Health IT

Alice Lipowicz

Health IT

By Alice Lipowicz

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New center to spur innovation in health care

The Centers for Medicare and Medicaid Services (CMS) is looking for help in setting up a new innovation center created under the health reform legislation.

Under the reform package, CMS is expected to develop new models for care reimbursements to allow for reduction of costs while also preserving quality of care. This may involve accommodating new practices such as telehealth.

The law required establishing a Center for Medicare and Medicaid Innovation in CMS by January 2011. The center will serve as a research and development arm of CMS.

To meet that deadline, CMS published a sources sought notice on the Federal Business Opportunities Web site on May 14 seeking companies that can assist in the design, planning, organizational development and implementation of the center.

The assistance would include identifying new models and solutions to solve existing problems in health care delivery, designing and assigning pilot projects to evaluate and test those ideas and forming policy proposals to carry out the initiatives in Medicare and Medicaid, the notice said.

The agency is seeking responses by May 28. The notice is specifically aimed at small businesses.

Posted on May 20, 2010 at 7:25 PM0 comments

Baker responds to VA VistA report

Roger Baker, assistant secretary for information and technology at the Veterans Affairs Department, today thanked an industry panel for its “exhaustive” study on modernization of the VA’s VistA electronic medical record system.

The panel, convened at Baker’s request, was sponsored by the American Council for Technology-Industry Advisory Council and chaired by Ed Meagher, a former deputy CIO at the VA. It recommended on May 3 to move VistA to an open source platform and phase out its reliance on the MUMPS computer language.

“The VA is pleased with the efforts of the ACT-IAC to review the option for moving VistA into an Open Source endeavor and especially the dedicated efforts of the members of the work group and leadership of ACT-IAC,” Baker said in an e-mailed statement today.

“Clearly the group did an exhaustive study covering the significant technical and governance aspects important to making decisions in the Open Source arena. We are currently reviewing the many recommendations covered in the report and look forward to a rich dialog and exchange of ideas and concepts with industry. VistA is the preeminent example of what a patient centered Electronic Health Record [EHR) can do, and its improvement will take the joined efforts of clinical experts, government and industry. The VA looks forward to continuing this review,” Baker wrote.

The 34 vendor panelists were said to be unanimous on the recommendation; however, reaction in the broader health IT has been divided.

VistA is considered a superior system with strong clinical content and effectiveness, but it operates with the relatively unpopular computer language known as MUMPS. Some supporters and practitioners of MUMPS strongly laud its qualities, while detractors assert that MUMPS is outdated.

I’m certainly no expert on MUMPS, so I will offer only one brief observation.

From what I’ve heard, one of the elements that makes VistA superior to many commercial EHRs is that it was created with substantial input from physicians who would be using it. It has been described to me as “clinically rich.” Because the doctors are — or should be -- the ultimate arbiters of how their own records should be kept, it seems to me it would be important to hear from physicians on whether the clinical richness would be threatened by moving to an open source development.

I asked Meagher about physician input into the industry committee’s work, and he told me the panel spent two months consulting with VA doctors and other VA officials about their needs. He also said VA physicians and “end users” would be included in the open source development process.

A principle of modernization is that “whatever is done must be at least as good as what we have,” Meagher said. “We want to make the system as robust as possible.”

Good intentions are certainly a necessary first step. It would be great if the VA physicians could get involved in this public discussion about a very significant issue that may have much broader implications for health IT implementations.

Posted on May 10, 2010 at 7:25 PM8 comments

VA industry group ready to give advice on VistA

Get ready for some long-awaited news on the modernization of the Veterans Affairs Department’s VistA electronic health records system.

Since October, Ed Meagher has been chairing the VistA Policy Industry Group that's preparing recommendations on the next phase of VistA at the request of VA Chief Information Office Roger Baker. Meagher told me the report will be delivered to Baker on May 3 and there will be press events near that time.

Meagher has formerly served as VA's deputy assistant secretary for information and technology, and currently is senior principal for health programs at SRA International Corp.

“VistA is the best health information system in the world, bar none,” Meagher told me earlier. “At the same time, VistA is very old, very hard to maintain, hard to manage and manipulate, and incredibly expensive to maintain. [All] of those statements are true, so what do you do to modernize it and make it easy to maintain?”

Stay tuned. We’ll be getting those recommendations soon.

Posted on Apr 30, 2010 at 7:25 PM0 comments

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