Health Care Law Blog: July 2006

Monday, July 31, 2006

Blawg Review #68: Jeremy Blachman

Blawg Review #68 is up at Jeremy Blachman's Brand New Weblog (aaka* Anonymous Lawyer and aka Jeremy's Weblog). Enjoy the week's best posts from the legal blawg world.

I'm nominating Jeremy for the Guinness World Record blawg category of "most law blogs owned and maintained by one person".

* aaka "also anonymously known as"

HR 4157: Health Information Technology Promotion Act of 2006

HR 4157, the Health Information Technology Promotion Act of 2006, was passed by the House on July 27, 2006. The bill promotes the use of health information technology to improve the safety and quality of the nation’s healthcare system.

Important to those groups, including West Virginia, looking at the barriers to health information technology adoption under the RTI funded Health Information Security & Privacy Collaborative (HISPC) is language requiring DHHS to study the impact of variation between state security and confidentiality laws and federal security andconfidentiality standards.

The legislation requires DHHS to report back to Congress within eighteen months whether “there is a need for greater commonality of the requirements of State security and confidentiality laws and current Federal security and confidentiality standards to better protect, strengthen, or otherwise improve the secure, confidential, and timely exchange of health information among States, the Federal government, and public and private entities.”

Also, the legislation calls for statutory exceptions in the Stark law (federal physician self-referral) and safe harbors to the Anti-Kickback Statute that would allow hospitals to supply physicians with HIT software and hardware used for the electronic exchange of clinical health information. Also, the bill requires adoption of International Classification Diseases (ICD)-10 codes sets by October 1, 2010.

The summary (as introduced) reads as follows:

SUMMARY AS OF:
10/27/2005--Introduced.

Health Information Technology Promotion Act of 2005 - Amends the Public Health Service Act to add a new title II part D (Health Information Technology).

Establishes within the Department of Health and Human Services an Office of the National Coordinator for Health Information Technology.

Directs the National Coordinator to: (1) maintain, direct, and oversee the continuous improvement of a strategic plan to guide the nationwide implementation of interoperable health information in both the public and private health care sectors; and (2) serve as the coordinator of federal government activities relating to health information technology.

Prescribes conditions under which any nonmonetary remuneration (in the form of health information technology and related training services) made by a hospital or a critical access hospital to a physician shall not be considered a prohibited payment (subject to civil and criminal penalties) made as an inducement to reduce or limit services to certain individuals.

Directs the Secretary of Health and Human Services to study and report to Congress on whether pertinent state laws and current federal standards should be conformed to create a single set of national standards to preserve and protect the security and confidentality of patient health information.

Amends SSA title XI to provide for establishment of uniform confidentality and security standards with respect to individually identifiiable patient health information.

Directs the Secretary to: (1) promulgate a final rule for upgrading specified Accredited Standards Committee X12 (ASC X12) and National Council For Prescription Drug Programs (NCPDP) Telecommunications standards and International Statistical Classification of Diseases and Related Health Problems, 9th revision, Clinical Modification (ICD-9-CM) codes; and (2) develop a strategic plan related to the need for coordination in the area of health information technology.

Wednesday, July 26, 2006

2005 Statistics on Physician Use of EHRs

Statistics on the use of electronic health record systems by office based physicians courtesy of iHealthBeat and a report by the National Center for Health Statistics.

The chart shows an increase in usage from approximately 18% in 2001 to 24% in 2005. Interestingly, the use varies among regions with the Northeast at 14.4% as compared to the West at 33.4%.

A recent report issued by the Healthcare Financial Management Association, "Overcoming Barriers to Electronic Health Record Adoption," provides more statistics on the adoption and barriers faced by the health care industry.

E-prescribing: privacy & security vs. lower cost & reduced errors

A tale of e-prescribing data breach courtesy of Instapundit. More on the e-prescribing breach and the suspension of the program at Georgetown University Hospital from iHealthBeat.

Alternatively, see this iHealthBeat report on a commitment by the auto manufacturers (Ford, Chrysler and GM) to continue support for an e-prescribing systemby pledging $1M.

Thursday, July 20, 2006

West Virginia E-Health Initiative Update

The West Virginia State Journal online edition provides an update of West Virginia's efforts to implement a statewide electronic medical records system.

The 2006 Legislature passed legislation creating the West Virginia Health Information Network responsible for guiding and overseeing West Virginia's efforts to coordinate and implement a private/public interoperable health information system. Governor Manchin has named Dr. Julian Bailes, chairman of WVU's Department of Neurosurgery as chairman of the Network.

Wednesday, July 19, 2006

Pew Study: Blog Stats

While on the topic of stats -- check out these interesting stats on the state of blogs from a recent Pew Survey. Courtesy of Yahoo News and Reuters.

Denise Howell, Reed Smith and the Blawg Effect

Robert Ambrogi at Inside Opinions: Legal Blogs raises many of the questions I've been thinking about over the last few days after learning about the separation of Denise Howell from Reed Smith. I first learned about the separation after reading the Aussie version of Blawg Review #66 (evidence that news travels quickly these days).

Prompted by Craig William's post, "Neo, Did you see that ripple in the Internet?," and other posts about the departure of Denise Howell from Reed Smith, I thought it would be interesting to provide some statistics (see below). Kevin O'Keefe at LexBlog reports that Reed Smith internet discussion is up 50%. Time will tell as to the overall impact (positive or negative) of the decisions made by Reed Smith and Denise. Do the stats below tell us anything? The stats reflect the first wave of interest in the news. It doesn't show us the lasting effect or the overall impact. It's also interesting to look at the stats over a longer period -- the Technorati charts below only show 30 days. Looking at the stats over a longer period of time makes this incident appear as more of a "blip."

My followup post from last week to Adam Smith Esq. post, "Are you making your times, or are they making you?" is more relevant now as we look at the decisions made by the parties. I would place Denise in the same category. She is a person who "makes the time" rather than being created by the time. Having a feeling of connection to both Denise and Greg Jordan I wish both Denise and Reed Smith success in the future.

Like no time ever before, the blogosphere (blawgoshere or bobbersphere) and electronic social networking allow for the quick sharing and discussion of opinions on a global scale. It simply amazes me everyday. The action taken by both parties and the resulting online dialogue in this case is but one example.

Update: A followup post by Kevin O'Keefe at LexBlog mentioning an article from the UK's Lawyer, "Reed Smith launches women's career forum and sacks female blogger."

Technorati stats:

Posts that contain "Reed Smith" per day for the last 30 days.

Get your own chart!

Posts that contain "Denise Howell" per day for the last 30 days.

Get your own chart!

Posts that contain "Denise Howell" And "Reed Smith" per day for the last 30 days.

Get your own chart!

Posts that contain "Denise Howell" Fired "Reed Smith" per day for the last 30 days.

Get your own chart!

Google statistics as of 7/19/2006:

Search of "Reed Smith" law 1,220,00 hits.

Search of "Denise Howell" 490,000 hits.

Search of "Denise Howell" and "Reed Smith" 690 hits.

Search of "Denise Howell" fired "Reed Smith" 154 hits.

Tags: Howell, Bag and Baggage, Reed Smith, blawg

Tuesday, July 18, 2006

New Medical Blog By Senator Frist

Senator Bill Frist has announced a new medical blog called MedicalMatters.org: a 21st Century Discussion of Health Care Issues.

According to the inaugural post:

MedicalMatters.org is a blog about health care and the politics of health care. In the coming days and weeks we will discuss stem cells, avian flu, electronic medical records, Health Savings Accounts, and much more. We will take a long term look at some of the health care challenges facing the country and start an online discussion encouraging different points of view. I will blog regularly as will 10-12 regular bloggers from a variety of health care-related fields. We will also encourage high profile, guest bloggers to join the discussion.

I'll be interested to watch the posts on this new health/medical blog. Based on the volume of comments already being submitted to the blog -- it should provide a lively debate on health care in the U.S.

I did leave a comment that the blog needs to incorporate RSS.

Tip to Instapundit.

Friday, July 14, 2006

Update on West Virginia's Participation in Health Information Security & Privacy Collaborative Project

Over the past few months I have had the opportunity to participate in the Legal Working Group of the Health Information Security & Privacy Collaborative (HISPC) being co-managed by the West Virginia Health Care Authority and West Virginia Medical Institute.

Following is an AP press release on the current status of the grant project in West Virginia which involves looking at the current barriers in West Virginia (legal, practical and otherwise) faced by health care providers as they work to move toward an interoperable health information system. Similar projects are occuring in various states and all of the information will then be combined to get a national perspective on the barriers.

The following article has appeared in Modern Healthcare and the local newspapers. It is my understanding that a more detailed article will appear in the State Journal in the coming weeks. For more information on the project you can check out WVMI HISPC website.

W.Va. agencies seek to protect privacy on state network
Being able to access personal medical information electronically might sound a little scary to some patients and healthcare providers. That's why the West Virginia Health Care Authority and the West Virginia Medical Institute are being asked to review existing privacy and security policies and regulations and business practices within the healthcare industry.

The agencies will be consulting with members of the medical community and consumers, trying to figure out how to protect patient confidentiality as they prepare to launch a statewide network containing medical histories, test results and other medical information.

With a patient's consent, that information would be electronically available to any medical provider in the state. In addition to creating the public-private network, a new state law passed earlier this year would allow secure electronic consultations between doctors and patients.

The West Virginia authority will be appointing a board of directors later this summer to plan and implement the statewide network.

Last month, West Virginia University Hospital and University Health Associates signed a contract for a $40 million information technology system that streamlines record-keeping and record-sharing at the Physicians Office Center, WVU Cheat Lake Physicians office and the WVU Harpers Ferry Family Medicine Center. It also consolidates several systems at Ruby Memorial Hospital, WVU Children's Hospital and Chestnut Ridge Hospital.

Thursday, July 13, 2006

West Virginia Hospital For Sale

Today's Charleston Daily Mail is reporting that St. Francis Hospital in Charleston and St. Joseph's Hospital in Parkersburg are again up for sale and according to the Daily Mail's sources the hospitals bids for the facilities are due on Friday. The article cites a recent article in Modern Healthcare about the sale of the four hospitals by HCA to Lifepoint.

In the June 30, 2006, new release by Lifepoint Hopsitals it was announced that St. Francis and St. Joseph's Hospital were classified as assets held for sale.

Google Health Portal

I've notice word circulating about a Google Health portal referred to as Google Health Scrapbook or M Scrapbook. Although I've expected Google's involvment in the health care industry sector, it will be interesting to watch Google approach on providing service to patients/customers, providers and others in the health care industry.

Thanks to the Wired General Counsel for the tip.

Tuesday, July 11, 2006

WV Hospital Licensure Rule

I recently became aware that the West Virginia Hospital Licensure Rule, CSR 64-12-1, was amended this past legislative session and became effective on May 1, 2006. I haven't had a chance to perform a paragraph by paragraph review of the changes but did notice that the regulations regarding retention of medical records appear to have changed under CSR 64-12-7.2.f. Under the past rule there was no direction given to hospitals on the duration for the retention of medical records.

The new provision states, "[t]he hospital shall preserve medical records, including records of patients treated in the emergency room or outpatient departments, for a minimum of five (5) years in their original form or in a legally reproduced form."

Wednesday, July 05, 2006

West Virginia Law Firm Leaders

Bruce McEwen over at Adam Smith, Esq., a law blog focused on the economics of law firms, has an interesting post, "Are you making your times, or are they making you?" where he discussed two global law firm leader CEOs, Greg Jordan of Reed Smith and Ralph Baxter of Orrick. Both men are originally from West Virginia. Mr. Jordan grew up in Wheeling, West Virginia and attended my alma mater, Bethany College. Mr. Baxter, grew up in New Martinsville, West Virginia and his family is originally from the Proctor area, similar to my family who lived out Proctor on Coffield Ridge.

Reed Smith and Orrick have been two of the most successful global law firms of the last 10 years. Consistent with the theme of Mr. McEwen's post I'd agree that both Mr. Jordan and Mr. Baxter are people "who make the time" rather than being individuals created by the time. However, I also have to believe that the caring community oriented West Virginia environment that both grew up inlargely influenced their ability to be successful.

Additional information about Ralph Baxter's background and connection to West Virginia appeared in this 2001 Daily Mail article about Orrick's move to centralize its global operations center in Wheeling.