IfG.CC -
Institute for eGovernment

When Rebekah McCormack visits her doctor, she expects the very best care. But, she’s finding that doesn't always demand an exam room.

Healthcare IT and health information exchange are tools of transformation that could lead to improved care as well as savings, the alliance asserts in a 60-page report released Tuesday called "Accelerating Progress - Using Health Information Technology and Electronic Health Information Exchange to Improve Care."

Tennessee Gov. Phil Bredeson, co-chairman of the alliance said the vote last week to study the issue of sustainability is an important one because there is “such an enormous gap in what is actually sustainable and the very high-minded things we’re all talking about.”

State and local agencies also are investing in electronic health records systems, which are a primary component of health IT. Their spending on such systems is projected to expand from $850 million this year to $1.85 billion in 2014, according to Input’s "Health IT Transformation: FY2009-FY2014 State and Local Market Forecast," which was released Aug. 26.

The State and Defense departments will partner on a pilot project to determine whether the Armed Forces Health Longitudinal Technology Application, or AHLTA, is suitable for transmitting health care information between overseas State posts and medical facilities in the United States.

Using wireless broadband technology, videoconferencing and the Internet, the Pakistan Telemedicine Project has connected a central coordinating facility at the Holy Family Hospital in Rawalpindi with a hospital in Attock District, a rural area with few doctors and limited medical resources.

The group, at a meeting of the State Alliance for e-Health, also gave a nod to the already established Certification Commission for Health Information Technology, and agreed states should be more involved in developing the certification process.

“Medicaid is interested in allowing their physicians the ability to exchange information across a Web portal,” said Dr. Roxane Townsend, secretary of the state Department of Health and Human Services. “The physicians would be able to adopt an electronic medical record in their office relatively inexpensively if we make it (the software) available through a Web site.”

Gov. Steve Beshear and Lt. Gov. Daniel Mongiardo hope to make Kentucky a national model for health-information technology in an effort to save money, reduce medical errors and improve preventive care in one of the nation's sickest states.

The statewide effort, announced yesterday, would cost an estimated $500 million.

So far 168 health IT bills have been introduced in 41 states, said Janet Marchibroda, chief executive officer of the Washington-based nonprofit group eHealth Initiative, speaking today at Input Inc.’s State and Local Marketview Conference in Vienna, Va.

The one-stop websites, scheduled to be online by 2014, will allow citizens to compare pricing and coverage for health insurance and enroll in a plan that satisfies government requirements.

Some facets of the marketplaces could be modeled after existing websites in the only two states that have them: the Utah Health Exchange and the Massachusetts Health Connector.

The Health Information Technology for Economic and Clinical Health (HITECH) Act contained in the economic stimulus law provides at least $2 billion for health information exchanges and up to $45 billion in incentive payments to doctors and hospitals for digitizing their patient records. The law sets a goal of 2014 to dramatically increase the number of providers who are using electronic patient records and participating in health exchanges.

That's a tall order for doctors and hospitals, because an estimated 90 percent of health care offices still stack their records in floor-to-ceiling shelves crammed with manila folders.

It recommends less reliance on the Health Insurance Portability and Accountability Act of 1996 and the rules issued to implement HIPAA. Instead, the committee calls for “a transformation, in which the focus is on appropriate data stewardship for all uses of health data by all users, independent of whether an organization is covered under HIPAA.”

The federal government must educate citizens about the benefits of electronic medical records to justify the trade-off between patient privacy and health care improvements, according to a report released on Wednesday by the National Academy of Public Administration.

The report, "A National Dialogue on Health Information Technology and Privacy," is the result of an online discussion the academy led last fall on how to use IT to improve care and protect patient information.

“During our test calls, customer service representatives typically provided incorrect and incomplete answers to the 300 policy-oriented questions we posed,” GAO reported. “Only 4 percent of their responses were correct and complete.”

Interoperability is generally more popular among those who mandate it than those who get stuck with the actual implementation. It demands meticulous planning, protracted implementation, monumental effort and convoluted problem-solving - not only to put data sharing technology in place, but also to create policies for sharing, establish common data standards and align operational procedures to coordinate care. Leaders of collaborative initiatives in public health and human services too often see the initial excitement evaporate and the ranks of participants dwindle as they somehow forget their initial commitment to make the initiative succeed.