Louisiana Works to Secure HIT Stimulus Money on Louisiana Medical News

Louisiana Works to Secure HIT Stimulus Money

By: TED GRIGGS

Rebecca Bradley, LHA Director of Rural Health Programs

Louisiana health officials hope detailed plans, such as forming workgroups to address nearly every information technology issue, and ongoing implementation efforts will help the state secure a big chunk of federal stimulus dollars.

"The focus is on trying to figure out how we can leverage what the state has already done and get a strategic plan in place to draw down as much of the funds as we can," said Rebecca Bradley, director of rural health programs for the Louisiana Hospital Association. "The $19 billion in the stimulus package is all competitive, so that's not going to be enough money for the entire nation."

The federal Department of Health and Human Services will award the health information technology funds competitively, based on the approaches each state takes to achieve its strategic goals, Bradley said.

Louisiana, as one of the nation's leaders in the push for electronic medical records, can point to some important steps it has taken, she said.

For example, over the past two years, Louisiana has invested $30 million toward development of a regional health organization in North Louisiana, furthering the adoption of health information technology, Bradley said.

In addition, the federal Centers for Medicare & Medicaid chose Louisiana as one of a dozen sites for a pilot project that will provide as much as $29 million in reimbursements for small- to medium-sized physician practices that adopt electronic medical records. The Louisiana Health Care Quality Forum, a state-created nonprofit, drafted the grant proposal for the state.

State Health Secretary Alan Levine has tapped the forum to oversee the planning process implementing the health information technology and health information exchange initiatives outlined in the American Recovery and Reinvestment Act, better known as the stimulus bill.

According to the Quality Forum, the relationships it developed previously throughout the healthcare community will help ensure the health IT initiatives are implemented successfully.

"So we have a lot of things we can leverage to illustrate our state's commitment and what we've done," Bradley said. "I think it's going to be all about that. Just showing that you do have momentum going in your state and that you do have partnerships in place and you have a comprehensive plan going forward and a strategic goal for adoption."

The comprehensiveness of the Quality Forum's approach is apparent in its health IT workgroups, which touch on everything from infrastructure programs and broadband technology to Medicare/Medicaid provider incentives and clinical education demos.

While Louisiana received a lot of help under the Bush administration and former HHS Secretary Mike Leavitt, Bradley said it is anyone's guess whether Democratic control of the White House and Congress will work against Louisiana and its highly visible Republican governor.

Louisiana is in a good place right now as far as what the state has done to date, Bradley said. Once the U.S. Health and Human Services Department makes more details of its plans available, the state will be able to put together an application positioning Louisiana for as much funding as possible.

Louisiana has already put together a white paper offering the feds a definition of "meaningful use" of electronic medical records, Bradley said. The federal government's definition of the phrase will help determine who qualifies for stimulus money.

The Health Care Quality Forum has already identified a number of key opportunities the state should pursue, including:

Regional Extension Centers, which provide technical assistance and best practice information toward adopting health information technology. Any regional center created under the act is eligible for federal financial support of up to 50 percent of its operating costs for up to four years.
State grants for the promotion of health IT. For fiscal year 2011, states will have to provide at least $1 for every $10 in federal funds; but the state match drops to 1:7 in fiscal 2012; and 1:3 beginning in fiscal 2013 and each year thereafter.
Loan program grants. The loans can be used by providers to help them buy electronic health records technology or upgrade them; train workers to use the technology; and improve the secure electronic exchange of health information. Providers would have to put up at least $1 for each $5 in federal funding.

Meanwhile, healthcare industry members say many questions remain about the stimulus funds and its guidelines, not the least of which is whether the bill's ambitious deadlines can be achieved.

Dr. David Blumenthal, the national coordinator for health IT, has suggested that getting the policies, standards and interoperable systems in place by fiscal 2011 may not be possible.

Bradley said it is unclear whether the Obama administration will urge Congress to delay the timetable.

And while Congress would like to see 85 percent of providers using electronic medical records by 2014, many healthcare industry members remain dubious.

A survey of 3,000 hospitals, published in the March edition of the New England Journal of Medicine, found that 7.5 percent used basic digital patient records.

The survey by Harvard University and the Robert Wood Johnson Foundation also showed that only 1.5 percent of the hospitals surveyed used comprehensive electronic records in each unit.