they were not interested in reinventing the wheel and the committee included a broad range of stakeholders, including providers, ancillary healthcare workers, consumers, purchasers, health plans, technology vendors, researchers, relevant Federal agencies, and individuals with technical expertise on health care quality, privacy and security, and on the electronic exchange and use of health information. I was thrilled to learn that John Halamka, M.D. Chief Information Officer and Dean for Technology at Harvard Medical School was named Vice Chairperson to this important committee. The 20 HIT Policy Committee members, established under the American Recovery and Reinvestment Act, are as follows:
Thursday, May 7, 2009
HIT Standards and Policy Committees
HHS Budget Plan Released
The fiscal 2010 budget proposal released by the Obama administration recaps the Medicare cuts it proposed earlier this year to pay for a health overhaul, but offers new details on efforts to fight fraud and how it might reduce the cost of legislation erasing deep scheduled Medicare cuts in payments to doctors. According to the HHS Press Release this budget would help control the skyrocketing cost of healthcare.
President Obama proposed Thursday to largely hold flat budgets for agencies under the Department of Health and Human Services in fiscal 2010, as they continue to spend billions of dollars in extra money they received under the economic stimulus law passed in February. He also has proposed some spending cuts and legislative changes for the department that could prove controversial, including the elimination of abstinence-only sex education programs.
Mr. Obama is requesting a total of $828 billion for HHS, including $78.3 billion in discretionary spending, according to the department. The discretionary amount would be slightly less than the $78.5 billion the department received in fiscal 2009. HHS Budget Request (PDF)
The economic stimulus law, however, provides the department an extra $22.4 billion in discretionary funds for fiscal 2009 and fiscal 2010, and $109 billion in total, obviating the budget reduction.
The Food and Drug Administration, which did not receive stimulus money, would get a $367 million increase in its fiscal 2010 budget. Obama also proposes that Congress allow the FDA to begin approving generic competitors to complex biotech drugs, and that it allow the agency to assess a fee for the approval of generic drugs. Obama proposes $141 million in new user fees for the agency, which together with increases in existing fees would provide the agency a $511 million spending increase over fiscal 2009 enacted.
The budget would add $125 million in funding next year to the nearly $1.5 billion now spent on the “HCFAC” program, established under 1996 legislation creating a joint effort by HHS and the Justice Department to crack down on health care fraud. A total of $311 million next year in discretionary funding for the Health Care and Fraud and Abuse Control Program would be allocated as follows: $220 million for Medicare; $31 million for Medicaid; $30 million for the Department of Justice; and $30 million for the HHS Office of the Inspector General.
Part of the Medicare money would be used to go after fraud in the private plan side of Medicare, the Medicare Advantage side offering private health plans and the Medicare Part D side offering coverage through private prescription drug plans.
The HHS Budget in Brief (PDF) (12.6MB) provides an overview of the HHS budget and how the budget supports the major initiatives of the Department. The HHS “Budget in Brief” document notes that “as part of health care reform, the administration would support comprehensive, but fiscally responsible, reforms to this payment formula. Consistent with this goal, the administration will explore the breadth of options available under current authority to facilitate such reforms including an assessment, both substantively and legally, of whether physician administered drugs should be covered under the payment formula.” According to a Centers for Medicare and Medicaid Services (CMS) estimate, not including the cost of those drugs in assessing adherence to physician spending targets would lower the 10-year legislative cost of a freeze from $311 billion to $181.5 billion. But the $129.6 billion reduction in how much the legislation would cost Congress would increase the federal deficit by that amount.
The HHS Performance Highlights (PDF) (1.31MB) summarizes key past performance and financial information and planned performance.
This list of Fiscal Year (FY) 2007 Performance Measures by HHS Strategic Goal and Strategic Objective (PDF) (775KB) provides more detailed information on HHS agencies’ performance measures.
Wednesday, May 6, 2009
HIT Policy Standards Committees to Meet
The HIT Policy Committee will hold its first meeting May 11 in Washington D.C. The HIT Standards Committee will hold its inaugural meeting on May 15, also in Washington D.C. More information on both meetings is available in notices published May 6 in the Federal Register, at:
Instructions on how to access the meetings and participate in person or on the web are below.
The policy committee will advise David Blumenthal, M.D. on issues involving implementation of a National Health Information Network (NHIN) and Electronic Health Records (EHRs). The standards committee will advise on standards, implementation specifications and certification criteria for the electronic exchange and use of health information. Sixteen appointments to the policy committee have been announced. Membership in the standards committee has not been announced. According to the published notices of both committees, members will be introduced at the May meetings. "Because of initial delays in processing members' nominations, the 15-day deadline for notification was not met."
My hope is that NeHC will evolve to become a part of the HIT Standards Committee. U.S. Government Accountability Office (GAO), announced the appointment of 13 members to the Health Information Technology Policy Committee. The Secretary of Health and Human Services will appoint three members of the HIT Policy Committee. President Obama can appoint additional members to represent federal agencies. Senate Majority Leader Mitch McConnell (R-Ky.) has not yet announced his appointment. The additional three members that have been named are:
- House Speaker Nancy Pelosi (D-Calif.) has appointed Paul Egerman, chair and CEO at eScription Inc., Needham, Mass.
- House Minority Leader John Boehner (R-Ohio) has appointed Gayle Harrell of Stuart, Fla., a former member of the Florida House of Representatives.
- Senate Majority Leader Harry Reid (D-Nev.) has appointed Frank Nemec, M.D., a Las Vegas-based gastroenterologist.
(PDF) GAO Announces Appointments to Health Information Technology
The first meeting of the HIT Standards Committee is:
Friday, May 15, 2009, 9:00 a.m. to 12:00 noon (Eastern) at the
Department of Health and Human Services
Mary C. Switzer Building
Suite 1200, Conference Room 1114330 C Street SW
Washington, DC 20201
Seating is limited and given on a first-come, first-served basis.
Health IT Standards Comittee Meetings: How to Participate Webconference:
At least 10 minutes prior to the meeting start time, please go to:
http://altarum.na3.acrobat.com/HITstandards
(If for any reason the link does not work, simply copy and paste the URL into your browser's address bar) Select "enter as a guest" Type your first and last name into the field Click “enter room”
Test Your System: You will need to have an up-to-date version of Flash Player to view the webconference. Please test your system prior to the meeting by visiting
http://altarum.na3.acrobat.com/common/help/en/support/meeting_test.htm
NOTE: when running this system test, you do not need to install the Adobe Connect Add-in (step 4 of the test), as that is not relevant to this meeting.
Audio: You may listen in via computer or telephone.
US toll free: 1-877-705-6006
International Direct: 1-201-689-8557
Confirmation Code: HIT Committee Meeting
The first meeting of the HIT Policy Committee is:
Monday, May 11, 2009 - 8:30 to 11:30 a.m. (Eastern) at the
Department of Health and Human Services,
Hubert H. Humphrey BuildingRoom 505A 200 Independence Avenue SW
Washington, DC 20201
Health IT Policy Comittee Meetings: How to Participate Webconference:
At least 10 minutes prior to the meeting start time, please go to: http://altarum.na3.acrobat.com/HITpolicy
(If for any reason the link does not work, simply copy and paste the URL into your browser's address bar) Select "enter as a guest" Type your first and last name into the field Click “enter room”
Test Your System: You will need to have an up-to-date version of Flash Player to view the webconference. Please test your system prior to the meeting by visiting
http://altarum.na3.acrobat.com/common/help/en/support/meeting_test.htm
NOTE: when running this system test, you do not need to install the Adobe Connect Add-in (step 4 of the test), as that is not relevant to this meeting.
Audio: You may listen in via computer or telephone.
US toll free: 1-877-705-6006
International Direct: 1-201-689-8557
Confirmation Code: HIT Committee Meeting
If you have any technical questions, please send an email to webmeeting@altarum.org
Friday, May 1, 2009
Record Locator Service / Community Electronic Health Record
As we look to the future to develop a National Health Information Network (NHIN), I think that the first piece needs to be accomplished locally. Using a community based Electronic Health Record (EHR), with possibly a Record Locator Service (RLS) to aggregate the data from disparate systems. I envision the beginnings of a regional Health Information Exchange (HIE) as a sort of virtual EHR. A key infrastructure component, after deployment of an Electronic Medical Record (EMR) system, would be a RLS that presents a unified view to clinicians at the point of care.
RLS code and message schemas are made available below courtesy of Connecting for Health.
I think it will be very important that we include all stakeholders and care providers in the discussions. Long-term care, public health, hospitals, clinics and physician practices will need to cooperate to create a meaningful system that will allow the data to be approriately and securely shared, with the result of better care and lower costs.
Once true EHRs are connected through an HIE a robust NHIN can develop, possibly including a web based Personal Health Record (PHR). A PHR has the ability to transcend local networks, but I do not think we should wait for these products to mature before developing EHRs connected via HIE at the local level.
