The Obama administration has unveiled $1.2 billion in federal grants for electronic health records systems. The grants are the first wave of funding under a healthcare reform plan to create vast records-sharing networks aimed at cutting costs and improving care in the coming decade. The administration has described such computer systems as a crucial step in overhauling the nation's increasingly expensive healthcare system.
Contrary to current U.S. strategy, vaccinating school children and their parents against the flu is the best way to protect the nation from influenza, including the new pandemic swine flu, U.S. researchers said on Thursday. They added that vaccine priority should be given to people most likely to spread the virus, not those most at risk of serious complications from it. Seasonal and H1N1 vaccination guidelines from the U.S. Centers for Disease Control and Prevention currently target people who are likely to become the most ill if infected.
Federal officials urged employers to prepare for a widespread outbreak of swine flu this fall that could result in high rates of sustained absenteeism and leave crucial posts vacant. Employers should cross-train workers so that vital functions are covered and must take steps to ensure that the H1N1 virus that causes the flu does not spread, officials said. Such steps include aggressively cleaning work areas, encouraging hand-washing, and sending employees home at the first sign of flu symptoms.
Senate healthcare negotiators agreed late Thursday to ignore the increasingly strident rhetoric from Republican and Democratic leaders and to keep working toward a bill that can win broad support from the rank-and-file in both parties, according to sources familiar with the talks. In a conference call, the three Democratic and three Republican members of the Senate Finance Committee agreed to redouble their efforts to craft a less costly alternative to the trillion-dollar initiatives so far put forward in Congress. They discussed the possibility of also reining in the scope of their package, the sources said.
Public confidence in President Obama's leadership has declined sharply over the summer, amid intensifying opposition to healthcare reform that threatens to undercut his attempt to enact major changes to the system, according to a new Washington Post-ABC News poll. Among all Americans, 49% now express confidence that Obama will make the right decisions for the country, down from 60% at the 100-day mark in his presidency. Forty-nine percent now say they think he will be able to spearhead significant improvements in the system, down nearly 20 percentage points from before he took office.
People in Britain complain endlessly about the National Health Service, which is financed by taxpayers and provides access to care, free at the point of delivery, to everyone in the country. They deplore the system's waiting lists, its regional disparities in treatment, its infection-breeding hospitals, and its top-heavy bureaucracy. But they can be a bit touchy when outsiders are the critics. They are furious, for example, that the health service is being held up as an example of the failures of socialized medicine by Americans opposed to President Obama's healthcare proposals.
Florida seniors are concerned about the healthcare debate in Washington and how it could affect them. Even supporters of the president are worried about Medicare cuts, elder care, and drugs and procedures being restricted to them. They paid into Medicare their entire working lives, several said, and basic fairness demands that they be allowed to keep what they have.
President Barack Obama, seeking to rally his base, accused Republican leaders Thursday of trying to block a healthcare overhaul from the start and again threw his weight behind a government-run insurance plan. During a radio call-in show and at a town-hall meeting of supporters, Obama tacked to the left as Democratic allies inched toward trying to pass a healthcare bill on their own.
Some of President Obama's strongest supporters are suggesting that his discipline has slipped as prospects for the passage of healthcare reform becomes murkier. In recent weeks, Obama has delivered mixed messages that have bogged down the debate and sapped momentum from his top domestic priority. Republicans, meanwhile, have stepped into the void of the August congressional recess and, in a page taken directly from Obama's 2008 playbook, are using a combination of online organization and message-of-the-day discipline to frame the legislation as a government takeover.
As work continues throughout the country on seeking healthcare reform and improving quality of care, observing how veterans' healthcare has evolved in recent years could be very instructive to the private sector—in more ways than one.
Just two decades ago, the veterans' healthcare system focused largely on inpatient hospital care and had a poor reputation for quality. However, beginning in the mid 1990s, the organization underwent a major transformation—improving the quality and efficiency of the care it provides to its patients, the Congressional Budget Office observes in a new paper on veterans healthcare and quality.
The Veterans Health Administration of the federal Department of Veterans Affairs ended up eliminating underutilized inpatient beds and facilities, expanded outpatient clinics, and restructured eligibility rules. And then, a major VHA change occurred when it began to track computerized performance indicators—including quality of care measures—and holding senior managers accountable to make improvements.
Today, with the return of veterans who have served in Iraq and Afghanistan—and with more veterans from earlier eras who are turning to the VHA for at least a part of their healthcare—more than 8 million veterans are receiving some of their care each year from VHA.
However, sharing individual patient data between VHA and other providers, specifically private sector providers, has been challenging. VHA's clinicians must proactively follow up with each veteran to ask about outside services. And, even if the records of those services are obtained from outside providers, they often must be entered into VHA's patient records systems by hand, CBO said in its report.
As more providers find themselves held accountable for quality measures such as Health Plan Employer Data and Information Set scores, the exchange of data on shared patients is going to become more important for both VHA and providers outside the system as well.
Also, providers outside of the VHA—some of whom provide a substantial amount of care to veterans—have expressed an interest in getting data from VHA on shared patients. However, issues have arisen regarding how to identify those shared patients while safeguarding privacy.
An answer is now evolving with a new Web based personal health record portion of VHA's system—called MyHealtheVet—that could serve as a conduit for improved communication between VHA and non VHA providers, the report noted.
Similarly, other PHRs have that same potential to help secure storage and exchange of health information have been emerging. The Department of Defense, for instance, has been developing its own PHR system, MiCare, by partnering with Microsoft and Google. VHA could benefit from analyzing the development of these other PHRs to make sure that information exchange information occurs—for all our veterans that need it.
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