The Governor’s Healthcare IT Conference

President Barack Obama and Massachusetts Governor Deval Patrick

Although healthcare reform has its supporters and detractors, healthcare IT reform – the use of technology to improve the quality, safety and efficiency of healthcare throughout the country – has broad support from all stakeholders.

The passage of last year’s $787 billion economic stimulus bill brought with it a healthcare IT modernization program that could inject about $30 billion into the economy. Since Massachusetts is a leader both in the use and the manufacturing of healthcare IT systems, this could translate into over a $1 billion for the Commonwealth of Massachusetts.

This isn’t a “cash for computers” program though – it’s much more than that. The stimulus bill was crafted very wisely. It’s not a field day either for the doctors and hospitals who would receive these funds, or for the vendors selling this hardware and software. That’s because in order to get these dollars, physicians and hospitals have to not only buy the new systems, they have to prove that they’re using them to improve care before they’ll qualify to get any money back from the government. What does it mean to improve care? The requirements are actually quite specific and include: improving care coordination, reducing healthcare disparities, engaging patients and their families, improving population and public health, and ensuring adequate privacy and security protections.

The health IT modernization program promotes the use of advanced tools which could significantly improve the quality and efficiency of healthcare in the country today. Massachusetts is well positioned to lead this charge.

The genius of the program is that it is carefully tailored to fit our
uniquely American economy and culture. We are a society that prizes
individual initiative and rejects “top-down” solutions, and no other
part of the economy is more reflective of that than health care
delivery. We also believe in the power of markets to allocate resources
where they’ll create the most value and to drive innovation that
improves peoples’ lives. So unlike other countries where the government
is creating its own infrastructure and dictating which systems the
medical community must use, the Obama Administration’s health IT
program uses federal dollars to give an adrenaline boost to the market.

It does this in three ways: incentives to providers who use IT to achieve higher quality, lower cost care; non-proprietary strict standards to create a level playing field for users and sellers of software and hardware systems; unbiased certification of software to provider assurance that it meets basic quality, safety, and efficiency standards.

Incentives. Medicare and Medicaid have defined 25 basic projects that each hospital and clinician office must complete to demonstrate that they have embraced technology to improve care. For example, medications must be electronically ordered, checked for safety, and routed to pharmacies – going from the clinician’s brain to the patient’s vein without paper or error-prone handwriting. Massachusetts is already the #1 electronic prescriber in the country and has been for the past 3 years. Even so, less than one-third of all prescriptions in the Commonwealth are transmitted electronically today. Fortunately, all of our regional health plans have been champions of e-prescribing, as have all of our major provider groups. Multi-stakeholder partnerships such as the New England Healthcare Institute, Massachusetts Health Data Consortium, and Massachusetts eHealth Collaborative have focused on medication safety. So even though we’re ahead of the pack, we still have a long way to go. The federal health IT program will provide a valuable boost to all of these efforts.

Standards. Well-defined precise electronic formats are needed to share data in our communities with patient consent. For more than a decade, Massachusetts has been a leading state in the secure exchange of patient data via the New England Healthcare Exchange Network (NEHEN), SafeHealth, Community Hospitals and Physician Practice Systems (CHAPS) and the Northern Berkshire eHealth Collaborative sponsored by the Massachusetts eHealth Collaborative. Massachusetts is also a national leader in providing patient access to their medical records through such programs as PatientSite, PatientGateway, myHealth Online, and Indivo Health and providers and health plans making their data available to GoogleHealth and Microsoft HealthVault.

Certification. Medical software, like any other technology that directly impacts public safety, must conform to basic testing and certification to ensure it has the capabilities needed to improve quality, safety and efficiency in hospitals and offices.

Incentives to physicians and hospitals adds fuel to the health care delivery sector, which is one of the engines of the Massachusetts economy. Furthermore, incentives to purchase software and hardware will draw dollars from other parts of the country because Massachusetts is home to several leading vendors of electronic record products such as eClinicalWorks in Westborough, AthenaHealth in Watertown, and Meditech in Westwood.

In addition to direct stimulus payments to hospitals and providers, our state has already garnered millions of dollars in grants to establish core infrastructure to spur the market. The Massachusetts eHealth Institute, a subsidiary of the quasi-governmental Massachusetts Technology Collaborative, has received almost $25 million to accelerate healthcare information exchange and facilitate electronic health record rollout. Harvard Medical School received $15 million for advanced research in electronic health records. Our academic, government, and industry experts will continue to compete successfully for additional grants as they become available.

On April 29 and 30, Governor Deval Patrick will host the Health Information Technology: Creating Jobs, Reducing Costs and Improving Quality Conference. HHS Secretary Sebelius, National Healthcare IT Coordinator David Blumenthal, and many governors will attend. It will offer us a remarkable opportunity to showcase the strength of our healthcare technology accomplishments in Massachusetts, and to learn from leaders from other parts of the country.

For all we’ve accomplished, there is much to do.

We still have silos of information locked away in hospitals, offices, pharmacies, and labs. We still have redundant and unnecessary testing because our care is uncoordinated. We’re still using a huge amount of paper in our healthcare facilities. Paper kills.


My grandmother’s life was cut short by medical error. She was prescribed a combination of medications that should never be given to an older person. She developed stomach bleeding, a sudden drop in blood pressure, a stroke, and ultimately died as a result of it.

With electronic health records, data sharing, and decision support rules that inform clinicians about best practices for personalized medical care, she would have avoided harm.

Massachusetts has been an intellectual, economic, and political leader for healthcare IT for decades. We’re now at the tipping point with the funding, momentum, and opportunity to ensure every patient has an electronic health record. The work ahead to complete the transformation of our manual workflows and data silos into a coordinated electronic healthcare system will be hard. Politicians, payers, providers, and patients must work together to make it happen over the next 5 years.

The lives of our grandmothers depend on it.

9 replies »

  1. This is a crock. And the governors will be on board because they need Obama to bail their bankrupt states out when the bill comes due.

  2. We certainly know that the demand of healthcare IT professionals will be increased. These healthcare IT professionals are not just software developers who only do programming, but we need people who need to understand the healthcare domain knowledge and communicate with physicians in a constructive way. That’s why we need people who are well train and certified. For those who want to get into the healthcare IT, they should look for certification. One reference, they can go to Healthcare IT Certification to look for more detail.

  3. “The genius of the program is that it is carefully tailored to fit our uniquely American economy and culture.”
    I would change that to:
    “The genius of the program is that it is carefully tailored to be impossible to implement except by the most bureaucratically top-heavy, inefficiently run medical practices.”

  4. Johnny,
    ^^^”My grandmother’s life was cut short by medical error. She was prescribed a combination of medications that should never be given to an older person. She developed stomach bleeding, a sudden drop in blood pressure, a stroke, and ultimately died as a result of it.
    With electronic health records, data sharing, and decision support rules that inform clinicians about best practices for personalized medical care, she would have avoided harm”^^^
    Most certainly appears that your grandmother got lousy medical care, period. Computerization would not have saved her.
    Also, pardon me, but where do these dead patients fit in with all of these dreams, especially the dead one at MGH, in January, or the dead one in Nebraska, in April, and dead ones reported here: http://www.huffingtonpost.com/2010/04/20/electronic-medical-record_n_545441.html
    Also, please explain how it will work when the computers go blank like here: http://www.nytimes.com/aponline/2010/04/21/business/AP-US-TEC-McAfee-Antivirus-Flaw.html
    Do you not know that certification is not a surrogate for safety. Do not confuse the two.

  5. So buy a boat anchor, make it sing like the Vienna Boys Choir, and then we will give you something, maybe.

  6. John, sorry to hear about the unnecessary death of your grandmother. E-prescribing is going to be mandated by law in the near future (there are already MediCare incentives). The prescribing doctor will have access to a complete medication history, and the system will automatically alert for adverse drug events.
    As a medical technology sales rep, I have visited hundreds of offices in the past 5 years. Doctors are hesitant to change to e-prescribing systems, because they are worried about changes in workflow. To make any sweeping changes, a federal mandate is a must.
    Jesse Katz
    Founding Team Member

  7. Gary;
    I didn’t see a comment that it would be a windfall for anyone. The post specifically says it would not be such.
    I don’t think it will be a windfall for HIT vendors unless providers fall into the trap of purchasing IT products that don’t do the job – like most of what’s commercially available today. It is my hope that, somewhere in all this, neutral advisors who don’t stand to gain can provide advice and guidance to both physicians and hospitals as to what to spend their hard earned $$ on, in order to make “meaningful use” meaningful. There will be a lot of used car salesmen out there.

  8. The comment that this would be a ‘windfall’ for doctors and hospitals is erroneous. The amount does not cover the capital investment required to adopt HIT, nor the maintenance costs. The government is exacting requirements for reporting and meaningful use to ‘earn’ the funds. The windfall is for HIT vendors, both hardware and software. Providers remain reluctant to adopt EMR because they know it will not reduce costs and will be inefficiant.. This is a last ditch effort on the part of CMS to stimulate HIT