CJR examines potential, weaknesses of health IT
In the Columbia Journalism Review, Trudy Lieberman, president of AHCJ’s board of directors, sought to shed light on the nebulous promise of health information technology by interviewing Jonathan Oberlander, a health policy expert and professor of social medicine and health policy & management at the University of North Carolina—Chapel Hill.
Focusing on the example of electronic medical records, Oberlander said only a small percentage of hospitals had adopted electronic medical records, primarily due to their prohibitive cost. Stimulus money, $19 billion of it, has been directed toward the problem, though the language — hospitals and practices should adopt “meaningful” information technology is vague — and payments won’t arrive until next year, at the earliest.
According to Oberlander, patients may not even benefit from all the money being thrown at health technology (and thus to hospitals and tech firms) unless it’s implemented properly. Likewise, Oberlander says, even widespread adoption of EMRs and other health IT likely won’t lead to substantial cost reductions.
The Congressional Budget Office estimates that the HIT provisions of the stimulus legislation could reduce federal spending on health care benefits by about $13 billion over the next decade. But the program will cost about $32 billion to implement in Medicare and Medicaid, so spending on HIT will increase the deficit by $19 billion or so during that decade.
Oberlander calls health IT “overhyped” because it’s such a politically attractive and relatively painless solution, and warns that, in the end, we can’t simply “compute our way out of the health care cost problem.”
He called for a more integrated national health IT system and said journalists should focus more attention on exactly who stands to profit from all the money being poured into the arena.
(Image by southerntabitha via Flickr)
15 areas get a share of NIH’s stimulus funding
The NIH has designated $200 million of its stimulus money for 200 or more “Challenge Grants” in specific areas where NIH has judged the money will have the most immediate impact.
“Challenge Areas” in which funds will be available:
- Behavior, Behavioral Change, and Prevention
- Bioethics
- Biomarker Discovery and Validation
- Clinical Research
- Comparative Effectiveness Research
- Enhancing Clinical Trials
- Enabling Technologies
- Genomics
- Health Disparities
- Information Technology for Processing Health Care Data for Research
- Regenerative Medicine
- Science, Technology, Engineering and Mathematics (STEM) Education
- Smart Biomaterials - Theranostics
- Stem Cells
- Translational Science
COBRA: Under-covered and misunderstood?
In the Columbia Journalism Review, Trudy Lieberman, president of AHCJ’s board of directors, reviewed recent media coverage of the federal COBRA plan and its recent stimulus subsidy. She found the plan’s portability provision to be particularly under-covered and poorly explained. Under the portability program, COBRA customers who meet certain requirements are guaranteed to opportunity to purchase private insurance upon finishing the program, regardless of pre-existing conditions. Here’s her take on the provision:
Enrolling and staying on COBRA gives you protection and rights you otherwise wouldn’t have. Let’s say you have a medical condition and don’t get a new job that offers insurance—but you know you still need coverage. The law protects you only if you sign up and stay on COBRA for the full eighteen months the law allows. After leaving COBRA, you must apply for new health insurance in the individual market within sixty-three days. There are a few exceptions, but generally if you satisfy these two requirements, any company must sell you a policy regardless of any preexisting conditions you might have.
Some states, though, may send you to their high risk pools instead. If you don’t complete eighteen months of COBRA, or if you wait too long to apply for coverage, you’re out of luck. Insurers can turn you down for any reason — even if you were sick years ago and no longer have that medical condition. You may end up with no insurance at all.
One more thing: Even if an insurer agrees to sell you a policy, it can refuse to cover a condition you had in the past or have now.
Related
A Commonwealth Fund analysis found that only 9 percent of laid-off workers took advantage of the COBRA program and that for many, the program was prohibitively expensive.
Doctors face obstacles in transition to costly EMRs
Filed under: Government, Health care reform, Hot Health Headline
In his American Journey blog, the Wall Street Journal’s Andy Jordan considered the impact of stimulus funds on the health-care system’s expensive and time-consuming transition to electronic medical records in terms of physicians he encountered in his cross-country travels.
In rural Alabama, Dr. Regina Benjamin switched to EMRs after losing paper records to a combination of hurricanes and fires.
“When a patient or pharmacy calls at night or on a weekend, I do not have to rely on memory. I can access the chart from any computer, at home, from the hospital, from my hotel room when traveling.
This prevents errors and I can give better care. I can also quickly look at trends and patterns, pick up things earlier than if I had to look thru paper charts.” She was able to fund her conversion through donations and foundation support.
In Cambridge, Ohio Jordan met Dr. Patrick Goggin, who he said spent about $300,000 to convert to electronic medical records five years ago. Jordan recorded a four-and-a-half minute video showing the Dr. Goggin’s system in action. Jordan also spoke with Dr. Goggin’s colleague, Dr. David Ray.
“Advantages are not quite there as far as outweighing the costs,” (Dr. Ray) says.
“The technology is probably just not quite there yet for most solo practitioners and small practices to implement such a system.”
In the Minneapolis Star-Tribune Kate Levinson reports on growing demand for centers to store this medical data and on a study that found mid-size Midwestern cities to be among the most attractive to the medical data storage industry.
Steve Lohr of The New York Times reports that the obstacles to a transition to electronic medical records are daunting. Experts say that how local organizations help doctors in small offices adopt electronic records will be crucial to success. Lohr explains “regional health I.T. extension centers,” called for in Obama’s budget proposal that has been submitted to Congress.
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- $150 billion of stimulus headed to health care
- Medical economist has questions for Obama
- Obama highlights technology in reform efforts
$150 billion of stimulus headed to health care
Filed under: Government, Health care reform, Health policy
Dr. Robert Steinbrook broke down health care’s share of the American Recovery and Reinvestment Act – also known as the stimulus package – in the New England Journal of Medicine. The article also features an itemized list of the health industry’s share of the stimulus.
Steinbrook said the act’s effects would be felt immediately, with some of the biggest winners being the National Institutes of Health and the movement for the adoption of health-related information technology.
“The spending includes $87 billion for Medicaid, $24.7 billion to subsidize private health insurance for people who lose or have lost their jobs, $19.2 billion for health information technology, and $10 billion for the National Institutes of Health (NIH).”
According to Steinbrook, “the economic crisis has allowed the Obama administration to undertake far-reaching health care initiatives that it could not otherwise have launched quickly, if at all.”
Stimulus funds study of effectiveness of treatments
Filed under: Government, Health care reform, Health policy, Hot Health Headline, Pharmaceuticals
Robert Pear reports in The New York Times that $1.1 billion of the $787 billion federal economic stimulus package will fund research into the relative effectiveness of drugs and other forms of medical treatment.
A council of federal employees will advise President Obama and Congress on the funding of studies that proponents hope will help bring down the soaring cost of health care. Advocates say the research will be used for reference purposes, and not to mandate certain treatments.
“The money will be immediately available to the Health and Human Services Department but can be spent over several years. Some money will be used for systematic reviews of published scientific studies, and some will be used for clinical trials making head-to-head comparisons of different treatments.”
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