Ahier.net

Healthcare, Technology and Government 2.0 ~ I find interesting stuff on the Internet and aggregate it here

The Survivor – Clayton Christensen: A Life In Health

Clayton Christensen beat a heart attack, cancer and a stroke in three years. In the latest issue of Forbes magazine David Whelan interviewed the Harvard Business School professor and those close to him about his experience battling these three grave illnesses. The story covers it all: life, death and a plan to fix the health care system.

Below are some video highlights from the article series.

Clayton Christensen on Healthcare:

Clayton Christensen On Diabetes:

Clayton Christensen On his Heart Attack:

Clayton Christensen On Cancer:

Clayton Christensen On his Parents:

Clayton Christensen On Eye Surgery:

Clayton Christensen On Disrupting Health Care:

Clayton Christensen On Science and Religion:

New Study: Americans Trust Doctors but not EHRs

Americans trust their doctors, but do not trust EHRs.  According to a study to be released by CDW Healthcare in March, half of Americans believe that EHRs will have a negative impact on the privacy of their health data.  Thirty-five percent of respondents are worried that their information will end up widely available on the internet.

 

Americans’ concern about EHRs comes just as many healthcare organizations are driving to implement EHRs during 2011 in an effort to capture early-adoption incentive payments.  As more information becomes digitized, healthcare organizations will have a completely new set of responsibilities.  Patients not only require that PHI be held securely, but also believe that healthcare organizations are responsible for protecting financial information (86 percent), personally identifiable information (93 percent), and any information provided about a patient’s family (94 percent). 

 

EHRs are not inherently less secure, but they do have different security requirements.  Digitizing information and storing it electronically requires new processes, technologies, and policies to protect sensitive data.  It is not clear that all healthcare organizations have ironed out all of the new details on IT security.  Recently, additional research from CDW Healthcare found that many physician practices have not yet prioritized basic IT security – 30 percent report that they lack basic anti-virus software and 34 percent report that they do not use network firewalls.

 

The March report is based upon a nationwide survey of 1,000 Americans who have visited a physician office and a healthcare facility in the last 18 months. 

Cdw_healthcare_elevated_heart_rates_ehr_and_it_security_report_021611_page_04

Cdw_healthcare_elevated_heart_rates_ehr_and_it_security_report_021611_page_06

Cdw_healthcare_elevated_heart_rates_ehr_and_it_security_report_021611_page_13

For all media questions and inquiries, please contact:

Kelly Caraher CDW Healthcare 847-968-0729 kellyc@cdw.com

Andrew H. LaVanway O’Keeffe & Company 703-628-2503 alavanway@okco.com

Video: ONC Announces Launch of Direct Project Pilots

View the press conference announcing the launch of Office of the National Coordinator for Health Information Technology (ONC) "Direct Project" with comments from Aneesh Chopra, Chief Technology Officer, White House; Dr. David Blumenthal, National Coordinator for Health Information Technology; Todd Park, Chief Technology Officer, U.S. Department of Health and Human Services; and other key contributors.

The White House and ONC announced that providers and public health agencies in Minnesota and Rhode Island began exchanging health information using specifications developed by the Direct Project, an 'open government' initiative that calls on cooperative efforts by organizations in the health care and information technology sectors. (February 2, 2011)

The press conference was moderated by Farzad Mostashari, MD, ScM, Deputy National Coordinator for Programs and Policy, ONC, and includes remarks from Dr. David Blumenthal and Aneesh Chopra.

Designed as part of President Obama's 'open government' initiative to drive rapid innovation, the Direct Project last year brought together some 200 participants from more than 60 companies and other organizations. "This is a new approach to public sector leadership, and it works," said Chopra. "Instead of depending on a traditional top-down approach, stakeholders worked together to develop an open, standardized platform that dramatically lowers costs and barriers to secure health information exchange. The Direct Project is a great example of how government can work as a convener to catalyze new ideas and business models through collaboration."

The two pilot programs that have already begun using Direct Project-based information exchange are in Minnesota and Rhode Island:

Minnesota: Hennepin County Medical Center, Minnesota's premier Level 1 Adult and Pediatric Trauma Center, has been successfully sending immunization records to the Minnesota Department of Health. "This demonstrates the success that is possible through public-private collaborations," said James Golden, PhD, Minnesota's state health information technology coordinator.

Rhode Island: The Rhode Island Quality Institute (RIQI) has delivered a pilot project with two primary goals: (1) RIQI is improving patient care when patients are referred to specialists by demonstrating simple, direct provider-to-provider data; and (2) RIQI is leveraging Direct Project messaging as a means to securely feed clinical information, with patient consent from practice-based electronic health records to the state-wide health information exchange, current care, to improve quality by detecting gaps in care and making sure the full record is available to all care providers.

Other speakers included industry and government professionals who helped make the Direct Project launch a success: Mark Briggs, MSc, Chief Executive Officer, VisionShare; Glen Tullman, Chief Executive Officer, Allscripts; Sean Nolan, Chief Architect, Microsoft Health Solutions; and, Albert Puerini, Jr, MD, President and CEO, Polaris Medical Management, President and CEO, Rhode Island Primary Care Physicians.

AAFP Unveils New Secure Electronic Messaging Service for Physicians Based on Surescripts Network for Clinical Interoperability

The American Academy of Family Physicians today announced AAFP Physicians Direct, a new service that supports secure, electronic communication between physicians. Built on the Surescripts Network for Clinical Interoperability, this new AAFP service is part of a larger program to help physicians more easily and securely share information such as referrals, patient summaries, discharge summaries and lab results when providing their patients’ care. The innovative collaboration will make the nation’s leading health information network available to nearly 75,000 family physicians across the United States.

AAFP physicians will be able to connect to the Surescripts network and share information securely through the new AAFP Physicians Direct web portal or a choice of electronic health record systems. Amazing Charts, e-MDs and SOAPware also announced today that they will connect their EHR systems to the Surescripts network and collaborate in the Physicians Direct program.

With this new service, AAFP will leverage the Surescripts network to provide electronic clinical interoperability among providers, allowing them to break down communication barriers due to incompatible technology and a lack of interoperability standards. Clinical interoperability between health care providers is viewed by experts as the next critical step to accelerate the digital transformation of the nation’s health care system. The advance of clinical interoperability plays a central role in a number of important national health care initiatives: improving continuity of care; supporting the “meaningful use” of electronic health records; and advancing the patient-centered medical home model of care.

“We are proud to empower physicians with a digital tool that will make their practice run more efficiently while improving the overall quality of care they provide,” said Glen Stream, MD, MBI, president-elect of the AAFP. “AAFP Physicians Direct will enhance communication among health care providers, and patients likely will experience more seamless coordination and continuity of care. Patients will benefit, and that’s always a ‘win.’”

“The AAFP has long played a leading role in advancing the adoption and use of health IT,” said Harry Totonis, president and CEO of Surescripts. “Today they demonstrate their leadership once more. Working together, AAFP will leverage the Surescripts network to provide an easy-to-use, cost effective means of enabling the nation’s family doctors to connect and share information like never before. AAFP’s new services — available to physicians and other health care providers serving large and small communities throughout the United States — help ensure that everyone can take part and benefit from the digital transformation of the nation’s health care system.”

The AAFP, Surescripts and many other organizations have collaborated with the federal government to create the standard protocols to make this type of electronic clinical communication possible. AAFP Physicians Direct will support all federal and state policies and standards for health information exchange, including privacy and security standards (such as HIPAA and state law), as well as technology interoperability standards and message types such as HL7, CCR and CCD. Use of standard protocols will allow AAFP physicians to communicate via the Surescripts network with any other physicians, whether they connect via an EHR, through a health information exchange or large hospital system, through a portal, or physicians using the new Direct Project protocols for clinical exchange.

“I commend the AAFP for its inspired leadership in helping to create the standard protocols and message types for clinical exchange,” said Farzad Mostashari, MD, ScM, deputy national coordinator for programs and policy at ONC. “AAFP Physicians Direct is a health IT innovation that will help providers achieve meaningful use and support continuity of care, which will reduce costs and medical errors.”

By enabling e-prescribing as well as the secure electronic exchange of clinical information, the Surescripts network offers broad support for the meaningful use of electronic health records. Taken together, these capabilities help improve health care quality and safety while reducing the cost of care.

For supporting statements from various stakeholder organizations, visit www.aafp.org/media/physiciansdirect.

How Family Physicians and Other Providers Can Connect

Today’s announcement introduces multiple new ways for physicians to connect for clinical interoperability.

Subscribers to AAFP Physicians Direct will be able to securely exchange messages with any other provider on the Surescripts Network for Clinical Interoperability. Also, as a way to make clinical interoperability as universal as possible, participants on the Surescripts network will be able to send message alerts to any other provider, including non subscribers. Message recipients will retrieve messages from a secure web page within the Physicians Direct portal and reply to messages for free. AAFP Physicians Direct will be offered as a subscription service for $15 per physician user per month. Subscribers will not be limited in the number of messages they can send through the secure portal.

“We are pleased to offer a digital solution to improve communication among primary care physicians, subspecialists and other health care providers,” said Steven Waldren, MD, director of the AAFP Center for Health IT. “AAFP Physicians Direct will make slow, fragmented and cumbersome patient referrals and follow-up care a thing of the past.”

“In four short months, the ability of one doctor to communicate and share information with another has been redefined,” said Cris Ross, executive vice president of Surescripts. “The days of family physicians having to fax or mail or hand deliver patient files to specialists are over. For less money than what it costs to provide basic cable to patients in their waiting room, clinical interoperability will enable family physicians to share clinical information with more providers in a more efficient and effective way than ever before. Today’s announcement represents a giant leap toward providing the right information to the right provider at the right time.”

Family physicians have the option of connecting to the Surescripts network through the new AAFP web portal as well as some of the leading electronic health record systems.

For more information on AAFP Physicians Direct, visit www.aafp.org/media/physiciansdirect.

New Research Demonstrates Need for Clinical Interoperability

A recent study by the Center for Studying Health System Change showed that primary care and subspecialist physicians have decidedly different views about how often their colleagues communicate with them. They found that 69.3 percent of primary care physicians reported regularly — “always” or “most of the time” — sending a patient’s history and the reason for the referral to the subspecialist, but only 34.8 percent of subspecialists said they regularly receive such information. On the flip side, 80.6 percent of subspecialists said they regularly send consultation results to the referring PCP, but only 62.2 percent of PCPs said they received such information, the study found.

Primary care and subspecialist physicians who did not receive timely communication regarding referrals and consultations were more likely to report that their ability to provide high-quality care was threatened.

 

# # #

About the American Academy of Family Physicians
Founded in 1947, the AAFP represents 97,600 physicians and medical students nationwide. It is the only medical society devoted solely to primary care.

Approximately one in four of all office visits are made to family physicians. That is 228 million office visits each year — nearly 84 million more than the next largest medical specialty. Today, family physicians provide more care for America’s underserved and rural populations than any other medical specialty. Family medicine’s cornerstone is an ongoing, personal patient-physician relationship focused on integrated care.

To learn more about the specialty of family medicine, the AAFP's positions on issues and clinical care, and for downloadable multi-media highlighting family medicine, visit www.aafp.org/media. For information about health care, health conditions and wellness, please visit the AAFP’s award-winning consumer Web site, www.FamilyDoctor.org.


About Surescripts
The Surescripts network supports the most comprehensive ecosystem of health care organizations nationwide. Pharmacies, payers, pharmacy benefit managers (PBMs), physicians, hospitals, health information exchanges and health technology firms rely on Surescripts to more easily and securely share health information. Guided by the principles of privacy, security, neutrality, choice, transparency, collaboration and quality, Surescripts operates the nation’s largest health information network. By providing that information for routine, recurring and emergency care, Surescripts is committed to saving lives, improving efficiency and reducing the cost of health care for all. For more information, go to www.surescripts.com and follow us at twitter.com/surescripts.

via aafp.org

 

Health and Human Services Launches Health Indicators Warehouse to Support Innovation

Hhs-logo
The U.S. Department of Health and Human Services (HHS) launched a new web portal providing important health and health care indicator data to support innovations in information technology. The Health Indicators Warehouse represents a vast collection of health and health care indicators along with new web 2.0 technologies to support automated data services through application programming interfaces (APIs).

HHS Secretary Kathleen Sebelius said, “The Health Indicators Warehouse provides a new public resource needed to fuel development of innovative information technology applications needed to improve health and health care decision-making.”

HHS featured the resource as an important step toward addressing data transparency and the agency’s commitment to its Open Government Plan and the Community Health Data Initiative.

The Health Indicators Warehouse is a collection of health indicators from a wide array of HHS data sources that are maintained to support researchers, technology developers and policymakers. Health indicators are measurable characteristics that describe the health of a population (e.g., life expectancy, mortality, disease incidence or prevalence, or other health states); determinants of health (e.g., health behaviors, health risk factors, physical environments, and socioeconomic environments); and health care access, cost, quality, and use. Depending on the measure, a health indicator may be defined for a specific population, place, political jurisdiction, or geographic area. Currently, the Health Indicators Warehouse includes nearly 1200 health indicators derived from over 170 different data sources, with all being downloadable via APIs.

“This resource is equipped with modern information services for the purpose of enhancing the dissemination and use of these valuable collections to improve community-level health practices,” noted Dr. Edward Sondik, director, National Center for Health Statistics.

The health indicator data sets and the web tools provided by the warehouse are expected to support technology development leading to a wide array of applications (apps) and data services. 

Todd Park, chief technology officer, HHS said, “We recognize that one of the keys to better health and health care is data-driven decision-making at all levels and the HHS warehouse lowers the barrier for development of technologies to achieve this goal.”

In 2010, HHS demonstrated the value of these data sets in creating a wide array of web apps as part of the Community Health Data Initiative.  In the coming months, HHS anticipates additional activities and projects to promote innovative uses of data and apps development to improve health and health care performance at the community level.  

For more information about the Health Indicators Warehouse, visit http://healthindicators.gov

via hhs.gov

 

Committee on Appropriations Releases Detailed Spending Cuts

House_seal
The House Appropriations Committee today introduced a Continuing Resolution (H.R. 1) to fund the federal government for the last seven months of the fiscal year while cutting spending by over $100 billion from the President’s fiscal year 2011 request. This CR legislation represents the largest single discretionary spending reduction in the history of Congress.

Chairman Hal Rogers gave the following statement on the introduction of the CR:

“This year, our nation is spending 1.5 trillion dollars more than we have, running our debt to $14 trillion. The taxpayers have told us loud and clear that this is simply unacceptable, and have demanded that we get our nation’s fiscal house in order.

“This CR responds to this call. The legislation includes the largest reduction in discretionary spending in the history of our nation – over five times larger than any other discretionary cut package ever considered by the House.

“The CR contains over $100 billion in cuts compared to the President’s request - fully meeting the spending reduction goal outlined in the Republican ‘Pledge to America’ while providing common sense exceptions for our troops and veterans. These cuts go far and wide, and will affect every community in the nation. These were hard decisions, and I know many people will not be happy with everything we’ve proposed in this package. That’s understandable and not unexpected, but I believe these reductions are necessary to show that we are serious about returning our nation to a sustainable financial path.

“The cuts in this CR are the result of difficult work by our subcommittees who have weeded out excessive, unnecessary, and wasteful spending, making tough choices to prioritize programs based on their effectiveness and benefit to the American people. My committee has taken a thoughtful look at each and every one of the programs we intend to cut, and have made determinations based on this careful analysis.

“It is my intent – and that of my Committee – that this CR legislation will be the first of many Appropriations bills this year that will significantly reduce federal spending. It is important that we complete the legislative process on this bill before March 4th -- when the current funding measure expires – to avoid a government-wide shut down and so that we can begin our regular budgetary work for this year.”

Summary of the Bill:  

 

Copy of the Legislation:

 

Studies Identifying Challenges Of Implementing Health Reform

Study Predicts Frequent 'Churning' Between Medicaid And State Exchanges Under Health Reform.

Tens of Millions to Experience Eligibility Shifts; Other Studies in February 2011 Issue Identify Costs, Safety Net Coordination, and Health Disparities as Continuing Challenges

Income fluctuations among people who will become eligible for subsidized health insurance under the Affordable Care Act could disrupt coverage for as many as 28 million adults within the first twelve months, as their eligibility shifts between Medicaid and the new state health insurance exchanges, according to a new study published in the February 2011 Health Affairs.

The study is one of several in this month's Health Affairs that explore in depth some of the most significant challenges to implementing health reform, including lack of access among people who can't afford out-of-pocket costs, the need for better coordination among components of local safety net systems, and persistent disparities in access to health care for socially disadvantaged patients.

In 2014, Medicaid coverage will be extended to all nonelderly citizens whose family income does not exceed 133 percent of the federal poverty level, while subsidized coverage through state health insurance exchanges will be offered to those not eligible for Medicaid with incomes up to 400 percent of the federal poverty level.

"The income-sensitive approach to subsidizing health insurance creates issues for people near the eligibility cutoff," says Benjamin Sommers, an assistant professor of health policy and economics at the Harvard School of Public Health, who coauthored the study with Sara Rosenbaum, the Hirsh Professor and chair of the Department of Health Policy in the School of Public Health and Health Services at the George Washington University. "Because there's no minimum enrollment period, eligibility and subsidy levels will change as income rises and falls—disrupting both coverage and care while potentially increasing administrative costs."

In fact, income changes could lead to the "churning" of millions of adults and their families between Medicaid and the state exchanges, often within months of their initial enrollment in the programs. Not only might these Americans experience gaps in coverage, but the moves could also trigger changes in their health plans and provider networks.

Sommers and Rosenbaum used national survey data to calculate churning among people initially eligible for Medicaid and those initially eligible for exchange coverage when the relevant provisions of health reform take effect in 2014. They estimate that more than 35 percent of adults with family incomes below 200 percent of the federal poverty level will experience a change in eligibility within six months, and 50 percent will experience a change within one year. In addition, 24 percent will churn at least twice within a year, and 39 percent will experience such churning within two years.

By the end of four years, only 19 percent of adults initially eligible for Medicaid will have been continuously eligible, while only 31 percent of adults eligible for exchange subsidies will have remained continuously eligible. In all, 38 percent will have churned four times or more.

The researchers note that many people who will experience churning will have incomes low enough to exempt them from the federal insurance mandate, which means that fatigue with frequent coverage changes could lead them to simply abandon insurance over time. This group includes millions of healthy adults whose participation is crucial to having robust risk pools, in which the costs of a minority of sick individuals can be spread throughout a far larger group that is healthier overall. Income changes were more common among adults who were younger, more educated, and white—characteristics that correlate with better health.

Sommers and Rosenbaum recommend several strategies at the federal and state levels to minimize churning and promote the quality and continuity of care:

  • Establish a minimum guaranteed eligibility period, a strategy that has been used by some state Medicaid and CHIP programs to reduce churning.
  • Create support services to address churning by ensuring that people have a way to report real-time income changes that could affect their eligibility.
  • Align coverage and benefits between Medicaid and the insurance exchanges.
  • Align exchange and Medicaid plan markets and provider networks.

Other Health Reform Implementation Challenges

How well does near-universal coverage address lack of access due to costs in diverse groups in Massachusetts? A study by Cheryl Clark, of Brigham and Women's Hospital, and colleagues found that nearly a quarter of Massachusetts adults in fair or poor health reported being unable to see a doctor because of cost during the implementation of state health reforms. Although some groups—men, non-Hispanic whites, those with low and high incomes, and people in good or excellent health —saw modest reductions in unmet needs, others did not. In addition, people earning less than $25,000 a year were much less likely than higher earners to get screening for cardiovascular disease and cancer. The authors call for policy actions that reduce access barriers faced by people in fair or poor health, along with better and more explicit monitoring of trends in diverse groups to assess the benefits of health reform and identify where further intervention is needed.

National health reform will bring profound changes to local safety net systems. Mitchell Katz and Tangerine Brigham evaluated San Francisco's experience transforming its traditional safety net into a comprehensive health care program, Healthy San Francisco. Katz and Brigham have served in the City and County of San Francisco's Departments of Public Health. (Katz is now director of health services for the County of Los Angeles.) They suggest that safety net providers should invest in information technology, establish primary care homes, increase coordination of care, and boost customer service as reform is implemented. Although Healthy San Francisco is only for the uninsured, it incorporates features of managed care, such as primary care homes, linkage to specialty care and hospitalization, prepaid program fees, and customer service. Its model of a local municipality creating a non-insurance-based care network could be applied by other municipalities, the authors write. Results to date indicate high enrollee satisfaction with the program, a low number of unnecessary emergency visits, and low administrative costs.

Universal access to care does not eliminate health disparities for people in disadvantaged groups, according to a study of 14,800 patients with access to Canada's universal health care system by David Alter and colleagues at the Institute for Clinical Evaluative Sciences, in Toronto. Patients involved in the study were all initially free of cardiac disease; they were tracked for at least ten years. The researchers found that patients from disadvantaged groups used health care services more than their wealthier and more educated counterparts—because they were sicker. However, greater use of health care services by people from disadvantaged groups did not translate into better outcomes, particularly with respect to mortality. The researchers speculate that continuing health disparities may be due to factors outside the medical care system, such as poorer diets, lower levels of physical activity, and higher levels of smoking. They suggest that better methods for delivering preventive care and health education and counseling may help address these disparities.

About Health Affairs

Health Affairs, published by Project HOPE, is the leading journal of health policy. The peer-reviewed journal appears each month in print, with additional Web First papers published weekly at www.healthaffairs.org. You can also find the journal on Facebook and Twitter and download Narrative Matters on iTunes. Address inquiries to Sue Ducat at (301) 841-9962 or sducat@projecthope.org.

via healthaffairs.org

ONC Announces Launch of “Direct Project” Pilots

‘Open Government’ process yields rapid drive toward early exchange of electronic health information

 The Office of the National Coordinator for Health IT (ONC) announced today that providers and public health agencies in Minnesota and Rhode Island began this month exchanging health information using specifications developed by the Direct Project, an ‘open government’ initiative that calls on cooperative efforts by organizations in the health care and information technology sectors. Other Direct Project pilot programs will also be launched soon in New York, Connecticut, Tennessee, Texas, Oklahoma and California to demonstrate the effectiveness of the streamlined Direct Project approach, which supports information exchange for core elements of patient care and public health reporting.

“This is an important milestone for Minnesota and a key step toward the seamless electronic movement of information to improve care and public health.”

The launch of the pilot demonstrations, less than a year from the inception of the Direct Project, shows the project is on track to give U.S. health care providers early access to an easy-to-use, internet-based tool that can replace mail and fax transmissions of patient data with secure and efficient electronic health information exchange.

“This is an important milestone in our journey to achieve secure health information exchange, and it means that health care providers large and small will have an early option for electronic exchange of information supporting their most basic and frequently-needed uses,” said Dr. David Blumenthal, national coordinator for health information technology. “Other efforts are also going forward at full-throttle to build a comprehensive structure of health information exchange. But by bringing together health care and IT companies, including competitors, to rapidly produce a system that supports basic clinical delivery and public health needs, we will be able to more quickly start building electronic information exchange into our health care system.”

Designed as part of President Obama’s 'open government' initiative to drive rapid innovation, the Direct Project last year brought together some 200 participants from more than 60 companies and other organizations. The volunteers worked together to assemble consensus standards that support secure exchange of basic clinical information and public health data. Now, pilot testing of information exchange based on Direct Project specifications is being carried out on schedule this year, aiming toward formal adoption of the standards and wide availability for providers by 2012.

“This is a new way of doing the public’s business, and it works,” said Aneesh Chopra, the White House Chief Technology Officer. “Instead of the traditional top-down approach, it calls on stakeholders to work together in a more open and fast-moving way to achieve results. It makes government a platform for innovation by those who really know the field. Then it makes their work available for the public good, and it serves as a basis for competition among the very entities that brought it about. It is a new model of challenge and cooperation, and the Direct Project is an example of how effectively it works.”

The two pilot programs that have already begun using Direct Project-based information exchange are in Minnesota and Rhode Island:

Since mid-January, Hennepin County Medical Center (HCMC), Minnesota’s premier Level 1 Adult and Pediatric Trauma Center, has been successfully sending immunization records to the Minnesota Department of Health (MDH). "This demonstrates the success that is possible through public-private collaborations,” said James Golden, PhD, Minnesota’s state HIT coordinator. “This is an important milestone for Minnesota and a key step toward the seamless electronic movement of information to improve care and public health."

Recognizing Minnesota's leadership in delivering high-quality, cost-effective healthcare, U.S. Senator Amy Klobuchar (D-MN) said “this is the type of innovation that can help strengthen our health care system by reducing waste and improving quality. We need to continue to improve our health care system by continuing to integrate information technology to better serve patients and providers.”

The second pilot implementation site, The Rhode Island Quality Institute (RIQI), has delivered a pilot project with two primary goals. First, RIQI is improving patient care when patients are referred to specialists by demonstrating simple, direct provider-to-provider data. Second, RIQI is leveraging Direct Project messaging as a means to securely feed clinical information, with patient consent from practice-based EHRs to the state-wide HIE, currentcare, to improve quality by detecting gaps in care and making sure the full record is available to all care providers.

Discussing RIQI’s collaborative approach to health IT, Laura Adams, president and CEO of RIQI said “All too often, providers do not have the data they need to take the best care of patients they serve. Direct Project allows the Quality Institute to be on the cutting edge – providing health information exchange via currentcare, delivering the efficient rollout of technology through the Regional Extension Center, and enabling and measuring real patient outcome improvements in our Beacon Community. The ability to bring together and drive consensus among a diverse set of stakeholders has been critical in the successful rollout of these innovative programs.”

“Rhode Island continues to be a nationwide leader in improving health care with better information technology," said Senator Sheldon Whitehouse (D-RI). "Health care providers communicating with each other in a secure and cost-efficient way helps patients get better sooner with less hassle and confusion.”

Other pilot projects to be launched this year include a Tennessee effort with the Veteran's Administration, local hospitals and CareSpark to provide care to veterans and their families; a New York effort including clinicians in hospital and ambulatory care settings with MedAllies and EHR vendors; a Connecticut effort involving patients, hospitals, ambulatory care settings and a Federally Qualified Health Center with Medical Professional Services, a PHR, and a major reference laboratory; an expansion of the VisionShare immunization data pilot to Oklahoma; a California rural care effort involving patients, hospitals and ambulatory care settings with Redwood MedNet; and an effort in South Texas with a collaboration of hospitals, ambulatory care settings, public health, and community health organizations to improve care to mothers with gestational diabetes and their newborns.

The Direct Project was launched in March 2010 as a part of the Nationwide Health Information Network, to specify a simple, secure, scalable, standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet in support of Stage 1 Meaningful Use requirements. Participants include EHR and PHR vendors, medical organizations, systems integrators, integrated delivery networks, federal organizations, state and regional health information organizations, organizations that provide health information exchange capabilities, and health information technology consultants.

Information transfers supported by Direct Project specifications address core needs, including standardized exchange of laboratory results; physician-to-physician transfers of summary patient records; transmission of data from physicians to hospitals for patient admission; transmission of hospital discharge data back to physicians; and transmission of information to public health agencies. In addition to representing most-needed information transfers for clinicians and hospitals, these information exchange capabilities will also support providers in meeting “meaningful use” objectives established last year by HHS, and will thus support providers in qualifying for Medicare and Medicaid incentive payments in their use of electronic health records. The Direct Project specifications can also support physician-to-patient information transfers, and Microsoft Corp. today announced an application for that purpose based on Direct Project standards. For more information about the Direct Project, please visit http://directproject.org.

Other ongoing efforts supported by ONC are underway to bring about a comprehensive health information structure in the U.S. These include technical and governance issues that are being addressed under the Nationwide Health Information Network, which embodies the standards, services and policies that enable health information exchange over the internet. The Nationwide Health Information Network Exchange is already supporting some health information exchange between federal agencies and the private sector. In addition, ONC provides grants to states to develop locally-appropriate policies and standards for health information exchange that are consonant with broader national standards.

For more information about the Office of the National Coordinator for Health Information Technology, please visit http://healthit.hhs.gov.

Note: All HHS press releases, fact sheets and other press materials are available at http://www.hhs.gov/news.