Electronic Health Record Systems Pave Way for Federal Government Rationing of Healthcare

Health IT Evangelists Find Help in the Cloud

Cloud app to help HHS centers trying to sell physicians on electronic health records

May 24, 2010

Federal Computer Week - The Health and Human Services Department is deploying a cloud-based customer-relationship management system to help its regional centers do a more effective job of promoting the use of electronic health record systems.

HHS' Office of the National Coordinator for Health IT created the 60 regional extension centers to assist physicians in smaller practices and in rural areas in purchasing and meaningfully using electronic health record systems under the economic stimulus law. HHS will distribute $17 billion in incentive payments to doctors and hospitals that buy the systems and achieve meaningful use.

Under a contract awarded in February, Acumen Solutions is to implement a cloud computing solution from Salesforce.com at the extension centers. The cloud solution provides customer relationship management as well as project management.

The software will assist the centers in managing their relationships with the physicians, and also will provide HHS with a measure of those efforts, said Marty Young, managing director of Acumen Solutions.

The centers will use the software to regularly update the names of physicians in their region and to manage their interactions with them. For example, the centers will be able to identify which doctors have been offered assistance, how many have responded, how many physicians have signed contracts to purchase electronic record systems, and how many have attained meaningful use of those systems.

“A lot of what the extension centers are doing is marketing and education,” Young said. The cloud solution assists in tracking the marketing activities and responses, he said.

At the same time, HHS is using the cloud-based system to help manage the regional centers and audit their performance in achieving milestones such as the number of doctors signed up for assistance, doctors who have purchased systems, and doctors who have attained meaningful use.

“HHS is running this like a business. They are using Salesforce.com to manage the regional extension centers,” Young said. “Each regional extension center is treated as a separate business unit.”

HHS provided the cloud computing service to the centers. However, some of the centers already have customer relationship management systems, which are being integrated with the Acumen/Salesforce.com system, Young said.

F.C.C. Says It Will Move Forward on Expanding Broadband Despite Recent Ruling that It Lacks Authority to Regulate the Internet

April 14, 2010

New York Times - The chairman of the Federal Communications Commission told a Congressional panel on Wednesday that a recent court ruling that the agency lacked authority to regulate the Internet should not prevent it from carrying out its plan to broadly expand the country’s high-speed Internet service.

But the chairman refused to say if the commission would try to reclassify Internet service as a utility similar to telephone service to overcome the court decision, a move that some Democratic senators supported but that several Republican senators strongly warned against.

Julius Genachowski, the F.C.C. chairman, said in testimony before the Senate Commerce Committee, that the agency’s lawyers were still considering the effect of the court case, Comcast v. F.C.C., on the commission’s effort, known as the National Broadband Plan.

The broadband plan seeks nationwide adoption of high-speed Internet service, greater availability of high-speed connections for wireless devices, and subsidies for rural broadband service.

Last week, a federal appeals court threw some of those plans into question, ruling that the F.C.C. had overstepped its authority when it tried to enforce a commission rule that required companies to give broadband users equal access to all Internet content.

The commission said it thought that it could pursue its goals and abide by the court ruling. It does not plan an appeal.

Mr. Genachowski said he thought that the court decision did not inhibit the F.C.C. from protecting consumers in their use of communications networks, “whether traditional networks or newer data networks.” But he acknowledged that the agency was still studying how it could carry out its goals, one of which would extend universal Internet service to rural areas using the Universal Service Fund, which helps pay for phone service in sparsely populated areas.

He predicted that the agency would still be able to undertake those efforts, saying they were “consistent with the Communications Act,” and similar to what the F.C.C. has done “for quite some time.”

Some Republican senators sharply disagreed.

Senator Mike Johanns of Nebraska said he thought the court’s ruling was “very specific in saying you don’t have the authority” to enforce equal-access standards.

“I don’t agree with that,” Mr. Genachowski replied. He said that the commission thought it could take steps to protect consumers from discriminatory Internet policies — an indirect reference to its equal-access efforts — “and I assure you that anything we do in all of the areas concerning communications will have solid legal authority.”

Some consumer advocates have urged the commission to reclassify Internet service from its current designation as a communications service, over which the F.C.C. has limited regulatory authority, to a category like telephone service, which the agency has the clear authority to regulate.

The F.C.C. itself moved to deregulate Internet service by moving it to its current status during the Bush administration. It could, therefore, reverse that decision without seeking the approval of Congress.

Senator Kay Bailey Hutchison of Texas, who is the committee’s ranking minority member, warned against such a move. If it did so without the authorization of Congress, she said, “the legitimacy of the agency would be seriously compromised.”

Several times, Mr. Genachowski ducked direct questions as to whether the F.C.C. was considering moving the regulatory designation of Internet service from one category to the other.

“I have instructed our lawyers to take the recent decision seriously,” he said, “and evaluate what our options are.”

Senator Byron L. Dorgan, a North Dakota Democrat, encouraged such a strategy.

“I love the free market, but it needs a referee,” he said.

Other senators were more restrained in their support of the idea. Senator John Kerry, Democrat of Massachusetts, said in a statement that while he was reserving judgment on whether the F.C.C. should reclassify broadband services, “because I want you to explore all options,” he added that he thought the commission had the legal authority to do so “if it wishes.”

In the meantime, he added, “ I do not believe broadband either should or needs to go without F.C.C. oversight.”

Broadband Plan Would Vastly Expand Government Power Over the Internet

March 21, 2010

The KPBJ - Wayne Crews, vice president for Policy Competitive Enterprise Institute:

The FCC deserves praise for acknowledging the importance of competition among technologies as a key ingredient for promoting a national broadband policy. At the same time, unfortunately, the Commission’s plan seeks new realms to rule even as the very need for regulation evaporates.

America’s challenge is not for the FCC to ‘do something’ in the communications and Internet realm, but rather to dismantle obsolete regulatory impediments that constrain the market’s freedom to expand infrastructure and content access. If we were starting from a clean slate in today’s world, we wouldn’t create a Federal Communications Commission with command over price, entry and services.

If ever an economic sector needed a coherent vision for substantial liberalization, broadband is it. The Internet has been among mankind’s most liberating technologies, erasing the constraints of distance and information scarcity while making broadcasters out of billions of people. Today’s communications landscape has empowered individuals to speak and exchange ideas in ways that our nation’s framers could never have imagined.

Ryan Radia, associate director of Technology Studies Competitive Enterprise Institute:

A year ago, Congress tasked the FCC with developing a plan for promoting broadband access and adoption throughout the United States. Unfortunately, the Commission seems to have interpreted this mandate as a license to vastly expand its regulatory powers in spheres ranging from energy to health care to education. These proposals endanger Internet freedom and threaten to further subjugate the broadband market to political manipulation.

The national broadband plan proposes the creation of numerous new federal programs designed to bring America closer to “universal” broadband access. But as the Universal Service Fund has illustrated, government-centric efforts to expand telecommunications networks suffer from inefficiencies, waste, and fraud.

Actual consumer demand should drive the growth of broadband networks, not government slush funds. Federal programs to subsidize the expansion of broadband service, whether funded via new taxes on broadband users or spectrum auction proceeds, amount to economically destructive wealth-redistribution schemes that divert resources from productive uses to unproductive ones.

The FCC’s proposals to expand access to spectrum should come as welcome news to consumers of mobile telecom services. If the airwaves are to realize their full potential, however, the Commission must resist the temptation to intervene in spectrum markets by imposing “public interest” conditions or other artificial constraints that have plagued past spectrum auctions. Such attempts by the agency to steer the future of the communications and broadband markets in politically favored directions threaten to harm consumers and obstruct the creation of telecommunications wealth.