WV HIT Funding Under HITECH: WVHIN Gets $7.8M and WV REC gets $6M

Health and Human Services Secretary Sebelius and the National Coordinator for Health Information Technology, David Blumenthal, announced the HITECH funding under the ARRA for State Health Information Exchanges (HIEs) and Regional Extension Center (RECs) across the country.

The White House Press Release provides a detailed list of HIEs and RECs receiving grants. Inormation is also available via the HHS News Release, Sebelius, Solis Announce Nearly $1 Billion Recovery Act Investments in Advancing Use of Health IT, Training Works for Health Jobs of the Future.

West Virginia will receive the following funding:

• West Virginia Department of Health and Human Resources in conjunction with the West Virginia Health Information Network HIE Award: $7,819,000

• West Virginia Health Improvement Institute, Inc. REC ward:$6,000,000

More information about the health information technology programs and awards can be found on the Office of National Coordinator HIT Website.

• State Health Information Exchange Cooperative Agreement Program

• Health Information Technology Extension Program

WVHCA Report: $1.1B Cost Saving from Adoption of HIT

iHealthBeat reports on the release of a new report prepared by CCRC Actuaries for the West Virginia Health Care Authority.

The full report is available via the West Virginians for Affordable Health Care website and is titled, Health Care Financing in the State of West Virginia: An analysis and Projection of the Current System and Potential Transformations, August 2009.

According to the articles, the report indicates that the adoption of health information technology (HIT) and implementation of centralized medical care through medical home concepts could save West Virginia's health care system more than $1.1B in 2014. The estimates in the report used insurance claims data from more that 800,000 West Virginia residents, including data from Medicaid and Mountain State Blue Cross Blue Shield.

More details in the AP article by Tom Breen from the Charleston Gazette and Washington Post, Report: Health strategy could save W.Va. $1B.

The Washington Post article indicates:

. . . In the case of electronic prescriptions, the report estimates an overall savings of $164 million in 2014, including nearly $51 million in savings to private insurers and $42 million in savings to policyholders. . .

. . . The report estimates that a statewide rollout of medical homes would cost about $45 million up front and incur ongoing costs of about $368 million . . .

. . . Estimates suggest that about nine in 10 health care offices still keep everything in paper. As the new report says, up front costs for physicians run from $25,000 to $45,000 and have annual costs thereafter of between $2,000 and $9,000, steep amounts for small practices . . .

UPDATE: Thanks to a reader comment - you can now read the full report. The report is titled, Health Care Financing in the State of West Virginia: An analysis and Projection of the Current System and Potential Transformations, August 2009.

Following is the Executive Summary of the report which contains some very interesting statistics on the state of health care in West Virginia.


Executive Summary

• A cohort model was developed to simulate health care eligibility, utilization and insurance availability of the projected 1,828,538 West Virginians in 2009.
• The model utilizes 8,640 cohorts to represent current insured status, health care utilization, age, gender, and household income.
• The projected average age in 2009 is 40.2 years.
  
• West Virginia is projected to have a population of 1,806,545 in 2019 and the average age is projected to increase to 42.2 years.
• The number of commercially insureds is 757,884 in 2009.
• The number of non-Medicare PEIA insureds is 175,324 in 2009.
• The number of non-dual eligible Medicaid insureds is 321,113 in 2009.
• The number of dual eligible Medicaid/Medicare insureds is 57,118 in 2009.
• The number of Medicare eligible PEIA insureds is 37,784 in 2009.
• The number of other Medicare insureds is 168,571 in 2009.
• The number of West Virginia CHIP insureds is 24,480 in 2009.
• The number of uninsured West Virginians is 286,264 in 2009.
• Health care costs can be defined as charges or as allowed charges. In terms of allowed charges, projected West Virginia expenditures total $13.1 billion in 2009.
• Allowed charges are projected to grow to $24.4 billion in 2019.
• In 2009, the uninsured population is projected to incur $3.2 billion in allowed charges, resulting in bad debt and charity care of almost $900 million.
• Initiative I, Adult Medicaid Expansion, is projected to cost the State of West Virginia $56.8 million and the Federal Government $162.0 million in 2014, while overall health care expenditures will decrease $611.5 million. Low income residents see the majority of the savings, spending $591.5 million less on health care.
• Initiative II, Adult Medicaid Expansion Combined with an Insurance Mandate for Employers and Individuals, is projected to cost the State of West Virginia $56.8 million in higher Medicaid expenditures and $1,004.3 million in insurance premium subsidy. The initiative will cost the Federal Government $162.0 million in 2014, while overall health care expenditures will decrease $2,176.0 million. Low income residents see the majority of the savings, spending $2,212.8 million less on health care.
• Initiative III, Adult Medicaid Expansion combined with an Insurance Mandate for Individuals, is projected to cost the State of West Virginia $56.8 million, $983.4 million in insurance premium subsidy. The initiative will cost the Federal Government $162.0 million in 2014, while overall health care expenditures will decrease $1,634.7 million. Low income residents see the majority of the savings, spending $1,656.2 million less on health care.
• Initiative IV, Medical Home, is projected to save the State of West Virginia $57.3 million in claim expenditures and the Federal Government $199.3 million in 2014, and overall health care expenditures will decrease $642.6 million. Low income residents and insurance companies see the majority of the savings, spending $170.6 million and $173.2 million less on health care, respectively. This initiative requires $45 million of initial costs and a total of $368.2 million of ongoing physician reimbursement per year.
• Initiative V, e-Prescribing, is projected to save the State of West Virginia $16.0 million in claim expenditures and the Federal Government $53.8 million in 2014, and overall health care expenditures will decrease $164.0 million. Low income residents and insurance companies see the majority of the savings, spending $41.9 million and $45.6 million less on health care, respectively. The cost of implementing e-prescribing has not been projected.
• Initiative VI, Electronic Medical Records, is projected to save the State of West Virginia $28.3 million and the Federal Government $98.5 million in 2014, and overall health care expenditures will decrease $317.6 million. Low income residents and insurance companies see the majority of the savings, spending $84.3 million and $85.6 million less on health care, respectively. This initiative requires around $25,000 to $45,000 of initial costs and an annual cost of $3,000 to $9,000 per provider. However, these cost estimates appear to be declining over time.
  

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's Statewide Health Information Technology Strategic Plan

Over the past several months I have been involved with a group in developing West Virginia's statewide strategic plan for health information technology.

The final draft of the West Virginia Health Information Technology Statewide Strategic Plan, September 2009 is now available for review and comment. Additional comments and feedback on the strategic plan are welcome.

The strategic plan is a part of West Virginia's efforts to position itself as a national leader in implementing and adopting health information technology to improve our health care system. The strategic plan will be a part of the the state's efforts to submit applications to the Office of the National Coordinator for Health Information Technology (ONC) for funding under the State Health Information Exchange Cooperative Agreement Program and the Health Information Technology Extension Program: Regional Centers Cooperative Agreement Program, both programs developed under the American Recovery and Reinvestment Act of 2009, Title XIII - Health Information Technology, Subtitle B.

The project has been lead by the Adoption of Health Information Technology Workgroup under the West Virginia Health Improvement Institute. Both private and public stakeholders from across West Virginia have collaborated and provided input into the development of the strategic plan.

NCVHS: Report of Hearing on "Meaningful Use" of Health Information Technology

The National Committee on Vital and Health Statistics (NCVHS) has issued its initial Report of Hearing on "Meaningful Use" of Health Information Technology.

The May 18,2009 report is directed to David Blumenthal, MD, National Coordinator of Office of the National Coordinator for Health Information Technology. The cover letter indicates that NCVHS will be sending additional observations related to the hearing.

The Hearing on "Meaningful Use" of Health Information Technology was held on April 28-29, 2009. More information about the hearing can be found at the NCVHS website, including a copy of the hearing transcript and copies of the individual written testimony submitted by those individuals who testified at the hearing. You can also listen to a recorded version of the hearing in the NCVHS hearing archives.

Modern Day Hatfield-McCoy: Google Health and Microsoft HealthVault

The Hatfields and McCoys, a metaphor for a modern day high-tech industry rivalry centered on personal health records (PHRs) involving Google Health, Microsoft HealthVault and other PHR vendors. An image that a West Virginia health care lawyer can really appreciate.

Thanks to a tweet by @2healthguru for pointing out the CNET article, Microsoft, Google in healthy competition. The article provides a good overview of the developing PHR movement and some insight into the future. However, I'm a bit concerned by the accuracy of the article when I see two of the individuals mentioned in the article (Matthew Holt and Dave deBronkart) tweeting (here and here) that they weren't really interviewed for the article.

Later this week I will be in D.C.along with others testifying at the Hearing on Personal Health Records before the National Committee on Vital and Health Statistics (NCVHS), Subcommittee on Privacy, Confidentiality and Security . The Subcommittee is looking at the future of the PHR marketplace and consumer-facing health information technology.

The story of the Hatfield-McCoy feud is woven into the fabric of southern West Virginia lore along the Tug River and well known by all West Virginians. Above is a photo of the West Virginia Hatfield clan around 1897, led by Devil Anse Hatfield, second from the left. For more history and photos check out the West Virginia Division of Culture and History.

Note: If you are into off-road vehicle trails, come visit West Virginia and check out the modern day version -- the Hatfield-McCoy Trails.

ONC Releases HIT ARRA Implementation Plan

The Office of the National Coordinator for Health Information Technology (ONC) has released an operating plan titled the Health Information Technology American Recovery and Reinvestment Act (ARRA) Implementation Plan.

The operating plan is included on the DHHS Agency Wide Plan page under the "List of Recovery Programs within HHS."

The operating plan outlines immediate actions to meet statutory requirements under the Health Information Technology for Economic and Clinical Health Act (HITECH) provisions of the ARRA. The

The topic headings for the operating plan include:

A. Funding Table
B. Objectives
C-E. Activities, Characteristics and Delivery Schedules
F. Environmental Review Compliance
G. Measures
H. Monitoring/Evaluation
I. Transparency
J. Accountability
K. Barriers to Effective Implementation
L. Federal Infrascructure Investment

Thanks to Jim Tate (@jimtate) and John Chilmark (@john_chilmark) for pointing out the report.

Update On HIT Policy and Standards Committees

Last week the Federal Register (April 29, 2009) contained a Notification of the Establishment of the HIT Policy Committee and HIT Standards Committee. I had previously posted about the creation of these committee and recommended suggested members.

More information will be made available via the "new" Health Information Technology website of the Office of the National Coordinator.

The summary of the notice on establishing the HIT Policy Committee states:

This notice announces the establishment of the HIT Policy Committee. The American Recovery and Reinvestment Act of 2009 (Pub. L. 111-5), section 13101, directs the establishment of the HIT Policy Committee.

The HIT Policy Committee (also referred to as the "Committee'') is charged with recommending to the National Coordinator a policy framework for the development and adoption of a nationwide health information technology infrastructure that permits the electronic exchange and use of health information as is consistent with the Federal Health IT Strategic Plan and that includes recommendations on the areas in which standards, implementation specifications, and certification criteria are needed. The HIT Policy Committee is also charged with recommending to the National Coordinator an order of priority for the development, harmonization, and recognition of such standards, specifications, and certification criteria.

The notice outlines the criteria for members of the HIT Policy Commitee and states that the appointments shall be made in the following manner:

• 1 member shall be appointed by the majority leader of the Senate;
• 1 member shall be appointed by the minority leader of the Senate;
• 1 member shall be appointed by the Speaker of the House of Representatives;
• 1 member shall be appointed by the minority leader of the House of Representatives;
• Such other members as shall be appointed by the President as representatives of other relevant Federal agencies;
• 13 members shall be appointed by the Comptroller General of the United States of whom-
• 3 members shall be advocates for patients or consumers;
• 2 members shall represent health care providers, one of which shall be a physician;
• 1 member shall be from a labor organization representing health care workers;
• 1 member shall have expertise in health information privacy and security;
• 1 member shall have expertise in improving the health of vulnerable populations;
• 1 member shall be from the research community;
• 1 member shall represent health plans or other third-party payers;
• 1 member shall represent information technology vendors;
• 1 member shall represent purchasers or employers; and
• 1 member shall have expertise in health care quality measurement and reporting.
• Non-federal members of the Committee shall be Special Government
• Employees, unless classified as representatives.

The summary of the notice on establishing the HIT Standards Committee states:

This notice announces the establishment of the HIT Standards Committee. The American Recovery and Reinvestment Act of 2009 (ARRA) (Pub. L. 111-5), section 13101, directs the establishment of the HIT Standards Committee. The HIT Standards Committee (also referred to as the "Committee'') is charged with making recommendations to the National Coordinator on standards, implementation specifications, and certification criteria for the electronic exchange and use of health information for purposes of adoption, consistent with the implementation of the Federal Health IT Strategic Plan, and in accordance with policies developed by the HIT Policy Committee.

The notice outlines the criteria for members of the HIT Standards Commitee and states that the appointments shall be made in the following manner:

The HIT Standards Committee shall not exceed thirty (30) voting members, including a Chair and Vice Chair, and members are appointed by the Secretary with input from the National Coordinator. Membership of the Committee shall at least reflect providers, ancillary healthcare workers, consumers, purchasers, health plans, technology vendors, researchers, relevant Federal agencies, and individuals with technical expertise on health care quality, privacy and security, and on the electronic exchange and use of health information and shall represent a balance among various sectors of the health care system so that no single sector unduly influences the recommendations of the Committee. Non-Federal members of the Committee shall be Special Government Employees, unless classified as representatives.

Thanks for the tip on the issuance of the notice to John Halamka at Life as a Healthcare CIO: Next Steps on the HIT Policy and Standards Committees.



UPDATE (5/7/09): Brian Ahier (@ahier) provides the latest update on with information on the first meetings of the HIT Policy Committee on May 11 and HIT Standards Committee meeting on May 15. Brian also provides links to the announcment by the GAO of 13 of the members of the HIT Policy Committee.

The announcment includes a list of the 13 members appointed by the Acting Comptroller General covering 10 different categories:

Advocates for Patients or Consumers

1. Christine Bechtel, Washington, D.C. (3 year term)
Vice President, National Partnership for Women & Families

2. Arthur Davidson, M.D., Denver Colorado (2 year term)
Denver Public Health Department; Director, Public Health Informatics; Director, Denver Center for Public Health Preparedness; Medical epidemiologist; Director, HIV/AIDS Surveillance, City and County of Denver

3. Adam Clark, Ph.D., Austin, Texas (1 year term)
Director of Research and Policy, Lance Armstrong Foundation

Representatives of Health Care Providers, including 1 physician

4. Marc Probst, Salt Lake City, Utah (3 year term)
Chief Information Officer, Intermountain Healthcare

5. Paul Tang, M.D., Mountain View, California (2 year term)
Vice President and Chief Medical Information Officer, Palo Alto Medical Foundation

Labor Organization Representing Health Care Workers

6. Scott White, New York City, New York (1 year term)
Assistant Director, Technology Project Director, 1199 SEIU Training and Employment Fund

Expert in Health Information Privacy & Security

7. LaTanya Sweeney, Ph.D., Pittsburgh, Pennsylvania (3 year term)
Director, Data Privacy Lab, Associate Professor of Computer Science, Technology and Policy, Carnegie Mellon University

Expert in Improving the Health of Vulnerable Populations

8. Neil Calman, M.D., New York City, New York (2 year term)
President and CEO, The Institute for Family Health, Inc.
Research Community

9. Connie Delaney, R.N., Ph.D., Minneapolis, Minnesota (1 year term)
Dean, School of Nursing, University of Minnesota

Representative of Health Plans or Other Third-Party Payers

10. Charles Kennedy, M.D., Camarillo, California (3 year term)
Vice President, Health Information Technology, Wellpoint, Inc.
Representative of Information Technology Vendors

11. Judith Faulkner, Verona, Wisconsin (2 year term)
Founder, CEO, President, Chairman of the Board, Epic Systems Corporation
Representative of Purchasers or Employers

12. David Lansky, Ph.D., San Francisco, California (1 year term)
President and CEO, Pacific Business Group on Health

Expert in Health Care Quality Measurement and Reporting

13. David Bates, M.D., Boston, Massachusetts (3 year term)
Medical Director for Clinical and Quality Analysis, Chief of General Internal Medicine, Partners HealthCare/Brigham & Women’s Hospital

More information on the upcoming meetings:

• HIT Standards Commitee - Federal Register (May 6, 2009) announcement of meeting.
• HIT Policy Committee - Federal Register (May 6, 2009) announcement of meeting.
  

WV Senator Rockefeller: The Health Information Technology Public Utility Act of 2009

Yesterday West Virginia Senator Jay Rockefeller introduced "The Health Information Technology Public Utility Act of 2009"(Senate Bill 890) to facilitate the nationwide adoption of electronic health records (EHRs) though an "open source" public utility model.

A copy of Senate Bill 890 is available on Thomas (GPO PDF version).  According to the press release the Act would:

• Create a new federal Public Utility Board within the Office of the National Coordinator for Health IT to direct and oversee formation of this HIT Public Utility Model, its implementation, and its ongoing operation.
• Implement and administer a new 21st Century Health IT Grant program for safety-net providers to cover the full cost of open source software implementation and maintenance for up to five years, with the possibility of renewal for up to five years if required benchmarks are met.
• Facilitate ongoing communication with open source user groups to incorporate improvements and innovations from them into the core programs.
• Ensure interoperability between these programs, including as innovations are incorporated, and develop mechanisms to integrate open source software with Medicaid and CHIP billing.
• Create a child-specific Electronic Health Record (EHR) to be used in Medicaid, CHIP, and other federal children’s health programs.
• Develop and integrate quality and performance measurement into open source software modules.