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Health IT and Healthcare Reform Information

August 19, 2009

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Declaration of Health Data Rights

June 23, 2009

Patients own their own health data. I am grateful for those working so patients can control their own health data. At Mid-Columbia Medical Center we have lived by the Planetree Philosophy of care, which includes an open chart policy. This policy encourages patients to read their medical records and write in the Patient’s Progress Notes. Access to understandable health information that can empower patients to participate in their health is one of the core values we live by. Patient’s must control their own health data.

From, the
Declaration of Health Data Rights:

In an era when technology is allowing personal health information to be more easily stored, updated, accessed and exchanged, the following rights should be self-evident and inalienable. We the people:

• Have the right to their own health data
• Have the right to know the source of each health data element
• Have the right to take possession of a complete copy of our individual health data, without delay, at minimal or no cost; If data exist in computable form, they must be made available in that form
• Have the right to share our health data with others as we see fit

Their should be NO LOSS OF RIGHTS with the transition from paper to electronic records. This may seem like common sense, but there are some that are trying to take control of our own health data, particularly with the advent of electronic health records. You can endorse the Declaration of Health Data Rights either by submitting your endorsement via this website or by entering the hash code #myhealthdata on Twitter. Please take a few moments to endorse this important declaration and let’s make our voices heard loud and clear.

A first step towards meaningful use of EHR

May 29, 2009
CPOE will be necessary in any defininition of meaningful use of EHR. But a recent survey by Leapfrog has concluded that only 7 percent of hospitals meet Leapfrog medication error prevention standards, which rely on CPOE. “According to our data,” said Leah Binder, CEO of Leapfrog, a healthcare watchdog organization, “a majority of hospitals have significant safety and efficiency deficits.”
Also the recent KLAS CPOE Digest 2009: Meaningful Use and Physician Adoption shows concern about the adoption rate. The report also suggests that the level of CPOE adoption could signify which vendor will have the best chance of stimulating physician EMR adoption and achieving meaningful use. “Though EMR technology has yet to be deployed at many community hospitals and most physician practices, the vast majority of hospitals with more than 200 beds have already chosen a strategy and a solution for electronic medical records,” said Jason Hess, general manager of clinical research for KLAS and author of the new CPOE study. “For those larger facilities, the goal now becomes one of proving that their EMR solutions will actually be used by physicians, replacing paper-based orders and instructions with computerized physician order entry.”
HIMSS has released definitions for meaningful use of certified electronic health records technology. They recommend in the first phase an EHR infrastructure that includes clinical data display and CPOE with “independent licensed practitioners” entering the order. “The vast majority of orders emanating from an ambulatory practice are medications, laboratory testing or consultative requests,” according to the recommendations. “For electronic prescribing, CPOE must be operational within the EHR.” Without CPOE it is doubtful that meaningful use will be determined ror an EHR.

Blumenthal at Brookings

May 22, 2009
The important part of supporting the nation’s healthcare IT initiatives is to back healthcare reform, said David Blumenthal, MD, the national coordinator for health information technology and the Obama administration’s top health information appointee. “We will not succeed in our agenda unless reform succeeds,” Blumenthal said Wednesday during a healthcare forum at the Engelberg Center for Health Care Reform of the Brookings Institution in Washington, D.C. He also noted that there’s considerable skepticism about the $20 billion in the stimulus package to further adoption of health IT that it will deliver on promises to improve quality and lower costs. But he said it can play a “critical” role in a reformed health system because of the need for information technology in health care decision making.

Blumenthal also talked about stimulus money for healthcare IT and the “meaningful use” of information technology in healthcare. He said the use of electronic health records in his own practice had made him a better doctor, and he envisioned a day when IT would be as common as a stethoscope in a physician’s practice and IT skills would become part of the licensing process. “It’s going to be ultimately incorporated in the culture,” he said.

Blumenthal said that his own office has moved into sharp focus since the stimulus passed because his budget has grown from $60 million to $2 billion, including grant programs it will handle for programs such as building up a health IT workforce, establishing resources to help providers adopt the technology and aiding the creation of broad health care information networks.

He said his priorities include providing a definition for “meaningful use” of healthcare IT, as required by ARRA. “There is obviously an enormous amount of expectation about that,” he said. He said the definition would “focus us on the outcome of adoption rather than on the process of adoption.” He claimed they will seek much public input in developing a regulation governing incentive Medicare and Medicaid payments to doctors who make “meaningful use” of the technology. Blumenthal said the definition won’t appear “fully formed” from the federal government without “enormous” public input. The term “meaningful use” is focusing policy makers on payment for the outcomes of the use of the technology rather than on the processes involved in the technology. “We’re going to have to talk about what we will measure to decide whether meaningful use is occurring; an enormous challenge in itself,” he noted.

He seems to realise that there is need to understand things from the provider’s perspective. “We are very sensitive to the need for hands-on technological support at the point of adoption,” he said. “We understand that that is a critical ingredient to success.”

He also touched on health information exchanges during his keynote address. The stimulus package includes least $3 million to promote HIE at regional and sub regional level. The ONC will provide an outline for a program this spring or early summer. He also briefly mentioned privacy and security. “Privacy and security is very much on our minds,” he said. “If there is not trust in this system, it will not be acceptable to the American people.”