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Wednesday, November 7, 2012

Congratulations, President Obama

Now, can we please get on with it?  No shortage of things to be done. Huge challenges remain across the breadth of policy fronts.
Today's REC blog word cloud



The Future of Health Care in Obama’s Second Term
Posted on November 7, 2012
By Joanne Conroy, MD

Although members of the Obama team are now celebrating their election victory, the next four years will not be smooth sailing. Ignoring the campaign rhetoric, there is still much more work to be done in order to reshape our health care system; the effect on academic medical centers and teaching hospitals will be significant.

The political conscience is still being driven by the fear of the fiscal cliff, which dominates most Washington conversations. Both political parties agree that health care is a significant contributor to our present and future deficit and that we have to figure out how to deliver more care at a lower cost. But, they argue about what to call it, who gets credit, and whether the solution is bigger government involvement or a dominant private market?The potential cuts to NIH funding and graduate medical education support do not go away with another four Obama years. We anticipate that the president will reform the tax code and transform how we deliver health care. The latter will be his lasting legacy.

However, in all this chaos, there are opportunities. While we no longer hope for a bipartisan middle ground on health care — and rancor will certainly escalate if President Obama is reelected — to many people, the Affordable Care Act is starting to look like a tangible business opportunity. Every insurer is looking at the 30 million uninsured people who will receive coverage through a mix of subsidized private insurance for middle-class households and expanded Medicaid for low-income people. These new markets could be worth $50 billion to $60 billion in premiums in 2014, and as much as $230 billion annually within seven years. The structure and implementation of these programs present specific challenges for AMCs...
A lot of fine content on this blog. Highly recommended. Added them to my blogroll.

Recent HIE news...

(SACRAMENTO, Calif.) — The UC Davis Health System's Institute for Population Health Improvement (IPHI) today released the first edition of its "HIE Ready Buyers' Guide" to facilitate health information exchange (HIE), especially in California.

Produced by IPHI's California Health eQuality (CHeQ) program in collaboration with California Health Information Partnership and Services Organization (CalHIPSO) and state HIE leaders, the guide identifies the base features and standards that should be in place to facilitate health-care data exchange today...
 Some very good information in the full pdf report, e.g.,

Click to enlarge

From the top:
Dramatic advances in telecommunications and information management technologies have substantially transformed American culture and many industries, but healthcare has materially lagged other sectors in adopting these new technologies. U.S. healthcare still relies on antiquated methods of recording, storing and sharing information, leading to many of the now well-documented problems in care coordination, quality and patient safety. Improving healthcare quality and care coordination requires that care-related information flow rapidly and securely between and among physician and other healthcare provider offices, hospitals, and other settings of care. To achieve this will require widespread adoption of electronic Health Information Exchange (HIE).

Notwithstanding the improved information flow that electronic health records (EHRs) make possible within a hospital or medical practice, even certified EHRs often have limited capacity to share important care-related data with other EHRs. Upgrading EHRs so that information can be exchanged with other EHRs typically requires additional customization to create interfaces that allow the EHRs to communicate with each other. This requires additional expense and time.

To facilitate the adoption of HIE and help address the need for EHRs to “talk with each other”, the California Health eQuality (CHeQ) program in UCD’s Institute for Population Health Improvement (IPHI), has produced this HIE Ready Buyers’ Guide to identify interoperability and interface features that should be in place to support healthcare data exchange today...
Kudos. Nicely done.


CMS made $645 million in meaningful use payments in October alone, according to draft estimates released Nov. 7.

That's approximately the 4-year price tag for all 62 RECs. A new infusion of REC funding would be in order, I would think.

Interesting YouTube: "Modern Compliance Solutions"


How Obama's Re-election Will Change Medical Practice Staff
Blog | November 07, 2012 | Staff, Healthcare Reform
By Aubrey Westgate
It’s official. President Obama has secured another four years in the Oval Office, and with it, healthcare reform. For many practices, that means big staffing changes are on the horizon.

An estimated 30 million people will gain insurance as a result of the Affordable Care Act. At the same time, the Association of American Medical Colleges anticipates a shortfall of 45,000 primary-care physicians and 46,000 specialists in the coming decade.

To deal, practices will need to find new ways to improve and enhance access to patient care — some practices already are.

“We’ve seen [demand for nurse practitioners (NPs) and physician assistants (PAs)] steadily climbing throughout the year and we don’t anticipate it changing or flattening off any time soon,” Tricia Pattee, director of product management at HealtheCareers Network, told Physicians Practice.

“This is due to the physician shortage, and we’re seeing a lot of the NPs and PAs backfilling where physicians haven’t been able to be filled and taking on a lot of those responsibilities. With the [outcome of] the election last night, we do anticipate the increased number of patients needing care to also affect this and to continue the increase in demand” for NPs and PAs.

Of course, as demand heats up, supply cools down. If your practice is considering hiring an NP or PA in the near future, prepare for some stiff competition...
Note: registration firewalled content. This is a highly contentious area in the health care press.

More to come...

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