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Monday, February 3, 2014 update

From WaPo: can’t handle appeals of enrollment errors
By Amy Goldstein, Published: February 2 

Tens of thousands of people who discovered that made mistakes as they were signing up for a health plan are confronting a new roadblock: The government cannot yet fix the errors.

Roughly 22,000 Americans have filed appeals with the government to try to get mistakes corrected, according to internal government data obtained by The Washington Post. They contend that the computer system for the new federal online marketplace charged them too much for health insurance, steered them into the wrong insurance program or denied them coverage entirely.

For now, the appeals are sitting, untouched, inside a government computer. And an unknown number of consumers who are trying to get help through less formal means — by calling the health-care marketplace directly — are told that’s computer system is not yet allowing federal workers to go into enrollment records and change them, according to individuals inside and outside the government who are familiar with the situation...
Recall my October 28th post.

ONC HealthIT Update

DeSalvo stays the course to better care
WASHINGTON | February 3, 2014

Karen DeSalvo, MD, took the helm at the Office of the National Coordinator for Health Information Technology on Jan. 13. Though she says she is still in "the listening phase," it would be incorrect to say she is still getting her bearings. Whether today as ONC chief, or as a medical resident in the 90s, or as a practicing physician at Charity Hospital in New Orleans, or as vice dean for community affairs and health policy at Tulane University School of Medicine, or as New Orleans’ health commissioner, DeSalvo has kept a steady course on doing everything she could to help improve care.

The story has already been told several times. She grew up poor in Austin, Texas. She and her two sisters were raised by a single mother.

"I experienced healthcare through the public system, in public clinics that were not as a consumer-friendly as we would like," DeSalvo told the Health IT Policy Committee during her second day on the job.

It’s one of the experiences that guides her today as she takes on the ONC mantle to continue her pursuit for better care.

DeSalvo talked with Healthcare IT News Editor Bernie Monegain about the challenges ahead...
I wish her well. She certainly has a huge, contentious task on her hands. Click the article title link above, read the entire interview.


Agenda here (pdf). It will be webcast for those who can't attend live.



New book order just arrived via Amazon.

It was expensive. Not available in Kindle edition at this point. Hope it will prove worth it. I will let you know.



One goal of the Health Resources and Services Administration (HRSA) is to ensure that all of its health centers implement health information technology (HIT), including electronic health record (EHR) systems. Since 2007, HRSA has awarded $176.9 million in grants to networks of health centers known as health center controlled networks (HCCNs) to support this goal through the acquisition, implementation, and “meaningful use” of EHR systems. To assess the grants’ contributions toward HRSA’s HIT goal, we assessed health centers’ progress in using HRSA grants—funded by the American Recovery and Reinvestment Act (ARRA)—to implement EHR systems that support meaningful use. HRSA did not require demonstration of meaningful use as a condition of the grants, but has stated that Stage 1 meaningful use objectives, as set forth by the Centers for Medicare & Medicaid Services, are a reasonable baseline to assess health center progress in implementing EHR systems. We also did this study to determine whether health centers face challenges related to the financial sustainability of their EHR systems.

We surveyed health centers that participated in HRSA’s ARRA-funded HCCN grant projects that supported EHR implementations and enhancements. Using survey responses, we determined the extent to which health centers established the capability for the Stage 1 meaningful use objectives. We also determined whether health centers reported facing challenges related to the financial sustainability of their EHR systems. To supplement the survey responses, we reviewed grantee progress reports and conducted visits at 11 health centers.

Most health centers established the capability for meaningful objectives related to capturing data. However, fewer health centers established the capability for meaningful use objectives related to sharing data. Establishing the capability for objectives relating to sharing data often requires health centers to incur additional EHR-related costs. Although 76 percent of health centers reported facing financial sustainability challenges, grantee progress reports contained limited information related to the financial sustainability of EHR systems at health centers.


We recommend that HRSA (1) use data to understand progress towards meaningful use objectives and to provide guidance and technical assistance to health centers, (2) ensure that HCCN grantees provide information on the financial sustainability of EHR systems at health centers, and (3) examine the feasibility of collecting information directly from health centers regarding the financial sustainability of their EHR systems. HRSA concurred with all of our recommendations.
Full report here (pdf).


I've wondered for some time why Apple hasn't taken a major run at the health care space. Even put up a quick blog touting it two years ago.
"They have more cash on hand than the U.S. Treasury. They exemplify innovation, how to delight customers, how to put them effortlessly in control. They know hardware. They know software. They know Mobile. They know the internet. They know strategic partnerships. They know how to succeed in the market while adding significant value to our lives. They could do PHR (Personal Health Records), they could do HIE (Health Information Exchange), they could do HIX (Heath Insurance Exchange). No other American company is positioned to do these things, either outright or via industry leadership coordination..."
This latest bears watching.

More to come...

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