Health costs Archives

While health-care professionals seem to love iPads, health IT professionals are less enamored with the consumer-friendly tablet computers, according to a new industry report.

Doctors and others are more likely to use technology they like, which could help chief information officers get everyone on board in using electronic health records and other health IT systems. But iPads in particular are challenging to integrate into existing health IT, according to the report from BizTechReports, "Diagnosis Danger: Governance and Security Issues Cause IT Concerns About iPad in Healthcare Settings."

"There is a sense of concern among healthcare IT executives that pressure to meet the demands of end-users to support consumer-grade computing and communications devices like the iPad is coming at the expense of other important priorities," the researchers reported.

Areas of concern reported by the 100 hospital and clinic CIOs and other health IT executives interviewed by BizTechReports, an independent, Washington, D.C.-based research group, include:

• Compliance with privacy governance requirements.


• The need to manage risk while sharing health information with other users.


• The ability to quickly react to and remediate data breaches.


• Integration with end-to-end productivity systems.

For example, electronic patient records are not meant to be managed on consumer-grade technology like the iPad, according to the report. It's also difficult to enter information from an iPad into an enterprise system like an EHR. Nor do iPads have mechanical keyboards or USB ports that can attach devices such as barcode scanners, severely limiting the number of applications they can support.

Panasonic Solutions Co. teamed with BizTechReports to produce the study.

A population that is on the move will increasingly turn to mobile health applications, predicts a new market study.

The Hampshire, England-based Juniper Research Ltd. projects that mobile networks will monitor 3 million patients by 2016, according to a company news release. The growth will be fueled in part by increasingly more capable smartphones, the company says.

U.S. insurers already offer reimbursement for mobile cardiac monitoring, which makes the monitoring of cardiac outpatients the top remote monitoring field, according to Jupiter. But the analysis projects growth in the monitoring of other chronic diseases, including diabetes and Chronic Obstructive Pulmonary Disease.

Other projections:

• Consumers will download 44 million mHealth and medical applications this year.


• That number will grow to 142 million in 2016.


• Electronic health records will eventually be an important piece of mHealth offerings.


• Smartphone-based patient monitoring will replace expensive specialized remote monitoring systems and drive down mHealth costs.

The nation's health IT czar polished off his crystal ball this week and predicted five major health IT trends for the year. Dr. Farzad Mostashari, national coordinator for health IT, shared the prognostications on his office's Health IT Buzz blog:

• Meaningful use takes off. Mostashari projects that at least 100,000 providers will demonstrate that their electronic health records meet ONC standards for "meaningful use" by the end of the year, enabling them to receive Medicare or Medicaid incentive payments.


• Health information exchanges turn a corner. "ONC efforts are critical," he writes. "Robust policies that protect information and create public trust will galvanize rapid growth and innovation in health information exchange.


• The dots connect between health IT and payment reform. Pay-for-service models lead to higher costs, he argues, just as health IT helps hospitals and practices to move away from traditional pay models. "We are headed toward a virtuous cycle where payment reform improves the business case for using health IT and greater use of health IT improves the chances that new payment models will succeed."


• Consumers take advantage of eHealth resources. Mobile apps and other technological advances make it easier for patients to become more involved in improving their health, Mostashari says.


• Innovation drives improvement. Efforts in 2012 will focus on improving the usability of EHRs, he says.

Venture capitalists continue to view health IT companies favorably.

Investment by VC funds in the health IT sector increased 22 percent last year over the 2010 total, far outpacing the overall 10 percent increase in the amount of capital raised across all industry sectors, according to a Jan. 20 report by Dow Jones VentureSource.

Venture capital firms invested $633 million in 86 health IT deals last year, according to a news release. That's a 26 percent increase in the number of deals done in 2010.

Overall, venture capitalists invested $8.4 billion in the health-care sector in 2011, up only slightly from the $8.3 billion invested in 2010. Biopharmaceuticals led the category, followed by medical devices.

Venture capitalists poured $32.6 billion into 3,209 deals across all industry sectors, according to the release.

The full report is available online for VentureSource subscribers.

Here are the top 10 developments in health IT for 2011, straight from the national coordinator for health IT. Dr. Farzad Mostashari released the month-by-month list Jan. 6 on his Health IT Buzz blog:

• January: Medicare and Medicaid electronic health record incentive programs launched. Since then, "the marketplace of certified products has grown quickly, interest in meaningful use among providers and hospitals is sky-high, and the pace of incentive payments has continued to accelerate," Mostashari said. More than $1.8 billion in incentives had been paid to more than 20,000 health-care providers and 1,200 hospitals as of Nov. 30.


• February: ONC launched Direct Project, providing "a simple, secure, standards-based way for providers and other participants to send encrypted health information directly to trusted recipients over the Internet - a kind of 'health email,'" Mostashari said. Multiple vendors and states are implementing the system.


• March: The Health and Human Services Department, ONC's parent agency, released its National Quality Strategy, a framework to guide efforts to improve health-care, with health IT as a critical component.


• April: The "Summer of Standards" kicked off, a series of standards and interoperability forums to support Stage 2 standards and certification requirements for EHR incentive programs, resulting in consensus being reached on the Consolidated Clinical Document Architecture. Mostashari described the architecture as a "single, broadly supported electronic data standard for patient care transitions."


• June: The Investing in Innovations (i2) program used challenges and prizes to promote innovations in health IT. Several i2 challenges have been launched since, including a call to create applications "activating and empowering patients to improve their heart health."


• July: Health IT training curriculum was released on the open market in July. Employment continued growing in the health IT workforce, which added more than 50,000 jobs between 2008 and 2010, according to the Bureau of Labor Statistics.


• September: HHS' Office for Civil Rights issued its first report to Congress on breaches of protected health information. Breaches now must be reported to HHS, those affected, and in some cases the news media.


• September: ONC formally launched its Consumer e-Health Program, with the Centers for Medicare and Medicaid Services and the Centers for Disease Control and Prevention proposing regulations making it easier for patients to access lab data. More than 250 organizations covering more than 100 million people, including Aetna, the Mayo Clinic and AARP, have "agreed to make health information easily available to consumers," Mostashari said.


• October: ONC's 62 Regional Extension Centers passed their goals to enroll 100,000 "priority" primary-care providers nationwide, and by mid-December had enrolled 116,000 providers requesting help with EHR implementation, including 70 percent of rural primary-care providers.


• November: A CDC survey of office-based physicians showed the percentage of nonhospital-based physicians with a basic EHR doubled from 17 percent in 2008 to 34 percent in 2011, with nearly 40 percent of primary-care physicians adopting an EHR. The proportion of hospitals operating EHRs with the functionality required in the Medicare and Medicaid incentive programs rose from 2 percent to 41 percent, among hospitals eligible for the incentives.

The District of Columbia is shifting away from a formal health information exchange to a less-robust email system for sharing medical data among providers, citing problems with financing and physician compliance as reasons for the shift.

Bids are due Jan. 13 for contractors seeking to build an email platform for D.C. physicians and hospitals to exchange information by the end of June, the Washington Business Journal reported Tuesday. The district can renew the one-year contract for three more years, the newspaper said.

The email system should be able to eventually plug into a nationwide health information exchange, the paper reported.

The D.C. Primary Care Association shut down its D.C. Regional Health Information Organization in October, citing lack of funding, according to the paper. Federal health IT grants that would have gone to the regional health exchange now will go to the email network, to be called Direct Project.

Spending by federal government agencies on health IT systems and services will grow from $4.5 billion in 2011 to $6.5 billion in 2016, a new report projects.

At an anticipated compound annual growth rate of 7.5 percent during the five-year forecast period, total federal health IT spending will increase an estimated 44 percent, according to the new GovWin report from research firm Deltek.

The forecast, Federal Health Information Technology Market, 2011-2016, looks at trends that are likely to affect the federal health IT market as well as the expected impact on vendors, systems integrators and federal contractors over the next five years.

Key findings of the report include:

• Technology advances, as well as potential long-term cost savings and better health outcomes, drive demand for mobility, telehealth, informatics, decision support, interoperability and common EHRs.


• Federal agencies possess the most advanced EHRs in the world, however due to their age and legacy architectures and technologies, they are overly ripe for major transformation.


• The federal government is the single largest payer of health care services in the U.S., and as such must transform from a "pay for service" model to a "pay for health" model in order to reduce costs and improve population health outcomes.


• Data security, program integrity, care coordination, political agendas, and the deficit present challenges to federal and nationwide health IT adoption and implementation.

In addition, the HITECH Act and the Affordable Care Act are driving government agencies to adopt health IT. "Agencies will be forced to spend money to save money in the long run by investing in electronic health record (EHR) systems, IT infrastructure modernization for health-related agencies, payment system transformation, and IT to promote advancement in population health," the report says.

GovWin is an industry information service of Deltek, a "provider of enterprise software and information solutions for professional services firms and government contractors."

If you were preoccupied last week with the seasonal imperative to give gifts, you may have missed an announcement, put out by the Office of the National Coordinator, that its gifts come with strings attached.

ONC announced in the Federal Register that it would create databases to track, monitor and assess the performance of individuals who receive grants intended to promote development of an interoperable system for sharing health information.

The "ONC Health IT Dashboard" will assess the progress of providers who receive incentive funds to spur the "meaningful use" of electronic health records as well as providers who participate in other health IT programs, including regional extension centers.

The program will take effect within 30 days, according to the announcement.

While the overall economy may well continue to sputter, the health IT market should be hitting on all cylinders over the next five years, a new industry report predicts.

One slice of the market, federal spending on health IT, is expected to grow from $4.5 billion in 2011 to $6.5 billion in 2016, for an annualized growth rate of 7.5 percent, according to a summary of the report, "Federal Health Information Technology Market, 2011-2016." The market report by Deltek, a Herndon, Va.-based software and information services provider, is available for purchase.

Key findings, according to the summary, include:

• Demand for mobility, telehealth, informatics, decision support, interoperability and common electronic health records will be driven by technology advances, potential long-term costs savings and improved patient outcomes.


• Aging EHRs operated by federal agencies "are overly ripe for major transformation."


• The federal government must transition from a "pay for service" model to a "pay for health" model that emphasizes outcomes.


• Health IT adoption is threatened by data security, program integrity, care coordination, political agendas and the federal deficit.

An industry trade group is proposing that Congress authorize Medicaid coverage for maternal and neonatal care via telemedicine "birthing networks." Medicaid recipients with high-risk pregnancies would be eligible for the program.

The proposal, by the Washington, D.C.-based American Telemedicine Association, encourages adoption of state networks through a "shared savings approach" that rewards participating health-care providers. To encourage state participation, it also recommends that the federal government cover 90 percent of network development costs in the first two years. The birthing network would be modeled after the nearly 10-year-old University of Arkansas ANGELS (Antenatal and Neonatal Guidelines, Education and Learning System) Program, the association says in a press release.

The networks "could leverage telemedicine technologies to more effectively treat major conditions associated with high-risk pregnancies, including pre-term labor, gestational hypertension, mild preeclampsia and gestational diabetes mellitus," the ATA says. The U.S. Department of Health and Human Services would monitor network performance.

The association cites a study it funded, saying birthing networks could save taxpayers up to $186 million over 10 years. The study, by Avalere Health of Washington, D.C., finds that savings would come from less use of hospital and physician services.