Two views of the IT stimulus package's future

[rninformatics, DNP, RN]

Please post/reply as to which scenario below you think is the most likely to occur and which components seem like good ideas.

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From FierceHealth IT Editor's Corner

Two views of the IT stimulus package's future

March 9, 2009-2:54pm ET | By Anne Zieger

Dear readers:

Given any thought to how the big health IT stimulus package might play out? Well, here's one set of possibilities proposed by reader Dr. Donald Simborg, below. In it, he proposes a choice "a" and a choice "b", one of which is a happy outcome and one of which we'd all hope to avoid:

Scenario #1: (Written from the point of view of three years from now)

"Disillusionment is widespread over the colossal waste of money that has occurred. Billions of dollars have been paid to doctors and hospitals to adopt electronic health systems and the result has been a set-back for the entire industry. Nearly half of the attempts to install new systems have resulted in abandonment of the projects from lack of appropriate preparation for implementation and installation training personnel. A recent study by the Congressional Budget Office has determined that for those installations that have succeeded, CMS costs have risen 30 percent because of increased billings for E&M codes and other procedures.

"The Office of the Inspector General has determined that fraudulent claims have more than doubled. Newly enacted privacy legislation has crippled the interoperable exchange of clinical information for both patient care and research. The newly formed Health Information Technology Policy and Standards Committees are paralyzed by competing special interest members."

Scenario #2: (Also written from the point of view of three years from now)

"Approximately 35 percent of physician practices either have implemented EHRs or are in the process of implementation--a significant step toward achieving the revised goal of having every American have an electronic health record by the year 2020. Although slower and more difficult than originally envisioned in the HITECH legislation of 2009, the focus on achieving new incentives for decision support and streamlining standards for interoperability have already paid dividends in terms of measurable improvements in both quality and costs as determined by two recent studies funded by AHRQ.

"The newly created Center for the Study of Healthcare Effectiveness has overcome both the technical and political problems in aggregating EHR data in a safe and secure manner. The newly formed Health Information Technology Policy and Standards Committees have adopted a stakeholder representation model that requires an appropriate mix of healthcare IT experts as well as consumer advocates and is fully federally funded to avoid special interest influences."

OK, readers, which of these seems more likely to occur--and which elements seem like good ideas? I'd love your input

[SuesquatchRN, BSN, RN]

" Newly enacted privacy legislation has crippled the interoperable exchange of clinical information for both patient care and research."

This is one of the biggest problems I foresee. Good encryption/firewalls don't come cheaply and our little facility gets slammed every time new privacy legislation is enacted.

Now, all we need is a record layout and a way to drop data in. Lemme at it!

[rninformatics, DNP, RN]

from iHealthBeat, March 24th

IT Incentives for Doctors, Hospitals Vary Under Federal Stimulus Package

by Protima Advani

"Treatment of Critical Access Hospitals Under Medicare"

"For qualifying critical access hospitals, the HHS secretary is charged with a slightly different calculation in determining the EHR payments. Such hospitals can apply for a cost-based reimbursement for EHR technology, and in calculating such costs the secretary cannot take depreciation into account. Moreover, in calculating the Medicare share portion of the incentive formula, the secretary is instructed to add 20 percentage points to the share. Finally, critical access hospitals are entitled to a prompt payment from CMS, rather than on annual or periodic incentive payout in place for other hospitals."

" Newly enacted privacy legislation has crippled the interoperable exchange of clinical information for both patient care and research."

This is one of the biggest problems I foresee. Good encryption/firewalls don't come cheaply and our little facility gets slammed every time new privacy legislation is enacted.

Now, all we need is a record layout and a way to drop data in. Lemme at it!