Ohio Health Policy Review

Ohio’s Hospital Compare site goes live

The Ohio Department of Health this month launched a new Web site that lets users look up outcomes, patient satisfaction and other performance measures for hospitals across the state (Source: “State launches new Web site to compare hospitals,” Akron Beacon-Journal, Jan. 4, 2010).

The free Ohio Hospital Compare tool includes more than 100 measures in a dozen categories: heart attack care, heart failure care, heart surgery, stroke care, pneumonia care, surgical care, hospital-acquired infections, infection prevention measures, patient safety, patient satisfaction, children's asthma care and pregnancy/delivery.

The majority of the data available online is based on patient care delivered in 2008. Although about 65 percent of the information is obtainable from other sources, primarily from the online hospital compare tool run by the U.S. Centers for Medicare & Medicaid Services, information about stroke care, heart surgery, patient safety, infection prevention measures and pregnancy care at hospitals previously wasn't easily accessible for Ohio patients, according to ODH officials.

Ohio hospitals listed among nation’s best for HIT quality

Health IT watchdog group Leapfrog has released its list of the 45 best hospitals in the nation for HIT quality, and it includes several from Ohio (Source: “Leapfrog names 45 best hospitals in country for 2009,” Healthcare IT News, Dec. 4, 2009).

Cincinnati Children’s Hospital was listed among the nation’s top pediatric hospitals, and both the Ohio State University Medical Center and its affiliated James Cancer Hospital and Solove Research Institute were listed among the top urban hospitals.

The rankings are based on Leapfrog’s Hospital Survey, which the organization touts as the only national, public comparison of hospitals on issues including mortality rates for certain common procedures, infection rates, safety practices, and measures of efficiency.

Harvard study raises doubts about HIT cost savings

A study by researchers from Harvard University concludes that new electronic records systems installed at hospitals across the country did little to reduce healthcare costs (Source: “No hospital savings with electronic records: study,” Reuters, Nov. 20, 2009).

A review of about 4,000 hospitals from 2003 to 2007 that adopted EMR systems found that administrative costs actually rose.  The study was published in the American Journal of Medicine and was released by Physicians for a National Health Program, an advocacy group that supports a single-payer healthcare system.

"Our study finds that hospital computerization hasn't saved a dime, nor has it improved administrative efficiency," said Himmelstein, who oversees clinical computing at Cambridge Hospital in Massachusetts. "Claims that health IT will slash costs and help pay for the reforms being debated in Congress are wishful thinking."

The researchers analyzed data from the industry's Healthcare Information and Management Systems Society, hospital reports on costs incurred through the Medicare insurance program for the elderly and the 2008 Dartmouth Health Atlas, which compiles government health data.

AHRQ study touts consumer benefits of HIT

A new study from the Agency for Healthcare Research and Quality concludes that consumer HIT tools hold “significant” promise for improving health outcomes (Source: “Consumer technology may improve health outcomes,” Government Health IT, Oct. 23, 2009).

The study (pdf, 549 pages)found that the use of consumer technology had the strongest influence on clinical outcomes for management of mental health symptoms of depressions, anxiety and stress.

“Available literature suggests that select consumer health informatics applications may effectively engage consumers, enhance traditional clinical interventions, and improve both intermediate and clinical health outcomes,” the study said.

Study: Medical home plus HIT may alleviate PCP shortage

A study by Seattle-based Group Health Cooperative has found that the combination of the medical home model and health information technology could alleviate the nation’s primary care physician shortage (Source: “Study: Medical home model increases quality of care, reduces cost,” Healthcare IT News, Sept. 1, 2009).

According to the study (pdf, 17 pages), which appeared in the American Journal of Managed Care, a comparison of a sample of 9,200 patients from Group Health’s medical home with a control group found that after one year, patient visits to emergency room decrease by 29 percent. The rate of hospitalizations dropped by 11 percent and the medical home had 6 percent fewer in-person visits.

The study also found that with the aid of HIT, only 10 percent of medical home doctors and staff felt “burnt out” or emotionally exhausted – compared to 30 percent of doctors from the control group.

According to the Department of Health and Human Services, there is a shortage of more than 16,000 primary care doctors in the United States. About 26,000 new doctors enter the workforce each year, but only about 6,500 enter primary care.

Report offers guidelines for states on HIT stimulus planning

The National Governors Association’s State Alliance for e-Health has published its interim guidelines for states as they begin work on implementing the HIT provisions of the federal economic stimulus plan (Source: “States Get Guidance for Promoting I.T.,” Health Data Management, Aug. 10, 2009).

The 32-page report (pdf) explains state roles and responsibilities in creating state-level health information exchanges; forthcoming stimulus grants for HIE efforts and electronic health records loan programs; Medicare and Medicaid incentive payments for EHR use; and forthcoming data standards and EHR certification criteria.

Report: Ohio docs lag behind on e-prescribing

A survey by the nation’s largest prescription network found that Ohio doctors are not embracing e-prescribing at the nearly the same rate as other states (Source: “Ohio doctors slow to sign on to system that allows electronic authorization of prescriptions,” Cleveland Plain Dealer, July 21, 2009).

In 2008, Ohio doctors electronically routed just 4.67 percent of prescriptions, according to Surescripts’ National Progress Report on E-Prescribing (pdf, 22 pages). Massachusetts tops the list for the second consecutive year with 20 percent, or more than four times Ohio's rate.

The number of prescriptions routed electronically nationwide grew from 29 million in 2007 to 68 million in 2008, and the number of e-prescribers jumped 12 percent.

Panel OKs HIT ‘meaningful use’ standards

The federal HIT Standards Committee approved Tuesday a set of recommended quality measures and standards that providers could use to demonstrate “meaningful use” of electronic health records (Source: “Health IT group approves standards and quality measures,” Government Health IT,  July 22, 2009)

Under the federal economic stimulus package, hospitals and physicians who demonstrate meaningful use of EHRs will qualify for Medicaid and Medicare incentive payments.

The standards panel endorsed a matrix of 27 quality measures and 12 standards that build on each other to improve patient outcomes. The standards call for health care providers to use health IT tools for transmitting:

• Continuity of care documents;
• Discharge summaries;
• Inpatient and outpatient prescriptions;
• Laboratory test results; and
• Other structured health data.

Dr. David Blumenthal, the national health IT coordinator, must craft an interim final rule on meaningful use criteria by December. The Centers for Medicare & Medicaid Services also is expected to issue a rule in December defining meaningful use for the incentive program.

Feds delay release of EHR ‘meaningful use’ definition

David Blumenthal, the Obama Administration’s point man on health information technology, has asked the federal Health IT Policy Committee’s meaningful use working group to amend recommendations on what defines “meaningful use,” a definition critical to determining who will receive a share of $19 billion in federal EHR money (Source: “First draft of EHR ‘meaningful use’ definition unveiled,” American Medical News, June 29, 2009).

"We had a lively discussion, and it was decided after considerable input on the topic of meaningful use that we would take it back to discussion to work on it a little bit longer," Dr. Blumenthal said. He said the committee expects to unveil revised recommendations by July 16, the date of its next scheduled meeting. The definition was originally expected to be released by late June.

In other health information technology news, the Agency for Healthcare Research and Quality is requestion information from small- and medium-sized practices on tools for analyzing and redesigning workflow before and after HIT implementation (Source: “AHRQ Seeks I.T. Workflow Options,” Health Data Management, June 25, 2009).

According to a notice (pdf, 3 pages) published in the Federal Registry, responses to questions will be incorporated into a toolkit used to assist small- and medium-sized practices in analyzing or redesigning workflow, either before or after health IT implementation. Comments should be submitted on or before August 24. Electronic responses should be addressed to WorkflowRFI@ahrq.hhs.gov. 

Feds unveil new rules for patient ID protection

Today marks the first day that the Federal Trade Commission will begin enforcing new identity theft rules for a number of industries including health care (Source: “Shield against ID theft grows,” Columbus Dispatch, May 1, 2009).

Under the new rules, health care providers must have a plan to verify a patient’s identity. The new rules also set more stringent standards for protecting paper medical records.

At the same time, the FTC announced last week that it is seeking public comment on a proposed rule that would require entities to notify consumers when the security of their electronic health information is breached (Source: “FTC Publishes Proposed Breach Notification Rule for Electronic Health Information,” TMC News/FTC news release, Apr 17, 2009) .

Among the HIT-related provisions in the American Recovery and Reinvestment Act is a requirement that the Department of Health and Human Services conduct a study and report, in consultation with the FTC, on potential privacy, security, and breach notification requirements for vendors of personal health records and related entities. The report must be completed by February 2010.

The FTC has created a special Web site to elicit public comments on its proposed EHR rules. The site will be open until June 1, after which the Commission will issue a final interim rule to be enforced until the HHS report is completed.