US releases $1.2 billion for EMRs

Tags: EMRs Government Information iS Standards US

26 Aug 2009

The US government is releasing $1.2 billion (€800m) to help healthcare providers implement and use electronic medical records.

The grants include $598m (€400m) to set up about 70 health information technology centres, which will provide technical assistance and support for the implementation of EMRs. A further $564m will be spent on health information networks to allow information to be shared nationwide.

Health and human services secretary, Kathleen Sebelius unveiled the plans in Chicago last week, alongside US vice-president Joe Biden.

“This is just the first wave of resources invested in health technology aimed at transforming of paper-driven system to an electronic system over the next several years,” Sebelius said.

President Barack Obama’s administration has pledged to give every American an electronic record within five years, arguing that this is “fundamental to reforming” the entire healthcare system.

The US government has set aside more than $20 billion (€14 billion) in economic stimulus funds to implement records nationwide to improve patient care and cut costs. At the grant launch, Sebelius argued they would help reduce medical errors, improve quality and make the system more efficient.

The first round of grants is being funded from the American Recovery and Reinvestment Act of 2009. They will be made available in 2010 in a series of waves.

However, a number of other issues have yet to be resolved. Future payments to healthcare providers will depend on them showing “meaningful use” of electronic records and this term has yet to be defined.

A federal advisory committee is to come up with meaningful use standards later this month. These may include requiring healthcare professionals to give patients electronic copies of lab results and medication lists, and to send out digital appointments.

Since fewer than 10% of US doctors are thought to use EMRs at the moment, there are concerns that providers will find it difficult to meet the president’s deadlines.

Under the stimulus legislation, providers will only have until 2015 to purchase equipment and software that meet federal requirements, in order to be reimbursed by the government.

Key providers of electronic patient records in the US include Cerner, McKesson, Eclipsys, Athenahealth, Quality Systems and Allscripts Misys Healthcare Solutions, all of which stand to benefit from the effort to expand the electronic healthcare system.

Sarah Bruce

Readers Comments

It's the demographics stupid

26 Aug 09 13:52

>>"health information networks to allow information to be shared nationwide"<<

1. Does the united States have a national person identifier system similar to the NHS number?

The US Social Security number may or may not be up to the task...
http://en.wikipedia.org/wiki/National_identification_number#United_States

2. Is there a suitable interface between all system(s) managing it and clinical and administrative healthcare systems?

3. Are they confident in the integrity of the demographic data?

4. Are they planning to mandate its use?

The good news is that in England we have demonstrated that [Yes, Minister] it will all work safely and reliably when you skip systems left outside Nationally negotiated contracts, let data quality [apparently] pass as moot and deem use of the number optional until over a decade after of its implementation (and even then sit on the fence).

And somehow the whole NPfIT project [including the trivial bonus of a shareable National Care Records Service] - came in at a budget of less than projected for the National ID Card. It's a miracle frankly.

Who's stupid?

26 Aug 09 23:46

Regarding the comment "It's the Demographics stupid", well I find that the inference of the word "stupid" a typical British crass comment (and I am a Brit) from the ill-informed of those without any real insight into health informatics beyond these shores. Your knowledge source - Wikipedia?!!! Mmm - authenticated research tool!

Freedom from EU Procurement law

31 Aug 09 11:18

It will be interesting to see how the Obama administration orchestrates system requirements, open tendering, and contract negotiations on a scale at least 10x the NPfIT, which itself was the (boastfully) 'largest civil government IT project on the planet'. As the NPfIT in 2003 was primarily about restructuring the IT supply chain rather than procurement of user-validated requirements, the American approach seems to be to first establish understanding of need and stimulate 'demand' at the sharp end for solutions, with patients and doctors.

I suspect the payment of $1.2BN (equivalent of £100-£200Mn England) just to educate and get insights on requirements would be illegal in the UK due to EU public sector procurement restrictions, thereby seriously impeding insights and agreement on NHS requrements. In 2003 NPfIT OBS (Outline Business Specification) was the sole underpinning to a massive procurement exercise with a host of bidders ignorant of healthcare IT and its history. It was done in the blind, without any serious inputs from stakeholders. The OBS was supposedly "vetted" by several hundred doctors brought in for an orchestrated 3-day exercise in Leeds to "comment" on the OBS. This was then used as a cynical attempt to show that doctors had been properly consulted on the NPfIT's requirements which then drove the whole procurement and subsequernt contract negotiations.

This disconnect between doctors, patients, and NPfIT requirements obfuscated the whole purpose of the programme making way for the muddle and funk which then ensued. Perhaps the US approach may enable clear(er) definition of requirements, a wider understanding of the issues early on, and earlier buy-in from doctors, thereby setting a better basis for strategic procurement and national contracting.

It's a travesty that EU so-called open procurement rules prevent us from spending serious money on such a critical step, and we now suffer returning to the same confusion as reigned in the late 90's. Ten years wasted.