April 2011

Move gradually on PCAST report recommendations: ONC work group

A work group of the federally chartered Health Information Technology Policy Committee concluded that it was feasible to move in the direction pointed to by a White House technology advisory council but that the Office of the National Coordinator for Health Information Technology should proceed by making incremental changes from its present technological course.

In December, the President's Council of Advisors on Science and Technology issued a 108-page report that called on ONC to use its leverage to create and adopt a universal exchange language and use so-called meta-data tagging to facilitate records search and retrieval. The tags also could host privacy and security constraints that would follow the data from user to user. Dr. William Stead, associate vice chancellor for strategy and transformation and director of the Informatics Center at Vanderbilt University Medical Center, Nashville, served as vice chairman of the work group appointed in January by then-ONC chief Dr. David Blumenthal. Stead, in presenting a draft of the letter at the April 13 policy committee meeting, summarized the work group's review in three points. One was that the PCAST report describes a nationwide use of advanced technology and provides “a compelling vision for how that technology could be beneficially used as an important aspect of the learning health system” advocated by the ONC's recently released national healthcare IT strategic plan. Another was that there are “major policy and operational feasibility concerns with the proposed technology.”

Electronic Health Record reminders can help docs avoid unnecessary treatments: study

Electronic clinical-decision support reminders can successfully steer physicians away from ordering unnecessary treatments, according to results of a new study published in the journal Pediatrics.

Researchers from the Stanford University School of Medicine and Lucile Packard Children's Hospital, both in Palo Alto, Calif., built automated alerts into the hospital's electronic health-record system to determine whether they would help physicians adhere to recently updated guidelines for ordering red blood-cell transfusions. The system alerted physicians ordering red blood-cell transfusions whenever a patient did not meet the clinical criteria for receiving the procedure. Researchers determined that the reminders prevented 460 unnecessary transfusions, for a total cost savings of $165,000 over one year.

Doctors question benefits of electronic records

The American Recovery and Reinvestment Act a series of information technology objectives for doctors to meet by 2014, and a series of incentives: $24,000 to $42,000 per doctor depending on when records are digitized. Failure to comply by 2014 means an escalating percentage of Medicare Part B payments will be forfeited to the federal government. A survey of 500 physicians by Athenahealth and medical networking site Sermo found that 7 percent fewer physicians than last year believe the financial benefits outweigh the costs, and 5 percent fewer said patient care benefits justify the investment. Sixty percent of docs said electronic records slow down patient care, up from 54 percent in 2010. “I do not find that physicians are techno-phobes,” said Athenahealth CEO Jonathan Bush. “I think they are angry and frustrated that things are imposed on them that they think are going to hurt their business.”

Barriers slow switch to electronic medical records

Electronic medical records could rein in the clutter, make charts more legible and better track care, she said, but the Bardstown Road practice isn't quite ready to take that step into the digital age. Why? E-records systems are too expensive. Medicare and Medicaid patients, and penalizes physicians and hospitals accepting Medicare if they don't become “meaningful users” of electronic health systems, by meeting a list of requirements, in four years. “In a complex world of practicing medicine…the computer can really assist. And it can speed things along,” said Dr. Mark Pfeifer, chief medical officer at University Hospital, which uses many digital information programs, although it's not yet paperless. “We're gonna be safer when we do paperless charts…It's gonna be better care and it's gonna be more effective care.”

AT&T Making Progress in Converting Former Alltel Markets

AT&T is expanding its wireless business in several rural markets, including territories in Minnesota, North Dakota, South Dakota, Colorado, Iowa and Montana, among others, having completed the transition of infrastructure in these states from that of its Alltel acquisition to its own mobile broadband network.

AT&T expects to complete the service transition in these states over the coming weeks, communicating with customers via text message and soundbite the specific dates and details. AT&T has also rebranded, as well as expanded the line-up, of consumer products at the former Alltel’s own retail outlets, as well as those of authorized retailers. AT&T has been offering Alltel subscribers the option of receiving free AT&T handsets of comparable quality with no additional service term commitment. They can otherwise choose to upgrade their devices by signing a 2-year contract, an AT&T rate plan and any associated data plan. Handset upgrades are necessary since AT&T is migrating the Alltel properties to a GSM platform from Alltel’s CDMA version. AT&T gained the Alltel properties as a result of divestiture requirements forced on Verizon to gain approval of Verizon’s acquisition of Alltel.

Promise Is Great but Growth Is Slow for Targeted TV Ads

For years, TV executives and advertisers have looked for ways to incorporate new technologies into the 30-second spot. Whether inspired or egged on by the measurability and interactivity of Internet ads, a number of formats for TV have emerged, including "addressability," where a number of different ads can target different households in the same 30-second timeframe; "requests for information," where people can request a brochure about a product advertised directly from the spot; and "telescoping," where viewers can click off a commercial onto an extended clip.

Despite the promises of these new formats, they've faced a number of hurdles. Advertisers, media buyers and agencies still see them as unproven products, and it's not entirely clear if enough of them will bother getting in the game. Some think TV's success has begotten a lack of urgency to change. TV continues to dominate media, with more people watching the medium than ever before, averaging 35 hours per week in early 2010, up from 33 hours a week the year before, according to Nielsen. Despite the emergence of digital video recording and web-enabled TV, people haven't lost their appetite for good, old-fashioned TV viewing. Advertisers are estimated to spend $60.5 billion on commercials this year, according to eMarketer. The major technological hurdle to addressable advertising is the difference in underlying technologies from each cable company. Advertisers that want to reach a national footprint would have to work with each provider separately to install their commercials. DirectTV and Dish are the only operators at the moment who can reach a national audience.

Does Minow Still Think TV Is a 'Vast Wasteland'?

Fifty years after calling television "a vast wasteland", what does former Federal Communications Commission Chairman Newton Minow think of TV now? "It's vaster, certainly," but it also gives viewers a "wider range of choice. That was the main thing I tried to do. At the time I was at the FCC there were two-and-a-half commercial television networks, there was no public television, no satellite. The choice was extremely narrow. Many cities had only one television station, some had two, a few had three, New York and Los Angeles had seven. But that was it. The most constructive thing the FCC could do was to expand choice. And in that we certainly succeeded." Minow said one of the downsides of so many choices on TV today is that "we've lost the common shared experience. I think it's increased the polarization of opinion. And now you have news appealing to particular ideologies, the left and the right, whereas before it was more in the middle. So that's a downside. On the other hand, the possibility that people can find something of their particular interest on television is much greater than it was before."

Why $#*! Our TVs Say Is No Longer Taboo

Sex and TV were once seen as a mismatch -- so much so that TV programs couldn't even show a husband and wife sleeping in the same bed. Now the two get along like, well, people having sex.

And TV isn't so shy about meeting up with violence or profanity, either. Despite all the gutter talk, TV networks maintain the issue remains delicate. A court case surrounding the exposure of part of Janet Jackson's breast on national TV during the 2004 Super Bowl continues to wend its way through the courts more than six years later. And yet, argues one broadcast executive who declined to be identified, TV "evolves with the culture," not the other way around. "We reflect culture more than leading it," this executive said. If that's the case, TV networks -- cable and broadcast -- are showing us a world in which the harshest profanities, grisliest scenes and most private sex acts have become as much a part of our daily routine as brushing our teeth or drinking coffee.

They Still Won't Pay for News

A new Harris poll gauged consumer willingness to pay for news content online. The results weren't encouraging for wall builders. Most people still don't want to pay for their news—and those who are willing to pay don't want to shell out very much.

Of consumers polled in December 2009, 23 percent said that they would pay for the Wall Street Journal’s online content while only 20 percent of consumers polled in March 2011 said that they would pay for The New York Times online. Of those groups, the majority said that they would only be willing to pay up to $10 for online content. Very few consumers said that they would pay more than $20 for the Times, and almost none would be willing to pay that much for the Journal.

Could advertising revenue close the gap between what consumers are willing to pay and what news outlets want to charge? Maybe. According to data from eMarketer, by 2015, online ad spending will increase from the current $28.5 billion to $44.5 billion, with retail, automotive, and consumer packaged goods leading the way.

FCC Seeks Nominees for Intergovernmental Advisory Committee

The Federal Communications Commission seeks nominations for membership on the Intergovernmental Advisory Committee (IAC). The IAC, comprised of 15 representatives from local, state, and Tribal governments, advises the FCC on a range of telecommunication issues for which their governments explicitly or inherently share responsibility or administration with the FCC. On December 4, 2009, the FCC reauthorized the IAC. The term of operations of the reauthorized IAC will be two years, with an option for reauthorization at the end of the two-year period, and the term will commence with its first meeting.

Benton

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