Rumor has it that HHS will be releasing Stage 2 Meaningful Use requirements this week. Why this week? The most likely reason is that the Healthcare Information Management System’s Society (HIMSS) annual conference, a collection of 25,000 or so healthcare IT professionals representing every angle of the industry, kicks off on Sunday.
What better time to drop the bomb all of us have been waiting for?
We do have some insight into what Stage 2 will look like. Indications over the past year have been that the specific things hospitals, and by proxy the vendors that serve them, are asked to do won’t change a great deal from Stage 1 to Stage 2. The thing that will change is the metrics hospitals use must demonstrate they are, in fact, meaningful.
Those metrics send a clear message, however. Not all Stage 1 criteria have been achieved equally by the physicians and hospitals that have attested, and some of the criteria were the usage of capabilities that are a stretch to consider as truly meaningful.
So look for the bar to be raised across the board, but particularly for those token items such as “implement one decision support rule.”
Find out the answer to this very question in Ben Dillon’s article in the July 2011 issue of eHealthcare Strategy & Trends.
Due to health reform, hospitals are increasingly focused on wellness and are turning to the Web as a tool to promote and manage these initiatives. In Ben’s Ask the Expert article, he share examples of healthcare systems that have successfully utilized the Web to motivate, educate and build awareness of their wellness programs to promote healthy behaviors in their communities. He also addresses the benefits of turning to the Web and the future of wellness promotion.
Healthcare is entering into a time of incredible change. This change comes from the need to modernize the practice of medicine, to align the interests of all of the entities involved, to create an actual coordinated system of care and, of course, to change the disastrous financial course healthcare is on.
But you knew all of that.
What you might not have realized is all the implications of these changes.
There’s lots of talk about EHR implementation spurred by meaningful use and the great potential of ACOs to change the way healthcare operates. Much attention is paid to hospital-physician relations, physician employment, hospital mergers and clinical integration.
But where is the patient in all of this?
Patients are not just an input and output of the healthcare system — at least, not if we hope to make the changes underway meaningful. Care organizations will need to communicate differently with patients. They’ll need to understand our current set of interactions between patient and care provider – the intermittent phone calls, office visits and the occasional mailing – aren’t the result of the way we provide care, they’re the reason the healthcare system functions (or fails to function) as it does today. Changing care delivery requires us to change our communications. New methods of communication are enabling the process behind new care models.
Proposed ACO regulations were issued at the end of March amid much fanfare. The industry has had a few weeks to digest it, and it appears we need go back to the drawing board.
First, a Review
ACOs, or Accountable Care Organizations, were introduced as part of healthcare reform as a tool to make providers and hospitals coordinate care and reward outcomes and quality. ACOs are a reaction to many of the biggest issues in our healthcare system: lack of communication and coordination, duplicated tests, incentive systems that reward overuse of care, and lack of follow up and unnecessary readmissions. While ACOs will initially be put to use for the Medicare system, private insurers are eyeing the concept hungrily and are expected to follow suit once the Centers for Medicare and Medicaid (CMS) sorts out the details.
There’s a lot that we still don’t know about health reform. ACOs are still unicorns, a mythical creature with impressive powers, and there’s still a real risk major portions of the legislation may not survive to implementation.
Despite this, there’s quite a lot we do know about health reform. Particularly if we recognize the goals pushing our organizations forward and the constraints that we’ll be facing in the future.
This message came through clearly in an afternoon-long session on Health Reform led by Ellen Barron of University of Iowa Health Care, Peter Brumleve of Scott and White Healthcare, and Suzanne H. Sawyer of University of Pennsylvania Health System. They assert that while we don’t know all of the details, we do know the types of challenges that we’ll be facing and, as a result, we can assess how prepared our organizations are for what’s coming.
Is your electronic health record (EHR) too expensive, slow and inflexible? Is it painful to use? If it is, have a look at Extormity, and then perhaps you’ll feel a little better. Extomity’s tagline is “Expensive, Exasperating, Exhausting.” Extormity is certified by SEEDIE, the Society for Exorbitantly Expensive and Difficult to Implement EHR’s. After looking at the site, you’ll at least get a good laugh out of the spoof on the worst of the EHR industry today.
The Extormity gag was taken a step further at HIMSS 2011 with an actual interview with the CEO of Extormity. Full of excellent lines like “We store sensitive patient data on old 8-tracks, no one ever steals REO Speedwagon 8-tracks” and “We’re a Manackled® patient portal. If you like tethered portals, you’re going to love Manackled® portals.”
We all laugh because we’ve all seen little bits of this in the real world of EHR vendors. What Extormity isn’t hitting on is the very real question – are EHRs improving care and outcomes as they’re implemented today?
Wednesday morning’s HIMSS keynotes were from The Honorable Kathleen Sebelius, United States Secretary of Health and Human Services, and Dr. David Blumenthal, National Coordinator for Health Information Technology, discussing the progress of EHR adoption under the ARRA HITECH program.
Sebelius and Blumenthal discussed just how far the industry has come. When the Obama administration came into the White House, only 2 out of 10 doctors had even a basic EMR. That number is now up to 3 out of 10; with 4 out of 5 hospitals and 2 out of 5 individual physician offices intending to qualify for ARRA HITECH funds. Clearly this incentive program has accelerated the adoption of digital records technologies across the healthcare spectrum.
The process of establishing the final Stage 1 Meaningful Use criteria was collaborative, albeit lengthy. It’s taken a lot to get to this point including the development of a process for selecting certification bodies, the creation of a network of Regional Extension Centers to assist with EMR adoption, and the Beacon Community grant program along with many other efforts.
I would have to agree that overall the political support for these initiatives has been robust and bipartisan. This is evident if you look back at keynote speakers at the HIMSS conferences over the past few years, which range from Newt Gingrich to Al Gore.
As I learn more and more about Accountable Care Organizations (ACOs) two thoughts come to mind. The first is the immense potential that this set of sweeping changes represents when it comes to bending the healthcare cost curve while improving overall health. The second is an overwhelming bewilderment at the twisted mess that will need to be sorted out to actually make ACOs a reality.
We all know the healthcare system in its current state is broken. It’s too expensive to sustain. It’s getting more costly every day. And its overall outcomes are subpar.
Fixing any one of these problems could be accomplished with a fairly straightforward approach. Fixing all three concurrently requires a more fundamental re-engineering of the healthcare system.
Dell’s Chief Medical Officer, Harry Greenspun, recently argued that aggressive implementation of information technology is necessary to make reform work. A position that has been enthusiastically embraced as part of the American Recovery and Reinvestment Act’s HITECH provisions.
While I agree with Greenspun’s assessment, it illustrates a gap in the way current reform implications are viewed. Implementing information technology in healthcare organizations is critical but not sufficient to fix the problems with our healthcare system. Providers also need to be using technology to reach out directly to patients.
As we awaken, bleary-eyed after a late night of watching election returns, it is clear that our national legislative bodies have taken a decisive step to the right. With many of the newly-elected running specifically against “Obamacare,” it is almost certain that changes to that legislation will soon be in the works.
Not that long ago, we were asking similar questions about the future of healthcare reform after the victory of Scott Brown. At that time, it focused the Democratic majority to move the legislation forward.
What is the realistic outcome of yesterday’s elections on the Healthcare Reform law?
First and foremost, reform is not going away – at least not entirely. The problems that initiated the push for healthcare reform haven’t changed. President Obama will prevent any outright repeals of the legislation while still in office. And let’s face it, there aren’t any other alternative plans on the table at this stage that create a sustainable healthcare system for the long run.
At the national level, the attack on health reform will come from two directions – budgetary starvation and general gridlock. The line in the sand will likely come around the Federal budget where legislators will attempt to kill components of the law by removing funding from the budget. Newly-elected members of Congress are already discussing publicly how they might avoid complete government shutdowns during what promises to be a difficult budgeting process.
Of all of the arguments surrounding health reform, the one that grabbed my attention was the critique that the health reform bill passed earlier this year fails to address the spiraling costs of our healthcare system. The need to bend the cost curve is truly the most pressing goal surrounding health reform. The remaining goals are irrelevant if the healthcare industry in the U.S. collapses under its own weight
So when I heard this again this morning on NPR, it got me thinking about health reform and pondering – does health reform address the cost question?
Yes and no.
The idea that health reform failed to tackle the cost question isn’t without merit; however, the bill does layout a framework and a set of pilot programs designed to move toward these goals over time.
As the saying goes, “may you live in interesting times.” If you work in healthcare today, you certainly have interesting times ahead as we enter into perhaps the most dramatic period of change our industry has ever seen.
Universal coverage, accountable care organizations, patient-centered medical home, and meaningful use converge to formulate the healthcare system of the future. Whether you’re a clinician, administrator, I.T. professional, marketer or eHealth professional, your job will look very different in a few years than it does today. This can be more than a little disconcerting for many of us, but knowledge is your best weapon for being prepared for the challenges – and opportunities — that lie ahead.
To help interpret what reform will mean for you, we created a series of educational webinars over the next three months:
October – Healthcare Reform: The Biggest New Mover Campaign of All Time
Universal coverage under the newly passed health reform law is going to bring millions of Americans into the ranks of the insured. Strategic healthcare organizations will be aggressive in their plans to pursue these new patients while being smart about which services to promote and which consumers to promote them to. Join us on October 21 to learn about the changes and opportunities ahead for marketers as they prepare to drive strategic market share growth.
In the wake of the passage of the health reform bill this week, one item that’s hit the radar is a report that health reform may cause physicians to leave practice in large numbers. The report, which suggested that as many as 46% of physicians would try to leave medicine, originally received exaggerated attention when it was erroneously attributed to the New England Journal of Medicine.
The actual research was performed by medical recruiting firm Medicus. The firm published their survey and results in greater detail in response to the high levels of interest. Respondents indicated that, if health reform were enacted with a public option (the survey was performed when that option was still on the table), 24% would attempt to retire early and another 21% would attempt to leave practice even if not near retirement age. As enacted, 22% indicated an interest in retiring early and another 8% would attempt to leave medicine without being near retirement age.
I recently read a Fast Company article about how Houlihan’s is using social media to drive growth.
According to the article, Houlihan’s was tired of being outspent and outshouted by Applebee’s and Chili’s in mass media, so Houlihan’s decided to target millennials by creating a social-networking site, HQ, which is an invite-only brand community of 10,500 “Houlifans.” The site serves as a virtual comment card, and the feedback has allowed the company to rebrand itself and revamp its new tapas-style product line. In the Kansas City area, the first test site, profits grew at 12% compared to an industry decline of 1%.