Deal could endanger health care law
By JENNIFER HABERKORN | 8/3/11 11:28 PM EDT
Politico.com
The debt ceiling agreement could jeopardize millions of dollars, and perhaps billions, in initiatives from President Barack Obama’s health care reform law if the super committee can’t come up with required spending cuts.
Many of the pots of money in the law — one of the Democrats’ most prized pieces of legislation — could get trimmed by the debt deal’s sequestration, or triggered cuts. The funds for prevention programs and community health centers, grants to help states set up insurance exchanges and co-ops, and money to help states review insurance rates could be slashed across the board if the panel can’t find enough cuts this fall.
Put health IT and the HITECH Act (the health IT component that 'somehow' found its way into the fantastically-successful American Recovery and Reinvestment Act of 2009) on the table.
Health IT devices are medical devices that are dangerous, unregulated and unproven (e.g., see 'Reading List' here) in their current state of development and lawless environment.
Cutting HIT funding probably would be beneficial in avoiding waste as well.
Note what just occurred in the UK:
Health IT devices are medical devices that are dangerous, unregulated and unproven (e.g., see 'Reading List' here) in their current state of development and lawless environment.
Cutting HIT funding probably would be beneficial in avoiding waste as well.
Note what just occurred in the UK:
While I do agree funding should be cut (it really isn't a massive incentive anyway). I am not sure we have enough counter-evidence to say all Health IT devices are unproven. AMIA probably has enough evidence to show benefit of some technologies. As we know, most of the issues filter down to user interface and workflow challenges. I have seen MDs use EHRs masterfully and get tremendous benefit. I have seen them use others and cause harm. It is not an easy road but probably a necessary one.
ReplyDeleteWhile I do agree funding should be cut (it really isn't a massive incentive anyway)
ReplyDeleteSure, tens of billions of dollars are just chump change.
I am not sure we have enough counter-evidence to say all Health IT devices are unproven.
I won't even comment on efficacy - there's enough doubt there as in articles in my aforementioned Reading List and on this blog.
In terms of safety, even FDA admits they are unproven and levels of risk unknown (links here). Perhaps you should seek my mother's opinion. You'll need a megaphone though, since she's six feet under as of June 6, 2011 thanks to HIT.
As we know, most of the issues filter down to user interface and workflow challenges.
"We" don't know that at all. Those are some of the issues, but when fundamental software engineering good practices are shunned in an unregulated ecosystem filled with health IT amateurs (amateurs in the same sense that I am a radio amateur), those problems become just a component of the mix (cf: work of Jon Patrick).
I have seen MDs use EHRs masterfully and get tremendous benefit.
You anecdotally saw some "masterful use." Ergo...time for national rollout no matter the costs or risks? Is that what you're trying to justify? My logic works differently. I know some people received benefit from drugs like VIOXX, cocaine and arsenic. Let's resume their marketing and promotion, OK?
It is not an easy road but probably a necessary one.
I see. "First do no harm" is replaced by "Cybernetik Uber Alles."
-- SS
Further, about that long and winding road, I think "Pill Guy" missed the "UK NHS pulls the plug on its £11bn IT system" link.
ReplyDeleteConsidering the meaningfully deadly effects of CPOE devices, HIT should be on the block for cuts.
ReplyDeleteI do not get it.
The government has been deceived by the propaganda of HIMSS and the non profits it spawned to legitimize HIT devices and avoid vetting for safety.
These devices are impediments to effective care and thought processes needed to solve complex cases.
Wait, HIT at the NHS is a big success see UPMC's great progress: http://www.guardian.co.uk/healthcare-network/2011/aug/03/newcastle-clinical-implementation-medical-software
ReplyDeleteIt is interesting how negative anecdotes are diminished and positive anecdotes such as what pillguy mentions justify $10,000,000,000+ government programs. (anecdotally, showing the zeros help to show the real size of a number).
I read that article about Newcastle. It is typical HIT industry propaganda from those who are paid to amplify and exaggerate EMR deployments.
ReplyDeleteHow did UPMC become a manufacturer and vendor of EMR and CPOE systems?
Where did it conduct its experiments? In its proving ground?
Who signed off on the safety and efficacy of the devices being sold in the UK by UPMC?
Did UPMC's IRB approve such experiments in its beta test site proving ground and did its patients sign consent to allow their care to be controlled and directed by these EMR and CPOE systems?
If anyone knows answers to the above questions, please reply.
If any one knows the details of the deal between UPMC, Cerner, and Newcastle, please reply.
I suggest we focus our efforts on making HIT better for those using it, instead of naysaying. Thank you for the opportunity to post comments on your site, but I am removing this from my list of blogs to review. Best of luck to you.
ReplyDeleteI suggest we focus our efforts on making HIT better for those using it, instead of naysaying.
ReplyDeleteWhile one cannot find a fever without taking a temperature (what you term "naysaying"), and while this blog is a cornucopia of material eminently useful towards improving HIT (e.g., here), I repeat a comment I made in 2009 here about such pronouncements:
Some have complained I am being "politically incorrect." At a time when our banks, major industries, investments, lifestyle and retirements have been seriously eroded by a combination of secrecy, incompetence, and criminal behavior on an unprecedented scale, I think such people need to get their priorities in order.
To that I add the issue of patients being harmed and killed by health IT, at levels the FDA admits itself are unknown ("tip of iceberg").
I am removing this from my list of blogs to review.
That is a shame, as there is much to be learned here from the posts of the multiple authors who write about threats to healthcare's core values.
See the poignant header in another one of my posts, the reading list on HIT problems, on this issue.
-- SS
Kansas returning $31.5 million in grant money
ReplyDeleteBy Jessica Zigmond
Posted: August 9, 2011 - 5:45 pm ET
Kansas Gov. Sam Brownback and Lt. Gov. Jeff Colyer announced Tuesday that Kansas will return the early innovation grant it received in February from HHS to implement a state health insurance exchange.
An HHS official said the agency has not received a formal letter about Kansas returning the $31.5 million it had been granted, but rather learned of the decision in a news release from the governor's office.
Kansas was one of seven states to receive funding from HHS earlier this year to set up the information technology infrastructure needed for an exchange. Oklahoma rejected its award of more than $54 million earlier this year. Meanwhile, HHS' grants office has not received word about the approximately $450,000 that Kansas has already drawn down from the grant, the HHS official said.
“We are disappointed that Kansas has given up an opportunity to be a leader in the development of technology for state exchanges, which could have benefited the citizens of Kansas as well those in other parts of the country,” said an official statement from HHS sent via e-mail.
Meanwhile, Brownback, a Republican, cited the current financial troubles in Washington as a reason for returning the money.
“There is much uncertainty surrounding the ability of the federal government to meet its already budgeted future spending obligations,” Brownback said in the release. “Every state should be preparing for fewer resources, not more. To deal with that reality, Kansas needs to maintain maximum flexibility,” he added. “That requires freeing Kansas from the strings attached to the ‘Early Innovator' grant.”
Colyer added that federal Medicaid mandates have cost Kansas more than $400 million in the last two years, and that “full implementation of the mandates in the president's healthcare law would cost billions more.”
http://www.modernhealthcare.com/article/20110809/NEWS/308099960#ixzz1Uh2DBbmJ
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