Blumenthal to leave ONC this spring

Posted on February 4, 2011 by Steve Fox and Vadim Schick

Dr. David Blumenthal, the head of the Office of the National Coordinator for Health IT (ONC), announced yesterday in a letter to his staff that he's leaving the ONC and returning to his position at Harvard University.  

According to Dr. Blumenthal, the move was "planned" and is expected to take place this spring. Here is a copy of his letter, via Healthcare IT News:

ONC Staff:

As you know, I have told Secretary Sebelius that I will be returning to my academic home this spring, as was planned when I accepted the position of National Coordinator for Health Information Technology. While we still have important work to do together, including the assurance of a productive transition for ONC, now is the time for me to express my deep gratitude to all of my ONC colleagues, and my admiration for all you have accomplished.

We have been privileged to be at the center of a great new enterprise at an historic moment in our health care system. For years America’s health policy leaders have understood that information technology offered the opportunity for transformational improvement of the Nation’s health care system and the health of individual Americans. Yet the obstacles are formidable: our fractured health care system, our dysfunctional payment methods, the lack of an infrastructure for exchanging health information, and more.

 

 The enactment of the Health Information Technology Economic and Clinical Health Act of 2009 handed us a rare opportunity to transcend these obstacles and to create a foundation, a strategy, and a self-sustaining movement toward a future of HIT-assisted health care. I believe we have effectively seized that opportunity, and you deserve the credit for this achievement.

Much attention has gone to the unprecedented resource commitment made by Congress and the President in HITECH – the allocation of as much as $27 billion in incentive payments to help support adoption of EHRs. The money is indeed crucial, and the Center for Medicare and Medicaid Services is doing a great job of putting it to use.

But I believe the key factor for success has been, and will continue to be, the concept of “meaningful use.” The HITECH Act recognized that EHR adoption alone would not bring about the transformative improvements that are possible with health information technology. EHRs must be used to support a new kind of information-rich health care. Meaningful use provides, for the first time ever, a consensus goal on how information should be used to enhance care. To realize its promise also requires changes in the processes of care delivery. HITECH gave ONC a major role in assisting health professionals and institutions to make these critical changes in the way care is delivered and we have begun this work in earnest.

We have successfully put in place the $2 billion support system created by HITECH, including:

  • Sixty-two Regional Extension Centers (REC), providing assistance to providers nationwide, with special attention to smaller primary care practices and rural hospitals.
  • Eight-four community college programs to provide HIT training and build a vitally-needed HIT workforce, including training for nurses, physician assistants and other in-place health care workers.
  • Seventeen Beacon communities, demonstrating how HIT can help bring community resources together to tackle specific local health needs.
  • State grants to support local solutions for health information exchange, consonant with broader national standards.
  • A program of research and development to help us continually improve EHRs and move quickly to the next level in HIT.

It is the efforts of the ONC staff, working cooperatively with the health care professions, the states, and so many others that have brought these programs quickly into being. They are now up and running. And we are already seeing results that indicate that the national shift to EHRs and HIT-assisted care is finally underway:

  • Adoption itself has turned up: from 2008 to 2010, the proportion of primary care physicians who had adopted a basic EHR increase by half, from 19.6 percent to 29.6 percent.
  • A significant proportion of providers were already indicating in the latter part of 2010 that they plan to achieve meaningful use objectives and qualify for incentive payments: 81 percent of hospitals, and 41 percent of office-based physicians.
  • A total of 291 EHR products have already been certified to support meaningful use objectives and qualify for use under the incentive payments program.
  • Some 38,000 providers have enrolled in REC assistance programs.
  • Community college programs will “graduate” an initial class of 3,400 HIT-trained students this spring, working toward a total capacity of 10,500 in each six-month session.

We have achieved these accomplishments together, as a hard-working team with a unique opportunity to make a difference.


On a personal note, I have profoundly enjoyed getting to know you and work with you. It has been one of the highlights of my professional life. And I am confident that the progress will continue and even accelerate after I have settled back into academic life in Boston.

Best wishes to you all.

David

 
Tags: , , , , , ,

HealthNet and Connecticut settle breach suit

Posted on July 8, 2010 by Steve Fox and Vadim Schick

In November of 2009, health insurance provider HealthNet reported a loss of a portable disk drive (which occurred six months prior to HealthNet's report). The disk drive contained compressed, though not encrypted, data, including social security and bank account information, on nearly half a million persons.  This loss outraged the Connecticut Attorney General Richard Blumenthal, eventually leading Connecticut to file suit against the insurer for HIPAA violations and noncompliance with HealthNet's own security policies by failing to encrypt the sensitive data.

However, on July 6, 2010, Blumenthal (who is currently running to replace Chris Dodd (D-CT) in the U.S. Senate) announced that Connecticut has reached a settlement with HealthNet and its parent companies over this breach.  According to Blumenthal, this is the very first time a state Attorney General reached such a settlement for a HIPAA violation. The settlement included:

  • $250,000 fine to be paid to Connecticut;
  • $500,000 contingency fund, to be paid to the state in the event it is determined that someone accessed the protected data on the lost disks; and
  • a "corrective action plan" which is aimed to enhance security of protected data in possession of HealthNet and its parent companies.

It is important to keep in mind that the penalties could have been even higher. Yet regardless of the amount of the fine, this breach cost much more to HealthNet than $250,000.  The costs associated with investigations, breach notification, and possible legal fees almost certainly cost the organization more than the amount of the fine imposed by Connecticut.  Thus, HealthNet's example should serve as a great reminder about the importance of doing everything possible to avoid a breach, and knowing how to handle a breach effectively if one does occur.

"Blumenthal wins $250,000 in Health Net settlement," TheDay.com (July 6, 2010).

Tags: , , , , , , , , , , ,

Pritts named first ONC Chief Privacy Officer

Posted on February 18, 2010 by Steve Fox and Vadim Schick

Joy Pritts, a researcher and faculty member at Georgetown University's Health Policy Institute, was named as the first Chief Privacy Officer for the Office of National Coordinator for Health IT.  This position was created pursuant to a provision in ARRA, last year's economic stimulus legislation.

In her new position, Ms. Pritts will advise Dr. Blumenthal on forming policies on privacy, security and data stewardship of electronic health information, as well as coordinate similar efforts on state, federal and international levels.

Ms. Pritts is a graduate of Oberlin College and Case Western Reserve University School of Law.  She has testified before Congress on data privacy issues, and served as a member of Technical Advisory Panel for the multi-state Health Information Security and Privacy Collaborative (HISPC) and on the board of the National Governors Association’s State Alliance for e-Health.

According to Government Health IT:

Blumenthal said Pritts, who started her job Feb. 16, has extensive experience on all the issues that ONC grapples with. For instance, she was heavily consulted by members of Congress in legislating the HITECH health IT incentive law.

'So she has an understanding of the legislative process and a policy understanding, in addition to having worked for the government previously,' Blumenthal said in answer to a reporter’s question after a meeting of HHS’s Health IT Policy Committee.

'She has a combination of an understanding of government, understanding of the issues, and her legal background is very important – her research and policy qualifications,' he added.

"HHS appoints Joy Pritts chief privacy officer," Government Health IT (February 17, 2010).

 
Tags: , , , , , , , , , , , ,

ALERT: CMS and ONC to Discuss Next Steps in EHR Programs Today

Posted on December 30, 2009 by Steve Fox and Vadim Schick

Today the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) will announce two regulations that lay a foundation for improving quality, efficiency, and safety through meaningful use of electronic health record (EHR) technology.

The regulations will help implement the EHR incentive programs enacted under the Health Information Technology for Clinical and Economic Health (HITECH) Act, which was part of the American Recovery and Reinvestment Act of 2009. Public comments on both regulations are encouraged.

Join today’s call; details are listed below:

WHO:
--David Blumenthal, MD, MPP, national coordinator for health information technology
--Jonathan Blum, director, Center for Medicare Management
--Cindy Mann, director, Center for Medicaid and State Operations

WHAT:
Briefing for HITECH Partners and Stakeholders – Providers, HIT Industry Organizations

WHEN:
Today, Wednesday, Dec. 30, 2009, 5:15 p.m. – 6:00 p.m. Eastern Time

WHERE:
Toll-Free Dial: (800) 837-1935
Conference ID: 49047605
Pass Code: HITECH

Stay tuned for more updates and information on the HIMSS Meaningful Use Web site at http://bit.ly/5IdkDe . HIMSS will be posting a statement tomorrow.

Tags: , , , , , , ,

In the news: EHR incentives; the rising threat of medical identity theft

Posted on November 30, 2009 by Steve Fox and Vadim Schick

  • In a letter to Dr. Blumenthal, the Medical Group Management Association (MGMA) urged the ONC to define "meaningful use" in a practical and achievable way.  Otherwise, many providers could fail to qualify for the HITECH Act's incentives.  The MGMA is recommending, inter alia, instituting a pilot test prior to the start of the program and before each new phase of the program; including only criteria for meaningful use that have widespread industry use or have been tested; permitting physicians to test their reporting systems prior to their “go-live” date; permitting flexibility in achieving meaningful use and avoiding a “pass/fail” approach; developing a simple process for physicians to attest that they have achieved meaningful use; simplifying the data-reporting process and ensuring that the government is ready to accept the data; closely monitoring the industry to ensure that the program logistics operate appropriately; and ensuring government oversight of the vendor community for its ability to produce high-quality and reasonably priced software.

  • A former Johns Hopkins hospital employee, Michelle Johnson, was sentenced to 18 months in prison and ordered to pay $200,000 in restitution for stealing patient information.  According to the Associated Press, Ms. Johnson, formerly a patient services coordinator, "provided a conspirator with names, Social Security numbers and other identifying information of more than 100 current and former patients of Johns Hopkins. That information was used to apply for credit. Johnson kept some of the fraudulently ordered merchandise for herself, including a computer monitor, a cordless phone, and clothes for herself and her children."

 

  • The Wall Street Journal reported on the rise in medical identity theft and that the situation is "expected to worsen."   Most of medical identity theft cases are committed by those who pay medical workers for patient data, exactly what Michelle Johnson was caught doing at Johns Hopkins.  According to the Journal and the World Privacy Forum report it cited, the adoption of electronic medical records may contribute to the problem by making such information more easily available. Data indicates that states with a high population of retirees experienced the most significant increases in medical identity theft, including California, Texas, New York, Arizona, and Florida.

"Patient ID Theft Rises," Wall Street Journal (November 30, 2009).

"MGMA concerned about success of EHR incentive program," Healthcare IT News (November 23, 2009).

"Woman Sentenced for Stealing Patients' Info," Associated Press (November 20, 2009).

 

 
Tags: , , , , , , , , , , ,

CBS News reports on EHR efforts

Posted on October 21, 2009 by Steve Fox and Vadim Schick

By popular demand, here is the video of David Pogue's report on the Obama Administration's efforts to digitize patient records in the U.S. 


Watch CBS News Videos Online

"Charting a New Course," CBS News (September 13, 2009).

Tags: , , , , , , , , , , , , , , , , , , ,

New York Times interviews David Blumenthal

Posted on October 21, 2009 by Steve Fox and Vadim Schick

David Pogue, a reporter for the New York Times, posted the transcript of his interview with Dr. David Blumenthal, National Coordinator for Health IT. Mr. Pogue interviewed Dr. Blumenthal for a CBS news report on digitization of healthcare in America (the video is available after the jump).

Here are some highlights from the interview:

On current state of health IT in the US:

We found that about 17 percent of physicians in 2008 had adopted an electronic health record, and about ten percent of hospitals. <...> The rest is paper. It's basically the same system that physicians have used since Hippocrates, which is writing on some piece of paper.

On reimbursement penalties for those failing to achieve meaningful use by 2015:

From 2011 to 2015, there is a bonus. The Congress has put $45 billion on the table to ease physicians and hospitals into this new world of computerized medicine.After 2015, if you have not adopted, and you see Medicare or Medicaid patients, you may experience a penalty. 2015 is six years off. Six years is plenty of time for physicians to get themselves organized to put a record in place and avoid those penalties.

 

On cost of EMRs:

On average, the cost is between $40,000 and $50,000, of which about a third is the software and the hardware, about a third is the cost of getting it set up in the office, and about a third is maintaining it. Much of the expense is related to the cost of implementing and the cost of maintaining it over time.

On privacy and security:

Privacy and security are foundational to a modern health information system. You cannot get the computer into this business without assuring people that their information, their personal information, will be safe.

So we are looking at the best possible technical solutions, technical protections, to privacy and security. We want to make sure that we have looked at every opportunity for encryption, every security device that the best minds can think of, to make information safer. We've got it in other parts of the industry, but we don't have it for healthcare. So I think that's a very important agenda item for us.

<...>

There are two kinds of anxieties. One is that their data may be used for purposes that they haven't authorized it. So if they haven't authorized their personal data to be used for research, they don't want it for that purpose. And the way the law gets around that problem is by saying that information should be de-identified; that is, it should be abstracted from the record in a way that can never be traced back to that individual.

And then that information can be used for research on drug safety, or research on the value of particular treatments, or anything els that may be useful to human health.

There's another kind of fear, and that is the fear of the breach or break-in, or hacking. And there have been some examples of that.

That's where better encryption and better barriers to hacking are critical. And, you know, we have a new cybersecurity initiative that President Obama has put in process. It's well known that the security of information is a national need for defense purposes. It's also, I think, a very important need for this domestic policy purpose. So we want to work with that security initiative to know that we've taken advantage of everything that the federal government and the computer industry knows about how to keep records secure.

Finally, the big picture:

Well, it's a big challenge, it's an exciting challenge, and a historic challenge. There's nothing that's worth doing that's easy to do in life, and this is one of those.

But I really think that history is on the side of this activity. To be a 21st-century physician, to be a 21st-century hospital, we can't record data the same way the Greeks did in 500 B.C. We've gotta move to use the computer to support our work. And that's what we're trying to do.

There'll be bumps on the road. We're not gonna be perfect. We'll make mistakes. But I think the wind is at our back in terms of the historical trends. And we'll get there, sooner or later.

"Computerized Health Records," New York Times (October 15, 2009).

"Charting a New Course," CBS News (September 13, 2009).

 


Watch CBS News Videos Online
Tags: , , , , , , , , , , , , , , , , ,

In the news: Blumenthal on "meaningful use," new health information management jobs, etc.

Posted on October 12, 2009 by Steve Fox and Vadim Schick

Dr. David Blumenthal, the National Coordinator for Health IT, gave an update on the Obama Administration's efforts to define "meaningful use" and to further adoption of EHRs nationwide.  Blumenthal did not reveal any new details regarding the upcoming regulations on meaningful use, reminding his audience of the upcoming "notice of proposed rulemaking in late 2009 with a public comment period in early 2010."

Meanwhile, according to Government HealthIT, the next meeting of the HIT Policy Committee, which will meet on October 27 and 28, will focus on how to map meaningful use objectives to medical specialties as well as small practices and hospitals.

Speaking at the 81st annual American Health Information Management Association convention in Grapevine, Texas, Dr. Blumenthal stated that he expects 50,000 health information management (HIM) jobs to be created as the U.S. moves from the paper-based to the digital system of healthcare.  AHIMA's CEO, Linda Kloss, noted that the interest in HIM careers has "exploded" during the last year.

Much more news after the jump.
  

 

  • American Medical News reported on the staffing changes for healthcare organizations necessitated by the nationwide switch to electronic health records. According to the article:

There are some assumptions about staff changes that are easy to make, experts say. Any job that was strictly paper-based prior to implementation, for example, will need to be overhauled or eliminated.

Other changes are not so easy to predict, and could depend on how willing your employees are to adapt and learn new skills.

  • According to Crain's Detroit Business, urban hospitals lag behind rural hospitals and physicians' practices in joining health information exchanges (HIE's) because such HIE's pose a combination of monetary, strategic, and technological challenges.
     
  • Washington Post reported on a pilot project in Ohio aimed at streamlining the cost of healthcare administration.  The state's eight major health insurers - representing 91% of the patients - have signed on to participate in this initiative.  The Post described the program as:

a single Web portal [that the participants] believe will reduce duplication, miscommunication, and confusion between doctors and insurance companies. That will mean quicker office and hospital service, more time for patient care, and, ultimately, cost savings, participants said.

  • Healthcare IT News reported that -- according to e-prescribing company Surescripts -- "the number of physicians using electronic prescribing will have more than doubled in 2009 and that "more than 140,000 – 23 percent of all office-based physicians, nurse practitioners and physician assistants in the United States – are e-prescribing today."
     
  • USA Today reported on the various hardships and setbacks to widespread implementation of EHRs.  The article ended on a somewhat hopeful note, with a great quote by Stephanie Reel, the CIO of Johns Hopkins University:

We've been saying that we're five years away from electronic medical records for the past 40 years ... Now maybe we really are only five years away.

"Meaningful" Progress Toward Electronic Health Information Exchange, David Blumenthal, MD (October 1, 2009).

"Specialists, primary care providers differ in meaningful use," Government HealthIT (October 6, 2009).

"Health IT effort to create thousands of new jobs, says Blumenthal," Healthcare IT News (October 6, 2009).

"How electronic medical records affect staffing," Amednews.com (October 5, 2009).

"Slow with the flow: Hospitals lag in joining health info exchanges," Crain's Detroit Business (October 4, 2009).

"Paperwork angst drives Ohio doctor, insurer effort," The Washington Post (October 5, 2009).

"More than 140,000 physicians on growing list of e-prescribers," Healthcare IT News (October 5, 2009).

"High-tech 'scribes' help transfer medical records into electronic form, " USA Today (October 7, 2009).
 


 

 
Tags: , , , , , , , , , , , ,

HIT Policy Committee workgroup presents preliminary definition for Meaningful Use

Posted on June 16, 2009 by Steve Fox and Vadim Schick

On June 16, 2009, the Workgroup on Meaningful Use presented its findings to the HIT Policy Committee.  The findings include two parts:  the preamble and the matrix.   The matrix consists of goals to be achieved by 2011, 2013, and 2015, and the metrics for such goals to evaluate hospital and clinician progress in meeting them.

We will have much more analysis on this preliminary definition later, so stay tuned for our updates.  Meanwhile, our favorite "geek doctor" John Halamka stated the following on his blog:

Now that the initial definition of meaningful use is available, the HIT Standards Committee workgroups and HITSP will work through the month of July to ensure the matrix is populated with the most up to date standards and implementation guide detail.

Hospitals and Clinician offices now know what is expected for 2011, so the time is now to begin your software implementations.


"Meaningful Use has Arrived", Life as a Healthcare CIO (June 16, 2009).

 

Tags: , , , , , , , , , ,

NEJM Study Finds Extremely Low Rates of EHR Adoption Among U.S. Hospitals

Posted on March 26, 2009 by Steve Fox and Vadim Schick

The New England Journal of Medicine published a study describing dismal rates of adoption and use of EHR technology in the United States.  The authors of the study found that

less than 2% of acute care hospitals have a comprehensive electronic-records system, and that, depending on the definition used, between 8 and 12% of hospitals have a basic electronic-records system.  With the use of the definition that requires the presence of functionalities for physicians' notes and nursing assessments, information systems in more than 90% of U.S. hospitals do not even meet the requirement for a basic electronic-records system.

Financial restraints is the most commonly cited reason for lack of electronic health records.  The authors found higher adoption rates among larger, urban, teaching hospitals (which the authors partially attributed to such institutions' financial resources available for EHR technology).  Interoperability and low levels of health information exchange also have a negative effect on EHR adoption levels.

However, the authors did provide a glimmer of hope, if not good news:

From a policy perspective, our data suggest that rewarding hospitals — especially financially vulnerable ones — for using health information technology may play a central role in a comprehensive approach to stimulating the spread of hospital electronic-records systems. Creating incentives for increasing information-technology staff and harmonizing information-technology standards and creating disincentives for not using such technology may also be helpful approaches.

Thus, hopefully the incentive payment provisions in the HITECH Act will have a positive effect on adoption rates in the foreseeable future.

It is worth pointing out that Dr. Blumenthal, the new head of ONCHIT, is one of the study's authors.  This study was covered by major national news outlets, including the Wall Street Journal and the New York Times.

"Use of Electronic Health Records in U.S. Hospitals" (New England Journal of Medicine, March 25, 2009).

 

 

 

Tags: , , , , ,

David Blumenthal Named National Coordinator for HIT

Posted on March 20, 2009 by Steve Fox and Vadim Schick

Dr. David Blumenthal was named as National Coordinator for Health Information Technology at the Department of Health and Human Services (HHS).  Dr. Blumenthal will "lead the effort for implementation of a nationwide interoperable, privacy-protected health information technology infrastructure" authorized by ARRA and the HITECH Act. 

According to the HHS Press Secretary,

As a practicing physician and a leading scholar on health information technology, Dr. Blumenthal is uniquely qualified to help America’s doctors, nurses, hospitals, and patients reap the benefits of a modernized health system. Dr. Blumenthal shares President Obama’s commitment to investing in a health IT infrastructure that will protect patient privacy, and improve both quality and efficiency in our nation’s health care system.

An adviser to Mr. Obama during his presidential campaign, Dr. Blumenthal is unquestionably qualified for this job.  Among numerous other accomplishments, he was a physician and director of the Institute for Health Policy at Mass General in Boston; Professor of Medicine and Professor of Health Care Policy at Harvard Medical School; and served as director of the Harvard University Interfaculty Program for Health Systems Improvement.

Dr. Blumenthal's appointment has been well-received by commentators.  According to Healthcare IT News, John Halamka, CIO of Beth Israel Deaconess and Harvard Medical School, called it a "great choice" and Joseph C. Kvedar, MD, chief of the Center for Connected Health, stated that "Dr. Blumenthal brings a wealth of relevant experience to the post. The health of our nation will improve due to his involvement."

We extend our congratulations and best wishes to Dr. Blumenthal as he takes on this important role.

David Blumenthal named new National Coordinator for Health IT (Healthcare IT News, March 20, 2009).

HHS Names David Blumenthal As National Coordinator for Health Information Technology (HHS Press release, March 20, 2009).

 
Tags: , , , , ,