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Vice President Joe Biden and Health and Human Services Secretary Kathleen Sebelius Thursday will formally announce the application process for $1.2 billion in grants to help expand the nation's electronic medical records system.

The funding, included in the $787 billion economic stimulus, comes as the vice president campaigns for a legislative health insurance overhaul at a roundtable discussion at Mt. Sinai Hospital in Chicago. He and Sebelius will be joined by David Blumenthal, the national coordinator for health information technology.

It's one of two administration events this week to highlight the efficiencies of electronic medical records, something concrete Democrats can point to as they promote their call for broader changes to the nation's health care system. A second event is scheduled for Friday in Ohio.

The grants include $598 million to establish 70 Health Information Technology Regional Extension Centers to help hospitals and clinicians, and $564 million to help states improve information sharing.

Biden, in a statement, said by expanding the use of electronic health records, "We are making health care safer; we're making it more efficient; we're making you healthier; and we're saving money along the way." Biden also will attend a fundraiser to stump for Rep. Debbie Halvorson, a freshman Democrat from Illinois.

A panel of educators and experts told the Federal Communications Commission today that its E-Rate program will need a lot more money to succeed in hooking more schools up with broadband connections.
Speaking today as part of the FCC?s series of hearings on developing a national broadband plan, the panel praised E-Rate for giving more schools and libraries across the United States access to telecommunications services. However, they noted that the program?s annual funding cap of $2.25 billion has gone unchanged since its inception last decade. Sheryl Abshire, the Chief Technology Officer for the Calcasieu Parish School System in Lake Charles, Louisiana, recommended raising the E-Rate cap to roughly $4 billion a year to give schools and libraries the ability to invest in more high-speed broadband equipment.

?The E-Rate program should have a major role in the forthcoming broadband plan,? she said. ?With more funding the program will deliver broadband to schools and libraries.?

Carrie Lowe, a director at the Office of Information Technology Policy for the American Library Association, also praised E-Rate for helping libraries across the country gain access to more telecommunications services, as she noted that ?65% of public libraries have benefitted from E-Rate? and that ?without E-Rate there?s no way libraries could achieve the level of success they have today.? However, Lowe seconded Abshire?s suggestion that the FCC raise the annual cap to help schools and libraries invest more in information technology.

Tom Greaves, the chairman of the Greaves Group consulting firm that specializes in school technology adoption, said that his group conducted a survey showing that while the E-Rate program had indeed helped schools and libraries purchase telecom services, it could be doing a lot more. For instance, he said that 54% of the schools surveyed said that they won?t be able to get enough money to effectively expand their broadband capabilities. 34% of schools surveyed said that even if had sufficient money to purchase broadband services, they wouldn?t get them because they aren?t yet available in their area.

A recent report issued by the Government Accountability Office backs up the panelists? claims that E-Rate is currently lagging behind where it should be in terms of both funding and school participation. However, the GAO said that the program?s funding problems weren?t merely that it doled out too little money, but that it didn?t efficiently disperse the funds that it allocated.

In a wide-ranging review of the program, the GAO found that only around 63% of the estimated 150,000 eligible schools and libraries have taken advantage of the program. There is a very sharp divide in the participation rate between public and private schools, as 83% of eligible public schools utilize the program vs. 13% of eligible private schools. Additionally, the report found that only half of eligible library systems participate in the program and that less than a third of eligible library branches utilize it.

Moving beyond the participation rate, the GAO said that the program has significant troubles with efficiently dispersing the funds it allocates. The GAO's review of E-Rate funding finds that more than one quarter of the $19.5 billion committed to schools and libraries between 1998 and 2006 were not paid out. In 2006, a full 35% of participants received less than 75% of the funds they were allocated through the program, and 9% of the schools and libraries didn't receive any of the funds they were allocated.

The two major reasons for these unused funds, says the GAO, are that participants overbudgeted their needs and applied for more money than necessary and that participants sometimes did not seek reimbursement for the full amounts of their expenses. These unused funds are a problem, the GAO argues, because it means vastly less funding for routers, switches and other technologies that help improve Web connectivity.

Original story - www.networkworld.com/nwlookup.jsp?rid=183554

Read more: http://www.sfgate.com/cgi-bin/article.cgi?f=/g/a/2009/08/20/urnidgns852573C4006938800025761800790659.DTL#ixzz0Ovzhx9PV

The Obama administration unveiled $1.2 billion in federal grants for electronic health records systems on Thursday, the first wave of funding under a health-care reform plan to create vast records-sharing networks aimed at cutting costs and improving care in the coming decade.

Local employers are heaping praise on the expansion of health information technology to be financed by pending national health care reform legislation.

That doesn’t quite compute: The bills being debated call for little health IT expansion beyond a proposed online marketplace to shop for plans. Still, employers that think health IT will drive any successful reform effort can stay juiced. It’s just that health IT’s multibillion-dollar jolt will come from another source.

“The significant investment in HIT was made through the stimulus bill,” said Robin McClean, a government relations specialist for Cerner Corp., a Kansas City-based vendor dedicated to taking the clipboard out of medicine.

Business views the electronic patient chart as a long overdue no-brainer, and reform advocates tout it as a cost-cutting offset to pricey reforms. But initially, health IT expansion won’t come cheap. The federal stimulus act President Obama signed in February provides nearly $54 billion for it, McClean said.

That includes about $35 billion for temporary Medicare and Medicaid reimbursement bonuses for providers who demonstrate “meaningful use” of health IT, she said. Scheduled to begin in 2011, the payment bonuses will total as much as $64,000 a physician and as much as $11 million a hospital.

Reform advocates hope the incentives — and eventual penalties for those who don’t meet the yet-to-be-released meaningful-use standards — will make interoperable electronic medical record systems standard by 2014.

They say that will lead to huge health care cost savings. But the savings remain hard to quantify outside of studies conducted to encourage government spending on health IT.

In 2005, a RAND Corp. study partly financed by Cerner found that widespread adoption of electronic medical record systems could save the U.S. system $81 billion to $162 billion a year.

Two years later, The University of Kansas Hospital began installing an electronic medical record system with a five-year capital and operating cost of $51 million. Installation is expected to be done next year, when a computerized physician order-entry system will be rolled out, allowing 950-plus doctors, residents and students to enter orders electronically. But Chris Hansen, KU Hospital’s chief information officer, still can’t quote expected returns on investment.

Judging from progress reports from the federal committee developing the meaningful-use standards, Hansen said, he’s confident KU Hospital’s electronic medical record system will qualify the institution for reimbursement bonuses.

“But if we spent $51 million and get $11 million back (in bonuses) — that’s not an ROI I would take to the board,” Hansen said. “I’m not even sure the system will save us money (in the short term). But I think it will provide additional data that will position us better to save money in the future.”

Lori Mallory, CEO of Kansas City Internal Medicine, said the practice installed an electronic health record system from Allscripts-Misys Healthcare Solutions Inc. five years ago. Mallory was not able to quantify a return on investment, either.

But “there are cost savings,” she said, noting the reductions in space needs, staff time and duplicate tests that electronic records make possible.

Other savings are expected to accrue long-term from improvements in care quality facilitated by electronic records. Mallory said that one of those improvements is e-prescribing, which eliminates errors in interpreting doctors’ handwriting and allows the practice to identify and alert patients taking recalled drugs.

The Allscripts system also allows Kansas City Internal Medicine to improve care, and presumably reduce the cost of care, for patients with chronic conditions. For instance, Mallory said, the system allows the practice “to identify patients who may have uncontrolled diabetes and develop a proactive patient outreach plan to bring them back in to better manage their chronic condition, which is truly wonderful.”

Bill Bruning, CEO of the Mid-America Coalition on Health Care, said the large, savvy employers the organization represents know that savings also can result from employees getting more engaged in their health through electronic access to their charts and online wellness programs. For employers that self-insure, reductions in employee claims result in direct and immediate savings, he said.

“Over time, there will be a clear return coming out of electronic records that can be exchanged among providers,” Bruning said. “But it’s unclear how long it will take and to whom the benefits will most directly accrue.”

Dr. John Yeast, vice president of medical affairs for Saint Luke’s Hospital, was also short of ROI statistics. But he said there’s little question that increased spending on health IT will lead to big long-term savings through the improvements in how providers are paid and how they treat patients.

Computerized physician order entry, for instance, uses embedded alerts to advise doctors when they are varying from agreed-upon evidence-based treatment protocols. Those protocols will continue to be refined as widespread use of electronic records delivers megadoses of new outcomes data that can be aggregated and mined by medical researchers.

Toward that end, Cerner’s McClean said, the stimulus act includes $10 billion for health IT research by the National Institutes of Health, plus $1.1 billion for evidence-based research.

In addition, Yeast said, health IT expansion should help facilitate a shift away from the current fee-for-service payments, in which doctors have an incentive to order more visits and procedures.

Yeast envisions a new world in which electronic systems track — and providers get paid for — things such as e-visits, medication management and condition tracking that improve quality and minimize costs.
What are electronic medical records, and how do they cut costs?

Electronic medical records are the computer-generated records that care providers use to collect and store data about patients and their medical histories.

Electronic health records are subsets of EMRs that are owned by the patient and accessible by multiple providers via some type of health information network.

Here are some of the ways electronic record systems can cut health care costs:

• Systems that require computerized physician order entry include embedded alerts and protocols that help providers make the best care decisions. This can minimize lengths of stay, complications and readmissions.

• In the future, proof that doctors have followed evidence-based protocols accessible through EMR systems may be considered grounds for avoiding or minimizing malpractice claims. This will reduce costs associated with “defensive medicine.”

• Medication data stored in the records can prevent adverse drug-drug, drug-lab and drug-allergy interactions.

• E-prescribing prevents errors in interpreting handwriting and allows patients who are taking recalled drugs to be identified and alerted.

• Care for patient populations with chronic conditions, such as diabetes, can be tracked electronically, allowing doctors to notify patients who have missed a recommended test or procedure. This can prevent complications and higher-cost procedures such as amputations.

• EMR systems allow providers to mine outcomes data to show they have met various quality measures. Government and private payers are increasingly using such metrics to justify differentials in payments to providers.

• By following patients to multiple points of care, electronic records prevent one provider from ordering a test that has just been administered by another provider.

• Costs associated with transcribing a doctor’s notes, and filing and storing paper documents can be eliminated.

• Widespread EMR use will produce megadoses of outcomes data that can be mined by researchers. This will lead to refined evidence-based protocols, which should improve outcomes and lower costs.

• Improved data collection could help facilitate a shift from a fee-for-service payment system that creates incentives for more visits and procedures to one with more rewards for high-quality outcomes and efficient care, such as e-visits, preventive measures and patient education.

• Patients become more engaged in their health through easy access to their medical records. It is widely thought that this improves wellness and lowers cost.

The Arizona Government Information Technology Agency will seek a $4.3 million grant to help map broadband Internet coverage in the state.

GITA submitted the grant to the U.S. Department of Commerce’s National Telecommunications and Information Administration.

Chad Kirkpatrick, the state chief information officer and director of GITA, said the project is designed to find unserved and underserved areas of broadband in order to tie in more rural communities to the state’s telecommunications infrastructure.

NTIA is issuing the grants in hopes of putting together a national map of areas where broadband penetration is weak. The state’s application includes $3.8 million for mapping and another $500,000 for planning, the maximum amounts allowed in each category.

NTIA is one of the agencies, along with the U.S. Department of Agriculture’s Rural Utiltiy Service, coordinating more than $7.2 billion to upgrade the nation’s broadband infrastructure.

The grants for the first part of the money were due last Friday, and the state should hear back from NTIA by Sept. 15.

Fall semester classes at Chipola College begin Aug. 24 with late registration continuing through noon on Friday, Aug. 28.

Students who missed regular registration also may choose to enroll in Fall Term C which begins Oct. 15.

Three different terms are offered during the Fall semester. Terms A and B both begin Aug. 24. Term A runs Aug. 24 through Dec. 16. Term B classes are Aug. 24 through Oct. 15. Term C runs Oct. 16 through Dec 16.

Chipola’s open-door policy guarantees acceptance to any student with a standard high school diploma or its equivalent. Prospective students should complete a college application which is available in the Office of Admissions and Records, or online at www.chipola.edu. Students also must provide an official high school and college transcript.

Chipola offers day and evening courses, as well as independent study and online courses. Chipola has expanded its offerings to include more than 40 individual programs, including BS, AA, AS, AAS, Workforce Certificates and Continuing Education programs.

The college offers eight Bachelor of Science (BS) degree programs, including: Business Management, Elementary Education, Mathematics Education (5-9 or 6-12), Science Education (5-9 or 6-12), Exceptional Student Education and RN to BSN in Nursing. The Educator Preparation Institute (EPI) offers Teacher Certification for those with a B.S. in a non-teaching field.

The majority of Chipola students are enrolled in the Associate in Arts (AA) Degree program designed for students who plan to complete their first two years of college work at Chipola and then transfer to a four year program at Chipola or another college. Credits earned are transferable and are applicable toward a bachelor’s degree. Academic plans for specific majors are available on the college website at www.chipola.edu.

Registration continues throughout the Fall semester for several Workforce Development Certificate programs. These include: Automotive Service Technology, Certified Nursing Assistant (CNA), Computer Systems Technology, Correctional Officer, Cosmetology, Corrections, Firefighting and Law Enforcement.

Chipola offers more than a dozen Associate in Science (AS) degrees which provide professional training associated with specific careers, including: Business Administration, Computer Engineering Technology, Computer Information Technology, Criminal Justice Technology (Corrections/Law Enforcement and Crime Scene Investigation), Culinary Management, Early Childhood Education, Fire Science Technology, Networking Services Technology, Nursing (RN and LPN) and Recreation Technology. One Associate in Applied Science (AAS) Degree program in Criminal Justice Technology is available.

Three College Credit Certificate programs are offered in Child Care Center Management, Emergency Medical Technician (EMT) and Paramedic.

A variety of continuing education programs are available on campus in areas ranging from Child Care to Real Estate. Through partnerships with www.ed2go.com and www.gatlineducation.com, Chipola offers online courses in courses such as health care, internet graphics/web design, business and law.

Privacy and security issues are priorities for the administration when it comes to electronic health records, said government officials and members of a health information technology panel this week.

"Fundamentally, we recognize that meaningful use [of health IT] unquestionably brings in the privacy and security risks to the provider and to the consumers and that effectively addressing these risks is critical to the ultimate objective of furthering the adoption and proliferation" of electronic health records and information exchanges, said Dixie Baker, who leads the privacy and security work group of a health IT standards advisory committee to the Health and Human Services Department.

The Recovery Act provides nearly $20 billion to ensure every American has an e-health record by 2014. Eligible health care providers will be reimbursed for using health IT in a manner outlined in forthcoming federal criteria, including security specifications. Baker's workgroup, which is tasked with recommending such specifications, on Thursday called for keeping disclosures of electronic health information to a minimum, providing an account of all disclosures and allowing consumers to obtain copies of their electronic health records.

"When the HIPAA rules came into being, no health organizations had used wireless let alone cellular phones with a camera built-in," said Baker, an official with technical services firm SAIC. The 1996 Health Insurance Portability and Accountability Act, requires patient confidentiality. But health IT vendors such as Google, Microsoft and data aggregators are exempt from the law.

Members of the work group also recommended periodic reviews of information system configurations to ensure access to patients' e-health records is granted only to relevant personnel. In addition, all personal health information transmitted internally should be encrypted, if there is a chance the data will travel over unsecured wireless or cellular networks.

Baker noted that some of the group's most extensive discussions have centered on encryption, or coding data to render it unintelligible.

All transmissions that leave a health care facility and cross over shared networks also should be encrypted, the members recommended.

Meanwhile on Wednesday, David Blumenthal, national coordinator for health IT, sent the first in a series of e-mail updates to the public on the rollout of initiatives mandated by the Recovery Act.

A footer on the message encouraged readers "to share this information as we work together to enhance the quality, safety and value of care and the health of all Americans through the use of electronic health records and health information technology."

Blumenthal's message acknowledged that widely available e-records will not be beneficial to people unless "we can assure all Americans that their personal health information will remain private and secure when this system exists" and called the establishment of safeguards for privacy "an ongoing priority that influences and guides all of our efforts."

Also on Wednesday, the Obama administration announced privacy safeguards aimed at regulating the entire health IT sector, including entities that HIPAA does not cover.

As part of that announcement, HHS issued new rules that require providers and insurers to notify patients when their electronic health information is breached. They also must alert the media when a breach affects more than 500 people.

In addition, the Federal Trade Commission released companion notification guidelines for personal health records that are handled by groups not covered under HIPAA.

The HHS rules include updated guidance on techniques for encrypting and destroying health information to render it unreadable to unauthorized users. Industries that follow these procedures do not have to notify patients when information is breached.

Under the guidance, which applies to the HHS and FTC rules, if a breach involves information that has been "deidentified" -- or stripped of names, birth dates, ZIP codes and other distinguishing data -- the leak would not be subject to notification requirements. The Center for Democracy and Technology, a civil rights organization, has criticized this exception because of the risk of re-identification. Part of the population can be re-identified when scrubbed information is combined with other data, such as voter registration lists, the group's officials said.