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A look back at health IT in 2008 - part two


By Joseph Conn
Posted: December 30, 2008 - 12:01 am ET
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Part two of a three-part series (Access parts one and three):

Health information technology became a central issue this year as the federal government pushed a number of initiatives to increase IT adoption among providers at all levels. In doing so, several key issues were raised, from transparency and interoperability to the privacy of data being exchanged and the cost of implementing that exchange. In all, 2008 might be known as the year of the electronic health record, which is seen by some to be the defining technology that is expected to bring together all facets of the health-delivery system, though many still question its effectiveness and expense.

Over the past year, Health IT Strategist has chronicled the key issues affecting the industry. Take a look at what readers found to be the most important, based on a review of page views for stories.

Privacy

Healthcare privacy violations made big news throughout 2008, with the largest headlines coming out of a Los Angeles hospital scandal involving multiple episodes of peeking into the medical records of several celebrities, including those of pop star Britney Spears and former TV newscaster Maria Shriver, the wife of California Gov. Arnold Schwarzenegger.

The California Legislature moved quickly to stiffen two state privacy laws, but the federal government has moved slowly, and some would say, ineffectively, for more than four years on a national healthcare IT privacy policy.

On April 27, 2004, President Bush signed an executive order instructing the newly created Office of the National Coordinator for Health Information Technology to come up with a "strategic plan" that would "address privacy and security issues to ensure appropriate authorization, authentication and encryption of data for transmission over the Internet." But over the next four years, the Government Accountability Office would issue four reports criticizing HHS for not having any privacy plan in place, going so far as to say that the lack of a privacy policy would inhibit its own IT promotion efforts.

HHS took more than four years to produce a privacy policy, releasing it June 2008 as part of a broader IT plan, then followed up with a supplemental, 12-page "privacy and security framework" released Dec. 15, 2008.

The privacy community was unimpressed, saying the framework wasn't worth the wait.

"The document is so vague as to be meaningless," said lawyer and health privacy expert Mark Rothstein, director of the Institute for Bioethics, Health Policy and Law at the University of Louisville School of Medicine and a former chairman of the privacy and security subcommittee of the HHS advisory panel, the National Committee on Vital and Health Statistics. The subcommittee spent 18 months coming up with dozens of privacy and security recommendations that HHS Secretary Mike Leavitt largely ignored.

Federal grants

One arm of the federal government not shy about spending money on healthcare IT in 2008 was the Federal Communications Commission. Actually, the FCC announced the awarding of grants to 69 communities in 42 states in November 2007. The plan calls for spending up to $400 million over three years to promote the extension of high-speed communications infrastructure to providers, particularly those in rural and medically underserved areas where fiber-optic cable capacity is limited or nonexistent.

The money comes from the universal service fee, a surcharge on telecommunications bills authorized by the Telecommunications Act of 1996, which also funds broadband connectivity to schools and libraries and subsidizes the cost of telephone service in rural areas.

The grants will pay up to 85% of the cost to deploy broadband connectivity to providers, including hospitals, physician offices and regional and statewide health information exchange organizations.

In 2008, many of the grantee programs were completing their plans and were cashing their federal checks while rolling out new connections to faster IT networks.

What do you think? Write us with your comments at hitsdaily@crain.com. Please include your name, title and hometown.

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