Last month marked the 10th anniversary of the publication of the November 1999 publication of the Institute of Medicine's report, To Err is Human: Building a Safer Health System. This landmark report highlighted the critical situation and the contributing factors in what it called the "nation's epidemic of medical errors." Two oft-quoted statistics from the 1999 report were the estimated annual cost of these medical errors, between $17B and $29B annually, and the number who die in hospitals as a result of them, "at least 44,000 people, and perhaps as many as 98,000," each year. In the intervening ten years since the IOM report we have clearly seen some improvements to patient safety, but there is still much need for improvement.

I've been thinking for some time now that in our celebrity-driven culture, it would take a big Hollywood name to latch on to health IT in order to get the masses--and the mainstream media--to make the connection between information technology and patient safety. A few candidates had been involuntarily brought to the fore with regards to EMR security breaches--Britney Spears, George Clooney and the dearly departed Farrah Fawcett come to mind--but I've been waiting for Dennis Quaid to make a splash.

The American Hospital Association and four other national hospital associations have expressed concern over the definitions given to "hospital" and "hospital-based physician" as they pertain to eligibility for ARRA incentives.

As the turkey makes its way into sandwiches, casseroles and tetrazzini, and as the family slowly revives itself from food coma, it's perhaps a good time to digest and reflect upon the year.

And what a year it has been. Economic crisis. Multi-billion dollar stimulus for health IT. The contentious battle over health care reform. And the persistent rhetoric proclaiming that health IT will save the day.

Health IT programs were cited as evidence of potential gains to be made when federal agencies make heir data more accessible, the goal behind an open government memo published Dec. 8 by the Office of Management and Budget.

Over the past five years, as margin pressure has increased and cost reduction efforts have taken center stage, companies have scanned the enterprise with a fine-tooth comb, looking for opportunities to regain margin. As more data has become available specifically highlighting the magnitude of potential losses from revenue leakage in the channel, this issue has quickly risen on corporate radar screens.

For years, we've relied on the carefully crafted one-way message, distributed through the traditional advertising, marketing and media relations channels, to communicate what we wanted to tell the consumer about our brand.

We've spent months conducting research, polling focus groups, writing marketing plans, and developing new advertising and branding campaigns to support an overall strategy with clear priorities. That's all well and good, but if you're not including social media as part of that strategy, the message just doesn't matter.

The House Leadership Bill: Affordable Health Care for America Act (H.R. 3962), October 29, 2009 establishes a clear mandate for healthcare coverage for all Americans. Beyond this, it leaves much of the current insurance and delivery system unchanged, with studies and recommendations regarding payment and some delivery changes to be addressed later. Although a new public health insurance option to be delivered through a National Health Insurance Exchange is included, no specific mandate for competitive efficiency, delivery or value is provided. Many of the directives toward reducing costs and increasing quality require studies to be executed during the first year or two (2011 and 2012) of this reform Bill. As more consumers are engaged in US healthcare insurance coverage, healthcare costs continue to rise and best practices for reimbursement and service delivery are restudied, focus will undoubtedly be the next industry theme and watchword.

Cloud Computing holds great potential to change the dynamics of the HIT industry. The ease of use, flexibility, scalability, and low up front costs are driving the growth of cloud at a CAGR of 27% (over 2008-12). But despite its numerous benefits, cloud computing still needs to answer concerns such as control, data security, privacy, availability, portability, vendor viability, and regulatory and compliance requirements for HIT.

I've been saying for some time now that health reform is nothing without payment reform. Today, I'm happy to report that outcomes-based reimbursement is becoming more than just a pilot or a demonstration or an experiment, at least in Massachusetts.

Radiologists can accurately diagnose acute appendicitis from a remote location with a mobile phone equipped with special software, according to a study presented Monday at the annual meeting of the Radiological Society of North America.

Right now, 25 percent of physician claims are submitted on paper each year. That's a whopping 3 billion claims still being handled the old-fashioned way. The vast majority of those claims are being filed by small provider offices with one to five physicians. Meanwhile, a full 90 percent of payments to providers come in the form of paper checks rather than electronic transfers.

Neighborhood Healthcare, which serves communities in Riverside and San Diego counties, will automate both the clinical and business sides of its health centers for its 115 providers across 11 locations.

The 40-year-old organization has selected technology from Westborough, Mass.-based eClinicalWorks. Neighborhood Healthcare will deploy both the unified electronic medical records system and the practice management solution along with eClinicalWorks Enterprise Business Optimizer's (eBO), which provides reporting capabilities.

Recent shortages of H1N1 flu vaccine have spurred numerous news reports highlighting alternative vaccine manufacturing options that could have rapidly filled current shortages and provided vaccines to consumers in the United States. It is clear that the current approach to vaccine production (i.e. growing virus in chicken eggs) is antiquated, cannot deliver vaccine in a timely fashion (other than routine annual vaccines with a long lead time), and is severely limited by availability of large quantities of raw materials. Vaccine alternatives, including use of adjuvants to improve the efficacy of existing vaccines (thereby allowing current vaccine supplies to be stretched farther) and cell culture based production methods that promise to reduce production time from months to weeks, are being highlighted while failing to recognize that these options are untested in large populations. From the layman's perspective, these options are a failure of the system to act. The industry and government's perspective is somewhat different, recognizing that unproven processes carry unknown risk that the public is unwilling to tolerate. This disconnect is the basis for misconception and confusion, driving specific agendas from across the business and political spectrum. While an informed public is the answer to this dilemma, it is virtually impossible to deliver a consensus opinion, since leading voices are afflicted with the agendas already mentioned.

With the passing of the HITECH Act in February of 2009, providers gained an unprecedented opportunity to receive incentive payments for implementing and using eligible electronic medical records (EMRs) under the conditions laid out in the law. In order to take advantage of the subsidies, providers must implement and demonstrate meaningful use of the EMR technology by specific deadlines, beginning in 2010. This incentive is driving interest in EMRs in all types of ambulatory practices.

In past FierceMobileHealthcare columns, I've questioned the value of Twitter. In other forums, I've openly mocked the idea of live tweets of surgeries that a few hospitals have experimented with. But after reading an article in the Miami Herald yesterday, I'm starting to see how the microblogging service can be useful in clinical settings.

The biotechnology and pharmaceutical industries are warily eyeing a U.S. House health reform bill that would double the financial burden on the industry.

While the bill lacks some of the fees proposed by the Senate, the House's tighter price controls on drugs covered by government programs would likely bring the total industry cost to $150 billion to $160 billion, compared with the $80 billion cost associated with the Senate version, according to an analysis by the Wall Street Journal.

For many years, the FDA was not unlike the Federal Reserve in its ability to only primarily exert a single weapon. In the Fed's case, it was its ability to modify the interest rate that banks charge each other. In the FDA's case, it is the ability to approve or reject a new drug application. While this is clearly an oversimplification of both the Fed and the FDA, it has been the general public's perception of both. Other than Vioxx (which I would highlight as the harbinger of change), few drugs have been taken off of the market. Few required Phase IV trials have been conducted and pharma advertising campaigns have advanced largely unchecked, with actions only after they have largely run their course. Some might say that the Vioxx issue only exacerbated FDA's use of its major weapon, slowing and further tightening its approval process for new drugs.