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By Mike Kappel
Senior Vice President of Government and
Industry Relations
McKesson Technology Solutions

With the stroke of a pen in February, President Barack Obama set the wheels in motion for a monumental change in how healthcare will be delivered in the U.S. The American Recovery and Reinvestment Act of 2009 (ARRA) puts muscle behind reforming healthcare by helping to fund widespread adoption of electronic health records (EHRs).
The landmark legislation includes $19.2 billion in the Health Information Technology for Economic and Clinical Health (HITECH) Act. The act provides incentives to hospitals and physician practices for the implementation and "meaningful use" of "certified EHRs." Widespread EHR adoption is expected to reduce healthcare costs by improving quality, safety and efficiency.
Announcement of the stimulus package created a flurry of uncertainty in the healthcare industry, particularly regarding vague definitions of certified EHR and meaningful use. Despite these unknowns, the need to accelerate implementation looms large.
The first stimulus incentives become available in October 2010 for hospitals and January 2011 for physicians, with lower incentives for delayed adoption and penalties for not demonstrating meaningful use of a certified EHR beginning in 2015. This puts pressure not only on providers and practitioners but also on vendors, all of whom are facing upgrade capacity, interoperability and database encryption challenges across their entire customer bases.
With the confirmation of Kathleen Sebelius as the Health and Human Services (HHS) Secretary, the key definitions are under consideration and are expected to be announced in early summer of 2009, but no later than December 2009. Meanwhile, McKesson is doing everything we can to ensure our customers have a voice in these critical decisions.
Sharing What We Know
To support our hospital and physician customers in understanding HITECH, McKesson launched the "Achieve HIT" program in February. The program is designed to help our customers optimize and accelerate their HIT deployments so they can take maximum advantage of the stimulus incentives. Efforts to date include:
One-stop Web sites for hospitals and office-based physicians. The
Web sites provide detailed information about the legislation and our
Electronic Health Record solutions as well as a physician telephone
hotline to explore EHR options.
Seven CEO Strategic Forums, where more than 50 customer CEOs
and McKesson leaders collaborated on strategies to accelerate HIT
adoption. During these highly interactive meetings, customers
discussed the potential for physician alignment and shared their
views on the definition of "meaningful use." McKesson experts
shared the latest from Capitol Hill and how McKesson can help
create a blueprint for the future.
CIO interactive Webinars and physician interactive Webinars about
the legislation and how McKesson can support customer EHR
efforts. These events have drawn close to 250 CIOs and more
than 1,000 physician practice participants, respectively.
Lessons from the Field
In March 2009, ideas from these events were taken to Washington, DC, for a "Lessons from the Field" summit featuring CEOs from large and small, rural and urban hospitals, health networks and physician practices. The goal of the summit was to provide policy makers with insight into what the road toward meaningful use looks like to people who have been traveling it for some time. These policy makers can then influence the remaining fine print to ensure that the legislation achieves its intended purposes.
The recommendations that came out of the summit were published in a recently released white paper, which in turn formed the basis of written testimony submitted by McKesson to the National Committee on Vital and Health Statistics Executive Subcommittee Hearing on "Meaningful Use" of Health Information Technology, which was held April 30, 2009.
This issue of Performance Strategies is devoted to the stories told by some of the CEOs who went to our nation's capital in March. As you will read, consensus on some recommendations is balanced by divergence based on the unique challenges presented by their medical staffs and the populations they serve. We've also included examples of the definitions of "meaningful use" that various industry groups are promoting.
Each organization has committed millions of dollars to implementing robust EHRs and exchanging data within their organizations and across their communities. Compared to their long-term investments, panelists agreed that the incentives are a small but critical catalyst for surmounting a number of complicated challenges on the path to achieving the full potential of healthcare, They are also likely a blip compared to the reimbursement changes coming on the heels of this legislation.
I hope you will recognize your own organization in at least one of these stories, and be energized to continue your own EHR journey.
Michael L. Kappel is active in a number of the healthcare industry's IT organizations. He recently was elected as Commissioner for the Certification Commission for Healthcare Information Technology (CCHIT), having previously served as co-chair of the CCHIT Network Certification Workgroup, Certification Process Workgroup and Advisory Panel. He is past chair of the Policy Committee of the National Alliance for Healthcare Information Technology and currently serves as a member of the Leadership Council of the eHealth Initiative and the steering committee of Connecting for Health. He also is a member of the HIMSS Electronic Health Record Association, which he helped to found in 2004 and where he has served as a past member of the Executive Committee.


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Five Questions to Ask Yourself
What IT systems do you have in place today?
What is your current rate of adoption?
What are your plans to increase adoption?
What is on your IT blueprint for the future?
Will you be ready in time to qualify for the maximum
amount of stimulus funds?
With the first date for qualifying for the maximum funds looming (October 2010), we can't wait for the final details on the requirements that define meaningful use. McKesson can help you gauge where you stand in qualifying for HITECH Stimulus funds. From our work with our contacts on Capitol Hill, the Advisory Board, HIMSS and other policy makers and industry groups, we have developed likely elements of the definition of meaningful use.
Our color-coded dashboard assessment addresses where you are today and where you likely need to be to qualify for maximum incentives. We identify opportunities to optimize current technology, and make recommendations for additional solutions to promote the adoption of HIT for meaningful use. The detailed assessment also includes financial benefits projections from implementing the recommendations, including the potential Medicare/Medicaid stimulus incentives.
Read about the healthcare incentives for health systems
and physicians.
For more information on a readiness assessment or our
HITECH Act incentive calculator, contact:
PerformanceStrategies@McKesson.com.
While it will take time to work through the details of this legislation and what is required to qualify for funding, McKesson believes that the incentives are significant enough that they could affect an organization's plans for physician alignment, implementing healthcare IT or completing IT projects.
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