Computer Software Update

• By Daniel J. Cho, Emily Morgan
• Apr 01, 2005

The government has always maintained a strong influence on the U.S. health care industry. The Health Insurance Portability and Accountability ACT (HIPAA), for instance, has been the principal affect for the last few years. While compliance of HIPAA's regulations has become a top priority for all providers, the government has introduced a new effort that will continue to reshape the medical community and further healthcare's use of electronic technology.

With the eHealth initiative's current bipartisan congressional support, the plan will likely move forward, presenting homecare companies with an opportunity to more effectively communicate with each other regarding their patients' care.

Last year, the Bush Administration announced a new eHealth initiative, which ensures that most Americans would have access to electronic health records (EHR) within 10 years. In April 2004, the new Office of the National Coordinator for Health Information Technology was created by executive order. Less than a month later, Dr. David Brailer was appointed as the National Coordinator, with the responsibility to oversee the implementation of the eHealth initiative.

What They Have in Mind
The details of the new eHealth initiative were released in a July 2004 report entitled The Decade of Health Information Technology: Delivering Consumer-centric and Information-rich Health Care. Commonly referred to as the "Framework for Strategic Action," the report defines four collaborative goals, supported by twelve strategies, towards establishing a national health information infrastructure.

The following is a breakdown of the four goals:

1. Bring EHRs into clinical practice. This means "providing complete and useful patient information and knowledge to clinicians when and where they need it, and in a manner linked to selection and ordering of tests and therapies for patients." This reaches far beyond a healthcare provider's office, as the primary focus is to bring EHR into practice across the healthcare continuum.

Various incentives have been identified, including regional grants and contracts, subsidized financing, amending self-referral and kickback statutes and direct payment for EHR systems. The report also acknowledges the financial risks involved in implementing an EHR, and recommends a low-cost support system reduce risk, failure or the partial use of EHRs.

2. Interconnect Clinicians. Once the EHRs have been implemented, they need to be interconnected; creating an infrastructure that allows patient care information to be portable from one point of care to another. This is a primary difference between the previous acronym, EMR -- short for electronic medical record -- and the currently preferred EHR.

This would require the development of a national health information network capable of ensuring the security of the data being transferred as well as communicating with federal health information systems. Pilot programs have already been launched in certain local markets to demonstrate the benefits of community wide connectivity.

3. Personalize care. We have all heard the term "Consumer-driven healthcare." This goal centers on improving how patients care for themselves and make health-care decisions. From delivering meaningful disease management information online to reimbursing for telemedicine visits, the government's eHealth plan can have a significant impact on the means by which patients manage their personal health care decisions.

4. Improve our medical knowledge and population health. The general objective is to encourage the collection, analysis and dissemination of timely and accurate information that impact public health. The government is in a unique position to improve population health via public/private partnerships and publicly funded research.

The practical uses of this idea include health surveillance systems to help warn about potential outbreaks, and tools that can accelerate scientific discoveries and their translation into clinically useful products, applications, and knowledge.

Government Actions
The specific actions initiated by the government provide a clearer explanation of the Framework's intent. These actions include establishing an HIT leadership panel, funding demonstrations of the exchange of community health information, requiring e-prescribing standards, establishing an Internet portal for Medicare beneficiaries, computerizing clinical research trials and promoting the use of standards.

Understanding the impact of these actions is vitally important to providers of healthcare services. Dr. Brailer's office has already launched many community-wide demonstration projects by funding Regional Health Information Organizations. The goal of these demonstrations is to provide seamless access to electronic patient health information across the continuum of care, from the hospital and physician office to the lab, pharmacy, payer, and yes, the homecare provider.

The government has fallen short of saying it will mandate use of a specific product or service from a specific vendor. However, it has stated that it plans to create standards by which products can be developed and delivered. This standardization should allow for more widespread adoption of EHR.

With the eHealth initiative's current bipartisan congressional support, the plan will likely move forward, presenting homecare companies with an opportunity to more effectively communicate with each other regarding their patients' care.

This article originally appeared in the April 2005 issue of HME Business.