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The U.S. market for ambulatory electronic health records will double from $1.3 billion in 2009 to an estimated $2.6 billion in 2012, according to a study published this month by Frost & Sullivan.

The report said the American Recovery and Reinvestment Act of 2009 and the Medicare and Medicaid EHR incentive programs encourage healthcare providers to invest in EHR. Efficiency concerns, outdated practice management systems, and safety improvements are also leading to interest in the systems. In addition, as more private practices align with hospitals for cost reasons, they will begin to adapt the hospital’s electronic health systems as well.

“I think the No. 1 driver is the change in reimbursement, the fact that it is becoming so complicated to document the process of care to get paid by the government as well as commercial payers,” said Nancy Fabozzi, a senior industry analyst at Frost & Sullivan and author of the report. “Everybody thinks that fee-for-service is doomed and we have to have a new system of reimbursing physicians for the quality of care instead of the quantity of care because costs are exploding.”

She added that although the market for EHR has been slow over the past few years, interest is picking up due in large part to federal funding.

“If you’re pumping $40 billion into a marketplace, it’s going to have some impact,” Fabozzi said.

The report predicted that profits will reach a peak by 2013 at $3 billion, after which the market will become saturated.

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Most business technology professionals believe the United States has lost its position as a global IT innovation leader, citing offshore job movement, failure in education, and national policy making as top three reasons, according to a new report.

The “Research: Innovation Mandate” report surveyed nearly 625 business technology professionals on whether the nation is losing its edge in tech competitiveness.

The findings reveal that one key concern is the offshoring of technology jobs to India and other countries. Among the 427 survey respondents who think the nation is losing or has lost its technology-leadership position, 66 percent cited offshore job movement as one of the top three reasons.

More than half of respondents who think the United States is losing or has lost its technology-leadership position cited a failure in education as another main reason. The report noted the U.S. education system has failed to prepare young students in  STEM subjects—science, technology, engineering and math—and U.S. companies are not providing their employees with adequate technical training.

Nearly one-third of respondents said they worry about a lack of technology leadership at the U.S. national policy-making level. The report noted how the United States, unlike Singapore, South Korea, Japan, Sweden, Finland and several other countries, has not had a cohesive national policy in technology areas such as mobile payments, intelligent electricity grids and transportation systems, green computing, and (until recently) broadband and electronic health records.

One-fourth of respondents think lack of leadership at the tech CEO level is a main reason for disintegrating U.S. tech competitiveness. The report noted how the U.S. government and U.S.-based companies do not spend enough on tech-based R&D and long-term innovation.

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Earlier this week, Vice President Joe Biden unveiled a new White House report detailing how last year’s economic stimulus package is pushing advancement in health IT by funneling billions of dollars to help hospitals, healthcare providers, states and other parties adopt health IT programs.

Overall, health IT is getting $20 billion from the American Recovery and Reinvestment Act. Approximately $18 billion of the ARRA funds will be used incentivize physicians and providers to adopt health IT in 2011 and beyond.

Of the $2 billion in upfront health IT spending, approximately $250 million is dedicated to the Beacon Community Program to demonstrate how health IT can change the ways communities manage health and unlock previously unrealized health-outcome benefits, the report said.

Another goal of ARRA is to expand broadband access, allowing for the implementation of electronic health record systems and e-prescribing. The act provides $6.9 billion to expand high-speed Internet access and adoption, and more than $2.5 billion of this investment has already gone to infrastructure projects that help bring broadband access to rural and remote communities in the United States.

The remaining $4.4 billion has funded infrastructure projects that benefit anchor-community institutions, public-safety broadband networks, state broadband-mapping and planning efforts, public computing centers, and sustainable broadband adoption, the report said.

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A Health and Human Services Department panel has approved a plan to build a federal database of business rules that could help states determine the eligibility of consumers for Medicaid and other federal health insurance programs, Government Health IT reports.

Having all state health-program enrollment data in a one database would also keep states from having to rebuild data sets that have already been compiled elsewhere, said federal Chief Technology Officer Aneesh Chopra.

“That will allow for transparency and innovation over time in eligibility rules,” he said at a policy committee meeting last week.

The exchanges will allow healthcare consumers to compare information on state health-insurance programs such as Medicaid, high-risk pools and other public and private health plans.

One business rule with Medicaid eligibility is that an insurance seeker’s income level must be under a certain threshold of the federal poverty line, Chopra said. Currently, the majority of business rules are not easily known or accessible, and it is hard to understand how some states determine eligibility, he said.

The committee also recommended that states confirm the personal income, citizenship and legal status of health-program applicants.

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HHS Secretary Kathleen Sebelius announced yesterday more than $32 million in FY 2010 funds to make healthcare more accessible for Americans living in rural areas.

“These funds reflect the priorities spelled out by President Obama in providing the best healthcare possible to rural Americans,” she said. “The ultimate goal is to build healthier rural populations and communities.”

The grants will boost partnerships among rural health providers, said HRSA Administrator Dr. Mary Wakefield.

“Funds will be used to recruit and retain rural healthcare professionals and modernize the healthcare infrastructure in rural areas,” she said.

More than $22 million will go toward the Medicare Rural Hospital Flexibility Program, which supports enhancement in healthcare quality in communities served by Critical Access Hospitals, efforts to improve the hospitals’ financial and operating performance, and the development of collaborative regional and local delivery systems.

Rural Health Workforce Development Program, which supports the development of rural health networks that seek to improve the recruitment and retention of emerging health professionals in rural communities, will receive more than $3 million.

More than $3 million will to toward two telehealth programs: the Telehealth Network Grant Program, which helps communities build capacity to develop sustainable telehealth programs and networks, and the Telehealth Resources Center Grant Program, which provides technical assistance to help healthcare organizations, networks and providers implement cost-effective telehealth programs serving rural and medically underserved areas and populations.

The Flex Rural Veterans Health Access Program, a new program that will help eligible entities coordinate innovative approaches, will receive nearly $1 million. The grants aim to improve mental-health services through the use of health information exchange and telehealth in states where veterans comprise a high percentage of the total population.

Additional programs awarded funds include the Frontier Community Health Integration Demonstration Program, and the Rural Training Track Technical Assistance Demonstration Program, which, respectively, will receive $770,000 and $500,000.

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The Department of Homeland Security has announced plans to implement an electronic health record system to increase the efficiency of its healthcare services for undocumented immigrants and fugitive aliens detained by the Immigration and Customs Enforcement agency, Government Health IT reports.

The department said it is overhauling its information systems, and the EHR system could be developed by government agencies or commercial companies, or could be a hosted service. The system must meet “meaningful use” requirements and be interoperable with other computer systems at DHS.

ICE’s Enforcement and Removal Operations average daily detention population consists of roughly 35,000 foreign nationals charged with violations of U.S. immigration law. In 2007, ERO removed more than 276,000 individuals  from the United States.

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In an effort to help chief information officers and executives across the United States implement electronic health records, the College of Healthcare Information Management Executives has released a guide that provides a plan on how IT executives can establish a robust foundation for their organization’s IT systems to meet the meaningful use requirements issued by the Centers for Medicare & Medicaid Services.

Titled “The CIO’s Guide to Implementing EHRs in the HITECH Era,” the guide tackles the important steps healthcare organizations have to take to  successfully implement electronic health records, from the initial planning through the final documentation of results.

Based on research involving nearly 170 CHIME members who provided input on real-world experiences of planning for and implementing electronic health records in their organizations, the guide provides new direction on the best practices for successful EHR adoption.

The plan suggests executives should first assess incentives for meaningful use and weight them against costs. However, organizations should avoid viewing EHR implementation as pure cost-benefit calculation as EHRs will be a vital foundation for a healthcare organization that wants to thrive. Instead of focusing on pure ROI calculation, CIOs should ask how much it would cost to accelerate our progress, and if that was done, will we qualify for a larger incentive or avoid penalties?

Senior executives should discuss the current state of IT and how far along their organization is in adopting clinical systems. They also need to decide how to manage the effort and the interdependencies across the organization, including where additional projects must be sponsored or chartered. It is also crucial that an organization first develops a comprehensive IT strategic plan that is aligned with the organization’s strategy. If the organization relies on an IT vendor, it should share gap analysis with it and get quotes to fill those gaps.

To successfully implement EHRs, the CEO and the senior executive team must fully support the organization’s efforts in a adopting a new system. While there is no one right way to implement EHRs, it appears as if the complete support from senior executives will make the transition smoother. Senior executives should set vision and lead the change to EHRs.

When it comes to adhering to the meaningful use rules, providers will need to demonstrate their compliance with the requirements. In some cases, that involves collecting data, a task what is expected to fall on the organization’s IT department. In this case, senior executives will have to depend on CIOs for guidance on data collection efforts needed to substantiate the achievement of meaningful use.

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To help the nation’s healthcare industry transition into the digital age in an effective and meaningful fashion, the National Institute of Standards and Technology has published approved procedures for testing IT systems that work with electronic health records.

Released in draft form earlier this year, the approved and finalized testing procedures are now available for use.

Under a certification program established by the Department of Health and Human Services Office of the National Coordinator, testing organizations authorized by HHS/ONC can use the tools to appraise EHR software and systems vendors would like to sell to doctor’s offices, hospitals and other healthcare providers. Starting next year, the federal government will provide extra Medicare and Medicaid payments to healthcare providers who adopt EHR systems certified to meet ONC requirements that adhere to technical standards and are put to meaningful use.

These ONC-approved test procedures help ensure EHRs function properly and work interchangeably across systems developed by different vendors. The set of 45 approved test procedures evaluate components of EHRs, including their encryption, how they plot and display growth charts, and how they control access.

The development of these tools was mandated by the American Recovery and Reinvestment Act to support a health IT infrastructure.

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Insurance companies in many states have long increased health-insurance premiums with little oversight, transparency, or public accountability, according to HHS.  During the past decade, health-insurance premiums have doubled on average, much faster than wages and inflation, making it hard for millions of Americans and business owners to afford health coverage.

Currently, only 26 states and the District have the authority to reject a proposed increase that is deemed excessive, lacks justification or otherwise exceeds state standards. Many states with authority lack resources to exercise it meaningfully.

The Affordable Care Act implements important market reforms to improve quality and cut the cost of healthcare for employers and individuals, Sebelius said. Increased competition, lower insurance overhead, and better risk pooling in health-insurance exchanges in 2014 are expected to reduce premiums in the individual market by anywhere from 14 to 20 percent, according to the Congressional Budget Office.

“Between now and then, we will continue to work with states to ensure consumers are receiving value for their premium dollars and to avoid the kind of double digit premium increases seen recently,” Sebelius said. “The state proposals approved today demonstrate the need and desire for new resources and tools to help them protect against unjustifiable premium increases.”

The Affordable Care Act gives states with $250 million in Health Insurance Premium Review Grants over five years to help create a more level playing field by improving how states review proposed health insurance premium increases and holding insurance companies accountable for unjustified premiums increases. Applications for the first round of Health Insurance Premium Review Grants were made available June 7.

States have proposed to use this funding in a variety of ways, including additional legislative authority; improving the Health Insurance Premium Review Process; making more information publicly available; and developing and upgrading technology.

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