Monday, February 8, 2010
$125 Billion Budget Request
Eric K. Shinseki, Secretary of the Department of Veterans Affairs appeared before the House Committee on Veterans Affairs on February 4th to discuss the President’s VA budget request for FY 2011. The President’s budget provides $125 billion in 2011 which is almost $60.3 billion in discretionary resources and nearly $64.7 billion in mandatory funding.The Secretary reported that in December 2009, the VA successfully exchanged electronic health record information in a pilot program between the VA Medical Center in San Diego and a local Kaiser Permanente hospital using the Nationwide Health Information Network. During the second quarter of 2010, DOD plans to join the pilot and there are plans to add additional Virtual Lifetime Electronic Record health community sites. The VA has $52 million available in IT funds in 2011 to continue the development and implementation of this priority.
The budget provides $51.5 million to use for medical care in 2011, which is an increase of $4 billion or 8.5 percent over the 2010 level. In 2011, the budget provides $2.6 billion to help meet the needs of veterans who have served in Iraq and Afghanistan.
The FY 2011 budget also includes funding to treat new patients resulting from the recent decision to add Parkinson’s disease, ischemic heart disease, and B-cell leukemia to the list of presumptive conditions for veterans with service in Vietnam.
The VA’s 2011 budget includes $250 million to strengthen access to healthcare for 3.2 million enrolled veterans living in rural and highly rural areas. Plans are to provide new rural health outreach and delivery initiatives and to expand the use of home-based primary care and mental health services.
The VA intends to expand the use of cutting edge telehealth technologies and would like to invest in $163 million in 2011 for home telehealth to take advantage of the latest technological advancement in healthcare delivery. The VA’s home telehealth program cares for 35,000 patients and a recent study found that patients enrolled in home telehealth programs experienced a 25 percent reduction in the average number of days hospitalized and a 19 percent reduction in hospitalizations.
According to the Secretary, the Department’s IT operations and maintenance program supports 334,000 users situated in 1,400 healthcare facilities, 57 regional offices, 158 national cemeteries around the country, plus the IT program maintains 8.5 million vital health and benefit records for veterans. The FY 2011 budget provides $3.3 billion for IT, which is the same level of funding provided in 2010.
The IT resources requested would fund IT to process education claims, to help the Financial and Logistics Integrated Technology Enterprise project replace outdated technology, further develop the paperless claims processing system, and continue to develop the VA’s EHR system for $342.2 million.
2/8/10
Federal Telemedicine News: $125 Billion Budget Request
12/10/09
California hospital's implementation of open-source EHR bears watching | EHR Watch
By the end of the year, Kern Medical Center, a county-owned 222-bed acute-care teaching hospital in Bakersfield, Calif., will have implemented Medsphere Systems’ OpenVista electronic health record (EHR). This deployment bears watching because it may become a trend in terms of providers adopting an open-source EHR.
For one, 2011 is the first year that providers can qualify for bonuses, or increased Medicare reimbursements, under ARRA. That’s shy of a year away from now. I think it’s virtually impossible to implement an EHR and derive meaningful use from it all within a year if you go the traditional, multi-million dollar, multi-year route. But KMC pointed out that the reason it chose OpenVista, which is the commercial version of the Dept. of Veterans Affairs’ VistA EHR, is for its ability to go live rapidly and its lower cost of implementation and maintenance.
In these tough economic times healthcare systems need to do more with less. KMC provides care for more than 16,000 inpatients annually, while its clinics provide care and services for more than 100,000 patients. Its emergency department handles some 43,000 visits per year. The data may be old (fiscal year 2001-2002), but they’re still relevant, especially for healthcare systems like KMC. Over the past three fiscal years prior to 2001-2002, the average daily patient census has increased. With nearly 75 percent of its patients either indigent or on Medi-Cal, KMC has to find ways to become more cost efficient in its delivery of care. On top of that, as a healthcare provider to county inmates and juvenile detainees the hospital system must also meet legal requirements for inmate and juvenile medical care. The KMC folks are banking on an open-source EHR to improve clinical outcomes in a cost-efficient manner.
What you’ll likely see in 2010 are resource-strapped healthcare systems that nonetheless believe in the clinical and financial benefits of health IT. The ARRA bonuses serve as an incentive to implement EHRs. The short timeline for qualification, however, is what will drive healthcare systems to choose EHRs that have a quick, inexpensive implementation.
The next step is achieving meaningful use. Stay tuned.
Open source systems are gaining acceptance in early phases of EHR adoption. Medicare reimbursement rates and whether choice of open source positively or negatively affects reimbursement policy will be the determinant of open source EHRs ultimate success/failure when 'meaningful use' guidelines are finally released in the coming months. Stay tuned...