AUGUST

Government provides boost for nation's healthcare IT leader The government will formalize the role of the nation's top healthcare information technology leader and create five sub-offices within the Office of the National Coordinator for Health Information Technology. Healthcare IT groups praised the announcement, saying it gives federal healthcare IT activities an added boost. Source: Healthcare IT News / Caroline Broder, Senior Editor

HIMSS Reports:  Another Patient Safety Bill Introduced by Senator Frist.  S. 1503, the "Healthy America Act of 2005", was introduced by Senators Frist, McConnell, Gregg, Enzi, Murkowski and DeMint on July 26 that proposes to reduce healthcare costs, expand access to affordable healthcare coverage, and improve healthcare and strengthen the healthcare safety net.  Specifically, the legislation includes provisions on:  value based purchasing, expansion of the Medicare-Medicaid Data Match pilot program, codifies the Office of the National Coordinator for Health Information Technology, codifies the American Health Information Collaborative, proposes to implement and certify health information standards, studies state laws and practices, studies HIPAA, and provides Stark Reform and Anti-kickback Act exemptions.  HIMSS Advocacy Legislation/Regulation Review task force is reviewing this new legislation and input is welcome at advocacy@himss.org.

HHS Clarifies Claims of Free EHR Software Offering By Neil Versel, contributing editor Officials in the Department of Health and Human Services (HHS) are clarifying claims made in a recent New York Times article that office-based physicians are in line to get free electronic health records systems. Although HHS is preparing to release a scaled-down version of a public-domain EHR system long in use at veterans hospitals and clinics nationwide, the software will not be totally free. Private medical practices will have to pay a $2,700 licensing fee, per doc, for the first year, according to Gary Carr, a spokesman for the Centers for Medicare and Medicaid Services (CMS), and even the Times said that implementation costs would run in the thousands for a typical physician practice. Media and healthcare interests all over the country picked up on the Times headline, which read, "U.S. Will Offer Doctors Free Electronic Records System," and on some of the more declarative statements in the article. "In an unprecedented move, [CMS] said it planned to announce that it would give doctors-free of charge-software to computerize their medical practices. An office with five doctors could save more than $100,000 by choosing the Medicare software rather than buying software from a private company, officials say," according to the Times. In truth, CMS has acknowledged for nearly a year that the Medicare agency was working with the Department of Veterans Affairs to create a version of the Veterans Health Information Systems and Technology Architecture (VistA) EHR system that is more suited to small medical practices as a means of promoting adoption of electronic records. (See CMS Unveils Plan for VistA-Lite, While AMA Lightens IT Proposal, Health-IT World, June 15, 2004.) Our main focus now is on the ambulatory electronic health record," national Health-IT coordinator David Brailer, M.D., said last week. "To me, this is not about buying technology. This is about changing healthcare," Brailer added. Indeed, several HHS representatives told Health-IT World News that "Medicare is not in the software business." The software, dubbed VistA-Office EHR, is coming from CMS because the VA does not have the authority to spend money on non-veterans. VistA-Office EHR is due to be released Aug. 1, but HHS officials said last week that CMS may miss the target date. The Times story did not quote any federal official and an aide Brailer said that the Times reporter did not contact the Office of the National Coordinator for Health Information Technology for the article.

Government Computer News Hill takes a scalpel to VA’s IT budget By Mary Mosquera GCN Staff Lawmakers slash funds for HealtheVet, saying VA didn’t provide spending details Congress is taking a hard line on the Veterans Affairs De-partment’s IT budget. After the failure of the Core Financial and Logistics System last year and a critical report on the agency’s next large IT project, HealtheVet, the House Appropriations Committee last week cut $383 million from the administration’s request for a $385.7 million increase. Lawmakers left HealtheVet with $11 million from the overall IT budget for a feasibility and planning study. VA had planned on $311 million as the first installment of a proposed $3.5 billion, 10-year program. Now the program could be delayed by at least a year. The House committee also cut $40 million for the Veterans Health Information Systems and Technology Architecture legacy hospital system, which HealtheVet is expected to modernize. Lawmakers also shaved $30 million from the CoreFLS project and from VA’s computing infrastructure. “The requested increase, most of it tied to one project, has not been adequately justified in the budget or in responses to questions asked during the budget hearing earlier this year,” the committee said in its report. The committee approved $68.1 billion in overall spending for VA programs, health care and construction in the Military Quality of Life and VA spending bill last week, $700 million more than what President Bush proposed in his 2006 budget request. Next, the full House will next vote on the legislation. The Senate Appropriations Committee will ideally start its VA considerations based on the completed House Appropriations version, said committee spokeswoman Jenny Manley. It could be several weeks before the Senate committee begins its deliberations on HealtheVet and other VA spending, she said. HealtheVet is a Web system designed to replace the VistA program, an electronic medical- records and clinical-care system used throughout VA’s 1,000 plus medical facilities. VA plans to re-host, enhance or re-engineer VistA and other current health information applications to process on the new platform but keep the same functionality. The impetus for the cuts, lawmakers said, were because VA officials did not provide them with sufficient details about how the agency would spend funds for HealtheVet, a committee spokes-man said. “It is incumbent upon the agency to provide details and substantive analysis, particularly IT projects, about how it will spend the money it is requesting,” said John Scofield, spokesman for the House Appropriations Committee. But VA CIO Robert McFarland said VA will and always has met lawmakers’ requests. “If they call and want more information on a particular project, I will give whatever they ask for, provided I have the information,” he said. McFarland would not comment on the legislation and how it would affect development of HealtheVet. “When the budget comes out, we will deal with the budget,” he said. The underlying fact, however, is that VA has gone back to the drawing board to fix problems revealed in an outside consultant’s assessment of the system. The House committee action comes several weeks after a report by Carnegie Mellon University’s Software Engineering Institute that criticized HealtheVet’s technical design and development. Second setback The latest assessment also follows last year’s CoreFLS debacle when VA had to pull the plug on its $372 million system because the pilot did not perform properly. “We are hoping to move forward on HealtheVet when we have completed a solid design and development plan that has been vetted through all channels,” McFarland said. That’s what SEI’s independent assessment was all about, he added. Lawmakers who oversee VA said they were waiting to see how the agency corrects the shortcomings outlined in the SEI study. Earlier in the appropriations process, the House Veterans Affairs Committee also put HealtheVet funding on hold. “We’re comfortable with withholding those funds if it is through 2006. It needs to be allocated only with confidence,” said Brooke Adams, spokeswoman for House Veterans Affairs Committee chairman Steve Buyer (R-Ind.). “I think we were taking a strategic pause to decipher how this is going to unfold. We just want to make sure there is some level of guarantee that it will be positive,” she said. Lawmakers want to be sure that HealtheVet and the legacy medical system will flow seamlessly. Adams praised McFarland for hiring outside government to determine the system’s shortcoming. Withholding funding for HealtheVet also presents mixed feelings for other lawmakers, such as Sen. Larry Craig (R-Idaho), chairman of the Senate Veterans Affairs Committee. Craig said he wants to provide veterans with improved health care but is constrained by the budget. “I want to get it right from the start so that we don’t waste money. At the same time I want today’s veterans to enjoy full access to the best medical systems and technology available. But we must do that within our means and within our budget,” he said. More news on related topics: IT Infrastructure, IT in Action, Policy / Regulation