iHealthBeat.org Reports on West Virginia's EMR Efforts

An article appearing in the May 27, 2005 issue of iHealthBeat reports on the the recent announcement of a working group formed to study the adoption and implementation of electronic medical record (EMR) in West Virginia.
The iHealthBeat article links to an article appearing on the WTRF website about the EMR efforts and the appointment of Dr. Julian Bailes to chair the workgroup. A more in depth article by Juliet A. Terry and titled "State Makes Push for Electronic Records" appears in the May 27, 2005, edition of The State Journal.

The article also reports on the following related news:
Leaders from West Virginia's Davis Health Systems recently met with National Health IT Coordinator Dr. David Brailer to share details about the health system's rural health care information infrastructure. For more on Dr. Brailer's connection to West Virginia see my post on Febuary 10, 2005.

inter alia recognizes Health Care Blog Law as the "blawg of the day"

Tom Mighell, the author of inter alia, an internet legal research weblog mentions my blawg, Health Care Blog Law, as the blawg of the day.

Thanks for the mention Tom!

West Virginia Court Videoconferencing Technology Saves Regional Jail Money

Brian Peterson's West Virginia Legal Weblog highlighted in a recent post an article that appeared in Washington Technology about the West Virginia court systems use of videoconferencing to reduce prisoner transportation costs for hearings involving inmates housed at the various West Virginia Regional Jail Authority facilities around the state.

The article indicates that the new technology has saved the State of West Virginia $30M in transportation costs during its first year.

I have first hand knowledge of the technology having been involved in a number of circuit court hearings before over inmate related health care matters. Each time the technology has been used it has worked very well for all involved and I can see how it definitely saves substantial time, effort, manpower and money.

Instead of the inmate being driven by one or two officers from the Regional Jail facility to the particular county court house (which in many cases can be a significant drive) the technology allows the inmate to be brought to a central location in the Regional Jail for the hearing and the judge, lawyers and inmate are brought together via videoconferencing.

Another benefit of the new technology is safety. The use of videoconferencing makes it safer for the general public because there is a reduction in the risk of a particular inmate escaping while away from the facility. Also the technology makes it it safer for circuit judges, their staff and others who visit the local court houses. The recent incident in Atlanta involving an inmate who overpowered a court officer, stole her gun and ended up killing three individuals, including Superior Court Judge Rowland Barnes, highlights the possible benefits of the technology.

For more information on the videoconferencing project you may want to check out the following past press releases from the Supreme Court of Appeals News.

December 26, 2001 - Supreme Court of Appeals Awarded $700,000
Videoconferencing Grant
September 15, 2004 - West Virginia Supreme Court Awarded
$25,000 Grant for Technology Training

New HIPAA Focused Blog: "ComPly With Me--- a HIPAA Forum"

Last week I came across a new blog focusing on HIPAA privacy and security issues. The blog called "Comply with Me -- A HIPAA Forum" is written by Michael Ehart.

I found a number of his posts very interesting and look forward to more information on HIPAA related issues and compliance. In one of his posts on the need for more education and understanding of the impact of HIPAA he included a link to a HIPAA resource provided by the Washington State Medical Assocation. I found the overview informaiton and resources very good, especially for smaller physician practices.

Governor Manchin Appoint Dr. Julian Bailes to Coordinate West Virginia Electronic Medical Records Initiative

A press release issued by Governor Joe Manchin on May 18, 2005 announced that Dr. Julian Bailes was appointed to oversee the development and implementation of a statewide electronic medical record (EMR) initiative. To learn more about Dr. Bailes you can review his CV here.

I'm excited to see West Virginia taking steps to coordinate and develop a statewide integrated electronic medical record initiative. The need for a coordinate effort on EMR technology is vital to an integrated and compatible system. Without a coordinated effort there will be a variety of incompatible hardware, software and health EMR systems which will defeat many of the reasons and benefits for making the conversion from paper record systems to electronic record systems.

The press release states:

CHARLESTON, W.Va. - Gov. Joe Manchin today announced his appointment of Dr. Julian E. Bailes, Professor and Chairman of the Department of Neurosurgery at West Virginia University School of Medicine, to oversee a statewide working group studying implementation of electronic medical records technology – an initiative highlighted in the governor’s first State of the State address.

A Louisiana native, Dr. Bailes brings a wealth of knowledge and experience from the medical and health care arenas to this leadership position. He has extensive experience in neurological research, telemedicine and patient care, and his written work has been published in more than 100 academic publications.

He established one of the nation’s largest specialty telemedicine networks while practicing in Pittsburgh, Pa. and was the co-principal investigator & leader of the National Medical Practice Knowledge Bank project, a $52 million effort at computerization and dissemination of medical information.

"Dr. Bailes is a precious asset to West Virginia’s medical community and I am pleased that he has agreed to assist with our efforts to improve doctor and patient accessibility to medical records through the innovative use of technology," the governor said. "Under his leadership and guidance, West Virginia will develop sound policy aimed at making health care information more readily available to consumers so that they can make timely and informed choices about their doctors and treatment options."

During Dr. Bailes five-year tenure at WVU, the Department of Nerosurgery has experienced significant growth. The department has increased to 10 faculty members with subspecialty expertise in all areas of neuroscience, and provides care for neurological conditions and injuries at WVU Hospital and in Wheeling.

Dr. Bailes is a graduate of Louisiana State University, where he earned his B.S. and Doctor of Medicine degrees.

For more information on the national perspective on the EMR intiative you can read one of my previous posts dicussing Health and Human Services Secretary Mike Leavitt's press release on a new report citing investment in information technology (IT) as an essential, high priority for the American health care system and the U.S. economy.

Another native West Virginian has been intregally involved in the national initiative to integrate health information technology, including EMR systems, into the national health care system.

Alaina Stout Joins FS&B Health Care Law Practice Group

I have been meaning to announce the addition of a new health care attorney who recently joined Flaherty, Sensabaugh & Bonasso, PLLC. We are very excited about Alaina joining our firm and becoming a member of the firm's health care practice group.

Alaina N. Stout joined Flaherty, Sensabaugh & Bonasso, PLLC in April 2005. She will be focusing her practice on health care and product liability law. She earned her bachelor's degree in Health and Society with a minor in Legal Studies from the University of Rochester, here Masters in Public Health from Boston University School of Public Health and received her law degree from the West Virginia University College of Law.

Personal Data: What's possible with a few dollars and internet access?

The PrivacySpot blog has an interesting post and link to a New York Times article from the May 18, 2005 Technology section. The article reports on the efforts of a computer security course at Johns Hopkins University to prove the vunerability of electronic personal data scattered across the country.

The project involved small teams of students who were allowed to spend no more than $50 and were to limit there search of legal and public sources of information, including death records, property tax information, campaign donations occupationa license registries, etc. The results of the efforts by these inquisitive computer science students were interesting.

Minnesota Attorney General and MInnesota Hospital Reach Agreement over Fair Pricing for Unisured Patients

The Minnesota Attorney General Mike Hatch issued a press release today announcing an agreement reached with a group of Minnesota hospitals on billing and collections policies and practices.

According to the press release, the agreement establishes a price cap for the uninsured that would guarantee those with household incomes at or below $125,000 the same discount that hospitals give their largest commercial insurer. The agreement also standardizes practices that hospitals and clinics will follow when attempting to collect medical debts from patients.

Each of the following health systems entered into separate agreements with the Attorney General (click on the health system to view the actual agreement):

• Allina Health System
• North Memorial Health Care
• Park Nicollet Health Services
• HealthEast Care System

I suspect that the agreements arose out of the various class actions that have been filed around the country challenging hospital charity care policies and the treatment of the unisured regarding billing and collection of the costs of health care services. It will be interesting to see whether other state attorney generals will follow suit by negotiating with hospitals over billing and collection practices involving uninsured health care consumers.

Charleston Daily Mail Reports that CAMC May Purchase HCA's St. Francis Hospital Facility

An article in today's Charleston Daily Mail reports that Charleston Area Medical Center may be one of the potential bidders exploring the idea of purchasing one or all of the four HCA, Inc. hospital facilities located in West Virginia, including St. Francis Hospital in Charleston, West Virginia.

The article also mentions that West Virginia University Hospitals may be one of the potential bidders, alone or in conjunction with CAMC. The article also states that there are nine potential bidders and theat HCA is in the second phase of process which involves the potential bidders to look at the facilities through the due diligence process.

Don Surber's Directory Of Blogs

I want to thank Don Surber for adding Health Care Blog Law to his newly created Directory of Blogs. The directory features a variety of interesting blogs, including various West Virginia blogs.

HHS Secretary and Leading U.S. Companies Say Health Information Technology Should Be Urgent Priority

On May 11, 2005 Health and Human Services Secretary Mike Leavitt issued a press release on a new report citing investment in information technology (IT) as an essential, high priority for the American health care system and the U.S. economy.

HHS released a new report, "Health Information Technology Leadership Panel: Final Report," at the Business Roundtable's Chief Executive Officer Health Care Summit. The Report, prepared by The Lewin Group, a health care policy consulting firm, through a contract with HHS, convened a Health Information Technology Leadership Panel made up of corporate executives from large U.S. companies that purchase a substantial amount of health care for their employees.

According to the press release, the Leadership Panel identified three key imperatives for health IT:

1. Widespread adoption of interoperable health IT should be a top priority for the U.S. health care system.
2. The federal government should use its leverage as the nation’s largest health care payer and provider to drive adoption of health IT.
3. Private sector purchasers and health care organizations can and should collaborate alongside the federal government to drive adoption of health IT.

The panel also reached six conclusions to guide health IT adoption by the federal government and private sector.

1. Potential benefits of health IT far outweigh manageable costs.
2. Health IT needs a clear, broadly motivating vision and practical adoption strategy.
3. The federal government should provide leadership, and industry will engage and follow.
4. Lessons of adoption and success of IT in other industries should inform and enhance adoption of health IT.
5. Stakeholder incentives must be aligned to foster health IT adoption.
6. Among its multiple stakeholders, the consumer – including individual beneficiaries, patients, family members and the public-at-large – is key to adoption of health IT and realizing its benefits.

Finally, the Leadership Panel identified themes regarding the relative benefits and costs of health IT implementation. First, investment in health IT is urgent and vital to rising health care demands, business interests and the broader US economy. Despite the initial costs, health IT will become an essential means -- among others -- for managing health care costs. Second, the potential benefits and costs of health IT must be clearly perceived by its stakeholders.

The press release announcing the release of the report can be found here.

"The Health Information Technology Leadership Panel: Final Report" can be found here.

West Virginia Supreme Court Agrees to Hear United Hospital Center Certificate of Need Appeal

An article in today's Charleston Daily Mail reports that the West Virginia Supreme Court of Appeals agreed to accept and hear arguments on an appeal of Judge Fred Fox's circuit court ruling reversing the West Virginia Health Care Authority's decision granting a certificate of need for United Hospital Center, Inc. to build a new $265M replacement hospital facility 8 miles from its current hospital location.

United Hospital Center, Inc., West Virginia United Health System, Inc., and the West Virginia Health Care Authority each filed separte petitions for appeal which were consolidated. The Supreme Court voted 3-1 (Albright voting not to grant and Starcher not participating) granting the petition for appeal.

Fairmont General Hospital appealed the original decision by the West Virginia Health Care Authority granting the certificate of need to United Hospital Center. Fairmont General Hospital appealed the decision to the Office of Judges, which upheld the decision, and then appealed the decision to the Circuit Court of Marion County.

Fairmont General Hospital had opposed the new facility from the beginning because the new site for the facility was 8 miles north of the current hospital location located along I-79, which was much closer to the current Fairmont General Hospital location. According to the Daily Mail article, as a result of the approval of the new hospital, Triad Hospital, Inc. decided not to purchase Fairmont General Hospital and construct a new $ 85 M hospital facility in Marion County.

The arguments on appeal revolve around the Certificate of Need Standards for Renovation-Replacement of Acute Care Facilities and Services which originally required that a replacement hospital be located no more than 5 miles from the exisiting facility and located in the same county. The Standards were subsequently changed to define "replacement" as, "a project for the erection, construction, creation other acquisition of a physical plant or facility. All beds in the replacement facility must be located within the same county or within fifteen (15) miles of the original facility." The new Standards were approved by Governor Wise on October 9, 2004.

In this case, the site for the new United Hospital Center hospital was located 8 miles from the existing facility. The West Virginia Health Care Authority's Decision issued on October 24, 2003, stated that the Cerficate of Need Rule does not require a CON application to be perfectly consistent with the State Health Plan (the State Health Plan is made up of a variety of Standards for particular services, including the Renovation-Replacement of Acute Care Facilities and Services). The Authority's decision also stated that a replacement hospital 8 miles rather than 5 miles from the existing hospital is not materially inconsistent with the definition of a "replacement" facility.

Judge Fox's November 24, 2004 Opinion and Order Reversing the Decision of the West Virginia Health Care Authority / Office of Judges recognized that the 8 mile distance between the current and proposed new facility exceeded the 5 mile regulatory limit. Judge Fox's Order also recognizd that one of the reasons for the mileage limit was to protect other area hospitals from the encroachment of new facilities into areas traditionally serviced by other area hospitals. Ultimately, Judge Fox found that the West Virginia Health Care Authority violated W.Va. Code 29A-5-4(g)(1) and exceeded its statutory authority.

For those interested in West Virginia certificate of need law this will be an interesting case to watch.

DHHR Proposal for Medicaid Cost Containment Plan

The 2005 West Virginia legislative session resulted in a budget bill for fiscal 2005-2006 which was passed with a shortfall of approximately $30 million in the projected funds needed to balance the Medicaid budget for the fiscal year. As a result of the loss of the federal 3 to 1 match on this $30 million dollars -- the true impact on providers and the public for the 2005-2006 fiscal year will be approximately $115 million.

As a result the Department of Health and Human Resource (DHHR) issued its proposal for Medicaid Cost Containment Plan. A copy of the draft plan can be found on the West Virginia Health Hospital Association website here.