by Dr. David Blumenthal

The Recovery Act called for the creation of two new committees--the HIT Policy Committee and the HIT Standards Committee. Created in May, 2009, and operating under the Federal Advisory Committee Act rules and regulations, the meetings and deliberations are open to the public. To date seven HIT Policy Committee meetings and eight Standards Committee Meetings have been held. Each committee has heard testimony from the public.

These committees have a lot on their plate, and from the outset, we knew that in order to accomplish the scope of work set forth by each committee in a timely manner and be responsive to legislation, workgroups would need to be created.

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Second of a two-part series.
By Emily Paulsen

Last week, we brought you Part I of this two-part series on the recent discussion we had with Lucian Leape, MD, a leader in the national patient safety movement. Currently, he is a health policy professor at Harvard School of Public Health, and chair of the Lucian Leape Institute, part of the National Patient Safety Foundation.

Hospital Impact: Why haven't we made more progress on the patient safety front? Is it just because culture change is so hard or is there another impediment?

Lucian Leape: There's no question that we're moving up hill in terms of the culture, but, in addition to that, the whole financing of healthcare works against us.

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by Joseph Ingemi

President Obama's appointment of Howard Schmidt as the nation's new cyber-security chief illustrates the importance of cyber-security in protecting us from what Schmidt called "great dangers to national security, public safety, economic competitiveness, and personal privacy."

Health IT is not immune from these dangers. So as we move forward with connecting our healthcare system electronically, we should not forget about the importance of security.

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by Paul Roemer
The national EHR market is ripe for the taking by a big three like Microsoft, Google and Oracle. Heck, I'll even go so far as to suggest that when the dust settles in about five or seven years, the National Health Information Network will be a regulated combination of a handful of those firms.

As for the other firms offering or planning to offer PHRs, permit me to suggest the following scenario: Let's say I am in charge of Google's somewhat non-existent healthcare line of business. One of my goals would be to have more users of my PHR than any other firm.

Why does this model make sense? Two ways, both of which come from the cable/telco business model.

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by Emily Paulsen

Part I of a two-part series -- In November 1999, the Institute of Medicine released its groundbreaking report, "To Err is Human," which found that medical errors were to blame for 98,000 patient deaths every year. The report was met with shock and some disbelief and brought the issue of patient safety to national attention. To get a perspective on the progress of the last decade, and a glimpse of priorities for the next few years, we spoke with health policy analyst Lucian Leape, a co-author of the report and a leading force in patient safety. Dr. Leape is currently an adjunct professor of health policy at the Harvard School of Public Health and chair of the Lucian Leape Institute, part of the National Patient Safety Foundation.

Hospital Impact: Looking back, what do you see as the most important development in patient safety during the past decade?

Lucian Leape: When the Institute of Medicine report came out in 1999, it got national and even worldwide attention. That's when the true conversation began, and we went through a period of increasing awareness. It has been very much like the grieving process: denial, outrage and anger, and gradually acceptance. Now patient safety is on the agenda of every healthcare organization.

There has been a tremendous increase in the science in the last 10 years. In the IOM report, we said, "It's not bad people, it's bad systems," and we advised healthcare organizations to redesign their systems. We had principles and concepts using human factors principles in the design of processes, but we didn't have specific solutions.

In the interim there has been research and development and validation of a number of safe practices.

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by Anne Zieger

Right now, if a patient has a large deductible plan--particularly those tipping the scales at $5,000 or more--your odds of collecting that money aren't great.

Realistically, those who buy high-deductible plans are largely those who don't have much money in the first place, and they're not likely to have thousands to give you on the spot.

What's worse, as any revenue cycle manager reading this knows, once they walk out the door the odds of collecting get smaller by the day. At that point you're lucky to get a portion of what you charged.

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by Paul Roemer

Can being an 'early adopter' save your hospital millions of dollars? We both know the answer depends on what you're adopting. Suppose we are discussing the adoption of an idea. Can that be analogous to not adopting another idea? I think it can. Allow me to explain.

Many providers are in the process of making a very expensive, highly complex, and wide-ranging decision regarding their healthcare information technology strategy (HIT) for their electronic healthcare records system (EHR) -- a non-trivial moment, to say the least.

Careers will be made and lost as a result--I'm betting more will be lost. Why? By making a bad choice on the EHR, on how to implement it, and on how to modify your organization.

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As some of you might recall, we recently published a list of nine of our favorite healthcare bloggers. While many of you liked our choices, you also noted that we didn't include any female bloggers on our list. Touche!

Today, we're sharing a list of some of our favorite healthcare blogs written by women in an effort to make sure we give credit where credit is due. On these blogs you'll find hands-on operational discussions, public policy analysis, visions of healthcare's future and more--written by women who have a great deal to say.

View our list.

by Dr. Kenneth H. Cohn

Just before Thanksgiving, I spoke at a gathering of 180 physicians about how physicians can overcome their frustration -- not just their frustration over losses in reimbursement, but also in authority and autonomy.

Part of the reason for these losses is that we lack training in such process skills as communication, negotiation, and conflict resolution that facilitate leadership and the implementation of sustainable solutions.

In general, our leadership skills are skewed too much toward command and control to actually contribute to high-performing teams. In fact, our teamwork and communication practices resemble those of the airlines in the 1970's.

But I do remain hopeful. The reason? I've worked with physicians who have overcome frustration and skepticism to establish themselves as leaders who make their time count. Three examples follow:

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by Paul Roemer

Ever wonder how the billions of dollars in healthcare IT came about? I imagine it went something like this:

DC Wonk 1: Email those fellows over at HHS and tell them we should just make the doctors install Electronic Health Records (EHR)!

DC Wonk 2: While we're at it, how about we pay them a bonus to do it?

DC 1: Yeah, and we could penalize them if they don't. We'll give 'em money with one hand and take it back with the other!

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