Please note: This post by the HIT Standards Committee’s Implementation Workgroup is now closed for comment. Monitor this blog for more posts from the FACA committees and its workgroups as issues develop. Also, please visit the Health IT Buzz Blog to join other Health IT related conversations.
Welcome to the new Federal Advisory Committee Blog! Since many of you may be unfamiliar with Federal Advisory Committees (FACAs) and their role at ONC, I wanted to give you some background and a preview of what you can look forward to on this blog.
“FACAs” get their name from the Federal Advisory Committee Act, which lays out the guidelines for such committees. FACAs are advisory and intended to provide external recommendations to the government. They are also very open committees – meetings are held in public, information on the meetings is posted in the Federal Register, and all FACA records are readily available. At the very root of the FACA mandate is transparency and collaboration.
ONC has two FACAs – the HIT Policy Committee and the HIT Standards Committee. These committees were established to obtain outside advice or recommendations on key health information technology topics from leaders who represent various stakeholder groups. HIT Policy Committee members were selected by the U.S. Government Accountability Office, the Department of Health and Human Services, and Congress. The HIT Standards Committee members were selected, invited, and appointed by the Secretary of the Department of Health and Human Services. Current members are listed on http://healthit.hhs.gov. In my role at ONC, I serve as the liaison between these Committees and ONC.
In the spirit of transparency and collaboration, this blog will help ONC’s FACAs open a broader dialogue with you. In the months to come, we will use this blog to let you know about key FACA activities. Since the FACAs do not meet frequently, there will be periods when the blog is not active. I hope you not only find the information that will be posted to this blog interesting and insightful, but, above all, that you heed our call to join this important conversation.
– Judy Sparrow, Office of the National Coordinator for Health IT
Blog post updated as of 1/21/2010
Tags: FACA, Federal Advisory Committee Act, health IT, HIT Policy Committee, HIT Standards Committee, ONC
We made the transition to EMR over two years ago and it has taken that long to smooth out the transition. We here at Roane County Family Health Care in Spencer, WV have 10 medical providers and do about 36,000 patient visits annually. Using EMR has increased our cost dramatically with no realistic way to improve productivity or reduce staffing levels. I am a proponent of the system even with the increased cost since we have realized many other important benefits. I would like to see more work done on the practice management side of IT, and importantly an effort to reduce audit expense. From my perspective almost all of the effort in EMR goes to clinical management but billing and finance tie it alltogether so that the entire system should be evaluated not just the clinical side of EMR. My audit bill this year is $50,000 and the audit is totally clean. That represents 10% of my 330 Grant that should go to provide health care in this the highest county for unemployment in WV. Surely with the technology that is available the government can prove compliance without the need for such expensive audits. For my part EMR is a global concept for the entire primary care organization not just the medical staff. Larry W. Dent, J. D. – CEO Roane County Family Health Care (FQHC)
Agree or Disagree:
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At DocSite, we have worked in the small and large physician space for a number of years – focusing on decision support, performance measurement, health team communication – essentially, trying to make it easier to deliver better care (www.docsite.com).
In many settings, it is possible to decrease failure rates (eg A1c missing or too high, vaccine adherence, etc) by 20% to 50% in a 3-6 month period — In most cases to date, without a physician touching a keyboard, but that is changing.
The key elements seems to be getting the right questions in front of the care giver when the patient is there (decision support), having the ability to see how the practice(s) are doing (performance reporting) and how to get the list of patients who are falling through the cracks / remain out of compliance (outreach) — all orchestrated by one or more people focused on coordinating the improvement of the clinical program of interest (interoperable information and cross-team communication). On the last one, there are examples using promotoras, RNs, Primary Care Physicians and NPs — that all work — Ironically, almost the exact same elements that are called for in the Recovery Act.
Lessons learned on this end: 1) Loose coupling works (eg CCR / CCD – Patient Context Sharing – SAML) – registry / decision support / documentation / e-prescribing / performance reporting. 2) The simpler the better to solve the task at hand 3) REALLY solving the problem with an early win for the END USERS is the best way to get momentum.
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I think registration should be required for comments. Verification by email is a much better way to avoid spamming than Captcha alone. I am looking forward to seeing the healthcare social media community using this medium and the conversations that will ensue…
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I have purposefully limited my EHR transition and dependence. I am a solo practice Optometric Physician with a staff of 4+/-. I am using very sophisticated diagnostic equipment and communicate efficiently with my colleagues and referring physicians. I am not using cut and paste texts, but address the specific constellation of needs of each individual patient.
I have worked with both the government run and emerging private health care systems in Russia for over ten years. I gave the first lecture on fee for service practice held in Petropavlovsk, Kamchatka, Russia.
I am cautious by nature and always provide double back up systems for all data collected and my accounts payable and receivable.
Despite this caution a single power supply event, loss of three phase power, and the surge that over rode all protection systems in place I lost over 25% of my annual billings. They were irretrievable and hard paper reconstruction collection efforts were lost in the insurance payer policies. Insurance coverage for my loss was lost for reimbursement in my casualty loss insurer policies.
I am a former Strategic Air Command Launch Officer and know the catastrophic effect a single high altitude blast generating electro-magnetic pulse would have on our chip and data intense society.
The promise of government stimulus money maximum payment being received is as naive as purchasing equipment for the deductibility of the depreciation and tax credits. You still have to cash flow the product in anticipation of the reimbursement.
If, as in all things, you follow the money, the unspoken goal is to consolidate to larger practice designs. Few practices will have the Medi-Care volume to nibble at the carrot of government reimbursement to a significant degree. An IT “expert” indicated that the cost to install appropriate hardware, software and IT support on retainer would exceed $80,000. Yikes!! From whence is that extra capital to cash flow to emerge?
To date no one has been able to define a certified system. Competing vendors are pre-financing their system anticipating capture of the reimbursement, holding the practitioner hostage in its absence to appear. No one has agreed upon the specific clinical data to be stored, held and shared within or between clinical disciplines. The concept of often subjective clinical work to be reduced to check off blocks bespeaks the tremendous clinical ignorance of advocates of the program.
The EHR movement / mandate is throwing money at EHR without purposeful utilization goals, physician productivity impact, realistic cost analysis in the face of aggressive software developers cum marketers, and appropriate clinical multi-disciplinary counsel.
Hot debate. What do you think?
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I have purposefully limited my EHR transition and dependence. I am a solo practice Optometric Physician with a staff of 4+/-. I am using very sophisticated diagnostic equipment and communicate efficiently with my colleagues and referring physicians. I am not using cut and paste texts, but address the specific constellation of needs of each individual patient.
I have worked with both the government run and emerging private health care systems in Russia for over ten years. I gave the first lecture on fee for service practice held in Petropavlovsk, Kamchatka, Russia.
I am cautious by nature and always provide double back up systems for all data collected and my accounts payable and receivable.
Despite this caution a single power supply event, loss of three phase power, and the surge that over rode all protection systems in place I lost over 25% of my annual billings. They were irretrievable and hard paper reconstruction collection efforts were lost in the insurance payer policies. Insurance coverage for my loss was lost for reimbursement in my casualty loss insurer policies.
I am a former Strategic Air Command Launch Officer and know the catastrophic effect a single high altitude blast generating electro-magnetic pulse would have on our chip and data intense society.
The promise of government stimulus money maximum payment being received is as naive as purchasing equipment for the deductibility of the depreciation and tax credits. You still have to cash flow the product in anticipation of the reimbursement.
If, as in all things, you follow the money, the unspoken goal is to consolidate to larger practice designs. Few practices will have the Medi-Care volume to nibble at the carrot of government reimbursement to a significant degree. An IT “expert” indicated that the cost to install appropriate hardware, software and IT support on retainer would exceed $80,000. Yikes!! From whence is that extra capital to cash flow to emerge?
To date no one has been able to define a certified system. Competing vendors are pre-financing their system anticipating capture of the reimbursement, holding the practitioner hostage in its absence to appear. No one has agreed upon the specific clinical data to be stored, held and shared within or between clinical disciplines. The concept of often subjective clinical work to be reduced to check off blocks bespeaks the tremendous clinical ignorance of advocates of the program.
The EHR movement / mandate is throwing money at EHR without purposeful utilization goals, physician productivity impact, realistic cost analysis in the face of aggressive software developers cum marketers, and appropriate clinical multi-disciplinary counsel.
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Everyone seems excited that this blog has been put up, but PLEASE, it sounds like a Twitter account already.
Lets get some substantive discussion going and stop the twitting.
Anyone else concerned about any of the comments made the past couple days…or wondering if this will all come to closure?
There seems to be lots of input being submitted…but precious little discussion about the input received (other than “thank you for your input”) by committee members. Seems everyone is very polite and accommodating but there comes a time to start sifting the wheat….
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Bravo! Taking steps to connect with those of us in the trenches is GREATLY appreciated. The more the federal initiatives can collaborate with the grassroots, the greater the likelihood of success.
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Key message today in Implementation Workgroup was “Keep it simple!” when it comes to standards and interoperability. Look forward to stakeholders across the spectrum from patients to experts, physicians and HIT leaders continue to engage in positive and accelerated movement that ONC, HIT Policy and Standards Committees, HITSP, public/private leaders, and state leaders have encouraged.
Committee members and the public in today’s workgroup at the Omni Shoreham in DC were in awe of the great new wall poster created by Robin Railford, RN-BC, Director, Gov’t Initiatives for Eclipsys, summarizing “Meaningful Use” across the broad spectrum of criteria and matrixes.
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Social comments and analytics for this post…
This post was mentioned on Twitter by Brian Ahier: COOL! New #HITpol Blog to support transparency and collaboration http://bit.ly/nFdEa #Gov20 (HT @GovHIT)…
Hot debate. What do you think?
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Two thumbs up for small practice discussions.
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