HEALTHY ONLINE

Yesterday, I found an email from Health and Human Services (HHS) in my inbox highlighting a new initiative where the “Obama Administration and Text4Baby join forces to connect pregnant women and children to health coverage and information”. The goal of this partnership is “to promote enrollment in both Medicaid and the Children’s Health Insurance Program (CHIP)”. Having more babies and children obtain insurance coverage is obviously a worthy endeavor, and if it can be accomplished by simply sending informative text messages to pregnant women, even better. Of course having insurance coverage doesn’t always translate into having access to an actual doctor, particularly for Medicaid enrollees. In an unrelated coincidental turn of events, it just so happened that I have had the recent opportunity to spend time with large numbers of Pediatric practices, most of which were small independent practices in middle-class suburban areas. The main goal of these conversations was to elicit doctors’...

As the Centers for Medicare and Medicaid Services (CMS) released their proposal for Meaningful Use Stage 2 requirements, the Office of the National Coordinator for Health Information Technology (ONC) released its updated requirements for EHR vendors intending to support Meaningful Use Stage 2. The document is chockfull of technical specifications and details which are probably more than any physician cares to know. There are, however, a couple of good reasons why you should have a general understanding of what your vendor, or soon to be vendor, is required to do because it will affect your finances and workflow and may also present some presumably unintended legal implications to your practice. Terminology The ONC proposal introduces several new terms that you should be aware of in order to avoid confusion, particularly if you are contemplating the purchase of an EHR in the next couple of years. A great slide deck from ONC can be viewed here . ONC HIT Certification Program – The EHR ...

The eagerly awaited Notice of Proposed Rule Making (NPRM) on Meaningful Use Stage 2 has been finally released in a sprawling 455 pages document. If you followed the discussions of the Federal Advisory Committees over the last year or so, you would know that Meaningful Use Stage 2 is just another small step towards an overarching goal of utilizing health information technology to support current policies aimed at providing better care for individuals, better health for populations and lower the costs of health care. We can agree or disagree on the wisdom of those policies, but if you are using electronic health records or just contemplating a move to computerized records, and have an interest in obtaining Meaningful Use incentives or avoiding penalties, you should have a basic understanding of what the next step on the technology escalator consists of. Meaningful Use Stage 2 distinguishes itself from Stage 1 mainly by proposing a major push to health information exchange. It also bring...

Enigma Machine We talk about trust a lot these days. Trust is one of those things that the scarcer it becomes, the more you find yourself thinking and talking about it. Trust is also a very fragile entity and it comes in a continuum of shades and magnitudes, from trusting your alarm clock, to implicitly trusting your mom, to trusting in God. Trust can be based on exact understanding (the alarm clock), reinforced by repeated experience (mom), or a result of pure faith (God). Trust that needs to be verified is no trust at all. Trust usually comes into play when one willingly relinquishes control over certain outcomes to a trusted entity. The amount of trust involved is in direct proportion to the importance of expected outcomes, thus “I trust you with my life” is very different than “I trust you to deliver my mail”. For a while now, I have been following ONC’s efforts to build public trust in health information exchange and electronic health records, summarized in this appeal to patients...