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HITECH

Tire Kickers Need Not Apply: 8 First Impressions of the Medicare ACO Rule

On March 31, CMS released the long-awaited “Medicare Shared Savings Program: Accountable Care Organizations” document (ACO Rule). Read the details here (strong suggestion: unless you’re working on your PhD in ACOs, start with the fact sheets).

There are many surprises. Here are eight first impressions on this 429 page tome:

The bar has been set high…very high.  Tire kickers need not apply.
Don’t expect to see many or any small ACOs.
Patients will be confused by ACOs.
Concerns over maintaining competition and avoiding antitrust are […]

A One in a Hundred Whitepaper: “Better to Best” Transcends PCMH, Care Coordination, Access, HIT, and ACO Payment Reform

Let me try to get you in the right frame of mind to read one of the most remarkable white papers in a long time: Better to BEST: Value Driving Elements of the Patient Centered Medical Home and Accountable Care Organizations — released yesterday by the Commonwealth Fund, Dartmouth Institute, and PCPCC.

Having been a debater in high school and then trained as a lawyer, my default mode of thinking is to be critical:

“Hey, Vince, how ya doin’? Great day isn’t […]

Top 20 iPhone Medical Apps: No Connection to EHRs…Yet

iMedicalApps recently published its list of Top 20 Free iPhone Medical Apps for Healthcare Professionals.

What struck me about the list is that the state-of-the-art is stand alone applications — I didn’t see any that had any connection to an EHR (electronic health record).  Here’s the top 5 to give you a flavor of what’s on the list:

Medscape
Micromedex
New England Journal of Medicine
Epocrates
Free Medical Calculators

I expect that this list will begin to look very different in coming years as EHRs continue to […]

Updates on Proposed Stage 2 and 3 Meaningful Use Criteria

The Health IT Policy Committee has published proposed Stage 2 and 3 Meaningful Use Recommendations and they’re open for public comment until February 25.

I’ll share a couple of particularly useful and well written analyses and commentaries by colleagues.

Health IT guru and thought leader Dr. John Halamka writes about The Proposed Stage 2 and 3 Meaningful Use Recommendations in his blog.

This is a great article to get a thumbnail overview of all the proposed recommendations. John lists 38 criteria and provides a quick […]

HITPC Meaningful Use Workgroup Offers First Draft of HITECH Stage 2 & 3 Objectives

At the December 13 meeting of the HITPC (Health IT Policy Committee), the MU (Meaningful Use) Workgroup proposed a first draft of HITECH Stage 2 and 3 objectives.

A full list of objectives for Stages 1, 2 & 3 is available in the PowerPoint presented to HITPC.

The proposed objectives contain a mix of items that are:

Unchanged from Stage 1
Similar MU criteria with higher implementation goals, e.g.,

Stage 1: CPOE for Rx orders 30%
Stage 2: CPOE for 60% of Rx, lab and radiology […]

Summarizing Early PCAST HIT Critiques: “Brilliant, but they didn’t do all their technical homework.”

Last week PCAST (The President’s Council of Advisors on Science and Technology) issued a major report — “Realizing the Full Potential of Health Information Technology to Improve Healthcare for Americans: The Path Forward”. 

The reviews are filtering in and I’m seeing two major themes: 

The vision is on target:  “extraordinary”, “breathtakingly innovative”.
These guys didn’t do all their technical homework. The range varies, but the message is consistent. 

Here are some early critiques of the PCAST report. Let the debate continue!

Is Physician EHR Adoption Getting Past the Penguin Problem?

Remember the penguin problem described by economists?

No one moves unless everyone moves, so no one moves. 

Overcoming the penguin problem has a lot to do with creating expectations. A recent writing by Dr. James O’Connor in Physician Practice expresses a voice from the physician community that I’ve never heard before.  His essay is entitled “Meaningful Use — Doctors Have No Choice”.

Walled Gardens vs. the Open Web: A Central Debate in Tech Finally Coming to Healthcare

The September issue of Wired magazine and an article in last Sunday’s New York Times illustrate a central debate in technology circles. The debate is not new — it’s being going on for two decades — but it has newfound vibrancy. The essence of the debate is about competing tech/business models: walled gardens vs. the open world wide web (web).

 

vs.

 

The debate is highly controversial and nuanced. There are “experts” on both sides.

My point today is not to take sides […]

Healthcare IT News Highlights Mobile Health Expo Presentation

Mike Miliard did a great job in capturing highlights and key points of my presentation at the Mobile Health Expo conference earlier this week. You can read his story here.

Please write me at vincek@bhtinfo.com in you’d like a copy of the PowerPoint presentation.

Update:  Neil Versel of FierceEMR also wrote up the presentation.  Here’s a link to his concise, on-target article “HIE, mobility, open platforms start to knock down ‘walled gardens’ of proprietary EMRs.”

Care Coordination Metrics: One Can of Worms that NEEDS to be Opened

“Track who is on a care team — and share info with the patient.”

That’s just one of the summary recommendations coming from expert testimony given in a recent public hearing on how to improve care coordination through the use of health information technology. The Meaningful Use workgroup and Quality Measures workgroups are now wrestling with how to translate this recommendation into meaningful use criteria for HITECH Stages 2 and 3.

Seems like […]