Joyce Frieden

The White House is trying to get health care workers ready to help physicians in computerizing their medical records.

Nearly $1 billion in American Reinvestment and Recovery Act awards will be made to help health care providers become “meaningful users” of health information technology and to train other allied health professionals for careers in health IT. Jobs created will include nurses, pharmacy technicians, and IT technicians and trainers, according to Health and Human Services Secretary Kathleen Sebelius and Labor Secretary Hilda Solis.

“These investments will serve to train almost 50,000 workers in Department of Labor programs plus thousands more hired for HHS regional extension centers in the months ahead,” Jared Bernstein, chief economist to Vice President Joseph Biden, said in a teleconference. “By providing seed capital, we are helping to seed an emerging industry that will create new jobs well after the Recovery Act has ended.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of the 2009 federal stimulus law, physicians who treat Medicare patients can receive up to $44,000 over 5 years for the meaningful use of a certified health information system. Those whose patient populations are made up of at least 30% Medicaid patients can earn up to $64,000 in incentive payments for their use of the technology.

The proposed regulations include a definition of meaningful use and outline other criteria for obtaining the full incentive payments.

The awards include over $750 million in HHS grants. Of that, $386 million will go to 40 states to help develop state-level health information exchanges (HIE), and another $375 million will be awarded to 32 nonprofit organizations to support the development of regional extension centers (REC), which will aid providers in using health IT. Additional HIE and REC awards will be announced soon.

The grants will make it easier for physicians who are just getting started with electronic health records, Ms. Sebelius said in an interview. “The people who will be trained by the grants … will actually provide the kind of hands-on technical support we think providers need to make this transition. It's not just that the Act gives physicians financial incentives to buy a computer and plug it in; we understand the steps along the way of reorganizing workflow and retraining staff that are going to require hands-on support. So the money going out is to establish an on-the-ground program for that kind of personal technical assistance and help.”

Ms. Sebelius noted that the grants are particularly targeted toward smaller providers “who haven't waded into the area before. This is an incredibly important part of making this transition.”

In December, the HHS issued a proposed regulation defining “meaningful use” and explaining how providers can meet the criteria. In response to a question about physician concerns that the regulation is too complex, Dr. David Blumenthal, national coordinator for health information technology, noted that the regulations are still only a proposal.

“We are very anxious to hear what the physician community has to say about it and the ways in which they feel it needs to be changed,” he said in an interview. “As an internist, I had to go through the process of learning how to use an electronic health record, and I know it's not easy, but we're going to be providing support nationwide.”

For more information, see www.hhs.gov/news/press/2010pres/02/20100212a.htmledocket.access.gpo.gov/2010/pdf/E9-31217.pdf

The White House is trying to get health care workers ready to help physicians in computerizing their medical records.

Nearly $1 billion in American Reinvestment and Recovery Act awards will be made to help health care providers become “meaningful users” of health information technology and to train other allied health professionals for careers in health IT. Jobs created will include nurses, pharmacy technicians, and IT technicians and trainers, according to Health and Human Services Secretary Kathleen Sebelius and Labor Secretary Hilda Solis.

“These investments will serve to train almost 50,000 workers in Department of Labor programs plus thousands more hired for HHS regional extension centers in the months ahead,” Jared Bernstein, chief economist to Vice President Joseph Biden, said in a teleconference. “By providing seed capital, we are helping to seed an emerging industry that will create new jobs well after the Recovery Act has ended.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of the 2009 federal stimulus law, physicians who treat Medicare patients can receive up to $44,000 over 5 years for the meaningful use of a certified health information system. Those whose patient populations are made up of at least 30% Medicaid patients can earn up to $64,000 in incentive payments for their use of the technology.

The proposed regulations include a definition of meaningful use and outline other criteria for obtaining the full incentive payments.

The awards include over $750 million in HHS grants. Of that, $386 million will go to 40 states to help develop state-level health information exchanges (HIE), and another $375 million will be awarded to 32 nonprofit organizations to support the development of regional extension centers (REC), which will aid providers in using health IT. Additional HIE and REC awards will be announced soon.

The grants will make it easier for physicians who are just getting started with electronic health records, Ms. Sebelius said in an interview. “The people who will be trained by the grants … will actually provide the kind of hands-on technical support we think providers need to make this transition. It's not just that the Act gives physicians financial incentives to buy a computer and plug it in; we understand the steps along the way of reorganizing workflow and retraining staff that are going to require hands-on support. So the money going out is to establish an on-the-ground program for that kind of personal technical assistance and help.”

Ms. Sebelius noted that the grants are particularly targeted toward smaller providers “who haven't waded into the area before. This is an incredibly important part of making this transition.”

In December, the HHS issued a proposed regulation defining “meaningful use” and explaining how providers can meet the criteria. In response to a question about physician concerns that the regulation is too complex, Dr. David Blumenthal, national coordinator for health information technology, noted that the regulations are still only a proposal.

“We are very anxious to hear what the physician community has to say about it and the ways in which they feel it needs to be changed,” he said in an interview. “As an internist, I had to go through the process of learning how to use an electronic health record, and I know it's not easy, but we're going to be providing support nationwide.”

For more information, see www.hhs.gov/news/press/2010pres/02/20100212a.htmledocket.access.gpo.gov/2010/pdf/E9-31217.pdf

The White House is trying to get health care workers ready to help physicians in computerizing their medical records.

Nearly $1 billion in American Reinvestment and Recovery Act awards will be made to help health care providers become “meaningful users” of health information technology and to train other allied health professionals for careers in health IT. Jobs created will include nurses, pharmacy technicians, and IT technicians and trainers, according to Health and Human Services Secretary Kathleen Sebelius and Labor Secretary Hilda Solis.

“These investments will serve to train almost 50,000 workers in Department of Labor programs plus thousands more hired for HHS regional extension centers in the months ahead,” Jared Bernstein, chief economist to Vice President Joseph Biden, said in a teleconference. “By providing seed capital, we are helping to seed an emerging industry that will create new jobs well after the Recovery Act has ended.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of the 2009 federal stimulus law, physicians who treat Medicare patients can receive up to $44,000 over 5 years for the meaningful use of a certified health information system. Those whose patient populations are made up of at least 30% Medicaid patients can earn up to $64,000 in incentive payments for their use of the technology.

The proposed regulations include a definition of meaningful use and outline other criteria for obtaining the full incentive payments.

The awards include over $750 million in HHS grants. Of that, $386 million will go to 40 states to help develop state-level health information exchanges (HIE), and another $375 million will be awarded to 32 nonprofit organizations to support the development of regional extension centers (REC), which will aid providers in using health IT. Additional HIE and REC awards will be announced soon.

The grants will make it easier for physicians who are just getting started with electronic health records, Ms. Sebelius said in an interview. “The people who will be trained by the grants … will actually provide the kind of hands-on technical support we think providers need to make this transition. It's not just that the Act gives physicians financial incentives to buy a computer and plug it in; we understand the steps along the way of reorganizing workflow and retraining staff that are going to require hands-on support. So the money going out is to establish an on-the-ground program for that kind of personal technical assistance and help.”

Ms. Sebelius noted that the grants are particularly targeted toward smaller providers “who haven't waded into the area before. This is an incredibly important part of making this transition.”

In December, the HHS issued a proposed regulation defining “meaningful use” and explaining how providers can meet the criteria. In response to a question about physician concerns that the regulation is too complex, Dr. David Blumenthal, national coordinator for health information technology, noted that the regulations are still only a proposal.

“We are very anxious to hear what the physician community has to say about it and the ways in which they feel it needs to be changed,” he said in an interview. “As an internist, I had to go through the process of learning how to use an electronic health record, and I know it's not easy, but we're going to be providing support nationwide.”

For more information, see www.hhs.gov/news/press/2010pres/02/20100212a.htmledocket.access.gpo.gov/2010/pdf/E9-31217.pdf

WASHINGTON — Although government health officials are hoping that most physicians will get on the “meaningful use” bandwagon, that's not likely to happen easily, according to Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society.

“I don't think [health care] professionals have any idea what's coming,” Dr. Lichtenfeld said during a panel discussion at an eHealth Initiative conference. “I think [federal officials] are risking failure because doctors will say, 'Are you kidding? I don't want to have anything to do with this.' I hope that isn't what happens, but I tell you, be prepared.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of last year's federal stimulus law, physicians who treat Medicare patients can be awarded up to $64,000 over 5 years for the meaningful use of a certified health information system.

But physicians who already have computers may find that they won't meet the requirements for the incentive, Dr. Lichtenfeld said. “Doctors have invested in these systems and now they're worthless. They don't have the time, they don't have the money, they don't have the expertise. And to have to get [a new system] up and running in 2-3 years—they won't do it. Something simpler would've gotten us to where we have to go.”

Despite a few patient-driven efforts (see box), no one has figured out how to use information technology as a way to get patients more involved in their care, Dr. Lichtenfeld contended. “A couple of years ago, personal health records … were the talk of the town. They were going to get everybody on board. Patients were going to run to various Web sites and fill out their health information. Health plans were going to get together and figure out how to bring their data so it would be downloadable and easily accessible.”

But none of that has yet come to pass, he said. “Personal health records landed with a thud. We need to figure out that sometimes we have to keep it simple.” For example, the cancer community should come up with a simple document to give to patients listing their diagnosis, their expected length of hospital stay, what kind of treatment they're getting, and what medications they need to take. “This is a good example of where we are not today.”

In the meantime, the Department of Health and Human Services is trying to get physicians to meet some meaningful use criteria that aren't even written yet, said Dr. Steven Stack, an emergency physician and member of two workgroups of the department's HIT Policy Committee. He noted that two criteria “were supposed to be finished on Dec. 31, 2008, by statute. It's 2010 and they're not done, and it may be a year before we get something.”

Instead of requiring physicians to meet lots of criteria, “if we focus on the smallest of things, then doggedly persist until we knock down those barriers, and then require people to meet those [expectations]—with the proper incentives, we can make a really great step forward,” said Dr. Stack, who is a member of the American Medical Association board of trustees.

Disclosures: The conference was sponsored by Ingenix, the AMA, and several other industry groups. The speakers reported that they had no relevant conflicts of interest.

Disease Web Sites Collect Patient Data

Patients can play a role in providing useful health information, Dr. Stack emphasized. As an example, he cited

www.patientslikeme.com

Visitors to the site can sign up for a free account and a screen name to use when posting comments and health statistics. “People voluntarily post their own health data. Some are very open about it—they post every pill they're on, the dose, the frequency, what's happening to them,” Dr. Stack said. In the ALS community, members developed “a patient population and a data set that was so robust that if [community members] put in enough of their own variables, [the site] could predict when you'd be in a wheelchair within a week and when you'd be on a ventilator within a week. It was that precise. We could never replicate that in a prospective, double-blind, randomized, controlled trial.”

But for patients such as these, “the motivation of your own health and the fear of death through your own illness is a motivator we can't replicate with money or incentives,” he said.

WASHINGTON — Although government health officials are hoping that most physicians will get on the “meaningful use” bandwagon, that's not likely to happen easily, according to Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society.

“I don't think [health care] professionals have any idea what's coming,” Dr. Lichtenfeld said during a panel discussion at an eHealth Initiative conference. “I think [federal officials] are risking failure because doctors will say, 'Are you kidding? I don't want to have anything to do with this.' I hope that isn't what happens, but I tell you, be prepared.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of last year's federal stimulus law, physicians who treat Medicare patients can be awarded up to $64,000 over 5 years for the meaningful use of a certified health information system.

But physicians who already have computers may find that they won't meet the requirements for the incentive, Dr. Lichtenfeld said. “Doctors have invested in these systems and now they're worthless. They don't have the time, they don't have the money, they don't have the expertise. And to have to get [a new system] up and running in 2-3 years—they won't do it. Something simpler would've gotten us to where we have to go.”

Despite a few patient-driven efforts (see box), no one has figured out how to use information technology as a way to get patients more involved in their care, Dr. Lichtenfeld contended. “A couple of years ago, personal health records … were the talk of the town. They were going to get everybody on board. Patients were going to run to various Web sites and fill out their health information. Health plans were going to get together and figure out how to bring their data so it would be downloadable and easily accessible.”

But none of that has yet come to pass, he said. “Personal health records landed with a thud. We need to figure out that sometimes we have to keep it simple.” For example, the cancer community should come up with a simple document to give to patients listing their diagnosis, their expected length of hospital stay, what kind of treatment they're getting, and what medications they need to take. “This is a good example of where we are not today.”

In the meantime, the Department of Health and Human Services is trying to get physicians to meet some meaningful use criteria that aren't even written yet, said Dr. Steven Stack, an emergency physician and member of two workgroups of the department's HIT Policy Committee. He noted that two criteria “were supposed to be finished on Dec. 31, 2008, by statute. It's 2010 and they're not done, and it may be a year before we get something.”

Instead of requiring physicians to meet lots of criteria, “if we focus on the smallest of things, then doggedly persist until we knock down those barriers, and then require people to meet those [expectations]—with the proper incentives, we can make a really great step forward,” said Dr. Stack, who is a member of the American Medical Association board of trustees.

Disclosures: The conference was sponsored by Ingenix, the AMA, and several other industry groups. The speakers reported that they had no relevant conflicts of interest.

Disease Web Sites Collect Patient Data

Patients can play a role in providing useful health information, Dr. Stack emphasized. As an example, he cited

www.patientslikeme.com

Visitors to the site can sign up for a free account and a screen name to use when posting comments and health statistics. “People voluntarily post their own health data. Some are very open about it—they post every pill they're on, the dose, the frequency, what's happening to them,” Dr. Stack said. In the ALS community, members developed “a patient population and a data set that was so robust that if [community members] put in enough of their own variables, [the site] could predict when you'd be in a wheelchair within a week and when you'd be on a ventilator within a week. It was that precise. We could never replicate that in a prospective, double-blind, randomized, controlled trial.”

But for patients such as these, “the motivation of your own health and the fear of death through your own illness is a motivator we can't replicate with money or incentives,” he said.

WASHINGTON — Although government health officials are hoping that most physicians will get on the “meaningful use” bandwagon, that's not likely to happen easily, according to Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society.

“I don't think [health care] professionals have any idea what's coming,” Dr. Lichtenfeld said during a panel discussion at an eHealth Initiative conference. “I think [federal officials] are risking failure because doctors will say, 'Are you kidding? I don't want to have anything to do with this.' I hope that isn't what happens, but I tell you, be prepared.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of last year's federal stimulus law, physicians who treat Medicare patients can be awarded up to $64,000 over 5 years for the meaningful use of a certified health information system.

But physicians who already have computers may find that they won't meet the requirements for the incentive, Dr. Lichtenfeld said. “Doctors have invested in these systems and now they're worthless. They don't have the time, they don't have the money, they don't have the expertise. And to have to get [a new system] up and running in 2-3 years—they won't do it. Something simpler would've gotten us to where we have to go.”

Despite a few patient-driven efforts (see box), no one has figured out how to use information technology as a way to get patients more involved in their care, Dr. Lichtenfeld contended. “A couple of years ago, personal health records … were the talk of the town. They were going to get everybody on board. Patients were going to run to various Web sites and fill out their health information. Health plans were going to get together and figure out how to bring their data so it would be downloadable and easily accessible.”

But none of that has yet come to pass, he said. “Personal health records landed with a thud. We need to figure out that sometimes we have to keep it simple.” For example, the cancer community should come up with a simple document to give to patients listing their diagnosis, their expected length of hospital stay, what kind of treatment they're getting, and what medications they need to take. “This is a good example of where we are not today.”

In the meantime, the Department of Health and Human Services is trying to get physicians to meet some meaningful use criteria that aren't even written yet, said Dr. Steven Stack, an emergency physician and member of two workgroups of the department's HIT Policy Committee. He noted that two criteria “were supposed to be finished on Dec. 31, 2008, by statute. It's 2010 and they're not done, and it may be a year before we get something.”

Instead of requiring physicians to meet lots of criteria, “if we focus on the smallest of things, then doggedly persist until we knock down those barriers, and then require people to meet those [expectations]—with the proper incentives, we can make a really great step forward,” said Dr. Stack, who is a member of the American Medical Association board of trustees.

Disclosures: The conference was sponsored by Ingenix, the AMA, and several other industry groups. The speakers reported that they had no relevant conflicts of interest.

Disease Web Sites Collect Patient Data

Patients can play a role in providing useful health information, Dr. Stack emphasized. As an example, he cited

www.patientslikeme.com

Visitors to the site can sign up for a free account and a screen name to use when posting comments and health statistics. “People voluntarily post their own health data. Some are very open about it—they post every pill they're on, the dose, the frequency, what's happening to them,” Dr. Stack said. In the ALS community, members developed “a patient population and a data set that was so robust that if [community members] put in enough of their own variables, [the site] could predict when you'd be in a wheelchair within a week and when you'd be on a ventilator within a week. It was that precise. We could never replicate that in a prospective, double-blind, randomized, controlled trial.”

But for patients such as these, “the motivation of your own health and the fear of death through your own illness is a motivator we can't replicate with money or incentives,” he said.

NHLBI Urged to Spill Coca-Cola

The Center for Science in the Public Interest is urging the National Heart, Lung, and Blood Institute to reverse its partnership with Coca-Cola in an effort to raise awareness of heart disease among women. In a letter to the institute, the nonprofit organization noted that Coca-Cola is the biggest manufacturer of “obesogenic” soft drinks. That means the sponsorship “is as inappropriate as it would be to allow Philip Morris to sponsor NHLBI's antismoking efforts,” the CSPI said in a letter to the institute. In a statement, CSPI Executive Director Michael F. Jacobson noted that although Diet Coke is the ostensible sponsor of the awareness campaign, “it is the entire Coca-Cola product line that is basking in the credibility conferred by a government heart-health agency … when in fact Coca-Cola promotes heart disease by marketing drinks that contribute to obesity. Coke has long sought to affiliate with or co-opt health groups, and associate its brand with athletes and models. I fervently hope that NHLBI officials understand that letting Coke bask in their agency's good reputation does American hearts far more harm than good.”

Access to Specialists a Problem

The Agency for Healthcare Research and Quality reports that 1 in 13 American adults who needed to see a specialist in 2007 said that getting access was a “big problem.” The data come from the Medical Expenditure Panel Survey. The agency said that respondents were not asked why they had access problems. But the survey report added that access problems can be due to lack of health insurance, specialists' nonparticipation in a patient's health plan, and long waits for appointments. The survey found that 16% of adults without primary care physicians had problems accessing specialists, compared with 6% of those who had a usual source of primary care. Nonelderly uninsured adults had the most difficulty getting in to see a specialist, followed by nonelderly adults with public health coverage and those with private insurance. More data are available in the agency's report, “Variations in Perceived Need and Access to Specialty Care Among Adults in the U.S. Civilian Noninstitutionalized Population, 2007,” available at

www.meps.ahrq.gov/mepsweb/data_files/publications/st274/stat274.pdf

PhRMA Chief Resigning

Billy Tauzin, president and chief executive officer of Pharmaceutical Research and Manufacturers of America, announced in February that he will leave the trade association at the end of June. Mr. Tauzin noted in a statement that he took on the PhRMA role in 2005 shortly after a battle with cancer. “As the first-ever cancer patient to lead PhRMA as its CEO, I now believe it is time I move on and hand the mantle of leadership of this great organization to others as passionate as myself, and to explore the many other interests I would like to pursue in this special second-chance life that I have been given,” Mr. Tauzin said. He also denied speculation that he was pushed out by PhRMA member companies unhappy with the deal that he made last year to support the Obama administration's health reform plan.

A Vote for Information Exchanges

Several state and regional health information exchanges are having positive effects on care, according to a report by the Government Accountability Office. The GAO studied 4 out of 60 health information exchanges currently operating and found that 2 of them link hospitals to their states' public health departments in ways that prompt early detection of disease outbreaks. For instance, one state used the link to obtain information about H1N1 influenza cases more quickly than other states were able to do. In another example of an exchange's usefulness, a hospital reported that an emergency department physician was able to discover that a patient requesting pain medication had done the same in five area hospitals over the preceding seven nights.

HHS Extends Medicaid Relief

The Department of Health and Human Services is giving states a $4.3-billion break on prescription drugs for people who qualify for both Medicare and Medicaid. That's how much less the federal government will charge states through this year for Medicare coverage of drugs for the “dual eligibles.” “We believe [this] action will help states as they struggle to maintain Medicaid and other budget priorities in these difficult economic times,” HHS Secretary Kathleen Sebelius said in a statement. The relief comes from last year's American Recovery and Reinvestment Act, which granted a temporary increase in the amount states receive from the federal government for Medicaid. The new action applies the funding adjustment for the period Oct. 1, 2008, through Dec. 31, 2010. California's estimated savings are the largest in the country, at $675 million, while Wyoming will probably receive the least, at about $4 million. In his proposed budget for 2011, President Obama called for again extending the funding break, through June 30, 2011.

MedPAC Calls for Pay Increases

Most Medicare beneficiaries are able to get timely appointments when they need them, according to an annual survey conducted by the Medicare Payment Advisory Commission. In fact, Medicare beneficiaries report better physician access than the privately insured population, according to the findings, which were based on a poll of 4,000 Medicare beneficiaries and 4,000 privately insured individuals aged 50–64 years. Of note, both groups reported that finding a new primary care physician was more difficult than finding a new specialist. In related news, MedPAC voted last month to request that Congress approve a 1% increase in the Medicare physician payment rate for 2011. In addition, the commission pushed for a budget-neutral payment increase specifically for primary care services.

NHLBI Urged to Spill Coca-Cola

The Center for Science in the Public Interest is urging the National Heart, Lung, and Blood Institute to reverse its partnership with Coca-Cola in an effort to raise awareness of heart disease among women. In a letter to the institute, the nonprofit organization noted that Coca-Cola is the biggest manufacturer of “obesogenic” soft drinks. That means the sponsorship “is as inappropriate as it would be to allow Philip Morris to sponsor NHLBI's antismoking efforts,” the CSPI said in a letter to the institute. In a statement, CSPI Executive Director Michael F. Jacobson noted that although Diet Coke is the ostensible sponsor of the awareness campaign, “it is the entire Coca-Cola product line that is basking in the credibility conferred by a government heart-health agency … when in fact Coca-Cola promotes heart disease by marketing drinks that contribute to obesity. Coke has long sought to affiliate with or co-opt health groups, and associate its brand with athletes and models. I fervently hope that NHLBI officials understand that letting Coke bask in their agency's good reputation does American hearts far more harm than good.”

Access to Specialists a Problem

The Agency for Healthcare Research and Quality reports that 1 in 13 American adults who needed to see a specialist in 2007 said that getting access was a “big problem.” The data come from the Medical Expenditure Panel Survey. The agency said that respondents were not asked why they had access problems. But the survey report added that access problems can be due to lack of health insurance, specialists' nonparticipation in a patient's health plan, and long waits for appointments. The survey found that 16% of adults without primary care physicians had problems accessing specialists, compared with 6% of those who had a usual source of primary care. Nonelderly uninsured adults had the most difficulty getting in to see a specialist, followed by nonelderly adults with public health coverage and those with private insurance. More data are available in the agency's report, “Variations in Perceived Need and Access to Specialty Care Among Adults in the U.S. Civilian Noninstitutionalized Population, 2007,” available at

www.meps.ahrq.gov/mepsweb/data_files/publications/st274/stat274.pdf

PhRMA Chief Resigning

Billy Tauzin, president and chief executive officer of Pharmaceutical Research and Manufacturers of America, announced in February that he will leave the trade association at the end of June. Mr. Tauzin noted in a statement that he took on the PhRMA role in 2005 shortly after a battle with cancer. “As the first-ever cancer patient to lead PhRMA as its CEO, I now believe it is time I move on and hand the mantle of leadership of this great organization to others as passionate as myself, and to explore the many other interests I would like to pursue in this special second-chance life that I have been given,” Mr. Tauzin said. He also denied speculation that he was pushed out by PhRMA member companies unhappy with the deal that he made last year to support the Obama administration's health reform plan.

A Vote for Information Exchanges

Several state and regional health information exchanges are having positive effects on care, according to a report by the Government Accountability Office. The GAO studied 4 out of 60 health information exchanges currently operating and found that 2 of them link hospitals to their states' public health departments in ways that prompt early detection of disease outbreaks. For instance, one state used the link to obtain information about H1N1 influenza cases more quickly than other states were able to do. In another example of an exchange's usefulness, a hospital reported that an emergency department physician was able to discover that a patient requesting pain medication had done the same in five area hospitals over the preceding seven nights.

HHS Extends Medicaid Relief

The Department of Health and Human Services is giving states a $4.3-billion break on prescription drugs for people who qualify for both Medicare and Medicaid. That's how much less the federal government will charge states through this year for Medicare coverage of drugs for the “dual eligibles.” “We believe [this] action will help states as they struggle to maintain Medicaid and other budget priorities in these difficult economic times,” HHS Secretary Kathleen Sebelius said in a statement. The relief comes from last year's American Recovery and Reinvestment Act, which granted a temporary increase in the amount states receive from the federal government for Medicaid. The new action applies the funding adjustment for the period Oct. 1, 2008, through Dec. 31, 2010. California's estimated savings are the largest in the country, at $675 million, while Wyoming will probably receive the least, at about $4 million. In his proposed budget for 2011, President Obama called for again extending the funding break, through June 30, 2011.

MedPAC Calls for Pay Increases

Most Medicare beneficiaries are able to get timely appointments when they need them, according to an annual survey conducted by the Medicare Payment Advisory Commission. In fact, Medicare beneficiaries report better physician access than the privately insured population, according to the findings, which were based on a poll of 4,000 Medicare beneficiaries and 4,000 privately insured individuals aged 50–64 years. Of note, both groups reported that finding a new primary care physician was more difficult than finding a new specialist. In related news, MedPAC voted last month to request that Congress approve a 1% increase in the Medicare physician payment rate for 2011. In addition, the commission pushed for a budget-neutral payment increase specifically for primary care services.

NHLBI Urged to Spill Coca-Cola

The Center for Science in the Public Interest is urging the National Heart, Lung, and Blood Institute to reverse its partnership with Coca-Cola in an effort to raise awareness of heart disease among women. In a letter to the institute, the nonprofit organization noted that Coca-Cola is the biggest manufacturer of “obesogenic” soft drinks. That means the sponsorship “is as inappropriate as it would be to allow Philip Morris to sponsor NHLBI's antismoking efforts,” the CSPI said in a letter to the institute. In a statement, CSPI Executive Director Michael F. Jacobson noted that although Diet Coke is the ostensible sponsor of the awareness campaign, “it is the entire Coca-Cola product line that is basking in the credibility conferred by a government heart-health agency … when in fact Coca-Cola promotes heart disease by marketing drinks that contribute to obesity. Coke has long sought to affiliate with or co-opt health groups, and associate its brand with athletes and models. I fervently hope that NHLBI officials understand that letting Coke bask in their agency's good reputation does American hearts far more harm than good.”

Access to Specialists a Problem

The Agency for Healthcare Research and Quality reports that 1 in 13 American adults who needed to see a specialist in 2007 said that getting access was a “big problem.” The data come from the Medical Expenditure Panel Survey. The agency said that respondents were not asked why they had access problems. But the survey report added that access problems can be due to lack of health insurance, specialists' nonparticipation in a patient's health plan, and long waits for appointments. The survey found that 16% of adults without primary care physicians had problems accessing specialists, compared with 6% of those who had a usual source of primary care. Nonelderly uninsured adults had the most difficulty getting in to see a specialist, followed by nonelderly adults with public health coverage and those with private insurance. More data are available in the agency's report, “Variations in Perceived Need and Access to Specialty Care Among Adults in the U.S. Civilian Noninstitutionalized Population, 2007,” available at

www.meps.ahrq.gov/mepsweb/data_files/publications/st274/stat274.pdf

PhRMA Chief Resigning

Billy Tauzin, president and chief executive officer of Pharmaceutical Research and Manufacturers of America, announced in February that he will leave the trade association at the end of June. Mr. Tauzin noted in a statement that he took on the PhRMA role in 2005 shortly after a battle with cancer. “As the first-ever cancer patient to lead PhRMA as its CEO, I now believe it is time I move on and hand the mantle of leadership of this great organization to others as passionate as myself, and to explore the many other interests I would like to pursue in this special second-chance life that I have been given,” Mr. Tauzin said. He also denied speculation that he was pushed out by PhRMA member companies unhappy with the deal that he made last year to support the Obama administration's health reform plan.

A Vote for Information Exchanges

Several state and regional health information exchanges are having positive effects on care, according to a report by the Government Accountability Office. The GAO studied 4 out of 60 health information exchanges currently operating and found that 2 of them link hospitals to their states' public health departments in ways that prompt early detection of disease outbreaks. For instance, one state used the link to obtain information about H1N1 influenza cases more quickly than other states were able to do. In another example of an exchange's usefulness, a hospital reported that an emergency department physician was able to discover that a patient requesting pain medication had done the same in five area hospitals over the preceding seven nights.

HHS Extends Medicaid Relief

The Department of Health and Human Services is giving states a $4.3-billion break on prescription drugs for people who qualify for both Medicare and Medicaid. That's how much less the federal government will charge states through this year for Medicare coverage of drugs for the “dual eligibles.” “We believe [this] action will help states as they struggle to maintain Medicaid and other budget priorities in these difficult economic times,” HHS Secretary Kathleen Sebelius said in a statement. The relief comes from last year's American Recovery and Reinvestment Act, which granted a temporary increase in the amount states receive from the federal government for Medicaid. The new action applies the funding adjustment for the period Oct. 1, 2008, through Dec. 31, 2010. California's estimated savings are the largest in the country, at $675 million, while Wyoming will probably receive the least, at about $4 million. In his proposed budget for 2011, President Obama called for again extending the funding break, through June 30, 2011.

MedPAC Calls for Pay Increases

Most Medicare beneficiaries are able to get timely appointments when they need them, according to an annual survey conducted by the Medicare Payment Advisory Commission. In fact, Medicare beneficiaries report better physician access than the privately insured population, according to the findings, which were based on a poll of 4,000 Medicare beneficiaries and 4,000 privately insured individuals aged 50–64 years. Of note, both groups reported that finding a new primary care physician was more difficult than finding a new specialist. In related news, MedPAC voted last month to request that Congress approve a 1% increase in the Medicare physician payment rate for 2011. In addition, the commission pushed for a budget-neutral payment increase specifically for primary care services.

The White House is trying to get health care workers ready to help physicians in computerizing their medical records.

Nearly $1 billion in American Reinvestment and Recovery Act awards will be made to help health care providers become “meaningful users” of health information technology and to train nurses and other allied health professionals for careers in health information technology. Jobs created will include nurses, pharmacy technicians, and IT technicians and trainers, according to Health and Human Services Secretary Kathleen Sebelius and Labor Secretary Hilda Solis.

“These investments will serve to train almost 50,000 workers in Department of Labor programs plus thousands more hired for HHS regional extension centers in the months ahead,” Jared Bernstein, chief economist to Vice President Joe Biden, said in a teleconference. “By providing seed capital, we are helping to seed an emerging industry that will create new jobs well after the Recovery Act has ended.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of the 2009 federal stimulus law, physicians who treat Medicare patients can receive up to $44,000 over 5 years for the meaningful use of a certified health information system. Those whose populations are made up of at least 30% Medicaid patients can earn up to $64,000 in incentive payments for their use of the technology.

The proposed regulations include a definition of meaningful use and outline other criteria for obtaining the full incentive payments.

The awards announced last month include more than $750 million in HHS grants. Of that, $386 million will go to 40 states and their designated entities to help develop state-level health information exchanges (HIE), and another $375 million will be awarded to 32 nonprofit organizations to support the development of regional extension centers (REC), which will aid providers in using health information technology. Additional HIE and REC awards will be announced soon, according to a statement.

The grants will make it easier for physicians who are just getting started with electronic health records, Ms. Sebelius told this publication. “The people who will be trained by the grants … will actually provide the kind of hands-on technical support we think providers need to make this transition. It's not just that the act gives physicians financial incentives to buy a computer and plug it in; we understand the steps along the way of reorganizing workflow and retraining staff that are going to require hands-on support. So the money going out is to establish an on-the-ground program for that kind of personal technical assistance and help.”

Ms. Sebelius noted that the grants are particularly targeted toward smaller providers “who haven't waded into the area before. This is an incredibly important part of making this transition.”

In December, HHS issued a proposed regulation defining “meaningful use” and explaining how providers can meet criteria for being meaningful users. In response to a question about physician concerns that the regulation is too complex, Dr. David Blumenthal, national coordinator for health information technology, noted that the regulations are only a proposal at this point.

“We are very anxious to hear what the physician community has to say about it and the ways in which they feel it needs to be changed,” he told this publication. “I can certainly identify [with physicians], because as an internist, I had to go through the process of learning how to use an electronic health record, and I know it's not easy, but we're going to be providing support nationwide—the kind of support doctors have never had before.”

For more information, see www.hhs.gov/news/press/2010pres/02/20100212a.htmledocket.access.gpo.gov/2010/pdf/E9-31217.pdf

The White House is trying to get health care workers ready to help physicians in computerizing their medical records.

Nearly $1 billion in American Reinvestment and Recovery Act awards will be made to help health care providers become “meaningful users” of health information technology and to train nurses and other allied health professionals for careers in health information technology. Jobs created will include nurses, pharmacy technicians, and IT technicians and trainers, according to Health and Human Services Secretary Kathleen Sebelius and Labor Secretary Hilda Solis.

“These investments will serve to train almost 50,000 workers in Department of Labor programs plus thousands more hired for HHS regional extension centers in the months ahead,” Jared Bernstein, chief economist to Vice President Joe Biden, said in a teleconference. “By providing seed capital, we are helping to seed an emerging industry that will create new jobs well after the Recovery Act has ended.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of the 2009 federal stimulus law, physicians who treat Medicare patients can receive up to $44,000 over 5 years for the meaningful use of a certified health information system. Those whose populations are made up of at least 30% Medicaid patients can earn up to $64,000 in incentive payments for their use of the technology.

The proposed regulations include a definition of meaningful use and outline other criteria for obtaining the full incentive payments.

The awards announced last month include more than $750 million in HHS grants. Of that, $386 million will go to 40 states and their designated entities to help develop state-level health information exchanges (HIE), and another $375 million will be awarded to 32 nonprofit organizations to support the development of regional extension centers (REC), which will aid providers in using health information technology. Additional HIE and REC awards will be announced soon, according to a statement.

The grants will make it easier for physicians who are just getting started with electronic health records, Ms. Sebelius told this publication. “The people who will be trained by the grants … will actually provide the kind of hands-on technical support we think providers need to make this transition. It's not just that the act gives physicians financial incentives to buy a computer and plug it in; we understand the steps along the way of reorganizing workflow and retraining staff that are going to require hands-on support. So the money going out is to establish an on-the-ground program for that kind of personal technical assistance and help.”

Ms. Sebelius noted that the grants are particularly targeted toward smaller providers “who haven't waded into the area before. This is an incredibly important part of making this transition.”

In December, HHS issued a proposed regulation defining “meaningful use” and explaining how providers can meet criteria for being meaningful users. In response to a question about physician concerns that the regulation is too complex, Dr. David Blumenthal, national coordinator for health information technology, noted that the regulations are only a proposal at this point.

“We are very anxious to hear what the physician community has to say about it and the ways in which they feel it needs to be changed,” he told this publication. “I can certainly identify [with physicians], because as an internist, I had to go through the process of learning how to use an electronic health record, and I know it's not easy, but we're going to be providing support nationwide—the kind of support doctors have never had before.”

For more information, see www.hhs.gov/news/press/2010pres/02/20100212a.htmledocket.access.gpo.gov/2010/pdf/E9-31217.pdf

The White House is trying to get health care workers ready to help physicians in computerizing their medical records.

Nearly $1 billion in American Reinvestment and Recovery Act awards will be made to help health care providers become “meaningful users” of health information technology and to train nurses and other allied health professionals for careers in health information technology. Jobs created will include nurses, pharmacy technicians, and IT technicians and trainers, according to Health and Human Services Secretary Kathleen Sebelius and Labor Secretary Hilda Solis.

“These investments will serve to train almost 50,000 workers in Department of Labor programs plus thousands more hired for HHS regional extension centers in the months ahead,” Jared Bernstein, chief economist to Vice President Joe Biden, said in a teleconference. “By providing seed capital, we are helping to seed an emerging industry that will create new jobs well after the Recovery Act has ended.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of the 2009 federal stimulus law, physicians who treat Medicare patients can receive up to $44,000 over 5 years for the meaningful use of a certified health information system. Those whose populations are made up of at least 30% Medicaid patients can earn up to $64,000 in incentive payments for their use of the technology.

The proposed regulations include a definition of meaningful use and outline other criteria for obtaining the full incentive payments.

The awards announced last month include more than $750 million in HHS grants. Of that, $386 million will go to 40 states and their designated entities to help develop state-level health information exchanges (HIE), and another $375 million will be awarded to 32 nonprofit organizations to support the development of regional extension centers (REC), which will aid providers in using health information technology. Additional HIE and REC awards will be announced soon, according to a statement.

The grants will make it easier for physicians who are just getting started with electronic health records, Ms. Sebelius told this publication. “The people who will be trained by the grants … will actually provide the kind of hands-on technical support we think providers need to make this transition. It's not just that the act gives physicians financial incentives to buy a computer and plug it in; we understand the steps along the way of reorganizing workflow and retraining staff that are going to require hands-on support. So the money going out is to establish an on-the-ground program for that kind of personal technical assistance and help.”

Ms. Sebelius noted that the grants are particularly targeted toward smaller providers “who haven't waded into the area before. This is an incredibly important part of making this transition.”

In December, HHS issued a proposed regulation defining “meaningful use” and explaining how providers can meet criteria for being meaningful users. In response to a question about physician concerns that the regulation is too complex, Dr. David Blumenthal, national coordinator for health information technology, noted that the regulations are only a proposal at this point.

“We are very anxious to hear what the physician community has to say about it and the ways in which they feel it needs to be changed,” he told this publication. “I can certainly identify [with physicians], because as an internist, I had to go through the process of learning how to use an electronic health record, and I know it's not easy, but we're going to be providing support nationwide—the kind of support doctors have never had before.”

For more information, see www.hhs.gov/news/press/2010pres/02/20100212a.htmledocket.access.gpo.gov/2010/pdf/E9-31217.pdf

WASHINGTON — Although government health officials are hoping that most physicians will get on the “meaningful use” bandwagon, that's not likely to happen easily, according to Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society.

“I don't think [health care] professionals have any idea what's coming,” Dr. Lichtenfeld said during a panel discussion at an eHealth Initiative conference. “I think [federal officials] are risking failure because doctors will say, 'Are you kidding? I don't want to have anything to do with this.' I hope that isn't what happens, but I tell you, be prepared.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of last year's federal stimulus law, physicians who treat Medicare patients can be awarded up to $44,000 over 5 years for the meaningful use of a certified health information system. For physicians whose patient populations are at least 30% Medicaid patients, the incentive is as much as $64,000.

But physicians who already have computers may find that they won't meet the requirements for the incentive, Dr. Lichtenfeld said. “Doctors have invested in these systems and now they're worthless. They don't have the time, they don't have the money, they don't have the expertise. And to have to get [a new system] up and running in 2–3 years—they won't do it. Something simpler would've gotten us to where we have to go.”

Despite a few patient-driven efforts (see box, p. 27), no one has figured out how to use information technology as a way to get patients more involved in their care, Dr. Lichtenfeld contended. “A couple of years ago, personal health records … were the talk of the town. They were going to get everybody on board. Patients were going to run to various Web sites and fill out their health information. Health plans were going to get together and figure out how to bring their data so it would be downloadable and easily accessible.”

But none of that has yet come to pass, he said. “Personal health records landed with a thud. We need to figure out that sometimes we have to keep it simple.” For example, the cancer community should come up with a simple document to give to patients listing their diagnosis, their expected length of hospital stay, what kind of treatment they're getting, and what medications they need to take. “This is a good example of where we are not today.”

In the meantime, the Department Health and Human Services is trying to get physicians to meet some meaningful use criteria that aren't even written yet, said Dr. Steven Stack, an emergency physician and member of two workgroups of the department's HIT Policy Committee. He noted that two criteria “were supposed to be finished on Dec. 31, 2008, by statute. It's 2010 and they're not done, and it may be a year before we get something. A lot of these things aren't ready for prime time.”

Instead of requiring physicians to meet lots of criteria, “if we focus on the smallest of things, then doggedly persist until we knock down those barriers, and then require people to meet those [expectations]—with the proper incentives, we can make a really great step forward,” said Dr. Stack, who is a member of the American Medical Association board of trustees.

In contrast, Steven Findlay, senior health policy analyst at Consumers Union, expressed impatience with the process. “We ought to try to push as far as we possibly can with the 2011 meaningful use criteria,” he said. “We ought to be exquisitely sensitive to what's doable in 2011 … but shouldn't be running from time to push. We've been talking about this stuff for 10 years, and for the good of patients and consumers, we need to do this.”

The conference was sponsored by Ingenix, the AMA, and several other industry groups. The speakers reported that they had no relevant conflicts of interest.

Disease Web Site Collects Patient-Reported Data

Patients can play a role in providing useful health information, Dr. Stack emphasized. For example,

www.patientslikeme.com

Visitors to the site can sign up for a free account and a screen name, which they use to post their comments and health statistics. “People voluntarily post their own health data. Some are very open about it—they post every pill they're on, the dose, the frequency, what's happening to them,” said Dr. Stack. In the ALS community, members developed “a patient population and a data set that was so robust that if they put in enough of their own variables, [the site] could predict when you'd be in a wheelchair within a week. It was that precise. We could never replicate that in a prospective, double-blind randomized controlled trial. We could never get an institutional review board to [accept it] and never get people to do it.”

But for patients, “the motivation of your own health and the fear of death through your own illness is a motivator we can't replicate with money or incentives,” he said.

WASHINGTON — Although government health officials are hoping that most physicians will get on the “meaningful use” bandwagon, that's not likely to happen easily, according to Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society.

“I don't think [health care] professionals have any idea what's coming,” Dr. Lichtenfeld said during a panel discussion at an eHealth Initiative conference. “I think [federal officials] are risking failure because doctors will say, 'Are you kidding? I don't want to have anything to do with this.' I hope that isn't what happens, but I tell you, be prepared.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of last year's federal stimulus law, physicians who treat Medicare patients can be awarded up to $44,000 over 5 years for the meaningful use of a certified health information system. For physicians whose patient populations are at least 30% Medicaid patients, the incentive is as much as $64,000.

But physicians who already have computers may find that they won't meet the requirements for the incentive, Dr. Lichtenfeld said. “Doctors have invested in these systems and now they're worthless. They don't have the time, they don't have the money, they don't have the expertise. And to have to get [a new system] up and running in 2–3 years—they won't do it. Something simpler would've gotten us to where we have to go.”

Despite a few patient-driven efforts (see box, p. 27), no one has figured out how to use information technology as a way to get patients more involved in their care, Dr. Lichtenfeld contended. “A couple of years ago, personal health records … were the talk of the town. They were going to get everybody on board. Patients were going to run to various Web sites and fill out their health information. Health plans were going to get together and figure out how to bring their data so it would be downloadable and easily accessible.”

But none of that has yet come to pass, he said. “Personal health records landed with a thud. We need to figure out that sometimes we have to keep it simple.” For example, the cancer community should come up with a simple document to give to patients listing their diagnosis, their expected length of hospital stay, what kind of treatment they're getting, and what medications they need to take. “This is a good example of where we are not today.”

In the meantime, the Department Health and Human Services is trying to get physicians to meet some meaningful use criteria that aren't even written yet, said Dr. Steven Stack, an emergency physician and member of two workgroups of the department's HIT Policy Committee. He noted that two criteria “were supposed to be finished on Dec. 31, 2008, by statute. It's 2010 and they're not done, and it may be a year before we get something. A lot of these things aren't ready for prime time.”

Instead of requiring physicians to meet lots of criteria, “if we focus on the smallest of things, then doggedly persist until we knock down those barriers, and then require people to meet those [expectations]—with the proper incentives, we can make a really great step forward,” said Dr. Stack, who is a member of the American Medical Association board of trustees.

In contrast, Steven Findlay, senior health policy analyst at Consumers Union, expressed impatience with the process. “We ought to try to push as far as we possibly can with the 2011 meaningful use criteria,” he said. “We ought to be exquisitely sensitive to what's doable in 2011 … but shouldn't be running from time to push. We've been talking about this stuff for 10 years, and for the good of patients and consumers, we need to do this.”

The conference was sponsored by Ingenix, the AMA, and several other industry groups. The speakers reported that they had no relevant conflicts of interest.

Disease Web Site Collects Patient-Reported Data

Patients can play a role in providing useful health information, Dr. Stack emphasized. For example,

www.patientslikeme.com

Visitors to the site can sign up for a free account and a screen name, which they use to post their comments and health statistics. “People voluntarily post their own health data. Some are very open about it—they post every pill they're on, the dose, the frequency, what's happening to them,” said Dr. Stack. In the ALS community, members developed “a patient population and a data set that was so robust that if they put in enough of their own variables, [the site] could predict when you'd be in a wheelchair within a week. It was that precise. We could never replicate that in a prospective, double-blind randomized controlled trial. We could never get an institutional review board to [accept it] and never get people to do it.”

But for patients, “the motivation of your own health and the fear of death through your own illness is a motivator we can't replicate with money or incentives,” he said.

WASHINGTON — Although government health officials are hoping that most physicians will get on the “meaningful use” bandwagon, that's not likely to happen easily, according to Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society.

“I don't think [health care] professionals have any idea what's coming,” Dr. Lichtenfeld said during a panel discussion at an eHealth Initiative conference. “I think [federal officials] are risking failure because doctors will say, 'Are you kidding? I don't want to have anything to do with this.' I hope that isn't what happens, but I tell you, be prepared.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of last year's federal stimulus law, physicians who treat Medicare patients can be awarded up to $44,000 over 5 years for the meaningful use of a certified health information system. For physicians whose patient populations are at least 30% Medicaid patients, the incentive is as much as $64,000.

But physicians who already have computers may find that they won't meet the requirements for the incentive, Dr. Lichtenfeld said. “Doctors have invested in these systems and now they're worthless. They don't have the time, they don't have the money, they don't have the expertise. And to have to get [a new system] up and running in 2–3 years—they won't do it. Something simpler would've gotten us to where we have to go.”

Despite a few patient-driven efforts (see box, p. 27), no one has figured out how to use information technology as a way to get patients more involved in their care, Dr. Lichtenfeld contended. “A couple of years ago, personal health records … were the talk of the town. They were going to get everybody on board. Patients were going to run to various Web sites and fill out their health information. Health plans were going to get together and figure out how to bring their data so it would be downloadable and easily accessible.”

But none of that has yet come to pass, he said. “Personal health records landed with a thud. We need to figure out that sometimes we have to keep it simple.” For example, the cancer community should come up with a simple document to give to patients listing their diagnosis, their expected length of hospital stay, what kind of treatment they're getting, and what medications they need to take. “This is a good example of where we are not today.”

In the meantime, the Department Health and Human Services is trying to get physicians to meet some meaningful use criteria that aren't even written yet, said Dr. Steven Stack, an emergency physician and member of two workgroups of the department's HIT Policy Committee. He noted that two criteria “were supposed to be finished on Dec. 31, 2008, by statute. It's 2010 and they're not done, and it may be a year before we get something. A lot of these things aren't ready for prime time.”

Instead of requiring physicians to meet lots of criteria, “if we focus on the smallest of things, then doggedly persist until we knock down those barriers, and then require people to meet those [expectations]—with the proper incentives, we can make a really great step forward,” said Dr. Stack, who is a member of the American Medical Association board of trustees.

In contrast, Steven Findlay, senior health policy analyst at Consumers Union, expressed impatience with the process. “We ought to try to push as far as we possibly can with the 2011 meaningful use criteria,” he said. “We ought to be exquisitely sensitive to what's doable in 2011 … but shouldn't be running from time to push. We've been talking about this stuff for 10 years, and for the good of patients and consumers, we need to do this.”

The conference was sponsored by Ingenix, the AMA, and several other industry groups. The speakers reported that they had no relevant conflicts of interest.

Disease Web Site Collects Patient-Reported Data

Patients can play a role in providing useful health information, Dr. Stack emphasized. For example,

www.patientslikeme.com

Visitors to the site can sign up for a free account and a screen name, which they use to post their comments and health statistics. “People voluntarily post their own health data. Some are very open about it—they post every pill they're on, the dose, the frequency, what's happening to them,” said Dr. Stack. In the ALS community, members developed “a patient population and a data set that was so robust that if they put in enough of their own variables, [the site] could predict when you'd be in a wheelchair within a week. It was that precise. We could never replicate that in a prospective, double-blind randomized controlled trial. We could never get an institutional review board to [accept it] and never get people to do it.”

But for patients, “the motivation of your own health and the fear of death through your own illness is a motivator we can't replicate with money or incentives,” he said.

WASHINGTON — Although government health officials are hoping that most physicians will get on the “meaningful use” bandwagon, that's not likely to happen easily.

“I don't think [health care] professionals have any idea what's coming,” said Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society during a panel discussion at an eHealth Initiative conference. “[Federal officials] are risking failure because doctors will say, 'Are you kidding? I don't want to have anything to do with this.' I hope that [doesn't] happen, but I tell you, be prepared.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of last year's federal stimulus law, physicians who treat Medicare patients can be awarded up to $44,000 over 5 years for the meaningful use of a certified health information system. For physicians whose patient populations are at least 30% Medicaid patients, the incentive is as much as $64,000.

But physicians who already have computers could find that they don't meet the requirements for the incentive, Dr. Lichtenfeld said. “Doctors have invested in these systems and now they're worthless. They don't have the time, they don't have the money, they don't have the expertise. And to have to get [a new system] up and running in 2-3 years—they won't do it. Something simpler would've gotten us to where we have to go.”

Despite a few patient-driven efforts, no one has figured out how to use information technology to get patients more involved in their care, said Dr. Lichtenfeld. “A couple of years ago, personal health records … were going to get everybody on board. Patients were going to run to various Web sites and fill out their health information. Health plans were going to get together and figure out how to bring their data so it would be downloadable and easily accessible.”

But none of that has come to pass, he said.

In the meantime, the Department Health and Human Services is trying to get physicians to meet some meaningful use criteria that aren't even written yet, said Dr. Steven Stack, an emergency physician and member of two work groups of the department's HIT Policy Committee.

Two criteria “were supposed to be finished on Dec. 31, 2008, by statute. It's 2010 and they're not done, and it may be a year before we get something. A lot of these things aren't ready for prime time,” he said.

Instead of requiring physicians to meet many criteria, “if we focus on the smallest of things, then doggedly persist until we knock down those barriers, and then require people to meet those [expectations]—with the proper incentives, we can make a really great step forward,” Dr. Stack said.

Ingenix, the American Medical Association, and several other industry groups sponsored the conference. The speakers reported that they had no relevant disclosures.

WASHINGTON — Although government health officials are hoping that most physicians will get on the “meaningful use” bandwagon, that's not likely to happen easily.

“I don't think [health care] professionals have any idea what's coming,” said Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society during a panel discussion at an eHealth Initiative conference. “[Federal officials] are risking failure because doctors will say, 'Are you kidding? I don't want to have anything to do with this.' I hope that [doesn't] happen, but I tell you, be prepared.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of last year's federal stimulus law, physicians who treat Medicare patients can be awarded up to $44,000 over 5 years for the meaningful use of a certified health information system. For physicians whose patient populations are at least 30% Medicaid patients, the incentive is as much as $64,000.

But physicians who already have computers could find that they don't meet the requirements for the incentive, Dr. Lichtenfeld said. “Doctors have invested in these systems and now they're worthless. They don't have the time, they don't have the money, they don't have the expertise. And to have to get [a new system] up and running in 2-3 years—they won't do it. Something simpler would've gotten us to where we have to go.”

Despite a few patient-driven efforts, no one has figured out how to use information technology to get patients more involved in their care, said Dr. Lichtenfeld. “A couple of years ago, personal health records … were going to get everybody on board. Patients were going to run to various Web sites and fill out their health information. Health plans were going to get together and figure out how to bring their data so it would be downloadable and easily accessible.”

But none of that has come to pass, he said.

In the meantime, the Department Health and Human Services is trying to get physicians to meet some meaningful use criteria that aren't even written yet, said Dr. Steven Stack, an emergency physician and member of two work groups of the department's HIT Policy Committee.

Two criteria “were supposed to be finished on Dec. 31, 2008, by statute. It's 2010 and they're not done, and it may be a year before we get something. A lot of these things aren't ready for prime time,” he said.

Instead of requiring physicians to meet many criteria, “if we focus on the smallest of things, then doggedly persist until we knock down those barriers, and then require people to meet those [expectations]—with the proper incentives, we can make a really great step forward,” Dr. Stack said.

Ingenix, the American Medical Association, and several other industry groups sponsored the conference. The speakers reported that they had no relevant disclosures.

WASHINGTON — Although government health officials are hoping that most physicians will get on the “meaningful use” bandwagon, that's not likely to happen easily.

“I don't think [health care] professionals have any idea what's coming,” said Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society during a panel discussion at an eHealth Initiative conference. “[Federal officials] are risking failure because doctors will say, 'Are you kidding? I don't want to have anything to do with this.' I hope that [doesn't] happen, but I tell you, be prepared.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of last year's federal stimulus law, physicians who treat Medicare patients can be awarded up to $44,000 over 5 years for the meaningful use of a certified health information system. For physicians whose patient populations are at least 30% Medicaid patients, the incentive is as much as $64,000.

But physicians who already have computers could find that they don't meet the requirements for the incentive, Dr. Lichtenfeld said. “Doctors have invested in these systems and now they're worthless. They don't have the time, they don't have the money, they don't have the expertise. And to have to get [a new system] up and running in 2-3 years—they won't do it. Something simpler would've gotten us to where we have to go.”

Despite a few patient-driven efforts, no one has figured out how to use information technology to get patients more involved in their care, said Dr. Lichtenfeld. “A couple of years ago, personal health records … were going to get everybody on board. Patients were going to run to various Web sites and fill out their health information. Health plans were going to get together and figure out how to bring their data so it would be downloadable and easily accessible.”

But none of that has come to pass, he said.

In the meantime, the Department Health and Human Services is trying to get physicians to meet some meaningful use criteria that aren't even written yet, said Dr. Steven Stack, an emergency physician and member of two work groups of the department's HIT Policy Committee.

Two criteria “were supposed to be finished on Dec. 31, 2008, by statute. It's 2010 and they're not done, and it may be a year before we get something. A lot of these things aren't ready for prime time,” he said.

Instead of requiring physicians to meet many criteria, “if we focus on the smallest of things, then doggedly persist until we knock down those barriers, and then require people to meet those [expectations]—with the proper incentives, we can make a really great step forward,” Dr. Stack said.

Ingenix, the American Medical Association, and several other industry groups sponsored the conference. The speakers reported that they had no relevant disclosures.

WASHINGTON — Although government health officials are hoping that most physicians will get on the “meaningful use” bandwagon, that's not likely to happen easily, according to Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society.

“I don't think [health care] professionals have any idea what's coming,” Dr. Lichtenfeld said during a panel discussion at an eHealth Initiative conference. “I think [federal officials] are risking failure because doctors will say, 'Are you kidding? I don't want to have anything to do with this.' I hope that isn't what happens, but I tell you, be prepared.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of last year's federal stimulus law, physicians who treat Medicare patients can be awarded up to $44,000 over 5 years for the meaningful use of a certified health information system. For physicians whose patient populations are at least 30% Medicaid patients, the incentive is as much as $64,000.

But physicians who already have computers may find that they won't meet the requirements for the incentive, Dr. Lichtenfeld said. “Doctors have invested in these systems and now they're worthless. They don't have the time, they don't have the money, they don't have the expertise. And to have to get [a new system] up and running in 2-3 years—they won't do it. Something simpler would've gotten us to where we have to go.”

Despite a few patient-driven efforts (see box), no one has figured out how to use information technology as a way to get patients more involved in their care, Dr. Lichtenfeld contended. “A couple of years ago, personal health records … were the talk of the town. They were going to get everybody on board. Patients were going to run to various Web sites and fill out their health information. Health plans were going to get together and figure out how to bring their data so it would be downloadable and easily accessible.”

But none of that has yet come to pass, he said. “Personal health records landed with a thud. We need to figure out that sometimes we have to keep it simple.”

In the meantime, the Department of Health and Human Services is trying to get physicians to meet some meaningful use criteria that aren't even written yet, said Dr. Steven Stack, an emergency physician and member of two workgroups of the department's HIT Policy Committee. He noted that two criteria “were supposed to be finished on Dec. 31, 2008, by statute. It's 2010 and they're not done, and it may be a year before we get something. A lot of these things aren't ready for prime time.”

Instead of requiring physicians to meet lots of criteria, “if we focus on the smallest of things, then doggedly persist until we knock down those barriers, and then require people to meet those [expectations]—with the proper incentives, we can make a really great step forward,” said Dr. Stack, who is a member of the American Medical Association board of trustees.

In contrast, Steven Findlay, senior health policy analyst at Consumers Union, expressed impatience with the process. “We ought to try to push as far as we possibly can with the 2011 meaningful use criteria,” he said. “We ought to be exquisitely sensitive to what's doable in 2011 … but shouldn't be running from time to push. We've been talking about this stuff for 10 years, and for the good of patients and consumers, we need to do this.”

The conference was sponsored by Ingenix, the AMA, and several other industry groups. The speakers reported that they had no conflicts of interest relevant to their presentations.

Disease Site Seeks Patient-Reported Data

Patients can play a role in providing useful health information, Dr. Stack emphasized. As an example, he cited

www.patientslikeme.com

Visitors to the site can sign up for a free account and a screen name, which they use to post their comments and health statistics. “People voluntarily post their own health data. Some are very open about it—they post every pill they're on, the dose, the frequency, what's happening to them,” said Dr. Stack. In the ALS community, members developed “a patient population and a data set that was so robust that if [community members] put in enough of their own variables, [the site] could predict when you'd be in a wheelchair within a week and when you'd be on a ventilator within a week. It was that precise.

“The motivation of your own health and the fear of death through your own illness is a motivator we can't replicate with money or incentives,” he said.

WASHINGTON — Although government health officials are hoping that most physicians will get on the “meaningful use” bandwagon, that's not likely to happen easily, according to Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society.

“I don't think [health care] professionals have any idea what's coming,” Dr. Lichtenfeld said during a panel discussion at an eHealth Initiative conference. “I think [federal officials] are risking failure because doctors will say, 'Are you kidding? I don't want to have anything to do with this.' I hope that isn't what happens, but I tell you, be prepared.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of last year's federal stimulus law, physicians who treat Medicare patients can be awarded up to $44,000 over 5 years for the meaningful use of a certified health information system. For physicians whose patient populations are at least 30% Medicaid patients, the incentive is as much as $64,000.

But physicians who already have computers may find that they won't meet the requirements for the incentive, Dr. Lichtenfeld said. “Doctors have invested in these systems and now they're worthless. They don't have the time, they don't have the money, they don't have the expertise. And to have to get [a new system] up and running in 2-3 years—they won't do it. Something simpler would've gotten us to where we have to go.”

Despite a few patient-driven efforts (see box), no one has figured out how to use information technology as a way to get patients more involved in their care, Dr. Lichtenfeld contended. “A couple of years ago, personal health records … were the talk of the town. They were going to get everybody on board. Patients were going to run to various Web sites and fill out their health information. Health plans were going to get together and figure out how to bring their data so it would be downloadable and easily accessible.”

But none of that has yet come to pass, he said. “Personal health records landed with a thud. We need to figure out that sometimes we have to keep it simple.”

In the meantime, the Department of Health and Human Services is trying to get physicians to meet some meaningful use criteria that aren't even written yet, said Dr. Steven Stack, an emergency physician and member of two workgroups of the department's HIT Policy Committee. He noted that two criteria “were supposed to be finished on Dec. 31, 2008, by statute. It's 2010 and they're not done, and it may be a year before we get something. A lot of these things aren't ready for prime time.”

Instead of requiring physicians to meet lots of criteria, “if we focus on the smallest of things, then doggedly persist until we knock down those barriers, and then require people to meet those [expectations]—with the proper incentives, we can make a really great step forward,” said Dr. Stack, who is a member of the American Medical Association board of trustees.

In contrast, Steven Findlay, senior health policy analyst at Consumers Union, expressed impatience with the process. “We ought to try to push as far as we possibly can with the 2011 meaningful use criteria,” he said. “We ought to be exquisitely sensitive to what's doable in 2011 … but shouldn't be running from time to push. We've been talking about this stuff for 10 years, and for the good of patients and consumers, we need to do this.”

The conference was sponsored by Ingenix, the AMA, and several other industry groups. The speakers reported that they had no conflicts of interest relevant to their presentations.

Disease Site Seeks Patient-Reported Data

Patients can play a role in providing useful health information, Dr. Stack emphasized. As an example, he cited

www.patientslikeme.com

Visitors to the site can sign up for a free account and a screen name, which they use to post their comments and health statistics. “People voluntarily post their own health data. Some are very open about it—they post every pill they're on, the dose, the frequency, what's happening to them,” said Dr. Stack. In the ALS community, members developed “a patient population and a data set that was so robust that if [community members] put in enough of their own variables, [the site] could predict when you'd be in a wheelchair within a week and when you'd be on a ventilator within a week. It was that precise.

“The motivation of your own health and the fear of death through your own illness is a motivator we can't replicate with money or incentives,” he said.

WASHINGTON — Although government health officials are hoping that most physicians will get on the “meaningful use” bandwagon, that's not likely to happen easily, according to Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society.

“I don't think [health care] professionals have any idea what's coming,” Dr. Lichtenfeld said during a panel discussion at an eHealth Initiative conference. “I think [federal officials] are risking failure because doctors will say, 'Are you kidding? I don't want to have anything to do with this.' I hope that isn't what happens, but I tell you, be prepared.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of last year's federal stimulus law, physicians who treat Medicare patients can be awarded up to $44,000 over 5 years for the meaningful use of a certified health information system. For physicians whose patient populations are at least 30% Medicaid patients, the incentive is as much as $64,000.

But physicians who already have computers may find that they won't meet the requirements for the incentive, Dr. Lichtenfeld said. “Doctors have invested in these systems and now they're worthless. They don't have the time, they don't have the money, they don't have the expertise. And to have to get [a new system] up and running in 2-3 years—they won't do it. Something simpler would've gotten us to where we have to go.”

Despite a few patient-driven efforts (see box), no one has figured out how to use information technology as a way to get patients more involved in their care, Dr. Lichtenfeld contended. “A couple of years ago, personal health records … were the talk of the town. They were going to get everybody on board. Patients were going to run to various Web sites and fill out their health information. Health plans were going to get together and figure out how to bring their data so it would be downloadable and easily accessible.”

But none of that has yet come to pass, he said. “Personal health records landed with a thud. We need to figure out that sometimes we have to keep it simple.”

In the meantime, the Department of Health and Human Services is trying to get physicians to meet some meaningful use criteria that aren't even written yet, said Dr. Steven Stack, an emergency physician and member of two workgroups of the department's HIT Policy Committee. He noted that two criteria “were supposed to be finished on Dec. 31, 2008, by statute. It's 2010 and they're not done, and it may be a year before we get something. A lot of these things aren't ready for prime time.”

Instead of requiring physicians to meet lots of criteria, “if we focus on the smallest of things, then doggedly persist until we knock down those barriers, and then require people to meet those [expectations]—with the proper incentives, we can make a really great step forward,” said Dr. Stack, who is a member of the American Medical Association board of trustees.

In contrast, Steven Findlay, senior health policy analyst at Consumers Union, expressed impatience with the process. “We ought to try to push as far as we possibly can with the 2011 meaningful use criteria,” he said. “We ought to be exquisitely sensitive to what's doable in 2011 … but shouldn't be running from time to push. We've been talking about this stuff for 10 years, and for the good of patients and consumers, we need to do this.”

The conference was sponsored by Ingenix, the AMA, and several other industry groups. The speakers reported that they had no conflicts of interest relevant to their presentations.

Disease Site Seeks Patient-Reported Data

Patients can play a role in providing useful health information, Dr. Stack emphasized. As an example, he cited

www.patientslikeme.com

Visitors to the site can sign up for a free account and a screen name, which they use to post their comments and health statistics. “People voluntarily post their own health data. Some are very open about it—they post every pill they're on, the dose, the frequency, what's happening to them,” said Dr. Stack. In the ALS community, members developed “a patient population and a data set that was so robust that if [community members] put in enough of their own variables, [the site] could predict when you'd be in a wheelchair within a week and when you'd be on a ventilator within a week. It was that precise.

“The motivation of your own health and the fear of death through your own illness is a motivator we can't replicate with money or incentives,” he said.

The White House is trying to get health care workers ready to help physicians in computerizing their medical records.

Nearly $1 billion in American Reinvestment and Recovery Act awards will be made to help health care providers become “meaningful users” of health information technology and to train nurses and other allied health professionals for careers in health information technology. Jobs created will include nurses, pharmacy technicians, and IT technicians and trainers, according to Health and Human Services Secretary Kathleen Sebelius and Labor Secretary Hilda Solis. “These investments will serve to train almost 50,000 workers in Department of Labor programs plus thousands more hired for HHS regional extension centers in the months ahead,” Jared Bernstein, chief economist to Vice President Joe Biden, said in a teleconference. “By providing seed capital, we are helping to seed an emerging industry that will create new jobs well after the Recovery Act has ended.”

Under the HITECH (Health Information Technology for Economic and Clinical Health) Act, physicians who treat Medicare patients can receive up to $44,000 over 5 years for the meaningful use of a certified health information system. Those whose populations are made up of at least 30% Medicaid patients can earn up to $64,000 in incentive payments for their use of the technology.

The awards, announced Feb. 12, include more than $750 million in HHS grants. Of that, $386 million will go to 40 states and their designated entities to help develop state-level health information exchanges (HIE), and another $375 million will be awarded to 32 nonprofit organizations to support the development of regional extension centers (REC), which will aid providers in using health information technology. Additional HIE and REC awards will be announced soon, according to a statement.

The grants will make it easier for physicians who are just getting started with electronic health records, Ms. Sebelius told this publication. “The people who will be trained by the grants … will actually provide the kind of hands-on technical support we think providers need to make this transition. It's not just that the act gives physicians financial incentives to buy a computer and plug it in; we understand the steps along the way of reorganizing workflow and retraining staff that are going to require hands-on support. So the money going out is to establish an on-the-ground program for that kind of personal technical assistance and help.”

Ms. Sebelius noted that the grants target smaller providers.

In December, HHS issued a proposed regulation defining “meaningful use” and explaining how providers can meet criteria for being meaningful users. In response to a question about physician concerns that the regulation is too complex, Dr. David Blumenthal, national coordinator for health information technology, noted that the regulations are only a proposal at this point.

“We are anxious to hear what physicians have to say about it and the ways in which they feel it needs to be changed,” he told this publication. “I can certainly identify [with physicians], because as an internist, I had to go through the process of learning how to use an electronic health record, and I know it's not easy, but we're going to be providing support nationwide—the kind of support doctors have never had before.”

For more information, see www.hhs.gov/news/press/2010pres/02/20100212a.html

The White House is trying to get health care workers ready to help physicians in computerizing their medical records.

Nearly $1 billion in American Reinvestment and Recovery Act awards will be made to help health care providers become “meaningful users” of health information technology and to train nurses and other allied health professionals for careers in health information technology. Jobs created will include nurses, pharmacy technicians, and IT technicians and trainers, according to Health and Human Services Secretary Kathleen Sebelius and Labor Secretary Hilda Solis. “These investments will serve to train almost 50,000 workers in Department of Labor programs plus thousands more hired for HHS regional extension centers in the months ahead,” Jared Bernstein, chief economist to Vice President Joe Biden, said in a teleconference. “By providing seed capital, we are helping to seed an emerging industry that will create new jobs well after the Recovery Act has ended.”

Under the HITECH (Health Information Technology for Economic and Clinical Health) Act, physicians who treat Medicare patients can receive up to $44,000 over 5 years for the meaningful use of a certified health information system. Those whose populations are made up of at least 30% Medicaid patients can earn up to $64,000 in incentive payments for their use of the technology.

The awards, announced Feb. 12, include more than $750 million in HHS grants. Of that, $386 million will go to 40 states and their designated entities to help develop state-level health information exchanges (HIE), and another $375 million will be awarded to 32 nonprofit organizations to support the development of regional extension centers (REC), which will aid providers in using health information technology. Additional HIE and REC awards will be announced soon, according to a statement.

The grants will make it easier for physicians who are just getting started with electronic health records, Ms. Sebelius told this publication. “The people who will be trained by the grants … will actually provide the kind of hands-on technical support we think providers need to make this transition. It's not just that the act gives physicians financial incentives to buy a computer and plug it in; we understand the steps along the way of reorganizing workflow and retraining staff that are going to require hands-on support. So the money going out is to establish an on-the-ground program for that kind of personal technical assistance and help.”

Ms. Sebelius noted that the grants target smaller providers.

In December, HHS issued a proposed regulation defining “meaningful use” and explaining how providers can meet criteria for being meaningful users. In response to a question about physician concerns that the regulation is too complex, Dr. David Blumenthal, national coordinator for health information technology, noted that the regulations are only a proposal at this point.

“We are anxious to hear what physicians have to say about it and the ways in which they feel it needs to be changed,” he told this publication. “I can certainly identify [with physicians], because as an internist, I had to go through the process of learning how to use an electronic health record, and I know it's not easy, but we're going to be providing support nationwide—the kind of support doctors have never had before.”

For more information, see www.hhs.gov/news/press/2010pres/02/20100212a.html

The White House is trying to get health care workers ready to help physicians in computerizing their medical records.

Nearly $1 billion in American Reinvestment and Recovery Act awards will be made to help health care providers become “meaningful users” of health information technology and to train nurses and other allied health professionals for careers in health information technology. Jobs created will include nurses, pharmacy technicians, and IT technicians and trainers, according to Health and Human Services Secretary Kathleen Sebelius and Labor Secretary Hilda Solis. “These investments will serve to train almost 50,000 workers in Department of Labor programs plus thousands more hired for HHS regional extension centers in the months ahead,” Jared Bernstein, chief economist to Vice President Joe Biden, said in a teleconference. “By providing seed capital, we are helping to seed an emerging industry that will create new jobs well after the Recovery Act has ended.”

Under the HITECH (Health Information Technology for Economic and Clinical Health) Act, physicians who treat Medicare patients can receive up to $44,000 over 5 years for the meaningful use of a certified health information system. Those whose populations are made up of at least 30% Medicaid patients can earn up to $64,000 in incentive payments for their use of the technology.

The awards, announced Feb. 12, include more than $750 million in HHS grants. Of that, $386 million will go to 40 states and their designated entities to help develop state-level health information exchanges (HIE), and another $375 million will be awarded to 32 nonprofit organizations to support the development of regional extension centers (REC), which will aid providers in using health information technology. Additional HIE and REC awards will be announced soon, according to a statement.

The grants will make it easier for physicians who are just getting started with electronic health records, Ms. Sebelius told this publication. “The people who will be trained by the grants … will actually provide the kind of hands-on technical support we think providers need to make this transition. It's not just that the act gives physicians financial incentives to buy a computer and plug it in; we understand the steps along the way of reorganizing workflow and retraining staff that are going to require hands-on support. So the money going out is to establish an on-the-ground program for that kind of personal technical assistance and help.”

Ms. Sebelius noted that the grants target smaller providers.

In December, HHS issued a proposed regulation defining “meaningful use” and explaining how providers can meet criteria for being meaningful users. In response to a question about physician concerns that the regulation is too complex, Dr. David Blumenthal, national coordinator for health information technology, noted that the regulations are only a proposal at this point.

“We are anxious to hear what physicians have to say about it and the ways in which they feel it needs to be changed,” he told this publication. “I can certainly identify [with physicians], because as an internist, I had to go through the process of learning how to use an electronic health record, and I know it's not easy, but we're going to be providing support nationwide—the kind of support doctors have never had before.”

For more information, see www.hhs.gov/news/press/2010pres/02/20100212a.html

WASHINGTON — Although government health officials are hoping that most physicians will get on the “meaningful use” bandwagon, that's not likely to happen easily, according to Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society.

“I don't think [health care] professionals have any idea what's coming,” Dr. Lichtenfeld said during a panel discussion at an eHealth Initiative conference. “I think [federal officials] are risking failure because doctors will say, 'Are you kidding? I don't want to have anything to do with this.' I hope that isn't what happens, but I tell you, be prepared.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of last year's federal stimulus law, physicians who treat Medicare patients can be awarded up to $44,000 over 5 years for the meaningful use of a certified health IT system. Those whose populations are at least 30% Medicaid patients can earn up to $64,000 in incentives.

But physicians who already have computers may find that they won't meet the requirements for the incentive, Dr. Lichtenfeld said. “Doctors have invested in these systems and now they're worthless. They don't have the time, they don't have the money, they don't have the expertise. And to have to get [a new system] up and running in 2-3 years—they won't do it.”

Despite a few patient-driven efforts, no one has figured out how to use IT as a way to get patients more involved in their care, Dr. Lichtenfeld contended. “A couple of years ago, personal health records … were the talk of the town. They were going to get everybody on board. Patients were going to run to various Web sites and fill out their health information. Health plans were going to get together and figure out how to bring their data so it would be downloadable and easily accessible.”

But none of that has yet come to pass, he said. “Personal health records landed with a thud. We need to figure out that sometimes we have to keep it simple.” For example, the cancer community should come up with a simple document to give to patients listing their diagnosis, expected length of hospital stay, what kind of treatment they're getting, and their medications. “This is a good example of where we are not today.”

In the meantime, the Department Health and Human Services is trying to get physicians to meet some meaningful use criteria that aren't written yet, said Dr. Steven Stack, an emergency physician and member of two workgroups of the department's HIT Policy Committee. He noted that two criteria “were supposed to be finished on Dec. 31, 2008, by statute. It's 2010 and they're not done, and it may be a year before we get something. A lot of these things aren't ready for prime time.”

Instead of requiring physicians to meet lots of criteria, “if we focus on the smallest of things, then doggedly persist until we knock down those barriers, and then require people to meet those [expectations]—with the proper incentives, we can make a really great step forward,” said Dr. Stack, who is a member of the American Medical Association board of trustees.

In contrast, Steven Findlay, senior health policy analyst at Consumers Union, expressed impatience with the process. “We ought to try to push as far as we possibly can with the 2011 meaningful use criteria,” he said. “We ought to be exquisitely sensitive to what's doable in 2011 … but shouldn't be running from time to push.”

Disclosures: The conference was sponsored by Ingenix, the AMA, and several other industry groups. The speakers said they had no conflicts of interest.

WASHINGTON — Although government health officials are hoping that most physicians will get on the “meaningful use” bandwagon, that's not likely to happen easily, according to Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society.

“I don't think [health care] professionals have any idea what's coming,” Dr. Lichtenfeld said during a panel discussion at an eHealth Initiative conference. “I think [federal officials] are risking failure because doctors will say, 'Are you kidding? I don't want to have anything to do with this.' I hope that isn't what happens, but I tell you, be prepared.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of last year's federal stimulus law, physicians who treat Medicare patients can be awarded up to $44,000 over 5 years for the meaningful use of a certified health IT system. Those whose populations are at least 30% Medicaid patients can earn up to $64,000 in incentives.

But physicians who already have computers may find that they won't meet the requirements for the incentive, Dr. Lichtenfeld said. “Doctors have invested in these systems and now they're worthless. They don't have the time, they don't have the money, they don't have the expertise. And to have to get [a new system] up and running in 2-3 years—they won't do it.”

Despite a few patient-driven efforts, no one has figured out how to use IT as a way to get patients more involved in their care, Dr. Lichtenfeld contended. “A couple of years ago, personal health records … were the talk of the town. They were going to get everybody on board. Patients were going to run to various Web sites and fill out their health information. Health plans were going to get together and figure out how to bring their data so it would be downloadable and easily accessible.”

But none of that has yet come to pass, he said. “Personal health records landed with a thud. We need to figure out that sometimes we have to keep it simple.” For example, the cancer community should come up with a simple document to give to patients listing their diagnosis, expected length of hospital stay, what kind of treatment they're getting, and their medications. “This is a good example of where we are not today.”

In the meantime, the Department Health and Human Services is trying to get physicians to meet some meaningful use criteria that aren't written yet, said Dr. Steven Stack, an emergency physician and member of two workgroups of the department's HIT Policy Committee. He noted that two criteria “were supposed to be finished on Dec. 31, 2008, by statute. It's 2010 and they're not done, and it may be a year before we get something. A lot of these things aren't ready for prime time.”

Instead of requiring physicians to meet lots of criteria, “if we focus on the smallest of things, then doggedly persist until we knock down those barriers, and then require people to meet those [expectations]—with the proper incentives, we can make a really great step forward,” said Dr. Stack, who is a member of the American Medical Association board of trustees.

In contrast, Steven Findlay, senior health policy analyst at Consumers Union, expressed impatience with the process. “We ought to try to push as far as we possibly can with the 2011 meaningful use criteria,” he said. “We ought to be exquisitely sensitive to what's doable in 2011 … but shouldn't be running from time to push.”

Disclosures: The conference was sponsored by Ingenix, the AMA, and several other industry groups. The speakers said they had no conflicts of interest.

WASHINGTON — Although government health officials are hoping that most physicians will get on the “meaningful use” bandwagon, that's not likely to happen easily, according to Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society.

“I don't think [health care] professionals have any idea what's coming,” Dr. Lichtenfeld said during a panel discussion at an eHealth Initiative conference. “I think [federal officials] are risking failure because doctors will say, 'Are you kidding? I don't want to have anything to do with this.' I hope that isn't what happens, but I tell you, be prepared.”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of last year's federal stimulus law, physicians who treat Medicare patients can be awarded up to $44,000 over 5 years for the meaningful use of a certified health IT system. Those whose populations are at least 30% Medicaid patients can earn up to $64,000 in incentives.

But physicians who already have computers may find that they won't meet the requirements for the incentive, Dr. Lichtenfeld said. “Doctors have invested in these systems and now they're worthless. They don't have the time, they don't have the money, they don't have the expertise. And to have to get [a new system] up and running in 2-3 years—they won't do it.”

Despite a few patient-driven efforts, no one has figured out how to use IT as a way to get patients more involved in their care, Dr. Lichtenfeld contended. “A couple of years ago, personal health records … were the talk of the town. They were going to get everybody on board. Patients were going to run to various Web sites and fill out their health information. Health plans were going to get together and figure out how to bring their data so it would be downloadable and easily accessible.”

But none of that has yet come to pass, he said. “Personal health records landed with a thud. We need to figure out that sometimes we have to keep it simple.” For example, the cancer community should come up with a simple document to give to patients listing their diagnosis, expected length of hospital stay, what kind of treatment they're getting, and their medications. “This is a good example of where we are not today.”

In the meantime, the Department Health and Human Services is trying to get physicians to meet some meaningful use criteria that aren't written yet, said Dr. Steven Stack, an emergency physician and member of two workgroups of the department's HIT Policy Committee. He noted that two criteria “were supposed to be finished on Dec. 31, 2008, by statute. It's 2010 and they're not done, and it may be a year before we get something. A lot of these things aren't ready for prime time.”

Instead of requiring physicians to meet lots of criteria, “if we focus on the smallest of things, then doggedly persist until we knock down those barriers, and then require people to meet those [expectations]—with the proper incentives, we can make a really great step forward,” said Dr. Stack, who is a member of the American Medical Association board of trustees.

In contrast, Steven Findlay, senior health policy analyst at Consumers Union, expressed impatience with the process. “We ought to try to push as far as we possibly can with the 2011 meaningful use criteria,” he said. “We ought to be exquisitely sensitive to what's doable in 2011 … but shouldn't be running from time to push.”

Disclosures: The conference was sponsored by Ingenix, the AMA, and several other industry groups. The speakers said they had no conflicts of interest.

The White House is trying to get health care workers ready to help physicians in computerizing their medical records.

Nearly $1 billion in American Reinvestment and Recovery Act awards will be made to help health care providers become “meaningful users” of health information technology and to train nurses and other allied health professionals for careers in health information technology. Jobs created will include nurses, pharmacy technicians, and IT technicians and trainers, according to Health and Human Services Secretary Kathleen Sebelius and Labor Secretary Hilda Solis.

“These investments will serve to train almost 50,000 workers in Department of Labor programs plus thousands more hired for HHS regional extension centers in the months ahead,” Jared Bernstein, chief economist to Vice President Joe Biden, said in a teleconference. “By providing seed capital, we are helping to seed an emerging industry that will create new jobs well after the Recovery Act has ended.”

Under the Health Information Technology for Economic and Clinical Health Act (HITECH), a part of the 2009 federal stimulus law, physicians who treat Medicare patients can receive up to $44,000 over 5 years for the meaningful use of a certified health information system. Those whose populations are made up of at least 30% Medicaid patients can earn up to $64,000 in incentive payments for their use of the technology.

The proposed regulations include a definition of meaningful use and outline other criteria for obtaining the full incentive payments.

The awards, which were announced Feb. 12, include more than $750 million in HHS grants. Of that, $386 million will go to 40 states and their designated entities to help develop state-level health information exchanges (HIE), and another $375 million will be awarded to 32 nonprofit organizations to support the development of regional extension centers (REC), which will aid providers in using health information technology. Additional HIE and REC awards will be announced soon, according to a statement.

The grants will make it easier for physicians who are just getting started with electronic health records, Ms. Sebelius told this publication. “The people who will be trained by the grants … will actually provide the kind of hands-on technical support we think providers need to make this transition. It's not just that the act gives physicians financial incentives to buy a computer and plug it in; we understand the steps along the way of reorganizing workflow and retraining staff that are going to require hands-on support. So the money going out is to establish an on-the-ground program for that kind of personal technical assistance and help.”

Ms. Sebelius noted that the grants are particularly targeted toward smaller providers “who haven't waded into the area before. This is an incredibly important part of making this transition.”

In December, HHS issued a proposed regulation defining “meaningful use” and explaining how providers can meet criteria for being meaningful users. In response to a question about physician concerns that the regulation is too complex, Dr. David Blumenthal, national coordinator for health information technology, noted that the regulations are only a proposal at this point.

“We are very anxious to hear what the physician community has to say about it and the ways in which they feel it needs to be changed,” he said.

“I can certainly identify [with physicians], because as an internist, I had to go through the process of learning how to use an electronic health record, and I know it's not easy, but we're going to be providing support nationwide—the kind of support doctors have never had before,” he said.

VITALS

The White House is trying to get health care workers ready to help physicians in computerizing their medical records.

Nearly $1 billion in American Reinvestment and Recovery Act awards will be made to help health care providers become “meaningful users” of health information technology and to train nurses and other allied health professionals for careers in health information technology. Jobs created will include nurses, pharmacy technicians, and IT technicians and trainers, according to Health and Human Services Secretary Kathleen Sebelius and Labor Secretary Hilda Solis.

“These investments will serve to train almost 50,000 workers in Department of Labor programs plus thousands more hired for HHS regional extension centers in the months ahead,” Jared Bernstein, chief economist to Vice President Joe Biden, said in a teleconference. “By providing seed capital, we are helping to seed an emerging industry that will create new jobs well after the Recovery Act has ended.”

Under the Health Information Technology for Economic and Clinical Health Act (HITECH), a part of the 2009 federal stimulus law, physicians who treat Medicare patients can receive up to $44,000 over 5 years for the meaningful use of a certified health information system. Those whose populations are made up of at least 30% Medicaid patients can earn up to $64,000 in incentive payments for their use of the technology.

The proposed regulations include a definition of meaningful use and outline other criteria for obtaining the full incentive payments.

The awards, which were announced Feb. 12, include more than $750 million in HHS grants. Of that, $386 million will go to 40 states and their designated entities to help develop state-level health information exchanges (HIE), and another $375 million will be awarded to 32 nonprofit organizations to support the development of regional extension centers (REC), which will aid providers in using health information technology. Additional HIE and REC awards will be announced soon, according to a statement.

The grants will make it easier for physicians who are just getting started with electronic health records, Ms. Sebelius told this publication. “The people who will be trained by the grants … will actually provide the kind of hands-on technical support we think providers need to make this transition. It's not just that the act gives physicians financial incentives to buy a computer and plug it in; we understand the steps along the way of reorganizing workflow and retraining staff that are going to require hands-on support. So the money going out is to establish an on-the-ground program for that kind of personal technical assistance and help.”

Ms. Sebelius noted that the grants are particularly targeted toward smaller providers “who haven't waded into the area before. This is an incredibly important part of making this transition.”

In December, HHS issued a proposed regulation defining “meaningful use” and explaining how providers can meet criteria for being meaningful users. In response to a question about physician concerns that the regulation is too complex, Dr. David Blumenthal, national coordinator for health information technology, noted that the regulations are only a proposal at this point.

“We are very anxious to hear what the physician community has to say about it and the ways in which they feel it needs to be changed,” he said.

“I can certainly identify [with physicians], because as an internist, I had to go through the process of learning how to use an electronic health record, and I know it's not easy, but we're going to be providing support nationwide—the kind of support doctors have never had before,” he said.

VITALS

The White House is trying to get health care workers ready to help physicians in computerizing their medical records.

Nearly $1 billion in American Reinvestment and Recovery Act awards will be made to help health care providers become “meaningful users” of health information technology and to train nurses and other allied health professionals for careers in health information technology. Jobs created will include nurses, pharmacy technicians, and IT technicians and trainers, according to Health and Human Services Secretary Kathleen Sebelius and Labor Secretary Hilda Solis.

“These investments will serve to train almost 50,000 workers in Department of Labor programs plus thousands more hired for HHS regional extension centers in the months ahead,” Jared Bernstein, chief economist to Vice President Joe Biden, said in a teleconference. “By providing seed capital, we are helping to seed an emerging industry that will create new jobs well after the Recovery Act has ended.”

Under the Health Information Technology for Economic and Clinical Health Act (HITECH), a part of the 2009 federal stimulus law, physicians who treat Medicare patients can receive up to $44,000 over 5 years for the meaningful use of a certified health information system. Those whose populations are made up of at least 30% Medicaid patients can earn up to $64,000 in incentive payments for their use of the technology.

The proposed regulations include a definition of meaningful use and outline other criteria for obtaining the full incentive payments.

The awards, which were announced Feb. 12, include more than $750 million in HHS grants. Of that, $386 million will go to 40 states and their designated entities to help develop state-level health information exchanges (HIE), and another $375 million will be awarded to 32 nonprofit organizations to support the development of regional extension centers (REC), which will aid providers in using health information technology. Additional HIE and REC awards will be announced soon, according to a statement.

The grants will make it easier for physicians who are just getting started with electronic health records, Ms. Sebelius told this publication. “The people who will be trained by the grants … will actually provide the kind of hands-on technical support we think providers need to make this transition. It's not just that the act gives physicians financial incentives to buy a computer and plug it in; we understand the steps along the way of reorganizing workflow and retraining staff that are going to require hands-on support. So the money going out is to establish an on-the-ground program for that kind of personal technical assistance and help.”

Ms. Sebelius noted that the grants are particularly targeted toward smaller providers “who haven't waded into the area before. This is an incredibly important part of making this transition.”

In December, HHS issued a proposed regulation defining “meaningful use” and explaining how providers can meet criteria for being meaningful users. In response to a question about physician concerns that the regulation is too complex, Dr. David Blumenthal, national coordinator for health information technology, noted that the regulations are only a proposal at this point.

“We are very anxious to hear what the physician community has to say about it and the ways in which they feel it needs to be changed,” he said.

“I can certainly identify [with physicians], because as an internist, I had to go through the process of learning how to use an electronic health record, and I know it's not easy, but we're going to be providing support nationwide—the kind of support doctors have never had before,” he said.

VITALS