The KHIT Blog: REC progress data release update from ONC

Thursday, May 2, 2013

REC progress data release update from ONC

Props to EHRintelligence.com

The Office of the National Coordinator for Health Information Technology (ONC) is announcing the availability of more than 100,000 additional data points through its Health IT Dashboard. The resource is part of the ONC’s mission to ensure transparency and enable access to data relative to the adoption of health IT systems, such as through the EHR Incentive Programs (i.e., meaningful use)...

From the Dashboard:

Some selected states of interest to me: the west coast (including Hawai'i). First, I note that Nevada and Utah comprise one REC contract. But, our in-house competition has been rather animated (and has some old vestigially chafing shotgun marriage roots going back to the days a generation ago when the Utah QIO -- then known as "UPRO") bought the Nevada QIO contract ("NPRO," which had lost its Medicare SoW contract).

Hawai'i (above) is pretty interesting. Long relative (albeit accelerating) time to appreciable milestones, then a sharp plateau. Seems, from what I can glean -- given that they won't talk with me --, that they have put the bulk of their eggs in the (federally funded through 02/2014) HIE operation going forward. And, according to recent news reports, it looks like 2014 post-federal "sustainability" for HHIE will hinge on a million dollar funding allocation from the Hawai'i legislature (bill now in reconciliation at last report).

An allocation of $1 million to sustain the Hawaii Health Information Exchange (HHIE) contract for FY14. The HHIE is a local non-profit organization designated by the State of Hawaii to build the statewide health information exchange, a secure electronic network that allows health care providers to transmit patient medical information more efficiently.

Probably doesn't hurt that HHIE Executive Director Sakuda is a Hawai'i Registered Lobbyist (pdf).

Lobbying for continuation of your own executive position and salary? Or, did you recuse?

Interesting.

Contrast Hawai'i with everybodys' darling, Massachussetts; they grabbed all the low hanging fruit early on (leveraging their DOQ-IT chops, I guess), then plateau'd as well.

JUST IN FROM MEDCITY NEWS

Four Ways an EMR Can Save You Money
May 3, 2013 10:26 am

Meaningful Use incentives are one reason to implement electronic medical record software, but there are other financial benefits to using an EMR, as well...

1. Reduce office supply expenses.
One of the things that EMR companies tend to advertise most is that implementing their software will allow practices to go paperless. Doctors relish the thought of all the money they can save by eliminating paper ’ and they’re sold.

The truth is EMRs don’t eliminate paper use altogether, and truly paperless practices don’t exist. But an EMR can significantly reduce the need for paper, driving monthly hard costs down and leaving money in the budget for other expenses...

2. Increase productivity.
Learning to use an EMR -- not to mention redesigning workflow to adapt to electronic charting -- can be overwhelming and will almost certainly slow physicians down at first. As learning takes place, however, particularly for practices that focus on the training aspect of implementation, productivity will slowly increase, translating into big savings over time...

3. Gain office space.
A benefit that practices often fail to consider is the storage space that is inevitably freed up by going digital. After all, once paper files have been scanned and are safely stored within the EMR, it becomes unnecessary to continue storing them on-site. But what to do with an empty chart room?

The obvious answer is to turn the space into an exam room so that it becomes an extra source of revenue...

4. Allocate staff resources more efficiently.
The most obvious example of how an EMR system allows practices to save money when it comes to staff is that it eliminates the need for a full-time medical records clerk. That’s savings of more than $2,000 a month, which for many practices is even greater.

Another alternative to cutting overhead without letting a staff member go is to use them in a more efficient way...

Yeah. Health IT ROI tools are fairly mature by now. Docs need to use them effectively to get past the nominal price "sticker shock" thing.

___

More to come...

1 comment:

EECPMay 3, 2013 at 1:51 AM
Excellent information
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Brave New Health

Commonwell Health Alliance

Another important read (pdf)

I love this kind of stuff. It sustains and humbles me. "As politicians, advertisers, salesmen, and propagandists for various political, economic, moral, religious, psychic, environmental, dietary, and artistic doctrinaire positions know only too well, fallible human minds are easily tricked, by clever verbiage... Common language—or at least, the English language—has an almost universal tendency to disguise epistemological statements by putting them into a grammatical form which suggests to the unwary an ontological statement. A major source of error in current probability theory arises from an unthinking failure to perceive this."

Quotes

"An economist is a person who sees something that works in practice and tries to figure out whether it will work in theory."

- J.D. Kleinke, medical economist
___

"The only person who enjoys change is a baby with a wet diaper."

"Every misspent dollar in our health care system is part of somebody's paycheck.

- Brent James, M.D., M.Stat

“We could do healthcare, at markedly higher quality, for everyone in this country, without rationing or denying anybody the care that they need, without having the government dictate how doctors practice or whether hospitals could expand, at half the cost we do it now.”

- Health Care Futurist Joe Flower

Most of the sciences, unlike parts of medical science, are not concerned with the impossible. There is not complementary and alternative physics, or chemistry, or biochemistry, or engineering. These disciplines compare their ideas against reality, and, if the ideas are found wanting, abandoned."

- Mark A. Crislip, MD

"Q: How much alcohol is too much?
A: More than your doctor drinks."

- a physician I once heard speak during a CME presentation

“Just because science doesn’t know everything, doesn’t mean you get to fill in the gaps with whatever fairy tale most appeals to you.”

- Dara O’Briain

'[I]t is one small step from using the computer for "helping" doctors to monitoring them, judging them, dictating to them what to do, and withdrawing payment for computer non-compliance. The use of computer data is a multi-edged sword. It can be used for the "good," facilitating diagnosis and treatment and making it more accurate and up-to-date, and for “evil,” invading privacy, inviting security breechs, and making decisions based on the opinions of remote authorities rather than those present at the patient-doctor encounter.'

- Richard Reece, MD

“[T]here ARE statistics which are non-political. Just because The Washington Post/Fox News reports the temperature is 75 degrees doesn’t mean it’s really snowing and sunscreen is a liberal/conservative plot. Even if you earn a living being ideological.”

- Michael L. Millenson

"It is a generally a fairly convincing argument that people shouldn’t have to be subsidized to undertake a change which is in their best interest.

The reconciliation seems to be that EHR is not supposed to make a doctor’s practice more efficient and higher quality. It is supposed to make the system of care more efficient and higher quality, which is not the same thing. Those of you who took calc recall that maximizing the total of variables is not achieved by maximizing any one variable and this is a perfect example of that.

Those of you have served in combat certainly noticed that too — if everyone works as a team the unit takes fewer casualties. If you try to save your own hide, you might, but at the expense of more casualties overall."

- Al Lewis

"There are two ideas to keep in mind about Bayesian reasoning and how we tend to mess it up. The first is that base rates matter, even in the presence of evidence about the case at hand. This is often not intuitively obvious. The second is that intuitive impressions of the diagnosticity of evidence are often exaggerated."

- Daniel Kahneman, "Thinking, Fast and Slow"

"Physicians apply advanced scientific knowledge, but they must do so without the favorable conditions that experimental scientists create for themselves. Multitasking is forced on physicians, often in chaotic environments and under severe time and resource constraints."

- Lawrence and Lincoln Weed, "Medicine in Denial"

"It’s time to stop the whining about Obama care and acknowledge we already have universal health care. We just pay for it in the stupidest way possible that ensures problems are that much more disastrous and complicated when they’re finally treated."

- Mark Hoofnagle, MD, PhD

"Every act of conscious learning requires the willingness to suffer an injury to one's self-esteem. That is why young children, before they are aware of their own self-importance, learn so easily."

- Thomas Szasz, MD
___

"Of course, one reason that process metrics* are so popular is that processes are much easier to define and measure than outcomes."

- The Skeptical Scalpel
___

"There is an “illusion of validity” for any random data point, a seductive sense that is colored by what we hope will be true. Mountains of pharmaceutical claims are often made from mere molehills of data."

- Danielle Ofri, MD
___

"Joy empowers people. It is a source of energy that enables people to hope and plan and change their lives for the better. Spend some time around someone who is relentlessly negative and how do you feel–drained, right? More and more research shows that joy is not something that just happens to you, like a bolt of lightening out of the blue. Joy is, instead, a habit to cultivate. Negative thinking and despair are the crabgrass of our souls–weeds that take root and spread, sometimes to all areas of life. Joy, in contrast, is a soul’s rose–hardy when cared for, able to put down roots over time and withstand disease and extremes. Like a rose, however, your joy can become blighted from neglect or harsh conditions. We all need to tend to our joy–to prune away the badness, and to know that, even though it may look like a prickly bare root, if you invest time in a joyous outlook, gorgeous things will bloom, even in the harshest conditions."

- Dr. Jan Gurley
___

"'Solutions' exist only in mathematics."

- Karen Martin
___

"The issue of how to regulate clinical software is, in the long run, indistinguishable from the issue of how to regulate medicine. The only difference is that medicine is practiced in the open, without secrecy, subject to peer review, and under a merit-based state license."

- Adrian Gropper, MD
___

"Economist, rope, tree: some assembly required."

- Source unknown

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I write this blog wholly on my own time and my own dime. The views proffered are expressly my own as a concerned and active citizen/taxpayer (in addition to being the result of my substantive experience in the various IT fields), and in no way reflect any policy views of my former employer, notwithstanding that some of the thinking has indeed obviously been spurred by the implications of the work with which I have been doing for them.

FAIR USE POLICY
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Thursday, May 2, 2013

REC progress data release update from ONC

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