My wish came true

This is a post by Karen Donovan filling in for David Williams who I occasionally allow to take a vacation day!

OK… so finally, my wish came true. In April I blogged that the government better “put up or shut up!” Well, they finally did it… The AP Press reported this week “Bush seeks better health care cost info” as he signed an executive order that directs four “government agencies to:

  • Use, where available, health information computer systems that talk to each other…
  • Enact programs that measure the quality of care, and develop those measures with the private sector and other government agencies.
  • Make available to beneficiaries the prices that agencies pay for common procedures.
  • Develop and identify practices that promote high-quality health care.

The agencies affected by the executive order are the Health and Human Services Department, which oversees Medicare; the Defense Department, which oversees health care for the military; the Veterans Affairs Department and the Federal Employees Health Benefit Program. A draft of the order says agencies must comply by Jan. 1, but Leavitt said the programs must be under way by that point, rather than completed.”

Frankly, the order seems like a “statement of the obvious,” and it’s sad that it had to be mandated by some executive order. But please don’t get me started on that…

Many companies and healthcare industry think-tanks have tried to develop large databases that can be used for efficiency and efficacy purposes. Anonymous longitudinal patient data has evolved into a large and rapidly growing industry over the past 5+ years to aggregate and track patient medical, pharmacy, and lab data over time. There have been many stumbling blocks, the least of which is the lack of electronic repositories for the various data elements. Ohhh, just one more reason for EHR adoption!

Inherently, payers have had the broadest set of claims data given our country’s healthcare reimbursement system. Companies such as PharMetrics (acquired last year by IMS Health) and Ingenix (part of United Health) have helped lead the industry from an outcomes research data perspective. PharMetrics boasts “over 75 health plans across the U.S. contribute to our growing anonymous, Patient-Centric Database, which contains integrated pharmaceutical and medical claims on over 55 million covered lives.” And Ingenix boasts “over 35 million covered lives” in their database. Clearly this excludes the over 40 million Medicare enrollees.

Some industry experts have predicted that the government would start releasing the data within the next few years. One of the most vocal supporters for government release of data was Dr. Mark McClellan. When he was the FDA Commissioner, he strongly advocated for this from a safety and pharmacovigilance perspective. In 2004, McClellan left the FDA and became the CMS Administrator. He spoke last month about the Institute of Medicine report and called for many of these efforts as well.

I’m glad to see that the federal government is getting with the program! Thank you Mark. And now this should help pave the way for the states to follow too.

August 25, 2006

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