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D.C. Report: Controversy Over Health IT Study, ACA Repeals Face Long Road

March 13, 2012
by Jeff Smith, Assistant Director of Advocacy at CHIME
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Computer-Using Docs Order More Tests, or Test-Ordering Docs Own Computers? A study released this week in the March edition of Health Affairs is causing a stir among health IT advocates.  According to research by Dr. Danny McCormick, assistant professor at the Harvard Medical School and a member of the department of medicine at the Cambridge Health Alliance, doctors with computerized access to a patient’s previous image results ordered more tests than those without the tracking technology – a lot more.  “Our research raises real concerns about whether health information technology is going to be the answer to reducing costs,” he said in an interview with the New York Times.  But that’s not really the point, contends National Coordinator for Health IT, Dr. Farzad Mostashari.  In the first of a series of retorts, Dr. Mostashari authored a blog Wednesday, saying, “The ultimate impact of EHRs on reducing cost will be through improvements in the coordination and quality of care, and the prevention of unnecessary and costly complications and hospitalizations.”  Dr. Mostashari outlines several other areas of concern with the report, including the fact that the study was not primarily concerned with EHR-based test ordering, the data was gathered in 2008 (before Meaningful Use) and that correlation does not mean causation.  He took up the issue during this week’s 33rd meeting of the Health IT Policy Committee again For more, see the NYT Bits Blog follow-up by Steve Lohr.

Unwinding ACA Programs May Not Be As Easy As Repeal Rhetoric Suggests, Sen. Suggests Long-time Republican opponents of the Affordable Care Act are now urgingcolleagues to take “a hard look at how they can mitigate some of the impacts of repealing the law.”  During his opening remarks to the Senate Appropriations Health subcommittee, Senator Richard Shelby (R-Ala.) said ACA funds had been used in such a way that could compromise long-standing, worthwhile programs if the law was repealed.  “The administration then diverts discretionary dollars to fund new programs,” he said.  “When the Affordable Care Act is repealed, many important programs like Community Health Centers and the [federal] Immunization program at the Centers for Disease Control will be in jeopardy because their base funding … has been so significantly reduced."

In her testimony to the Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies, Secretary Kathleen Sebelius highlighted the $5 million increase to ONC’s budget (bringing the Office’s total budget request up to $66 million in fiscal year 2013).  She said the increase would allow ONC to provide more assistance to health care providers as they become meaningful users of health IT.  “By encouraging providers to modernize their systems, this investment will improve the quality of care and protect patient safety,” she said.  Secretary Sebelius also pointed to work being done by the CMS Innovation Center, saying that pilots currently underway “can serve as crucial stepping stones towards a higher-quality, more efficient healthcare system.”

HHS CTO Becomes Nation’s CTO Late Friday afternoon, the Obama administration announced that HHS CTO Todd Park would be the replacement for Aneesh Chopra, who stepped down earlier this year as the nation’s first Chief Technology Officer.  In a blog postFriday, White House Office of Science and Technology Policy Director John Holdren said Park will have “the important task of applying the newest technology and latest advances to make the federal government work better for the American people.”  Mr. Park has been CTO at HHS since 2009, and prior to working at HHS, Park helped co-found Athenahealth.

CHIME Begins Look at Meaningful Use Stage 2 NPRM While some of the hysteria over Meaningful Use Stage 2 has calmed down, CHIME’s Policy Steering Committee is gearing up (and staffing up) to form our policy positions and public comments.  As the result of hard work and planning, the PSC is moving forward with three working groups to help flag and recommend changes to the recent Stage 2 NPRM.  Those workgroups include (1) Objectives and Measures (2) Clinical Quality Measures and (3) Standards & Certification Criteria.  Over a dozen members from the Advocacy Leadership Team will soon be working with members of the PSC, so look for more information to come soon.

In addition to reading Advocacy Corner on a weekly basis, CHIME CIOs can attend next Thursday’s Advocacy Community Meeting at 11am ET to hear from CMS Policy Analyst and Meaningful Use guru, Travis Broome, drill down on Stage 2.  Be on the lookout for a registration link to this important and unique event.