July / August 2005
NEWS ITEMS FROM SOURCES WORLDWIDE
Pulse
HIMSS Compares and Contrasts Current Healthcare IT Legislation
With seven pieces of healthcare information technology (IT) legislation now under consideration by the 109th Congress, the Healthcare Information and Management Systems Society (HIMSS) evaluates the specifics of each bill in the HIMSS Health IT Legislation Crosswalk developed by the HIMSS Advocacy team. The tracking tool, which is a new service that will be regularly updated for HIMSS members, federal decision-makers and the media, compares and contrasts provisions of the legislation. This type of evaluation and tracking system is often used on Capitol Hill by Congressional staffers to better understand legislation introduced on a specific topic.
The legislation listed on the crosswalk includes:
- National Health Information Incentive Act of 2005 (H.R. 747)
- 21st Century Health Information Act of 2005 (H.R. 2234)
- Affordable Health Care Act (S.16)
- Patient Safety and Quality Improvement Act of 2005 (S.544)
- Information Technology for Health Care Quality Act (S. 1223)
- The Health Information Technology Act of 2005 (S. 1227)
- Health Technology to Enhance Quality Act of 2005 (S. 1262)
Providing an easy but efficient glance at each bill's provisions, the HIMSS Health IT Legislation Crosswalk illustrates, for example, that each of the seven healthcare IT Acts promotes the adoption of standards in healthcare IT and all, but one, support interoperability. Each piece of legislation also has specific funding designations, some calling for new funding and all but one offering grants for designated health IT demonstrations.
"The Congressional focus on healthcare IT is unprecedented, which means that legislation now under consideration demands both understanding and evaluation from the healthcare industry," said Dave Roberts, FHIMSS, HIMSS director of public policy. "As Congress continues its emphasis on improving the delivery of healthcare through this legislation, HIMSS will continue to track their progress, provide input and update the legislation crosswalk to offer key details on what has occurred with each bill."
To access the HIMSS Health IT Legislation Crosswalk, visit www.himss.org/Content/files/LegislationCrosswalk-109thcongress.pdf.
HHS Releases Report on Nationwide Health Information Exchange
The U.S. Department of Health and Human Services (HHS) has released a report summarizing over 500 responses from individuals and private industry on interoperable health information exchange. The report, Summary of Nationwide Health Information Network Request for Information Responses, is a compilation of responses to a request for information (RFI) that sought input from the public on how to move forward on the development and adoption of a nationwide health information exchange.
"We asked the health care and IT sectors to tell us what we need to know to plan a health information exchange system that will work — delivering health care records when and where they're needed, and strictly protecting their privacy and confidentiality," said HHS Secretary Mike Leavitt. "These ideas provide invaluable first specs' for a plan that will transform health care in America."
Last year, President Bush called for the widespread adoption of electronic heath records (EHRs) for most Americans within 10 years and established the position of National Coordinator for Health Information Technology. In July of 2004, HHS issued a Framework for Strategic Action, outlining an approach toward nationwide implementation of interoperability. In order to gain broad input on the best mechanisms to achieve nationwide interoperability, HHS published an RFI seeking input on the development of a nationwide health information network (NHIN) — an Internet-based architecture that links disparate health care information systems together to allow patients, physicians, hospitals, community health centers and public health agencies across the country to share clinical information securely. Respondents were asked, among other things, to explore the role of the federal government and private industry in facilitating the deployment of a NHIN.
"The responses from the RFI yielded one of the richest and most descriptive collections of thoughts on interoperability and health information exchange that has likely ever been assembled in the U.S.," said David J. Brailer, MD, PhD, National Cordinator for Health Information Technology.
While the report is an illustrative summary of the RFI responses and does not attempt to evaluate or discuss the relative merits of any one individual response over another, it does provide some key findings. Among the many opinions expressed, significant support emerged for the following concepts:
- A NHIN should be a decentralized architecture built using the Internet, linked by uniform communications and a software framework of open standards and policies.
- A NHIN should reflect the interests of all stakeholders and be a joint public/private effort.
- A governance entity composed of public and private stakeholders should oversee the determination of standards and policies.
- A NHIN should be patient-centric with sufficient safeguards to protect the privacy of personal health information.
- Incentives will be needed to accelerate the deployment and adoption of a NHIN.
- Existing technologies, federal leadership, prototyperegional exchange efforts, and certification of EHRs will be the critical enablers of a NHIN.
- Key challenges to developing and adopting a NHIN were listed as: the need for additional and better refined standards; addressing privacy concerns; paying for the development and operation of, and access to the NHIN; accurately matching patients identity; and addressing discordant inter- and intra-state laws regarding health information exchange.
A variety of healthcare entities representing a cross-section of industry stakeholders as well as private citizens submitted responses totaling nearly 5,000 pages of information. The report is available at http://www.hhs.gov/healthit/rfisummaryreport.pdf.
Commonwealth Fund Establishes Commission on a High Performance Health System
The Commonwealth Fund, a private foundation supporting independent research on health and social issues, has announced the creation of a Commission on a High Performance Health System, which aims to move the U.S. toward a healthcare system that achieves better access, improved quality, and greater efficiency, with particular focus on the most vulnerable due to income, race/ethnicity, health, or age.
The Commission will seek opportunities to change the delivery and financing of health care to improve system performance, and will identify public and private policies and practices that would lead to those improvements. It will explore mechanisms for financing improved health insurance coverage and investment in the nation's capacity for quality improvement, including reinvesting savings from efficiency gains. The Commission, approved by the Fund's Board of Directors at its April meeting, will have an initial five-year term. It is charged with tracking performance targets, developing policy options, and disseminating innovative practice changes to improve the U.S. health care system.
"The U.S. healthcare system is the most expensive in the world, yet there is little question that, by any number of measures, we are not getting what we're paying for," said Commonwealth Fund President Karen Davis. "We see the establishment of this commission as one crucial step in determining what needs to be done to ensure that we get the best care — and the best value — for our healthcare dollars."
The Commission is chaired by James J. Mongan, MD, president and CEO of Partners HealthCare. The 18 commissioners represent broad interests in healthcare and a commitment to each of the elements of a high-performance health system — coverage, quality, and efficiency.
IHI Announces Program for Improvement Advisors
Healthcare organizations need someone with expertise and experience in improvement methods to lead change efforts — someone devoted solely to helping identify, plan, and execute improvement projects throughout the organization and deliver demonstrable results.
Recognizing this need, the Institute for Healthcare Improvement (IHI), in conjunction with Associates in Process Improvement (API), has designed a nine-month support program to develop improvement advisors and equip them with the advanced knowledge and skills to be successful. The goal of this program is for participants to become highly effective leaders in helping their organizations accomplish strategic improvement plans. This intense development program allows participants to achieve maximum results by immediately applying the knowledge and skills they learn.
Healthcare professionals who are currently, or plan to become, a source of improvement expertise in their organization should participate in this program. They may hold titles such as quality facilitator, black belt, quality improvement specialist, or quality coach.
During the intense nine-month program, each improvement advisor will be responsible for one or more improvement projects that are connected to his or her organization's business plan. These projects will be the focus of the workshops and support activities. Improvement projects may be in any one of three categories: 1) improving quality of care; 2) reducing costs while maintaining or improving quality; or 3) expanding patient or customer demand with the development of new services or innovative ways of providing existing services.
The comprehensive curriculum includes:
- Three four-day meetings: November 29-December 2, 2005; February 7-10, 2006; May 16-19, 2006; in Cambridge, Massachusetts
- All program materials and tools
- Monthly conference calls with faculty and colleagues
- Faculty coaching for individual projects
- An active community of colleagues whose continued collaboration will be facilitated by IHI.
To learn more, visit www.ihi.org/IHI/Programs/ConferencesAndTraining/
ImprovementAdvisorProgramNovember2005.htm
Patient Safety Culture Survey Tool Available in Spanish
Premier's Safety Institute has developed a Spanish version of the Agency for Healthcare Research and Quality's (AHRQ) Hospital Survey on Patient Safety Culture survey tool as well as a customized Excel data tool for easy entry and rapid display of survey results. These tools complement other resources from AHRQ for implementing the survey as well as analysis and benchmarking of results and include:
- Complete toolkit - the survey, detailed user's guide for administration of paper or Web-based methods, data collection and analysis, customizable templates for reporting results, references, and results of the pilot study<
- Survey form - now in either English or Spanish, in PDF or MS Word versions
- Benchmarking data - preliminary benchmarks permitting comparisons against the results from 20 hospitals that participated in a 2003 pilot
- Hospital culture survey feedback template test
- Premier's customized Excel data tool
- Audio Conferences - three PowerPoint presentations, (Interpretation of results; case studies; communication)
To access these resources go to: http://www.premierinc.com/all/safety/culture/
NCQA Updates Disease Management Standard Public Comment Through August 10
The National Committee for Quality Assurance (NCQA) has released for public comment proposed changes to its Disease Management (DM) Accreditation and Certification programs. The changes address selected areas of the programs, including strengthening patient privacy and confidentiality requirements and introducing requirements related to how DM programs identify eligible patients. Also proposed is changing the scoring methodology to make it more consistent with other NCQA Accreditation programs.
Among the proposed changes:
- Use of specific data sources, such as claims data, lab results, or health risk appraisal results, to identify patients eligible for DM programs. Programs will also be assessed for how frequently they survey such data sources for eligible members.
- New requirements regarding confidentiality and sharing of patient information with client organizations. These changes relate to compliance with provisions in the Health Insurance Portability and Accountability Act (HIPAA) and standards in other NCQA Accreditation programs, notably Quality Plus.
- The introduction of quality improvement measurement standards that will require DM organizations to annually assess their performance and identify areas for quality improvement.
NCQA's DM Accreditation and Certification programs are flexible — a wide variety of entities beyond stand alone disease management organizations are eligible for DM Accreditation or Certification, including medical groups, managed care organizations, preferred provider organizations, pharmacy benefits managers, and nurse call centers.
The proposed changes to DM standards can be downloaded from NCQA's Web site at www.ncqa.org. Those who wish to comment on the new measures may do so by sending an e-mail to DM2006@ncqa.org. The final revised standards for NCQA's Disease Management program will be published in November and will go into effect on July 1, 2006.
|
