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House Panel Approves Bill To Spur Use of Electronic Health Records
Congressional Quarterly – July 23, 2008
By Drew Armstrong and Leah Nylen, CQ Staff
The House Energy and Commerce Committee, racing a rapidly shrinking legislative calendar, cleared one more obstacle for a floor vote on legislation designed to promote faster adoption of electronic medical records.
After considering amendments from members of both parties, the committee approved the bill (HR 6357) by voice vote. The measure seeks to spur a shift to electronic records by hospitals, doctors and other health care providers through loans and grants. It also would set up privacy protections for patient data.
Before the bill was approved, the committee adopted, by voice vote, a substitute amendment by Chairman John D. Dingell, D-Mich., that embodied a bipartisan compromise between committee leaders.
Committee ranking Republican Joe L. Barton of Texas called the bill a good faith effort by all parties.
Committee members debated a series of amendments, largely dealing with patient privacy issues. Most were withdrawn with a promise from Dingell to work with their authors, including one from Rep. Mike Rogers, R-Mich., that Rogers said would make sure health care providers could share records within their organization, for business purposes.
Rogers argued that if the privacy considerations were important, so too were the large dollar savings and increased patient safety that could result from a comprehensive health information technology system.
Dingell and other Democrats were skeptical of Rogers amendments actual effect, however, but promised to work on the language with him.
What were trying to do here is balance out the protection of privacy but also make sure the system moves, Dingell said.
The House bill would authorize grants and loans to help hospitals and doctors especially small practices buy health information technology equipment. It also would require the government to settle on a standard for electronic health records and start using them in its health programs as it replaces existing equipment. Lawmakers hope those standards would spread to the private health industry.
Several amendments were adopted by voice vote, including those offered by:
Mike Rogers, R-Mich., clarifying that any graduate professional school would be eligible for grants for demonstration projects to develop academic curricula integrating health IT into clinical education.Anna G. Eshoo, D-Calif., to require the secretary of Health and Human Services to conduct a study on the use of technology for care of seniors and the disabled.
Eshoo, to clarify language in the bill to ensure that it is technology-neutral. Edward J. Markey, D-Mass., to require the secretary to create a model informed- consent agreement in plain language that is easily understandable.The House Ways and Means Committee has partial jurisdiction over the bill, and will hold a hearing Thursday on the topic. The bills supporters on the Energy and Commerce have been optimistic about their bills chances this year, despite the few remaining legislative days. But others have been less sunny about getting the bill through this year, including Rep. Michael C. Burgess, R-Texas, who has said the bill will provide too large a burden on health care providers, and who doubts the bill can be finished this year. If were going to have a little more time, we ought to get it right, Burgess said Wednesday.
In the Senate, Massachusetts Democrat Edward M. Kennedy and Wyoming Republican Michael B. Enzi, the chairman and ranking member of the Health, Education, Labor and Pensions Committee, have been working on their own health IT bill (S 1693). However, Kennedy has been largely absent from the Senate since undergoing brain surgery on June 2.
Jun 11, 2008
Governor Jindal Joins HHS Secretary in Naming Louisiana One of First Four Siites Selected for Major Medicare Demonstration of Electronic Health Records
Governor Jindal is joined (from l to r) by HHS Secretary Mike Leavitt and DHH Secretary Alan Levine at a press conference announcing that Louisiana was selected as one of the first four states to participate in a Medicare Demonstration encouraging electronic health records.
BATON ROUGE Today, Governor Bobby Jindal welcomed HHS Secretary Mike Leavitt to Louisiana and joined him in announcing that the state has been selected to take part in a national Medicare demonstration project that provides incentive payments to physicians for using certified electronic health records (EHR) to improve the quality of patient care. The five-year, first-of-its-kind project is expected to improve the quality of care provided to an estimated 3.6 million Americans.
I congratulate Louisiana on this achievement, which demonstrates the states strong commitment to improving health care starting at the local level, Secretary Leavitt said. Indeed, the use of electronic health records, and of health information technology as a whole, has the ability to transform the way health care is delivered across our nation. We believe that EHRs can help physicians deliver better, more efficient care for their patients, in part by reducing medical errors. This project is designed to demonstrate these benefits and help increase the use of this technology in practices where adoption has been the slowest at the individual physician and small practice level.
This HHS award to the Louisiana Health Care Quality Forum is a huge accomplishment for our state, said Governor Bobby Jindal. This federal funding will allow the Forum to provide financial incentives to Louisiana physicians who use electronic health records to improve the quality of care they provide their patients. This is another incredible step forward in our work to ensure access to quality health care for all Louisianans.
The Quality Forum is excited to serve as a community partner in this endeavor. The mission of our organization is to lead collaborative efforts to improve the quality of care for the people of Louisiana, said Shannon Robshaw, Louisiana Health Care Quality Forum Executive Director. Our success with this application is the direct result of many stakeholders statewide committing to this effort, and the resulting award will benefit thousands of patients.
The other communities selected to work with the Centers for Medicare & Medicaid Services (CMS) on the Medicare EHR demonstration project range from county- and state- level to multi-state collaborations. These include Alabama; Delaware; Jacksonville, FL (multi-county); Georgia; Maine; Maryland/Washington, DC; Oklahoma; Pittsburgh, PA (multi-county); South Dakota (multi-state); Virginia; and Madison, WI (multi-county).
The administration has worked with the Louisiana legislature to invest more than $18 million to assist physicians and rural hospitals with the implementation of electronic health records. These electronic health records allow for better privacy and security of health information, and fewer medical errors. This award by HHS will further the implementation of electronic health records in 100 physician practices in Louisiana.
Studies have shown that up to 100,000 Americans die every year from avoidable medical errors, and that nurses spend an hour filling out paperwork for every hour they provide care, in many hospital settings.
The project will be implemented in two phases. CMS will begin working with partners in the four Phase I communities including Louisiana over the coming months to develop site-specific recruitment strategies, and recruitment of physician practices will start in the fall. For Phase II sites, these activities will begin in 2009.
The sites were selected through a competitive process from a field of more than 30 applicants. Criteria for selection of communities included active community collaboration among stakeholders; likelihood that incentives like Medicares would be implemented by private employers or health plans in the community; and adequate size to recruit a sufficient number of practices.
While the number of sites selected was limited to 12, we are greatly encouraged by the substantial multi-stakeholder initiatives ongoing across the nation, Secretary Leavitt said. It is my hope that those communities not selected and others that were not yet prepared to apply will continue working together to improve health care and consider creating their own incentive-based projects to advance the use of EHRs.
Findings from the demonstration will help determine the role of EHRs in delivering high-quality care and reducing errors. The demonstration will also assess the role of incentive payments in adoption and correct use of EHRs.
Broad adoption of EHRs has the potential to transform health care and the way medicine is practiced in our nation, said Acting CMS Administrator Kerry Weems. Medicares EHR demonstration can help measure that potential, and at the same time help bring about change.
Over the five-year demonstration project, financial incentives will be provided to as many as 1,200 physician practices in the selected communities that use certified EHRs to improve quality as measured by their performance on specific clinical quality measures. In addition to the incentive payments, bonus payments may be awarded based on a standardized survey measuring the number of EHR functionalities a physician group has incorporated into its practice. Total payments under the demonstration for all five years may be up to $58,000 per physician or $290,000 per practice.
In addition to practices chosen to receive incentive payments, another set of practices will be chosen in each community to be observed but not receive payments. They will serve as controls for the demonstration in order to objectively measure the effect of the incentive payments and EHR use.
This initiative is also part of HHS bold vision for health care reform built on the four cornerstones of value-driven health care. These include: adopting interoperable health information technology; measuring and publishing quality information to enable consumers to make better decisions about their providers and treatment options; measuring and publishing price information to give consumers information they need to make decisions on purchasing health care; and promoting incentives for high-quality, efficient delivery of care.
To learn more about Connecting to Better Health Care, please visit: www.hhs.gov/secretary/connecthealthcare.
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WSJ Poll: Most Adults Say EHR Benefits Outweigh Privacy Risks – November 2007
*National Healthcare Security and Privacy Standards Approved by ANSI Oct 24, 2007” Direct Link Here