Health Information Exchange Pilot Projects Paving the Way for Nationwide Exchange

By 2012, you may have access to an easy-to-use Internet-based tool that can replace mail and fax transmissions of patient data with secure, efficient electronic health information exchange (HIE), thanks in part to physicians and other health care providers now testing HIE using specifications developed by the Direct Project.

The Direct Project is a streamlined version of the Nationwide Health Information Network and is designed to help health care providers with limited resources meet criteria for the meaningful use program.

The Office of the National Coordinator for Health IT has launched the first pilot demonstrations of the Direct Project for simple electronic health information exchanges in Minnesota and Rhode Island.  Other pilot programs will be launched soon in New York, Connecticut, Tennessee, Texas, Oklahoma, and California to demonstrate the effectiveness of the streamlined Direct Project approach, which supports information exchange for core elements of patient care and public health reporting.

Both large and small health care organizations will have an option for electronic exchange of information, including the ability for a specialist to send a care summary report back to the referring provider.  For more information, see:  http://wiki.directproject.org/Specialist+sends+summary+care+information+back+to+referring+provider

Physician Payments Could be Revealed Under Bipartisan Bill

Senators Ron Wyden (D-Ore) and Chuck Grassley (R-Iowa) plan to cosponsor legislation requiring the Department of Health & Human Services to publicize information on Medicare payments made to  physicians. 

This information has been off limits to the public since the 1970's, when the Florida Medical Association and the American Medical Association sued to keep it secret.  The issue has resurfaced in recent months after the Wall Street Journal and the Center for Public Integrity sued the Department of Health & Human Services to obtain information on payments made to doctors and other individual providers in the Medicare claims database.  After their lawsuit, the Wall Street Journal and the Center for Public Integrity agreed to receive a pared-down version of the database, and were forbidden from identifying the 5% of providers on whom they received data. 

Even with those restrictions, both organizations were quickly able to identify patterns of likely fraud and the idea of opening the database has been gaining traction across party lines as Medicare and Medicaid fraud - estimated at $70 billion to $120 billion a year - becomes an even bigger worry. 

The AMA argues that opening up the database would be a violation of doctors' privacy and could lead to some of them leaving the program.  While pointing out they have zero tolerance for fraud, the AMA believes Medicare claims are already subject to scrutiny by organizations specifically designed to aggressively ferret out improper claims.