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Wednesday, April 4, 2012

Attestation money thus far

From an ONC / CMS "Meaningful Use Acceleration" webinar call.

Through Feb 29th, 2012, actually. I don't think I'd have used that particular graphic. The "HITstone Pipeline"? The 2012 GOP campaign attack ad lines just write themselves.

But, that $4.3 billion is roughly equivalent to 13 days of DoD in Afghanistan. And, the entire 4-year national REC Technical Assistance funding is TWO DAYS worth of Afghanistan action.

Be nice if they'd give the RECs another two days' worth (and make REC engagement mandatory). ONC keeps puffing up our Good Works (Farzad enthusiastically shouted out during a recent national call "REC People, my People!"). But, the REC funding reality is "Stage One And Done." Stage Two doesn't even now ensue until 2014, and providers who make it that far will be in the decreasing outer years of MU reimbursements, and you can bet that vendors are gonna charge them for upgrades.

So, where will EPs find the money to pay unsubsidized market rates for REC technical assistance, at a time when MU Incentive payments will be declining and care reimbursement rates may well be doing significantly likewise?


From another ONC web conference call slide:

What can I say? Seriously?


via John Pulley at
It's a little-known fact, but the health information technology regional extension program was really my idea. 
I'm from Indiana, where we do corn and beans right. One reason is Purdue University, which runs our cooperative extension service. Purdue has helped farmers introduce new technology, best practices and workflow improvements for more than a century. Now, it's doing the same for healthcare providers, running Indiana's health IT extension service...
...Representatives from about half of the RECs met in St. Louis last week to discuss the program's future, Kendall said. Under the stimulus law, federal money for the program dries up in just four years. 
I asked Kendall whether HHS intends to ask Congress for ongoing funding of the REC program, since its model, the cooperative extension service, receives annual appropriations ($475 million this year). He said such a request was beyond his "scope." But it's not beyond mine. So, here goes: 
To HHS Secretary Kathleen Sebelius and ONC Chief Dr. Farzad Mostashari:
There are more than 500,000 physicians in office-based practice in the U.S. And there are many thousands of dentists, federally qualified health centers, critical-access hospitals, nursing homes and home health programs that also need trusted information brokers and experienced educators to help them install EHRs, connect to each other, link to health information exchange organizations, and gather, share and adopt best practices. This is all extension work.
You should put together the success story of the health IT extension program and take it to Congress. Tell its members the country needs this program and should fund it going forward.
Joseph Conn, former extension agent

Relatedly, in the "Meaningful Use" news, from
Friday, April 06, 2012
MedPAC Raises Concern About Meaningful Use Attestation
During a meeting in Washington, D.C., on Thursday, several Medicare Payment Advisory Commission members raised concerns about the small number of eligible professionals and hospitals that have successfully attested to the Medicare portion of the meaningful use program, AHA News reports (AHA News, 4/5).
Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments.
MedPAC Data
Commission members noted that health care provider participation in the meaningful use program is lower than the federal government projected...
Some hospital and physician advocates cited high EHR adoption costs and overly burdensome program requirements as reasons for the low adoption rates (Daly, Modern Healthcare, 4/6).
MedPAC members indicated an interest in monitoring the meaningful use program to determine if EHR adoption reduces costs and boosts efficiency (AHA News, 4/5).
That latter "ROI" thing remains a vigorous topic of contention -- in addition to "improving patient safety and patient and population health," which also remain in hot dispute. Many critics decry what they see as technology significantly adverse to productivity and ROI in the aggregate and inimical to patient safety and health.

It is the job of REC Technical Assistance staffs to help clinicians overcome and negate those concerns. 

More to come...

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