1. The Senate Health, Education, Labor and Pensions Committee chaired by Senator Ted Kennedy (D-MA) will host a nomination hearing on Tuesday for Kansas Governor Kathleen Sebelius to be the next Secretary of the Department of Health and Human Services (HHS) Secretary, followed by a nomination hearing by the Senate Finance Committee on Thursday. While both Senate committees have jurisdiction over federal healthcare issues, the Senate Finance Committee has ultimate jurisdiction over approving the HHS Secretary nomination and following the Thursday hearing will vote to send the nomination to the full Senate for a vote. Once passed by the full Senate, the nominee is then considered confirmed by the Senate. It is anticipated that Governor Sebelius will assume the office of Secretary of HHS following Senate confirmation as soon as President Obama returns home from overseas and swears Governor Sebelius into office.
2. The U.S. House has two committees with jurisdiction over healthcare issues. Subcommittees of the House Energy and Commerce Committee chaired by Rep. Henry Waxman (D-CA) will hold three healthcare hearings this week. On Tuesday, the Health Subcommittee of the House Energy and Commerce Committee will examine public health in the context of overhauling the nation's healthcare system, and the Commerce, Trade and Consumer Protection Subcommittee of the House Energy and Commerce Committee will examine legislation that would prohibit brand-name pharmaceutical companies from paying generic drug makers to delay selling their low-cost versions. The Health Subcommittee of the House Energy and Commerce Committee will hold another hearing this Thursday on a healthcare overhaul that examines ways to save money in the system and improve safety.
3. Finally, the House Ways and Means Committee chaired by Rep. Charles Rangel (D-NY) will hold a hearing this Wednesday on modernizing the healthcare delivery system, with a focus on care coordination and improving quality of care.
Monday, March 30, 2009
Immediate HITECH Timeline
Within 45 days of enactment (April 3, 2009):
• Appointment of HIT Policy Committee members - Section 3002(b)
After 45 days from date of enactment (April 3, 2009), but prior to 90 days (May 18, 2009):
• HIT Policy Committee makes recommendations to ONC on areas in which standards, implementation specifications, and certification criteria are needed including those to protect privacy, ensure security, account for disclosures, encrypt information and use EHRs for quality improvement (Section 3002)
Within 90 days of enactment (May 18, 2009):
• HIT Standards Committee will develop a schedule for assessment of the policy recommendations developed by the HIT Policy Committee (Section 3003)
• NIST to conduct pilot testing of standards and implementation (Section 3003 and Section 13201)
• Draft description of program for establishing regional centers for HIT Implementation Assistance (Section 3012)Not later than 45 days after the HIT Standards Committee delivers recommendations to ONC
• ONC makes a determination whether to endorse each standard, implementation specification, and certification criterion for the electronic exchange and use of health information that is recommended by the HIT Standards Committee and delivers recommendations to HHS Secretary (Section 3001)
By December 31, 2009:
• HHS Secretary (in consultation with other Federal Agencies) will determine what standards should be adopted from those endorsed by ONC, and adopt them through rulemaking processes (Section 3004)
• Secretary will adopt an initial set of standards, implementation specifications and certification criteria through release of Interim Final Regulations (Section 3004)
• Appointment of HIT Policy Committee members - Section 3002(b)
After 45 days from date of enactment (April 3, 2009), but prior to 90 days (May 18, 2009):
• HIT Policy Committee makes recommendations to ONC on areas in which standards, implementation specifications, and certification criteria are needed including those to protect privacy, ensure security, account for disclosures, encrypt information and use EHRs for quality improvement (Section 3002)
Within 90 days of enactment (May 18, 2009):
• HIT Standards Committee will develop a schedule for assessment of the policy recommendations developed by the HIT Policy Committee (Section 3003)
• NIST to conduct pilot testing of standards and implementation (Section 3003 and Section 13201)
• Draft description of program for establishing regional centers for HIT Implementation Assistance (Section 3012)Not later than 45 days after the HIT Standards Committee delivers recommendations to ONC
• ONC makes a determination whether to endorse each standard, implementation specification, and certification criterion for the electronic exchange and use of health information that is recommended by the HIT Standards Committee and delivers recommendations to HHS Secretary (Section 3001)
By December 31, 2009:
• HHS Secretary (in consultation with other Federal Agencies) will determine what standards should be adopted from those endorsed by ONC, and adopt them through rulemaking processes (Section 3004)
• Secretary will adopt an initial set of standards, implementation specifications and certification criteria through release of Interim Final Regulations (Section 3004)
Monday, March 23, 2009
ROI
A few great case studies:
There are numerous studies showing that EHR has a significant ROI: http://content.healthaffairs.org/cgi/content/full/hlthaff.w5.10/DC1 http://content.healthaffairs.org/cgi/content/full/24/5/1103
http://www.ncbi.nlm.nih.gov/pubmed/12714130
http://www.jamia.org/cgi/content/full/13/3/261
http://www.ncbi.nlm.nih.gov/sites/entrez
http://www.greenwaymedical.com/dynamic/pdf/roi/roi_nine_doctor_obgyn.pdf
http://www.greenwaymedical.com/dynamic/pdf/casestudies/testimonial_oswego_greenway_sept2004.pdf http://www.greenwaymedical.com/dynamic/pdf/roi/post%20deployment%20roi%20-%20oswego%20obgyn.pdf.
For example, a detailed case study of the cost and quality benefits of EHR at Family Care of Concord, NH found net benefits per clinician per year of $30,324 https://www.acponline.org/atpro/timssnet/products/tnt_products.cfm?action=long&primary_id=330371070.
Another study of hospital-based provider order entry identified net savings of $1.7 million per year from drug dosing guidance, nursing time utilization, and error prevention http://www.jamia.org/cgi/content/full/13/3/261.
Studies show that there is benefit for health conditions like diabetes and heart disease from EHR http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=15802479, http://www.ncbi.nlm.nih.gov/pubmed/18373141, and http://www.bmj.com/cgi/content/abstract/330/7494/765.
EHRs increase overall patient safety. Children's Hospital of Seattle, following best practices for implementation, have experienced a trend toward a lower mortality rate http://pediatrics.aappublications.org/cgi/content/abstract/118/1/290.
The level of medication error reduction with computerization of prescribing seen in multiple studies is over 80%
http://www.jamia.org/cgi/content/full/6/4/313; http://archinte.ama-assn.org/cgi/content/full/163/12/1409.
There are numerous studies showing that EHR has a significant ROI: http://content.healthaffairs.org/cgi/content/full/hlthaff.w5.10/DC1 http://content.healthaffairs.org/cgi/content/full/24/5/1103
http://www.ncbi.nlm.nih.gov/pubmed/12714130
http://www.jamia.org/cgi/content/full/13/3/261
http://www.ncbi.nlm.nih.gov/sites/entrez
http://www.greenwaymedical.com/dynamic/pdf/roi/roi_nine_doctor_obgyn.pdf
http://www.greenwaymedical.com/dynamic/pdf/casestudies/testimonial_oswego_greenway_sept2004.pdf http://www.greenwaymedical.com/dynamic/pdf/roi/post%20deployment%20roi%20-%20oswego%20obgyn.pdf.
For example, a detailed case study of the cost and quality benefits of EHR at Family Care of Concord, NH found net benefits per clinician per year of $30,324 https://www.acponline.org/atpro/timssnet/products/tnt_products.cfm?action=long&primary_id=330371070.
Another study of hospital-based provider order entry identified net savings of $1.7 million per year from drug dosing guidance, nursing time utilization, and error prevention http://www.jamia.org/cgi/content/full/13/3/261.
Studies show that there is benefit for health conditions like diabetes and heart disease from EHR http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=15802479, http://www.ncbi.nlm.nih.gov/pubmed/18373141, and http://www.bmj.com/cgi/content/abstract/330/7494/765.
EHRs increase overall patient safety. Children's Hospital of Seattle, following best practices for implementation, have experienced a trend toward a lower mortality rate http://pediatrics.aappublications.org/cgi/content/abstract/118/1/290.
The level of medication error reduction with computerization of prescribing seen in multiple studies is over 80%
http://www.jamia.org/cgi/content/full/6/4/313; http://archinte.ama-assn.org/cgi/content/full/163/12/1409.
Friday, March 20, 2009
NEW ONC DIRECTOR ~ David Blumenthal, M.D., M.P.P.
David Blumenthal, M.D., M.P.P., is director of the Institute for Health Policy at Massachusetts General Hospital and Samuel O. Their Professor of Medicine at Harvard Medical School. Previously, he held posts as senior vice president at Boston's Brigham and Women's Hospital and executive director of the Center for Health Policy and Management at Harvard's John F. Kennedy School of Government. During the late 1970s, he was a professional staff member on Senator Edward Kennedy's Senate Subcommittee on Health and Scientific Research. Dr. Blumenthal is the founding chairman of AcademyHealth, the national organization of health services researchers; national correspondent for the New England Journal of Medicine; and a trustee of the University of Pennsylvania Health System
Interesting Stimulus Factoid - CMS Website posts Eligible Stimulus Recipients, including Hospitals
`(B) POSTING ON WEBSITE- The Secretary shall post on the Internet website of the Centers
for Medicare &Medicaid Services, in an easily understandable format, a list of the names of
the eligible hospitals that are meaningful EHR users under this subsection or subsection (b)(3)(B)
(ix) (and a list of the names of critical access hospitals to which paragraph (3) or (4) of section
1814(l) applies), and other relevant data as determined appropriate by the Secretary. The
Secretary shall ensure that an eligible hospital (or critical access hospital) has the opportunity
to review the other relevant data that are to be made public with respect to the hospital (or
critical access hospital) prior to such data being made public.
This can be found on page 447 of the Stimulus Package (HR1).
for Medicare &Medicaid Services, in an easily understandable format, a list of the names of
the eligible hospitals that are meaningful EHR users under this subsection or subsection (b)(3)(B)
(ix) (and a list of the names of critical access hospitals to which paragraph (3) or (4) of section
1814(l) applies), and other relevant data as determined appropriate by the Secretary. The
Secretary shall ensure that an eligible hospital (or critical access hospital) has the opportunity
to review the other relevant data that are to be made public with respect to the hospital (or
critical access hospital) prior to such data being made public.
This can be found on page 447 of the Stimulus Package (HR1).
Interesting Stimulus Factoid - CMS Website posts Eligible Stimulus Recipients
All Medicare & Medicaid recipients of Stimulus incentive funds will be posted on a CMS website. It obviously will show the care providers and eligible professionals who adopt and successfully use 21st Century health IT such as EHRs to provide high-quality care to their patients.
"POSTING ON WEBSITE- The Secretary shall post on the Internet website of the Centers
for Medicare &Medicaid Services, in an easily understandable format, a list of the names,
business addresses, and business phone numbers of the eligible professionals who are
meaningful EHR users and, as determined appropriate by the Secretary, of group practices
receiving incentive payments."
This can be found on page 436 of the Stimulus Package.
"POSTING ON WEBSITE- The Secretary shall post on the Internet website of the Centers
for Medicare &Medicaid Services, in an easily understandable format, a list of the names,
business addresses, and business phone numbers of the eligible professionals who are
meaningful EHR users and, as determined appropriate by the Secretary, of group practices
receiving incentive payments."
This can be found on page 436 of the Stimulus Package.
Thursday, March 19, 2009
EHR Association Chair Supports Stimulus Package as Key to Healthcare Transformation
Please click on the image to see an enlarged version/read the text.
Wednesday, March 18, 2009
Budget update to HITECH:
Incentives through Medicare for the Meaningful Use of Certified EHR Technology -
Establishment of incentive payments through Medicare for the meaningful use of certified EHR technology by “eligible professionals and hospitals”. The CBO estimates the total cost of Medicare and Medicaid incentives for eligible professionals and hospitals that demonstrate a meaningful use of certified EHR technology to be $20.819. $20.819 is derived from the sum of the total costs of the incentives in fiscal year 2009 – fiscal year 2015 ($36.368 billion) and the total savings that are achieved in fiscal year 2016 – fiscal year 2019 through the incentives ($15.549 billion).
Establishment of incentive payments through Medicare for the meaningful use of certified EHR technology by “eligible professionals and hospitals”. The CBO estimates the total cost of Medicare and Medicaid incentives for eligible professionals and hospitals that demonstrate a meaningful use of certified EHR technology to be $20.819. $20.819 is derived from the sum of the total costs of the incentives in fiscal year 2009 – fiscal year 2015 ($36.368 billion) and the total savings that are achieved in fiscal year 2016 – fiscal year 2019 through the incentives ($15.549 billion).
Wednesday, March 11, 2009
Optimizing the Opportunities in Economic Stimulus for the Physician Practice
HIMSS09 will include 10 education sessions focused on the impact of the health IT provisions in the American Recovery & Reinvestment Act of 2009. $19 billion is being invested by the federal government in the healthcare industry, primarily to achieve widespread adoption and use of EHR technologies within hospitals, physician practices, community health organizations, public health settings, and others - and to make electronic exchange of health information a reality throughout the United States. Make sure to mark your calendars so you do not miss these highly informative educational sessions!
Conference Highlight:
Optimizing the Opportunities in Economic Stimulus for the Physician Practice
Monday, April 6, 2:15 PM - 3:15 PM
HIMSS Annual Conference, McCormick Place, Chicago, IL
Register here.
This session will provide the attendee with an overview of the incentives related to the Economic Stimulus Package as well as prepare practices for what they must do to adopt an electronic health record (EHR). You will hear from industry, legal, vendor and consulting experts on this topic, including Justin Barnes, VP of Government Affairs and Marketing at Greenway Medical Technologies and Chairman of the EHR Association.
Conference Highlight:
Optimizing the Opportunities in Economic Stimulus for the Physician Practice
Monday, April 6, 2:15 PM - 3:15 PM
HIMSS Annual Conference, McCormick Place, Chicago, IL
Register here.
This session will provide the attendee with an overview of the incentives related to the Economic Stimulus Package as well as prepare practices for what they must do to adopt an electronic health record (EHR). You will hear from industry, legal, vendor and consulting experts on this topic, including Justin Barnes, VP of Government Affairs and Marketing at Greenway Medical Technologies and Chairman of the EHR Association.
HIMSS on EHR Adoption
Interesting piece addressing the urgency of needing to adopt EHRs sooner rather than later to maximize incentives and avoid penalties. This article seems to indicate that only 08 CCHIT Certified EHR solutions could qualify for the functionality requirements in the Stimulus legislation.
Thursday, February 19, 2009
Healthcare Information and Management Systems Society President and CEO H. Stephen Lieber said that although many of the details of the health IT provisions included in the stimulus packaged still need to be worked out, health care providers should start planning the rollout of electronic health record systems now to gain the maximum financial incentives, Health Data Management reports.
…he said that software vendors and health care providers cannot afford to delay health IT projects because health care providers must have qualifying EHR systems in place by 2011 to maximize incentive payments.
Qualifying Systems
Under the stimulus package, qualifying EHR systems must include:
The ability to support the exchange of clinical data with other organizations (interoperability).
Upfront Costs
Lieber said that while the stimulus package does include some funding for health IT grants and loans, "most providers will have to make their own upfront investments in technology."
…Lieber stressed that if health care providers fail to invest in health IT, they could face substantial long-term cuts in Medicare funding (Anderson, Health Data Management, 2/18).
Thursday, February 19, 2009
Healthcare Information and Management Systems Society President and CEO H. Stephen Lieber said that although many of the details of the health IT provisions included in the stimulus packaged still need to be worked out, health care providers should start planning the rollout of electronic health record systems now to gain the maximum financial incentives, Health Data Management reports.
…he said that software vendors and health care providers cannot afford to delay health IT projects because health care providers must have qualifying EHR systems in place by 2011 to maximize incentive payments.
Qualifying Systems
Under the stimulus package, qualifying EHR systems must include:
The ability to support the exchange of clinical data with other organizations (interoperability).
Upfront Costs
Lieber said that while the stimulus package does include some funding for health IT grants and loans, "most providers will have to make their own upfront investments in technology."
…Lieber stressed that if health care providers fail to invest in health IT, they could face substantial long-term cuts in Medicare funding (Anderson, Health Data Management, 2/18).
Monday, March 2, 2009
On Feb 13th, in the 111th CONGRESS, 1st Session, H. R. 1087 was introduced to amend the Internal Revenue Code of 1986 to increase the deduction under Section 179 for the purchase of qualified health care information technology by medical care providers, and for other purposes. This is a very important tax deduction utilized in 2008 to incentivize investment in EHR – we will keep you posted if it is implemented for perpetuity.
111th CONGRESS
1st Session
H. R. 1087
To amend the Internal Revenue Code of 1986 to increase the deduction under section 179 for the purchase of qualified health care information
technology by medical care providers, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 13, 2009
Mr. Gingrey of Georgia (for himself, Mr. Sessions, Mr. Sam Johnson of Texas, Mr. Brown of South Carolina, Mr. Akin, Mr. Smith of Texas, Mr.
Bishop of Utah, Mr. Hensarling, Mrs. Schmidt, Mr. Bartlett, Mr. Pitts, Ms. Fallin, Mr. Burton of Indiana, Mr. Fleming, Mr. Cole, Mr. King of Iowa, Mr. Price of Georgia, and Mr. Lamborn) introduced the following
bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration
of such provisions as fall within the jurisdiction of the committee
concerned
_______________________________________________________________________
A BILL
To amend the Internal Revenue Code of 1986 to increase the deduction under section 179 for the purchase of qualified health care information
technology by medical care providers, and for other purposes.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Assisting Doctors to Obtain Proficient and Transmissible Health Information Technology Act of 2009'' or the ``ADOPT HIT Act of 2009''.
SEC. 2. PURCHASE OF QUALIFIED HEALTH CARE INFORMATION TECHNOLOGY.
(a) In General.--Section 179 of the Internal Revenue Code of 1986 (relating to election to expense certain depreciable assets) is amended by adding at the end the following new subsection:
``(f) Health Care Information Technology.--
``(1) In general.--In the case of qualified health care
information technology purchased by a medical care provider and
placed in service during a taxable year--
``(A) subsection (b)(1) shall be applied by
substituting `$250,000' for `$125,000',
``(B) subsection (b)(2) shall be applied by
substituting `$600,000' for `$500,000', and
``(C) subsection (b)(5)(A) shall be applied by
substituting `$250,000 and $600,000' for `$125,000 and
$500,000'.
``(2) Definitions.--For purposes of this subsection--
``(A) Qualified health care information
technology.--The term `qualified health care
information technology' means section 179 property
which--
``(i) has been certified by the Secretary
of Health and Human Services pursuant to
section 3 of the ADOPT HIT Act of 2009, and
``(ii) is used primarily for the electronic
creation, maintenance, and exchange of medical
care information to improve the quality or
efficiency of medical care.
``(B) Medical care provider.--The term `medical
care provider' means any person engaged in the trade or
business of providing medical care.
``(C) Medical care.--The term `medical care' has
the meaning given such term by section 213(d).''.
(b) Effective Date.--The amendment made by this section shall apply to property placed in service after December 31, 2008.
SEC. 3. CERTIFICATION OF HEALTH CARE INFORMATION TECHNOLOGY.
(a) In General.--The Secretary of Health and Human Services shall develop criteria to ensure and certify that hardware, software, and support services for the electronic exchange of health information meet certain standards, as determined by the Secretary.
(b) Certification Assistance.--The Secretary of Health and Human Services may recognize a private entity or entities to assist in the certification described under paragraph (1) using the criteria developed by the Secretary under this section.
111th CONGRESS
1st Session
H. R. 1087
To amend the Internal Revenue Code of 1986 to increase the deduction under section 179 for the purchase of qualified health care information
technology by medical care providers, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 13, 2009
Mr. Gingrey of Georgia (for himself, Mr. Sessions, Mr. Sam Johnson of Texas, Mr. Brown of South Carolina, Mr. Akin, Mr. Smith of Texas, Mr.
Bishop of Utah, Mr. Hensarling, Mrs. Schmidt, Mr. Bartlett, Mr. Pitts, Ms. Fallin, Mr. Burton of Indiana, Mr. Fleming, Mr. Cole, Mr. King of Iowa, Mr. Price of Georgia, and Mr. Lamborn) introduced the following
bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration
of such provisions as fall within the jurisdiction of the committee
concerned
_______________________________________________________________________
A BILL
To amend the Internal Revenue Code of 1986 to increase the deduction under section 179 for the purchase of qualified health care information
technology by medical care providers, and for other purposes.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Assisting Doctors to Obtain Proficient and Transmissible Health Information Technology Act of 2009'' or the ``ADOPT HIT Act of 2009''.
SEC. 2. PURCHASE OF QUALIFIED HEALTH CARE INFORMATION TECHNOLOGY.
(a) In General.--Section 179 of the Internal Revenue Code of 1986 (relating to election to expense certain depreciable assets) is amended by adding at the end the following new subsection:
``(f) Health Care Information Technology.--
``(1) In general.--In the case of qualified health care
information technology purchased by a medical care provider and
placed in service during a taxable year--
``(A) subsection (b)(1) shall be applied by
substituting `$250,000' for `$125,000',
``(B) subsection (b)(2) shall be applied by
substituting `$600,000' for `$500,000', and
``(C) subsection (b)(5)(A) shall be applied by
substituting `$250,000 and $600,000' for `$125,000 and
$500,000'.
``(2) Definitions.--For purposes of this subsection--
``(A) Qualified health care information
technology.--The term `qualified health care
information technology' means section 179 property
which--
``(i) has been certified by the Secretary
of Health and Human Services pursuant to
section 3 of the ADOPT HIT Act of 2009, and
``(ii) is used primarily for the electronic
creation, maintenance, and exchange of medical
care information to improve the quality or
efficiency of medical care.
``(B) Medical care provider.--The term `medical
care provider' means any person engaged in the trade or
business of providing medical care.
``(C) Medical care.--The term `medical care' has
the meaning given such term by section 213(d).''.
(b) Effective Date.--The amendment made by this section shall apply to property placed in service after December 31, 2008.
SEC. 3. CERTIFICATION OF HEALTH CARE INFORMATION TECHNOLOGY.
(a) In General.--The Secretary of Health and Human Services shall develop criteria to ensure and certify that hardware, software, and support services for the electronic exchange of health information meet certain standards, as determined by the Secretary.
(b) Certification Assistance.--The Secretary of Health and Human Services may recognize a private entity or entities to assist in the certification described under paragraph (1) using the criteria developed by the Secretary under this section.
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