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

[Catherine Britain]

I just participated in a conference call to discuss this issue.  A counter
argument is being drafted to assure that CAHs are appropriately included in
both the grants and incentive programs for HIT.  The reason for the
exclusion from the incentives program has to do with CAH eligibility to
receive funding for HIT using the cause/cost report and they would therefore
be perceived as double dipping. There is a lot of confusion right now as
there are three separate mark-ups in the House.  I hope to have more
direction for you this afternoon.

Thanks,
Cathy

On Fri, Jan 23, 2009 at 6:42 AM, Catherine Britain <csbritain at gmail.com>wrote:

> 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
>



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