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Healthcare Reform Putting Additional Pressure on Public and Medicaid CIOs-The Health IT Bubble Gets Closer As Money And Digital

Posted Dec 30 2010 12:57am

I’ll go back to this one more time and again mention how valuable those with Health IT experience are today.  I said this back two years ago after the election that folks with hands on IT experience were needed and that figure heads should be out, and it’s coming full circle.  Why do I see some of this ahead of the game, because I used to write code and wrote an electronic medical records system and couple that with 25 years of sales you get a hybrid that can walk and code at the same time to be a little humorous here.  The demands and wants from the Non IT Literate are going to burn out the CIOs as they don’t understand nor do most take time to learn.  I made this post a few weeks ago.

CIO Confidence In Meaningful Use Drops-The New Left Curve of Technology That Arrives Daily Contributes-Don’t Burn These Folks Out

I have spent the last part of 2 years trying to educate readers as to what the processes are as I have watched this build and understand the mechanics behind it.  Those who have no first hand experience have to rely on others for figuring this out.  I have also spent a good deal of time around doctors and watching them work, back when I was writing the EMR I spent many hours observing and if you have not been there and done that, you cant see the same picture.  Here’s a good quote from the article and its very true as clinicians in hospitals are bombed.  Not only do we have meaningful use going on but now add on accountable care organizations and all of which require data processes to work and everyone is over loaded, all so the insurance companies basically can their data as a a big part of this. 

“Hospitals have had the infrastructure in place for years, but it has been difficult to convince them to participate,” Daniel said. “They have so many reporting requirements that unless it is a requirement, it’s difficult to get them to do it”.

Now the public CIOs are having issues too and they have budgets and need to implement systems too and it’s no magic shake of the want and if you read this article in it’s entirety, you can see where they too are trying to get up to speed with healthcare IT technologies themselves! 

YOU NEED IT LITERATE LEADERS TODAY AND THE MORE HANDS ON KNOWLEDGE AND USE THEY HAVE, THE BETTER IT IS FOR EVERYONE.

In one fashion when things were simpler the IT technicians made some of what they do look easy but now there’s no way they can even think about making it look easy at all because of varied data systems, tons more data to analyze and constant pressures to make money. There may be some states where health IT-related issues haven’t hit home yet, but it will happen.  Back at the Federal level CMS announced they need to update too and are pushing everyone else in that direction to get ready and get the data in order. 

CMS Releases Plan for a Much Needed IT Infrastructure Upgrade With Computers, Data Systems And Those Updated Algorithms

You have problems like this with insurance running the Medicaid programs to let people die and not get their drugs due to trying to run everything on an algorithm and not looking at individuals. 

Insurance companies are waiting to come in and scoop up some money and situations like the link above will continue and grow.  They will profitize everything with their business intelligence algorithms  and care will suffer. 

Figure heads are throwing money and grants every which direction and that is a good thing by all means but again unless one understands how data system work and come together, unreasonable demands and rules are created due to lack of knowledge. 

One final note on all of this too is the creation of way too many technologies and lack of standards and collaboration makes the job harder too.  Everyone runs around and talks about Innovation but they forget Collaboration and we are certainly seeing it now as all innovation may not survive but collaboration must work and thus the need to dump or combine technologies quickly is upon us.   

The“back door deals” that happen outside the knowledge or consulting of the CIO is beginning to happen more frequently and without a CIO that ties everything together, companies end up spending tons more than needed and sometimes areas of security are left untied, so the CIO needs to be included and consulted with and not to the point of burning them out either, and I am starting to see some of that with complicated IT infrastructures.  The It illiterates in a company want a 30 second answer when it is not possible without a study and full analysis, so don’t get impatient with the CIO. Gaps between what consumers and employees want versus what can be implemented safely and with cost effectiveness are growing.  BD

Lisa Feldner is getting a crash course in health care. The North Dakota CIO came to state government with a background in education, having served as the technology director for Bismarck Public Schools. But in the last year, she has quickly become conversant in terminologies related to electronic health record incentive programs, health information exchange (HIE) and Medicaid eligibility systems.
Because her Information Technology Department centrally manages most of the state’s computer systems, questions about the interoperability of health data often land on her desk.

At the federal level, beyond the more than $20 billion in provider incentives for health IT adoption, HITECH allocates approximately $2 billion in grants for other projects, including work force development, telehealth initiatives and research. State-level HIE programs will get $564 million in grant funding.
That means public CIOs must become more knowledgeable about and involved in health IT policy issues, say analysts and consultants. “It is absolutely critical that state CIOs be involved in deciding what role the state should play in governance of health information sharing,” said Mark Danis, vice president of public-sector health for IT services company Keane. “It should be part of state CIOs’ strategic planning for next year.”

If state CIOs are feeling overwhelmed by the change of pace, the CIOs of state Medicaid agencies are feeling even more anxiety. Ivan Handler, CIO of the Illinois Department of Healthcare and Family Services, thinks about the HITECH Act and health reform every day. “We have to move on eligibility and enrollment,” he said. “We have to be prepared to handle a half million new Medicaid enrollees in 2014.” Illinois’ systems that handle Medicaid, the Children’s Health Insurance Program and Child Support Services were developed in-house more than 20 years ago.
“We have to upgrade everywhere, and we are doing planning activities around that,” Handler said, “but we cannot do five to seven separate technology initiatives at once to re-create our own infrastructure. Our staffing is down, and we cannot afford to buy applications in the traditional way.”

To help CIOs like Campbell, the U.S. Department of Health and Human Services plans to offer an enhanced federal matching rate of 90 percent for the design and development of new systems and 75 percent for the maintenance and operation of Medicaid eligibility systems. But even that may not be enough. “With the budget situation in Washington state, it is difficult to come up with the 10 percent,” Campbell said.

“Some states just won’t have the intestinal fortitude to take this on, because they haven’t made progress on health IT, or they don’t have the people, knowledge or resources,” Keane’s Danis said, predicting that states with outdated eligibility systems will not be jumping into it. But there’s a short list of states that, regardless of which party is in power, have already made progress and will pursue their own exchanges.

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