Schwartz Healthcare IT Blog

Billions in Stimulus Funding for Healthcare IT - What To Do?

2009-04-02T20:17:53Z

Part of the larger, $787 billion stimulus package signed by President Obama in mid-February is $19.2 billion under a bill called the HITECH, or Health Information Technology for Economic and Clinical Health Act. Hey, no one said these things would have simple names.

That $19.2 billion directs most of the funding - $17.2 billion of it - to pay for the widespread adoption and "meaningful use" of "certified" interoperable electronic health record (EHR) technology. The other $2 billion covers a wide range of healthcare information technology projects including health records, health information exchange, computerized physician order entry, clinical decision support systems and electronic prescribing. Recently we ran a webinar about the HITECH funding - slides and an audio are available below.

The EHR funding will be administered through CMS - Medicare and Medicaid - in the form of reimbursements available to physicians and hospitals, and spread over several years. The $2 billion is allocated by the Office of the National Coordinator for Health IT to be headed by Dr. David Blumenthal, appointed to the job on March 20, 2009. A couple questions come to mind:

How do you get healthcare stimulus money? As of this week the details of the process are still being developed by several federal agencies.

So what does this mean for healthcare IT companies and how can companies get stimulus funding?

First, the stimulus funding is intended to boost rapid technology adoption in the hopes of controlling healthcare costs, making healthcare more efficient and perhaps creating jobs. Despite the fact that there are more than 200 companies offering some form of EHR technology to physicians and hospitals, adoption is still too slow - by some estimates, well below 15% market penetration with perhaps a third of those using the systems effectively. An even worse EHR market assessment was published on March 26, 2009, which said that just 1.5% of non-Federal hospitals in the U.S. are using a comprehensive EHR system. Yikes!

(An interesting recent development is the start of a backlash, often from doctors, against the orthodoxy that widespread use of HCIT technology is an unquestioned good. The latest is this opinion piece from Time, this week. Among other intriguing points, it argues that EMRs could increase healthcare costs and push providers to input inaccurate information. I’ll write more about this later.)

Second, the stimulus funding is intended to foster better integration among the various proprietary HCIT technologies, which have been notoriously complex and difficult to integrate.

Third, the EHR funding encourages adoption through a payment schedule that can subsidize the costs of purchase and implementation, but it also includes a penalty. In 2014 physicians will see reduced Medicare and Medicaid reimbursements if they have not implemented EHR technologies and are not using them effectively.

The details of accessing the ARRA and HITECH funds are not yet fully developed, but the race is on for companies to tap into these funds. Whatever the details turn out to be, HCIT companies with a strong public image and strong brand awareness will be best positioned to take advantage of this rare opportunity in which the government is essentially funding their customers to buy their products. That means HCIT companies with strong government relations, strong brands and a strong public presence must maintain and extend it. HCIT companies without those advantages had better build them, and fast.

Several of us from our Healthcare IT Practice will be at HIMSS next week. We’ll be in booth # 3145, so please stop by and let’s talk about this.

Healthcare IT Spotlight Burns Bright

2009-01-21T21:06:02Z

Last week saw a series of announcements and events that underscore the importance the Obama administration and new Congress have placed on healthcare information technology (HIT) to stimulate the economy and help solve a national crisis in healthcare access, costs and outcomes.

First up was the "Investing in Health IT: A Stimulus for a Healthier America" hearing chaired by Senator Mikulski's HELP Committee. It featured compelling testimony on the need for better applications to solve the electronic health record (EHR) problem, specifically interoperability.

Next up, the House Appropriations committee unveiled its $825 billion "American Recovery and Reinvestment Bill of 2009," calling on significant investments to "update and computerize our healthcare system to cut red tape, prevent medical mistakes, and reduce healthcare costs." Key provisions include billions in federal HIT funding for computerize health records, with billions more targeted at disease prevention/wellness; healthcare effectiveness research; community health centers, and training primary care providers.

The new climate in Washington provides a once-in-a-decade opportunity for HIT companies to become part of a massive and coordinated effort to fix the broken healthcare system. Healthcare IT has become a bright spot in the otherwise dismal economic climate. Schwartz Communications will continue to monitor the HCIT landscape, offering insight into turning the current legislative agenda into real business opportunity through public relations. This includes hot button issues like consumer directed healthcare, transparency, interoperability and others. Stay tuned.

Coming up: Schwartz will be conducting a free Webinar titled, "The New Administration and Healthcare IT: Positioning Your Company for Success." scheduled for Thursday, February 26 at 2:00 PM Eastern. Details to follow soon.

FUD Factors

2008-10-03T15:21:02Z

An Envision Solutions/Kelton Research survey found that 85.6 million U.S. adults, or 38 percent of the population, have doubted the opinion of their doctors or other medical professionals when it conflicts with information found online. Forty three percent of consumers ages 18 to 34 reported they doubted their health provider's advice when it conflicted with online sources.

Only 3 percent of Americans seeking advice about how to manage a serious medical condition would view patient developed online health information as trustworthy. I’m sure this perspective would change if a consumer was faced with a serious disease or condition, hence the popularity of sites like PatientsLikeMe.com.

Few consumers listed the government, the media or non-profits as credible healthcare information sources. The survey shows that a majority of Americans still view health providers as their most trusted source of medical information overall.

Docs Rate Plans

2008-09-30T18:15:32Z

The AMA recently issued its first health insurance report card grading how quickly and accurately doctors get paid. Docs hope the report card will reduce the cost of claims processing and help in contract negotiations with the health plans.

According to the AMA, the report card compares Medicare and seven national commercial health insurers on the timeliness and accuracy of claims processing. UnitedHealthcare had the lowest rate – only 62 percent of medical services billed were paid by them at the agreed rate. Aetna came in higher at 71 percent, and the Medicare at an impressive 98 percent.

What you can do: If you are a healthcare IT physician practice management or EMR vendor who facilitates electronic coding and billing, use the AMA report to highlight how you can improve payment rates for you customers. It's likely your solution improves reimbursement rates and speed, translating into a more efficient and profitable practice.

Costs and Opportunities

2008-09-28T23:11:40Z

Health care costs are expected to rise more than 10 percent into next year, says an Aon Consulting survey of 70 national health insurers. This is actually good, considering it’s the smallest increase Aon has seen in six years.

Employers take measures to combat such increases through new designs, adoption of CDHP and HSA plans. Costs are still rising to keep up with growing patient demand for services, the needs of an aging population and prescription drug and technology costs, according to Aon.

What you can do: If you are a healthcare technology vendor whose solutions help lower costs for employers, leverage surveys such as this to highlight the savings you can provide customers. Highlight employer group success stories in the HR and benefits trades. Consider a round table of customers and experts to put your solution in a trend story context.

EHRachusetts

2008-09-23T21:11:14Z

Here in Massachusetts, Gov. Deval Patrick signed legislation mandating hospitals and community health centers to implement interoperable electronic health records systems by Oct. 1, 2015, as a condition of their state license. The state will develop regulations to define EHRs.

The systems must be certified by Certification Commission for Healthcare Information Technology (CCHIT.) Further, the law mandates collection and reporting of quality and cost data by providers and insurers, for dissemination to consumers via a state Web portal.

For HCIT practitioners of EHR vendors, this gives you an interesting message point to weave into pitching any Massachusetts hospital or health center customers.

PHR Thoughts

2008-09-16T15:03:18Z

While it may take a decade for widespread adoption of PHRs, it will definitely happen. It is another medium for communicating your medical condition to a doctor, which today is done verbally. Data supplied into the PHR by health plans, or the doctors via EMR interchange, will be more accurate as patients memory – selective or otherwise – isn’t often reliable.

What will help doctors is a high degree of interoperability between the PHR and the EMR, otherwise it’s still easier to take down a patient’s information verbally. When the Certification Commission for Healthcare Information Technology (CCHIT) starts certifying PHRs this will hopefully be addressed.

Other obstacles that will be overcome with time is general technology acceptance by doctors. The old guard's resistence will be replaced by younger doctors who are more comfortable and trusting of technology. Ubiquity of PHRs via Microsoft, Google, health plans and hospitals will move PHRs from “nice to have” to “must have."

This presents PHR vendor PR folks with opportunities to highlight how their solutions are making adoption easier, helping facilitate the vision of universal PHRs.

Who Watches the Watchmen?

2008-09-09T10:54:28Z

University of Missouri researchers conducted a national survey and found that the majority of health journalists have not had specialized training in health reporting and face challenges in communicating new medical science developments.

Health literacy, as defined by the American Medical Association, is ‘the ability to obtain, process and understand basic health information and services needed to make appropriate health decisions and follow instructions for treatment.’

According to the UM press release, of the journalists surveyed, only 18 percent had specialized training in health reporting and only 6.4 percent reported that a majority of their readers change health behaviors based on the information they provide. The journalists had an average of 18 years of journalism experience and seven years experience as health journalists.

Journalists reported quoting medical experts, avoiding technical terms, and providing data and statistics, as the three most important elements to making health information understandable.

According to the survey, a majority of journalists reported believing that their readers understand information from medical professionals, but are not proficient with scientific information and more prone to believe health myths. The results suggest that newspaper journalists view their roles as information providers, while magazine journalists perceive themselves more as advocates for behavioral change.

PHR Factoids

2008-09-02T22:39:52Z

A recent Markle Foundation survey found that regardless of their interest in using an online PHR service, 79 percent or more of the public believe using an online PHR would provide benefits to individuals in managing their health. Fifty six percent cited worries about privacy and confidentiality as a reason for their reluctance.

Only 2.7 percent of adults have an electronic PHR today (representing about 6.1 million persons). Most (57.3 percent) do not keep any form of personal health records, and 40 percent keep some paper health records.

What you can do: If you're a PHR vendor PR person, utilize the survey findings to support your solution. Use the statistics in press releases or collateral to help make your case. Highlight the privacy and security safeguards that your product takes, given that privacy is a major obstacle to PHR acceptance.

Most Powerful?

2008-08-26T16:07:23Z

Modern Healthcare's annual "100 Most Powerful People in Healthcare" list for 2008 has been published and includes healthcare IT vendors in the top three spots.

1) Steve Case, CEO/founder of Revolution Health

2) Eric Schmidt, Chairman/CEO of Google

3) Bill Gates

4) Hillary Clinton

5) Barack Obama

6) Ted Kennedy

7) Arnold Schwarzenegger

8) George W. Bush

9) John McCain

10) Newt Gingrich

These popularity/political contests are amusing. As a healthcare IT PR practitioner it’s good to see the vendors in the top spots, as it indirectly helps all our causes. Personally I think none of them deserve to be there. Revolution, Google and Microsoft’s consumer health efforts are so early stage with virtually no users that they really should be in the low ‘teens.

No one seems to like Bush, but you can bet that doctors have privately thanked and rooted for him in not cutting Medicare reimbursement rates. That would put Bush from #8 to #1 no question. And Newt’s quasi-political think tank which charges vendors $50,000+ for representation is in many circles (as discussed by the Associated Press on occasion) a questionable operation. I could go on. But most people will agree that in our own real world, the most powerful person in healthcare is your or your child’s very own doctor.

Cloudy Outlook for PHRs?

2008-08-20T18:31:40Z

According to market research firm Gartner, government ITexecutives should investigate the impact of personal health records (PHRs) and health information exchange programs.

PHRs, such as Google Health, Microsoft HealthVault and ActivePHR from ActiveHealth Management, are free and controlled by the consumer and could achieve a high degree of interoperability with clinical systems operated by healthcare providers and other third parties, says Gartner. Microsoft recently announced a pilot project with Kaiser Permanente to enable data transfers between consumers' medical records and Microsoft's HealthVault online health site.

Gartner says these publicly available applications are built on important characteristics of cloud computing - they are enormously scalable resources that offer services directly to end users and to other IT products through an application program interface (API). Gartner reports they have the potential to achieve several important benefits:

]]> -They could provide a lifetime consumer health record that is free to consumers and healthcare payers because the vendors have very low costs through their cloud-computing facilities and the ability to monetize their PHRs by drawing consumers to their other online products.

- They have the potential to scale up to cover the dramatic expansion in healthcare data driven by increased use of diagnostic imaging, genomics and proteomics.

- They offer Internet-savvy approaches to the two most vexing issues in sharing electronic information in many jurisdictions: consumer authorization and consumer identification.

- Their cloud-computing approach, offering data access as a software service, can help to create a new market of consumer-oriented healthcare applications, enabling better consumer lifestyle choices and more active consumer participation in choosing a course of treatment for serious health problems.

- The cloud-computing approach is synergistic with the underlying philosophy of these products, which is to engage consumers in managing their own data. This consumer engagement is another reason that better consumer choices could stem from their use.

"It is very early in the life of these products and there are numerous obstacles that the vendors will have to overcome to achieve the benefits," said Gartner’s Wes Rishel in a press release. "The availability of these cloud-based approaches can disrupt health information-sharing initiatives and policies that some jurisdictions have in place by providing PHRs that better leverage vendor and global healthcare provider partnerships."

Gartner defines cloud computing as a style of computing where massively scalable IT-related capabilities are provided "as a service" using Internet technologies to multiple external customers.

Gartner recommends that policymakers prepare now to deal with issues pertaining to consumer confidentiality, competition with government programs, disenfranchisement of disadvantaged populations and policies on the secondary use of consumer health data.

"PHRs can impact government IT organizations and executives by creating the need for informed participation in policy initiatives and by impacting beliefs about whether some initiatives should be governmentally operated," said Rishel. "For almost all jurisdictions, preventing the entry of PHRs is not a viable approach. Delay is not a long-term strategy, but a limited amount of delay may provide time to ensure good confidentiality and craft an approach that is synergistic with government programs."

Additional information on personal health records is available in the report "The Cloud-Based Personal Health Record." The report is available on Gartner's Web site.

The Cost of National EHR

2008-08-15T16:30:31Z

Government Health IT reported that full implementation of networked e-health records in U.S. doctors’ offices and hospitals could cost around $150 billion over eight years.

According to Robert Miller, a professor of health economics at the University of California, San Francisco, this $150 billion estimate is actually “manageable” because it amounts to less than a 1 percent increase per year in the nation’s total health care spending.

Miller said hospitals are further along the path toward implementing clinical information systems, partly because they get some boosts in revenues when they install EHRs. With hospital profit margins around 5 percent, most hospitals can afford it.

Miller’s projections call for hospitals to spend $35 billion to acquire and expand EHR systems and $55 billion in new operating costs over eight years. Financial incentives and reporting requirements are going to be key to getting useful data from EHR users, Miller said.

The Rand Corp. reported in 2005 that the total cost over 15 years would be $114 billion, an amount Rand said would be completely offset by cost efficiencies and other financial benefits of EHR use.

What you can do: HCIT PR practitioners may want to consider highlighting the ROI of their EHR solutions in contrast to all this talk about costs. For those vendors with low cost hosted solutions, take full advantage of this feature in comparison to the bigger and more expensive licensed solution vendors.

Finally a Fine

2008-08-09T16:46:58Z

Some past posts of mine have talked about the lack of HIPAA enforcement fines. Finally a nursing home company in Seattle got fined. The A.P. reported that Providence Health & Services was socked with a $100,000 fine and mandate to fix it’s security in light of past privacy complaints.

Providence failed to properly secure backup tapes, disks and laptops with electronic patient information, even after thefts of the tapes and laptops.

Providence agreed to revise its policy on transporting patient records improve training.

Buzz Kill

2008-08-04T15:22:13Z

Part Two on Corporate America's Abuse of the English Language

I've written before on this topic in my "Good Business Writing: An Oxymoron?" post, with some extra commentary from Gary Baldwin of HealthLeaders magazine (now with Health Data Management.) Today my colleague Brian Bogie weighs in on the topic, with some insights from Eric Wicklund of Healthcare IT News...

Companies have news they need to communicate to their constituents. This news is made up of new customer wins, product announcements, partnerships, recent hires, etc. The most common method of distributing that news is the humble press release. Tried and true, a well written press release can get the word out quickly and effectively. Unfortunately, a great barrier stands in the way of effective communication in a press release: buzzwords.

It’s not the buzzwords fault, really. In a culture of hype, the buzzword is royalty. It shows you are “with it,” you are “now,” and you are “happening.” Ok, really bad examples, but you get the idea. With business book titles leading the way for a real-time, paradigm-changing, seamless business consciousness, we all end up believing the hype. And we are all guilty of using them. Besides, isn’t the news about our client’s fantastic new technology, or the greatest partnership in the history of mankind that you just signed with Microsoft worthy of a buzzword or two? For that answer, I went to Eric Wicklud, managing editor of Healthcare IT News.

Eric was kind enough to give some thought to the overuse of buzzwords. A master craftsman when it comes to understanding and reporting on news of the healthcare technology industry, Wicklund has simple advice: just say no.

Illustration: Katy Hanlon

“Long-winded words are tossed about as often as acronyms in the healthcare field these days, making it difficult to conduct a normal conversation or read through an article without consulting some kind of reference guide,” says Wicklund.

Please follow the "Continue Reading" link below...

]]> The importance of effective communication in a press can be summed up in one word–coverage. Unless the press release communicates the news value of the announcement in a concise, easily-understood manner, it’s likely to be passed over. Eric sees on average 60 press releases cross his desk daily, and standing in the way of your deserving news receiving coverage are buzzwords. “Buzzwords don’t effectively communicate anything. Rather then bring luster to a release, they only bring confusion,” says Wicklund. Eric openly wonders if there’s a “Healthcare IT for Dummies” out there somewhere.

With that in mind, Wicklund provided Schwartz with his list of most overused buzzwords. An explanation in his own words follows. Trying to sneak a few past him may just relegate your release to the circular file.

Buzzwords
1.    Solution – The use of the word “solution” has always bothered me. The word implies an answer to a vexing problem, and is used in marketing terms to refer to a company’s product. My question is, if the product doesn’t work, then it’s not a solution to anything.
2.    Utilization - Bothers me. It’s a longer version of “use.”
3.    Transparency - Sounds like something’s invisible.
4.    Seamlessly - As in “seamlessly integrating.” If it’s being integrated, the whole process should be seamless, or free of wrinkles. If it isn’t, you need an iron. And a better metaphor.
5.    Real-time - As opposed to fake time? Is there any other kind of time?
6.    Efficiencies - Aren’t they apartments? How does one “improve operational efficiencies?” If they’re efficient, they don’t need improving – unless they can be made more efficient, which makes one wonder if they were efficient in the first place.
7.    Innovative - Really? Who says? How do you prove it?
8.    Advanced - As in “advanced technology.” If it isn’t advanced, is it primitive? In my opinion, everything we’re reading about nowadays in healthcare IT is pretty advanced.
9.    Strategic Partnership – All partnerships are strategic. They’re not partnering just for the fun of it.
10.    Intuitive - If it’s intuitive, why say it?
11.    Paradigm - Actually, I like that word. I’ll never use it, because so few people know what it actually means, but it’s a cool word.

I suggest a new scale when weighing the communicative quality of the press release you are currently writing, the “Wicklund Scale.” It may not be a paradigm shifting, transparent, seamless, innovative release living with a few friends in efficiencies, but it may get covered.

PR Plug

2008-07-29T15:26:46Z

A quick plug today for some of the great work that our healthcare IT practice has been doing here at Schwartz.

The new iPhone 3G has provided great guerilla PR opportunities for consumer medical software clients who’ve developed apps for the phone. ePocrates, an early partner of Apple and one of the first to use the SDK, was featured in the Wall Street Journal’s iPhone piece the day of the launch on July 11. Healthcare content company A.D.A.M. developed the Symptom Navigator for iPhone, which was written about in the New York Times “Phone Smart” column, the Wall Street Journal Health Blog, PC World, and dozens of trades and blogs.

This month’s launch of American Well, the online healthcare marketplace, garnered coverage in USA Today, the Wall Street Journal Health Blog, and many trade media and online outlets.

I’d be happy to talk with any healthcare IT PR practitioners on how we went about these campaigns.