Washington Report- August 2, 2011


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• Quote of the Week
• Indicium Brevis – Ongoing snippets of information for your consideration…
• The Debt Ceiling Agreement – Explaining how Congress avoided the first default in American history and what it means for the country.
• Out of the Cloud and into the Business of “Yes, Now” – Michael Dell explains his vision of the future of technology.
• Health IT Roundup – A weekly digest of the latest health technology developments.

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Washington Report- August 2, 2011

  1. 1. August 2, 2011Hi All,The following is this week’s edition of the Dell Services weekly Washington Report.Information and updates in this report include:  Quote of the Week  Indicium Brevis – Ongoing snippets of information for your consideration…  The Debt Ceiling Agreement – Explaining how Congress avoided the first default in American history and what it means for the country.  Out of the Cloud and into the Business of “Yes, Now” – Michael Dell explains his vision of the future of technology.  Health IT Roundup – A weekly digest of the latest health technology developments.Quote of the Week“It ensures also that we will not face this same kind of crisis again in six months, or eightmonths, or 12 months…and it will begin to lift the cloud of debt and the cloud of uncertaintythat hangs over our economy.”President Barack Obama speaking on Sunday night on the bipartisan compromise reached inCongress that would end the impasse over America’s debt ceiling negotiations.Indicium BrevisOngoing snippets of information for your consideration…Right to Obtain EHR Access-Related Data? - HIPAA states that healthcare providers areresponsible for protecting the information in patients’ health records. On May 31, theDepartment of Health and Human Services published a notice that would allow patients theright to obtain a record of who has viewed their health data. The American HealthInformation Management Association supports many parts of the proposed rule but voicedconcerns and recommendations. It has not been required to track this level of access-relateddata in the past, at least not to this extent. The Medical Group Management Association(MGMA) conducted a study with over 1,400 participants to determine the impact theproposed rule would have on medical practices. Ninety percent of those surveyed saidproducing a government-compliant access report would be “very” or “extremely”burdensome for their practice and almost two thirds of participants stated that they hadreceived between zero and one access report request per full-time physician in the pastyear.Classifying Health Technology Errors- Two Texas researchers and professors recentlypublished an analysis in which they describe how to understand the root of many healthinformation technology (HIT) errors. They identified 19 different types of HIT-related medical
  2. 2. errors and eight categories to classify situations that could lead to HIT errors. Thesecategories may be the first step to establishing an error-reporting program and one dayprovide HIT users access to error reports.Social Media Improving Public Health- According to a study done at the University ofPennsylvania Perleman School of Medicine, social media may help the public health systembe better prepared for, respond to, and recover from disaster. With over 40 millionAmericans using various social media outlets, such as Facebook, Twitter and Foursquaredaily, these outlets can allow public health officials to push alerts or other information out tothe public while pulling in information from witnesses at the scene at the same time.The Debt Ceiling AgreementExplaining how Congress avoided the first default in American history and what it means forthe country.While the clock didn’t strike midnight on Congress’ debt negotiations, we certainly saw thebetter part of 11:55 on the high stake discussions. After months of talking and countlesshours of disagreeing with each other, Republicans and Democrats finally came to anagreement on how to avoid the first default in American history. It was an ugly process, butin the end a compromise was reached. So, what does all this mean and what exactly didCongress decide on? Let’s break it all down…The Debt Ceiling (Part I): In the end, Congress decided to raise America’s current $14.3trillion debt ceiling by as much as $2.4 trillion through 2013 (aka after the 2012 election).Upon passage, the president will immediately be given authority to raise the debt ceiling by$400 billion. Once this occurs, the White House can then request an additional $500 billionfrom Congress. While the House of Representatives will reject such a request, the Presidentwill veto the House’s rejection. Since Congress will not have the votes to override the veto,the debt ceiling will be raised an additional $500 billion (or $900 billion in total).The Debt Ceiling (Part II): Also upon passage of the compromise package, a Congressional“super-committee” of 12 members evenly split between Republicans, Democrats, Senators,and Representatives will be established. This committee will have until November 23, 2011 tofind a way to reduce the deficit by at least $1.5 trillion and Congress must then vote byDecember 23 on these recommendations. If this fails, the President will have the authority toraise the debt ceiling by $1.2 trillion, but $1.2 trillion would also be cut from domestic anddefense spending. If the committee succeeds, the President will have the authority to raisethe debt ceiling by an equal amount of the cuts proposed.The Cuts: $917 billion in deficit reduction will be immediately cut over a 10 year periodbeginning in 2013. $350 billion of this will be from the Pentagon and the rest will come fromdiscretionary spending caps. Then, the new Congressional “super-committee” will cut anadditional $1.5 trillion from the deficit by year’s end. Additionally, during future debt ceilinghikes, Congress is now required to cut an equal amount in discretionary spending so futureincreases will not allow America’s deficit to grow. While the Pentagon is not immune tothese reductions, Medicare, Medicaid and Social Security will not be touched.
  3. 3. Taxes: While at the outset no taxes are set to be increased, the agreement creates what issure to become a major battle over tax reform in Congress this fall. In order for the “supercommittee” to create the additional $1.5 trillion in deficit reductions, Congress will be forcedto reexamine tax codes and shut loopholes. While further cutting government spending willaccomplish this, lawmakers will also likely be forced to somehow increase revenues to meetthe $1.5 trillion requirement.Balanced Budget Amendment: Language is included within the package that could begin theprocess of creating a Balanced Budget Amendment (BBA) to the U.S. Constitution. Thiswould require that the federal government balance its budget every year to avoid futuredebt increases like the situation we are in now. The President has been opposed to thismeasure and it would require ratification from 38 of the 50 states. If a BBA is in fact sent tothe states, the President would then have authority to raise the debt ceiling by $1.5 trillioninstead of $1.2 trillion.Pell Grants: As an additional note, the debt ceiling package does increase Pell Grants (federalneed-based grants awarded for students to attend college as an undergraduate) by $20billion but also cuts subsidies for graduate student loans.Out of the Cloud and into the Business of “Yes, Now”: By Michael DellMichael Dell explains his vision of the future of technology.When I was a teenager, about 30 years ago, I ran what we then called a Bulletin BoardSystem, which was a way of electronically connecting with other early computing adoptersvia a modem and phone line. We shared code, posted messages, exchanged news andformed connections.By modern standards, it was the Stone Age. There were no pictures or videos – justluminescent green words on a dark screen.But the ability to connect with people I’d never met and solve problems through a networklarger and more flexible than anything I could have created on my own changed the way Iviewed technology and became a catalyst for why I started Dell in my college dorm roomjust a few years later.I’m proud of the role Dell has played in helping to democratize the Information Age bybringing compute power to millions of users around the world for more than two decades.We have given individuals, schools, communities and small businesses technology solutionsthat enable them to be more productive and access more information that had once beenreserved only for big business.Today, we stand at the threshold of a similar revolution, only this time the focus isn’t just onthe computing device or the Internet. Instead, the focus is on the urgency of unlimitedexpectations. The combination of connectivity and mobility has created a demand andexpectation for unfettered access and immediate results that I call “Yes, Now” computing.“Yes” and “Now” – two very simple, very straightforward words that together represent themindset and expectations of every IT user I know. Today, we all expect to be told “yes” when
  4. 4. we ask our IT colleagues for a new application or a way to more efficiently access theinformation that is most important to us. And of course we naturally expect it “now,” withoutdelay. “Maybe” and “later” are no longer acceptable answers for today’s aptly named“prosumer.”The main enabler of this new age is not merely the Internet, but the many interconnectednetworks – public and private – that have come to be known (perhaps unfortunately) as the“cloud.” Through these networks, we are once again experiencing an exponential jump inthe resources and flexibility available both to individuals and organizations in accessinginformation and applications without having to invest in massive infrastructure. The cloudcan give us what we need, when we need it and how we want it.When we fully realize this promise of “Yes, Now,” imagine what we can accomplish.  Doctors treating a child with a rare illness in a small town hospital will access not only published research but the real-time medical records of the handful of others around the globe experiencing the same illness – with full protection for individuals’ privacy.  Small- and medium-sized businesses will access applications they could never otherwise afford, and larger businesses will be able to control their costs by shared use of what would otherwise be excess computing capacity.  Schools and colleges will gain access to information that even the greatest library could not contain, and a means to enhance online learning for people of every age.For IT teams, this spells efficiency. Embracing “Yes, Now” is about evolving legacy ITinfrastructure quickly and with a clear purpose for driving better outcomes for users. It’sabout freeing up resources to move away from the “as is” state in order to achieve the “tobe” state of greater innovation and stronger business results.But if we are to seize this opportunity, we in the IT industry need to do some things better.We need to stop surrounding the cloud with a fog of tech-speak and explain to potentialusers what it can do for them, rather than focusing on how it works. We also need to becareful in our excitement about the technology not to over-hype it to a skeptical public.Recent outages in public cloud environments demonstrate why concerns about reliability,security and privacy need to be taken seriously and addressed transparently.Only with a straightforward approach that recognizes the cloud’s opportunities and itschallenges will we clear the obstacles to realize the true potential of the Age of “Yes, Now.”The cloud gives us one of the greatest opportunities we’ve seen in a long history of IT trendsto fundamentally change the way we work and live.We can do this. Just like that teenager searching out ideas from unseen collaborators on abulletin board system, we can forge connection points with today’s massively morepowerful tools to find solutions to the most critical unsolved problems the world faces.Welcome to “Yes, Now” computing and all the potential that lies ahead for the IT industryand the billions of users we serve.
  5. 5. (Note – This article first appeared in Forbes Magazine on May 23, 2011)Health IT RoundupA weekly digest of the latest health technology developmentsHHS Proposes Updates to Research Subject Safety Regulations - The U.S. Department ofHealth and Human Services (HHS) announced its proposal to update regulations that protecthuman research subjects. The regulation, often referred to as the Common Rule, was writtenin 1991 when most research was conducted at a single research site. HHS has acknowledgedthe need to update the Rule to account for changes in research processes that haveoccurred in the past two decades, including data security regulations for the personalinformation of research subjects. The proposed changes are meant to enhance ethicalpractices and the safety of research participants. The Department is seeking public commenton the proposed rulemaking through September 23.National Institute of Health Develops Genetic Testing Registry - The National Institute ofHealth (NIH) is developing a public online registry that will allow clinicians, researchers andconsumers to access information regarding the availability and utility of genetic tests.The goal of the Genetic Testing Registry (GTR) is to encourage transparency among genetictesting providers and to advance genetic health and disease research. It will also serve as apublic resource to locate laboratories that offer various genetic tests. The registry will holdtesting information for over 2,000 genetic conditions. NIH will require that data providerswill update their information at least once a year and will be open to international datasubmissions.Institute of Medicine Proposes National Chronic Disease Surveillance System - TheInstitute of Medicine (IOM) proposed a framework for creating a national surveillance systemfor the monitoring of chronic cardiovascular and lung diseases. The system would utilizedata collection technology in order to monitor nationwide chronic disease trends. IOMsuggests that a national monitoring system is necessary, as current gaps in tracking thenational health status exist despite technological advances. The IOM report proposes thatmore effort be made on the part of HHS to integrate chronic disease data and generatetimely responses for stakeholders at all levelsFor Past UpdatesFor past editions of the Washington Report, click here. Also, follow DellHealth on Twitter atwww.twitter.com/DellHealth. To contact me, send an email toAsk_Dell@Dell.com.