State & Local, Tech Goes Wrong

Massachusetts “Romneycare” site killed after rejecting Obamacare transplant | Ars Technica

 

The Massachusetts Health Connector is getting its plug pulled.

Nevada, Maryland, Massachusetts, Minnesota, and Oregon are members of a club that no one wants to join—all of these states have largely failed at getting their electronic health insurance exchange sites to work properly (or, in some cases, at all). Given the legislatively mandated deadline, the delays in delivery of requirements by the federal government, and the scale of the task that faced states developing their own healthcare exchange sites under the Affordable Care Act, people familiar with government information technology projects might tell you that it’s surprising that any of the websites worked at all.

But if any state had a greater shot at success, it was Massachusetts—the state that served as the model upon which the Affordable Care Act was based. Now, Massachusetts’ health exchange has decided to shutter its own site at least temporarily, switching to the federal exchange to buy time for a better fix.

States running their own exchanges need to be ready by November 15 for the next round of open enrollment for health plans. That has put a number of states with floundering exchange sites in a pinch. Oregon was the first state with its own exchange to completely abandon its own website after spending more than $300 million in federal grants on the project.

Oregon officials have publicly blamed the database giant Oracle, the state’s primary contractor for the site, for its failure. In March, the Government Accountability Office announced that it would conduct an investigation of the Cover Oregon exchange project; last week, The Wall Street Journal reported that the FBI is now conducting its own investigation.

In an official statement in April, an Oracle spokesperson said that “Oracle looks forward to providing any assistance the state needs in moving parts of Oregon’s health care exchange to the Federal system if it ultimately decides to do so.” Last week, the board of the exchange voted to move to the federal exchange.

via Massachusetts “Romneycare” site killed after rejecting Obamacare transplant | Ars Technica.

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Enterprise IT, State & Local, tech

Why You Should Buy Storage Stocks: Electronic Health Records

I was talking the other day to the network administrator of a 70-bed hospital with a dozen internal physicians’ practices about the trials and tribulations of achieving the first phase of the “meaningful use” standards set by the American Recovery and Reinvestment Act’s embedded Health Information Technology for Economic and Clinical Health (HITECH) Act.  Yes, I sometimes talk to people about such things.  And maybe more people should.

Back when they passed the “bailout” bill (ARRA) last year, Congress embedded the HITECH Act, which basically offers a bounty to hospitals if they can not just put electronic health records in place, but use them in a meaningful way across their organization to improve care, reduce errors, and reduce paperwork.  There’s a big cash reward for meeting Phase I of these standards before the end of 2011–$2 million, plus $200 for every patient discharged past the 1150th patient and up to the 23,000th patient. In other words, high-volume hospitals could see as much as $6.37 million in incentives in the first year.  That amount goes down by a quarter for each succeeding year.  So over 4 years, hospitals that comply with meaningful use could see between $5 million and $10.9 million.

Not enough of an incentive? There’s a stick with that carrot–hospitals that don’t get their IT systems in compliance with the Health Insurance Portability and Accountability Act’s security and privacy standards are exposed to potential government civil suits and penalties. And the Department of Health and Human Services has finally started to get serious about HIPAA–Prince Georges’ County, MD based Cignet can tell you about that.

So, hospitals are paying out a big chunk of their capital budgets this year, if they haven’t in previous years, to upgrade their patient information systems.  And they’re discovering that electronic health record systems are, to put it bluntly, storage pigs.

The network administrator I was talking to said that in the two years they’ve had their EHR system in place, their tier 1 storage requirements — that’s their mission-critical online data storage–has grown by almost 500 percent.   Mind you, this is a relatively small hospital, and that 500 percent increase came from going from 20 terabytes to almost 100 terabytes.

But those storage requirements grow daily. And as they bring their systems into meaningful use compliance,  their audit trail data will amount to about another terabyte of data a month–which they’ll have to retain for seven years or so.  So, add another 84 terabytes of audit trails over 7 years, plus whatever natural growth in records they have from new patients, emergency room visits, and visits to the dozen or so physicians practices they own.

In other words, the big winner from ARRA HITECH is the storage industry.  The storage dillema of that small hospital is being writ small, medium, and large across the country at every clinic, doctor’s office, and hospital.  That means petabytes of new storage sitting in someone’s data center somewhere.

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