The Centers for Medicare and Medicaid Services (CMS) is looking for help in setting up a new innovation center created under the health reform legislation.
Under the reform package, CMS is expected to develop new models for care reimbursements to allow for reduction of costs while also preserving quality of care. This may involve accommodating new practices such as telehealth.
The law required establishing a Center for Medicare and Medicaid Innovation in CMS by January 2011. The center will serve as a research and development arm of CMS.
To meet that deadline, CMS published a sources sought notice on the Federal Business Opportunities Web site on May 14 seeking companies that can assist in the design, planning, organizational development and implementation of the center.
The assistance would include identifying new models and solutions to solve existing problems in health care delivery, designing and assigning pilot projects to evaluate and test those ideas and forming policy proposals to carry out the initiatives in Medicare and Medicaid, the notice said.
The agency is seeking responses by May 28. The notice is specifically aimed at small businesses.
Posted on May 20, 2010 at 7:00 AM0 comments
Roger Baker, assistant secretary for information and technology at the Veterans Affairs Department, today thanked an industry panel for its “exhaustive” study on modernization of the VA’s VistA electronic medical record system.
The panel, convened at Baker’s request, was sponsored by the American Council for Technology-Industry Advisory Council and chaired by Ed Meagher, a former deputy CIO at the VA. It recommended on May 3 to move VistA to an open source platform and phase out its reliance on the MUMPS computer language.
“The VA is pleased with the efforts of the ACT-IAC to review the option for moving VistA into an Open Source endeavor and especially the dedicated efforts of the members of the work group and leadership of ACT-IAC,” Baker said in an e-mailed statement today.
“Clearly the group did an exhaustive study covering the significant technical and governance aspects important to making decisions in the Open Source arena. We are currently reviewing the many recommendations covered in the report and look forward to a rich dialog and exchange of ideas and concepts with industry. VistA is the preeminent example of what a patient centered Electronic Health Record [EHR) can do, and its improvement will take the joined efforts of clinical experts, government and industry. The VA looks forward to continuing this review,” Baker wrote.
The 34 vendor panelists were said to be unanimous on the recommendation; however, reaction in the broader health IT has been divided.
VistA is considered a superior system with strong clinical content and effectiveness, but it operates with the relatively unpopular computer language known as MUMPS. Some supporters and practitioners of MUMPS strongly laud its qualities, while detractors assert that MUMPS is outdated.
I’m certainly no expert on MUMPS, so I will offer only one brief observation.
From what I’ve heard, one of the elements that makes VistA superior to many commercial EHRs is that it was created with substantial input from physicians who would be using it. It has been described to me as “clinically rich.” Because the doctors are — or should be -- the ultimate arbiters of how their own records should be kept, it seems to me it would be important to hear from physicians on whether the clinical richness would be threatened by moving to an open source development.
I asked Meagher about physician input into the industry committee’s work, and he told me the panel spent two months consulting with VA doctors and other VA officials about their needs. He also said VA physicians and “end users” would be included in the open source development process.
A principle of modernization is that “whatever is done must be at least as good as what we have,” Meagher said. “We want to make the system as robust as possible.”
Good intentions are certainly a necessary first step. It would be great if the VA physicians could get involved in this public discussion about a very significant issue that may have much broader implications for health IT implementations.
Posted on May 10, 2010 at 12:40 PM8 comments
Get ready for some long-awaited news on the modernization of the Veterans Affairs Department’s VistA electronic health records system.
Since October, Ed Meagher has been chairing the VistA Policy Industry Group that's preparing recommendations on the next phase of VistA at the request of VA Chief Information Office Roger Baker. Meagher told me the report will be delivered to Baker on May 3 and there will be press events near that time.
Meagher has formerly served as VA's deputy assistant secretary for information and technology, and currently is senior principal for health programs at SRA International Corp.
“VistA is the best health information system in the world, bar none,” Meagher told me earlier. “At the same time, VistA is very old, very hard to maintain, hard to manage and manipulate, and incredibly expensive to maintain. [All] of those statements are true, so what do you do to modernize it and make it easy to maintain?”
Stay tuned. We’ll be getting those recommendations soon.
Posted on Apr 30, 2010 at 11:23 AM0 comments
I have to give the Health and Human Services Department credit for its Open Government Plan. The plan was bursting at the seams with lots of new ideas for government transparency and accountability, mostly in the form of new dashboards and datasets. So kudos to HHS for promoting open government!
Let’s talk about some of the details. For example, the new FDA-Track project has 40 online performance management dashboards; that’s right, 40. That is both impressive and, possibly, unwieldy; It takes quite a bit of scrolling around to get the full picture.
Looking over a few of the FDA-Track dashboards (which are still in beta mode), I read through many of the performance measures. Some were useful; others a bit esoteric. One of the performance measures for the Information Management Office is the percentage of IT outages resolved in three hours. I don’t know about the FDA but, at my house, the question of how quickly a power outage is resolved is beyond my control and in the hands of the utility companies. So it is not immediately clear to me how it is in the FDA IT department’s control to resolve power outages quickly. That’s a small quibble that is not meant to detract from what looks like one of the largest open government initiatives I’ve seen.
Next, I checked out the Centers for Medicare and Medicaid Services (CMS) dashboard after an FCW reader asked me to write about it. Well, after 10 minutes, I’m still trying to decipher the first three charts I looked at. It does not help that the charts are sprinkled with acronyms and jargon. It seems to me that the CMS dashboard is very ambitious in scope and designed for people with some familiarity with these datasets. I may come back to visit later, when I have more time.
Third, I visited the newly published list of HIPAA breach notifications from the HHS Office for Civil Rights. Technically, this is not part of the open government plan, but shouldn’t those principles apply across the board? It’s great that the breach list is published. But as for easily finding if there were breaches in my state, or with my own health plan, that wasn't possible. A simple chart format would have solved that problem.
Posted on Apr 20, 2010 at 1:02 PM0 comments
Senate legislation that would boost the Food and Drug Administration’s capabilities to prevent, identify and respond to foodborne illnesses is expected to come to the floor within days. If the bill becomes law, does that mean there will be more money for FDA information technology systems? Most likely so, but you might have to read between the lines on that.
The House passed a food-safety bill last July. The Senate bill, sponsored by Sen. Dick Durbin (D-Ill.) had been waiting in the wings during the health care reform debate, but now is in line for a Senate vote. Durbin’s FDA Food Safety Modernization Act would give the FDA new authority, tools and resources, according to an April 11 statement from Durbin’s office.
“Today, FDA is working within the constraints of outdated laws, inadequate staff and not enough funding,” said Durbin. “The agency has been set up to react to outbreaks of contamination. My legislation would take the FDA to a new level by empowering the agency to prevent outbreaks. The bill gives FDA the resources and authority to quickly trace food borne illnesses back to their source.”
It also increases FDA surveillance of foodborne illnesses, access to testing records and results and FDA authority to do recalls.
According to a copy of Durbin’s bill posted in the Library of Congress database, standards will be set for the information, format and time frame for people to submit records about foodborne illnesses to the FDA. The legislation refers to use of “technologies, including existing technologies, that enhance traceback and trace forward.” It also refers to use of surveillance systems to improve the collection, analysis and reporting of data on foodborne illnesses, and increased participation in federal information-sharing in networks for that purpose.
However, the bill also is careful to say that “nothing in this section shall be construed as giving the secretary the authority to prescribe specific technologies for the maintenance of records.”
Later on, the bill states that increased capacity of FDA systems is aimed at “working toward automatic electronic searches”-- and that is about as close as it gets for a description of what types of FDA systems might be expanded under the bill. The legislation does not mention fancy new IT applications and IT system expansions—which might have scared off the small farmers that already are complaining that the legislation brings in too much new regulation and raises their expenses—but if you search for IT in the bill, you can find something.
Posted on Apr 14, 2010 at 1:20 PM0 comments
The National Library of Medicine wants to be part of the conversation on “e-patients.” So it made sense to Dr. Donald Lindberg, director of the library, to co-sponsor an e-patient conference on April 6 and April 7 on the National Institutes of Health campus in Bethesda. The event brought in experts and patients who are using social media tools and other health IT applications to help manage their care.
“I was struck by the patients going after the information on the Internet. They deem themselves e-patients,” Lindberg told me. “Call if chat groups or whatever, the patients get helpful information from each other.”
The focus of the e-patient conference was on personal health records and personalized health care, Lundberg said. The national library can help with developing technical and vocabulary standards in those areas, he said.
What else should government do? I asked him.
“It should stand back,” Lindberg said.
I could not help noticing that relatively few vendors appeared to attend the event, in contrast to other recent well-attended health IT conferences. I asked Dr. Andrew Balas, board member of the Friends of the National Library of Medicine, also a co-sponsor of the event, whether vendors were more interested in electronic health records (EHRs), rather than personal health records (PHRs).
EHRs are used by doctors’ offices and institutions, while PHRs are used by patients to access their own records. The bulk of the $20 billion in economic stimulus law funding goes for EHRs.
Balas said personalized health care covers more than just PHRs. It is a set of technologies, including genomics, that allows for personalized care. And there also is some convergence with PHRs and EHRs, he added.
“You can talk about PHRs, or EHRs, or about patient access to EHRs,” Balas said.
Posted on Apr 08, 2010 at 2:08 PM1 comments