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Am Fam Physician. 2005;72(4):559-560

Latest Senate EHR Bill Combines and Replaces Previous Proposals

Physicians and hospitals could compete for federal grants to help purchase or improve electronic health record (EHR) systems under a bill that was recently passed by the Senate Health, Education, Labor and Pensions Committee. The Wired for Health Care Quality Act (Senate bill S. 1418) combines the provisions of and replaces two previous proposals: the Health Technology to Enhance Quality Act (S. 1262) and the Better Healthcare Through Information Technology Act (S. 1355). The Wired for Health Care Quality Act would provide competitive grants to physicians and others to buy or improve certified health information technology (IT) systems, and it would provide grants to states for low-cost loans to physicians and others to buy or upgrade health IT systems. The bill also creates a demonstration program to integrate health IT into clinical education and requires the development of evidence-based, risk-adjusted health quality measures that cover process, structure, patient experience, efficiency, and equity and that identify overuse, underuse, and misuse of health care services. The full text of the bill is available online at http://thomas.loc.gov.

Agencies Collaborate to Help Patients Recover from Mental Illness

Several federal agencies will collaborate to help ensure that persons with mental illness have an opportunity for recovery, according to the Substance Abuse and Mental Health Services Administration. The Social Security Administration and Departments of Education, Health and Human Services, Housing and Urban Development, Justice, Labor, and Veterans Affairs have detailed 70 specific steps in a mental health action agenda, “Transforming Mental Health Care in America. The Federal Action Agenda: First Steps.” Highlights of the agenda include: reinforcing the message that mental illnesses and emotional disturbances are treatable and that recovery is expected; developing a plan to promote a mental health workforce better qualified to practice mental health care that is culturally sensitive and based on evidence-based practices in specialty settings and at the primary care level; promoting early intervention with informed parental consent for children identified to be at risk for mental disorders; expanding the “Science-to-Services” agenda to develop new toolkits outlining evidence-based practices for use by providers, administrators, educators, and consumers; and designing an electronic health records and information system that will help providers and consumers better manage mental health care and that will protect the privacy and confidentiality of consumers’ health information. Additional information is available online at http://www.samhsa.gov/Federalactionagenda/NFC_TOC.aspx.

Study: Most Americans Do Not Think Obesity Risks Are Overestimated

A new opinion poll by the Harvard School of Public Health finds that despite recent studies that have varied in their estimates of the seriousness of obesity and its impact on premature death, most Americans have not changed their minds about the seriousness of the obesity problem in the United States and do not believe that scientific experts are overestimating the health risks of obesity. Three out of four survey respondents rate obesity as an “extremely” or “very” serious public health problem in the United States. Four out of five respondents said they believe that scientific experts have been portraying accurately or even underestimating the health risks of being obese. However, the survey found that trust in scientific experts on the issue of obesity is mixed. Only 48 percent of respondents said they have a “great deal” (14 percent) or a “good amount” (34 percent) of trust in the advice scientific experts give about how to control weight. Additional information about the survey is available online at http://www.hsph.harvard.edu/press/releases/blendon/ObesityTopline.doc.

NIAAA Issues New Guide for Helping Patients Who Drink Too Much

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has released a new guide to help physicians identify and care for patients with heavy drinking and alcohol use disorders. Helping Patients Who Drink Too Much: A Clinician’s Guide provides a research-based approach to alcohol screening and brief interventions. It updates earlier NIAAA guidelines, which used a lengthier screening process. In the new guide, alcohol screening is simplified to a single question about heavy drinking days. If a patient drinks heavily (i.e., five or more drinks per day for men, or four or more for women), the guide shows physicians how to assess for symptoms of alcohol abuse or dependence. It provides an optional written screening tool in English and Spanish, patient education charts about U.S. adult drinking patterns and alcohol content in different beverage types and serving sizes, a new section about prescribing medications for alcohol dependence, new forms for recording patient baseline and progress notes, and resources for making referrals to treatment and support groups. The guide is available online at no charge at http://www.niaaa.nih.gov. Printed copies, with pocket guides, can be ordered at the same Web site or by calling the NIAAA at 301–443–3860.

Buprenorphine Mentoring Program for Physicians Debuts Nationwide

A physician mentoring program is now available to help relieve the shortage of U.S. physicians prescribing buprenorphine (Subutex), a drug approved nearly three years ago for treatment of addiction to opioids, including pain medications and heroin. A team of 45 practicing physicians will serve as mentors for the Physician Clinical Support System, which will provide telephone, e-mail, and on-site support to physicians who have completed the required buprenorphine training program. Up to 3,000 physicians currently prescribe buprenorphine, a nearly twofold increase from one year ago. However, more physicians are needed because an estimated 3.5 million patients need the drug, according to David Fiellin, M.D., associate professor of medicine at Yale University School of Medicine, New Haven, Conn., and chair of the American Society of Addiction Medicine’s buprenorphine training subcommittee. Federal law limits the number of patients that a single physician or group of physicians can treat with buprenorphine at one time. Additional information about the mentoring program is available online at http://www.asam.org/conf/BupMentoring/ASAM%20PCSS.pdf.

AAFP Launches Online Quality-Improvement Module for CAD Care

The American Academy of Family Physician’s (AAFP’s) Measuring, Evaluating and Translating Research Into Care (METRIC) quality improvement initiative has a new module on coronary artery disease (CAD) online and is available for members to earn continuing medical education (CME) credit at https://www.aafp.org/x29503.xml. “METRIC Coronary Artery Disease: Improving Patient Care” is the second module offered this year. The first module, on diabetes care, also is available online at the same Web address. METRIC allows physicians to earn CME credit as they complete practice-based performance measurement and improvement projects. The AAFP plans to offer two new METRIC modules each calendar year, and each module will be reviewed for 20 AAFP Prescribed CME credits. The METRIC initiative was designed to help family physicians fulfill the requirement for Part IV of the American Board of Family Medicine’s Maintenance of Certification Program for Family Physicians.

$3 Million Awarded to Help Physicians Promote Healthy Behaviors

The Robert Wood Johnson Foundation and the Agency for Healthcare Research and Quality have awarded $3 million in grants (10 grants worth $300,000 each) through Prescription for Health: Promoting Health Behaviors in Primary Care Research Networks, an initiative supported by both organizations. The program is aimed at developing effective, practical strategies for changing Americans’ unhealthy behaviors through primary care. Grant recipients are concentrating on four leading health risk factors: lack of physical activity, unhealthy diet, tobacco use, and alcohol abuse. The projects are conducted by practice-based research networks, groups of medical practices that investigate how health care is managed or delivered.

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