[ORTCCTelehealth-TAO] Fwd: House Stimulus Bill Excludes Critical Access Hospitals from HIT Incentives

[Catherine Britain]

Good Morning, All,

This is a very important message forwarded to us by the Office of Rural
Health.  If you or your organization works with/for a critical access
hospital, you may want to weigh in on this.  I am asking that TAO send a
letter of concern to our Congressional delegation and am hoping that Bob and
Kim can get that going.  The letter below from Tim Size is well crafted and
provides you with some great talking points.

Please consider sharing your concern.  If we don't help ourselves during
these tough times, most likely we will be left out of the picture.  In
Oregon we need stand up for all of the members of our healthcare community.

Thanks,
Cathy





---------- Forwarded message ----------
From: Robert Duehmig <duehmigr at ohsu.edu>
Date: Thu, Jan 22, 2009 at 9:04 PM
Subject: Fwd: House Stimulus Bill Excludes Critical Access Hospitals from
HIT Incentives
To: Catherine Britain <csbritain at gmail.com>



FYI
Sent from my iPod

Begin forwarded message:

 *From:* "Kassie Clarke" <clarkek at ohsu.edu>
*Date:* January 22, 2009 8:42:39 PM PST
*To:* "Robert Duehmig" <duehmigr at ohsu.edu>, "Scott Ekblad" <ekblads at ohsu.edu
>
*Subject:* *FW: House Stimulus Bill Excludes Critical Access Hospitals from
HIT Incentives*

  Did you get this?



*From:* Information on Rural Health Issues
[mailto:RH-INFO at LIST.NIH.GOV<RH-INFO at LIST.NIH.GOV>]
*On Behalf Of *Tim Size
*Sent:* Thursday, January 22, 2009 7:35 PM
*To:* RH-INFO at LIST.NIH.GOV
*Subject:* House Stimulus Bill Excludes Critical Access Hospitals from HIT
Incentives



Dear All:

Please read the below statement; hopefully you will share our concern and
contact the Members of your Congressional delegation. AHA, NRHA (and I know
WHA in Wisconsin) are aware of the problem and weighing in. But grass roots
support is important.

If you have any questions, please feel free to contact Louis Wenzlow, the
RWHC Director of Health Information Technology at <lwenzlow at rwhc.com>.

Thx.

Tim
*

House Stimulus Bill Excludes Critical Access Hospitals from HIT Incentives
*
Nearly thirteen-hundred Critical Access Hospitals (CAHs) that serve over
fifteen million Americans in small, mostly rural, communities are excluded
from* *the new health information technology incentives in the proposed
Economic Recovery and Reinvestment Act (in H.R. 598). The draft language in
the Act effectively excludes CAHs from receiving incentives for EMR adoption
even though CAHs average just 1.3 on the HIMSS EMR adoption scale, while
General Medical/Surgical hospitals average 2.4. (The HIMSS EMR adoption
scale is the nationally recognized standard scale for determining provider
EMR adoption rates)

Our smallest hospitals and the rural communities they serve are barred from
the vast majority of the Act's Health Information Technology (HIT)
investment, which will revolutionize (1) HIT adoption, (2) HIT-related
quality reporting and evaluation, and (3) healthcare information exchange.

It's difficult to imagine how this could have happened when many HIT
advocates have indicated the importance of small hospital inclusion.
 According to the well known E-Health Initiative, "Special attention should
be paid to those with little access to capital, particularly in the current
economic environment, including small physician practices, hospitals, and
those who support underserved communities."  Rather than receiving special
attention, small hospitals and the communities they serve have been
effectively shunned from participation in the future of HIT-driven,
quality-focus healthcare.

The rationale for this policy decision is difficult to understand.  While
certainly behind larger hospitals, CAHs throughout the country have shown
they are capable of substantial Electronic Medical Record (EMR) adoption,
with adoption increasing.  Many inpatient EMR vendors that serve CAHs have
been certified by the Certification Commission for Healthcare Information
Technology and offer the functionality to take CAHs to the highest level of
EMR adoption. But this takes an investment out of reach for many CAHs. Due
to the specific challenges that small hospitals face, EMR implementation, a
prerequisite for clinical information exchange, is particularly important in
the small hospital setting.

If not addressed, this flaw in this legislation will result in grave damage
to rural and small providers/communities. As most hospitals are subsidized
to implement comprehensive EMRs, small hospitals, already lagging, will get
even farther behind*.*  The continuity of care between small hospitals and
their tertiary partners will remain fractured, since clinical data will not
be available for exchange.  Small hospitals will in many cases be forced to
rely on the large hospitals that have been subsidized, which will strike at
community hospital independence.  Most important, the underserved residents
in small and rural communities will be largely deprived of the efficient,
quality healthcare that it is the goal of this legislation to deliver to all
other Americans.  CAH exclusion in in the Economic Stimulus Bill should be
reconsidered in favor of HIT for all providers and the communities they
serve.

---

Tim Size, Executive Director
Rural Wisconsin Health Cooperative
880 Independence Lane
Sauk City
Wisconsin  53583
(v) 608-643-2343  (f) 608-643-4936
<www.rwhc.com> or <http://www.rwhc.com>




-- 
Catherine S. Britain
CSB Consulting
csbritain at gmail.com
541-910-7366
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