(HIS)Hospital/Healthcare Info Systems

Tele-Tracking Technologies

Bar Coding & ID Tracking Systems

Zebra Technology Grp

Claims-Coding/Processing

Language and Computing

Document Management/Document Imaging

Perceptive Software Inc

Pfu Ltd/Fujitsu

Electronic Data Interchange(EDI)

New Wave Software

Hardware-Printers/
Copiers/Scanners

Dell Inc

Mobile Workstations

Artromick International Inc

Networks/Network Management

Qwest

Other Products & Services

T-System Inc

Point-of-Care/Mobile Systems

Carstens

CDW

Infologix

Lionville Systems

System Integration Services

Intersystems Corp

Wireless Technology

Verizon Wireless

• May 2007 FEATURE ARTICLES •

HMT
Industry Watch for May 2007

Health Plans, Managed Care

CMS BQI Project Expands
With the recent additions of California and Arizona, the total is now up to six regional healthcare collaboratives that have joined the Centers for Medicare and Medicaid Services’ (CMS) Better Quality Information (BQI) project. The California Cooperative Health Care Reporting Initiative and Arizona State University’s Center for Health Information and Research are the latest to combine claims data or clinical information with that of Medicare in an effort to provide consistent measures of quality for provider services. The Delmarva Foundation for Medical Care has entered into subcontracts with each region. As one of CMS’s quality improvement organizations, the Delmarva Foundation is a national nonprofit that implements quality improvement projects and CMS-related initiatives with healthcare providers, organizations and health plans in Delaware, Maryland and Virginia. The other four collaboratives in the BQI project include Indiana Health Information Exchange, Massachusetts Health Quality Partners, Minnesota Community Measurement and Wisconsin Collaborative for Healthcare Quality. All of the regional collaboratives are part of the Value Driven Health Care Initiative spearheaded by Secretary of Health and Human Services Mike Leavitt.

CMS Consolidates Medical Claims System
The Centers for Medicare and Medicaid Services (CMS) moves a step closer to consolidating data centers with the awarding of the third task order to Electronic Data Systems Inc. (EDS). The company will provide application hosting and production support at its data center for 180 million Medicare claims from twelve states at a cost of $92 million. The EDS indefinite-delivery, indefinite-quantity contract vehicle goal is to reduce the CMS data centers, which house computer and network equipment supporting agency program operations, from 20 to four. The EDS third task order contract will last for one year with five 1-year options for full fruition of the award. EDS also was awarded an earlier task order to provide Web hosting services to support all of CMS’s outward facing Websites, as well as the task order to provide processing of fee-for-service Medicare claims.

South Carolina-based Companion Data Services (CDS) also has been awarded a 6-year $200 million task order to provide electronic data processing and hosting services for about 650 million claims filed annually by hospitals and physicians in 30 states, the District of Columbia and Puerto Rico. CDS will be required to process about 54 percent of the 840 million Medicare claims filed annually by January 2008. CDS, EDS and IBM are the three companies competing for task orders under the 10-year, $1.9 billion EDC contracts. CMS will move software applications and hosting operations for Medicare, Medicaid and the states’ children’s health insurance program to the new data center over the next five years.

Massachusetts Introduces Mandatory Health Plans
The Massachusetts Commonwealth Health Insurance Connector Board recently approved 28 low-cost plans offered by seven insurers. The move is part of Massachusetts’ effort to extend healthcare insurance to every resident. Beginning July 1, uninsured residents will face growing penalties such as losing their personal state income tax deduction. The plans, known as Commonwealth Choice are intended to cover the state’s nearly 200,000 residents who earn too much for subsidized coverage. Previously, the state introduced free health coverage for low income residents and subsidized plans for those earning up to three times the federal poverty level, or about $29,000 a year for an individual.

Among the basic plan designs are the "Bronze" level, which provides lower monthly premiums but higher out-of-pocket expenses in the form of copayments, deductibles and coinsurance, and a "Gold" level with higher premiums but fewer out-of-pocket expenses. There are also low cost plans for young adults, with all of the plans providing comprehensive coverage options as determined by the Connector Board.

Critics worry about the plan’s affordability for the working and middle class. Many cite the coinsurance aspect, which they say requires a patient to pay a percentage of the total healthcare cost rather than a set copayment. State officials are considering exemptions. Insurers participating in the plan include Blue Cross and Blue Shield of Massachusetts and Harvard Pilgrim Care, who will offer statewide coverage, as well as ConnectiCare, Fallon Community Health Plan, Health New England, Neighborhood Health Plan and Tufts Health Plan who will provide regional coverage.

Physician Practices

Medical Information Wiki
AskDrWiki.com is the latest Wikipedia-style medical information site to go online. Started by four doctors from the Cleveland Clinic, the site primarily focuses on cardiology and electrophysiology clinical notes—the specialties of three of the four founding physicians. Ask Dr Wiki has more than 350 articles with 50 percent of the nearly 200 unique daily visitors coming from outside the United States. There are currently more than 20 wiki medical information sites that deal with a variety of approaches and specialties, some open source and some peer reviewed. Most require posters to register with verifiable credentials. Physicians are generally skeptical of the accuracy and therefore safe use of the information contained on many of the open source medical information sites. However, an equal number see them as having definitive benefits to physicians and the general public. Ask Dr Wiki recently went from an open source setup where virtually anyone could update the information, to a registration-based approach where the posters must verify their credentials before being allowed to post or change information.


Briefly

Grant for Physician Informatics Competency.
The Robert Wood Johnson Foundation has awarded a $300,000 grant to the American Medical Informatics Association (AMIA) with the goal of creating a system that measures physician competency as a subspecialty of applied informatics. Both organizations see greater numbers of physician informaticians as necessary to helping healthcare organizations make the most of their investments in information technology. AMIA President and CEO Don E. Detmer M.D., MA, FACMI, was quoted as saying that "The establishment of a mechanism to support applied clinical informatics as a formal discipline is essential for the future of medicine." The first step in the process will be the creation of a core content document and an essential training requirements document.

Mayo Clinic Studies Interference.
According to researchers from the Mayo Clinic College of Diseases in Rochester, Minnesota, normal use of cellular telephones in hospitals and other medical facilities should not cause harmful interference with medical devices. The research methods included the use of two cellular telephones of differing technology that use separate cellular carriers. Throughout various patient care areas, over 300 tests were performed involving a total of 192 medical devices. No occurrence of any kind of interference from the cell phones was recorded during five months of study. However, other Mayo Clinic studies showed that a potential risk for malfunction of implanted heart devices exists with anti-theft devices, or EAS (electronic article surveillance) systems used at the doorways of many stores.

Google Inc. To Help Offer Free EHRs.
Google Inc. has agreed to leverage its substantial Internet advertising network with Practice Fusion, a San Francisco-based startup that offers practice management and electronic medical records systems. The business model behind the agreement would use advertising driven by Google’s AdSense network to pay for the service. The network will generate ads through keywords and will be shown to users while their records systems are in use. Physicians who do not wish to use the free model can pay a fee to use the system without the advertising.

CCHIT Launching Inpatient EHR Certification.
A pilot test for inpatient electronic health records (EHR) certification has been announced by the Certification Commission for Healthcare Information Technology (CCHIT). Testing began in late April and continues through early May. The goal of the pilot test is to validate the inpatient certification criteria and test scripts in preparation of CCHIT’s launch of inpatient EHR certification in August. CCHIT is an independent, nonprofit organization that has been recognized by the U.S. Federal Government as an official certification body for electronic health record products.


Personal Health Records

AHIC Votes for PHR Certification
While the American Health Information Community (AHIC) voted unanimously in favor of a recommendation for certification of personal health records (PHRs), five AHIC Consumer Empowerment Workgroup members disagreed. Among the dissenters were David Lanskey of the Markle Foundation, Stephen Dowd of the Robert Wood Johnson Foundation, JP Little of RxHub, Steve Shihadeh of Microsoft and Myrl Weinberg of the National Health Council. All five signed a dissent letter to HHS Secretary Mike Leavitt. Dissenters collectively felt that it is too early for government involvement in PHRs, while advocates felt it would help push them through to realization. One concern about PHRs is that many are not regulated under privacy rules promulgated after passage of the Health Insurance Portability and Accountability Act of 1996.

David Lansky noted that his colleagues on the AHIC work group on confidentiality, privacy and security have spent time working on security function recommendations that impact identity authentication of a user of a healthcare IT system. According to Lansky, there is a difference between best practices, which are how users interact with a system, and functions that can be coded into a system’s software. Secretary Leavitt, who presided over the meeting, acknowledged that this would not be the last time the workgroup will disagree. The combined meeting and teleconference was open to the public via an HHS Webcast. The Consumer Empowerment Workgroup is one of seven such working committees under the umbrella of the American Health Information Community, a public-private advisory panel appointed by Leavitt in 2005.

Hospitals and IDNS

Solucient 100 Top Hospitals
The annual Solucient 100 Top Hospitals National Benchmarks for Success study reveals that more than half of the winning hospitals are in the Midwest with 30 of them based in Michigan and Ohio. The study looks at clinical outcomes, efficiency, patient safety, financial performance and growth in patient volume. Additionally, the study found that the 100 top hospital winners in the West and South had the lowest expenses in the nation. David Foster, Ph.D, chief scientist for Thompson Healthcare, of which Solucient is a part, attributes this to fewer patients in the West rely on Medicare than in the Northeast or Midwest region. Benchmark hospitals also treated more patients per bed and more patients who were sicker and requiring more complex treatment than hospitals that did not make the top 100. To view the study, go to www.100tophospitals.com.