Archive for Healthcare Data Mining

As Obama goes so go many groundbreaking ACA benefits

The presidential election holds potential to alter the Patient Protection and Affordable Care Act’s (ACA) fate.

For most of the ACA’s impactful benefits to be realized, President Barack Obama must be re-elected, because GOP nominee Mitt Romney has spent many months campaigning on the promise that he will repeal the ACA on his first day in office.

Acknowledging that the health reform law “is not the end of efforts to improve healthcare,” the Democratic Party National Platform lays out the vision to “continue to fight for a strong health care workforce” by “emphasizing primary care,” and “eliminating disparities in health” as well as strengthening Medicaid.
That last phrase also shows up in the Republican’s National Party Platform, which lists ‘Strengthening Medicaid in the states’ as one of its top two tenets; the other is ‘Saving Medicare for future generations.’

[One-liner: Health IT in the Democratic platform. And Don’t blink: What health IT means to the GOP.]

Both platforms are indicative of parties looking toward the future. Indeed, the health reform law will become more popular over time as it is put in place and people use its benefits, according to an advisor for the Obama campaign. “People get used to the law, and they become dependent upon it. And it becomes very hard to repeal it,” said Chris Jennings, who is also president of Jennings Policy Strategies Inc. and former senior healthcare advisor to former President Bill Clinton, at a recent conference sponsored by the Bipartisan Policy Center. Historically, the initial response to Social Security and Medicare were similar.

Individuals and families are already taking advantage of ACA benefits, namely young adults staying on their parents’ plans until they are 26; insurers unable to refuse to cover children with pre-existing conditions; and seniors able to close the funding gap known as the “donut hole” for prescription drugs.

The 2012 Democratic National Platform, released Sept. 4, also highlighted provisions, such as preventive screenings for women and contraception with no out-of-pocket costs; small businesses receiving tax credits to help them cover their workers, and insurers paying rebates to businesses and families when they are overcharged based on the ratio of medical-to-administrative costs.

As more elements of the health reform law take effect, insurers will no longer be able to deny coverage based on pre-existing conditions; Medicaid will cover more working households; and those who don’t get insurance through an employer will shop for coverage on exchanges and may be eligible for tax credits to help afford it.
The re-election of Obama will offer more certainty that those elements will be realized.

Whereas the Democratic platform views health care as a linchpin for economic prosperity and security “so people, business and government are not constrained by rising costs,” the Republicans offer stark contrast.
Romney pledged in his speech in accepting the GOP nomination to repeal and replace the Affordable Care Act, which the Supreme Court recently upheld for the most part. In addition to repealing the law, Romney has indirectly supported strong cuts for Medicaid through calling for its conversion to a block grant program, Jennings said.

[Survey analysis: Romneycare vs. Obamacare, do Americans care?]

Not only would the millions of citizen who stand to gain coverage under the ACA lose it, but many who are currently covered could see reduction or elimination of such coverage.

“It means a shifting of cost and burden to people and to states and fundamentally undermining the insurance market and making it even worse than what we already have,” Jennings said (pictured at right).

For Republicans, however, the effect of the Supreme Court decision on health reform feeds into the GOP view that the elections will be about choosing “big government or not so big government,” said Tom Scully, general partner, Welsh Carson Anderson & Stowe, senior counsel, Alston & Bird; and a Romney campaign designee. He was also an administrator of the Centers for Medicare and Medicaid Services under former President George W. Bush.

Scully doesn’t anticipate hearing a lot of details revealed about health care between now and the election. The perception of the health reform law is more about “taking on a massive entitlement expansion and massive growth of the federal government.”

“Doing massive entitlement expansion, even though it may be something you morally believe in, is not responsible,” Scully said, with debt and entitlement spending at unsustainable levels.
“Someone has to take leadership in fixing our national problems,” he added. “You can’t punt everything forever.”

For the Republican view, reining in healthcare costs is about state-based and market incentives.

“Money is getting tighter across the board. Even with Democratic governors, the world is moving to capitation and Medicaid managed care,” Scully said. It makes sense shifting to a third party contractor and reducing risk, referring to them as “private managed care bundlers.”

Scully knows about entitlement expansion. As CMS administrator, he was instrumental in shepherding the Medicare modernization law and the prescription drug plan, which favored using the market to provide services.

[Related: Political strategists on how candidates should shape healthcare messages in the election.]

“In Part D, once you came up with the money, and if the structure can work and provide the services they predict that they can manage and market, they will show up,” Scully said.

For the Obama administration, it was important to have broad healthcare industry and consumer support for the health reform legislation to make the market work, Jennings said.

“Coverage is a moral imperative, but that really wasn’t their driver. Theirs was to make sure people were in the system so you can have plans compete on cost and quality and not on their ability to avoid certain people, which creates all sorts of strange and warped incentives,” Jennings said. “We can have a discussion of allocation of resources and making it work, but the fundamentals of coverage, exchanges, insurance reform, tax credits are all pillars to make the system work.”

And a number of those pillars will likely die or survive depending on the outcome of Tuesday, November 6, 2012.

View the original article here

What the platforms tell us about parties’ stance on health IT

It’s a joke without a punch line: Both Republican and Democratic national party platforms make sparse mention of health IT.

To be certain, there’s plenty of focus on the broader healthcare issues. The GOP platform, in fact, dedicates its first two sections to ‘Saving Medicare for future generations’ and ‘Strengthening Medicaid in the states’, while the Democrats also address the issue early on with a section about healthcare as part of ‘The middle class bargain’ and another on ‘Social Security and Medicaid.’

[Survey analysis: Romneycare vs. Obamacare, do Americans care?]

As for any particulars of health IT, well, that’s another matter. Quite literally, each party offers up a single sentence on its intentions for health IT.

From page 33 of the 2012 Republican Platform PDF:
We support technology enhancements for health records and data systems while affirming patient privacy and ownership of health information.

Now, should that strike you as oddly vague, just wait.

“If anyone was disappointed in the scant attention given to health IT in the Republican Party Platform, then the Democratic Party Platform should give them pause,” said Brian Ahier, health IT evangelist at Mid-Columbia Medical Center, author of the Healthcare, Technology, and Government 2.0 blog, and city councilor in The Dalles, Ore. “Health IT is barely mentioned at all, and only in the context of broader technology initiatives.”

Indeed, in the 2012 Democratic National Party Platform health IT is on page 41 of the PDF:
We will ensure that America has a 21st century digital infrastructure – robust wired and wireless broadband capability, a smarter electrical grid, and upgraded information technology infrastructure in key sectors such as health care and education.

Reactions to the perhaps pithy stances of both parties stance have been mixed.

“I regret that the platforms are largely silent on HIT,” former four-term Vermont Governor Jim Douglas wrote in an email exchange with Government Health IT. Douglas is now a member of the Bipartisan Policy Center’s Governor’s Council and executive-in-residence at Middlebury College. “Perhaps it’s not a sexy topic, but it’s essential to our efforts to improve the quality of care and contain costs.”

So, why such vague references to health IT? Shouldn’t the national party platforms include a greater vision of and intent for the technologies forging the underpinnings of next-gen healthcare in America? Or is what the parties outlined enough for the majority of American voters?

“At this point in time I think maybe it is enough,” said Iowa State Representative Linda Upmeyer (R), a career nurse practitioner who has proposed health IT legislation since being elected 10 years ago. “I hope what it means is that this is really in an early state, but there’s a commitment to move health IT forward, that they’re listening and trying to continually improve so that the government doesn’t get this wrong.”

While some will argue that the November elections might test the bipartisan nature of health IT, at least for now Ahier, Douglas and Upmeyer view the party platforms as evidence that bipartisanship remains intact.

“It would seem that both parties agree that when health IT is used effectively it can help address the challenges confronting our healthcare system,” Ahier said. Douglas added that “the current administration continues to move the ball down the field through grants to the states, incentives to providers and implementation of the meaningful use standards,” he said. “I’m confident that the bipartisan support will continue because both parties understand the value of HIT.”

Which leads back to the beginning, where both parties support health IT, but are short on detail about exactly how – which may be because neither party can say for sure precisely what committing to health IT will really mean for the future.

[See also: Political strategists on how candidates should shape healthcare messages in election.]

“It’s always important to have something that keeps policymakers pushing health IT to the forefront, but we policymakers, be it inside the beltway or inside the golden dome in Iowa, don’t have the solutions or all the answers. So we can commit to investing in health IT and rely on the people really doing it to help determine what the next steps are,” Upmeyer, the Iowa rep said. “I don’t really want congressmen or senators or legislators deciding for them.”

Neither does Steven Waldren, MD, director of the Center for Health IT at the American Academy of Family Physicians.

“I’d much rather health IT not be a political football and remain behind the scenes a little because there’s no political urgency such that either side is going to try to politicize it and move forward. Instead, they recognize it’s an important issue,” Waldren said. “The two platforms have different philosophies but at least it’s not being debated at the level of lies, made up truths, or spinning things out of context.”

Although, there might be a solid punch line or two to emerge from that manner of rhetoric.

For more of our politics coverage, visit Political Malpractice: Healthcare in the 2012 Election.

View the original article here

Mostashari calls for vendors to add Blue Button quickly

Farzad Mostashari, MD, the national health IT coordinator, has challenged vendors to make it easy for consumers by early 2013 to view, download and transmit to another party their health information in the form of a Blue Button feature.

The Office of the National Coordinator for Health IT has established a Twitter hashtag of #VDTnow for companies and organizations to post their commitment to establishing the feature.

Implementing the functionality for view, download and transmit (VDT) to a third party, “I think, is underappreciated for how significant that’s going to be to the concept of consumer-mediated health information exchange,” Mostashari said at a Sept. 10 ONC summit on consumer health IT.

[Related: For National Health IT Week, a look in the cyrstal ball.]

“It moves us from personal health records tethered to this particular provider’s or that particular health plan’s data source to the concept of a personally controlled health record,” he  said, adding that it will accelerate capabilities for stage 2 meaningful use requirements in 2014 for patient engagement and health information exchange.

The summit was the first of several events observing Health IT Week in the Nation’s Capital.

Health IT companies, providers and healthcare organizations can offer patients access to and a copy of their electronic information through patient portals linked to their electronic health records (EHRs), a Blue Button feature on their personal health record (PHR) software or other applications on patients’ computers.

Blue Button was developed first for veterans to access their information through their HealtheVet personal record in a simple ASCII text file. More than 1 million veterans have downloaded their information, according to the Veterans Affairs Department. Military service members and Medicare beneficiaries also have a Blue Button capability, and it is beginning to be deployed in the private sector.

[See also: ONC drops pursuit of NwHIN governance.]

Among the vendors who said they would have a Blue Button feature early next year by the time of the HIMSS 2013 annual conference in March were eClinicalWorks, Greenway Medical, SOAPware, Athenahealth and Cerner. RelayHealth said it already has Blue Button available.

“Blue Button has evolved from veterans getting their own data, but is now a national concept ‘to give me my data’,” Mostashari said. Among the goals for ONC’s consumer health IT program is to nudge patients to access their data and take action with it.

One of the first veterans to participate in using Blue Button, Randy Watson, of Joplin, Mo., who has complex heart ailments and diabetes, said he did so because “it’s my right to have my record.”

“They are my medical records, and with Blue Button I have control over them, and they are correct,” he said, adding that he also has the mobile phone app for Blue Button.

Surveys have shown that patients want their information but are unaware that they can ask for it, according to Lygeia Ricciardi, acting director of ONC’s Office of Consumer eHealth.

One year ago when ONC launched its consumer ehealth program, 30 organizations that are data holders and non-data holders pledged to make it easier for patients to gain access to their information, and now more than 400 organizations have committed to doing that over time, Ricciardi said.

“Data holders are pledging to make the information easily electronically available, while the non-data holders, a broader category, is helping to spread the word to go out there and do it, and also building the tools that are going to make that appealing and useful to people,” she said.

[Related: Celebrating HIT as an essential during Natonal Health IT Week.]

For example, ONC will announce the winner next week of a developer’s challenge to mash up Blue Button data with other kinds of data.

ONC also wants to help change attitudes of patients. “Have you ever felt a little uncomfortable asking your doctor for your information? Part of what we’re doing to encourage people is to let them know that it’s ok to ask for your records,” Ricciardi said, including a video challenge for the public to show how they use or would use their data and IT.

ONC also plans to add two work groups to its advisory Health IT Policy and Standards committees to advance patient engagement. The public will have a chance to nominate folks to those groups, she said.

View the original article here

HHS opens innovators program to public voting

For the first time, the public can vote on their favorite innovation from among the finalists of the HHSinnovates Program, Health and Human Services Secretary Kathleen Sebelius announced this past Friday.

Launched in the spring of 2010 as part of HHS’s open government efforts, HHSinnovates is meant to recognize innovative projects from HHS employees aimed at helping solve thorny healthcare challenges.

“The HHSinnovates Program recognizes and rewards good ideas and facilitates the exchange of innovations throughout the Department and beyond,” said Secretary Sebelius. “Innovative ideas and practices aren’t restricted to the private sector: government workers are developing new ideas and facilitating connections to improve the way government works and improve the health of all Americans.”

[See also: HHS aims to cut medical errors.]

Twice a year, HHS employees are invited to submit their innovations, and the top picks are posted for secure, online voting by the entire HHS community. Six finalists are chosen and publicly announced. The Secretary then selects her top picks.

Now, for the first time, the public will pick the “People’s Choice” winner. In the program’s fifth round, the public is invited to choose from among six finalists. They come from 60 total submissions from across HHS, officials say, noting that each embodies an innovative spirit, and is scalable and replicable:

The 100K Pathogen Genome Project. This collaborative project, originating from the Food and Drug Administration, academia, and industry partners, aims to sequence the genetic codes (genome) of 100,000 strains of important food pathogens (tiny organisms that cause food-borne illnesses – bacteria, viruses and others) and make them available in a free and public database at the National Institute of Health’s (NIH) National Center for Biotechnology Information.  Open access to sequences allows researchers to develop tests that can identify bacteria present in a food within a matter of hours or days, significantly faster than the two weeks it now takes to grow and analyze bacterial cultures conventionallyNational Institute of Allergy and Infectious Diseases (NIAID) Exchange. NIH’s NIAID developed an internal supply exchange for their institute called “NIAID Exchange” to help increase the speed and efficiency of government.  They developed a user-friendly Web resource where staff can advertise existing government-owned scientific and office equipment and supplies they no longer need and search for available items advertised by other staff members.  The NIAID program has saved over $30,000 since its release to the institute last January.Online Food Handler Training Project. The Albuquerque Area Indian Health Service (IHS) led the development of an online food handler certification program that trains an average of 3,500 food handlers a year in class room food handler trainings, while compensating for a 20 percent reduction in staff.  This novel training program, which was developed in collaboration with local partners, incorporates the principles of adult learning and story-telling in a way that is culturally sensitive and resonates with tribal customers.  The training is available to the public on the IHS website, and numerous people from across the country has registered and initiated the training.Development and Use of Coal Dust Explosibility Meter. The Centers for Disease Control and Prevention’s National Institute of Occupational Safety and Health in association with industry and commercial partners developed a coal dust meter that gives users real-time feedback on environmental conditions – a significant improvement over the lengthy measurement procedure currently employed.  This tool, which gives immediate results, represents an improved means for underground coal miners and coal mine operators to assess the relative hazard of dust accumulations in their mines.  To date, more than 200 of these devices have been sold and are being deployed in mines across the United States.National Health Service Corps Jobs Center. Many underserved communities remain underserved because it is very difficult to recruit physicians to high-need areas; in some instances it can take up to two years and $60,000.  To help improve this process, the Health Resources and Services Administration’s National Health Service Corps established the NHSC Jobs Center, an online employment site connecting thousands of job-seeking medical professionals, doctors, nurses, dentists, and mental health providers in primary care disciplines to thousands of employers in underserved communities throughout the United States and U.S. territories.National Institute of Health Research Portfolio Online Reporting Tools. The National Institute of Health developed a Research Health Portfolio Online Reporting Tool (RePORT) that serves as a one-stop shop to provide the public with an interactive suite of tools to search NIH-funded research and the work of its investigators.  By providing the scientific community with better tools to explore the portfolio of NIH-funded research, RePORT furthers progress to foster fundamental creative discoveries, innovative research strategies, and their applications.

[See also: HHS aims to spur software apps development.]

Public voting is open until Sept. 14, 2012. Winners will be announced on Sept. 24. To learn more, visit the HHSinnovates website.

View the original article here

Mostashari calls for vendors to add Blue Button quickly

Farzad Mostashari, MD, the national health IT coordinator, has challenged vendors to make it easy for consumers by early 2013 to view, download and transmit to another party their health information in the form of a Blue Button feature.

The Office of the National Coordinator for Health IT has established a Twitter hashtag of #VDTnow for companies and organizations to post their commitment to establishing the feature.

Implementing the functionality for view, download and transmit (VDT) to a third party, “I think, is underappreciated for how significant that’s going to be to the concept of consumer-mediated health information exchange,” Mostashari said at a Sept. 10 ONC summit on consumer health IT.

[Related: For National Health IT Week, a look in the cyrstal ball.]

“It moves us from personal health records tethered to this particular provider’s or that particular health plan’s data source to the concept of a personally controlled health record,” he  said, adding that it will accelerate capabilities for stage 2 meaningful use requirements in 2014 for patient engagement and health information exchange.

The summit was the first of several events observing Health IT Week in the Nation’s Capital.

Health IT companies, providers and healthcare organizations can offer patients access to and a copy of their electronic information through patient portals linked to their electronic health records (EHRs), a Blue Button feature on their personal health record (PHR) software or other applications on patients’ computers.

Blue Button was developed first for veterans to access their information through their HealtheVet personal record in a simple ASCII text file. More than 1 million veterans have downloaded their information, according to the Veterans Affairs Department. Military service members and Medicare beneficiaries also have a Blue Button capability, and it is beginning to be deployed in the private sector.

[See also: ONC drops pursuit of NwHIN governance.]

Among the vendors who said they would have a Blue Button feature early next year by the time of the HIMSS 2013 annual conference in March were eClinicalWorks, Greenway Medical, SOAPware, Athenahealth and Cerner. RelayHealth said it already has Blue Button available.

“Blue Button has evolved from veterans getting their own data, but is now a national concept ‘to give me my data’,” Mostashari said. Among the goals for ONC’s consumer health IT program is to nudge patients to access their data and take action with it.

One of the first veterans to participate in using Blue Button, Randy Watson, of Joplin, Mo., who has complex heart ailments and diabetes, said he did so because “it’s my right to have my record.”

“They are my medical records, and with Blue Button I have control over them, and they are correct,” he said, adding that he also has the mobile phone app for Blue Button.

Surveys have shown that patients want their information but are unaware that they can ask for it, according to Lygeia Ricciardi, acting director of ONC’s Office of Consumer eHealth.

One year ago when ONC launched its consumer ehealth program, 30 organizations that are data holders and non-data holders pledged to make it easier for patients to gain access to their information, and now more than 400 organizations have committed to doing that over time, Ricciardi said.

“Data holders are pledging to make the information easily electronically available, while the non-data holders, a broader category, is helping to spread the word to go out there and do it, and also building the tools that are going to make that appealing and useful to people,” she said.

[Related: Celebrating HIT as an essential during Natonal Health IT Week.]

For example, ONC will announce the winner next week of a developer’s challenge to mash up Blue Button data with other kinds of data.

ONC also wants to help change attitudes of patients. “Have you ever felt a little uncomfortable asking your doctor for your information? Part of what we’re doing to encourage people is to let them know that it’s ok to ask for your records,” Ricciardi said, including a video challenge for the public to show how they use or would use their data and IT.

ONC also plans to add two work groups to its advisory Health IT Policy and Standards committees to advance patient engagement. The public will have a chance to nominate folks to those groups, she said.

View the original article here

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