A surprise move by ONC/HHS indicates the wheels may be falling off health IT reform at about the same rate they've fallen off Democrats' broader health reforms.
David Blumenthal and his staff have unveiled two separate plans to test and certify EHR technology products and services. We don't think this is a good idea. We've supported the purpose and spirit of the ARRA/HITECH incentive programs, and believe ONC's/HHS' re-definition of EHR technology puts it on a trajectory to improve the quality and efficiency of health care in the U.S. But this recently-announced two-stage EHR technology certification plan bears all the marks of a hastily drawn up blueprint that, if rushed into production, could easily collapse of its own bureaucratic weight.
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8
March
As I noted in another post, the media seems to be turning “reconciliation” into an ugly word.
But “filibuster” is the word with a more unsavory history. (Thanks to HeathBeat reader Barry Carroll who sent me a link to the history of the word.)
“Filibuster” finds its root in the Spanish word “filibustero,” which means “pirate.” The filibuster was originally seen as an opportunity to “pirate” or “hijack” a debate.
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3
March
Dr. Lavizzo-Mourney is the President and CEO of the Robert Wood Johnson Foundation. Before joining Robert Wood Johnson she taught at the University of Pennsylvania, where she was the Sylvan Eisman Professor of medicine and health care systems and director of Penn’s Institute on Aging. In Washington, D.C., she was deputy administrator of what is now the Agency for Health Care Research and Quality.
Thanks to a new set of reports, we now know that where you live matters to your health. People who call Prince George’s County Maryland home are twice as likely to die prematurely from disease as their neighbors just across the line in Montgomery County. The data cut both ways. People who live in the healthiest counties, such as Montgomery or Howard County Maryland have a two-to-three times better chance of living longer than people who live in less healthy counties such as Prince Georges or Baltimore.
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24
February
The Massachusetts health reform law Part II, enacted in 2008 - laid the groundwork for cost control and quality improvement, as a follow-on to the initial legislation's emphasis on achieving near-universal coverage. The legislation authorized several studies -- including a report published a few months back on global payment strategies -- and set the stage for hearings on health care cost containment to be held before the state Division of Health Care Finance and Policy (DHCFP), which are scheduled to begin March 16, 2010.
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17
February
Twenty-seven years ago, President Ronald Reagan and a Congress split between Republican and Democratic control agreed to a radical new payment scheme for Medicare. The resulting legislation trimmed billionsof dollars from the federal budget and caused medical inflation to plummet, yet still maintained quality of care.
Although this stunning achievement led to a permanent change in how both the public and private sector pay for health care, it has gone curiously unmentioned during more than a year of rancorous health reform debate. Nor isit likely to arise at the much-ballyhooed bipartisan summit. The topic simply raises too many squirm-inducing questions. In this instance, conservatives and liberals alike can agree that political discretion is the better part of valor.
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16
February
Wellpoint is getting killed in the press over a “39%” rate increase for their individual health insurance block in California.
HHS Secretary Sebelius has pointed to the Wellpoint individual rate increases demanding an explanation. The President even brought it up in his interview on Sunday. At a time Democrats are fond of calling insurance executives “villains” this story just adds more fuel to the fire.
No less than five reporters called me the day the story broke asking me to explain it all.
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11
February
I think health care reform is dead. And the proposed reform was relatively inconsequential anyway, as it would have left in place Medicare as is, Medicaid as is but bigger, employment-based health insurance, and fee-for-service medicine. And with Scotty Brown winning in Massachusetts, and harsh political winds stripping off the Blue Dog votesfrom the House Democratic majority, it seems that there’s no hope. In that context Obama’s not entirely spirited defense and offer to have a parlay on TV in a couple of weeks doesn’t sound like a recipe for action.
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10
February
This April 6–7, the Health 2.0 Europe conference will feature the many ways in whichWeb 2.0 tools are providing innovative solutions to, amongst others, our fundamental need for self-expression, known more recently as “user-generated content”.
Several panels will refer to these issues, but we will focus in this post on the Hospital and Payers’ panel. Payers want to ensure that their patients are being oriented to good care. Hospitals want to know that they are being considered “justly”.The Health 2.0 panel will include demonstrations byGuide Santé (France) and Patient Opinion (UK), both web 2.0 sites created by physicians concerned by patient satisfaction with hospitals and clinics. Payerslike the UK NHSand Big-Direkt from Germany will participate in the conversation and Big-Direkt will also demo their new online tools.
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9
February
When Charlie Baker began his run for Governor of Massachusetts, the Boston Globe critiqued his record and found it wanting (State aided Baker’s business triumph), a piece that struck me as weakly argued and unfair (Why is the Globe picking on Charlie Baker?). To the Globe’s credit, they published an excerpt of my post in their VoxOp column.
Saturday’s Globe carried a piece that was similar in tone (Baker finds campaign trove in health field) arguing that Baker is sucking big bucks out of the health care sector to fund his election campaign and implying that there is something wrong about it. After describing how some Democrats are giving to Baker (a Republican), the article says:
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9
February
Every now and then, I read and enjoy a book, but only later fully appreciate it as its lessons and insights slowly become apparent. Judging by the number of times I’ve said, “That reminds me of Gawande’s observations about ___” over the past month, The Checklist Manifesto is one such book.
In this short, deceptively simple volume, Atul (who I count as both friend and inspiration) discusses the history of “the lowly checklist,” the impact of checklists on various industries, how he came to understand the value of checklists to medical care, and what makes a useful checklist. Most of this content could have been written by a thoughtful healthcare journalist. But Atul put his interest in checklists to practical use, spearheading a WHO initiative to test a checklist-based “safe surgery” program in 8 diverse hospitals around the world, an effort that saved hundreds of lives. His description of this program forms the core of the book.
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8
February