How the health IT stimulus could hit device market

By | April 23, 2010, 7:19am PDT

Summary: The proposal is to create something like the Patient Safety Organization that already exists within HHS, through which clinicians and hospitals can share patient safety data without fear of retribution.

The process of handing out HITECH stimulus could hit the medical device market.

The certification workgroup of National Coordinator David Blumenthal’s advisory committee is suggesting a range of patient safety actions be made part of the process, covering devices as well as software.

The recommendations are in a letter, posted to Scribd, signed Paul Egerman and Marc Probst, co-chairs of the adoption certification workgroup, to Blumenthal.

The letter is important for two reasons. First, because it addresses a key problem that has long faced health IT, the fact that peripherals like scanners wag the medical record dog. Second, because it proposes new burdens be placed on hospital device makers which their trade group, Advamed, is almost certain to oppose.

Egerman is CEO of eScription, a medical transcription company owned by Nuance. Probst is CIO of Intermountain Healthcare.

The proposal is to create something like the Patient Safety Organization that already exists within HHS, through which clinicians and hospitals can share patient safety data without fear of retribution.

In this case the new group would take reports related to health IT, which could include those related to devices connected to the networks. Probst and Egerman want this made part of the final rules on meaningful use, with a better feedback loop operating by fiscal 2013 for groups getting stimulus funds.

The most controversial aspect of this may be its suggestion for patient engagement, encouraging patients and families to look at their own medical records and reporting errors as “best practices.” That reads like an invitation to lawsuits.

Egerman and Probst want these rules to be in place at least 18 months before they’re enforced meaning final rules on 2013 would need to be published by the end of next March.

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Disclosure

Dana Blankenhorn

Dana Blankenhorn has been a journalist, writer and part-time futurist for over 30 years. At the present moment I run only a personal blog in addition to my ZDNet open source blog. DanaBlankenhorn.Com has the subtitle The War Against Oil. In the past I have used it to write about political history, e-commerce, personal matters, some ideas related to open source, and The World of Always On, which is the idea of using sensors, motes and RFID to turn WiFi links into platforms for applications which live in the air. My IRA account at Schwab holds a few tech shares, most notably some Intel and Applied Materials, but there are no open source companies in it. I don’t even own any CBS stock.

Biography

Dana Blankenhorn

Dana Blankenhorn has been a business journalist since 1978, and has covered technology since 1982. He launched the Interactive Age Daily, the first daily coverage of the Internet to launch with a magazine, in September 1994.

Talkback Most Recent of 11 Talkback(s)

  • "Stimulus" = other word for spending stolen money
    1) Liberals steal money from the working people by taxes.

    2) Liberal steal money from future generations by incurring massive debts (multiplying that of any previous administration). Future tax payers will have to pay it back.

    3) Then treat it as 'their' money to spend.

    4) Then spend it and call it 'stimulus' and we're supposed to be oh-so-happy about it.

    Nah. We need some sense in politics. And an at-home-born president that sticks to the constitution.
    ZDNet Gravatar
    GeorgeOrwell2
    23rd Apr 2010
  • oy vey
    That's a set of political statements which to my
    mind support Hooverism, but which I really don't
    want to argue about.

    My point is that things like CAT scanners are
    peripherals, that they will increasingly be
    connected to networks via Electronic Medical
    Records, and that the meaningful use rules under
    which EMRs are encouraged will impact the devices.
    ZDNet Gravatar
    DanaBlankenhorn
    23rd Apr 2010
  • Hooverism = gov't interventionism
    Hoover was an interventionist.

    http://en.wikipedia.org/wiki/Herbert_Hoover "As the United States Secretary of Commerce in the 1920s under Presidents Warren Harding and Calvin Coolidge, he promoted government intervention under the rubric "economic modernization". "Hoover, a trained engineer, deeply believed in the Efficiency Movement, which held that government and the economy were riddled with inefficiency and waste, and could be improved by experts who could identify the problems and solve them."

    http://en.wikipedia.org/wiki/Efficiency_Movement "The Efficiency Movement was a major dimension of the Progressive Era in the United States. It flourished 1890-1932. Adherents argued that all aspects of the economy, society and government were riddled with waste and inefficiency. Everything would be better if experts identified the problems and fixed them."

    FDR had much in common with Hoover after all. As does Obama.
    ZDNet Gravatar
    pranavb99@...
    23rd Apr 2010
  • So Hoover is a leftie now? Interesting
    Until 1929 we had a regular series of financial
    panics that ruined millions, caused by an
    unregulated financial market and a government
    unwilling to do anything about it.

    Hoover resisted pressure to regulate or do more.
    So you would have called for him to do less in
    that situation...really.

    Hoover in his later life became the doyen of
    modern conservatism through the creation of the
    Hoover Institution at Stanford.

    You should embrace your inner Hoover.
    ZDNet Gravatar
    DanaBlankenhorn
    24th Apr 2010
  • Unprecedented invasion.
    Maybe, but some sure things are that the ARRA health IT provisions and massive monies being spent are:

    1) A very invasive for practically everyone large private industry and federal power grab.
    2) Going to be very wasteful taxpayer monies.
    3) Not going to meet many if not most expressed or implied goals.

    Why? Because it does nothing to change the fundamentals of a classic traditional capital market failure which is/was proprietary EHR's.
    ZDNet Gravatar
    ivaldes1
    23rd Apr 2010
  • Here it comes! The RNCC spin points!!
    Federal Power Grab?
    "Congress shall...have the power to regulate trade between the states".
    The feds ALWAYS HAD THIS POWER, there is no power grab!!
    ZDNet Gravatar
    mykmlr@...
    23rd Apr 2010
  • Agreeing on the language
    One powerful aspect of meaningful use involves
    simplified, standard terminology, and office
    staff trained to explain it before the patient
    leaves. That should minimize misunderstanding in
    the future.

    It's one way in which the industry is changing.
    Some of these changes were underway before 2009,
    but the stimulus (mainly the promise of it) has
    accelerated these changes throughout health IT.
    Not just on the hospital and clinic side, but on
    the insurance side as well.
    ZDNet Gravatar
    DanaBlankenhorn
    24th Apr 2010
  • Meaningful use
    Actually, meaningful use changes that.

    While previous certification was based on
    checking feature boxes, and was managed by the
    industry, meaningful use is being defined based
    on what the software does to facilitate change,
    and industry is not driving the train.

    Most of the money hasn't been spent, but based
    on what I saw at HIMSS 2010 change within the
    industry has already been profound. Witness GE's
    effort to bring the best practices of
    Intermountain Health to the patient bedside with
    Qualibria.
    ZDNet Gravatar
    DanaBlankenhorn
    24th Apr 2010
  • Information Access, but will patients understand?
    The idea of improving access to medical information is
    nice, but will people understand what they are reading?
    Maybe they'll Google a few big words to get a clear grasp.

    If I was a doctor I sure wouldn't want the average person
    (like GeorgeOrwell2) trying to understand their records
    without someone helping him (or her) understand what
    they are reading. I certainly wouldn't want to be the
    "interpreter" for GO2 or any of his friends.

    What I believe we as patients need to be able to do is
    access our records, lab reports, images, etc. for
    consolidating into our preferred system, be that a
    computer, smart phone or iPad type device. That
    information can then "be in our hands" in order for us to
    provide it when needed.

    Flowing information within the medical community is the
    first step as the medical community is now using the
    same devices that the patients are using - including the
    iPad.
    ZDNet Gravatar
    Ken_z
    23rd Apr 2010
  • Improving medical terminology
    One of the hallmarks of the patient record
    you're supposed to be given under meaningful use
    is that it is written in plain English. It
    describes in plain English what just happened,
    what you need to do, and the next steps of the
    medical system.

    This is variously called a Continuing Care
    Record (CCR) or Continuing Care Document (CCD).
    I reported recently that industry groups have
    recently united around a common standard for
    this documentation.
    ZDNet Gravatar
    DanaBlankenhorn
    24th Apr 2010
  • Access Required, Doctors Don't Expect Patients to Even Read Records
    I had an experience that illustrated this matter and I will provide a brief recount. While riding my bicycle, I was coasting at a speed of not less than 10 mph toward a red light in the right side of my lane that would allow me to proceed straight through the intersection. There was another lane to the right that was right turn only so I heeded that by riding in my lane as far to the right that was both safe and practicable. I'm an experienced bike rider, a considerate motor vehicle operator, and knowledgeable about vehicle codes so I know what I'm talking about irt the law and safety. Suddenly, a van directly smashed into my rear tire to launch me airborne for several yards. As a consequence, I violently struck the pavement numerous times as my body flipped and rolled over the hard, rough surface. The rear tire was hit with enough force to collapse it like the letter U. I never engaged the brakes. The bike was catapulted down the road too. My entire body has suffered from severe injuries and extreme pain. The police report found the driver at fault and indicated the impact point was clearly within a third of the bumper's right side.
    Since I'm a military retiree, the ambulance decided to deliver me to the Naval Hospital in San Diego. Next to the VA in San Diego, that was the worst experience I have ever had irt negligent treatment and fraud. Initially, there was much interest in my health but when they discovered I was a mere retiree with TriCare coverage but no other private insurance then the level of attention noticeably turned to disregard and inattention that leveled upon negligence. Despite my vital signs indicating stress, clear indication of injuries, and my complaints of pain there were no further X-Ray or MRI diagnostics taken other than a look at my right hip. I had flipped along the road like a rag doll, literally twisted my neck under my left arm, had smashed my helmeted head into the pavement several times, and had other body parts violently smash into the pavement. Though I felt nauseous, could feel crunching and popping in my neck and shoulders even as my body was stiffening, couldn't lift my right arm, had numerous abrasions, and could barely walk without wobbling it was astounding that the "doctors" treated me like I had merely fallen into the grass while riding at the park.
    My friend had arrived before they even took the hip X-Ray and even asked why I wasn't getting examined for other injuries. It was astounding to hear the doctor babble through a lame explanation provided but indicated that I should return if the pain worsened so released me with pain medication and minimal treatment instructions that were the basic first aid measures of R-I-C-E. I had immediately noticed that they made a mistake on the injury cause, injuries, and complaints of pain. I wanted to have it corrected iaw the information on my admission sheet. They indicated that information is not retained and it had been shredded but that the record would be changed anyway. I returned within the next day 48 hours with worsening conditions and elevated pain. I received morphine injections for pain relief and only took a CAT scan of my torso. Despite the information I provided on the admission forms that clearly and specifically indicated the cause of the injuries along with all the indications and pain, I was neglected and released with more pain medications. From all of that information, how does the record surmise that I was "clipped", not indicate my injuries or pain, and amazingly instructed that I would recover so long as I took the required dosage of pain medications. It was the beginning of my problems with that facility and the VA. I have been neglected, harrassed, misdiagnosed, misled with false information that did not correspond to that on the records, discovered fraud and forgery, never provided information regarding costs let alone provided a statement that indicated costs for specific treatment, had a surgery cancelled on the day it was supposed to occur without any warning or arrangement, and many other issues that caused me to not just waste nearly a year but that exacerbated my injuries to where my health has deteriorated as much as the affected areas have atrophied. I would recant the suffereing and successive problems as a consequence of the neglect and healthcan't provided by the government run medical faclilities but I'm sure that you understand. The message is that there is great risk associated with those facilities; patients are in peril and they are to be avoided. An ER doctor at the VA had informed me, as others eventually would, that they would not recommend the VA or Naval Hospital to get treated for an injury and the latter facility does indeed consider retirees bothersome, nonprofitable, and to provide minimal services if at all in order to quickly send them on their way. However, it seems that they get to write their own stories about the cause of injuries and how they had came through with all the treatment the patient needed despite all evidence to the contrary. As the harrassing person that refused to give me their name over the phone had explained, "they never make mistakes". What does that say about the credibility of health reform? My advice is to instill video cameras and voice recorders in places where medical treatment occurs as well as in courts. If not available then provide your own voice recording equipment while ensuring that an actual copy of the recording would be provided. Regardless of the problems with transcripts of records, I wonder how many doctors, lawyers, if even judges would still participate ... which goes to show you about the issue with honesty and value of trust in the USA.
    ZDNet Gravatar
    donnydo77@...
    26th Apr 2010

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