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Quovadx Participates in Developing Accenture Nationwide Health Information Network Prototype

2007-01-26T13:05:00.000-07:00

Quovadx Participates in Developing Accenture Nationwide Health Information Network Prototype
Accenture-Led Consortium Shows Benefits of Nationwide Network Are within Reach of U.S. Citizens and Healthcare Community
GREENWOOD VILLAGE, Colo.--(BUSINESS WIRE)--Jan. 25, 2007--Quovadx, Inc. (Nasdaq: QVDX), a global software and vertical solution company, today announced its Integration Solution division's (ISD) role in the Accenture-led team that developed a fully integrated health information system prototype.
The Accenture solution, which works with legacy clinical systems, is a significant step toward building an interoperable, standards-based network. Quovadx ISD, as part of the Accenture-led team, provided its clinical interoperability solution, leveraging flagship Cloverleaf(R) Integration Suite technology to support secure interoperability, and its Secure Object Client to facilitate physician office connectivity for the networked community. Quovadx also provided implementation services for each of these technologies.
"We are extremely proud to be working alongside Accenture and the other consortium members to create an integrated health information system prototype as part of the Nationwide Health Information Network (NHIN) program," said Harvey A. Wagner, chief executive officer, Quovadx. "At Quovadx, we feel strongly that clinical data sharing can help improve patient safety and the quality of care while reducing healthcare costs, and we are excited to be part of Office of the National Coordinator for Health Information Technology (ONCHIT) initiative to facilitate interoperability between healthcare organizations and advance this cause."
The Accenture prototype shows that patient data can be extracted from disparate information systems and converted to a common language that enables sharing between physician offices, medical laboratories, hospitals and other clinical settings - offering a "single view" of a patient's medical information. This approach, which allows the industry to build on existing investments in legacy provider systems, allows rapid implementation of a secure infrastructure to facilitate data sharing.
In November 2005, the U.S. Department of Health and Human Services awarded a contract to Accenture to lead the development of a prototype network for secure information sharing among healthcare communities in West Virginia, eastern Kentucky, northeastern Tennessee and southwestern Virginia. This region has a wide variety of clinical systems among different provider organizations, much like the majority of the United States.
About Accenture
Accenture is a global management consulting, technology services and outsourcing company. Committed to delivering innovation, Accenture collaborates with its clients to help them become high-performance businesses and governments. With deep industry and business process expertise, broad global resources and a proven track record, Accenture can mobilize the right people, skills, and technologies to help clients improve their performance. With approximately 146,000 people in 49 countries, the company generated net revenues of US$16.65 billion for the fiscal year ended Aug. 31, 2006. Its home page is www.accenture.com.
About Quovadx, Inc.
Quovadx (Nasdaq: QVDX) offers software and services for system development, extension, integration and analysis to enterprise customers worldwide. Quovadx has three divisions, including the Integration Solutions division (ISD), which offers private and public healthcare organizations software infrastructure to facilitate system interoperability and leverage existing technology, the CareScience division, which provides care management and analytical solutions to hospitals and health systems and pioneered regional healthcare information organization (RHIO) technology, and the Rogue Wave Software division, which provides software and services for enterprise-class application development and high-performance SOA. Quovadx serves companies in the healthcare, financial services, telecommunication and public sectors. For more information, please visit http://www.quovadx.com.
QUOVADX is a trademark of Quovadx, Inc. and Cloverleaf is a registered trademark of Quovadx, Inc. in the United States and other countries. All other company and product names mentioned may be trademarks of the companies with which they are associated.
CONTACT: Quovadx, Inc.Andrea Lashnits, 720-554-1246andrea.lashnits@quovadx.comorAbby Cohen, 212-850-5710abby.cohen@fd.comSOURCE: Quovadx, Inc.

Progress report on federal healthcare IT goals

2007-01-25T12:19:00.000-07:00

HHS releases progress report on federal healthcare IT goals

Healthcare IT News

By Bernie Monegain, Editor
01/24/07
WASHINGTON – Since 2004, the United States has made strides toward automating its healthcare system, according to a report released Wednesday by the Department of Health and Human Services. The report details HHS accomplishments toward the goal of healthcare automation that President Bush first called for in his 2004 State of the Union Address, reiterated in his 2005 speech and again in the State of the Union Address Tuesday night.
“In 2006, HHS achieved several major milestones to meet the president’s call for most Americans to have access to electronic health records by 2014,” HHS Secretary Michael Leavitt stated in the report. “These significant accomplishments will provide tangible value to healthcare consumers – helping to reduce costs and medical errors with better information technology.”The report casts 2004 as “laying the foundation,” and 2005 as initial steps and progress.” HHS lists “major accomplishments” in 2006 and spells out some goals for 2007. Among the accomplishments: • Recommendations delivered by the American Health Information Community having to do with consumer empowerment, chronic care, electronic health records and bio-surveillance. • Standards harmonization that form the basis of interoperability• President Bush’s Executive Order on value-driven care• EHR certification developed by the Certification Commission for Healthcare Information Technology• Changes to regulations to allow hospitals or other healthcare organizations to donate healthcare IT to physicians• Healthcare IT adoption measurement – working with George Washington University, HHS conducted a physician survey to establish a baseline for measuring healthcare IT adoption. “These accomplishments will encourage broad, standards-based adoption of health IT that will improve the health and healthcare of all Americans,” according to the HHS report. “Already, the markets are responding to federal leadership.”Looking forward, the report cites the upcoming demonstrations of four prototype architectures for development of a nationwide health information network and work by the American Health Information Community workgroups on matters of privacy and security, quality and personalized healthcare.

Companies poised to take part in EMR shift

2007-01-24T10:24:00.000-07:00

Posted on Sun, Jan. 21, 2007

Poised to assist the medical sector in connecting the data

By Jane M. Von BergenInquirer Staff Writer
Imagine cradle-to-grave personalized health information, computerized and centralized.
Scary? Or part of the salvation of America's expensive and unwieldy health system? If it saves lives and improves efficiency, as proponents say, it will mean billions of dollars of business for hardware, software and consulting companies.
No wonder companies are positioning themselves to profit from electronic medical records.
Tens of billions of dollars worth of technology - depending on who's estimating and how - would be needed to bridge existing islands of medical information now stored in files in doctors' offices, pharmacies, insurance companies, hospitals, laboratories and workplaces.
Doctors' offices, now notoriously paper-dependent, would need to go digital. So would hospitals, and they would all need help.
Gone would be those under-the-bed cartons of old X-rays, children's immunization records, and medical bills. The pharmacist could log on to see all a patient's prescriptions, avoiding dispensing pills in harmful combinations.
An electronic medical record, linked to hospitals, doctors and pharmacies, would follow someone from her first day to her last. Under some scenarios, the individual would control the record; in others, control would remain with health-care providers.
Whether payers, such as insurance companies, or academics doing broad-based research would be able to link in remains an open question. So does the amount of access that employers would have.
However it is set up, it will cost billions to implement.
BBC Research & Consulting, a Denver market-research firm, predicts that the market for health-information technology will reach $34.7 billion in sales by 2011 - and that does not include computer systems used by insurers, employers or even individuals to keep track of their care.
"It bodes very well for a company like mine, being in the right place in the right time with the right product," said Dennis Gallagher, a salesman for Vitalize Consulting Solutions Inc. in Kennett Square, a 115-employee firm that helps hospitals and doctors convert from paper to electronic systems.
And it also bodes well for Gallagher's former employer, Siemens Medical Solutions USA - a multibillion-dollar unit of the German company with its U.S. headquarters in Malvern. Siemens is one of the nation's largest providers of clinical software coordinating patient care in hospitals and doctor practices.
Earlier this month, Gallagher and 130 other members of the Delaware Valley Healthcare Information and Management Systems Society went to the Siemens corporate campus for its regular monthly meeting.
The speaker?
Former GOP House Speaker Newt Gingrich, whose Center for Health Transformation think tank in Washington has been a major advocate of using information technology to enable patients to receive better care at lower cost. And Siemens, which helps fund Gingrich's center, is trying to boost its presence in the electronic-medical-record market.
"Our commitment is to educate" doctors and hospitals, said Connie D'Argenio, vice president of health services for Siemens, who introduced Gingrich at the event earlier this month. If doctors and hospitals want to spend money on technology, she said, "then we'll be well-positioned to be their partners."
About half of Siemens Medical's $10.3 billion in annual sales derives from the United States, and a sizable portion of that comes from information-technology systems that Siemens sells to coordinate and computerize clinical care in hospitals and doctors' offices.
For example, Siemens showed Gingrich its bar-code technology that requires a nurse, before dispensing medicine, to scan bar codes on her identification badge, on the medicine package, and on the patient's hospital bracelet. That raises the patient's chart on a computer wheeled into the room and confirms that the right patient is receiving the right dose of the right medicine at the right time, while also pointing out any potential counterindications and generating a care record for the future.
Gingrich said the government should finance an electronic medical network as part of the nation's defense system against, for example, a bioterrorism attack, just as Dwight Eisenhower initially funded the interstate highway as a national defense network during the Cold War.
"It is virtually inevitable that we will move to an electronic health record for every person, and that health record will start with prenatal care and end with analytics after you passed away," Gingrich said in his speech, which was Webcast to 803 Siemens customers and employees around the nation.
Although there has been talk of electronic medical records for at least a decade, several factors have been moving it to the forefront.
The rising cost of health care and its effect on the nation's competitiveness, the health needs of aging baby-boomers, leadership from the Bush administration nationally and the Rendell administration in Pennsylvania, and increased technological proficiency are all driving support for such records.
On Wednesday, Rendell included the idea of electronic health records in his sweeping plan to change how health care has been provided and funded in Pennsylvania.
Around the nation, experiments and projects are cropping up - financed by a variety of sources.
"Philadelphia is one of the most innovative leaders in this respect," said Elliot Menschik, founder of Hx Technologies in Center City.
In the second quarter, Hx Technologies' Philadelphia Health Information Exchange will begin to trade patient data - with patients' approval - among several competing health organizations, including the University of Pennsylvania Health System and Thomas Jefferson University Hospital.
Menschik said the launch would build on results from a 20-month experiment completed last year - an experiment that he said showed how electronic health records could improve patient care and cut costs.
His company analyzed medical imaging done in the two health systems, selecting imaging because CT scans, X-rays and MRIs are already digitized and would be easy to share.
The experiment showed that 20,000 patients sought care in both systems. These patients generated 125,000 imaging examinations. Of those, 10,000 would have been useful to doctors at the other hospital.
For example, a doctor at one hospital might have liked to compare older X-rays taken at the other hospital to improve diagnosis. Of the 10,000, 1,520 were straight duplicates that cost $218,000 - an expense that could have been avoided.
"Our company believes the strongest potential is working with the health plans," Menschik said. So far, funding has come from the National Institutes of Health and the hospital systems. He said he has been talking to local insurers.
Some regions, including Boston and California, have established nonprofit organizations to set up similar exchanges, called Regional Health Information Organizations. Next week in Washington, leaders will be sharing business prototypes at a conference sponsored by the U.S. Department of Health and Human Services.
Last month, five major corporations - among them Intel Corp., Wal-Mart Stores Inc. and Pitney Bowes Inc. - announced they would finance the development of Dossia, a Web-based personal health record available to their 2.5 million employees, dependents and retirees.
Controlled by employees, Dossia would cull information from their doctors, hospitals and pharmacies to create a comprehensive health history that would be portable and private.
"As an employer, we've got 50,000 people," said Colin Evans, director of policy and standards at California-based Intel.
Evans said the company's motivation in financing Dossia was more about concerns it has as one of the nation's largest employers, rather than for potential new business it might garner through electronic medical records.
"We spend half a billion dollars on health care every year," he said. "One could argue that it is out of control. The amount we spend on health care is pricing jobs out of the U.S. to other places."
From Paper to Computer
Here's a glossary of some of the most frequently used terms for digital medical information:
Personal Health Record (PHR): Controlled by individuals, these records could include prescriptions, laboratory results, physicians' reports, lab images. Some think these records should also link to sources of relevant medical information, including, for example, help in controlling diabetes or asthma.
Electronic Medical Record (EMR): Controlled by doctors or hospitals, these records keep track of the care given to patients in a clinical setting. These can also assist with billing.
Computerized Physician Order Entry (CPOE): These systems keep track of physicians' orders, partly to ensure that bad handwriting doesn't contribute to medical errors.
Regional Health Information Organization (RHIO): Typically nonprofits, these organizations orchestrate the electronic exchange of information among area hospitals and other providers, with the consent of the patients. They choose standards and protocols.
Health Information Exchange (HIE): The technology infrastructure that a RHIO would use.
Workplace reporter Jane M. Von Bergen and Elliot Menschik, founder of Hx Technologies, chat online at noon tomorrow about how sharing digital patient information could improve care and cut costs.
Read more at http://go.philly.com/hxfiles.
E-mail your questions to: businessnews@phillynews.com.

WellPoint Launches E-Prescription Pilot

2007-01-23T12:46:00.000-07:00

January 23, 2007

Indianapolis-based WellPoint on Monday announced the launch of an electronic-prescription pilot program for 100 physicians in its subsidiary, Anthem Blue Cross and Blue Shield of Ohio, the Indianapolis Star reports.

The program will allow participating physicians to submit patient prescriptions electronically to pharmacies and provide information about the prescriptions, such as possible drug interactions, drugs with similar names and cheaper generic options.

Physicians will be reimbursed $750 for computer hardware and $40 per month for the cost of the e-prescribing service. WellPoint said that other e-prescribing programs have resulted in changes to 2% of prescriptions because of alerts about safety concerns.

General Motors, an Anthem customer in the Ohio area, also is providing funding for the program. WellPoint has not yet decided if the program will be expanded to its other markets (Lee, Indianapolis Star, 1/23).

Free E-prescribing to Every Physician in America

2007-01-22T11:17:00.000-07:00

Washington, DC – Jan. 16, 2007 – A coalition of the nation’s most prominent technology
companies and leading healthcare organizations announced today a national initiative to provide
free electronic prescribing for every physician in America. The National ePrescribing Patient
Safety InitiativeSM (NEPSISM) is the first nationwide effort to improve patient safety by offering a
solution to the medication errors that harm millions of people each year.
Preventable medication errors injure at least 1.5 million Americans and claim more than 7,000
lives each year, according to a July 2006 study by the Institute of Medicine (IOM) of the National
Academy of Sciences. In an effort to reduce these errors, the IOM has called on all of the
nation’s physicians to adopt electronic prescribing by 2010.
“While medication errors and adverse drug events can be common and serious, electronic
prescribing is clearly a tool that can dramatically reduce errors and improve patient safety,” said
Nancy W. Dickey, currently President of the Health Science Center and Vice Chancellor for
Health Affairs at the Texas A&M University System and formerly President of the American
Medical Association. “Yet despite the many benefits of electronic prescribing, physician adoption
is still modest. The situation calls for a solution that will overcome the barriers many physicians
face in adopting this life-saving technology.”
The challenge, according to the eHealth Initiative, is that fewer than 1 in 5 of the nation’s
practicing physicians currently process prescriptions electronically. Studies indicate that most
physicians have been reluctant to adopt electronic prescribing largely because of the cost of the
systems, and a perception that the technology requires too much time to learn and install.
NEPSI will help address those barriers by providing physicians simple, safe and secure electronic
prescribing at no cost. NEPSI is led by Allscripts (Nasdaq: MDRX), the leading provider of clinical
software, information and connectivity solutions that physicians use to improve healthcare, and by
national sponsor Dell Computers, Inc. (Nasdaq: DELL), the world’s leading computer company.
Other technology companies sponsoring NEPSI are Cisco Systems Corp., Fujitsu Computers of
America, Inc., Google, Inc. – the coalition’s Search Sponsor – Microsoft, Corp., Sprint Nextel
Corp., SureScripts, Inc., and Wolters Kluwer Health, Inc.
“Medication errors represent a significant challenge for our nation and we know we can and we
must do better by taking action – right now,” said Glen Tullman, Chief Executive Officer of
Allscripts. “The National e-Prescribing Patient Safety Initiative brings together a diverse group of
technology companies, payers and physicians who share a commitment to one remarkable idea –
that providing free electronic prescribing for every physician will ultimately reduce errors and
improve care. This initiative delivers a simple yet comprehensive solution, and represents an onramp
to a complete Electronic Health Record.”
Kevin Rollins, President and Chief Executive Officer of Dell, NEPSI’s national sponsor,
commented, “We are proud to add sponsorship of the NEPSI Coalition to the growing list of
healthcare-related initiatives that Dell is helping to lead. Information technology holds great
promise as a means to help upgrade our nation’s healthcare system, and we look forward to
working with partners such as Allscripts to help demonstrate its potential to improve the quality,
efficiency and productivity of healthcare in the America.”
In addition to Dell, a number of the largest technology companies in the world are sponsoring
NEPSI including Microsoft and Intel.
"Microsoft is proud to support the NEPSI initiative, which we believe is a major step forward in the
effort to arm our nation’s physicians with the technology they need to eliminate paper from the
prescription process and deliver higher quality, safer patient care,” said Steve Shihadeh, General
Manager of Sales, Marketing and Partners for Microsoft’s Health Solutions Group. “We believe
that consumers will be the biggest beneficiaries of this technology adoption by physicians,
enabling real-time access to the most relevant patient information".
Craig Barrett, Intel Chairman, who recently announced an initiative with major employers to
provide a personal health record system for their employees, commented, “Paper prescriptions
are a key cause of cost, errors and inefficiency in U.S. health care. Which other industry could
tell their customers it was OK to have a 15 percent error rate; imagine the airlines landing at the
wrong destination 15 percent of the time. Electronic prescribing should be the rule not the
exception. We look forward to working together with Allscripts and this initiative to lower health
care costs and drive improvements, ultimately providing more timely and accurate information to
our employees through direct feeds to the Dossia lifelong health record.”
A key element of the NEPSI initiative is participation by two of the nation’s largest health benefits
companies, Aetna and WellPoint, as well as influential regional payers such as Horizon Blue
Cross Blue Shield of New Jersey. The coalition’s health benefits sponsors will provide a range of
incentives to physicians in their networks to encourage adoption and use of electronic prescribing
technology. Their view is that electronic prescribing adds quality and efficiency to the patient care
process.
"WellPoint views electronic prescribing as an essential tool in providing high-quality, safe and
cost-effective care to our members,” said Charles Kennedy, M.D., Vice President of Health
Information Technology for WellPoint. “We are excited about the potential of the NEPSI program
to improve care when executed by our network physicians."
To add local presence and expertise, NEPSI also includes more than a dozen of the most
prestigious and leading academic medical centers, integrated delivery networks and physician
groups representing thousands of physicians across the country. These organizations will serve
as regional supporters of NEPSI, leading the delivery and support of electronic prescribing to
physicians in their states and regions by providing education, training, incentives and local
physician support.
Leading healthcare provider organizations acting as regional supporters of the NEPSI rollout of
free electronic prescribing include: Advocate Health Partners, Mount Prospect, IL; Brown &
Toland Medical Group, San Francisco, CA; Delta Health Alliance/University of Mississippi Medical
Center, Stoneville, MS; George Washington University Medical Faculty Associates, Washington,
DC; Healthcare Partners Medical Group, Torrance, CA; Holston Medical Group, Kingsport, TN;
LSU Health Network, New Orleans, LA; MaineGeneral Health, Augusta, ME; Novant Health,
Winston-Salem, NC; Sierra Health Services and Southwest Medical Associates, Las Vegas, NV;
UMass Memorial Healthcare, Worcester, MA; University of South Florida/USF Physicians Group,
Tampa, FL.
The backbone of the NEPSI program is eRx NOW™, web-based software from Allscripts
powered by the same engine used today by more than 20,000 physicians to write millions of
electronic prescriptions each year. Designed to appeal to physicians in solo practice or small
groups, eRx NOW™ is available free to any healthcare provider with legal authority to prescribe
medications, and requires no download, no new hardware, and minimal training.
The product includes the ability to quickly generate secure electronic prescriptions that can be
sent computer-to-computer or via electronic fax to 55,000 retail pharmacies – more than 95
percent of all U.S. pharmacies – via SureScripts. All prescriptions are instantly checked for
potentially harmful interactions with a patient’s other medications using a real-time complete
medication database provided by Wolters Kluwer Health, as well as real-time notification of
insurance formulary status from leading payers, plans and pharmacy benefit managers. The
product also includes the ability for physicians to search and find targeted health-related
information for themselves or patients using a custom search engine from Google. The NEPSI
Custom Search Engine was created for medical professionals and enables those using the eRx
Now™ product to get search results tailored for the medical community.
eRx NOW™ offers physicians and patients the highest levels of security available, with multiple
redundant layers of firewall, deep-packet inspection, SSL encryption, database encryption,
intrusion detection and virus, spyware and malware protection for the program’s remote servers.
To ensure patient privacy, all patient information is stored on remote servers in a secure location,
so information cannot be compromised even if a physician’s computer or phone is stolen.
Interested physicians can visit the NEPSI web site, www.nationaleRx.com to register for the
program. The solution is currently being used by physicians and will begin national deployment
within 30 days.
ABOUT NEPSI
The National ePrescribing Patient Safety Initiative (NEPSI) is a coalition of the nation’s most
prominent technology companies and leading healthcare organizations dedicated to improving
patient safety by providing free access to simple, safe and secure electronic prescribing for every
physician in America. The coalition is led by Allscripts (Nasdaq: MDRX) and national sponsor
Dell, Inc. (Nasdaq: DELL); and includes Aetna, Inc., Cisco Systems, Inc., Fujitsu Computers of
America, Inc., Google, Inc., Microsoft, Corp., Sprint Nextel, Inc., SureScripts, Inc., WellPoint, Inc.,
and Wolters Kluwer Health, Inc.
The NEPSI offering also is supported by a growing number of academic medical centers,
integrated delivery networks and physician groups across the U.S., who are leading the rollout of
the NEPSI electronic prescribing solution, eRx NOW™, within their states and regions. For more
information, visit NEPSI on the web at www.nationaleRx.com.

Contacts:
Tarsis Lopez Dan Michelson Todd Stein
Fleishman Hillard Allscripts Allscripts
847-921-8353 312-506-1217 312-506-1216
tarsis.lopez@fleishman.com dan.michelson@allscripts.com todd.stein@allscripts.com
National Patient Safety Initiative Launched To Provide
Free Electronic Prescribing To Every Physician In America
Leading Healthcare and Technology Companies Join in Support of Initiative:
Aetna, Allscripts, Cisco, Dell, Fujitsu, Google, Intel, Microsoft, Sprint Nextel,
SureScripts, WellPoint, Wolters Kluwer Health

Cause of Death: Sloppy Doctors

2007-01-22T09:50:00.000-07:00

Doctors' sloppy handwriting kills more than 7,000 people annually. It's a shocking statistic, and, according to a July 2006 report from the National Academies of Science's Institute of Medicine (IOM), preventable medication mistakes also injure more than 1.5 million Americans annually. Many such errors result from unclear abbreviations and dosage indications and illegible writing on some of the 3.2 billion prescriptions written in the U.S. every year.

To address the problem—and give the push for electronic medical records a shove—a coalition of health care companies and technology firms will launch a program Tuesday to enable all doctors in the U.S. to write electronic prescriptions for free. The National e-prescribing Patient Safety Initiative (NEPSI) will offer doctors access to eRx Now, a Web-based tool that physicians can use to write prescriptions electronically, check for potentially harmful drug interactions and ensure that pharmacies provide appropriate medications and dosages. "Thousands of people are dying, and we've been talking about this problem for ages," says Glen Tullman, CEO of Allscripts, a Chicago-based health care technology company, that initiated the project. "This is crazy. We have the technology today to prevent these errors, so why aren't we doing it?"

One of the reasons is that doctors haven't invested in the needed technology, so it's being provided to them. The $100 million project has drawn support from a variety of partners, including Dell, Google, Aetna and numerous hospitals. "Our goal long-term is to get the prescription pads out of doctors' hands, to get them working on computers," says Scott Wells, a Dell vice-president of marketing. Google is designing a custom search engine with NEPSI to assist doctors looking for health data. Insurance companies such as Aetna have pledged to provide incentives for physicians using e-prescription systems.

Although some doctors have been prescribing electronically for years, many still use pen and paper. This is the first national effort to make a Web-based tool free for all doctors. Tullman says that even though 90% of the country's approximately 550,000 doctors have access to the Internet, fewer than 10% of them have invested the time and money required to begin using electronic medical records or e-prescriptions.

By providing doctors with free tools and support—and perhaps a little prodding from the big insurers who pay the bills—the NEPSI alliance hopes to encourage a quickening in adoption of electronic prescribing. Because the new program is Web-based, no special software or hardware is required, and NEPSI says the new system takes 15 minutes to learn. Sprint plans to give away 1,000 web-enabled phones to be used to transmit e-prescriptions and to demonstrate the technology's ease of use. To keep pharmacies plugged into the new system, SureScripts, which links pharmacies around the country much like the national ATM network connects banks, will handle the e-prescriptions traffic from doctors to the country's 55,000 pharmacies.

Automation should eliminate many of the errors that occur when pharmacists misunderstand or misrecord medication names or dosages conveyed messily on paper or hurriedly by phone. Given that there are more than 17,000 pharmaceutical brands and generics available, a spoken request for Celebrex, for instance, can be mistaken for Celexa, or a notation requesting 150 milligrams of a drug might be read as 1500. In electronic systems, drugs and dosages are selected from menus to prevent input errors, and pharmacists don't need to re-enter information.

SureScripts CEO Kevin Hutchinson says one key to reducing medication errors is to get the most prolific prescribers to transition to electronic processing. "Not a lot of people understand that 15% of physicians in the U.S. write 50% of the prescription volume," Hutchinson says. "And 30% of them write 80%. So it's not about getting 100% of physicians to e-prescribe. It's about getting those key 30% who prescribe the most. Then you've automated the process."

Wider adoption of e-prescribing could lead to further efficiency in medical record keeping, which many believe is vital to both improving health care delivery and lowering costs. "Electronic prescribing could be an on-ramp for physicians beginning to use a full-featured electronic medical records system," Hutchinson says. "That's the holy grail."

nations's Capital Welcomes It's First Electronic Prescription

2007-01-22T09:47:00.000-07:00

FOR RELEASE
8:00 A.M. EST
January 17, 2007

Contact:
Jennifer Mead
703-921-5328
jennifer.mead@surescripts.com

New Year Hastens Countdown to 100 Percent, Nationwide E-Prescribing Eligibility:
Two States Remain As Washington, D.C. Joins 48 States
that Allow Safer, More Efficient E-Prescribing

Washington, D.C. – January 17, 2007 – Today, SureScripts®, operators of the Pharmacy Health Information Exchange™, announced that the first prescription has been transmitted electronically from physician to pharmacist in the nation’s capital. Less than one month after the Washington, D.C. Board of Pharmacy adopted new rules making electronic prescribing legal, a D.C.-based Rite Aid pharmacy became the first to receive and process a new prescription electronically from a D.C.-based physician.

“Utilizing e-prescribing is a huge benefit for our patients, our pharmacists and our physician partners,” said Phil Keough, senior vice president of pharmacy operations for Rite Aid.
“E-prescribing improves accuracy, eliminates unnecessary phone calls and faxes to physician offices and, most importantly, allows our pharmacists to spend more time counseling their patients, answering their questions, and ensuring their compliance with medication therapy.”

The announcement follows last July’s release of a report by the Institute of Medicine (IOM) that focused national attention on the 1.5 million preventable medication errors that occur in the United States each year. To prevent these errors and the injuries they cause, the IOM report made a series of recommendations, including one that all prescribers and pharmacies prescribe electronically by 2010.

“These new rules present an opportunity for patients and physicians in the District of Columbia to enter a new era of medication safety, enabled by health information technology,” said
Dr. Peter Basch, a practicing internist and medical director for eHealth at MedStar Health in Washington, D.C. “Electronic prescribing has been shown to reduce medication errors caused by illegible prescriptions, improper dosing, and drug interactions. We see e-prescribing as part of any health system’s approach to make high quality care even better.”

“Many physicians, like myself, practice in or see patients from Maryland, D.C. and Virginia and it has been difficult to deal with different rules for each jurisdiction in recent years,” said
Dr. Alan Zuckerman, a pediatrician practicing in the District of Columbia. “When we use electronic prescribing tools today, prescriptions travel directly to the pharmacy computer system in some locations, but, unfortunately, are turned into a fax in others. The changes to the D.C. electronic prescribing rules to allow direct electronic prescriptions is a most welcome change that will help accelerate adoption of electronic prescribing and help achieve critical benefits in patient safety and quality.”

To capitalize on this new opportunity for safer and more cost efficient prescribing, SureScripts, operators of the Pharmacy Health Information Exchange, is working closely with community pharmacies throughout the nation’s capital to immediately activate previously certified computer systems for electronic prescribing. SureScripts has certified the software solutions being used by more than 95% of the nation's retail pharmacies. As a result, the great majority of the Washington, D.C. area's 113 retail pharmacies can now begin e-prescribing. Once activated, community pharmacies in the District will be able to receive new prescriptions from physicians directly into their pharmacy computer systems – instead of by fax or handwritten prescription. The same applies to prescription refill requests, which can now be sent from pharmacies to physicians electronically – no faxing or phone calls required.

“CARE Pharmacies is pleased that the D.C. Board of Pharmacy has approved the use of e-prescribing for pharmacies,” said Gerry Serody, CEO and chairman, CARE Pharmacies, Inc. “We feel strongly that this technology will be extremely important for the practice of pharmacy in the twenty first century.”

“When the nation’s community pharmacies founded SureScripts in late 2001, we began building the technical capability in our network to support e-prescribing between physicians and pharmacists anywhere in the nation,” said Ken Whittemore, senior vice president of clinical practice integration for SureScripts. ”At that time, however, there were only a dozen states with laws and regulations that would even allow electronic prescribing. A little over five years later, we are proud to announce that Washington D.C. has joined with 48 other states that allow their physicians and pharmacists to electronically exchange life-saving prescription information.”

About SureScriptsFounded by the pharmacy industry in 2001, SureScripts operates the Pharmacy Health Information Exchange™ which facilitates the electronic transmission of prescription information between physicians and pharmacists and provides access to life-saving information about patients during emergencies or routine care. Today, more than 95 percent of all pharmacies and all major physician technology vendors in the United States are certified on the Pharmacy Health Information Exchange. More information about SureScripts is available at www.surescripts.com.

Draft Requirements for EHR

2007-01-17T12:15:00.000-07:00

Draft requirements for electronic health records that are intended to detect fraud and claims errors have been posted for public comment, Technology Daily reports (Technology Daily, 1/16).The requirements are based on guiding principles established during an earlier phase of the project contract with the Office of the National Coordinator for Health IT, AHA News reports. Comments, which will be submitted to the Certification Commission for Health IT, are due on Jan. 22 (AHA News, 1/16).HHS publicly announced late Friday afternoon the more than 60 proposed requirements in 16 categories, Modern Healthcare reports (Conn, Modern Healthcare, 1/15). One proposed requirement would enable users to view the method of entry for each piece of data. "Having an audit version of the (records that) indicates which of these tools were used could enable detection of patterns of abuse or fraud," RTI International researchers said (Technology Daily, 1/16).The Web site for RTI International, which created two work groups to prepare the recommendations, states that "the term 'model requirements' used in this project is meant to indicate a product that will be put forth as recommended criteria for future EHR certifications," adding that the criteria "will not become official requirements unless they are adopted as such by entities in the future." Some privacy advocates oppose the draft requirements. Dr. Deborah Peel, founder of the Patient Privacy Rights Foundation, in a response writes, "This draft is yet another instance of ONCHIT/HHS putting corporate interests ahead of the lives and health of the American people." She adds that the requirements "eliminate patients' fundamental rights to control access to their medical records, by claiming that such access is needed to detect fraud" (Modern Healthcare, 1/15).

Democrats to push health IT funding, privacy

2007-01-16T11:29:00.000-07:00

By Heather B. Hayes
Published on Jan. 11, 2007

Congress did not pass national health information technology legislation last year, but it remains one of few truly bipartisan issues the new Congress will deal with, advocates say. As Democrats exert their leadership, industry observers also expect a shift in how health IT laws are approached.

“Democrats will certainly re-address the issue, and in fact, there’s already been talk among staffers about putting together a new broad-based [health IT] bill,” said David Merritt, project director for the Center for Health Transformation. “But it is for certain that their priorities will differ somewhat.”

Four themes are likely to emerge among the Democrats’ talking points: funding, privacy, systems interoperability and personal health records. Funding and privacy are potential sticking points.

Democrats will likely target funding to encourage small medical practices in underserved communities to adopt health IT. But Dave Roberts, vice president of government relations at the Healthcare Information and Management Systems Society, said they will have to be creative, because the Democrats have already committed to using a pay-as-you-go budgeting approach.

“They’re going to have to find sources to pay for it or raise taxes,” he said. “That’s going to be a real trick, since there’s going to be a lot of competition for funding among other health care concerns.”

Privacy is another issue that promises to produce a vigorous debate. House Democrats have long been pushing for comprehensive patient privacy protections as part of health IT legislation, including the right to consent to data disclosure, to opt in and out of electronic databases, and to be notified of privacy breaches.

“It’s going to be a different ballgame because the Democrats are at least going to hold extensive hearings on privacy and have a lot more oversight of what’s been going on at the Department of Health and Human Services,” said Deborah Peel, executive director of the Patient Privacy Rights Foundation.

Last year, the Republican-led Congress largely avoided the privacy issue. The Senate bill relied on existing Health Insurance Portability and Accountability Act protections, while the final House bill directed the HHS secretary to study existing privacy law and recommend a single national standard.

Zix Corporation Expands e-Prescribing Contract

2007-01-11T11:36:00.000-07:00

Zix Corporation Expands e-Prescribing Contract with Independence Blue Cross

Successful PocketScript® deployment and program results lead to expanded contract for 350 physicians with the Philadelphia region's largest health insurer

DALLAS — January 10, 2007 — Zix Corporation (ZixCorp®), (Nasdaq: ZIXI), the leader in hosted services for email encryption and e-prescribing, today announced that Independence Blue Cross (IBC) has expanded its e-prescribing contract with ZixCorp for an additional 350 physicians based on ZixCorp’s earlier success with IBC's e-prescribing pilot. IBC is the Philadelphia region's leading health insurer with more than 2.6 million members locally and 3.4 million nationwide.
"Since our e-prescribing pilot program began over a year ago, we have seen improvement in generic and formulary prescribing by the participating pioneer physicians," said Dr. Steven Udvarhelyi, Chief Medical Officer for Independence Blue Cross. "With ZixCorp's help, we now have more than 265 physicians writing prescriptions electronically — much faster and easier for physicians and patients, and safer than paper prescriptions with hard-to-read handwriting. We look forward to continuing to improve patient safety and generic usage through e-prescribing with ZixCorp's PocketScript service."
PocketScript enables participating IBC physicians, through a wireless handheld PDA, to write prescriptions and then send them immediately and electronically to pharmacies, improving patient convenience. Prescriptions can also be written and managed through a ZixCorp secure Web site using a common browser. During the prescribing process, the application provides real-time access to formulary information, a drug reference guide, drug-to-drug and drug-to-allergy checking, and patient-specific dispensed-drug lists.
"IBC continues to demonstrate its leadership in this market by fueling the broader adoption of e-prescribing technology in the state of Pennsylvania," said Rick Spurr, chief executive officer for ZixCorp. "We’re proud to have been selected as the vendor for this next phase, which represents yet another expansion of a successful e-prescribing program."
About Independence Blue Cross Independence Blue Cross is the leading health insurer in Southeastern Pennsylvania. Nationwide, IBC and its affiliates provide coverage to nearly 3.4 million people. For nearly 70
2711 N. Haskell Ave. Suite 2300, LB 36 Dallas, TX 75204 phone 214 37 0 2000 fax 214 37 0 207 www.zixcorp.comZix Corporation
years, Independence Blue Cross has offered quality health care products and services tailored to meet the changing needs of members, employers, groups and providers.
Independence Blue Cross recently received the highest ratings from the National Committee for Quality Assurance for its HMO and PPO health care plans. In addition, in 2005, Independence Blue Cross's Personal Choice was rated the No. 1 PPO in the nation and its Keystone HMO was ranked the No. 1 HMO in the region by health care consumers in a leading independent consumer magazine.
About Zix Corporation
Zix Corporation (ZixCorp®) provides easy-to-use-and-deploy email encryption and e-prescribing services that protect, manage, and deliver sensitive information to the healthcare, finance, insurance, and government industries. ZixCorp's email encryption services enable policy-driven email security, content filtering, and send-to-anyone capability. Its e-prescribing service provides point-of-care access and transmission of patient and payor data that improves patient care, reduces costs, and improves efficiency. For more information, visit www.zixcorp.com.

New Congress, Same IT Issues

2007-01-08T10:47:00.000-07:00

New Congress, Same I.T. Issues
By Joseph Goedert
(January 2007) With the 110th Congress starting work this month will come a renewed push to get health care information technology legislation through the House and Senate.
Many of the existing I.T. advocates in the two chambers remain, but the power centers have switched with Democrats now in charge.
For instance, Rep. Pete Stark (D-Calif.) will chair the House Ways and Means health subcommittee. Stark has been an ally of the health I.T. industry but not supportive of proposals to broaden the Department of Health and Human Services' rules to permit the donation of I.T. to physicians,
Donald Asmonga, director of government relations at the American Health Information Management Association in Chicago, expects Stark and other Democrats to push for deadlines for implementation of interoperable electronic medical records software, more aggressive enforcement of privacy protections and funding for that task, and more federal grants and other financial incentives to accelerate I.T. adoption.
But increased I.T. funds aren't guaranteed. Democrats have pledged to pay for new spending with budget cuts elsewhere or increased revenue. "You have to be careful about going down the road giving away money when you have to balance everything," explains Ann Berkey, vice president of public affairs at San Francisco-based McKesson Corp.
Watch for Stark to push to make the Veterans Administration's VistA electronic medical records software available for public use, Asmonga says. He also believes Democrats will attempt to require informed patient consent for the release of health information and continue to oppose a uniform privacy standard that preempts stronger state laws. But he cautions that could change with Democrats' new status on Capitol Hill. "When you get in the majority, it changes your outlook on everything."
Democrats may, however, seek to expand the HIPAA privacy rule to cover personal health records, notes Steve Wojcik, vice president of public policy at the National Business Group on Health in Washington.
Of all the health care legislation before Congress in the last session that will come back again, health I.T. is one of the least affected by which party is in control because it has the most bipartisan support, Wojcik says.
Still not easy
But despite support from the Bush administration and major congressional players from both parties in both houses, I.T. legislation didn't get through last year and won't be a cakewalk in 2007, observers say. "I'm not thinking the dynamics will change that much," Berkey says.
One way to remove an obstacle to passing legislation is to keep out language that would amend the new HHS donation rules and wait a year or two to see how the rules work out. "I don't think there will be an appetite to change what HHS has done so far," says Hugh Zettel, director of government and industry relations of the Integrated IT Solutions division at GE Healthcare, Waukesha, Wis.
If the rules are changed, Zettel believes there may be efforts to wave the required 15% physician payment for the value of donated technology if physicians participate in a health information exchange.
Another major sticking point in 2006 legislation-mandated implementation of the ICD-10 code set-won't be going away this year.
The House-passed bill in 2006 included language to mandate ICD-10 by October 2010 and the Senate-passed bill did not address the issue.
However, many physician and payer organizations are pushing for implementation by October 2012, and their influence, particularly the Blue Cross and Blue Shield Association, remains strong. "The Blues won't lose clout because they're so darn big," Asmonga says.
Observers say there will be plenty of members of both parties and in both chambers that likely will take leadership roles in pushing health I.T.
In the Senate, watch for Thomas Carper (D-Del.) to introduce legislation to offer personal health records to all federal employees, and for Sam Brownback (R-Kan.) to push for creation of independent health records banks.
Other Senate I.T. players likely will include Hillary Clinton (D-N.Y.); health committee leaders Edward Kennedy (D-Mass.) and Michael Enzi (R-Wyo.); and finance committee leaders Max Baucus (D-Mont.) and Chuck Grassley (R-Iowa).
House members expected to play roles include Stark, Patrick Kennedy (D-R.I.), Tim Murphy (R-Pa.), John Dingell (D-Mich.), Henry Waxman (D-Calif.), Frank Pallone (D-N.J.) and Jim McCrery (R-La.).

HIT movers and shakers in 2007

2007-01-04T10:49:00.000-07:00

Industry leaders identify movers and shakers to watch in 2007
By Bernie Monegain, Editor
01/03/07
Since President Bush mentioned the electronic medical record in his 2004 State of the Union Address, the concept of automating healthcare has become part of everyday talk. A concept that may have seemed abstract to many just three years ago seems complex, but doable today.
It won’t be that simple or quick, of course, to transform a behemoth into a smart, new machine, industry insiders say. But, there are plenty of movers and shakers doing their part.
Healthcare IT News asked a few of these leaders to identify who – besides themselves – would likely influence healthcare IT initiatives in 2007. Who is worth watching?
Some familiar names – and initiatives – emerged.
William F. Jessee, MD, president and CEO of the Medical Group Management Association, predicts there will be a flock of players in the personal health records space. He mentioned the recent launch of Dossia by a coalition of employers led by Intel, followed by a similar announcement from America’s Health Insurance Plans and the Blue Cross Blue Shield Association. Jessee expects ICW, a German company, to make a splash in the U.S. market in 2007 with its LifeSensor PHR, a product he says is already well proven in Europe.
“What is new in all this,” said Jessee, “is the idea of encouraging consumers to create their own PHR as a ‘pull-through’ strategy to get more physicians to use EHRs that can interface with those PHRs. Unfortunately, Dossia is more of a concept than a product at this point, but it demonstrates the kind of large corporate investments that I think we are likely to see more of in 2007.”
Concept or product, the prospect of Dossia was enough to put Intel Chairman Craig Barrett on Jeffrey Hill’s list of potentially top influencers for 2007. Hill is CEO of Anceta, a subsidiary of the American Medical Group Association. Hill admires Barrett for taking the lead on personal health records.
“He’s not going to sit and wait until it all gets fixed,” he said.
The AMGA itself is not sitting still, having charged Anceta with gathering data from its membership of more than 300 large multi-specialty groups for comparison and analysis.
Hill credits Donald W. Fisher, AMGA president and CEO, with the vision to get the comparative data project launched and for creating a direction for other critical initiatives, such as CAPP, the Council of Accountable Physician Practices, which promotes a model of care focused on performance, efficiency, use of electronic clinical systems and results-based reimbursement.
“He’s the one who is tying all these things together,” Hill said,
Hill expects continued accomplishments on the healthcare IT front from Janet Marchibroda, CEO of eHealth Initiative. Marchibroda has been brilliant at pulling together all the different factions that – together – can transform healthcare, he said.
Francois de Brantes, from GE who, as head of Bridges to Excellence, has dedicated himself to effecting change, is on Hill's movers and shakers list, too. de Brantes is developing a model of pay for performance and “trying to get his hands on data in the real world,” Hill said.
Donald Mon, vice president of practice leadership at the American Health Information Management Association will be watching who fills top positions at JCAHO (the Joint Commission on Accreditation of Healthcare Organizations) and Health Level 7, a standards development organization.
Mon is also keeping his eye on Robert Kolodner, MD, the nation’s interim healthcare IT chief. If he stays in the position, he could have broad influence.
Carolyn Clancy is director of the government’s American Healthcare Research and Quality. It will be interesting to see how she leads the AHIC (American Health Information Community) quality work group, Mon said, and what AHRQ does to advance quality reporting across the country.
Mark Leavitt, MD, chairman of the Certification Commission on Healthcare Information Technology, is another leader expected to accomplish great things, Mon indicated. He noted that Leavitt has deftly handled the process of certifying ambulatory EHRs. Now Leavitt faces new challenges as the commission begins certifying network components and specialty areas.
On the project front, Jessee of the MGMA predicts that hospitals are finally about to turn the corner on their IT investments. “Many of them have been in the selection/development mode, and more are going to transition into an operational mode in 2007,” he said. “So the stars will be those organizations and vendors that have done a good job of preparing to throw the switch – and the horror stories will be those that haven’t.
“The number of stories – both successes and failures – will really take an upswing in 2007 as more and more systems come online.”

Hawaii Blues to Docs: We'll Help With EMRs

2007-01-03T10:08:00.000-07:00

Hawaii Blues to Docs: We'll Help with EMRs
By Joseph Goedert
A $50 million program from the Hawaii Medical Service Association, under which the Blues plan would give providers substantial financial help to purchase electronic medical records systems, could wire up most physicians in the state.
"I think it will come close to covering the whole market," says Patrick Kennedy, president at PJ Consulting, a Rockville, Md.-based consulting firm serving payers. "Fifty million will go a long way out there."
Honolulu-based HSMA also thinks the program will foster the longer-term goal of establishing regional health information organizations. "We're making this investment to move the community along to wider adoption of I.T. so we can be ready for RHIO activity," says Cliff Cisco, senior vice president. "There's a lot of RHIO talk, but we're a ways off from implementing a network. We want to prepare for that and give motivation."
Under the three-year HMSA Initiative for Innovation and Quality, the plan has committed $20 million to the purchase of EMRs for physician practices. It will contribute up to half the cost of an EMR, capped at $20,000 per physician, for about 1,000 physicians.
The remaining $30 million of the funding, to be given out over three years, is available to state hospitals in Hawaii to finance proposed projects-that could include use of information technologies-to improve patient care and outcomes. Cisco believes a "significant" amount of funds under the hospital program will go toward I.T., but the overall goal is to reduce practice variances and improve safety. Details of the program remain under development. "We've made the commitment and now are talking to hospitals," he adds.
Getting the docs
Hawaii has about 2,200 practicing physicians. About half are closely affiliated with urban hospitals, and many of their practices are using some clinical software.
The program to help pay for EMRs is open to any physician who doesn't have EMR software. But the focus will be on small and rural practices where adoption rates are low. HMSA hopes it will get most of these practices to take up its offer, Cisco says. "This is an effort to bring on slower adopters of the technology."
The Blues plan this fall was developing criteria for EMRs purchased with its financial assistance. "They'd have to be known systems with wide adoption rates," Cisco says. "We're not going to pay $20,000 for a system someone's nephew built in his garage."
The EMRs also will have to be certified by the Certification Commission for Healthcare Information Technology. HMSA expected to have a list of acceptable EMRs available by the end of 2006.
Heavy penetration of EMRs in Hawaii could support more comprehensive pay-for-performance programs. HMSA for five years has had a pay-for-performance program that gives physicians and hospitals "modest" payments for meeting certain quality standards, Cisco says. The new initiative is much larger than existing P4P programs, he notes. "Our board thought we'd ramp this up a bit, put out this $50 million commitment and see what it achieved."
Joining the fray
Several other Blues plans-particularly Highmark Inc. in Pennsylvania, CareFirst in Maryland, and Blue Cross and Blue Shield of Massachusetts-have launched significant initiatives to help defray physician costs for EMRs.
HMSA has an advantage, however, because the Blues plan controls 80% of the private insurance market in Hawaii, says Kennedy, the consultant. That's about three times the market share of most Blues plans.
Consequently, other Blues can't expect to get the same type of return on investment that HMSA should get, he adds.
Nor can other commercial insurers expect the same ROI, even large ones like Aetna Inc., Cigna Corp. and UnitedHealth Group. Despite their size, these national payers don't have a dominant market share in most of their regions, Kennedy says.
But many commercial insurers are talking with Blues plans about cooperating in regional I.T. incentive strategies, he notes.
Payers, however, are not yet convinced that state laws-and the recently changed federal rules governing the Stark Act and anti-kickback laws-are clear enough to allow the insurers to work together, Kennedy adds. "They're not sure they can do this without getting their hands slapped."

Improving Health Care Access: Grantmakers Share Their Experiences

2007-01-02T14:19:00.000-07:00

Improving Health Care Access: Grantmakers Share Their Experiences

This report is a collection of profiles that tells the stories of how health funders across the country are working to improve access to health care. With these profiles, we have attempted to capture the priorities, funding strategies, accomplishments, and challenges of a cross section of grantmakers, giving readers a place to look for insights that they can adapt to their own circumstances.

The report profiles the work of 11 foundations: Blue Cross Blue Shield of Massachusetts Foundation, The California Endowment, The Health Foundation of Greater Cincinnati, Robert Wood Johnson Foundation, The Henry J. Kaiser Family Foundation, W.K. Kellogg Foundation, Maine Health Access Foundation, Quantum Foundation (West Palm Beach, Florida), The Rhode Island Foundation, Rose Community Foundation (Denver, Colorado), and Universal Health Care Foundation of Connecticut.

Related Information

	Improving Access to Health Care (1386K) [download]
	Improving Access Executive Summary (77K) [download]

Ahead for 2007: Open-source software for RHIOs?

2007-01-02T13:35:00.000-07:00

BY Nancy Ferris

Related Links

The California HealthCare Foundation is considering turning the software developed for the Santa Barbara County Care Data Exchange into an open-source software product that other regional health information organizations (RHIOs) could use.

Foundation officials revealed their tentative plan at a Washington, D.C., forum where people from many organizations discussed the potential of open-source software for health information exchanges. A Forrester Research executive said at the forum that the use of open-source software could result in a 20 percent increase in nationwide RHIO expansion by 2014.

Forrester Vice President Eric Brown said open-source software would not solve all the problems that RHIOs are encountering as they try to establish information exchanges. But he said a survey Forrester undertook for the foundation suggested that if open-source systems were available, 60 percent of the country might have access to a RHIO by 2014, compared with 48 percent without open-source software.

President Bush set 2014 as a target for all Americans to have e-health records. Health care providers could share those records via RHIOs.

In Santa Barbara, the foundation and other organizations spent nearly $20 million on the software that underlies one of the country’s first RHIOs. To increase the return on that investment, the foundation might submit the software to a consortium or other nonprofit that could license it to other users, said Sam Karp, the foundation’s vice president of programs. As a result, RHIOs could acquire less expensive software and easily modify or enhance the system to meet their needs, forum speakers said.

The Forrester study suggested that the software from Santa Barbara could be converted to an open-source product for about $695,000. Even if less than 10 percent of RHIOs used it, Brown said, its existence in the marketplace would influence other software vendors, holding prices down and tending to make products more open and standards-compliant, he said.

Lori Hack, director of government relations and policy at California RHIO, endorsed open-source software for health information exchanges.

“We have to find a sustainable model,” she said, “and what’s out there today just isn’t working.”

With open-source software, users can see the source code and modify it to meet their needs. They are expected to share enhancements with other users. As is the case with the open-source Linux operating system, for-profit companies can make money on open-source software by providing custom implementations and support.

About 75 people attended the forum, and many expressed interest in joining an open-source community for clinical systems. The foundation will hold a similar meeting in California this week.

Tradeshows and Speaking Engagements

2007-01-02T13:18:00.000-07:00

IHE Connectathon & Educational Conference
January 15-19, 2007
Hyatt Regency, Chicago, IL

Building Community Health Information Exchange
January 26-27, 2007
Hilton Garden Inn, Bloomington, Indiana
Speakers: Keith Hepp, CFO, HealthBridge
Alan Snell, M.D., CEO of Michiana Health Information Network

2007 EHR & E-Prescribing Summit
January 29-31, 2007
Hyatt Regency Orange County, Anaheim, CA
Speaker: Robert Keet, MD

HIMSS RHIO/ HIE Symposium
Sunday, February 25, 2007
Ernest N. Morial Convention Center, New Orleans, LA
Sponsor

2007 Annual HIMSS Conference and Exhibition
Sunday-Thursday, February 25-March 1, 2007
Ernest N. Morial Convention Center, New Orleans, LA
Booth #5127
Real RHIO's Achieving Real Results, 2/27/2007 from 3:15 - 4:00 PM
Speakers: Keith Hepp, CFO, HealthBridge, Cincinnati and Robert Keet, MD, President, Western Medical Associates, Santa Cruz

4th Annual Health Information Technology Policy Summit / 14th HIPAA Summit
March 28-30, 2007
Hyatt Regency on Capitol Hill
Washington, DC

Illinois and Missouri Health Information Management Association
Wednesday - Friday, April 18-20, 2007
Saint Charles Convention Center, St. Charles, Missouri

Connecting Communities Regional Forum
May 3, 2007
Rosen Shingle Creek, Orlando, FL
Sponsor

Connecting Communities Regional Forum
May 10, 2007
Boston, MA
Sponsor

Michigan Health Information Management Association
Monday-Wednesday, May 21-23, 2007
Kalamazoo, MI

Florida Health Information Association Convention and Exhibit
Monday-Thursday, July 25-28, 2007
Rosen Shingle Creek Resort, Orlando, Florida

California Health Information Association Convention and Exhibit
Sunday - Wednesday, June 10-13, 2007
La Quinta Resort & Club in La Quinta, California
Booth 29

Group prescribes changes

2007-01-02T13:13:00.000-07:00


	Posted on Tue, Jan. 02, 2007

	Group prescribes changes By Cheryl Powell Beacon Journal medical writer The days of walking out of the doctor's office with a prescription in hand could be numbered. Rather than handing over a prescription scrawled on a piece of paper, doctors are starting to send their medication orders over secure computer connections directly to the pharmacy of the patient's choice. Electronic prescribing -- known as ``e-prescribing'' for short -- is being heralded as a way to cut down on medication errors while reducing costs and improving patient compliance with their doctor's orders. In fact, the National Institute of Medicine recently issued a recommendation that all prescriptions be written electronically by 2010 to help cut down on medication errors. This month, a group representing many of the region's largest employers is launching a program to encourage more doctors in the Akron-Canton area to adopt e-prescribing. The Employers Health Purchasing Corp. of Ohio wants to find 25 area doctors who are willing to be the first physicians in the region to use an e-prescribing tool called ``iScribe.'' The Canton-based group is made up of area employers that pay medical bills for their employees. Participating businesses -- including FirstEnergy, Diebold, the cities of Akron and Canton, Summit County, numerous school districts and others -- employ about 430,000 people. The employer group is offering the program in partnership with Caremark Rx Inc., the Nashville-based company that manages the employee pharmacy benefits for the coalition's member companies. The Canton-based group and Caremark will share the cost -- estimated at $8,000 per participating doctor -- to provide training and purchase the software, personal digital assistants and other hardware needed for iScribe. Doctors won't face any out-of-pocket costs to participate, said Christopher Goff, president and chief executive of Employers Health Purchasing. The goal is to have the system operational in the region by the end of June, he said. ``We feel it will bring a lot of convenience to our employers' employees, retirees and dependents,'' Goff said. Records computerized Caremark's iScribe program gives doctors computerized access to their patients' medication history, allergies and potential drug interactions, said Dr. Jan Berger, senior vice president and chief clinical officer with Caremark. ``We see this first and foremost as a patient safety issue,'' Goff said. Doctors also can get access to more than 4,000 formularies. Those are lists indicating which prescription drugs insurance companies will cover, as well as which medicines carry higher co-payments for patients. Armed with that information, Goff said, doctors hopefully will be more likely to order generic medicines and preferred brand-name drugs that cost the patients -- and their employers -- substantially less money. ``We think it will have a positive financial impact to employees, dependents and retirees in that if a physician writes a brand script and a generic equivalent or substitute is available, the system should prompt the physician to write that alternative,'' Goff said. ``... It will also generate that consumer discussion about what more cost-effective options are available.'' Indeed, there is some evidence that e-prescribing can drive down drug costs. Costs could drop Preliminary results from a study of four Dayton doctors who used e-prescribing found those physicians were more likely to order generics or cheaper brand-name drugs, said Marc Sweeney, past president of the Ohio Pharmacists Association and chair of pharmacy practice at the University of Findlay School of Pharmacy. ``It definitely changed prescribing patterns,'' Sweeney said. Another study by Caremark found that doctors who used the iScribe system were three times more likely to prescribe a generic treatment for an acid-related gastrointestinal problem. Practice already here A few practices throughout Northeast Ohio already have adopted e-prescribing. Last year, for example, physicians at the Cleveland Clinic wrote almost 3 million prescriptions electronically from computers in their examining rooms, according to Dr. C. Martin Harris, chief information officer. The e-prescribing tool is part of an extensive electronic medical record system the Clinic has installed to provide computerized access to personal health information for doctors and their patients. Cleveland Clinic patients who sign up for online access to their medical records can use the computer system to send medication refill requests directly to their doctor rather than having to call the office or come in for a visit, Harris said. ``It really had a dramatic impact on phone calls,'' he said. ``What it's done is allowed the telephone calls that are really needed to get through.'' Doctors at Falls Family Practice in Cuyahoga Falls also launched e-prescribing as part of a $750,000 investment in electronic medical records. ``You get legible writing, clear concise instructions and checks for drug interactions,'' said Dr. Hugh McLaughlin, a family physician with the practice who's been using e-prescribing for eight months. ``It's foolproof.'' Not necessarily, Sweeney said. Doctors still can point and click to the wrong drug or dose, creating ``a nice, legible error.'' Getting doctors to abandon their pen and prescription pad can be challenging. Initially, Sweeney said, some doctors find it more time-consuming to switch to e-prescribing. ``One of the challenges is getting physicians to adopt it,'' he said. ``The reality is, in a time-pressured environment, there's nothing faster than just writing it down on a piece of paper. ``However,'' he added, ``once they're up and running, the nice thing is that it ultimately will save time because they don't have to re-enter information.'' Cheryl Powell can be reached at 330-996-3902 or chpowell@thebeaconjournal.com.

Expanding the reach and Impact of Consumer E- Health Tools

2006-11-29T07:46:00.000-07:00

Expanding the Reach and Impact of Consumer E-HEALTH TOOLS (HHS, June 2006)
Report (230 p.)

http://www.health.gov/communication/ehealth/ehealthTools/pdf/ehealthreport.pdf

Summary & related documents:
http://www.health.gov/communication/ehealth/ehealthTools/default.htm This report summarizes a study undertaken by the Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services, on the potential utility and value of consumer e-health tools for populations that experience health disparities.

National Office for Health IT Awards State E-Health Alliance Contract

2006-10-19T10:05:00.000-07:00

National Office for Health IT Awards State E-Health Alliance Contract

October 19, 2006

The Office of the National Coordinator for Health IT has awarded a contract to the National Governor's Association to form a State E-Health Alliance in 2007, reports.

NGA's Center for Best Practices will develop a steering panel composed of governors and state legislators working to form health information networks, according to Jodi Daniel, director of ONCHIT's Office of Policy and Research.

Daniel said that three task forces will work on issues, including:

Health information exchanges;
Licenses and other legal issues;
Privacy; and
Security.

The one-year contract, which is the third awarded by ONCHIT to promote health IT at state and regional levels, is worth nearly $2 million, according to ONCHIT spokesperson Nancy Szemraj (Ferris, Government Health IT, 10/18).

Cost called largest obstacle for EMR adoption

2006-10-19T09:41:00.000-07:00

DENVER – The price tag remains the single most significant barrier to electronic medical record system adoption by physicians today, two leaders of prominent physician organizations said Tuesday.

William F. Jessee, MD, president and CEO of the Medical Group Management Association, and Douglas Henley, MD, executive vice president of the American Academy of Family Physicians, were part of a panel speaking to the members of the American Health Information Management Association at their annual meeting here

With doctors facing an average 5 percent cut in Medicare reimbursement in 2007, the $32,600 estimated cost per physician to adopt an EMR, plus additional annual costs for maintenance, is off-putting, said Jessee. It’s not that physicians are “technological Luddites,” he said.

Jessee noted that vendors’ quoted prices typically run 20 percent higher than estimated. A hard-to-perceive ROI - or return on investment, an almost certain change in workflow, and a still fragmented market add to the resistance, he said.

Henley’s remarks closely mirrored Jessee’s. The AAFP, which has more than 50,000 members, had a goal of having 50 percent of its members adopt electronic medical record systems by 2005. It achieved 30 percent adoption.

“We are now focused on the next 30 percent,” Henley said. “Half of them say they are ready to write the check in the next 12 months”

A recent MGMA study estimated that 75 percent of medical practices are paper-based. Fourteen percent have what Jessee called a true electronic record with a relational database. The rest employ a combination of paper and automation in their offices,

Both organizations are working to boost IT adoption rate among their members, and despite the stated roadblocks, they offered reasons for optimism.

“Forces are converging to accelerate change,” said Jessee, who pointed to federal initiatives from Congress (both parties), the Centers for Medicare and Medicaid; the Office of the National Health Information Coordinator; and the American Health Information Community.

Jessee also mentioned certification of products by the Certification Commission for Healthcare Information Technology as helping to reassure physicians regarding the functionality of products on the market today.

Among Jessee’s laundry list of pros for EMR adoption:
- Safety improves
- Workflow improves
- Productivity improves (after about six months)
- Charge capture improves
- Transcription costs go down
- Records are easily accessed (not so likely to be in the trunk of a physician’s car)
- Rx management is streamlined
- Patient satisfaction is enhanced

Jessee and Henley agreed that insurers could encourage physicians to adopt electronic medical records by creating incentives for those groups that do “take the plunge.”

“We’ve got to adopt health information technology, and get on with it,” Henley said.

Drug Reactions Send 700,000 Yearly to ER

2006-10-19T09:35:00.000-07:00

By LINDSEY TANNER

The Associated Press
Tuesday, October 17, 2006; 7:00 PM

CHICAGO -- Harmful reactions to some of the most widely used medicines _ from insulin to a common antibiotic _ sent more than 700,000 Americans to emergency rooms each year, landmark government research shows.

Accidental overdoses and allergic reactions to prescription drugs were the most frequent cause of serious illnesses, according to the study, the first to reveal the nationwide scope of the problem. People over 65 faced the greatest risks.

"This is an important study because it reinforces the really substantial risks that there are in everyday use of drugs," said patient safety specialist Bruce Lambert, a professor at the University of Illinois at Chicago's college of pharmacy.

Even so, the study authors and other experts agreed that the 700,000 estimate was conservative because bad drug reactions are likely often misdiagnosed.

The study found that a small group of pharmaceutical warhorses were most commonly implicated, including insulin for diabetes; warfarin for clotting problems; and amoxicillin, a penicillin-like antibiotic used for all kinds of infections.

"These are old drugs which are known to be extremely effective. We could not and would not want to live without them. But you've got to get the dose exactly right. Variations, especially on the high side, are really dangerous," Lambert said. He was not involved in the research.

Those aged 65 and older faced more than double the risk of requiring emergency room treatment and were nearly seven times more likely to be admitted to the hospital than younger patients.

The results, from 2004-05, represent the first two years of data from a national surveillance project on outpatient drug safety. The project was developed by the federal Centers for Disease Control and Prevention, the Food and Drug Administration and the U.S. Consumer Product Safety Commission. The study was published in Wednesday's Journal of the American Medical Association.

The database included 63 nationally representative hospitals that reported 21,298 bad drug reactions among U.S. adults and children treated in emergency rooms during the two-year period. The tally is based on what emergency room doctors said were complications from using prescription drugs, over-the-counter medicines, dietary supplements or herbal treatments.

The researchers said it translates to 701,547 complications nationwide each year.

"Experts had thought that severe outpatient drug events were common, but no one really had good numbers" until now, said lead author Dr. Daniel Budnitz, a CDC researcher.

Complications included diabetics on insulin passing out from low-blood sugar, excessive bleeding in patients on warfarin, and severe skin rashes in patients taking amoxicillin. Drug reactions were severe enough to require hospitalization in about 17 percent of patients. The study did not include information on whether any of the reactions were fatal.

"The numbers are quite troubling," said Jim Conway, senior vice president at the Institute for Healthcare Improvement. The tally underscores that "there is a tremendous number of consumers in the United States taking medication."

The CDC has estimated that about 130 million Americans use prescribed medication every month. U.S. consumers buy far more medicine per person than anywhere else in the world.

Yet a recent study found that doctors' conversations with patients when prescribing new drugs aren't very thorough and that side effects often aren't mentioned. Many of the drugs implicated in the new study require frequent physician monitoring to make sure the dose is correct.

The new findings highlight the need for better doctor-patient communication about use of medicines, Conway said.

The number likely underestimates the number of people who have bad drug reactions outside a hospital setting because many don't get ER treatment, while others who do may have symptoms that are mistakenly attributed to something else, said patient safety expert Dr. David Bates, a professor at Harvard Medical School.

Still, Bates called the effort a significant contribution since previous reports on the problem have not been national in scope.

Developing a national HIT network

2006-10-19T09:26:00.000-07:00

WASHINGTON – The marketplace is still defining PHRs and whether they should include claims data, National healthcare IT interim chief Robert Kolodner, MD, told an audience at the 2nd Nationwide Health Information Network Forum held earlier this week in the nation's capital. Kolodner and John Loonsk, director of the Office of Interoperability and Standards, responded Monday to several questions from some of the hundreds of stakeholders at the forum.

Patient health records
Question: Are there any plans to establish small portions of patient health records as an initial effort?
Kolodner: Yes. There are plans to develop an “e-clipboard” where patients can electronically record the basic information usually collected in the waiting room at a first visit with a doctor. A second idea is to create a way for patients to access a simple list of their prescriptions.

Volunteer burnout
Question: What does HHS plan to do about the limited pool of private entities available to build the National Health Information Network? (Glen Marshall, standards and regulations manager, Siemens Medical Solutions)
Loonsk: Volunteer burnout is a concern and one possible solution could be to bring in organizations that can participate on a smaller scale.

Property rights for PHRs and EHRs
Question: Who has property rights over PHRs and EHRs?
Loonsk: This is a complicated issue that should be addressed by states, with federal support.

PHRs vs. EHRs
Question: How do you differentiate between electronic health records and patient health records? Also, will PHRs include patient claims data, and is that needed in both PHRs and EHRs? (Ann Will, vice president, CGI Federal)
Kolodner: The marketplace is still defining PHRs and whether they should include claims data. For now, the development of EHRs–the electronic record of a patient’s healthcare to be exchanged through IT networks–takes higher priority than personal records retained by patients themselves.

International data exchange
Question: Are there plans for including international data exchange in a federal healthcare IT network? (Amy Verstappen, Adult Congenital Heart Association)
Loonsk: There have been a number of discussions over the issues, concerns and approaches for international data exchange. There is a desire to exchange data between nations.

Creating networks
Question: Standards for the financial world were not sufficient enough to create a network; how will this be addressed in developing a successful healthcare information network? (an Environmental Protection Agency representative)
Loonsk: There has been a lot of discussion about interoperability, and constraint testing will be an important part of it. There is tension between what can actually be adopted and the broader vision. “Because of the complexity, we might have to settle for less [than the broader vision].”

State AHICs
Question: What states will participate in ONC’s upcoming plans to launch several state versions of the American Health Information Community? (Donald Mon, American Health Information Management Association)
Kolodner: That information is not readily available because the project is in the initial stages.

Are We Close to Real Data Integration

2006-10-09T21:44:00.000-07:00

Are We Close to Real Data Integration 'Redefining Healthcare'?
By Matthew Holt

Michael Porter and Elizabeth Teisberg in their book Redefining Healthcare tout the concept of hospitals competing over excellence in treating specific medical conditions nationally. The Cleveland Clinic, among others, is marketing its online second opinion service. Technology vendors such as Sun ("services-oriented architecture"), Cisco ("application-oriented networks"), and Microsoft -- which just acquired interface technology company Azyxxi -- are all narrowing in on the problem of information exchange between existing clinical and operational systems. The PACS market is growing fast, and the amount spent on medical imaging is growing faster. Meanwhile, physician shortages in rural areas mean that hospitals are outsourcing radiology to larger regional, national, and even international players.

This all sounds like the perfect environment to share information regionally. There's just one tiny problem. The average CIO is already minding more than a hundred interfaces between systems, and the concept of having to extend that management beyond the bounds of the institution is frightening -- and a major stumbling block in front of the RHIOs.

What's needed is an easy way of extracting and exchanging clinical data in its context. Companies such as TeraMedica and Philips (via its acquisition of Stentor) are all working with brand-name clients to achieve this, but some of the boldest claims being made come from a small company called CMTC. CEO Shimon Schurr says, "The concepts that RHIOs are in policy discussions about for the future, our technology can do today." For example, CMTC can take clinical data from a variety of system, allow it to be put on a secure Web site and have it uploaded into a completely different system (e.g., PACS and EMR), including keeping the surrounding workflow information and patient context. Adding videoconferencing and this creates an online workspace for consults.

Schurr says that at the core of CMTC's .NET-based technology is a concept called Semantic Interoperability, which essentially allows data to be automatically normalized and exchanged between systems. Thus far, it's been used for remote consultation between New York Presbyterian Hospital and medical centers in Turkey and Israel. In conjunction with Kodak and Accenture, University of Virginia Medical Center will soon start testing the system with community oncologists and regional hospitals.

If the Porter/Teisberg concept is to succeed, for technology to bring the expertise of centers of excellence virtually to patients in any setting requires an easy, secure method of combining patient records, workflow information, images, and conferencing technologies online. Then remote physicians or teams of clinicians can view it at one time (or asynchronously) without new interfaces or expensive infrastructure. The promise is a real "dislocation" of the workflow for how diagnoses are currently managed. Possibly using technology like CMTC's, that promise could become reality sooner rather than in some pie-in-the-sky futures.

Rural Assistance Center Announces New State Information Resource

2006-08-15T12:53:00.000-07:00

Rural Assistance Center Announces New State Information Resource

Aug 15, 2006

GRAND FORKS, N.D. -- The Rural Assistance Center (RAC), a national resource for rural health and human services information, has launched State Resources on its Web site allowing easy access to continuously updated demographics and statistics, documents and resources, contacts and success stories for all 50 states.

“People using our services are often looking for state-level contacts, resources or information that can help them to maintain and improve services in their local communities,” said Kristine Sande, RAC’s director. “The new part of the RAC Web site has been developed in response to these information needs.”

The new State Recourses, located at http://www.raconline.org/states, feature an overview of each state and its rural health and human services environment. In addition, the pages include:

State-level contacts and organizations relevant to rural health and human services;
Tools, such as web sites with demographic and statistical information for the state;
Possible funding sources for rural health and human service projects;
Documents, articles and journals written about the state;
Success stories from the state that can serve as model projects in rural communities; and
News and upcoming events from the rural community.

“The new State Resources help rural communities find information and resources that can assist them in important activities such as locating and competing for funding opportunities and networking within their state,” said Sande. “We are working with state-level partners, such as the State Offices of Rural Health, to ensure that these pages remain current and feature the best information available for each state.”

“In small towns, health care providers and human services representatives juggle many responsibilities,” explained Mary Wakefield, director of the Center for Rural Health which houses the Rural Assistance Center. “The federally-funded Rural Assistance Center’s State Resources is a one stop shop to help these individuals quickly find local resources and information. It’s about helping them to do their jobs more efficiently and serve their rural communities even better.”

About RAC
The Rural Assistance Center (RAC) serves as a rural health and human services information portal which helps rural communities access the full range of available programs, funding, and research that can enable them to provide quality health and human services. RAC is a collaboration of the University of North Dakota Center for Rural Health and the Rural Policy Research Institute (RUPRI). It is funded through HRSA's Office of Rural Health Policy.

Since its launch in December 2002, RAC’s web site has received over 680,000 visits, with over 335,000 of those visits coming in the last year. In addition, RAC has responded to nearly 3,600 customized assistance requests from people in all 50 states, Puerto Rico, and several foreign countries.

RAC's other web-based services, available at www.raconline.org, include an online clearinghouse of news, documents, maps, and success stories; a calendar of events; a directory of rural contacts and organizations; and a searchable database of funding opportunities. Also available on the web site are Information Guides, which provide in-depth information focusing on rural aspects of an issue or topic. RAC’s electronic updates on rural health and human services keep subscribers abreast of new happenings and resources available. RAC also provides free customized assistance on topics related to rural health or human services. Contact RAC at 1-800-270-1898 or info@raconline.org to request customized assistance from RAC's information specialists.

Legislative jam-up

2006-08-15T09:44:00.000-07:00

More than 50 bills related to health information technology and personal medical records were introduced during the 109th Congress, but it now looks as if only one piece of legislation — the result of two still-evolving companion bills in the House and Senate — stands any chance of becoming law, according to health IT industry observers.

With the session winding down even as midterm election battles heat up, many advocacy groups are wondering whether lawmakers have the political commitment and goodwill to push any health IT legislation through this year, especially after a partisan divide unexpectedly flared up in early June over the issues of privacy and funding.

“People are getting awful nervous at this point,” said Dave Roberts, vice president of government relations at the Healthcare Information and Management Systems Society (HIMSS).

The legislation with the most potential involves two bills: The Wired for Health Care Quality Act (S. 1418), sponsored by Sens. Hillary Rodham Clinton (D-N.Y.) and Bill Frist (R-Tenn.) and passed by the Senate in November 2005; and the Health IT Promotion Act of 2006 (H.R. 4157), sponsored by Reps. Nancy Johnson (R-Conn.) and Nathan Deal (R-Ga.), which House leaders are still working to get to the floor for a vote.

Both bills would begin the process of setting national standards for medical records storage and interoperability and codify the Office of the National Coordinator for Health IT within the Department of Health and Human Services.

However, the bills also have their differences. H.R. 4157 directs the secretary of HHS to recommend to Congress a single privacy standard that consolidates existing state and federal privacy laws, while S. 1418 defers to the confidentiality requirements laid out in the Health Insurance Portability and Accountability Act (HIPAA).

The Senate also provides some public funding, while the House does not. And Johnson’s bill would create exceptions to conflict-of-interest laws that prohibit health entities from sharing technology with physicians. The Senate bill does not address the issue.

Most health IT advocates believe that compromises would be easy to agree on in a conference committee and that the bill could pass both houses. “If members are really committed to getting this thing done, it is doable,” said Bruce Fried, a partner and co-chairman of the Health Care Group at Sonnenschein Nath & Rosenthal.

Election-year roadblocks
However, that commitment came into question in June, when several political hurdles popped up that could eventually kill any legislation this year, according to Scott Wallace, president of the National Alliance for Health IT.

First, Johnson’s bill was marked up by the House Ways and Means and Energy and Commerce committees. Not surprisingly, the two panels ended up with different versions of the bill. What surprised analysts was that votes came down completely along party lines, even though health IT has so far been largely a nonpartisan issue.

Questions over privacy and funding caused the gap. “Overall, we think it’s more an issue of general political climate raining down on health care IT rather than a fundamental change in attitude toward health care IT,” Wallace said.

Despite the political coloring of the bills, most analysts believed lawmakers could work out their differences in a June conference. But legislators and health IT advocates alike were taken by surprise when the Congressional Budget Office weighed in and projected that the bill would increase federal spending and decrease revenues.

“The CBO really threw sand in the gears,” Fried said. “It’s unclear at this point whether anything will go forward.”

At first it seemed as if Republicans would do whatever it took to push a health IT bill through so they could campaign on an accomplishment to which most constituents can relate. But health IT advocates said that the issue of patient privacy is becoming a larger concern among conservatives, who are now trying to stall the legislation.

“We’ve definitely noticed a real shift in people’s attitudes toward health technology on the Hill,” Roberts said. “People have been hearing a lot of things regarding possible abuses and issues with health records, and they’ve gotten very concerned and taken those concerns to Capitol Hill.”

Privacy advocates pleased
Privacy advocates were more than happy with the development.

“We think that the privacy issue is causing consternation on this whole health IT push, and we think that’s exactly correct,” said Dr. Deborah Peel, executive director of the Patient Privacy Rights Foundation.

“It should cause incredible consternation,” she said, “and we’ve heard from key insiders on the Hill who don’t think the legislation is going anywhere this year because privacy has become so controversial.”

Peel and others think that both the Clinton/Frist and Johnson/Deal bills put patient privacy at risk. Peel said she believes the Johnson bill in particular could ultimately dismantle a set of strong state privacy laws.

“We think it’s a bad bill, and while we think that technology can be a wonderful thing for health care, it has to be the right technology with the right protections,” she said. “We’d rather see Congress pass nothing than to pass a bad bill.”

Despite the challenges, health IT advocates still hold out hope that the issues will be resolved and that Congress will pass a bill. But they worry that the legislation could end up getting stripped of any real substance.

“If all they do is pass a bill that codifies the office of the national coordinator, why bother?” Fried asked.

Already, members of the House Ways and Means Committee have deleted a 2009 deadline for health care providers to convert to ICD-10 billing codes.

That version also appropriates no federal money for providers to adopt new health IT tools.

Extra innings
Wallace continues to hope for a bill that sets up a structure for creating national interoperability standards, codifies the office of the national coordinator, provides some funding to rural safety-net organizations to help them close the IT adoption gap, addresses privacy and includes some type of requirement for ICD-10 conversion.

“It’s hard for me to find words that don’t involve baseball analogies and grand slams to describe the magnitude of that kind of success,” Wallace said. “But I still wouldn’t describe it as a silver bullet. We will not have an interconnected health information system by dint of passage of this bill. There are a number of other major issues that still have to be crossed, not the least of which is the confidentiality debate.”

If the Johnson bill is passed, advocates believe it will move through conference with the Senate bill fairly quickly and go to President Bush. Though he hasn’t spoken publicly about any pending health IT measure, Roberts said, the president is likely to sign the bill given the vision for the use of electronic health records for all Americans by 2014, which he laid out in his State of the Union address earlier this year.

If no legislation is passed this year, health IT is likely to be taken up quickly in 2007 regardless of who controls the House and Senate. Health IT watchers say that the issue has such broad bipartisan support that it will move ahead.

Even though the legislative process would have to start all over, health IT advocates think they’ve made progress in the current Congress. “In terms of getting congressional committee staff educated, getting some members educated and beginning to define what the issues are and what some of the challenges are, I think we’re well under way,” Fried said. “So while we’d be starting from square one, we would be starting from an informed advantage.”

An e-prescription for Medicaid

2006-08-14T10:05:00.000-07:00

An e-prescription for Medicaid

Information technology could help save Medicaid, but complexity and a lack of standard practices continue to hobble the program

BY Nancy Ferris
Published on Aug. 14, 2006

Related Links

States are beginning to incorporate clinical information technology into their Medicaid systems, but the nation’s broadest health care program is by no means at the forefront of the movement to digitize medical information.

That’s the consensus of health industry observers, some of whom say the program is missing opportunities. Medicaid could help lead the nation toward a 21st-century health information environment, they say, while making a dent in two major national problems: the high cost of and lack of consistent care for uninsured Americans.

Despite much talk about the potential of electronic health records (EHRs), few examples of their use in Medicaid programs are available for study and even less is known about their impact on costs. And for every advocate who says EHRs will improve the quality of care, there is another who says the states can’t afford the care they provide now.

In a study conducted in late 2005 for the Agency for Healthcare Research and Quality (AHRQ), Avalere Health found that of 101 health information exchanges under way in 35 states, only 19 mentioned Medicaid as a stakeholder. Meanwhile, the University of Massachusetts is conducting another AHRQ-funded investigation into how Medicaid can help advance health IT.

Mike Leavitt, secretary of the Department of Health and Human Services, said he wants to reform Medicaid and the other major federal health insurance program, Medicare, so that they “are viewed as leaders in the collaborative development and use of health information technology, quality measurement and pay for performance.”

But Medicare, which insures about 42.5 million senior citizens, has gained most of the high-level attention at HHS. Medicaid insures about 55 million low-income citizens and is widely viewed as the stepchild of the Centers for Medicare and Medicaid Services (CMS), the HHS agency that operates both programs. In Leavitt’s statement in May outlining the HHS budget for the coming fiscal year for a Senate subcommittee, Medicare got five paragraphs and Medicaid only one.

Even with HHS picking up the most of the tab, escalating Medicaid costs are making headlines in most states. Total expenditures increased 7.6 percent in 2004 after an increase of 6.9 percent in 2003, according to a May report from the Kaiser Commission on Medicaid and the Uninsured. Health care now is the single largest expenditure for state governments, and some could face bankruptcy if such trends continue.

As a result, states and the federal government have been bickering over cost controls, which distracts them from making long-term improvements to the program. But even without the financial difficulties, cooperation on health IT could be difficult because of the split responsibility for Medicaid.

Advocates of more Medicaid leadership on health IT, such as former Speaker of the House Newt Gingrich, say the program is a prime candidate for expanded use of health IT because of the difficulty of coordinating care for low-income individuals. With primary care physicians increasingly in short supply in parts of the nation, Medicaid recipients often turn to hospital emergency rooms, free-standing clinics and other sources of care, especially in emergencies.

They often receive duplicate diagnostic tests and treatments, and providers have difficulty finding out what care they have received elsewhere. “There’s a fair amount of overutilization of services,” said Rick Friedman, director of state systems for CMS’ Medicaid division.

The various providers may also unknowingly prescribe medicines that interact and harm the patient. Having an EHR available to each doctor who sees a patient could improve the quality of care, health IT proponents say.

In addition, Medicaid fraud and abuse are a constant concern among legislators and auditors. “There’s at least 10 percent fraud in Medicaid,” said Sen. Tom Coburn (R-Okla.) at a recent hearing. “That’s $4 billion we don’t have.”

Coburn, who is a physician, added that he would like to see more physicians and providers go to jail for such abuses.

Another common problem involves patients who receive multiple prescriptions for painkillers and other drugs, then abuse or resell the medicines. More comprehensive recordkeeping systems would make it easier to spot such abuses. But policy experts say health IT is not a priority for Medicaid decision-makers for a variety of reasons.

First of all, Medicaid is administered by the states. They split the costs with the federal government according to a complex formula that results in the federal government paying one-half to three-quarters of the costs, depending on the state.

Each state’s program is different, said JoAnn Lamphere, state health policy manager at the Lewin Group, a Virginia consulting firm. However, most states face the same challenges of dealing with strict and arcane Medicaid rules and providing the necessary health services to the low-income people the program serves, Lamphere said.

Bruce Greenstein, vice president of health care at technology company CNSI, said that “on the state side, all too often the technology and the policy leadership are bifurcated” and reside in different government divisions. Some states also operate Medicaid systems separately from their other health programs.

In addition, most states have opted for managed care delivery systems that operate under contract to the governments. That adds another layer of complexity because those governments do not deal directly with some of the doctors and hospitals that might use health IT.

However, because the federal government pays 90 percent of the cost of buying the computer systems that process Medicaid claims, CMS has some leverage when a state applies for funds to upgrade its systems.

CMS is beginning to push the states toward a standards-based, modern IT architecture that can link data from a variety of sources, including Medicaid claims, to provide a more comprehensive picture of each patient’s health. It is called the Medicaid IT Architecture (MITA).

Like the rest of the nation’s health IT infrastructure, MITA is less than 100 percent complete. “It will take a fair amount of time,” maybe a decade, to flesh out the architecture and deploy it nationwide, said Friedman, who is responsible for MITA.

The new architecture provides ways for Medicaid to link up with a larger health IT system and incorporate clinical information, thereby giving providers a holistic view of each patient’s case, Friedman said. Systems will be modular, flexible and responsive to program changes.

Part of Friedman’s vision for MITA includes connecting to regional health information organizations (RHIOs) or other data repositories. He described state Medicaid systems as future nodes on a nationwide health information network.

Medicaid currently relies on an infrastructure in which little interoperability exists among state systems. For example, New York’s system cannot connect with Florida’s, even though a substantial number of people get services in both states. And information from systems supporting other health-related services, such as mental health and substance abuse, is usually not available to those caring for Medicaid patients.

Although some people abuse the system, lack of good information means that even well-intentioned people sometimes get unnecessary tests and treatment, Friedman said. The key to reducing such duplication is to create a complete picture of a patient’s interactions with health care providers and services such as pharmacies, he said. Such a networked clinical architecture would include doctor and nurse interactions with the patient, prescriptions, diagnoses, laboratory test results and medical procedures performed, no matter where the patient received care.

However, Lamphere is not convinced that the states will be eager to participate. Despite the hype about savings and benefits from systems that support better program management, she said, the states might not spend the money needed to provide EHRs for their Medicaid patients.

The return on investment is likely to be slow to materialize, Lamphere said, and states have become wary of the unanticipated costs that seem to pop up every time a new system is built. “The goal is a worthy one,” she said, but “it’s not the highest agenda item for state Medicaid policy.”

Friedman agreed that state Medicaid managers are skeptical about health IT. They are often preoccupied with the crisis du jour, which at midyear was the new federal requirement that Medicaid recipients prove they are U.S. citizens.

Another barrier to Medicaid involvement in health information exchanges is cultural. Program managers have a deep-seated belief that data about their clients must be kept confidential at all times. New York officials have requested a letter from CMS confirming that participation in clinical data exchanges is appropriate and legal.

Despite those barriers, some Medicaid officials are taking a longer-term view. In North Carolina, for example, more than a dozen community groups coordinate care for Medicaid patients. Although they are organizations rather than data networks, they could become the foundation for RHIOs, said Dr. Allen Dobson, assistant secretary for health policy and medical assistance at North Carolina’s Division of Medical Assistance.

One group has developed a Web-based system for managing the care of patients with chronic diseases such as asthma and hypertension and is sharing it with other communities, Dobson said. He envisions similar community-based development of other health IT systems, perhaps with financial support from the state.

“We’ll use Medicaid as a lever to try to get into the communities” and encourage them to build systems that share information for the benefit of the entire population, Dobson said. The whole point of health IT, he added, is to improve people’s health.

The Utah Health Information Network (UHIN) has operated for more than a decade, sharing claims information among doctors, hospitals, insurers such as Medicaid, laboratories, local health departments and other providers. Now the network is adding clinical information to help reduce paperwork and speed the movement of records to providers involved in coordinating patient care. The state’s Medicaid program is a founding member of UHIN.

“Right now, we’re in a transition phase” with several pilot projects under way, said Dr. David Sundwall, executive director of the Utah Department of Health.

Like their federal counterpart, state governments have been reluctant to force doctors to adopt health IT as a condition of receiving Medicaid reimbursements. In some parts of the nation, doctors are reluctant to accept Medicaid patients, and a health IT mandate could cause more of them to drop out of the program.

Yet some kind of mandate might be necessary before patients can benefit from health IT. At a federal Medicaid Commission meeting in July, members discussed recommending a Medicaid EHR mandate in their report, which is due in December.

It’s more likely, however, that policy-makers will opt for some kind of incentive program, such as paying doctors a small sum each time they use health IT in a Medicaid-funded encounter with a patient. That could help doctors justify the cost of acquiring EHR systems, but it would also drive up the program’s already high costs.

Another option is for CMS to require that state Medicaid programs participate in health information exchanges such as RHIOs as a condition of receiving federal funds. Such a requirement would demonstrate that the federal government is committed to advancing health IT.

But in the end the states are responsible for the Medicaid program, and they must take the lead, Greenstein said. As the largest single payer of health claims in every state, he said, Medicaid “ought to be in the forefront and in the driver’s seat.”

Physicians' Foundations Invest $2.6 Million to Support Doctors' Use of Technology

2006-08-09T06:18:00.000-07:00

August 9, 2006

Physicians' Foundations Invest $2.6 Million to Support Doctors' Use of Technology

Boston-based Physicians' Foundations has announced a $2.6 million program-related investment to help physicians use health information technology (HIT) to improve patient safety.

The organization is partnering with DocSite LLC in Cary, North Carolina, which will develop front-end tools that allow small or solo practices to use HIT through company's Internet-based technology, Web-enabled training modules, and an array of bundled products. According to DocSite CEO and medical officer John Haughton, the product suite will be designed to integrate into systems easily and intuitively, even into paper-based offices that might not consider themselves "IT-ready."

According to Physicians' Foundations president Jack Lewin, even though the spread of HIT has become a national priority, the cost, difficulty, and disruption of deploying electronic medical record systems have been significant barriers to entry for the practicing physician. "With this program, we are [creating] a model that will help fulfill the promise of HIT as a means to improve patient care and safety in a practical fashion for physicians," he said.

“Physicians' Foundations Invest $2.6 Million to Support Physicians' Use of Technology.” Physicians' Foundations Press Release 8/02/06.

Report: Health Care IT Programs To Reach $12 Billion In 2011

2006-08-04T11:33:00.000-07:00

Report: Health Care IT Programs To Reach $12 Billion In 2011

By W. David Gardner, TechWeb Technology News

State and local health care and welfare IT programs are expected to grow from $7.6 billion in fiscal year 2006 to surpass $12.2 billion by fiscal year 2011, government research firm Input said Wednesday.

Input cited recently government actions that will contribute to the growth including the Health Information Technology Promotion Act of 2006.

The market research firm also pointed to new efforts by the National Coordinator Office for Health Information Technology (ONCHIT) and the Certification Commission for Healthcare Information Technology (CCHIT) as measures that will drive health care and welfare IT growth.

"Both the amount of action and the type of action we are seeing are indicative of forward momentum for health IT," said James Krouse in a statement. "We are seeing notable health IT projects from numerous states essentially serving as laboratories for the national efforts." Krouse is acting director of Input's public sector market analysis.

Projecting that state and local IT spending for health and welfare will be driven by an increasing need for program efficiencies, the Input report observed that fraud and abuse reduction will lead to consolidation of current IT systems.

Report: Health Care IT Programs To Reach $12 Billion In 2011

2006-08-04T11:29:00.000-07:00

	August 02, 2006 (4:55 PM EDT)
	By W. David Gardner, TechWeb Technology News State and local health care and welfare IT programs are expected to grow from $7.6 billion in fiscal year 2006 to surpass $12.2 billion by fiscal year 2011, government research firm Input said Wednesday. Input cited recently government actions that will contribute to the growth including the Health Information Technology Promotion Act of 2006. The market research firm also pointed to new efforts by the National Coordinator Office for Health Information Technology (ONCHIT) and the Certification Commission for Healthcare Information Technology (CCHIT) as measures that will drive health care and welfare IT growth. "Both the amount of action and the type of action we are seeing are indicative of forward momentum for health IT," said James Krouse in a statement. "We are seeing notable health IT projects from numerous states essentially serving as laboratories for the national efforts." Krouse is acting director of Input's public sector market analysis. Projecting that state and local IT spending for health and welfare will be driven by an increasing need for program efficiencies, the Input report observed that fraud and abuse reduction will lead to consolidation of current IT systems.

CMS Awards First of 15 Contracts to Process and Pay Medicare Part A and Part B Claims

2006-08-01T11:58:00.000-07:00

CMS Awards First of 15 Contracts to Process and Pay Medicare Part A and Part B Claims

Aug 1, 2006

The Centers for Medicare & Medicaid Services (CMS) have announced the award of the first of 15 contracts for the combined handling in six states of both Part A and Part B Medicare claims. The winning contractor is Noridian Administrative Services, LLC, (NAS), headquartered in Fargo, N.D.

As the new Part A/Part B Medicare Administrative Contractor (A/B MAC), NAS will serve as the first point-of-contact for processing and paying fee-for-service claims from hospitals and other institutional providers, physicians, and other practitioners in Arizona, Montana, North Dakota, South Dakota, Utah and Wyoming .

“The contract award is a major step to improved Medicare service for beneficiaries and providers, and significant cost savings from greater efficiency in managing the original fee-for-service Medicare program,” said CMS Administrator Mark B. McClellan, M.D., Ph.D. “Noridian Administrative Services was selected through a full and open performance-based competition to administer the program as effectively and efficiently as possible.”

The A/B MAC contract, which has a value of $28.9 million for the first year of performance, is the first of 15 to be awarded by 2011 to fulfill requirements of the contracting reform provisions of the Medicare Modernization Act of 2003. NAS will immediately begin implementation activities and will assume full responsibilities for the claims processing work in its six-state jurisdiction no later than March 2007.

Under the current system, fiscal intermediaries process claims for Medicare Part A providers, including hospitals and skilled nursing facilities. Part B contractors, known as carriers, handle claims for doctors, laboratories and other practitioners. When contracting reform is fully implemented, the fiscal intermediaries and carriers will be replaced by MACs that will be responsible for both Part A and B claims.

“For beneficiaries and providers, the new structure will mean that they each have a single point of contact with the Medicare program,” Dr. McClellan said. “The MACs will serve as the point of contact for all Medicare providers and physicians in their respective jurisdictions, while beneficiaries will pose any questions about their claims to a Beneficiary Contact Center.”

CMS awarded the A/B/MAC contract to NAS which offered the best overall value to the federal government, when both cost and technical qualifications were considered. The contract, which includes a base period and four one-year options, will provide NAS with an opportunity to earn award fees based on its ability to meet or exceed the performance requirements set by CMS.

These requirements, based on CMS’ key objectives for MACs, are enhanced provider customer service, increased payment accuracy, improved provider education and training leading to correct claims submissions, and cost savings resulting from efficiencies and innovation. In accordance with the Medicare Modernization Act, MAC contracts must be put up for competitive bidding at least every five years.

For more information, see: http://www.cms.hhs.gov/MedicareContractingReform/

Source: CMS Press Release

Tommy Thomson briefs Congressional caucus on healthcare IT

2006-08-01T09:42:00.000-07:00

Tommy Thomson briefs Congressional caucus on healthcare IT

Healthcare IT News

By Bernie Monegain, Managing Editor

07/31/06

WASHINGTON – Former Health and Human Services Secretary Tommy Thompson told a congressional caucus last week that the decision physicians face today about implementing healthcare information technology is not about whether to go electronic, but how soon. Thompson and other panelists called for federal incentives to boost healthcare IT adoption by physicians.

More than 36 members of Congress attended the session on July 26. They represented the medical and dental doctors in Congress and the 21st Century Health Care Caucuses.

"Health Information Technology adoption is vital to the future of our Nation's health system," Thompson said. "We need interoperable solutions that provide physician incentives and give them options to choose which technology is right for them."

Thompson led a panel that briefed the lawmakers on the barriers physicians face in implementing electronic health record systems and other healthcare information technology.

A 2004 national survey of physicians conducted by the Commonwealth Fund showed that 56 percent of physicians viewed start-up costs as a major barrier to implementing healthcare IT. A more recent survey by the Centers for Disease Control indicates that one-quarter of office-based physicians report using fully or partially electronic medical record systems in 2005, a 31 percent increase from the 18.2 percent reported in the CDC’s 2001 survey.

For Dr. Michael A. Poss, a physician at Professional Park Medical Services in Carrollton, Ga., converting to an electronic record system seemed the only choice, though cost was always a factor, Poss said, particularly in the face of declining reimbursement rates for physicians.

"Professional Park Medical Services knew that we could not maintain the status quo and that our patients deserved the best in patient care, "Poss told lawmakers. "I am here today before Congress advocating for support and increased incentives for physician practices to adopt HIT. Our practice would have implemented an integrated EHR solution much sooner had financial incentives been aligned more properly."

"Hopefully, after today, members of Congress and their staff will better understand the pressures that physician practices are under from decreasing reimbursement rates to increasng costs to malpractice hikes," Poss said. "All affect the bottom line of critically important businesses like ours that are dedicated to supporting and caring for communities across America."

More Physicians Using Electrical Medical Records

2006-07-26T07:47:00.000-07:00

More Physicians Using Electrical Medical Records

Jul 24, 2006

CDC's National Center for Health Statistics is issuing a new Health E-Stat today entitled "Electronic Medical Record use by Office-based Physicians: United States, 2005."

The E-Stat is the latest look at the growing trend towards electronic record-keeping in the medical community. Some of the key findings in the report include:

Nearly one in four (23.9 percent) of physicians reported using full or partial electronic medical records (EMRs) in their office-based practice in 2005 - a 31 percent increase from the 18.2 percent reported in 2001.

Physicians in the Midwest (26.9 percent) and West (33.4 percent) were more likely to use EMRs than those in the Northeast (14.4 percent).

Physicians in metropolitan statistical areas (nearly 24.8 percent) were more likely to use EMRs than were those in non-metropolitan areas (16.9).

Only one in ten (9.3 percent) physicians, however, used EMRs with all four of the basic functions (computerized orders for prescriptions, computerized orders for tests, reporting of test results, and physician notes) considered necessary for a complete EMR system.

The entire E-Stat can be accessed at the CDC/NCHS web site at www.cdc.gov/nchs.

Source: CDC Press Release

Medication Errors

2006-07-22T10:28:00.000-07:00



Read Full Report Date: July 20, 2006 Contacts: Christine Stencel, Media Relations Officer Chris Dobbins, Media Relations Assistant Office of News and Public Information 202-334-2138; e-mail <news@nas.edu> FOR IMMEDIATE RELEASE Medication Errors Injure 1.5 Million People and Cost Billions of Dollars Annually; Report Offers Comprehensive Strategies for Reducing Drug-Related Mistakes WASHINGTON -- Medication errors are among the most common medical errors, harming at least 1.5 million people every year, says a new report from the Institute of Medicine of the National Academies. The extra medical costs of treating drug-related injuries occurring in hospitals alone conservatively amount to $3.5 billion a year, and this estimate does not take into account lost wages and productivity or additional health care costs, the report says. The committee that wrote the report recommended a series of actions for patients, health care organizations, government agencies, and pharmaceutical companies. The recommendations include steps to increase communication and improve interactions between health care professionals and patients, as well as steps patients should take to protect themselves. The report also recommends the creation of new, consumer-friendly information resources through which patients can obtain objective, easy-to-understand drug information. In addition, it calls for all prescriptions to be written electronically by 2010 and suggests ways to improve the naming, labeling, and packaging of drugs to reduce confusion and prevent errors. "The frequency of medication errors and preventable adverse drug events is cause for serious concern," said committee co-chair Linda R. Cronenwett, dean and professor, School of Nursing, University of North Carolina, Chapel Hill. "We need a comprehensive approach to reducing these errors that involves not just health care organizations and federal agencies, but the industry and consumers as well," she said. Co-chair J. Lyle Bootman, dean and professor, College of Pharmacy, University of Arizona, Tucson, added, "Our recommendations boil down to ensuring that consumers are fully informed about how to take medications safely and achieve the desired results, and that health care providers have the tools and data necessary to prescribe, dispense, and administer drugs as safely as possible and to monitor for problems. The ultimate goal is to achieve the best care and outcomes for patients each time they take a medication." Estimates of Rates and Costs Medication errors encompass all mistakes involving prescription drugs, over-the-counter products, vitamins, minerals, or herbal supplements. Errors are common at every stage, from prescription and administration of a drug to monitoring of the patient's response, the committee found. It estimated that on average, there is at least one medication error per hospital patient per day, although error rates vary widely across facilities. Not all errors lead to injury or death, but the number of preventable injuries that do occur -- the committee estimated at least 1.5 million each year -- is sobering, the report says. Studies indicate that 400,000 preventable drug-related injuries occur each year in hospitals. Another 800,000 occur in long-term care settings, and roughly 530,000 occur just among Medicare recipients in outpatient clinics. The committee noted that these are likely underestimates. There is insufficient data to determine accurately all the costs associated with medication errors. The conservative estimate of 400,000 preventable drug-related injuries in hospitals will result in at least $3.5 billion in extra medical costs this year, the committee calculated. A study of outpatient clinics found that medication-related injuries there resulted in roughly $887 million in extra medical costs in 2000 -- and the study looked only at injuries experienced by Medicare recipients, a subset of clinic visitors. None of these figures take into account lost wages and productivity or other costs. Improving the Patient-Provider Partnership Establishing and maintaining strong partnerships between health care providers and patients is crucial to reducing medication errors, the report says. The committee called on consumers to be active partners in their medication care and on physicians, nurses, and pharmacists to know and act on patients' medical care rights. The report recommends specific steps that physicians, nurses, pharmacists, and other health professionals should take to ensure that their patients are fully informed about their drug regimens and to minimize opportunities for mistakes to occur. Health care organizations also should make it a standard procedure to inform patients about clinically significant medication errors made in their care, whether the mistakes lead to harm or not. Currently, health care providers typically do not inform the patient or the patient's guardians about errors unless injury or death results. The report also provides consumers with a list of specific questions to ask health care providers, such as how to take their medications properly and what to do if side effects occur. Also included are actions consumers should take, such as requesting that their providers give them a printed record of the drugs they have been prescribed. Patients should maintain an up-to-date list of all medications they use -- including over-the-counter products and dietary supplements -- and share it with all their health care providers. This list should also note the reasons they are taking each product and any drug and food allergies they have. New and Improved Drug Information Resources Although consumers can find helpful drug information online or in the printed materials provided by pharmacies, this information often is too difficult for many people to understand, too scattered, or otherwise not consumer-friendly. The quality of the drug information leaflets that accompany prescriptions varies widely, and these printouts are typically written at a college reading level. The U.S. Food and Drug Administration (FDA) should work with other appropriate groups to standardize the text and design of medication leaflets to ensure that they are comprehensible and useful to all consumers. The committee called on the National Library of Medicine (NLM) to be the chief agency responsible for online health resources for consumers; it should create a Web site to serve as a centralized source of comprehensive, objective, and easy-to-understand information about drugs for consumers. In addition, NLM should work with other groups to evaluate online health information and designate Web sites that provide reliable information. The committee also recommended that NLM, FDA, and the Centers for Medicare and Medicaid Services evaluate ways to build and fund a national network of telephone helplines to assist people who may not be able to access or understand printed medication information because of illiteracy, language barriers, or other obstacles. This telephone network should also enable consumers to report medication-related mistakes or problems. Electronic Prescribing and Other IT Solutions New computerized systems for prescribing drugs and other applications of information technology show promise for reducing the number of drug-related mistakes, the report says. Studies indicate that paper-based prescribing is associated with high error rates. Electronic prescribing is safer because it eliminates problems with handwriting legibility and, when combined with decision-support tools, automatically alerts prescribers to possible interactions, allergies, and other potential problems, the committee found. While it acknowledged that significant regulatory issues and problems with automated alerts still need to be worked out, the committee said that by 2008 all health care providers should have plans in place to write prescriptions electronically. By 2010 all providers should be using e-prescribing systems and all pharmacies should be able to receive prescriptions electronically. The Agency for Healthcare Research and Quality (AHRQ) should take the lead in fostering improvements in IT systems used in ordering, administering, and monitoring drugs. All health care provider groups should be actively monitoring their progress in improving medication safety, the committee recommended. Monitoring efforts might include computer systems that detect medication-related problems and periodic audits of prescriptions filled in community pharmacies. Drug Naming, Labeling, and Packaging Confusion caused by similar drug names accounts for up to 25 percent of all errors reported to the Medication Error Reporting Program operated cooperatively by U.S. Pharmacopeia (USP) and the Institute for Safe Medication Practices (ISMP). In addition, labeling and packaging issues were cited as the cause of 33 percent of errors, including 30 percent of fatalities, reported to the program. Drug naming terms should be standardized as much as possible, and all companies should be required to use the standardized terms, the report urges. FDA, AHRQ, and the pharmaceutical industry should collaborate with USP, ISMP, and other appropriate organizations to develop a plan to address the problems associated with drug naming, labeling, and packaging by the end of 2007. The report also recommends studies to evaluate the impact of free drug samples on overall medication safety. In general, there has been growing unease among health care providers and others about the way free samples are distributed and the resulting lack of documentation of medication use, as well as the bypassing of drug-interaction checks and counseling that are integral parts of the standard prescription process. The study was sponsored by the U.S. Department of Health and Human Services and Centers for Medicare and Medicaid Services. Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public. A committee roster follows. Pre-publication copies of Preventing Medication Errors are available from the National Academies Press; tel. 202-334-3313 or 1-800-624-6242 or on the Internet at http://www.nap.edu. Reporters may obtain a copy from the Office of News and Public Information (contacts listed above). # # # [ This news release and report are available at http://national-academies.org ] INSTITUTE OF MEDICINE Board on Health Care Services Committee on Identifying and Preventing Medication Errors J. Lyle Bootman, Ph.D., Sc.D., (co-chair) Dean and Professor University of Arizona College of Pharmacy, and Founding and Executive Director University of Arizona Center for Health Outcomes and PharmacoEconomic Research Tucson Linda R. Cronenwett, R.N., Ph.D. (co-chair) Professor and Dean School of Nursing University of North Carolina Chapel Hill David W. Bates, M.D., M.Sc. Chief Division of General Medicine Brigham and Women’s Hospital; Medical Director of Clinical and Quality Analysis Partners Healthcare System; and Professor of Medicine Harvard Medical School Boston Robert M. Califf, M.D. Associate Vice Chancellor for Clinical Research; Director Duke Clinical Research Institute; and Professor of Medicine Division of Cardiology Duke University Medical Center Durham, N.C. H. Eric Cannon, Pharm.D. Director of Pharmacy Services and Health and Wellness IHC Health Plans Intermountain Health Care Salt Lake City Rebecca W. Chater, M.P.H. Director of Clinical Services Kerr Drug Inc. Asheville, N.C. Michael R. Cohen, Sc.D. President Institute for Safe Medication Practices Huntington Valley, Pa. James B. Conway, M.S. Senior Fellow Institute for Healthcare Improvement, and Senior Consultant Dana-Farber Cancer Institute Boston R. Scott Evans, Ph.D. Senior Medical Informaticist Department of Medical Informatics LDS Hospital and Intermountain Health Care, and Professor Department of Medical Informatics University of Utah Salt Lake City Elizabeth A. Flynn, Ph.D., R.Ph. Associate Research Professor Department of Pharmacy Care Systems Harrison School of Pharmacy Auburn University Auburn, Ala. Jerry H. Gurwitz, M.D. Chief Division of Geriatric Medicine; Dr. John Meyers Professor of Primary Care Medicine; and Executive Director Meyers Primary Care Institute University of Massachusetts Medical School Worcester Charles B. Inlander President People’s Medical Society Allentown, Pa. Kevin B. Johnson, M.D., M.S. Associate Professor and Vice Chair Department of Biomedical Informatics, and Associate Professor Department of Pediatrics Vanderbilt University Medical School Nashville, Tenn. Wilson D. Pace, M.D. Professor of Family Medicine and Green-Edelman Chair for Practice-based Research University of Colorado, and Director National Research Network American Academy of Family Physicians Aurora, Colo. Kathleen R. Stevens, Ed.D., R.N. Professor and Director Academic Center for Evidence-Based Practice University of Texas Health Science Center San Antonio Edward Westrick, M.D., Ph.D. Vice President of Medical Management University of Massachusetts Memorial Health Care Worcester Albert W. Wu, M.D. Professor of Health Policy and Management and Internal Medicine Johns Hopkins University Baltimore INSTITUTE STAFF Philip Aspden, Ph.D. Study Director

Announcement to Help Speed Adoption of Electronic Health Records

2006-07-19T19:00:00.000-07:00

Announcement to Help Speed Adoption of Electronic Health Records

Jul 19, 2006

The first round of ambulatory electronic health record products (EHRs) have been certified by the Certification Commission for Healthcare Information Technology (CCHIT), HHS Secretary Mike Leavitt announced today. HHS awarded CCHIT a contract in fall 2005 to develop certification criteria and a certification process.

“This seal of certification removes a significant barrier to wide-spread adoption of electronic health records. It gives health care providers peace of mind to know they are purchasing a product that is functional, and interoperable and will bring higher quality, safer care to patients,” Secretary Leavitt said.

CCHIT certification indicates that EHR products meet base-line levels of functionality, interoperability and security in compliance with CCHIT’s published criteria. This impartial seal of approval paves the way for adoption of health IT products by limiting the risk associated with investing in health IT. CCHIT is continuing to evaluate products, and additional results will be announced at the end of the month and quarterly thereafter.

“Volunteers from across the health care spectrum developed CCHIT’s criteria and inspection process, ensuring fairness and balance between the interests of diverse stakeholders,” said Dr. Mark Leavitt, CCHIT Chair.

In September 2005, HHS awarded a $2.7 million contract to CCHIT, a private, non-profit organization, to develop an efficient, credible, and sustainable mechanism for certifying health care information technology products. The CCHIT will certify health IT products in three initial phases:

First, outpatient or ambulatory EHRs;
Second, inpatient, or hospital EHRs; and
Third, architectures, or systems that enable the exchange of information between and among health care providers and institutions.

The announcement of the first round of vendors to earn certification for electronic health record products from the CCHIT came at the George Washington University’s Medical Faculty Associates, who adopted an EHR system last year. That system achieved certified status today.

“George Washington Medical Faculty Associates was an early adopter of the electronic health record system which has transformed our practice, enabling us to be proactive instead of reactive,” said Stephen Badger, CEO of the George Washington University Medical Faculty Associates. “It has enhanced the overall patient care, significantly reduced our administrative costs and led to happier physicians and patients, because of this transformation.”

Additionally, Secretary Leavitt noted that HHS will soon publish rules creating Anti-Kickback statute safe harbors and Physician Self-Referral law exceptions. These changes will allow certain donations of health information technology that may not have been permitted before, allowing hospitals and other health care providers and suppliers to take a more active role in contributing to health IT adoption. The regulations will finalize proposals made by the Office of Inspector General and the Centers for Medicare & Medicaid Services on Oct. 11, 2005.

To learn more about the CCHIT, and for a list of certified products, visit www.cchit.org.

Source: HHS Press Release

Health Information Technology: A Rural Provider's Roadmap to Quality

2006-07-17T06:22:00.000-07:00

Plan now to attend the HRSA's Office of Rural Health Policy (ORHP) national meeting on health information technology (HIT) to be held September 21-23, 2006 in Kansas City, MO.

REGISTRATION:

Registration will start Thursday, April 20th, 2006 and will be on a first come, first served basis. Space is limited, register today! REGISTER HERE

WHO:

This conference is specifically designed for the rural provider who is considering making an HIT investment to meet quality aims, but is not sure where to start. The ideal attendee is closely tied to the decision-making process in their facility, has not thoroughly explored their HIT options, and who is excited about learning how to improve quality outcomes through the use of health information technology.

The meeting seeks to attract rural health care providers and vendors, including: small and solo physician practices, Critical Access and other small rural hospitals, rural health clinics, Federal Qualified Health Centers, and vendors interested in serving rural health care providers.

WHAT:

In an effort to to explore the benefits of health information technology adoption and its link to quality improvement, this conference will provide an opportunity for rural providers to:

Learn about the basic components of HIT
Focus on the initial steps of strategic planning for HIT investments
Understand how to find appropriate technology to meet individual quality aims
Share best practices and lessons learned about HIT implementation.

WHEN & WHERE:

September 21-23, 2006 at the Kansas City Downtown Marriot, Kansas City, MO.

For Further Information Contact:
Carrie Cochran
HRSA's Office of Rural Health Policy
Phone: 301-443-0835
ORHP@hrsa.gov
http://ruralhealth.hrsa.gov

For Further Information Regarding Conference Logistics Contact:
Sandy Barnes

McKing Consulting Corporation

Phone: (301) 468-0172, x261

Fax: (240) 221-0771

Email: sbarnes@mcking.com

WyHIO Update

2006-06-30T07:02:00.000-07:00

WyHIO Update

Posted to Christina's Considerations by thielst on Fri, 05/26/2006 ? 9:18am Health IT

My friends in Wyoming continue to move forward with their creation of a RHIO to support a statewide EHR system. WyHIO received an initial grant earlier this year and has just entered a subcontract with RTI International, Inc. (RTI) to address privacy and security policy questions affecting interoperable health information exchange (HIE).

The formal WyHIO board is preparing for their first meeting and they will soon start interviewing for the executive director position. I anticipate new proposed legislation will be next!

Hold on to your hats, Wyoming, its going to be a wild ride!

House HIT legislation faces obstacles

2006-06-27T09:57:00.000-07:00

Healthcare IT News

By Caroline Broder, Senior Editor

06/23/06

(WASHINGTON) Healthcare IT legislation in the U.S. House of Representatives is stalled and unlikely to move before the July 4th congressional recess.

Two key committees – House Ways and Means and Energy and Commerce – have passed different versions of H.R. 4157, a bill from Reps. Nancy Johnson, R-Conn., and Nathan Deal, R-Ga. The bills would codify the Office of the National Coordinator for Health Information Technology, provide safe harbors in Stark and anti-kickback laws to allow hospitals and other healthcare groups to share IT tools with doctors and examine variations in state privacy laws. A provision that called for a transition by Oct. 1, 2009 to ICD-10 billing codes was dropped. The transition by 2009 was opposed by insurance companies, which wanted a longer time to prepare for the new coding system. The Energy and Commerce version of the bill calls for a demonstration program that would provide grants to small physician practices.

Lawmakers must now work out difference in both versions of this legislation before a bill can move to the House floor. However, the bill faces some roadblocks. First, the Congressional Budget Office forecast that the bill could increase spending and reduce revenues over the 2007-2011 and 2007-2016 periods. The CBO said the increase in direct spending would result from “safe harbors” that allow for donations of health information technology and that such donations by entities other than hospitals, group practices, Medicare Advantage plans, and prescription drug plans would lead to an increase in the volume of services that Medicare and state Medicaid programs pay for, thus increasing costs.

The CBO also said the move from ICD-9 to ICD-10 codes would carry a substantial cost to providers and claims processors. The CBO argued that a transition before 2012 would result in higher premiums for health insurance in those years.

David Merritt, a project director for the Center for Health Transformation, a group led by Former House Speaker Newt Gingrich, called the CBO’s estimate disappointing but not surprising.

“What they failed to understand and failed to look at is the effects of the technology,” he said. “At the same time they do not look at the impact on costs and quality.”

Gingrich has been a long-time critic of the CBO, which scores legislation for Congress. Merritt called CBO’s estimate a minor setback for healthcare IT legislation in the House.

“It’s a speed bump,” he said.

House Democrats have also opposed both versions of the bill, saying it does not go far enough to protect patient privacy or provide adequate incentives to spur healthcare IT adoption.

“There is substantial democratic concern about the content of these bill,” said Michael Zamore, a policy advisor for Rep. Patrick J. Kennedy (D-R.I.). Kennedy introduced his own healthcare IT bill last year.

“I think they’re going to push through a bad health IT bill. They don’t need Democrats and they don’t want Democrats’ input,” he said.

Once differences in the bills are resolved, the bill would move to the House floor for a vote. The bill will then need to be reconciled with a similar Senate bill (S.1418), which passed last year with bi-partisan support. The bills would need to pass both Houses again before moving to the President’s desk for a signature.

House Committees Approve Health IT Bil

2006-06-16T09:46:00.000-07:00



House Committees Approve Health IT Bill June 16, 2006
The House Energy and Commerce and Ways and Means committees on Thursday each approved separate versions of a bill (HR 4157) that would promote the use of health care IT, CQ Today reports. The bill passed the Energy and Commerce Committee by a vote of 28-14, while Ways and Means approved its version 23-17 (Schuler, CQ Today, 6/15). The legislation, sponsored by Reps. Nancy Johnson (R-Conn.) and Nathan Deal (R-Ga.), would codify the Office of the National Coordinator for Health IT within HHS and would establish a committee to make recommendations on national standards for medical data storage and develop a permanent structure to govern national interoperability standards. The Senate passed health IT legislation (S 1418) in November 2005. Many Democratic lawmakers contend that funding sources are needed to help providers adopt the technology. Neither of the House committees' versions includes grant provisions for providers, while the Senate's version does. In addition, the House Ways and Means version includes a provision that would increase the number of procedure and billing codes from 24,000 to more than 200,000 by 2009. The Energy and Commerce version does not include that provision. Opponents maintain that the deadline is too soon to adapt to a new system, CQ Today reports. The two House versions will have to be reconciled before the legislation is considered by the full chamber, possibly next week (CQ Today, 6/15). Meanwhile, CMS Administrator Mark McCellan said that the current billing and coding systems is "bursting at the seams" and needs to be updated (Carey, CQ HealthBeat, 6/15).

EHRs Offer Benefits, but Privacy Risks Remain

2006-06-12T13:58:00.000-07:00



EHRs Offer Benefits, but Privacy Risks Remain June 12, 2006
There are many benefits associated with electronic health record adoption, but centralizing patient information also poses privacy risks that must be addressed, according to a column in Monday's Boston Globe. EHRs would ensure that prescriptions are more legible and filled accurately, and they would reduce repetitive medical tests and help public health officials identify disease outbreaks and track their spread. In addition, EHRs would minimize adverse drug interactions and other errors and give scientists "access to a gold mine of data about diseases," according to the Globe. However, Dr. Deborah Peel, a psychoanalyst and founder of the Patient Privacy Rights Foundation, said, "If privacy is not fully protected, we won't be building anything except the most valuable motherlode of information for data mining on earth." She added, "If the Veterans Administration can't prevent the theft of 26 million names and Social Security numbers from an electronic file, why would any patient believe their personal sensitive health data is safe online?" To further the national health IT effort, HHS has formed the American Health Information Community, an advisory panel that oversees four HHS workgroups leading national EHR initiatives. However, there is only one consumer representative on the 17-member panel, the Globe reports. To guarantee that patients have sufficient privacy and control over their health records, "more could be done to increase consumer participation in the e-health records process," said Ray Campbell, a privacy advocate and executive director of the Massachusetts Health Data Consortium. A major issue is how centralized health information databanks should be, according to the Globe. John Halamka, CIO for Harvard Medical School and chair of the Health IT Standards Panel, said a "very decentralized approach" has worked well so far. Also, he recommended that only limited information, such as names, birth dates and indications to where care has been given be kept in regional databases. "The good news is that the push to make medical records electronic is still a work in progress," according to the Globe. "It's not too late for more consumer voice" (Foreman, Boston Globe, 6/12).

Health IT Access Among Physicians Remains Low

2006-06-07T08:27:00.000-07:00

Health IT Access Among Physicians Remains Low

June 07, 2006

The percentage of U.S. physicians who have access to IT that can perform at least four of five clinical functions almost doubled over the past four years, but the percentage of doctors who use the tools remains low, according to a report released on Wednesday by the Center for Studying Health System Change, the AP/Houston Chronicle reports.

For the report, HSC examined responses from two separate telephone surveys of members of the American Medical Association and the American Osteopathic Association. The first survey, conducted in 2000-2001, included responses from about 12,000 physicians. The second survey, conducted in 2004-2005, included responses from more than 6,600 physicians.

About 21% of respondents in the 2004-2005 survey said they had access to IT that can obtain clinical guidelines, access patient information or write prescriptions, compared with 11.4% in the 2000-2001 survey, the report finds. According to the report, about 65% of respondents in the 2004-2005 survey said they had access to IT that can obtain clinical guidelines, compared with 52.9% in the 2000-2001 survey.

However, almost 17% of respondents in the 2004-2005 survey said they did not have access to IT that can perform those three clinical functions or exchange data and images with other physicians or provide reminders to complete certain tasks, and only 20% said that they had access to technology that can perform one of those five clinical functions, according to the report.

Joy Grossman, a senior health researcher at HSC, said that many physicians do not use IT because of the cost and time required to implement the technology (Agovino, AP/Houston Chronicle, 6/6).

State Privacy and Security Subcontract Opportunities Announced Under Expanded HHS Contract with RTI

2006-06-07T08:24:00.000-07:00

State Privacy and Security Subcontract Opportunities Announced Under Expanded HHS Contract with RTI

May 24, 2006

The U.S. Department of Health and Human Services (HHS) announced today that 22 states and territories have entered subcontracts with RTI International, Inc. (RTI) to address privacy and security policy questions affecting interoperable health information exchange (HIE). Additional states are expected to sign subcontracts within the next two weeks. HHS' Office of the National Coordinator for Health Information Technology (ONC) and the Agency for Healthcare Research and Quality (AHRQ) jointly manage and fund AHRQ's contract with RTI for this work. Today, the ONC is adding $5.73 million to the existing contract with RTI, bringing its total value to $17.23 million. The additional funding will make it possible to fund all proposals with technical merit, which were submitted in response to a January request for proposals from RTI.

Subcontractors will be working with health care professionals, patients and others in their states and territories to address privacy and security issues and identify solutions for broad application. This will include identifying variations in privacy and security practices and laws affecting electronic clinical HIE; developing best practices and proposed solutions to address identified challenges; and increasing expertise about health information privacy and security protection in communities. The states will also work to develop implementation plans for future HIE activities.

"One of the strongest early lessons we're learning from our research on electronic health information is that some of the main challenges for adoption are not technical issues. Rather, they're issues of inclusion and trust," said AHRQ Director Dr. Carolyn M. Clancy. "This work on privacy and security will leave an indelible mark on the ultimate formulation of a national health information network."

Acting Deputy National Coordinator for Health Information Technology Dr. Karen Bell said, "States and territories have a critical role in working with the health care industry and consumers so that health information continues to be appropriately protected as we move forward into the digital era of medicine. This effort to partner with states and territories will ensure that the health care system serves consumers' needs and meets the President's goal for health information technology."

The RTI contract serves as a broad and critical initiative to enable HIE. Identification of privacy and security issues under this contract with RTI, and the solutions that are ultimately crafted in response to those issues, will provide a foundation for future work by ONC and AHRQ, and facilitate health information exchange across states.

RTI International, a private, nonprofit corporation, awarded the subcontracts under the contract it entered into with AHRQ last September: "Privacy and Security Solutions for Interoperable Health Information Exchange." RTI will work in partnership with the National Governors Association (NGA).

The ONC is tasked with coordinating federal health IT programs across executive branch agencies, as well as coordinating with the private sector on its health IT efforts. Information about the ONC is available at www.hhs.gov/healthit.

AHRQ funds more than 100 projects throughout the nation as part of its $166 million health IT initiative. AHRQ's National Resource Center for Health Information Technology supports this initiative. Information about AHRQ's health IT portfolio is available at healthit.ahrq.gov.

HHS is working to support President Bush's initiative to use health IT to improve the nation's health care system.

The subcontracting states thus far are: Alaska, Arkansas, Colorado, Iowa, Illinois, Indiana, Kentucky, Massachusetts, Maine, Michigan, Minnesota, Mississippi, North Carolina, New York, Ohio, Oklahoma, Rhode Island, Utah, Washington, Wisconsin, West Virginia, and Wyoming.

Coalition Pushes for Privacy in Electronic Health Records

2006-04-07T07:10:00.000-07:00

Coalition Pushes for Privacy in Electronic Health Records
========================================================================

A broad coalition of 26 organizations, led by Patient Privacy Rights,
has issued a letter urging that privacy be included as a core part of
any health information technology (HIT) system. Patient Privacy Rights
was joined by the American Conservative Union, the American Civil
Liberties Union, the Free Congress Foundation, the Christian Coalition
of America, and the Electronic Privacy Information Center in the letter.

Proponents of electronic access to health records argue that a HIT
system can ease medical treatment. For instance, patients who need
treatment when far from home will benefit if doctors can access their
medical records. However, the organizations said that patients should
have the ability to grant or deny access to that information in ordinary
circumstances. "The proper balance to ensure timely access to medical
records for treatment and preserve patient control of medical records
means allowing access in emergencies if consent cannot be obtained, but
requiring patient permission before records are disclosed in everyday
situations," the groups wrote.

The organizations also stressed the need for strong security measures
for any HIT system. In light of the many security breaches reported by
commercial and financial institutions, security standards for a HIT
system must be stronger than those currently used by the financial
services industry.

The flexibility of an electronic system of health records should also
allow patients to control the levels of access for different groups. For
instance, while treating physicians may need access to personal
information like names, addresses, and phone numbers, medical
researchers conducting statistical studies would not need such
information.

Congress is currently considering several health information technology
bills, each named the "Wired for Health Care Quality Act." Last
November, the Senate passed S. 1418, which is awaiting action in the
House. There are also two House companion bills, H.R. 4642 and H.R.
4726.

Patient Privacy Coalition Letter:

http://www.patientprivacyrights.org/site/PageServer?pagename=CoalitionSignOnLtr

EPIC's Medical Privacy Page

http://www.epic.org/privacy/medical/

Patient Privacy Rights

http://www.patientprivacyrights.org/

S. 1418:

http://thomas.loc.gov/cgi-bin/bdquery/z?d109:s.01418:

H.R. 4642:

http://thomas.loc.gov/cgi-bin/bdquery/z?d109:h.r.04642:

H.R. 4726:

http://thomas.loc.gov/cgi-bin/bdquery/z?d109:h.r.04726:

Press Release - Connecting for Health Common Framework

2006-04-06T11:01:00.001-07:00

Press Releases

Health and Technology Leaders Release the Connecting for Health Common Framework for Initiating Private and Secure Health Information Sharing

Common Framework provides an essential set of technical and policy components for private and secure health information sharing among existing and developing health information networks

Washington, DC; April 6, 2006 – Connecting for Health, a public-private collaborative of more than 100 organizations, today released its Common Framework: Resources for Implementing Private and Secure Health Information Exchange. The Common Framework provides the initial elements of a comprehensive approach for secure, authorized, and private health information sharing, so that patients and their authorized providers can have access to vital clinical data when and where they are needed. This capability is essential for providing high-quality care and reducing medical errors.

The Common Framework includes 16 technical and policy components, which were developed by experts in information technology, health privacy law, and policy. This initial set of critical technical and policy components demonstrates how various health information networks can share information while protecting privacy and allowing for local autonomy and innovation. The components being released today include technical documents and specifications, testing interfaces, and code, as well as a companion set of privacy and security policies and model contractual language to help organizations interested in information exchange move quickly towards the necessary legal agreements for private and secure health information sharing. The components were tested since mid-2005 by Connecting for Health teams in Indianapolis, Boston, and Mendocino County, Calif., the three communities in which the prototype was developed. All of the Connecting for Health Common Framework materials are available for download at no cost at www.connectingforhealth.org.

"We have long believed that personal privacy and security, values that are prized by the American people, must inform the design and functionality of new health information-sharing networks," said Zoë Baird, president of the Markle Foundation, which leads and manages Connecting for Health. "We put the patient at the center of this effort, and the Common Framework demonstrates that we can achieve state-of-the-art access to life-saving health information without sacrificing privacy and security."

Work on what has become the Common Framework was initiated in 2003, when the Connecting for Health collaborative began to create a Roadmap (PDF, 8.0 MB) that called for the public and private sectors to work together to build an infrastructure that would allow for the rapid, accurate, and secure exchange of health information, essential for improving health care quality and safety. The collaborative recognized that protecting the privacy of personal information needed to be foundational to the design of any system for sharing health information, if it was to earn the public's trust. Connecting for Health understood that achieving that goal would require everyone committed to information sharing to make specific decisions about the technology approaches and policies that would ensure privacy protections.

"We believe it was critical that these technology and policy resources be designed in tandem. Together, they protect patient privacy while enabling the authorized exchange of medical records," said Carol Diamond, MD, MPH, managing director of the Markle Foundation and chair of Connecting for Health. "Our approach to a technical architecture for health information exchange started with a set of policy principles for keeping information private and secure. With that goal and those principles in mind, we tested the technical architecture and developed a set of specific policies that are critical to implementation of the Common Framework."

To protect privacy, the Connecting for Health Common Framework architecture recommends use of a record locator service (RLS), an index that identifies where specific patient records are kept, but not what information the records contain. This approach allows records to be stored locally by doctors and hospitals and only shared electronically with other providers when appropriate and authorized by the patient. The Common Framework also relies on common, open web standards, making this approach both affordable and achievable.

"We demonstrated the exchange of clinical information, by using a critical set of common, open technical standards," said Clay Shirky, who directs the technical work for Connecting for Health and teaches at New York University. "The Common Framework avoids large-scale disruption and huge upfront capital investments by allowing the use of existing hardware and software. It is compatible with current methods of institutional and provider record keeping, while enabling existing systems to exchange information."

"The Common Framework identifies a number of policies which should be commonly adopted to assure that personal health information is managed securely and remains protected," said Mark Frisse, MD, director of regional informatics programs through the Vanderbilt Center for Better Health and co-chair of Connecting for Health's Policy Subcommittee. "These include an overall privacy 'architecture,' policy recommendations regarding patient notification, how users are correctly identified, the audit responsibilities of health information exchanges, how patient information from multiple sources can be linked, and what to do in the event of breaches of confidentiality."

"By participating in the Connecting for Health framework, we demonstrated the tremendous potential of this approach to health information sharing for improving care and sharing life-saving information in our community," said J. Marc Overhage, MD, PhD, senior investigator, Regenstrief Institute and president and CEO, Indiana Health Information Exchange, Indianapolis, Ind. "The Common Framework focuses on how to share information securely, without specifying the features and functions of the medical record systems that it connects. This gives maximum flexibility to local organizations and private companies to shape their own systems and be innovative in creating new products, while connecting to health information networks."

"In developing the policy guidelines for the Common Framework, we wanted to ensure that this approach to health information sharing leaves decisions regarding the sharing of health information exactly where it should be - with patients and their health care providers," said John Halamka, MD, CEO of MA-SHARE and emergency physician, Beth Israel Deaconess Medical Center, Boston, Mass. "This approach protects patient privacy by keeping information with the doctors and institutions that patients know and trust, eliminating the need for national patient identifiers or central databases. The policy components of the Common Framework can save time and effort on the part of many organizations and networks working on health information exchange by providing them with a jump-start in their efforts to address the key policy topics related to sharing health information."

The Connecting for Health Common Framework was tested in 2005 in Boston, Indianapolis, and Mendocino, Calif. The Connecting for Health teams in each of the three communities include: MA-SHARE and its technology partner, Computer Sciences Corporation, in Boston; the Regenstrief Institute and the Indianapolis Health Information Exchange in Indianapolis; and the Mendocino Health Records Exchange and its technology partner, Browsersoft Inc., in California. Together these teams demonstrated that completely different health information networks can communicate with one another and exchange information, even if they operate on different technological platforms, use different registration systems, and organize patient data differently.

"The Common Framework is ideal for our small, rural health care providers," said Will Ross, project manager, Mendocino Health Records Exchange. "Using software based on open standards to achieve interoperability, our network connects a group of community health centers. With this approach, other health providers caring for the most vulnerable Americans or those in rural communities can afford to deliver better care to those who may need it the most."

Connecting for Health believes that the organizations that will benefit most from the Common Framework are those that are prepared and committed to creating private and secure health information exchange through a decentralized approach. To benefit fully, such organizations should be capable of using digital information from remote sources, be in compliance with HIPAA and state rules governing privacy and security of health information, and have Internet access in place and the hardware and software to establish secure communications. These entities should also have an electronic method for accurately linking or separating the records of patients who share the same or similar names within their own enterprise. For these groups, the resources in the Common Framework can reduce the many existing, financial, legal, and technical barriers to achieving private and secure health information sharing, thus encouraging new entrants into the field.

One of the key functions of the Common Framework is to enable a diverse group of existing and developing networks to have a common way to share health information. The Common Framework makes it possible for health organizations working within regions, as well as those that are not limited to one geographic region, such as a group of specialty providers in multiple regions, to have a common way to communicate with one another.

"The Common Framework enables industry to innovate approaches to information exchange to improve health care quality," said Wes Rishel, managing vice president, Gartner Research. "Because it was developed to apply to very diverse communities, it can stimulate private sector development that will greatly reduce the cost, delay, and risk for each individual community."

The broad array of stakeholders participating in Connecting for Health are confident that the Common Framework can accelerate and provide structure to the development of health information exchange, but they also recognize that this approach is still evolving and much remains to be done.

"The resources being released today bring us closer to achieving the great promise that health information technology has to improve the quality, safety, and effectiveness of health care." said John Lumpkin, MD, MPH, senior vice president of the Robert Wood Johnson Foundation and vice chair of Connecting for Health. "The Connecting for Health Common Framework provides a foundation that everyone can build on. Soon we will see doctors, hospitals, pharmacies, software companies, consumer groups, and others adding to and improving the framework. It is a very significant contribution to the development of private and secure exchange of health information nationwide to improve care for each patient."

###

About Connecting for Health
Connecting for Health is committed to accelerating the development of a health information-sharing environment by bringing together an array of private, public, and not-for-profit groups to develop common standards and values. Connecting for Health also works to overcome the technical, financial, and policy barriers to bringing health care into the information age. As one of its first steps, Connecting for Health convened a group of leading government, industry, and health care experts, who have shaped and led the national debate on electronic clinical data standards. The group forged consensus on the adoption of an initial set of standards, developed case studies on privacy and security, and helped define the electronic personal health record. For more information, visit www.connectingforhealth.org.

About the Markle Foundation
Emerging information and communication technologies possess enormous potential to improve people's lives. The Markle Foundation works to realize this potential by accelerating the use of these technologies to address critical public needs, particularly in the areas of health and national security. Markle's overarching goal in the health area is to accelerate the rate at which information technology enables consumers and the health system that supports them to improve health and health care. The Markle Foundation's goal is to ensure that the extraordinary potential of 21st-century information technology to improve the health and health care of each citizen is translated into everyday use as quickly and effectively as possible. For more information, visit www.markle.org.

About the Robert Wood Johnson Foundation
The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation's largest philanthropy devoted exclusively to improving the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful, and timely change. For more than 30 years, the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. Helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in our lifetime. For more information, visit www.rwjf.org.

EHRs Enter Patient-Doctor Relationships

2006-04-05T10:37:00.000-07:00

EHRs Enter Patient-Doctor Relationships

By M.L. Baker, Ziff Davis Internet
April 2, 2006

When brought into the exam room, computers act as a kind of third member in the relationship between doctor and patient, concludes a study published in Annals of Family Medicine.

Whether the computer enhances or weakens the relationship depends both on how easy it is to use and how skilled physicians are in making use of it.

"Physicians were often conflicted between recording data in the EHR [electronic health record] and giving patients one-on-one attention," wrote the study's authors, led by William Ventres of Multnomah County Health Department in Portland, Ore.

Is optimism waning over EHRs? Read more here.

The researchers observed and videotaped physicians in four primary care clinics who were all using the same EHR system.

Relatively simple fixes could help doctors move from being data gatherers to caretakers. For example, most physicians walked straight to the computer monitor with only a cursory greeting to the patient.

Others, however, listened to a patient's concern, and then tacitly asked permission to use the computer to review previous notes.

According to the study, the EHR seemed to affect the quality of the notes physicians took during encounters; compared to dictated notes, notes recorded in EHRs seem to include less detail about patients' concerns and situations, information that doctors need to persuade patients to adhere to recommended medical regimes.

In a separate study published last year, Richard Frankel of Indiana University and colleagues found that doctors who were already skilled communicators could use EHRs to enhance discussions with patients, but that EHRs kept less-skilled communicators from paying attention to their patients.

Some problems that occurred had more to do with the computers than with the physicians. Screen templates used to collect information worked well for simple, straightforward problems, but did not capture patients' emotional issues or help manage patients with multiple, interacting conditions.

Although physicians did not always think to use screens this way, mobile screens can allow physicians and patients to look at data together. Giving physicians access to the EHR while on call, in the office, or at the hospital was also productive. Because information could be entered during any "encounter," researchers wrote, "the EHR gave physicians and patients the sense of seamless communication."

Frankel praised the current study. He said the study, which classified four "domains" of how doctors use and perceive EHRs, could give engineers a framework for designing better systems.

Frankel also said Ventres' study showed how doctors need to change their own frameworks for using EHRs. For example, trainee physicians interviewed by Ventres' team balked at learning patient communication and use of EHR simultaneously. Frankel said the young doctors were making an "artificial distinction."

"These resident physicians aren't thinking of the EHR as a communication tool, as much as typing up information," he said, adding that physicians will need specific training to change that mindset. "The medical record for so many years has been the private domain of the physician, and the notion of using it as a shared document is relatively new."

The Annals of Family Medicine study is available here as a PDF. The researchers also wrote tips for physicians using EHRs that include showing patients information on screen and recording their concerns and situations.

David Brailer is a doctor by trade

2006-04-04T10:21:00.000-07:00

Aggressive schedule over next 8 months to get technology into the hands of doctors, patients

David Brailer is a doctor by trade, but as the national coordinator for health IT, he is proving to be more of an engineer.

For the last two years, Brailer has set in motion health IT efforts that individually and in tandem will let physicians, hospitals, insurers and pharmacists exchange patient data to transform the quality of medical care.

Like the gears of a complex machine, he said, the health IT efforts are beginning to mesh and are building a national momentum that promises to change the way physicians go about the business of providing health care and change the way Americans receive it.

“These are all different gears that have to turn together to get the wheel to turn. What’s happening is that they’re all turning and they’re turning slightly out of speed with each other, but they’re all starting to get cranked up,” Brailer said.

The initial efforts that the Health and Human Services Department is cranking up this year will give physicians and consumers their first dose of what is to come. One example would be retiring the medical clipboard holding those paper forms that patients fill out over and over, often with the same information, at their physician’s office. Some consumers will be able to use an electronic registration summary containing information such as name, address and basic medication history, that they can direct their physicians to use.

As each critical cog of the health IT machine turns another notch this year, the success of each near-term result will help propel the realization of long-term health IT goals. Those include adoption of interoperable electronic health records by physicians and hospitals, easy-to-use personal health records that consumers own, remote monitoring systems for patients with chronic conditions, and electronic tools for real-time nationwide public health event monitoring and rapid response to crises.

HHS has seeded or promoted—or greased the wheels of—eight major initiatives that depend on physicians, hospitals, insurers, IT companies and government working together.

Over the long term, Brailer anticipates that the adoption of electronic health records and transformation of business processes in physicians’ offices and hospitals will improve the quality of health care, reduce medical errors and cut costs.

“We’re doing things that precipitate specific examples of change that can be real evidence of what’s to come,” Brailer said.

Grabbing the low-hanging fruit first to show early successes is an example of how the federal government is taking the right initial steps to push health IT adoption, said Robert Cothren, chief scientist for Northrop Grumman Corp., one of the contractors for a nationwide health information network architecture.

“It’s one thing to talk about these things. But if you can touch it and feel it, then you start to believe the stories,” he said.

Besides mothballing the medical clipboard, the public-private American Health Information Community, which HHS secretary Mike Leavitt leads, has made these early health IT uses its goal to become reality in 2007:

Give authorized providers access to patients’ current and historical laboratory results
Transmit emergency room and physician office chief complaint data, such as fever or headache, in a standardized and anonymized format to public health agencies within 24 hours
Exchange secure messaging between physicians and patients so patients can begin to manage the care of their chronic conditions.

Initial standards are the foundation on which these early health IT versions depend. From May through August, AHIC will recommend what government and industry need to do to realize the short-term breakthroughs.

“We want to peel off the low-hanging fruit in May if we can to get started. We’re facing real deadlines for getting some breakthroughs out,” Brailer said.

Major milestones

The Health IT Standards Panel plans to release in late August the first set of standards, which will support the portability of laboratory results as part of an electronic health record system. AHIC selected lab results for the panel to work on because widely accepted standards already exist, making them easy to agree on and simplifying the task of advancing a limited electronic health record capability.

“There’s not this fractious debate that’s been in other data areas,” Brailer said. Another key piece of the puzzle comes in June when the Certification Commission for Health IT will announce its first batch of vendors whose electronic health records systems meet its criteria for exchanging data. Certification will give physicians the assurance that the technology they invest in will perform as advertised.

These standards also will play an important role in the development of prototypes for a nationwide health information architecture. Four contractors are designing the draft architectures, scheduled to be completed by September, and HHS will put these architectures through several levels of review to, in part, make sure the information locator services, patient authentication, security protections and specialized network functions can work together. HHS also will test the feasibility of large-scale deployment.

By the end of the year, the four groups will each produce a prototype that reflects their individual approach. The prototype must be able to function but not necessarily be implemented and operational, said John Loonsk, director of the Office of Interoperability and Standards in the national coordinator’s office.

“It is our expectation at the end of the year, after we’ve gone through a harmonization pro- cess, that we will have identified those standards that will enable the prototypes to be able to exchange data,” he said.

Playing it safe

Brailer’s office also will start work on the biggest challenges: security and privacy. The Health Information Security and Privacy Collaboration will announce state subcontracts later this month in coordination with the National Governors’ Association. The Health Insurance Portability and Accountability Act provides a baseline for health information privacy and security among states. But some states have established more stringent privacy laws, which could pose challenges for interoperability of electronic health record systems. HHS hopes that a partnership between states and federal leaders will evolve to develop models for privacy, and the subcontracts are the chief enabler of that, Brailer said.

One other key piece in the health IT puzzle is an exception to the Stark Law, governing physician self-referral of Med- icare and Medcaid patients, and anti-kickback laws to encourage investment in health IT. The exception, which HHS proposed last year, is about to be finalized, although Brailer said that, by law, he could not indicate when. Under the exemptions, hospitals could provide hardware, software and training to physicians who refer patients to them, which is currently illegal.

“It’s a front-burner issue. The next public step we do is the final rule,” he said.

Equipment question

The anti-fraud laws currently are broad and limit the value of what a provider can give to physicians if they refer patients to the provider, said Peter Kazon, senior counsel at Alston and Baird LLP in Washington, and a former Federal Trade Commission attorney specializing in health care. A large hospital, lab or pharmacy benefits provider likely would want to integrate all physicians with whom they do business into their network.

“Is it necessary for a provider to be giving equipment? That’s a $100,000 question,” Kazon said.

The federal government has a large stake in health IT, since it pays for almost 50 percent of health care costs through Medicare, Medicaid, federal employee health plans and military and veteran health benefits.

Just by getting the government involved, there’s been an increase in interest in health IT, Northrop’s Cothren said.

“In some respect, this has already been a wildly successful program, even though we’re still in the early stages, because all that discussion is new and [government] is very active in moving forward,” he said.

HHS is trying to coordinate activities of all the major stakeholders across an entire industry around adoption of health information exchange and electronic medical records, said Greg DeBor, partner for global health solutions at Computer Sciences Corp., also an NHIN contractor.

“They need to keep in mind all those different groups’ perspectives, to some extent attenuate them, so they can herd the cats that they need to make adoption happen in an accelerated time frame,” DeBor said.

Their progress has been good, and what they have done well is set up transparent and process-driven groups, such as the contract collaborations and AHIC.

Heavy lifting

That coordination effort is getting everyone on the same page and will spur agreement on terminology and standards.

“I can see the heavy lifting that wasn’t being done in large scale across the industry,” DeBor said.

The government is helping to jump-start the health IT market as it has done historically with other industries by putting up seed money to develop new technologies, he said—as it did with the Internet, which grew out of Defense Advanced Research Projects Agency.

HHS’ health IT efforts are a process of moving and coordinating parts.

“I wouldn’t call it quite a clean-turning circle, but we did not want to set these up as separate, disparate pieces. All the pieces flow together with significant interdependencies,” Brailer said.

Ultimately, the adoption of interoperability standards and common terminologies will let scientists mine huge amounts of medical data to identify trends and best practices, said Dave Webster, certified executive IT architect at IBM Corp.’s Business Consulting Services.

“I am convinced that the next big medical breakthrough will occur once we make the use of standard, clinically-relevant codification schemes the rule rather than the exception,” he said.

Technology grants

2006-04-03T06:31:00.000-07:00

National Funding Programs

Community Connect Grant Program
Grants to provide broadband transmission service to extremely rural, lower-income communities.
Geographic Coverage: Nationwide
Application Deadline: May 15, 2006
Sponsor: USDA Rural Utilities Service

Internet Project
Provides toll free dial-up Internet access and e-mail to rural law enforcement agencies nationwide.
Geographic Coverage: Nationwide
Application Deadline: Applications accepted on an ongoing basis
Sponsor: Bureau of Justice Assistance

Microsoft Unlimited Potential (UP)
A global initiative that focuses on improving lifelong learning for disadvantaged young people and adults by providing technology skills through community technology and learning centers (CTLCs).
Geographic Coverage: Nationwide
Application Deadline: Applications accepted on an ongoing basis
Sponsor: Microsoft Community Affairs

Public Housing Neighborhood Networks
Provides grants to updte and expand existing Network Neighborhood/community technology centers and establish new NN centers.
Geographic Coverage: Nationwide
Application Deadline: Jun 23, 2006
Sponsor: U.S. Department of Housing and Urban Development

Resident Opportunity and Self-Sufficiency (ROSS) - Family and Homeownership Program
Funding for the delivery and coordination of supportive services and other activities designed to help public and Indian housing residents attain economic and housing self-sufficiency.
Geographic Coverage: Nationwide
Application Deadline: Aug 8, 2006
Sponsor: U.S. Department of Housing and Urban Development

RGK Foundation Grants
Grants that support projects in the broad areas of education, community, and medicine/health.
Geographic Coverage: Nationwide
Application Deadline: Applications accepted on an ongoing basis
Sponsor: RGK Foundation

Rural Broadband Access Loans and Loan Guarantees Program
Loans and loan guarantees for the construction, improvement, and acquisition of facilities and equipment for broadband service in eligible rural communities.
Geographic Coverage: Nationwide
Application Deadline: Applications accepted on an ongoing basis
Sponsor: USDA Rural Development

Rural Business Opportunity Grant
Grants to improve the economic conditions of rural areas including technical assistance for business development and economic development planning.
Geographic Coverage: Nationwide
Application Deadline: May 26, 2006
Sponsor: USDA Rural Development

Rural Health Care Service Discounts
Provides discounts to rural health care providers to obtain Internet and telecommunications access.
Geographic Coverage: Nationwide
Application Deadline: Applications accepted on an ongoing basis
Sponsor: Universal Service Administrative Company

HHS Calls on Federal Advisory Group to Make EHRs Available to First Responders

2006-03-10T17:52:00.000-07:00

http://www.rwjf.org/portfolios/features/digest.jsp?iaid=141&id=92427

The National Electronic Disease Surveillance System (NEDSS)

2006-03-09T11:25:00.001-07:00

http://www.cdc.gov/nedss/About/overview.html

Briefing by the Nationwide Health Information Network

2006-03-09T11:22:00.001-07:00

http://www.hhs.gov/healthit/documents/AHICMarchNotebook.pdf

Brailer Says RHIOs Are Crucial

2006-03-03T07:38:00.000-07:00

March 2006

TOP RHIO NEWS

Brailer Says RHIOs Are Crucial
In his keynote address at the 2006 Annual HIMSS Conference and Exhibition, National Coordinator for Health Information Technology (ONC) Dr. David Brailer said his office will be focusing its efforts on forming guidelines and minimum standards to help regional health information organizations (RHIOs) form and grow. “I did not start out by believing the national solution will be a network of regional networks,” he said. “Our goal with the national health information network is to allow those who do not want to [participate in RHIOs] not have to do it. We want RHIOs to know where we are heading so they can make their plans accordingly.”

Calling RHIOs ‘crucial’ to the nation's move toward an electronic health information system, Brailer also announced plans for a new RFP within two months assessing existing RHIO efforts and developing best practices guidelines. Brailer said he would like to see a RHIO in every state, establishing governance and local structure to a national health information network (NHIN).

NHIN Prototypes Discussed at HIMSS Conference
Dr. John Loonsk, director of interoperability standards for the ONC, moderated a discussion among representatives from the four companies chosen by HHS to create prototypes for a NHIN. The discussion, which took place at HIMSS 2006, offered insight into the approaches that each of the companies - Accenture, Computer Sciences Corporation, IBM and Northrop Grumman - is taking to develop a viable data exchange model for the U.S.

Loonsk said most of the prototypes have not yet achieved significant information exchange but that there have been "a number of very encouraging efforts to improve data sharing." He reminded attendees that the prototypes still are in the first phase of development and that the groups all are confronting "regional risk factors" that need to be addressed strategically.

Although the companies all are taking slightly different approaches to designing their prototypes, they each envision a network that can accommodate significant variation between communities. For the most part, the prototypes steer away from central data repositories and instead employ record locator services to sleuth out information on a local level.

According to Loonsk, there will be four public forums - in May, July, October and another towards the end of the year - during which health IT stakeholders will be able to inquire about progress. The expectation is to have a prototype by the end of the year, he added. Although the prototype probably will not be "implementable" by the end of 2006, it will be ready to move into "next-step efforts."

Australia Reconsidering eHealth….Could This Happen in the U.S.?
Health IT experts in Australia are calling on Prime Minister John Howard to take control of the faltering national e-health reform agenda, according to AustralianIT.com.

Frustration is rising over changes to plans for the centerpiece HealthConnect network, and a perception the federal government is trying to shove responsibility for health technology to the states. Independent consultant David More said the vision of HealthConnect as a "health market change management strategy," rather than a blueprint for a lifelong shared e-health record, was disturbing.

CalRHIO Sets Agenda for 2006
CalRHIO, which provides services to RHIOs in California, has announced its agenda for 2006. The organization is preparing several guidance documents that will include recommendations for a statewide infrastructure to facilitate the sharing of patient records, a list of data sharing standards that providers and vendors can reference when designing or purchasing systems, and a recommendation for the kind of data that should be included in records and exchanges.

In addition, CalRHIO is working on standardized agreements to outline terms under which sensitive data should be exchanged and a pilot project to enable emergency departments to obtain patient information from pharmacies, laboratories and insurers.

Inland Empire RHIO Formed
The initial seminal meeting of the Inland Empire RHIO was held on February 21at the
San Bernardino and Riverside County Medical Associations. The Inland Empire RHIO represents a combined provider base of almost 4,000 physicians serving a population of roughly 4.5 million people.

“The agenda included an overall representation and historical perspective of RHIOs in general and specifics regarding our region, said Dr. Gary M. Levin, coordinator of the Inland Empire RHIO Task Force. There was a high level of interest and several potential stakeholders have agreed to join the steering committee. Moreover, CalRHIO has offered a business model, which will be considered.

Several vendors demonstrated their version of "portals," he added. The overall opinion of the providers was that the portal is more important at this point than the EMR. Physicians need to have access to hospital, radiology and other reports generated by other providers, which a portal can facilitate either by push or pull technology or "spider" algorithms.

ADVOCACY AND PUBLIC POLICY

AMA to Develop More than 100 Standards
The American Medical Association has signed a pact with Congress promising to develop more than 100 standard performance measures, which doctors will report to the federal government in an effort to improve the quality of care.

The deal comes as the Bush administration pushes "pay for performance" arrangements with various healthcare providers in an effort to publicize their performance and link Medicare payment to quality. And it mirrors efforts in the private sector, where consumer groups, insurance companies and large employers who pay for healthcare are demanding more information on the quality of care.

However, in a separate letter to Congressional leaders, ten national physician groups representing a wide range of specialties wrote "We are dismayed that an agreement was reached on issues that are critical to the future of our specialties and our patients without our participation or knowledge. The American Medical Association cannot be the sole representative for the groups who are paramount to the development and implementation of quality measures."

The Community Work Groups Make Progress
The American Health Information Community (the Community) consumer empowerment work group met on February 21 to discuss the creation of a model electronic health record for consumers and providers within a year. The consumer work group is focusing on helping consumers make the transition to health IT.

Personal health records will be an essential part of the Community’s goal of a national IT infrastructure, said Kevin Hutchinson, a member of the panel and president and CEO of SureScripts. The PHRs will contain patients' medical and drug histories, will be easy to update and eventually will be integrated into practice management systems in physician offices. The next scheduled meeting is March 20.

The EHR work group is focusing on physician offices instead of patients. According to Hutchinson, the two committees will collaborate and provide "the perfect complement to developing the kind of integrated systems that most officials foresee.

Rhode Island to Issue $20 Million Bond to Create Health Information Network
Rhode Island Gov. Donald Carcieri (R) announced plans to establish a $20 million bond to develop a real-time patient health information network. As more providers adoptEHRs, the state funding would play an essential role in designing, implementing and overseeing a health information network, Government Technology reports.

In addition, the bond would help influence federal and private resources to secure hardware, software and network capabilities needed to share, secure and compile medical data.

"We need to bring healthcare into the information age," Carcieri said. "Relying on paper records means that critical information may not be available to patients when they most need it." Also, a health information system would reduce healthcare costs by eliminating redundancies, according to Carcieri.

EHR Bill Fails in Wyoming
In a tie vote on February 21, the Wyoming Senate stopped legislation that would have made Wyoming the first state in the country to create an EHRnetwork. Opponents of the bill questioned whether the multimillion-dollar system would actually be launched.

State Sen. Phillip Nicholas (R) said he had "grave concern as to whether the plan [would] ever work," the Associated Press reports. Critics of the bill also cited privacy concerns.
The bill's supporters argued that the proposed EHR network would reduce healthcare costs and improve care.

RHIO SPOTLIGHT

Physicians in Israel Reaping Benefits of RHIOs
More than 60% of Israel’s population is benefiting from its RHIO, CLALIT Health Services. “Our physicians wonder how they practiced without our RHIO,” said Dr. Orna Blondheim, CEO of CLALIT Health Services. “It’s better for the patients. In the future, the smart consumer will demand it. If aviation had the same rate of error that occurs in medicine, no one would ever fly. The healthcare world must be as safe as the aviation world. We expect human error because no one is perfect but we must do better.”

The key to their success was very senior level people who were dedicated to the idea and the rest flowed naturally, Dr. Blondheim explained. “Now physicians see the advantages. Our physicians are in several networks. Medicine is socialized in Israel. There’s no support outside so physicians choose to be in our network. Three of the four organizations in the network require electronic medical records and the health fund helps with the other.”

However, the problem was there were different EMRs within the same hospital. “We knew that was bad. Medicine is more complex now and patients do not know so we can’t rely on the patient and the family to bring us information. No banking system would work that way so why medicine. The medical world was behind for a lot of reasons. Change was necessary.”

First, they defined what they wanted, set prerequisites, and organized committees. Then they needed a solution. The organization began with a local pilot project in southern Israel. “We began just by connecting departments within one organization, which was a start-up company, and that paved the road for continuing, she noted. “We began developing the concept in the late 90s.”

The RHIOs’ prerequisites included no central database, complete ownership by people who formed the EMR, retrieval of information in one minute, security and privacy (compliance with national and international laws), full integration, minimal data sets, user friendly, and connectivity with existing and future operating systems.

They also organized committees for consumers and hospitals, said Dr. Blondheim. Each group had their own Steering, Users, and Legal and Ethics Committees. People from every profession were involved. The profiles of the users varied so they had to be involved at the outset.

“We have so many success stories,” said Dr. Blondheim. There was a young woman who was about to be admitted for elective surgery. However, she remembered the night before the surgery she had an allergic reaction to anesthesia during a previous surgery. However, she couldn’t recall the specifics. Fortunately, we were able to obtain her EMR, which included her allergies. In another case, a child with numerous childhood illnesses was seen by several doctors because the parents chose to change physicians. Fortunately, the doctors were making decisions regarding the child’s health with his complete medical history.”

TECHNOLOGY CORNER

RHIOs Giving Master Person Index Technology New Meaning
Enterprise master person index (EMPI) technology is already successfully used in various segments of the healthcare delivery system. In a RHIO environment, the EMPI matches and aggregates medical records and information across participating systems without requiring either existing (social security number) or new (national health number) common identifiers to locate and match patient information.

RHIO FEDERATION UPDATE

RHIO Federation Members Reap Many Benefits
To support the emerging RHIO industry with education, outreach, networking, tools, resources, and advocacy support, the HIMSS RHIO Federation launched on October 21, 2005. The RHIO Federation Website now features information on lessons learned, case studies, current issues and trends as well as RHIO Federation projects. At 56RHIO members and counting, participating RHIOs receive free monthly education sessions on timely topics that affect their business as well as access to HIMSS' RHIO Federation Portal. There is no charge for RHIOs to join the Federation. Each RHIO will provide a point of contact to the Federation and will be connected with the Chapter RHIO Federation Roundtable member in their geographic location.

Members of the RHIO Federation are supported by a 110-HIMSS-member task force, a 38-person Chapter RHIO Federation Roundtable in support of regional and local activities, and four work groups building official HIMSS' definitions, position statements, pilot projects and an industry-focused guidebook.

If you are a RHIO and interested in participating in the RHIO Federation, contact David Clark at dclark@himss.org or at 703-837-9816.

ASK THE EXPERT

How will RHIOs work with emergency departments?

A RHIO may afford some capacity to ameliorate information issues with better communication between hospitals, ambulatory public health clinics and providers who will accept uninsured patients. Hospitals may be willing to underwrite parts of the RHIO cost to provide this service to the emergency department, thereby lessening their individual burden. As the crisis has deepened more and more hospitals have closed their emergency room doors, transferring additional load to still functioning emergency rooms.
For more information on this topic, click here.

RESOURCES

Health IT Resources Available Online at AHRQ
HHS' Agency for Healthcare Research and Quality (AHRQ) launched a new suite of "learning resources" designed to help healthcare providers adopt health information technologies quickly and effectively.

The step represents a new phase for the AHRQ National Resource Center on Health Information Technology, as the Agency acts rapidly to convey the lessons learned through AHRQ-funded projects and other sources. The new resources are at the center's web site, http://www.healthit.ahrq.gov.

CHCF Issues Report on ePrescribing
Doctors write more than 3 billion prescriptions each year, with a combined value that tops $221 billion. Within the complex and largely automated prescription drug industry, the information flow between physicians and pharmacies remains the only part of the process that isn’t managed electronically.

This California Health Care Foundation-funded report, The Prescription Infrastructure: Are We Ready for ePrescribing?, provides a comprehensive overview of the prescribing process, including the organizational, financial, and technical elements that influence how prescriptions are handled today. It examines the issue of ePrescribing (eRx) — currently practiced by only 15% of physicians — including the opportunities it presents to streamline information management and the potential payoffs for both clinicians and pharmacies.

First National RHIO Finance Survey Planned
A newly designed survey, titled "RHIO Startup Funding and Finance for Life: Survey of Regional Health Information Organization Finance," is being prepared by Healthcare IT Transition Group. The survey questionnaire will be distributed to a large sample of RHIO/HIE leaders next month. Results of this first national RHIO finance survey will be reported at the upcoming national conference of the Workgroup for Data Interchange (WEDI), and will be published in May. RHIO personnel who would like to respond to the survey questionnaire are encouraged to request the questionnaire at this link.

CALENDAR OF EVENTS

RHIO EVENTS

HIMSS Hawaii Chapter
Honolulu, HI
April 5, 2006
Topic: RHIO Update
Speaker: David Clark
Contact Person: Steven Hurlbut
shurlbut@queens.org

HIMSS NCA Chapter
Key Bridge Marriott
Rosslyn, VA
April 20, 2006
Topic: RHIOs: Lessons Learned from the Field
Contact Person: David Clark
dclark@himss.org

Gain New Insights on Successful RHIO Development
If you are a stakeholder in a RHIO or you currently play a role in EHR transformation, you won't want to miss this powerful webinar on using service- oriented architecture (SOA). Presented on March 13 by the HIMSS RHIO Federation, this online session will reveal how SOA can help RHIOs save money by leveraging existing IT infrastructures to support local efforts.

Alan Boucher, Director of Health Care Architecture within the Digital Health Group at Intel Corporation, will share his expertise in the delivery of products, technologies and platforms for healthcare IT, along with new insights on national healthcare infrastructures and the personal health, biotech and pharmaceutical sectors.
Peter T. van der Grinten, General Manager, dbMotion Inc., will share how the Calit Health Services RHIO in Israel utilized SOA to build a health information exchange that now serves more than 3.5 million individuals. Mr. van der Grinten, with an extensive background in EMR usage and software development and HL7 experience, has successfully managed the installations of clinical systems for nursing, physician, and pharmacy environments.

Only $50 for HIMSS members and $145 for non- members.
Register/more information

OTHER EVENTS

HIMSS to Sponsor Six Conferences for Independent Physicians
The HIMSS’ Physicians Adopting Computer Technology (PACT) Conference is a one-day event, launched in 2004, that features a distinguished group of award winning, nationally recognized presenters who bring home the realities of the EHR. Exhibitors can take advantage of this exclusive opportunity to showcase their product to this targeted audience. During the conference, physician attendees hear from colleagues who have succeeded in EHR implementation and who are eager to share their real-world implementation experience in their own practices. Each PACT conference is designed to attract physicians in small (1-4 physicians) and large (10+ physicians) practices, as well as technology professionals, office managers and administrators who are responsible for EHR decision-making.

The 2006 PACT conferences will be held on the following dates: March 11 – Denver, Colo.; March 18 – New York, N.Y.; March 25 – San Francisco, Calif.; April 22 – Dearborn, Mich.; May 6 – Kingsport, Tenn.; and June 24 – Boston, Mass. Share Your EHR Solution with Physicians - Exhibit at PACT. Visit our web site, www.himss.org/pact. Companies interested in exhibiting should contact Kelly Laidler via email, klaidler@himss.org, or at 312-915-9285.

Plan Ahead: National Health IT Week and Advocacy Day, June 5-9 in Washington
Health IT public policy issues have taken center stage in Washington, DC. In order to continue to influence change and transform healthcare, HIMSS has joined with other industry stakeholder groups to co-sponsor the first National Health IT Week, which will be held June 5-9 in Washington, DC.

During National Health IT Week, there will be an industry-wide Advocacy Day at the Ronald Reagan Building and International Trade Center on Tuesday, June 6, 8:00 a.m. to 6:30 p.m. This event will be open on a complimentary basis to all HIMSS members. At a minimum, all hapters should plan to sponsor their Chapter Advocate(s) for the HIMSS co-sponsored Health IT Week Advocacy Day and the HIMSS Summit, June 7 and 8. Two scholarships will be available this year for Chapter Advocates to attend Health IT Week Advocacy Day. Interested Chapters should contact Tom Keefe at tkeefe@himss.org.

American Health Information Community Workgroup Meetings Scheduled
The American Health Information Community (the Community) has released the calendar for workgroup meetings in 2006. The workgroups—biosurveillance, consumer empowerment, chronic care , and electronic health records—are scheduled to meet approximately 10 times per year, each. The workgroups will make recommendations to the Community that will produce tangible and specific value to the health care consumer that can be realized within a one-year period. Members of the public can listen in on the meetings via the Web. Details on how to access each workgroup meeting are available under that workgroup's page of the Community's web site. Questions and comments about the Community workgroups should be directed to onchit.request@hhs.gov or 866-505-3500.

HIMSS RHIO Connection is your official source for timely, comprehensive coverage and analysis of the RHIO Revolution. We hope you have enjoyed the RHIO Connection. If you and your colleagues would like to permanently subscribe to each and every complimentary edition, click here.

HIMSS Integration and Interoperability Team
David E. Clark, MIM, Director of Integration and Interoperability, 703-837-9816
Sharolyn Rosier Hyson, MPP, Editor of the RHIO Connection and Manager of Public Policy Communications, 703-837-9819
Noel Quander, Coordinator of Integration and Interoperability, 703-837-9824
901 King Street, Suite 200
Alexandria, VA 22314

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AHRQ

2006-02-20T17:32:00.000-07:00

http://healthit.ahrq.gov/portal/server.pt?open=512&objID=650&PageID=0&parentname=ObjMgr&parentid=106&mode=2&dummy=

Healthcare IT News

2006-02-20T07:46:00.000-07:00

http://www.healthcareitnews.com/topic.cms?id=13

PFHSE Excellence in Practice Concept Paper

2006-02-20T07:39:00.000-07:00

Wyoming Health Information Organization

PFHSE Excellence in Practice

Concept Paper ? January 31, 2006

Background and Need Wyoming presents a unique blend of geographies that encompass wide-open rangeland, towering mountains, monumental national parks, and weather extremes to match. Due in part to this unique geography, Wyoming, with approximately 500,000 people spread over a little under 100,000 square miles, is one of the most sparsely populated states in the nation. As such, access to needed medical services can be a significant challenge. With the objective of utilizing technology to exchange healthcare information, collaborative healthcare partners have sought to improve the quality and access to healthcare by achieving such goals as fewer hospital admissions from the emergency department, fewer readmissions, reduction in medical errors, shortened hospital length of stay, enhanced revenue from proper coding, and test duplication avoidance.

In 2003, the Wyoming Legislature created the Wyoming Healthcare Commission (WHCC) to develop strategies to improve health care and reduce health care costs for Wyoming citizens. In 2004, the legislature passed Enrolled Act 31, directing the Commission to create an Information Technology Technical Management Subcommittee (IT2) to study and plan for statewide interoperable electronic health records (EHR) implementation by Oct. 15, 2005. John Snow, Inc. (JSI) was selected by WHCC and IT2 to assess Wyoming’s electronic health records readiness and make recommendations for rapidly increasing the utilization of technology to access patient health information. In the summer of 2005 more than 50 representatives of local, state and federal government, business, medical care providers, and healthcare purchasers and payers gathered and formed the nonprofit Wyoming Health Information Organization (WYHIO).The stakeholders chose an interim board of directors representing a broad cross-section of interests in the state’s healthcare delivery system. WYHIO is positioned to evaluate and endorse projects and processes that will integrate with the unfolding Wyoming health information network. The WyHIO sees ePrescribing as a high-priority initiative and need for Wyoming given the high number of real-world models demonstrating an excellent return on physician, pharmacy and patient time investments.

As part of the EHR feasibility study, feedback was gathered from key stakeholder interviews and from focus groups held throughout the state, Wyoming physicians view electronic prescribing as the single most popular and acceptable medical computing application. Many of them also view it as potentially the most valuable first step toward medical practice automation. Even providers who do not see any immediate value for a full-scale electronic medical record in their practice tend to be enthusiastic about the advantages of electronic prescribing because it promises to reduce some of their office workload.According to the Wyoming Board of Medicine, there are 801 registered physicians in the state of Wyoming. The Wyoming Board of Pharmacy lists 139 registered pharmacies. Of the thousands of prescriptions filled every month, many require direct contact between the pharmacy and the provider who signs the prescription for clarification, confirmation or to complete missing information. In addition, thousands of refill requests need to be processed by pharmacies and physician offices, requiring another round of communication. The overall prescribing process can be cumbersome and time consuming. One Wyoming primary care physician recently estimated receipt of 20 telephone messages on average per day about prescriptions he has written.

The WyHIO ePrescribing Initiative is needed to increase efficiency, accuracy and appropriateness of medication to benefit patients, physicians, pharmacists and payers. ePrescribing is a major step to the statewide interoperable electronic health records implementation.

Purpose of Project To facilitate adoption of technology in the physician office, a statewide e-Prescribing initiative is proposed, beginning with a pilot implementation to demonstrate viability. Physicians and allied health professionals participating in the initiative will send prescriptions electronically to pharmacies through personal computers, PDAs or tablet devices. The practitioner will have the ability to review drug interactions, review formulary requirements and access a disease reference database. The WyHIO will assist the practices in installation of the system, training, matching incentives and ongoing support.

While significant technical, legal and operational issues need to be resolved before a national electronic prescribing plan goes into effect, developing such systems for electronic prescribing is a national and state priority. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173) specifies the development of national standards for enabling the exchange of basic prescription data to and from prescribers and pharmacists, as well as standards for information exchanged about a patient's drug utilization history, possible drug interactions, the drug plan (including information about the formulary and cost-sharing), and information about lower-cost therapeutically appropriate alternatives.

Description of Project The system is designed to prevent medical errors due to illegible handwriting, decrease the need for time consuming telephone communications between the pharmacy and prescriber, and improve the turn around time filling prescriptions at the pharmacy.

The project will establish the baseline of preferred drug list use and use of generic drugs in the Medicaid program prior to initiating the project and will analyze these measures after adoption of e-Prescribing. These measurements will be made at 6 months (after an initial pilot), and after a prescriber has used the system for at least a full year after the rollout of the statewide project. Provider adoption will be tracked at the same intervals using a survey process to assess characteristics of early adopters.

Impact Sponsoring an ePrescribing initiative will streamline the prescription process by integrating payers, pharmacies, and providers. ePrescribing is being widely implemented through regional initiatives and is supported by accepted HIT standards. An ePrescribing system represents a low risk/high reward opportunity relative to other initiatives that may be considered.

Transmitting drug prescriptions electronically to pharmacies has been shown to reduce errors caused by handwriting and reduce the considerable time currently expended between pharmacies and prescribers in clarifying prescription information. In addition, with the cumulative electronic collection of prescription information, it is possible to develop a history of all medications that have been dispensed for an identified patient. This permits automated checking of interactions between drugs – a vitally important patient safety process. Moreover, accurate medication lists can be time and even lifesaving at the point of patient care.

Further, drug utilization data can be valuable for disease management of chronic conditions, and is indispensable information for measuring costs of care. Other uses of accurate patient medication lists include facilitating drug alerts and recalls, and identifying prescription drug abuse. Payers, who administer formularies with different coverage for different drugs can expect greater compliance when coverage information is available at the time of prescribing. JSI received positive feedback on ePrescribing from groups of physicians and pharmacists in Wyoming, who tend to view electronic prescribing as potentially delivering significant efficiencies for their daily practices.

Wyoming Legislative Update

2006-02-15T13:59:00.000-07:00

SF 50, the HIT bill passed out of the senate committee this morning on
unanimous vote.  The bill was amended to restrict spending during the first
year to under $1 million for any contracts and allows the WYHIO
to explore other options besides setting up a hub and some other minor
changes.  There were no changes in the funding overall.

National Health IT Coordinator Pushes Networking EHRs

2006-02-15T13:53:00.000-07:00

http://www.eweek.com/article2/0,1895,1926367,00.asp

RFP Bulletin

2006-02-06T07:51:00.000-07:00

 RFP-BULLETIN
    a service of the Foundation Center
=========================================

February 3, 2006
Volume 7, Issue 5

The RFP Bulletin is a publication of the Foundation
Center. To search or browse the Bulletin on the Web,
visit: http://fdncenter.org/pnd/rfp/

To subscribe or unsubscribe, or to change your e-mail
address, visit: http://fdncenter.org/newsletters/

This week's PND Poll wants to know: How would you rate
U.S. philanthropy's engagement with global health
issues?

To vote, visit: http://fdncenter.org/pnd/

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New from Philanthropy News Digest! Receive e-mail
notification of the latest news and jobs posted to
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------------------------<<>>--------------------------

1)  Cintas Fellowships in Visual Arts and Architecture
      Available to Cuban Artists
2)  Tourism Cares for Tomorrow Announces 2006 Worldwide
      Grant Program
3)  Youth Service America Announces Katrina's Kids
 Community Service Grants Program
4)  Baltimore Community Foundation Invites Applications
      for Neighborhood Grants Program
5)  MetLife Foundation Community-Police Partnership Awards
 Program
6)  Kessler Foundation Offers Disability Employment Grant
 Program for New Jersey Citizens
7)  Entergy Launches 2006 Environmental Stewardship Grant
 Application Process
8)  Nominations Invited for Rosalynn Carter Caregiving
 Award 
9)  Robert Wood Johnson Foundation Launches Finding
 Answers: Disparities Research for Change Grant
 Program
10) Susan G. Komen Breast Cancer Foundation Seeks Nominees
 for Professor of Survivorship Awards
11) American Indian Journalism Institute Accepting
 Nominations 
12) Asia Society Seeks Nominations for Osborn Elliott
 Prize for Excellence in Asian Journalism
13) Entries Invited for Casey Medals for Meritorious
 Journalism 
14) Open Society Institute Announces Katrina Media
 Fellowships 
15) Caring for Carcinoid Foundation Seeks Research
 Proposals 
16) San Francisco Foundation Invites Entries for
      Community Leadership Awards 
17) William Randolph Hearst Endowed Fellowship for
 Minority Students Accepting Applications
 
------------------------<<>>--------------------------     

1) Cintas Fellowships in Visual Arts and Architecture
 Available to Cuban Artists

Deadline: February 17, 2006 (Visual Arts) and
         March 17, 2006 (Architecture)

Cintas Fellowships are designed to acknowledge the
creative accomplishments of artists of Cuban citizenship
or direct descent and encourage the excellence of these
artists in architecture, literature, music composition,
and the visual arts.

Eligibility for these fellowships is limited to creative
artists, living outside of Cuba, of Cuban citizenship or
direct lineage (having a Cuban parent or grandparent).

Cintas Fellows are free to pursue their artistic
activities as they wish. The fellowships are not awarded
for academic study or research, or to performing artists.
Fellowships are not awarded more than twice to the same
person. Second awards are granted only to candidates
demonstrating outstanding artistic development.

Fellowships are awarded annually in the amount of $15,000
each and are paid in quarterly stipends, beginning in
September, for twelve consecutive months.

For 2006, fellowships will be awarded in the fields of
Visual Arts and Architecture (2007 fellowships will be
awarded in the fields of Visual Arts and Music
Composition; 2008 fellowships will be awarded in the
fields of Visual Arts and Creative Writing.)

Visit the program's Web site for complete fellowship
guidelines and application procedures.

RFP Link:
http://fconline.fdncenter.org/pnd/10000704/iiecintas

For additional RFPs in Arts and Culture, visit:
http://fdncenter.org/pnd/rfp/cat_arts.jhtml

------------------------<<>>--------------------------

2) Tourism Cares for Tomorrow Announces 2006 Worldwide
 Grant Program

Deadlines: March 1, June 30, and November 1, 2006 (Letters
     of Inquiry)

Tourism Cares for Tomorrow
( http://www.tourismcaresfortomorrow.org/ ), the tourism
industry's nonprofit organization, exists to preserve,
conserve, and promote the responsible use of our world's
natural, cultural, and historic treasures and to support
education and research to help secure the positive future
of travel and tourism worldwide.

As part of its mission, Tourism Cares for Tomorrow
distributes charitable grants to worthy tourism-related
nonprofit organizations worldwide.

Tourism Cares for Tomorrow considers projects or programs
with either or both of the following goals: 1) Projects
that protect, restore, or conserve sites of exceptional
cultural, historic, or natural significance; and
2) Programs that educate local host communities and the
traveling public about conservation and preservation of
sites. Preference will be given to applicants that are
able to leverage Tourism Cares for Tomorrow's grant
funding to provide increased philanthropic support through
vehicles such as matching grants or challenge grants;
are endorsed by the local, regional, or national tourism
office; and demonstrate strong support from the local
community.

Tourism Cares for Tomorrow's grantmaking goals for 2006
call for a balanced distribution to U.S. and non-U.S.
recipients. Grant recipients must be classified as
nonprofit and tax-exempt under section 501(c)(3) of the
U.S. Internal Revenue Code or, in the case of non-U.S.
organizations, must function as the equivalent.
Historically, grant amounts have ranged between $10,000
and $20,000. However, based on merit and availability of
funds, some grants of up to $100,000 will also be
considered.

(Please Note: The 2006 grant application cycles have
changed to every four months rather than quarterly, as
they were in 2005.)

Visit the Tourism Cares for Tomorrow Web Site for complete
program information and application procedures.

RFP Link:
http://fconline.fdncenter.org/pnd/10000704/tourismcares

For additional RFPs in Arts and Culture, visit:
http://fdncenter.org/pnd/rfp/cat_arts.jhtml

------------------------<<>>--------------------------

3) Youth Service America Announces Katrina's Kids
 Community Service Grants Program

Deadline: March 3, 2006

America's Promise ( http://www.americaspromise.org/ )
and Youth Service America ( http://www.ysa.org/ ) have
announced the Katrina's Kids Community Service Grants
for hurricane relief.

The program will offer seventeen grants of $1,000 to young
people who wish to implement hurricane-relief projects.

The Katrina's Kids Community Service Grant is open to all
U.S. citizens between the ages of 5 and 25.

Applicants will be expected to develop and implement a
sustainable relief project that supports hurricane-relief
efforts in the Gulf Coast region. The program welcomes
projects in which children and youth work in partnership
with adults (parents, coaches, teachers, youth leaders,
etc.); however, projects should be youth-led and created,
and must take place on National and Global Youth Service
Day (April 21-23, 2006) ( http://www.ysa.org/nysd/ ).

The application form and an FAQ are available at the YSA
Web site.

RFP Link:
http://fconline.fdncenter.org/pnd/10000704/ysa

For additional RFPs in Children and Youth, visit:
http://fdncenter.org/pnd/rfp/cat_children.jhtml

------------------------<<>>--------------------------

4) Baltimore Community Foundation Invites Applications
      for Neighborhood Grants Program

Deadline: March 15, 2006

The Baltimore Community Foundation's ( http://bcf.org/ )
Neighborhood Grants Program offers funding for resident-
driven and -led community-based organizations in Baltimore
City and Baltimore County neighborhoods.

The primary purposes of the NGP are to support and
increase residents' involvement and investment in their
communities; to increase the effectiveness of community
organizations by providing financial resources and other
support to enable them to initiate and complete priority
neighborhood projects; to help neighborhoods become
supportive environments for families and businesses; and
to strengthen neighborhoods so that current and potential
residents and businesses are more willing to invest time,
effort, and money in the community.

The NGP offers the following types of funding:

Mobilization Grants -- Grants of up to $5,000 for small
projects with total budgets of no more than $5,000. Grants
are to assist resident-driven and -led community groups in
low- to moderate-income neighborhoods with an active,
engaged resident base to design, develop, and carry out
projects. The applicant organization's board must be at
least 51 percent neighborhood residents. The applicant
organization does not need to be a 501(c)(3) organization,
but must prove that the grant will be used for "charitable
purposes" as defined by Section 501(c)(3) of the Internal
Revenue Code.

Leadership Grants -- Grants of up to $10,000 for projects
with total budgets of no more than $10,000 (less match).
Grants are to assist resident-driven and -led community
groups in low- to moderate-income neighborhoods, with a
demonstrated track record of neighborhood leadership, a
history of resident involvement, and an active, engaged
resident base to design, develop, and carry out projects.
The applicant organization must have a 501(c)(3) desig-
nation from the IRS and must provide a minimum match of
25 percent of the grant request. This match may be met
through in-kind donation, volunteer labor, or cash.

Please note: All grantseekers must attend an application
workshop before applying for a grant from the Neighborhood
Grants Program. Application workshops will be held on
February 15 and February 17 at BCF. Visit the BCF Web site
for workshop details and to download grant guidelines.

RFP Link:
http://fconline.fdncenter.org/pnd/10000707/bcf

For additional RFPs in Community Improvement/Development,
visit: http://fdncenter.org/pnd/rfp/cat_community.jhtml

------------------------<<>>--------------------------

5) MetLife Foundation Community-Police Partnership Awards
 Program

Deadline: February 24, 2006

The RFP for the 2006 MetLife Foundation Community-Police
Partnership Awards is now available.

Since 2002, the MetLife Foundation ( http://metlife.org/ )
and the Local Initiatives Support Corporation
( http://www.lisc.org/ ) have partnered to recognize,
sustain and share the work of innovative partnerships
between community groups and police to promote neighbor-
hood safety and revitalization. Through the MetLife
Foundation Community-Police Partnership Awards, the
MetLife Foundation and LISC identify and honor partner-
ships that exhibit tangible accomplishments in their
efforts to advance the process, outcome, and evaluation
of potent police-community collaborations.

Eligible applicants must be member organizations of
partnerships that include, but need not be limited to,
community organizations and police. Awardees receive a
monetary grant and their work is promoted via case studies
to a wide audience of practitioners, policymakers, and
academics.

Five to eight awards totaling $100,000 will be made, with
award amounts ranging from $10,000 to $35,000. Awards are
unrestricted funds that may be used by the recipient in
any manner that, in the awardee's opinion, promotes,
furthers, or strengthens the recognized partnership.

Interested applicants must complete and submit a brief
preliminary application form, available online at the
LISC Web site.

RFP Link:
http://fconline.fdncenter.org/pnd/10000708/lisc

For additional RFPs in Community Improvement/Development,
visit: http://fdncenter.org/pnd/rfp/cat_community.jhtml

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Federal Grant" Audio Conference

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restrictions. Learn what you can and can't do when faced
with the patchwork of federal statutory and regulatory
policies when you register to attend this 90-minute,
interactive audio conference on March 2, from Bob Lloyd,
a respected authority on federal policies affecting
acquisition, administration and audit of federal grants.

Register today at:
http://fconline.fdncenter.org/pnd/10000722/thompson

------------------------<<>>--------------------------

6) Kessler Foundation Offers Disability Employment Grant
 Program for New Jersey Citizens

Deadline: March 31, 2006 (Letter of Intent)

The Mission of the Henry H. Kessler Foundation
( http://www.hhkfdn.org/ ) is to improve the lives of
people with physical disabilities. The foundation does
this by supporting the research of Kessler Medical
Rehabilitation Research and Education Corporation, by
engaging in activities to assist people with physical
disabilities, and by supporting the efforts of others
who serve people with physical disabilities.

People with disabilities have high rates of unemployment
and underemployment. In response to this problem, the
foundation adopted a new strategic direction in 2005
focused on increasing employment for people with dis-
abilities in New Jersey. The goal of the foundation's
Signature Employment Grant Program is to award funds that
support efforts to increase the number of individuals with
disabilities in community-based employment making a living
wage.

The program will support collaborative projects, pilot
initiatives, and new and creative programs that lead to
the employment of New Jersey citizens with physical
disabilities. The foundation is committed to identifying,
initiating, and funding allocations for funds through a
proposal process or through foundation-initiated projects.

A priority is placed on those programs which primarily
serve individuals with physical disabilities (65 percent
of project population), are collaborative, and use effec-
tive cost-sharing or multiple funding source techniques.
Foundation trustees are specifically interested in knowing
how the project will be judged effective and sustained
beyond the grant period.

The SEG funding cycle can be up to three years, beginning
January 1, 2007. Grants may range from $100,000 to
$500,000 per year and can include up to a 15 percent
budget allocation for indirect expenses. There is approx-
imately $1.5 million of funding available under this
program in 2006.

Applicants must be nonprofit organizations that are tax-
exempt under 501(c)(3) of the Internal Revenue Code or
other IRS code.

For complete program guidelines and application
procedures, visit the Kessler Foundation Web site.

RFP Link:
http://fconline.fdncenter.org/pnd/10000709/hhkfdn

For additional RFPs in Disability, visit:
http://fdncenter.org/pnd/rfp/cat_disabled.jhtml

------------------------<<>>--------------------------

7) Entergy Launches 2006 Environmental Stewardship Grant
 Application Process

Deadline: March 10, 2006

Entergy Corporation ( http://www.entergy.com/ ), an
integrated energy company, is accepting applications for
the company's seventh annual Environmental Stewardship
Grant program. The program provides support to community-
based projects in Entergy's service area that address
energy efficiency and provide sustainable solutions that
preserve the environment. For 2006, the program will
award grants totaling $250,000, up from $150,000 last
year.

In considering requests for grants, priority is given to
programs in locations where Entergy has customers and/or
employees. Areas in the following states will receive
priority:  Arkansas, Louisiana, Mississippi, Massachu-
setts, New Hampshire, New York, Texas, and Vermont.
(See the Entergy Web site for lists of specific counties
where Entergy has operations.)

To be eligible for this program, applicant organizations
must be established and have a mission or charter
consistent with improving the environment. Project should
improve or address a significant environmental need in
the region, and must show sustainable characteristics
with measurable results demonstrating lasting effects.

Grants typically range between $5,000 and $25,000.
However, more may be awarded for worthy projects.

Organizations can obtain grant guidelines and apply
online at the Entergy Web site.

RFP Link:
http://fconline.fdncenter.org/pnd/10000710/entergy

For additional RFPs in Environment, visit:
http://fdncenter.org/pnd/rfp/cat_environment.jhtml

------------------------<<>>--------------------------

8) Nominations Invited for Rosalynn Carter Caregiving
 Award

Deadline: March 1, 2006

The Rosalynn Carter Caregiving Award
( http://www.rci.gsw.edu/care_award.htm ) is presented
each year by the Rosalynn Carter Institute for Caregiving
to recognize an individual for leadership and innovation
in caregiving. The nominee may or may not represent or be
affiliated with an organization.

The recipient of the award shall clearly demonstrate
dedication to caring for persons who have mental ill-
nesses, physical illnesses, developmental disabilities,
or the  difficulties of the frail elderly; encouragement
of collaboration and partnerships between all stakeholders
in the caregiving process; and the potential for develop-
ing or more effectively using financial, educational, and
human resources in these pursuits.

Former First Lady Rosalynn Carter presents the recipient
with a statuette and a cash award of $2,500. The award
winner is invited to deliver an address at an educational
event sponsored by the RCI. Travel funds to accept the
award and deliver the address are provided.

Visit the Rosalynn Carter Institute for Caregiving Web
site for complete nomination guidelines.

RFP Link:
http://fconline.fdncenter.org/pnd/10000711/rci

For additional RFPs in Health, visit:
http://fdncenter.org/pnd/rfp/cat_health.jhtml

------------------------<<>>--------------------------

9) Robert Wood Johnson Foundation Launches Finding
 Answers: Disparities Research for Change Grant
 Program

Deadline: March 16, 2006 (Brief Proposals)

In an effort to improve the quality of health care for
all Americans, the Robert Wood Johnson Foundation
( http://www.rwjf.org/ ) is working to identify and
implement real-world solutions to eliminating the gaps
in care experienced by patients from racial and ethnic
minority populations. As part of this effort, RWJF has
released a Call for Proposals for a new program, Finding
Answers: Disparities Research for Change.

The three-year, $5 million program is a research and
tracking initiative that will focus on evaluating
approaches already underway in the field to reduce racial
and ethnic disparities in healthcare. Approximately
twenty-five grants will be made over the course of this
three-year period.

While the existence of racial and ethnic disparities in
health care is well documented, there is a shortage of
practical and effective solutions. Finding Answers seeks
to address this challenge by funding evaluations of
efforts that target the treatment of cardiovascular
disease, depression, and diabetes. These three diseases
were selected because the racial and ethnic disparities
in their treatment are significant and because there is
general consensus about the right way to care for these
illnesses.

Finding Answers seeks successful interventions that attack
different causes of disparities. Provider organizations
such as medical groups, hospitals, community health
centers as well as health plans and employers, community
organizations, and academic institutions are encouraged
to learn more about the Call for Proposals. Interventions
spanning the range from organization-wide quality improve-
ment initiatives to initiatives aimed at individual
providers and patients are eligible for funding.

Six to eight grants ranging between $50,000 and $300,000
will be awarded in October 2006.

The Finding Answers Call for Proposals is available online
at the RWJF Web site.

RFP Link:
http://fconline.fdncenter.org/pnd/10000712/rwjf

For additional RFPs in Health, visit:
http://fdncenter.org/pnd/rfp/cat_health.jhtml

------------------------<<>>--------------------------

10) Susan G. Komen Breast Cancer Foundation Seeks Nominees
 for Professor of Survivorship Awards

Deadline: March 1, 2006

Nominations are being accepted for the Susan G. Komen
Breast Cancer Foundation's ( http://www.komen.org/ )
Professor of Survivorship awards, an honor that recognizes
extraordinary achievement in research and clinical work
specifically related to breast cancer survivorship.

The award, which was established by the Komen Foundation
in 1999, is granted each year to two individuals who have
distinguished themselves in research specific to long-term
breast cancer survivor issues or in work with survivors
that takes place in a clinical setting. Awardees are
appointed Komen Professors of Survivorship for a one-year
period, and each awardee receives a $20,000 honorarium to
advance their work.

The Komen Foundation established the Professor of
Survivorship awards in direct response to the growing
numbers of breast cancer survivors and to enhance under-
standing of psychosocial and physical health issues
related to survivorship. A specially appointed committee
of peers and breast cancer survivors selects the awardees.

Previous Komen Professor of Survivorship awardees have
been recognized for efforts ranging from authoring popular
books on survivorship issues to the establishment of Web
sites and other informational resources for survivors and
their families. The award also has helped to advance
academic research on the impact of treatment and psycho-
social distress experienced after treatment completion;
quality-of-life issues in minority communities; the impact
of cognitive disorders sometimes associated with treatment;
treatment of side effects such as weight gain; and the
potential benefits for survivors in making dietary adjust-
ments and following specially designed exercise programs.

visit the Komen Foundation Web site for application
criteria and/or to obtain a downloadable nomination form.

RFP Link:
http://fconline.fdncenter.org/pnd/10000713/komen

For additional RFPs in Health, visit:
http://fdncenter.org/pnd/rfp/cat_health.jhtml

------------------------<<>>--------------------------

11) American Indian Journalism Institute Accepting
 Nominations

Deadline: March 31, 2006

The Freedom Forum ( http://www.freedomforum.org/ ) is
accepting nominations for the sixth annual American
Indian Journalism Institute, a training program for
Native American journalism students.

AIJI will take place at the Freedom Forum's Al Neuharth
Media Center and the University of South Dakota in
Vermillion June 4-23, 2006. Any Native American college
student with an interest in becoming a newspaper
journalist may apply.

Once accepted into the program, AIJI participants will
be placed in one of four courses according to their
interests and experience. Courses offered in 2006 will
include "Basic News Reporting," "Advanced News Reporting,"
"News Editing," and "Photojournalism."

The Freedom Forum will facilitate and fund the program.
Tuition, fees, books, room, and board are provided free
to enrollees.

To be eligible, Native students must have completed at
least one year of college. Applications for the program
will be accepted from new participants and from returning
AIJI students seeking specialized instruction.

Program graduates will earn four hours of college credit
from the University of South Dakota that students may
transfer to their current school. In addition, graduates
will receive a $500 stipend/scholarship from the Freedom
Forum, paid when the student resumes full-time classes
in the fall.

Top AIJI graduates will receive paid internships as
reporters, copy editors, and photographers at daily
newspapers and with the Associated Press for up to six
weeks during the summer. Graduates also will have the
opportunity to join the staff of http://www.reznetnews.org,
the online Native American college newspaper, as paid
journalists when they return to school.

AIJI administrators prefer that students be nominated by
educators, mentors, elders, or other interested parties.
Students may, however, nominate themselves.

Visit the Freedom Forum Web site for complete program
information and nomination procedures.

RFP Link:
http://fconline.fdncenter.org/pnd/10000714/freedomforum

For additional RFPs in Journalism/Media, visit:
http://fdncenter.org/pnd/rfp/cat_journalism.jhtml


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------------------------<<>>--------------------------

12) Asia Society Seeks Nominations for Osborn Elliott
 Prize for Excellence in Asian Journalism

Deadline: March 1, 2006

The Asia Society ( http://www.asiasociety.org/ ), the
leading global organization working to strengthen
relationships and promote understanding among the people,
leaders, and institutions of Asia and the United States,
has announced that it is now seeking nominations for the
fourth annual Osborn Elliott Prize for Excellence in Asian
Journalism.

The Osborn Elliott Prize honors legendary journalist and
author Osborn Elliott, former editor-in-chief of Newsweek,
who set new standards for reporting and editing and became
one of the earliest practitioners of "civic journalism" --
the deliberate focusing of the journalistic enterprise on
urgent issues of public policy.

The $10,000 prize is awarded annually to a writer who has
produced the best example of journalism about Asia in
print or online during the calendar year. Criteria for
the prize include consideration for the impact of the
work, its originality, creativity, depth of research, and
educational value in informing the public about Asia. The
next winner of the "Oz Prize," for work produced in
English during the 2005 calendar year, will be announced
at a special program at the Asia Society in New York City
this spring.

An independent jury of distinguished writers, award-
winning journalists, and Asia-hands will review
nominations for the prize from both media organizations
and journalists. All nominations or direct applications
are limited to one per organization or journalist.

For the purposes of this award, "Asia" is termed as
defined by the Asia Society, comprising countries from
Iran eastward to and including Australia and New Zealand.
It does not include the Arab Middle East.

Visit the Asia Society Web site for complete program
information.

RFP Link:
http://fconline.fdncenter.org/pnd/10000715/asiasociety

For additional RFPs in Journalism/Media, visit:
http://fdncenter.org/pnd/rfp/cat_journalism.jhtml

------------------------<<>>--------------------------

13) Entries Invited for Casey Medals for Meritorious
 Journalism

Deadline: March 1, 2006

The Casey Medals for Meritorious Journalism are designed
to inspire and recognize exemplary reporting on children
and families. The Casey Journalism Center on Children and
Families ( http://www.casey.umd.edu/ ), which presents
the awards, is devoted to deepening the media coverage of
social issues that affect children and families, particu-
larly the disadvantaged. The awards are funded by the
Annie E. Casey Foundation ( http://www.aecf.org/ ).

Winning stories will be well-crafted, illuminate complex
issues, and contribute to public awareness. Judging is
conducted by a panel of prominent journalists and
journalism educators.

First-place winners in fourteen categories will receive
$1,000 and will be honored at a luncheon in Washington,
D.C.; runners-up and honorable mentions will be recog-
nized with certificates of merit.

All work must be published or aired in the United States
between January 1, and December 31, 2005. Work must
focus on children and families in the United States. A
contestant or team of contestants may submit only one
entry per category per contest period. Entries in
languages other than English require complete transla-
tions. If a team wins a first-place award, authors share
the $1,000 equally.

Visit the CJC Web site for complete awards program
information.

RFP Link:
http://fconline.fdncenter.org/pnd/10000716/casey/umd

For additional RFPs in Journalism/Media, visit:
http://fdncenter.org/pnd/rfp/cat_journalism.jhtml

------------------------<<>>--------------------------

14) Open Society Institute Announces Katrina Media
 Fellowships

Deadline: March 31, 2006

The Open Society Institute ( http://www.soros.org/ ) has
announced a fellowship competition in response to critical
issues exposed by Hurricane Katrina. By supporting in-
depth journalism and media projects, OSI aims to stimulate
and sustain a national conversation on these issues.

The Katrina Media Fellowships will support dynamic print
and radio journalists, photographers, and documentary
filmmakers in the creation, and improvement, of media
coverage of issues exposed by Katrina. Applicants should
propose projects that will expand and deepen the public's
understanding of race and class inequalities in the United
States. Applicants may also propose projects that will
address the government's response to problems caused or
illuminated by Katrina, the use or misuse of public funds,
the role of private contractors, the effectiveness of
clean-up and rebuilding efforts, citizen involvement in
these efforts, and lessons learned that should inform
the handling of future natural and man-made disasters.
In addition, applicants may propose projects that draw
attention to OSI's current or past programmatic priori-
ties, using Katrina as the frame. These priorities include
access to legal services and government assistance,
criminal justice reform, improving end of life care, and
access to healthcare and education reform.

OSI expects to award twelve to fifteen one-year fellow-
ships. Fellows will receive between $15,000 and $35,000
to carry out projects in print, radio, photography, and
documentary film and video production. Award amounts
will cover a stipend and project expenses and will vary
depending on the project duration, medium, and costs
involved. The fellowship term begins June 15, 2006.

Applicants must be mid-career or veteran print or radio
journalists, photographers, or documentary filmmakers with
proven track records as serious media-makers. OSI will
give special consideration to applicants who have been
displaced from or are residents of the Gulf Coast region.

The Katrina Media Fellowships are a one-time competition
and will not be offered in subsequent years.

Fellowship guidelines and application instructions are
available at the OSI Web site.

RFP Link:
http://fconline.fdncenter.org/pnd/10000717/soros

For additional RFPs in Journalism/Media, visit:
http://fdncenter.org/pnd/rfp/cat_journalism.jhtml

------------------------<<>>--------------------------

15) Caring for Carcinoid Foundation Seeks Research
 Proposals

Deadline: March 1, 2006 (Letter of Intent)

The 2006 Request for Proposal from the Caring for
Carcinoid Foundation ( http://caringforcarcinoid.org/ ),
the leading nonprofit funder of carcinoid research, is
now available online.

The mission of the Caring for Carcinoid Foundation is
to discover a cure for carcinoid. The foundation believes
in making rapid advances in the battle against carcinoid,
and seeks to award research grants to scientists whose
work will unlock the genetic causes of carcinoid and lead
to new, genetically targeted therapies.

Specifically, the foundation funds research that builds
on novel ideas; applies cutting-edge technology; leverages
insights from related cancers, such as pancreatic endo-
crine cancer; fosters collaboration between scientists and
institutions; and demonstrates the potential to expand
in scope and attract additional support, particularly from
the NIH.

The purpose of this Request for Proposal is to fund
scientists who will accelerate our search for a carcinoid
cure. Applicants must demonstrate how their proposed
research will align with the foundation's Research Road
Map ( http://www.caringforcarcinoid.org/research/researchroadmap.asp ).

Applicants must also demonstrate how they will use
performance metrics to track their rapid progress in
contributing to a carcinoid cure.

Applicants must have an M.D., Ph.D., or equivalent degree
and be sponsored by a nonprofit institution, as defined
by Section 501(c)(3) of the U.S. Internal Revenue Code.

The program will award $50,000 to $150,000 per year, for
a minimum of two years. Funds may only be used for per-
sonnel salaries, supplies, equipment, and/or services.
Use of funds for institutional overhead costs is strictly
prohibited.

The complete 2006 Request for Proposals is available at
the Caring for Carcinoid Foundation web site.

RFP Link:
http://fconline.fdncenter.org/pnd/10000718/carcinoid

For additional RFPs in Medical Research, visit:
http://fdncenter.org/pnd/rfp/cat_medical_research.jhtml

------------------------<<>>--------------------------

16) San Francisco Foundation Invites Entries for Community
  Leadership Awards

Deadline: March 1, 2006

The San Francisco Foundation ( http://www.sff.org/ )
Community Leadership Awards recognize individuals and
organizations whose leadership has made a significant
impact in their particular Bay Area communities. This
work may confront social or health problems, address
environmental concerns, or promote arts and humanities.

One of the four awards is designated for an under-
recognized, mature artist who has made a significant and
ongoing contribution in the Bay Area. Artists from the
performing, literary, media, and visual arts, including
craft, folk, and traditional forms, will be considered.

Individuals receive $10,000 awards, while  organizations
are awarded $20,000. Individuals and nonprofit organiza-
tions in Alameda, Contra Costa, Marin, San Francisco,
and San Mateo counties are eligible to apply.

Individuals from all sectors are eligible for these awards.
Nominations for emerging and innovative leadership as well
as for longstanding accomplishments are encouraged.

For additional information about the program and the
nomination process, visit the SFF Web site.

RFP Link:
http://fconline.fdncenter.org/pnd/10000719/sff

For additional RFPs in Philanthropy and Voluntarism,
visit: http://fdncenter.org/pnd/rfp/cat_philanthropy.jhtml

------------------------<<>>--------------------------

17) William Randolph Hearst Endowed Fellowship for
 Minority Students Accepting Applications

Deadline: February 15, 2006 and July 15, 2006

The Nonprofit Sector Research Fund ( http://nsrf.org/ ),
a grantmaking program of the Aspen Institute
( http://www.aspeninstitute.org/ ) in Washington, D.C.,
is accepting applications for the William Randolph Hearst
Endowed Fellowship.

The fellowship, which is based on academic excellence and
need, is open to both undergraduate and graduate students
who are members of minority groups. The Hearst Fellow
serves as an intern with the fund. Through the program,
the fund seeks to introduce a diverse group of students
to issues relating to philanthropy, volunteerism, and
nonprofit organizations. Recipients may arrange with their
colleges or universities to receive academic credit for
this experience. In his or her internship, the Hearst
Fellow undertakes general research and program support
for the fund's grantmaking and outreach efforts.

The ideal candidate for this fellowship is a highly
motivated continuing graduate or undergraduate student
from an underrepresented community. She or he should have
an excellent academic record and also have the following:
outstanding research skills; a background in the social
sciences or humanities; excellent writing and communica-
tion skills; demonstrated financial need; and American
citizenship.

The student must be able to intern for ten to fifteen
weeks at the Washington, D.C., office of the Aspen Insti-
tute. A fellowship grant of between $2,500 and $5,000
will be awarded, depending on the recipient's educational
level, financial need, and time commitment.

For the Summer 2006 internship, the deadline is February
15, 2006; for the Fall 2006 internship, the deadline is
July 15, 2006.

See the Nonprofit Research Fund Web site for complete
program information and application procedures.

RFP Link:
http://fconline.fdncenter.org/pnd/10000720/nonprofitresearch

For additional RFPs in Philanthropy and Voluntarism, visit:
http://fdncenter.org/pnd/rfp/cat_philanthropy.jhtml

::::::::::::::::: THIS WEEK IN PND ::::::::::::::::::

NEWSMAKER: Stephen Heintz, president, Rockefeller Brothers
Fund

PND spoke to the president of the Rockefeller Brothers
Fund about the role of philanthropy in an increasingly
interdependent world, risk and the concept of failure in
a philanthropic context, and the importance of leadership
in a time of rapid change.

To read the complete interview, visit:
http://fconline.fdncenter.org/pnd/10000727/nm/heintz

::::::::::::::::: ON THE BOARDS ::::::::::::::::::

The PND message boards are open, and we're talking about
cultivating funders, the overlap of grantwriting/program
planning, founders' syndrome, ethical codes for a board
of directors, and more.

Stop by and share your thoughts. Or start a new thread:

http://members4.boardhost.com/PNDtalk/
http://members5.boardhost.com/ARTStalk/

:::::::::::::::: PND ON THE WEB ::::::::::::::::::

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WyHIO Web Page

2006-02-06T07:35:00.000-07:00

http://www.wyhio.org

Information Links - RWJF narrative

2006-02-06T07:29:00.000-07:00

InformationLinks:
Connecting Public Health with Health Information Exchanges

Proposal Narrative
Organization: Wyoming Health Information Organization

BACKGROUND
In 2003 the Wyoming Legislature created the Wyoming Healthcare Commission (WHCC) and in 2004 passed Enrolled Act 31 directing the Commission to create an Information Technology Technical Management Subcommittee (IT2) to study and paln for a statewide electronic health records inmplementation by Oct. 15, 2005.
John Snow, Inc (JSI) was selected by WHCC and IT2 to assess Wyomingâ€™s electronic health records readinsess and make recommendations for rapidly increasing the utilization to access patient health information. On June 29, 2005 as part of the IT2â€™s vision resulting from the JSI study process â€“ the WHCC recommended to Governor Dave Freudenthal and the Legislatureâ€™s Joint Interim Labor, Helath and SOcial Services COmmittee that Wyoming form a self-sustaining regional health information organization (RHIO) to facilitate an intrastate, regional interstate and national federal partnership for the rapid deployment of Wyomingsâ€™ electronic health information.
On July 18, 2005, in Casper â€“ the center of Wyoming â€“ more than 50 representatives of local, state and federal governement, business, medical care providers and healthcare purchasers and payers gathered and agreed to form a RHIO to ready Wyoming for health information technology standards, funding and implementation assistance.Memorandums of Understanding were immediately submitted by a majority of the attendees and a second meeting was held Aug. 11 to nem the RHIO (now being registered with the Wyoming Secretary of Stateâ€™s Office and the Internal Revenue as the nonprofit Wyoming Health Information Organization (WYHIO). The stakeholders
chose on that night an interim board of directors representing a broad cross-section of the stateâ€™s investors in the healthcare delivery system. A consensus was reached that the WYHIO can serve as the catalyst for the facilitation of health information technology demonstration projects, can foster collaboration on electronic health information infrastructure and will evaluate and endorse projects and processes that will integrate with the health information network.
The WYHIOâ€™s 7 interim board members are:
Dr. Geoffrey Smith, Casper radiologist (chairman)
Dr. Robert Fagnant, Rock Springs Obstetrician-Gynecologist (provider representative)
Lee Clabots, Deputy Director Wyoming Department of Health (state government representative)
Andrew Fisher, Assistant Director Great West Life and Health (payer representative)
Dana Barnett, Director, Outreach Services, United Medical Center
Steve Chasson, Director, Wyoming Primary Care Association (provider representative)
Larry Madsen, Vice President Blcak Hills Bentonite (purchaser representative)
Carol Jenkins, Buffalo Healthcare Delivery Systems Consultant (WHCC
ex-officio)

Stakeholders who have signed Memorandums of Understanding:
Community Health Center of Central Wyoming
Ivinson Memorial Hospital
Johnson County Healthcare Center
MBA of Wyoming
Memorial Hospital of Converse County
Memorial Hospital of Sweetwater County
Mountain Pacific Quality Health Foundation
Niobrara Life and Health Center
West Park Hospital
Jack Webb, IT Director
WIN Health Partners
Wyoming Department of Health
Wyoming Lodging and Restaurant Association
Wyoming Medical Center
Wyoming Medical Society
Wyoming Primary Care Association
Wyoming Rural Development Council
Wyoming State Board of Pharmacy

VISION
Currently, the U.S. health care system is highly fragmented and paper-based, with critical information about the patient stored in a variety of forms across hospitals, laboratories, pharmacies, physician offices, and administrative data systems within health plans. Wyoming is no different and as a result of this current state, clinicians often donâ€™t have comprehensive information about the patient when and where it is needed mostâ€”at the point of care.
At the same time, reports from a wide range of philanthropic, private sector and non-profit organizations, as well as several agencies in the public sector, recognize the value of health information technology and the mobilization of data in addressing the quality, safety and efficiency challenges in the U.S. health care system. Interest has now turned to the development of policies and practices for accelerating the effective implementation and use of such systems in a way that will assure that expected quality, safety and efficiency of outcomes will be achieved.
There are over 100 emerging state, regional and community-based initiatives focused on the mobilization of health care information across organizations within their respective locales. Based on a survey conducted by eHealth Initiative in December 2004, such initiatives are in a wide range of readiness states. It is the goal and vision of WYHIO to become the catalyst in Wyoming to this information exchange by enabling:
1. Anytime, anywhere health care information and decision support.
2. Immediate availability of complete medical record (compiled from all sources)
3. Up-to-Date decision support at any point of care
4. Selective reporting (e.g. for public health)
5. Use of tools to facilitate delivery of care (e.g. e-prescribing)
6. Allow patients to control acccess to their information
7. Align/direct incentives to those who create value
8. Allow each care facility to maintain its own data
9. Minimize cost(s) and risk
10. Use proven implementation strategies where appropriate.

Wyoming is the 10th largest state in area but is least popluated in the nation. It includes within its borders an area of 97,818 miles. Winter weather is harsh and roads are often unpassable or closed due to storms. This makes the delivery of health a challenge a best. A patient who is admitted at one point of care often needs to be transferred to another facility or city where appropriate treatment is offered. Time is of the essence especially when critical situations arise, and often a patient must be transferred without a complete medical record because it is not accessible on short notice. The receiving caregiver is at a disadvantage without a complete medical history to provide the needed treatment. Lifesaving treatment may be interrupted untill records are recieved There is also the issue of unnecessary tests or duplicate tests being performed because previous results are not readily available to the caregiver. In bottom-line terms, the WYHIO can save lives and incredible amounts of money. A recent Vanderbilt University study indicated that a 600-bed hospital participating in a RHIO could save up to $5.6 million per year. These savings are a direct result of: Decreased number of duplicate laboratory tests (e.g. blood work, samples). Decreased number of duplicate radiology tests (e.g. x-rays, MRIs). Reduced number of in-patient hospitalizations. Fewer patient visits to the emergency department.

OBJECTIVES/KEY ACTIVITIES
A strategic business plan must be developed and maintained by the WYHIO and a team responsible for soliciting and managing funds must be formed and sustained. A technology plan that describes the technology infrastructure, support requirements, and phased build-out through iterative steps must be defined and supported. Revenue models for all initiatives must be defined, approved, and implemented. An Executive Director/Chief Information officer will be hired who will report directly to the board. This person must posess a variety ofhigh-levelskills in organizational development and leaderhsip, communications, decision-making, and health information technology. This person will be key to the development of health information technology initiatives of the WYHIO. One project director will be hired in the first year and will report to the Executive Director/CIO. One administrative support staff will also be hired in the first year and will be responsible for administrative and secretarial support to the WYHIO staff. A Systems Analyst will be hired in the first year also who will have the responsibility of to research and assist in developing plans, specifications, RFPâ€™s and other documents for the information exchange intitiatives of WYHIO.

TARGET POPULATION

Recognizing that some Wyoming residents work in the mines of surrounding states, and conversely, residents of other states work in the mines of Wyoming this is one population that would benefit greatly from an electronic health record. There is an energy boom affecting the state at this time that is comprise of a largely transient population who do not have primary care physicians. The main target popluation of the WYHIO is every resident in the state of approx 500,000, as they are all potential patients of the healthcare system. Due to a larger proportion of the baby-boomer generation (born between 1946 and 1962), Wyomingâ€™s population is aging rapidly. In 2000, the median age of 36.2 in the state passed the national average of 35.3. It will be particularly intensified in about ten years as this age cohort reaches retirement, which will create possible labor shortages and increased demand for health and social services.

LEADERSHIP AND COMMITMENT
Describe the organizational roles and qualifications of applicant agency personnel that will participate. Include level of time commitment (FTE) that these personnel will devote to the planning process and the roles they will play in that process. Discuss the role of the agencyâ€™s chief executive. Also, describe plans to continue participation in the health information exchange after the grant.

xxxxxx (your response goes here) xxxxxx

COLLABORATION
NOTE: A letter of support from the head (e.g. health officer) of the applying organization must be mailed to the Program Office. In addition, organizations applying on behalf of a state or local public health agency must supply a letter of support from that agency (or agencies). Letters of support from collaborating partners should also be mailed to the Program Office. See instructions on â€œAdditional Documents Screenâ€�.

List here the names of the collaborating organizations (health departments and members of the health information exchange) from whom we should expect to receive letters of support.

Please describe any collaborative relationships or arrangements related to this proposal, i.e. between local health departments and state health departments or between these health departments and the health information exchange. Discuss your agencyâ€™s role in such collaborations and in any other activities related to health information technology in your state. Also include any past successful collaborative efforts with these partners. Please include details on past collaborations.

xxxxxx (your response goes here) xxxxxx

READINESS OF THE HEALTH INFORMATION EXCHANGE
Please describe the degree to which the health information exchange has developed to provide a valuable opportunity for public health agencies to participate. What is the breadth of participation and the level of commitment on the part of the key stakeholders? Has the exchange developed a governance structure? What is the extent of its funding? For example, has the exchange received federal grants or contracts from the Agency for Healthcare Research and Quality or the Foundation for eHealth Initiativeâ€™s Connecting Communities for Better Health program? Have specific data sharing projects been planned or initiated? Has a business plan or multi-year strategic plan been completed?

xxxxxx (your response goes here) xxxxxx

CHALLENGES

The data gathering conducted by JSI has facilitated the compilation of a number of constraints that must be addressed by the recommendations put forward above and during the coming phases of this project. â€¢ There is a wide and significant variation across the State with regard to level of exposure to, understanding and adoption of health information technology (HIT) across all types of provider entities: physician practices, hospitals, pharmacies, and public health facilities. There is a very limited pool of HIT technical staff resources available to support providers in the acquisition, installation and maintenance of such systems. Of those organizations that have implemented some level of HIT, administrative systems are typically installed first and clinical information systems tend to be a secondary consideration. A very wide range of views exists with regard to the potential benefits and opportunities for implementing and utilizing HIT to improve the quality of healthcare services provided. Across both the physician and hospital segments, groups are looking to the State of Wyoming for guidance with regard to standards and/or â€œpreferred vendor solutionsâ€� Broad resistance to the idea of mandated HIT implementation exists across the State. Expectation that appropriate incentives should be provided (mainly financial), in order to support the cost of implementing and sustaining HIT, particularly among the smaller physician practices in the State. Some resistance to the idea of creating a â€œcentralized database of personal health informationâ€� exists. Opportunities exist to simultaneously develop both broad, statewide HIT initiatives, as well as those that are focused on HIT in local communities. Moving forward with HIT efforts in the State will require the constant and consistent attention of a central, coordinating organization working with multiple stakeholders.

SPECIAL CONSIDERATIONS
Summarize any special features that make your application unique and innovative. Describe how your project may serve as a model for other health departments.

Health Information Security and Privacy Collaboration (HISPC)

2006-02-06T07:18:00.000-07:00

RTI Request For Porposals

http://www.rti.org/page.cfm?objectid=09E8D494-C491-42FC-BA13EAD1217245C0

ePrescribing Concept Paper

2006-02-06T07:10:00.000-07:00

Wyoming Health Information Organization
PFHSE Excellence in Practice
Concept Paper â–ª January 31, 2006

Background and Need Wyoming presents a unique blend of geographies that encompass wide-open rangeland, towering mountains, monumental national parks, and weather extremes to match. Due in part to this unique geography, Wyoming, with approximately 500,000 people spread over a little under 100,000 square miles, is one of the most sparsely populated states in the nation. As such, access to needed medical services can be a significant challenge. With the objective of utilizing technology to exchange healthcare information, collaborative healthcare partners have sought to improve the quality and access to healthcare by achieving such goals as fewer hospital admissions from the emergency department, fewer readmissions, reduction in medical errors, shortened hospital length of stay, enhanced revenue from proper coding, and test duplication avoidance.

In 2003, the Wyoming Legislature created the Wyoming Healthcare Commission (WHCC) to develop strategies to improve health care and reduce health care costs for Wyoming citizens. In 2004, the legislature passed Enrolled Act 31, directing the Commission to create an Information Technology Technical Management Subcommittee (IT2) to study and plan for statewide interoperable electronic health records (EHR) implementation by Oct. 15, 2005. John Snow, Inc. (JSI) was selected by WHCC and IT2 to assess Wyomingâ€™s electronic health records readiness and make recommendations for rapidly increasing the utilization of technology to access patient health information. In the summer of 2005 more than 50 representatives of local, state and federal government, business, medical care providers, and healthcare purchasers and payers gathered and formed the nonprofit Wyoming Health Information Organization (WYHIO).The stakeholders chose an interim board of directors representing a broad cross-section of interests in the stateâ€™s healthcare delivery system. WYHIO is positioned to evaluate and endorse projects and processes that will integrate with the unfolding Wyoming health information network. The WyHIO sees ePrescribing as a high-priority initiative and need for Wyoming given the high number of real-world models demonstrating an excellent return on physician, pharmacy and patient time investments.

As part of the EHR feasibility study, feedback was gathered from key stakeholder interviews and from focus groups held throughout the state, Wyoming physicians view electronic prescribing as the single most popular and acceptable medical computing application. Many of them also view it as potentially the most valuable first step toward medical practice automation. Even providers who do not see any immediate value for a full-scale electronic medical record in their practice tend to be enthusiastic about the advantages of electronic prescribing because it promises to reduce some of their office workload.According to the Wyoming Board of Medicine, there are 801 registered physicians in the state of Wyoming. The Wyoming Board of Pharmacy lists 139 registered pharmacies. Of the thousands of prescriptions filled every month, many require direct contact between the pharmacy and the provider who signs the prescription for clarification, confirmation or to complete missing information. In addition, thousands of refill requests need to be processed by pharmacies and physician offices, requiring another round of communication. The overall prescribing process can be cumbersome and time consuming. One Wyoming primary care physician recently estimated receipt of 20 telephone messages on average per day about prescriptions he has written.

The WyHIO ePrescribing Initiative is needed to increase efficiency, accuracy and appropriateness of medication to benefit patients, physicians, pharmacists and payers. ePrescribing is a major step to the statewide interoperable electronic health records implementation.

Purpose of Project To facilitate adoption of technology in the physician office, a statewide e-Prescribing initiative is proposed, beginning with a pilot implementation to demonstrate viability. Physicians and allied health professionals participating in the initiative will send prescriptions electronically to pharmacies through personal computers, PDAs or tablet devices. The practitioner will have the ability to review drug interactions, review formulary requirements and access a disease reference database. The WyHIO will assist the practices in installation of the system, training, matching incentives and ongoing support.

While significant technical, legal and operational issues need to be resolved before a national electronic prescribing plan goes into effect, developing such systems for electronic prescribing is a national and state priority. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173) specifies the development of national standards for enabling the exchange of basic prescription data to and from prescribers and pharmacists, as well as standards for information exchanged about a patient's drug utilization history, possible drug interactions, the drug plan (including information about the formulary and cost-sharing), and information about lower-cost therapeutically appropriate alternatives.

Description of Project The system is designed to prevent medical errors due to illegible handwriting, decrease the need for time consuming telephone communications between the pharmacy and prescriber, and improve the turn around time filling prescriptions at the pharmacy.

The project will establish the baseline of preferred drug list use and use of generic drugs in the Medicaid program prior to initiating the project and will analyze these measures after adoption of e-Prescribing. These measurements will be made at 6 months (after an initial pilot), and after a prescriber has used the system for at least a full year after the rollout of the statewide project. Provider adoption will be tracked at the same intervals using a survey process to assess characteristics of early adopters.

Impact Sponsoring an ePrescribing initiative will streamline the prescription process by integrating payers, pharmacies, and providers. ePrescribing is being widely implemented through regional initiatives and is supported by accepted HIT standards. An ePrescribing system represents a low risk/high reward opportunity relative to other initiatives that may be considered.

Transmitting drug prescriptions electronically to pharmacies has been shown to reduce errors caused by handwriting and reduce the considerable time currently expended between pharmacies and prescribers in clarifying prescription information. In addition, with the cumulative electronic collection of prescription information, it is possible to develop a history of all medications that have been dispensed for an identified patient. This permits automated checking of interactions between drugs â€“ a vitally important patient safety process. Moreover, accurate medication lists can be time and even lifesaving at the point of patient care.

Further, drug utilization data can be valuable for disease management of chronic conditions, and is indispensable information for measuring costs of care. Other uses of accurate patient medication lists include facilitating drug alerts and recalls, and identifying prescription drug abuse. Payers, who administer formularies with different coverage for different drugs can expect greater compliance when coverage information is available at the time of prescribing. JSI received positive feedback on ePrescribing from groups of physicians and pharmacists in Wyoming, who tend to view electronic prescribing as potentially delivering significant efficiencies for their daily practices.

Federal Telemedicine Update

2006-02-05T22:50:00.000-07:00

Federal Telemedicine UpdateFederal Telemedicine NewsFederal Telne News

Wyoming Establishing a Regional Health Information Organization

The Wyoming Healthcare Commission, Subcommittee on Health Information Technology has been meeting to study and develop a plan to implement electronic health records in the state. John Snow Inc. was chosen to do a study to analysis what is essential for health information technology to take place in Wyoming.

The goals of the Wyoming Electronic Health Records Study are to:

Develop a statewide electronic health record model
Identify a model for funding the EHR
Define a supportive governance model such a an RHIO
Propose a timeline for implementation
Promote open standards and business policies for data sharing

At a meeting in July, Dr. Scott Young, AHRQ said there are about 20 RHIOs up and running. Most are nonprofit, quasi-governmental entities. He said only two are in the black that do not require a steady influx of money such as Utah Health Information Network and the New England Health Information Network. One uses a subscription model, and the other shaves off a small amount of money per transaction. He also said that AHRQ has not worked with a state as rural as Wyoming and indicated that Wyoming is well positioned to pursue agency support.

The Healthcare Commission felt that they were on the right track, but it was felt at a formation meeting held August 11, 2005, that a board needed to be formed to finalize the project to be called WYHIO. According to the Star-Tribune, the board would include representatives from the Wyoming Department of Health, Wyoming Primary Care Association, and Black Hills Bentonite, Great West Insurance, Wyoming Hospital Association and the Wyoming Medical Society

Wyoming Creates a Regional Health Information Organization (RHIO)

2006-02-05T22:46:00.000-07:00

<>Wyoming Creates a Regional Health Information Organization (RHIO)

Congratulations to the people of Wyoming who have taken another major step towards improving access, quality, safety and efficiency of healthcare by establishing the Wyoming Health Information Organization (WYHIO). See the most recent news! Casper Star Tribune

Update: October 2005

The Wyoming Healthcare Commission is recommending that the state spend $41 million over five years to create a statewide network of electronic health care records. Casper Star Tribune View the WHCC EHR Study.

Wyo. Establishes Health IT Commission

2006-02-05T22:41:00.000-07:00

Wyo. Establishes Health IT Commission

August 15, 2005

Volunteers in Wyoming on Thursday formed a commission to develop a statewide health IT system, the Casper Star-Tribune reports. The existing Wyoming Healthcare Commission began the effort, but organizers said a separate board was necessary to execute the project, the Star-Tribune reports.

The new group - called the Wyoming Health Information Organization - will be chaired by Dr. Geoff Smith, a radiologist in Casper. Other members will include Wyoming Department of Health Administrator Leland Clabots, Wyoming Primary Care Association Director Steve Chasson, Black Hills Bentonite Vice President Larry Madsen, and representatives from Great-West Insurance, the Wyoming Hospital Association and the Wyoming Medical Society, the Star-Tribune reports.

WyHIO's first priorities will be to hire an executive director, increase the number of practices that electronically file insurance claims, develop a system that will enable physicians to send prescriptions over e-mail, coordinate hospitals and physicians and build basic patient health records, the Star-Tribune reports. WyHIO hopes to obtain funding through grants and government subsidies.

Sen. Michael Enzi (R-Wyo.) asked the Agency for Healthcare Research and Quality for help developing Wyoming's system, and a representative from the group offered technical assistance last week in Casper.

"The system currently is expensive and inefficient, and we need to find ways to make it more efficient and more affordable so that more people can get access and better health care," said Anne Ladd, executive director of the Wyoming Healthcare Commission (Nordby, Casper Star-Tribune, 8/13).

WyHIO

Quovadx Participates in Developing Accenture Nationwide Health Information Network Prototype

Progress report on federal healthcare IT goals

Companies poised to take part in EMR shift

WellPoint Launches E-Prescription Pilot

Free E-prescribing to Every Physician in America

Cause of Death: Sloppy Doctors

nations's Capital Welcomes It's First Electronic Prescription

Draft Requirements for EHR

Democrats to push health IT funding, privacy

Zix Corporation Expands e-Prescribing Contract

New Congress, Same IT Issues

HIT movers and shakers in 2007

Hawaii Blues to Docs: We'll Help With EMRs

Improving Health Care Access: Grantmakers Share Their Experiences

Ahead for 2007: Open-source software for RHIOs?

Tradeshows and Speaking Engagements

Group prescribes changes

Expanding the reach and Impact of Consumer E- Health Tools

National Office for Health IT Awards State E-Health Alliance Contract

Cost called largest obstacle for EMR adoption

Drug Reactions Send 700,000 Yearly to ER

Developing a national HIT network

Are We Close to Real Data Integration

Rural Assistance Center Announces New State Information Resource

Rural Assistance Center Announces New State Information Resource

Legislative jam-up

An e-prescription for Medicaid

An e-prescription for Medicaid

Information technology could help save Medicaid, but complexity and a lack of standard practices continue to hobble the program

Physicians' Foundations Invest $2.6 Million to Support Doctors' Use of Technology

Report: Health Care IT Programs To Reach $12 Billion In 2011

Report: Health Care IT Programs To Reach $12 Billion In 2011

Report: Health Care IT Programs To Reach $12 Billion In 2011

CMS Awards First of 15 Contracts to Process and Pay Medicare Part A and Part B Claims

CMS Awards First of 15 Contracts to Process and Pay Medicare Part A and Part B Claims

Tommy Thomson briefs Congressional caucus on healthcare IT

Tommy Thomson briefs Congressional caucus on healthcare IT

By Bernie Monegain, Managing Editor

07/31/06

More Physicians Using Electrical Medical Records

More Physicians Using Electrical Medical Records

Medication Errors

Announcement to Help Speed Adoption of Electronic Health Records

Announcement to Help Speed Adoption of Electronic Health Records

Health Information Technology: A Rural Provider's Roadmap to Quality

WyHIO Update

WyHIO Update

House HIT legislation faces obstacles

By Caroline Broder, Senior Editor

06/23/06

House Committees Approve Health IT Bil

EHRs Offer Benefits, but Privacy Risks Remain

Health IT Access Among Physicians Remains Low

State Privacy and Security Subcontract Opportunities Announced Under Expanded HHS Contract with RTI

State Privacy and Security Subcontract Opportunities Announced Under Expanded HHS Contract with RTI

Coalition Pushes for Privacy in Electronic Health Records

Press Release - Connecting for Health Common Framework

EHRs Enter Patient-Doctor Relationships

David Brailer is a doctor by trade

Technology grants

National Funding Programs

Suggested Links

HHS Calls on Federal Advisory Group to Make EHRs Available to First Responders

The National Electronic Disease Surveillance System (NEDSS)

Briefing by the Nationwide Health Information Network

Brailer Says RHIOs Are Crucial

AHRQ

Healthcare IT News

PFHSE Excellence in Practice Concept Paper

Wyoming Legislative Update

National Health IT Coordinator Pushes Networking EHRs

RFP Bulletin

WyHIO Web Page

Information Links - RWJF narrative

Health Information Security and Privacy Collaboration (HISPC)

ePrescribing Concept Paper

Federal Telemedicine Update

Wyoming Creates a Regional Health Information Organization (RHIO)

Wyo. Establishes Health IT Commission