Wednesday, July 23, 2008

Toot-Toot on the Health Train Express

embargoed until  July 24,2008
Quote of the day:
My definition of an expert in any field is a person who knows enough about what's really going on to be scared. - P. J. Plauger

The horns are blowing at the health train express hurtles down the track, first leaning to the right, then the left travelling along tracks laid in 1960 or even further back than that.

Who is blowing the horns? Is it the government, health insurance plans, consumer advocacy groups, employers, or some hidden

demonic forces


Here are several relevant news articles in regard to health information technology.

iHealthbeat reports the following:

PHR Networks Better Model Than RHIOs To Exchange Health Data

Speakers at the Third Annual Leadership Summit on the Road to Interoperability in Boston on Tuesday said personal health record networks likely will provide a better model for health data exchange than regional health information organizations, Healthcare IT News reports.
R. Tim McNamar -- founder and CEO of e-certus, a software company, and former member of the Reagan administration -- said PHR platforms offer hope for the exchange of health data sooner than could be achieved through RHIOs. McNamar criticized President Bush for not pushing interoperability. He added, "There's no viable model for RHIOs."
David Kibbe, senior adviser to the American Academy of Family Physicians, said, "We can't expect government to build a network. Government didn't build the Internet. Government didn't build PCs."
Vince Kuraitis, a lawyer and principal of Better Health Technologies, predicted that companies would begin developing applications for PHR platforms such as Google Health, Microsoft's HealthVault and Dossia (Monegain, Healthcare IT News, 7/23

There actually are models for RHIOs, that will work. The technology is there, but the financing is not. I am not at all sure how consumers, or employers or whomever are going to build a PHR  that would work for providers, or hospitals.  PHRs as they now stand do not address the issue of P4P, management of chronic diseases and many other important issues. 

This is a little like asking the consumers to design their own ATM network for banking , or a computer inventory system for their local supermarket.

iHealthbeat goes on:

House Committee Passes Revised Health Care IT Legislation

Today, the House Energy and Commerce Committee approved health IT legislation (HR 6357) aimed at driving widespread adoption of electronic health records, Health IT Strategist Alert reports.
The legislation also is intended to strengthen federal patient security and privacy laws.
The bill would authorize more than $560 million in grants and loans for health care providers (Health IT Strategist Alert, 7/23).

Changes to Bill

On Tuesday, House Energy and Commerce Committee Chair John Dingell (D-Mich.) and ranking member Joe Barton (R-Texas) released a revised version of the bill.
According to CongressDaily, the lawmakers significantly changed the legislation's information-sharing and privacy provisions to address recent concerns from health care, high-tech and consumer advocacy stakeholders (Noyes, CongressDaily, 7/22).
Under the revised bill, patients would give their consent only once to health care companies that want to access health care records without identifying information for HHS-approved purposes, such as hospital audits or fraud and abuse allegations. The bill previously would have required patient consent each time the records were accessed.


Mary Grealy, president of the Healthcare Leadership Council -- who on Monday sent a letter to Dingell and Barton stating her concerns about the proposed bill's effect on the Confidentiality Coalition -- said, "They did make improvements in those provisions we had some concerns about, so I do feel like we're making progress." However, she added, "Do I think they have completely addressed all the issues? No" (Young, The Hill, 7/22).
A spokesperson for America's Health Insurance Plans said the provision that would allow patients to access their medical records and require them to provide consent for third-party access could restrict health care providers from developing wellness, disease management, quality assurance and other essential programs (CongressDaily, 7/22).
A spokesperson for Patient Privacy Rights said the revised bill is being reviewed and declined to comment (The Hill, 7/22).

It is apparent there are many hands in the cookie jar. Health data exchanges will undoubtedly be heterogeneous and probably never be fully integrated, nor should they be.

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