President Bush says he will create a new post at HHS to help achieve his goal of ensuring every American has a personal electronic medical record within 10 years. The yet-to-be-named official would report to the HHS secretary and would be charged with encouraging the adoption of EMR standards and coordinating public-private partnerships. Bush was speaking on the topic of innovation at the American Association of Community Colleges convention in Minneapolis, where he also unveiled initiatives on energy and the Internet.
JCAHO plan would put bar codes at bedside
Hospitals would have to develop a plan for implementing bar-code technology at the bedside, to be operational by January 2007, as part of significantly revised patient-safety goals proposed by the Joint Commission on Accreditation of Healthcare Organizations. Under a potential expansion of JCAHO goals, which hospitals must meet for accreditation, adopting bar-code readers would become part of an overall goal of improving patient identification. The Food and Drug Administration has published regulations requiring drug manufacturers to add bar codes to single units of medication by April 2006, but the rules do not require hospital participation.
AHRQ looking for proposals
The Agency for Healthcare Research and Quality is soliciting proposals for demonstration projects that improve healthcare quality and efficiency through comprehensive sharing of healthcare data on a statewide or regional level. The primary contractor must be either a state government or an agent of one or more state governments that has a formal agreement specifying the involvement of state agencies, the AHRQ says. The total dollar value of the grants has not been established, but an AHRQ spokesman says it will be "substantial." Project participants should include major purchasers of healthcare within the state or region; significant health plans and other payers, both public and private; and healthcare providers, including hospitals, ambulatory-care facilities, home healthcare and long-term-care providers. Participants should be chosen to ensure complete geographic coverage of the state or region, the AHRQ says. To read the request, go to eps.gov/spg/HHS/AHRQ.
Employers group plans report cards
A coalition of 28 large U.S. employers will create hospital and physician report cards on quality and cost measures and distribute them to its members' 2 million employees. The Care Focused Purchasing initiative will use data from employee health claims, government databases and participating health plans. Empire Blue Cross and Blue Shield and Humana have agreed to supply data and expertise to the project, and Mercer Human Resource Consulting will provide staff support, the coalition says. Members include Capital One Financial Corp., PepsiCo, Sprint Corp., Texas Instruments and Xerox Co. "What you're seeing right now is purchasers in a state of almost total quality blindness," says Arnold Milstein, M.D., medical director of the Pacific Business Group on Health and a Mercer consultant. "We're way past due having a robust quality measurement system in place for doctors and for hospitals."
Quality effort to track new measures
A public-private reporting initiative on hospital quality will more than double the number of quality indicators tracked by May 2005, as well as add a fourth medical condition. The new reporting requirements generally broaden the scope of care expected of hospitals in treating heart attacks, heart failure and pneumonia, the three medical conditions targeted when the CMS and several hospital associations launched the initiative in December 2002 with a "starter set" of 10 measures. Beginning in February 2005, seven additional quality measures for the three medical conditions will be introduced, the CMS says. The program will be further expanded in May 2005 to include three measures of surgical-infection prevention and two more pneumonia-care measures, for a total of 12 new quality indicators. To date, about 2,700 hospitals, or 58% of those eligible, have registered to participate in the voluntary initiative.
MedPAC: Loans might speed IT adoption
Medicare Payment Advisory Commission Chairman Glen Hackbarth says the federal government might need to make loans to hospitals and health systems to speed implementation of information technologies that can prevent medical errors. During a hearing on healthcare quality by the House Ways and Means Committee's health subcommittee, Hackbarth said hospitals' slow adoption of electronic medical records is due in part to a continuing inability to show a return on investment. Linking Medicare payments to quality of care also would increase use of error-preventing technologies, he said. Also speaking to the committee, Federation of American Hospitals President Chip Kahn said varied approaches to reporting quality data are "producing incomplete, poorly analyzed, conflicting and even misleading information."
Standardized IT could save $87 billion
A standardized means of exchanging healthcare information electronically would save nearly $87 billion annually if fully implemented at all healthcare systems, hospitals and physician offices, according to a cost-benefit analysis of "interoperability" of healthcare computer systems and data. Of the annual net savings, about $34 billion would accrue to providers, $30 billion to payers and the balance to laboratories, radiology centers and pharmacies, says the Center for Information Technology Leadership, or CITL. Savings would derive from fewer tests and better efficiency, the center says. Researchers used a 10-year implementation scenario, during which providers purchased new information systems allowing them to use a single set of technical requirements and data definitions. Under the scenario, the nation would break even in the fifth year and rack up a total of $395 billion in net returns by year 10. In addition, a California Healthcare Foundation-financed study by CITL concludes that top-quality ambulatory computerized physician order-entry systems could prevent 250,000 medication-related injuries in California each year, saving the state $4 billion and individual providers about $29,000 a year. "We are very excited to show that the impact of advanced CPOE could have huge benefits for the state and its residents," says CITL Chairman Blackford Middleton, M.D.