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Wednesday, February 22, 2012

Stage 2 and CEHRT 2014 announcements

Breaking. Farzad is the HIT Rock Star!

The Stage 2 NPRM won't be posted in the Federal Register until tomorrow, they told us. The conference hall was packed, SRO overflowing to a 2nd location. What I saw and heard on Stage 2 looks pretty good. The 2014 EHR Certification stds are another matter. That should be interesting.

A significant question remains. Dr. Mostashari went to great lengths in multiple sessions to exuberantly extoll the virtues of "our 62 Regional Extension Centers." But, I have yet to hear or read one peep about any more REC funding. Our federal REC grant money essentially runs out mid- 2013 -- before Stage 2 even ensues. I rather doubt that financially stressed PPCPs are likely to line up to pay us "commercial" consulting rates (begging that whole REC "sustainability" issue), particularly given that the incentive reimbursement payments decline year after year.

While it's certainly swell that "ONC [is] in line for [a] budget boost" of 8.2% in the President's FY2013 budget proposal, I find this article excerpt, well, curious.
Among ONC’s efforts, the 62 health IT regional extension centers have registered 130,000 physicians – about one-third of all primary care providers and more than two-thirds of all rural providers in the nation – to help them adopt and demonstrate meaningful use.

“As of January 2012, nearly 60,000 REC-assisted providers had implemented EHRs with e-prescribing and quality reporting capabilities, and more than 5,000 of these providers have achieved meaningful use,” HHS said in its proposed budget.
OK, yeah, but these were the low-hanging fruit fairly attestation-ready providers, more or less early HIT adopters (ignoring for the sake of simplicity the myriad "free money" 2011 Medicaid A/I/U attestors). So, let's see, the REC work will get more difficult per new EP signup, the subsequent years' reimbursements will go down (and with it perhaps the incentive to participate), vendors are sure to charge for Stage 2 compliant upgrades, but RECs will magically become "sustainable" pronto and be able to continue to serve?

OK, yeah. I suspect an increase in Moments.

Relatedly, according to Federal Computer Week,
At the same time, the national coordinator office’s influx of Recovery and Reinvestment Act of 2009 funding is trickling to a halt, from $157 million in fiscal 2011, to $5 million in the current year, to zero next year, the budget document shows.
One last observation, per
The [2013] budget also includes funding to increase ONC's staff by 11% to 191 employees.
Expect an uptick in the DC wonky "you-actually-have-to-tie-'em" bowtie market. In fairness, ONC is a very small shop as Beltway federal entities go, and I have yet to meet one ONC employee that wasn't at the top of her/his game.

Modern medicine is designed for groups. The interactions of drugs, patients, and diseases are unpredictable—clinical trials are population based and do not account for personal idiosyncrasies, much less medical histories. In The Creative Destruction of Medicine, pioneering geneticist and cardiologist Eric Topol introduces a radical new approach—by bringing the era of big data to the clinic, laboratory, and hospital. With personal technology, doctors can see a full, continuously updated picture of each patient and treat each individually. Powerful new tools can sequence one’s genome to predict the effects of any drugs, and improved imaging and printing technology are beginning to enable us to print organs on demand. Topol offers a glimpse of the medicine of the future—one he is deeply involved in shaping.

Yeah. Weeds' 101, really. See my posts "Down in the Weeds'."

More to come. Run out of time today. Got invited to an AthenaHealth dinner at Trump tonight. Below, my UT colleague the awesome Christie North at this afternoon's Beacon Communities presentation.

Great job, Christie and the other panelists from MN, OK, and CA.

Off to The Trump.

Thanks, Sam, great evening with you and a number of REC folks!

Run home. Sleep hard, sleep fast. Got an early meeting in the morning at the office.


Sen. Warner calls for tougher standards for electronic medical records

By Julian Pecquet - 02/22/12

Congress’s gambit to create a national system of electronic health records is “at risk of failure or mediocrity” if federal regulators continue to water down the standards that doctors and hospitals must meet, Sen. Mark Warner (D-Va.) wrote in a letter to federal health officials...

...Warner said the process so far has been “too limited.” For example, regulators don’t publish performance data for certified vendors, and failing to deliver medical data to a public health agency is still acceptable...

Indeed. Critics joke that "you could get a spreadsheet 'certified'."

Erratum: Below, check this out. Click the logo banner.

Funny stuff. Click her blog link.

More to come...

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