By MICHAEL LAKE

This is a summary of the HIT Trends Report for August 2010.

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Large insurers make HIT commitments.  This month’s trends are dominated by national health plans revealing more about their HIT strategies.  Dr. Blumenthal called HIT a “team sport,” when asking for private industry support for meaningful use.  National insurers responded.  Humana announced that it will collaborate with athenahealth in 100 physician practices and pay for 85% of the costs of its EHR.  It will also pay a 20% bonus for hitting outcomes targets.  Ingenix, part of UnitedHealthcare Group, reported it is buying Axolotl, a leader in health information exchange.  Aetna announced a partnership between its ActiveHealth care management solution and IBM who will provide clinical decision support to providers in large groups using cloud computing.  And WellPoint told the WSJ that it is investing hundreds of millions of dollars to finance the HIT infrastructure for rural providers.  In response to a consumer advocate raising questions about an inherent conflict when payers support provider HIT efforts, health plans responded by insisting their focus is on improving patient outcomes which will lower costs.  Payer investments in provider HIT will be supported by its inclusion as a medical expense when insurers calculate medical loss ratios.  The National Association of Insurance Commissioners approved its inclusion in new MLR blanks.

Analysts predict hospitals will be challenged to meet federal EHR criteria. McKinsey successfully argues in a recent report that hospitals need to take a long view toward EHR implementation and will recoup expenses from gains in efficiency and fewer ADEs.  It calculates that the incentives are insufficient to cover the costs of deployment but the long term benefits will.  CSC also reports that some advanced functions are required beyond a basic EHR to meet quality reporting.  Its analysis outlines the demands of measuring quality and the importance of exclusion criteria.  For example, the documentation for excluding patients with orders for “comfort care only,” may only be in the physician note or elsewhere. And researchers at Brigham and Women’s in Boston use AHA data to report that hospitals have a way to go to meet Stage 1 meaningful use criteria. Larger hospitals fare better than smaller.  For example, less than half have a current problem list.  CHiME, a CIO professional org, published a primer on how hospitals can do better. The CIO Guide is a comprehensive plan (16 chapters, 80 pages) for executives engaged in the transformation of their organizations through implementing HIT.  It includes practical summaries for executive guidance and extensive comments by hospital CIOs.  There are also suggestions for going deeper and links to other content. A key is that it considers HITECH incentives, but focuses on the enterprise issues.  Accenture also weighed in this month offering suggestions for how information governance, such as data privacy and security, are at the core of EHR projects.  Yet, these issues notwithstanding, Premier, a hospital-owned services company, announced that 40 health systems have signed on to its Accountable Care Organization collaborative to pursue progress as potential ACOs.

Consumers benefit from innovations in care communications. GE and Intel announced a joint venture focused on telehealth and independent living.  They had been working as partners in the space.  WellDoc reported it received FDA approval for its DiabetesManager® System.  Health economist Jane Sarasohn-Kahn argues on her blog (and I wholeheartedly agree) that this is a big deal and will help the dialog on automated care management.  Jane highlights the recent review by the FDA to improve its pre-market 510(k) review process to ensure innovation and safety.  Mobile communications continues to grow in importance.  This month Walgreen’s CTO commented that it is seeing dramatic growth in mobile SMS texting alerts with its customers, in that signups for SMS text is outpacing email.  Any Mayo Clinic, a leader in healthcare social media, launches it Center for Social Media to leverage its most-popular YouTube status and 60,000 Twitter followers.

The Art of HIT.  The art this month is 180 Colors, Gerhard Richter, 1971. Richter’s work looks like an enlarged page from a paint sample book.  The color blocks were created according to precise mathematics using the building blocks of the three primary colors, red, yellow and blue.  12 hues times 15 tones of dark to light is 180 colors.  But the positioning of each color block is entirely random.  This is where we are in HIT.   We’ve used our best collaborative science over the past many months to construct meaningful use and regional extension centers and state exchanges and all the rest.  But now the randomness of market forces enters and we get innovation and creativity.

Michael Lake has been a healthcare technology strategist for over 30 years.  He is President of Circle Square Inc., a San Francisco-based strategy, business development and market research firm, focused exclusively on the healthcare information technology market.  He publishes the HIT Trends Report monthly.  For more information, please see Michael Lake Healthcare Technology Strategies.