ONC: Health IT Buzz

The Office of the National Coordinator for Health Information Technology (ONC) has launched a second blog called the Health IT Buzz Blog.

Just a few weeks ago ONC announced the new Federal Advisory Committee Blog (FACA Blog).

The initial post by Dr. David Blumenthal, MD, MPP, National Coordinator for Health Information Technology, talks about the importance of using technology to continue the conversation on Health IT and create a forum for engagement.

Dr. Blumenthal's post goes on to state:

We intend to address a wide and diverse range of timely topics relevant to the “why’s and how’s” of efforts to support the secure and seamless exchange of electronic health information. We will discuss our ongoing work to protect patient privacy, secure information, and implement standards. We’ll also be using the blog to provide additional information regarding our new grant programs. And the conversation wouldn’t be complete without discussing the meaningful use rulemaking and incentive programs, clarifying our vision and addressing key challenges.

We want to hear from citizens, patients, health professionals, managers, policymakers, technology enthusiasts and technology skeptics. We can’t succeed unless we understand the wishes and concerns of the many constituencies we serve. So join us.

Tip to @ahier who pointed out the new ONC Blog.

AHLA: EHR, HIE and PHR Legal Liability Task Force

Today I participated in the first call of the American Health Lawyers Association's Task Force on Electronic Health Records and Legal Liability.

The task force will focus its efforts on the legal liabilities associated with Electronic Health Records (EHR), Health Information Exchanges (HIE) and Personal Health Records (PHR).

The group is being led by Jud DeLoss and Kathy Kenyon, both members of AHLA. There was a wealth of health lawyer experience and expertise on the initial conference call. I'm looking forward to helping out on the effort and learning lots from the the task force members on this project.

To follow up on Jud's blog post, we would welcome any input that others have on the legal liability issues.

A 1930 Medical Record

I was recently in my hometown of New Martinsville visiting my dad, a retired family physician. When I arrived he had waiting for me a copy of one of my grandfather's medical records from the 1930s. My grandfather, Dr. Albert Coffield, practiced rural medicine in Wetzel County, West Virginia from 1911 until his death in 1936.

My dad told me the following story about the medical record.

My dad was a doctor who practiced out of his house on Coffield Ridge in Wetzel County. After my dad died in 1936 our mother sold the household furnishing and his office equipment. I was 12 years old when he died and my older brother was a first year student at West Virginia University. Since my mother wasn't employed she decided to move us to Morgantown where the University was so that my older brother could continue his college education. As a way to continue the family income she rented rooms to college students - many who came to the University from Wetzel County.

Included in the sale of the household and office furnishing was a wooden credenza with metal alphabetized slides. Behind some of the slides were some old medical records that were left in the credenza.

Thirty years later a lady who was a patient of mine brought the wooden credenza to me and told me that she had bought the credenza at the auction of my family's household items in 1936. She told me that she thought I would appreciate having it.

Here are photos of the medical record of a patient from 1934. The medical record format is simple yet complete. It contains all the important demographic and clinical information - including the patient statement, habits, family history, past history, physician examination and diagnosis. On the back is additional space for notes and a drawing of the internal organs that I suspect was meant to be used with the patient for education and instruction. It even has a built in billing record section that even the change:healthcare crowd would love.

What can these photos tell us about the current health care reform debate. Compare these photos of a medical record from 1934 to those that cost .73 cents today. Could today's physician and his or her patient get "meaningful use" out of this record?

A close up of the billing section for the change:healthcare gang.

Visualizing HR 3962: Affordable Health Care for America Act

Below is a visual of the top 500 words used in HR 3962: Affordable Health Care for America Act. Since most people (including many of our representatives in Washington) haven't read all 1,990 pages of the Health Care Reform Bill, I thought a visual aid might be helpful.

I had been thinking of creating the word cloud of the Bill since it was introduced on October 29, 2009, however, yesterday a couple of tweets by Vince Kuraitis caught my eye and I finally got around to creating the HR 3962 Wordle Cloud this morning. Vince's tweets looked into the word count of a couple of key words in the Bill. His tweets:

• @VinceKuraitis "medical home" referenced 67 times in latest House #healthreform leg
• @VinceKuraitis "pilot program" referenced 106 times in latest #healthreform leg -- lots of experimentation

In creating the cloud I was able to look at the use of some other words in the Bill. Here is what I found:

• Privacy referenced 28 times
• Insurance referenced 552 times
• Physician referenced 182 times
• Hospital referenced 330 times
• Consumer referenced 36 times
• Consumer-directed referenced 1 time
• Consumer-oriented referenced 1 time

Click graphic for larger/clearer version. Thanks to Wordle (www.wordle.net) for the cloud.

Federal Advisory Committee Blog (FACA Blog)

The Office of the National Coordinator for Health Information Technology (ONCHIT) has launched a new blog called the Federal Advisory Committee Blog (FACA Blog).

The initial post by Judy Sparrow discusses that the FACA Blog will be uses in a spirit of transparency and collaboration to help open a broader dialogue on the issues before the Health IT Standards Committee and the Health IT Policy Committee. The post also provides some background on the role that Federal Advisory Groups play under the Federal Advisory Committee Act.

The second post by Aneesh Chopra, Federal Chief Technology Officer, spells out the planned process for an open conversation that will take place over the next couple of weeks with various committee members blogging about a variety of topics (Proposed Standards, Interoperability, Vocabularies, Privacy, Security, Quality, Implementation Cases Studies).

The FACA Blog allows individuals to share public comments on each post and has an RSS feed. Great to see ONCHIT using a blog platform to quickly and efficiently distribute information about the ongoing work being done by the committees to further the health information technology efforts under HITECH.

West Virginia H1N1 (Swine) Flu Resource Center

The West Virginia Department of Health and Human Resources (DHHR) unveiled a website for sharing information and updates specific to West Virginia about the H1N1 Flu also known as Swine Flu. The website has information for prevention, schools, businesses, parents and providers.

The new West Virginia H1N1 (Swine) Flu Resource Center can be found at www.wvflu.org. The website also has includes a link to the federal Flu.Gov website with national information.

Please spread the word about the new website (but don't spread the flu).

HIPAA Enforcement Meets HITECH: HIPAA Administrative Simplification: Enforcement Rule

On October 30, 2009, the Secretary of the Department of Health and Human Services (HHS) issued the HIPAA Administrative Simplification: Enforcement Interim Final Rule, 45 CFR Part 160 (74 Federal Register 56123, October 30, 2009).

This new rule was developed and adopted by HHS to conform the enforcement regulations under HIPAA to the revisions made to HIPAA under the Health Information Technology for Economic and Clinical Health Act (HITECH), which was part of the American Recovery and Reinvestment Act of 2009 (ARRA).

The rule amends the HIPAA enforcement regulations to include the imposition of tiered ranges for civil money penalty amounts based upon an increasing culpability associated with the violation. A full chart of the violation categories and related amounts can be found in the rule.

The interim final rule is effective on November 30, 2009. Comments on the rule can be made prior to December 29, 2009.