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Pilots, Demonstrations & Innovation in the PPACA Healthcare Reform Legislation
Here’s a bit of trivia that will make you the hit of the next cocktail party you attend. How many times are the words “demonstration” and “pilot” mentioned in the newly passed Federal healthcare reform legislation — the Patient Protection and Affordable Care Act (PPACA)?
Answer:
“demonstration” — 312 mentions
“pilot” — 80 mentions
This weekend I’ve been trying to wrap my head around the question “Just what are these demos and pilots in the PPACA all about?” I have been boggled by the sheer number […]
Chilmark Needs to Chill Out on CCR/CCD Findings
John Moore of Chilmark Research and I agree on things 90+ percent of the time. He even thanked me personally for our collegial relationship in a Thanksgiving Day essay on his blog.
However…I can’t help but comment on John’s misleading story “CCD Standard Gaining Traction, CCR Fading” in The Health Care Blog. He writes:
In a number of interviews with leading HIE [Health Information Exchange] vendors, it is becoming clear that the clinical standard, Continuity of Care Document (CCD) will be the dominant standard in […]
How Long Have We Known This?
Hospitals charge on a cost basis, which places no penalty on inefficient operations. Moreover, present systems of hospital management make it very difficult to maintain effective control over hospital costs. The Commission concluded:
“If the needs for health care are to be met, the health care system must be organized to employ its resources with more wisdom and effectiveness. The two areas which appear to offer the greatest potential for improvement are (1) reducing unnecessary (or unnecessarily […]
A Compendium of Resources on the Federal HIT Meaningful Use NPRM and Standards IFR
* = highly recommended
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Descriptive Summaries and Documents
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 *Dissecting the Meaningful Use Proposed Rule PowerPoint
eHealth Initiative Policy Webinar; January 8, 2010
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*What You Need to Know About the Meaningful Use Proposed Rule, Standards and Implementation Specification, and Interim Final Rule Certification Criteria PowerPoint
Is Gawande Right? Are Pilot Programs the Key to Delivery System Cost Reductions?
Atul Gawande’s most recent New Yorker article “Testing, Testing” addresses the critics who lament that there is no master plan to curb delivery system costs in pending health reform legislation.
Gawande retorts: “Is that a bad thing?”
…and he answers his own question by describing the value of pilot programs contained in both the Senate and House versions of health reform legislation.
Is Gawande correct? Yes and no….
The Real Secret Sauce of Medicare’s Participation in Regional Collaboratives — Network Effects
Last week I asked whether Medicare’s Biggest Change in 40 Years is on the horizon. That post described and discussed implications of Medicare’s new direction for the medical home — the shelving of Medicare Medical Home Demonstration (MMHD) and the refocusing on the recently announced Multi-Payer Advanced Primary Care Initiative (MAPCI).
In that post I touched briefly on the potential for MAPCI to create effective networks at multiple levels — contracting networks, health IT networks, social and collaborative care networks. I’d like to expand […]
John Halamka’s Stunning 180: “Dogs and Cats Should Live in Harmony”
The King of the Cats has just acknowledged that indeed cats and dogs should co-exist peacefully.
Dr. John Halamka — Vice Chair of the HIT Standards Committee of the ONC and one of the most vocal and influential figures in health IT — writes a blog post this morning entitled “The Genius of AND”. Halamka reasonably summarizes the essence of the debate about standards and interoperability as being between “the healthcare informatics crowd” (cats) and the “Internet crowd” (dogs):
He notes that the debate […]
Medicare’s Biggest Change in 40 Years on the Horizon?
Earlier this week CMS issued a typically cryptic Announcement indicating that they were shelving the Medicare Medical Home Demonstration (MMHD) and instead would focus on the recently announced Multi-Payer Advanced Primary Care Initiative (MAPCI). My blog post from Tuesday provides details and asks the question “What does all this mean?”
Today’s blog post will tackle:
Medicare’s biggest change in 40 years?
The rise of MAPCI
The fall of MMHD
Implications/discussion
Medicare’s Biggest Change in 40 Years?
Senator Grassley: You’re on Track About EMR Problems, But Here Are Some More Questions to Ask
An article in today’s Washington Post links to a letter written by Senator Charles E. Grassley.
The letter is directed at 10 EMR (electronic medical record) vendors, and asks very pointed questions about whether the vendors have been negligent in not addressing patient safety issues in their technologies.
Senator Grassley, you have the scent and you’re on the trail. There are several other questions you should be asking these vendors:
We’re Building a REALLY BIG Health Internet!
How big a network will the Health Internet (aka National Health Information Network) be?
My BOTE (back-of-the-envelope) calculation is that this network could consist of about 301 million nodes. Here’s my math (pls. clarify or amplify):
300 million individuals in U.S.
700 K doctors
5 K hospitals
295 K — other B2B healthcare entities
Very rough…but I hope you get the point.
So let’s put into perspective press releases from Google or Microsoft announcing that they have developed new “partnerships” (i.e.nodes in the network) for Google Health or Microsoft HealthVault. As an example, […]