Tuesday, July 13, 2010

The Final Rule Is Out!

It's been a long time since I've posted to the blog, but this morning's announcement of the Final Rule for meaningful use of electronic health records (and health information exchange) has me feeling inspired.

I've written a blog entry for my company's meaningful use community site at: https://community.csc.com/community/meaningful_use/blog/2010/07/13/hie-and-the-final-rule

I will be cross-posting links to anything I write for CSC (my current employer) here, so my personal blog will be seeing some more activity in the coming weeks and months.

Enjoy the summer!
- C

Saturday, October 24, 2009

Keeping Perspective

Building on my last blog entry on putting personal health expenditures in perspective, I'd like to share a resource with you that I use for keeping the economy's health in perspective.

Just as with a good investment portfolio, it pays to diversify your sources of information. One source in my panoply is Russell Investments' Economic Recovery Dashboard. (Disclosure: I have absolutely no relationship with Russell Investments; I invest with a different financial advisor)

It is an excellent way to quickly view market indicators and economic indicators, for current and lagging trends respectively, in historical context. I don't know a lot of people who can claim to know how the current rate of inflation compares to historical norms, so I find this resource helpful.

I subscribe to their monthly update (I have received no solicitations through them to-date, so I think it's safe) but if you mind giving up your email address they claim to update the data on every 22nd of the month - so bookmark the page and mark your calendar.

Here's the link: http://www.russell.com/Helping-Advisors/Markets/EconomicRecoveryDashboard.asp

Thursday, October 8, 2009

Do We Need Public Entertainment Option?

I want to play Devil’s Advocate for a moment. When I read the Bureau of Labor Statistics’ report on Consumer Expenditures (link here) I noticed something interesting.

To set the stage, we’ve all heard about how much individual consumer spending on healthcare is “out of control” and how it’s taking up an “unsustainable” amount of consumers’ paychecks. This squeeze on the average American’s wallet is one of the main reasons, assuming everyone’s being honest, that we are debating healthcare reform and the need for government intervention in what is described as a broken system.

But what if the numbers show that individual Americans spend almost as much on entertainment as they do on their healthcare?

That’s precisely what the Bureau of Labor Statistics 2008 report shows: that Americans allocate as much of their income to having fun as to taking care of themselves. Furthermore, the rate at which the spending is increasing is greater for entertainment: 5.1% to healthcare’s 4.3%.

This raises the tongue-in-cheek questions: do we need comprehensive entertainment reform to reign in these spiraling costs? Are we getting quality for our entertainment dollar? And do we need a public entertainment option to compete with private entertainment in order to keep it honest?

Monday, October 5, 2009

Health Insurance Exchanges

There's been a lot of discussion lately about the possible mandate for individuals to carry health insurance - much like we're obliged to have an auto insurance policy if we drive. A key enabler of the individual mandate is a means for every person to comparison shop for, and purchase, health insurance.

In an Amazon.com-like fashion, health insurance exchanges seek to fill that need. My company, CSC, built the U.S.'s first health insurance exchange: The Commonwealth Connector.

Given the current health reform debate, I thought it would be timely to write a case study on our successes and lessons learned from the experience so that other State and Federal entities could benefit. Just this week, my piece was published at HealthNewsDigest.com, and the link to it is here.

As always, I welcome your feedback.

Wednesday, September 9, 2009

Is $44,000 Enough?

I was recently on a conference call with the manager of a physican practice, and he was asked "is the money being allocated to physicians for EMR implementation in the stimulus package enough?"

For those of you who don't know, the American Recovery and Reinvestment Act (ARRA) of 2009 has a section in itspecifically targeted towards health information technology - called HITECH. In it, there are dollars set aside for providers who take Medicare and Medicaid patients to encourage them to adopt electronic medical records (EMR) systems. There are also penalties for not adopting the technology by a certain deadline. A practice that begins its adoption by no later than 2012 can earn up to a maximum of $44,000, though the practice will have to bear the up-front cost and apply for repayment. I've included a picture of the payment schedule from my reading of the act.

While $44,000 might sound like a lot of money for a piece of software, it's not the software that was the cost driver for this practice. Of course the manager mentioned how the EMR changes a practice's workflow; an EMR is not a bolt-on technology that helps solve one particular problem more effectively, such as a new bed management system that optimizes the utilization of the beds in a facility. So the time spent by the practice to change how they do business is a cost, but not one that's easily quantified.

The cost that surprised me, and one I'd taken for granted, was pointed out when the manager talked about the conversion of paper charts to the EMR. A brand-new practice that started on Day 1 with an EMR wouldn't incur this cost, but one that had been in business for decades would have an enormous burden to bear in inputting a patient's history into the EMR.

So when this tangible and necessary cost is taken into account, the $44,000 is a contribution, but is certainly not sufficient in covering the cost of EMR adoption by physician practices. Any practice that is considering pursuing the dollars promosed by HITECH for EMR adoption will need to broaden their perspective of what the total cost of an EMR truly is.

Thursday, August 27, 2009

"A Computer Never Healed Anyone"

"Health information technology is just another way for consultants to make money, after all, a computer never healed anyone."

Those are the sentiments I've read and heard from some skeptical physicians. While it's true that a computer never healed a person of its own volition, I do believe that health information technology can play an important role in improving outcomes.

Now, there's another piece of evidence supporting that belief. A study released this month by the Integrated Healthcare Association (IHA) suggests that there is a positive relationship between adoption and use of information technology in physician-hospital organizations (PHOs) and the quality of care delivered to patients.

The study assigned a score to PHOs and their adoption of HIT, and those PHOs with the highest scores had a statistically significant correlation to improved quality of care. A picture of the key chart is in this post above.

The executive summary of the report can be found here, and the data supporting the summary can be found here.

By the way, my response to the HIT-skeptical physican has been, "and neither has a telephone, but do you think the phone has helped outcomes and quality of care?"

Thursday, August 20, 2009

Things Are Looking Up

So, the Conference Board released their August report on economic indicators today and things are indeed looking up.

The big news isn't that the leading indicators are trending upward, though that is certainly good news. The big news is that the concurrent index (i.e., indicators of activity going on right now) have flattened for the first time since October 2008.

This could mean that the negative economic conditions have bottomed out, and because the leading indicators are trending up we could see current conditions begin to trend upward next month.

The original publication is here, and a PDF version is here. Pay close attention to the graph in the PDF, it's pretty illustrative of why can be at least a little optimistic.