Joe Biden and the dawn of the MediNet

Joe Biden and the dawn of the MediNet

Summary: All this money does is help assure the tech industry can achieve what its customers state as their goal, getting data where it's needed, eliminating paperwork, turning records into meaningful information. Where the savings go is another debate, one now taking place in the Congress.


This week Vice President Biden announced the first hard decisions on $19.2 billion in stimulus money for medical records, dubbed HITECH, passed in February. (Picture from CBS.)

Half of about $1.2 billion goes to 70 extension centers, modeled on agriculture extension services, that will educate doctors about electronic records so they not only buy gear that meets guidelines but learn to get value from it.

The other half goes to build state Health Information Exchanges (HIEs) to move records around when needed.

That leaves $18 billion, which will go to subsidize technology purchases under guidelines still being developed by the Department of Health and Human Services' (HHS) National Coordinator for Health Information Technology (NCHIT), David Blumenthal.

This is smart policy. The money for HIEs is in line with what the industry is already doing successfully. The extension centers are even smarter, because training is often overlooked in favor of marketing wherever tech products are sold.

Many press reports, however, tried to tie this directly to the President's ongoing efforts to pass health reform.

This is a completely different subject.

The entire health care industry -- insurers, hospitals, clinics, doctors, pharmacists -- has been trying to automate for over a decade. What the HITECH money does is completely in line with the industry's priorities, or at least buyers' desires.

All this money does is help assure the tech industry can achieve what its customers state as their goal, getting data where it's needed, eliminating paperwork, turning records into meaningful information. Where the savings go is another debate, one now taking place in the Congress.

HIEs work. As was true in the pre-Internet days of the 1980s the question is who pays for what. With $564 million in grants available those arguments can go away, replaced by questions like standards and interoperability, which are more important and useful.

Anyone who has come home from Best Buy with a $500 copy of Microsoft Office and a Dummies book will tell you how important training is, both before and after the sale. So $598 million is going into delivering something other than sales pitches and training that goes beyond what you would get in a book.

The Vice President's dog-and-pony show about the importance and value of records could have been written by the HIMSS trade group, which is based in Chicago.

His gaffe du jour, that the U.S. government already provides half the nation's health care through Medicare and Medicaid, was a bonus for the media, and helped pay reporters' way to the event with their editors.

Of course inside the gaffe was a little grain of truth. The government does have an enormous health care budget, and it can direct that budget or, as has been the case in the past, let that budget direct it.

That's the real argument in the health IT debate, namely whether the vendors or the customers will control its terms.

Through HIMSS, vendors have made some progress this decade on questions like interoperability, guided (as telephone companies were on X.400) by each vendor's corporate agenda, rather than the needs of the market as a whole.

We know how that logjam was broken. One big customer, the government, took questions of who would pay for what off the table, pushing engineers for simple solutions to its own problems. That's why you're reading this on the Internet instead of CompuServe.

If the Administration truly understands that history, and these grants are the first true indication that it does, then Biden's day out will prove to have been historic, something well worth celebrating.

Maybe we'll call it the dawn of the MediNet. Just don't let Joe Biden claim in some future campaign he created it. As a Catholic he will understand his true role. He was the priest at its baptism.

Topics: Health, CXO, IT Employment

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  • what a waste, just model VA Hospitals

    they have one of the most efficient medical records on the planet.
    • HIE

      These funds are not to develop electronic
      medical records (your right, the VA's VISTA
      system is very good - and I am a strong
      advocate of open source solutions) This is to
      develop Health Information Exchange. Simply
      having an electronic medical record is not much
      good if it is not interoperable with other
      systems. There is much debate about the most
      effective way to accomplish exchange, but with
      funding available, now solutions can be found
      and things should move forward.
      • Two trains running

        There's an EHR track -- the 70 or so offices -- and there's an HIE track. Two different tracks.
    • VistA needs work

      It is a good platform and there are many people working on it. But the current implementations, by themselves, are insufficient to the present task.

      One could use the code base as a base and build a good, free EHR system. And that is also being done, offered in the market alongside commercial competition.
  • RE: Joe Biden and the dawn of the MediNet

    And you want all your personal private information located on goverment computers?

    lemmings ...
    • They're not government computers

      Does it really matter to you whether the computer where your data is stored is controlled by a private insurance company or the government? Why? At least with the government I have some efficient means of recourse.

      Oh and when I mentioned the idea of setting up a system for small medical claims guess what the response was? "Why if you just insist on their credit or debit card numbers you can get the money yourself."

      Everything you accuse government of doing, darkly, private industry is doing, in the dark.
  • RE: Joe Biden and the dawn of the MediNet

    Oh great, the "Talking Shirt" is feeling empowered again. What's the next? Hacker's need not apply! He's going to share the "secrets" to get the info out of the HIE. My fifth grader will get it as a technology class project.
    • What are you talking about?

      HIEs today are run through private consortia. Such things don't have to be a state function, certainly not directly.

      Is it government or network computing you fear?
  • RE: Joe Biden and the dawn of the MediNet

    My medical records in private insurance files is one thing. My medical records in the hands of the govt is totally another thing. People need to understand that their files can be shared with any govt dept without our knowledge. Govt control over medical records will also be used to determine what kind of medical treatment people will receive under Obamacare. Read the section of the Bill dealing with appropriate care.
    • Absplute stupidity

      I've read it, and the most onorous rules in the
      bill represent common industry practice. In other
      words, your complaints are the current practice of
      big insurance companies.

      Plus it costs twice as much. Plus there are the
      lifetime caps. Plus it's not healthcare, but fee
      for service when you're sick, which is different.
  • RE: Joe Biden and the dawn of the MediNet

    I got my medical records in e-format. It took the legal equivalent of a CROWBAR to the CEO's of Stanford and Exempla Lutheran to get them. And when I did get them, the local doctor complained it would take too much time to read them ( in a PDF format )

    Stanford was supposed to have this done by the turn of the Millenium ( 2000 ) and my physician at a Stanford clinic was asking me where the $50M went.

    This was in 2006....

    We need a common communication protocol ( and not have someone sitting at a scanner all day ) and the means to FORCE all medical providers to use it.

    Sending in HACKERS to set up access all the medical databases may be the only way to get it done.

    One of the profit centers is the outrageous charges to get your medical records..that is why I had to fight tooth and nail ( and use the HIPAA guidelines ) to get them.

    Old Timer 8080
    • That's the present situation

      Big hospitals and insurers treat your EHR data as
      proprietary to them. They each have a proprietary
      set of data standards and protocols so as not to
      lose that advantage.
  • RE: Joe Biden and the dawn of the MediNet

    As a lifelong resident of the State of Delaware, I am forced to inform you that Joe Biden, (like Barak Obama), is a man man that cannot be believed!!!
    • What did you say?

      I think you wanted to say he's a mad man, not a
      man man. (Or did you mean a man's man, i.e. a
      mensch?) And the name of the President is Barack
      Obama. That's Barack Hussein Obama. He's been in
      office over seven months, long enough for you to
      learn it.

      And if he drives you crazy because he's a
      Democrat, that's the way it's supposed to be.
      That's not oppression. That's called losing an
  • My only question is this...

    Who is going to wind up the 'approved vendor' these 'extension centers' teach? Seems to me the government is in a position to (irresponsibly) dump a lot of money into one company's pocket.

    I'm entirely for digitizing records, but I think the solution should not be tied to any one platform, and should attempt to make use of existing infrastructure.
    • Valid Questions

      My guess is they are not going to teach one
      "approved vendor," but the standards being
      developed by the advisory committee under Dr.
      Blumenthal, a subject we've covered here.

      Those standards are based on functions, not
      specific technologies, so many systems will be
      able to meet them.

      And this is what the extension services will
      teach -- what the standards are, what you need
      to ask vendors, and how to use what you get.

      Think of it as advanced, unbiased customer