Category — Economic Stimulus

In a comment letter sent Friday, the College of Healthcare Information Management Executives stressed the importance of ensuring that the electronic health record certification process can adequately handle the demand to certify EHR systems, Healthcare IT News reports (Merrill, Healthcare IT News, 4/30).

CHIME also said EHR systems that receive certification under the temporary certification program being established this year should be able to have that certification carry over to the permanent program that will be established in 2012 (Goedert, Health Data Management, 4/30).

The comments are in response to the Office of the National Coordinator for Health IT’s Notice of Proposed Rulemaking on EHR certification.

CHIME also recommended that ONC:

• Ensure that the certification program has the capacity to handle demand;
• Focus on EHR certification before expanding to other technologies (Healthcare IT News, 4/30);
• Provide details on how it will coordinate the EHR testing and certification process with the National Institute of Standards and Technology;
• Explain what constitutes a self-developed EHR;
• Require vendors to disclose what functions their products are certified to perform and any known compatibility issues; and
• Give vendors adequate time to recertify their products if a certifying body loses its authority to certify products (Health Data Management, 4/30).

Above article publish on http://www.ihealthbeat.org/articles/2010/5/3/chime-offers-input-on-electronic-health-record-certification-plans.aspx

By Liv Osby

Stimulus money to the tune of $5.6 million was awarded to Health Sciences South Carolina with a goal of getting 1,000 primary care doctors in the state to adopt the new electronic medical records system.

The funds will be used to set up a regional program called the Center for Information Technology Implementation Assistance. HSSC worked with the state Department of Health and Human Services to develop a statewide strategy for forging ahead with EMR.

“CITIA-SC will play a key role in supporting medical professionals throughout the state as they adopt and expand health information technologies in their practices,” said DHHS Director Emma Forkner.

DHHS spokesman Jeff Stensland said the University of South Carolina estimates about 60 percent of physician practices and 42 percent of hospitals have fully-integrated EMRs.

DHHS recently got a $9 million grant for its statewide health information exchange, which gives hospitals, doctors, clinics and other health care providers access to medical records.

HSSC is a partnership between universities and hospitals in the state to foster economic growth and improve health.

Above article publish on http://www.greenvilleonline.com/article/20100426/NEWS/304260003/1004/NEWS01/Medical-records-system-benefits–from-stimulus-funds-

Yesterday, Reps. Patrick Kennedy (D-R.I.) and Tim Murphy (R-Pa.) introduced a bill (HR 5025) that would allow behavioral, mental health and substance abuse treatment providers to qualify for incentive payments for the “meaningful use” of electronic health records, Healthcare IT News reports.

Under the 2009 federal economic stimulus package, hospitals and physicians who demonstrate meaningful use of EHRs can qualify for incentive payments through Medicaid and Medicare.

The new Health Information Technology Extension for Behavioral Health Services Act of 2010 would extend eligibility for the incentive payments to:

• Behavioral and mental health professionals and clinics;
• Substance abuse professionals and treatment facilities;
• Psychiatric hospitals; and
• Licensed psychologists and clinical social workers (Merrill, Healthcare IT News, 4/16).

Above article publish on http://www.ihealthbeat.org/articles/2010/4/16/bill-would-expand-eligibility-for-meaningful-use-incentives.aspx

By Mike Miliard

CLEVELAND – Case Western Reserve University (CWRU) School of Medicine has received nearly $8 million in federal stimulus money from the Ohio Health Information Partnership (OHIP), the state designated entity for health information exchange development. That funding will position the school as a regional extension center (REC), allowing it to help 1,765 healthcare providers in Lorain, Cuyahoga, Lake, Geauga and Ashtabula counties advance the use of health IT in their practices.

The CWRU School of Medicine is one of seven RECs in Ohio established by OHIP and made possible by funding from the American Recovery and Reinvestment Act (ARRA). An eighth REC was awarded directly by the federal government to HealthBridge, a not-for-profit health information exchange serving Greater Cincinnati and surrounding areas.

The federal and state initiative is providing smaller primary care practices with an incentive to early adoption of health information technology.

“Electronic health records tend to be financially out of reach for private practitioners and small practices,” said Julie Rehm, senior associate dean of the CWRU School of Medicine and associate vice president of strategic initiatives for CWRU. “If healthcare providers adopt early they are eligible for additional reimbursement from the Centers of Medicare and Medicaid Services until 2011. After that, the reimbursement declines and penalties kick in starting in 2015.”

The REC endeavor, as directed by the federal government, is targeted towards primary care providers, specifically, physicians—MDs or DOs who are family physicians, general internal, pediatric or OB/GYN, and other primary care providers such as nurse practitioners, nurse midwives, or physician assistants with prescriptive privileges and practicing in one of the previously mentioned areas.

The CWRU School of Medicine will provide administration and management to multiple contractors whose roles will vary by expertise but overall will help providers select products and provide training on how to use the technology to its fullest potential in order to improve patient care. This includes providing workforce support, implementation and project management, practice and workflow design, vendor selection, privacy and security best practices, progress towards meaningful use, functional interoperability and health information exchange.

The CWRU REC has a number of stakeholders, including University Hospitals, the Cleveland Clinic and Massachusetts eHealth Collaborative. In addition, the entities likely to participate in the CWRU REC include Kaiser Permanente, Medical Mutual of Ohio and CareSource.

“The School of Medicine is committed to improving the health of our community,” said Pamela B. Davis, MD, dean of the School of Medicine and vice president for medical affairs, CWRU. “We believe that HIT is a key tool in healthcare reform and we look forward to partnering with independent healthcare providers to encourage quick adoption of HIT. Once enabled, HIT provides a two-fold benefit: 1) improving patient care, for example, through electronic alerts that notify healthcare providers of a patient’s need for annual testing e.g., mammograms, and 2) by lowering healthcare costs by reducing redundant testing.”

The Case Western Reserve REC is expected to begin work sometime this month.

“Success for the CWRU REC will be measured in three ways,” said Rehm. “First, we must meet the milestones and metrics that are being asked of us by the federal government. Second, we must enable the earliest adoption possible which will allow primary care providers to pull in the maximum amount of federal dollars from reimbursements. And third, we must improve the quality of care through the utilization of this technology which will ultimately improve the health of Clevelanders.”

Above article publish on http://www.healthcareitnews.com/news/case-western-reserve-help-providers-adopt-ehrs-ohio

According to recommendations from a large collaboration of organizations, the success of the new federal incentives program for health information technology (“HIT”) largely depends on a specific set of health improvement goals, a prioritized set of metrics, and the widespread participation of health care providers and patients.

Health care leaders from 56 different organizations filed a joint public comment on the program, which is part of the economic stimulus in the American Recovery and Reinvestment Act (“ARRA”). The Markle Foundation, the Center for American Progress, and the Engelberg Center for Health Care Reform at Brookings coordinated the collaborative comments on the Centers for Medicare & Medicaid Services’ Notice of Proposed Rulemaking for the Electronic Health Record Incentive Program.

The joint public comment recommends priorities to the U.S. Department of Health and Human Services (“HHS”), which will manage the new Medicare and Medicaid subsidies to doctors and hospitals for “meaningful use” of HIT starting in 2011.

The comment requests that HHS make clear a set of health improvement goals such as improving medication management and reducing readmissions to hospitals, so that everyone can contribute to these priorities.

Peter Basch, MD, senior fellow at the Center for American Progress, said: “As a practicing physician who has gone through the process of implementing health IT, I can say that it’s critical to set a bar that is ambitious but also achievable for the many diverse practices and hospitals that might participate in this program. We point out areas in which HHS can lower burdens on physicians without losing focus on the important goals of using health IT in ways that improve the patient’s experience and outcomes.”

Among other things, the collaborative letter stressed that the HIT program should encourage broad participation of providers by prioritizing the requirements necessary to receive payments and should enhance the ability of patients to obtain electronic copies of their health information.

Above article publish on http://pvwlaw.wordpress.com/2010/03/21/56-organizations-agree-on-priorities-for-%E2%80%9Cmeaningful-use%E2%80%9D-program/

By Andrea Kraynak

Hospitals with electronic health records (EHR) may be eligible for meaningful use incentives as early as October 2010, and physicians follow soon after. What if a provider is hoping to take advantage of the incentives, but is still fully paper-based? Waiting for the release of final rules on the incentive program and EHR certification before moving forward may not be wise.

Providers should begin by looking into the reasons their facility doesn’t have many of the components that make up an EHR, or lacks an electronic system altogether. For example, if providers haven’t begun to invest in a system because of high up-front costs, they may be able to obtain funding that can help.

“Right now, there is a significant amount of money that is being funneled through the states for health IT,” says Chris Apgar, CISSP, president of Apgar & Associates, LLC, in Portland, OR. Depending on their location, healthcare providers may be able to take advantage of it.

“Go to the medical association in your state that you’re a member of, and put a little pressure on them,” he says.

If your state has grant or loan funding available, remind your association that there is money available and encourage them to lobby and partner with others to push your state to start allocating EHR funding, whether it happens to be low- or no-interest loans or outright grants.

If your state is not offering funding, there may be other programs you can find that offer no- and low-cost loans and other programs to provide support and consultative assistance, especially for small hospitals and physicians, says Margret Amatayakul, RHIA, CHPS, CPHIT, CPEHR, FHIMSS, president of Margret\A Consulting in Schaumburg, IL.

Smaller providers may also want to look into independent physicians associations (IPA), some of which are purchasing EHRs and making them available through a subscription fee. With this option, you have your own Web-based version, and you pay the IPA a certain amount annually to host the EHR, explains Apgar.

“This can be affordable because you don’t have to go out and buy a brand-new system and implement it and have someone administer it and all that,” he says. “You’re paying a subscription fee to use it, in essence, so you don’t have the cost of ownership.”

Remember, however, that subscription-based EHRs may end up costing more in the end, even though they are becoming more common, Apgar says.

If you are still searching for an EHR vendor, don’t forget about the big picture. With additional requirements coming soon, whether additional meaningful use measures or other capabilities your EHR will need to be ICD-10 compliant, look for a product and vendor that will be able to keep up.

“If you are in the position of buying a product today, you want to be buying a product that is going to take you through those stages,” Amatayakul says. “My sense is that you approach this by trying to address the long haul. Otherwise, you’re going to be faced with pieces of things that don’t work together real well.”

And avoid vendors who don’t have a sense of the upcoming changes and how they plan to address them.

“If there is little to no understanding on the part of the vendor as to what this means, or the vendor can’t describe for you what they plan to do, I would avoid that vendor,” Amatayakul says. “That means they’re not going to be able to keep up.”

Above Article Publish on http://www.healthleadersmedia.com/page-1/TEC-247509/Get-Moving-to-Catch-Early-EHR-Meaningful-Use-Incentives

The Health IT Standards Committee’s implementation work group is considering the development of an online collection of resources to help health care providers and vendors meet proposed “meaningful use” criteria for electronic health records, Government Health IT reports.

Earlier this year, CMS published a notice of proposed rulemaking describing how health care providers can demonstrate meaningful use of certified EHRs to qualify for incentive payments under the 2009 federal economic stimulus package.

At a recent work group meeting, health care providers asked for more guidance on how to comply with the meaningful use rules.

Aneesh Chopra — chair of the panel and U.S. Chief Technology Officer — said the work group could generate a digital library that would enable health care providers to access details about requirements for each meaningful use provision.

He said the panel’s blog could serve as an initial source of information. He added that the work group also could pass along user feedback to the Office of the National Coordinator for Health IT.

The work group is scheduled to offer recommendations to the full Standards Committee on April 28. The panel might propose a formal resource Web site as part of its recommendations (Mosquera, Government Health IT, 3/31).

Above article publish http://www.ihealthbeat.org/articles/2010/4/1/panel-mulls-creation-of-resource-web-site-for-meaningful-use-rules.aspx

The American Academy of Family Physicians is calling for significant changes to “meaningful use” criteria that will be used to determine whether health care providers are eligible for federal subsidies for health IT usage, Modern Healthcare reports.

In a seven-page letter to acting CMS Administrator Charlene Frizzera, Ted Epperly, chair of AAFP’s board of directors, wrote that the group agrees with many of the criteria’s stated goals, but urged CMS to reconsider:

• Requirements to report computerized physician order entry measures that he maintains could force health workers to manually enter results from laboratories that do not have an interoperable interface;
• A requirement that a patients’ health information be shared with them within 48 hours; and
• Language that requires physicians to meet all of the proposed requirements to receive incentive payments.

In addition, Epperly asserts that the term “health information” is used throughout the proposed criteria but is never defined explicitly (Robeznieks, Modern Healthcare, 3/7).

Above Article Publish on http://www.ihealthbeat.org/articles/2010/3/8/aafp-asks-cms-for-significant-changes-to-meaningful-use-criteria.aspx

WASHINGTON - The Obama administration announced $975 million in grants to help states, doctors and hospitals move from paper to computerized record-keeping.

Studies show electronic medical records help reduce medical errors and improve the quality of patient care. The grant money comes from the economic stimulus passed by Congress last year and is part of a push to get health care providers to adopt electronic record-keeping.

The White House says the awards will help make electronic record-keeping technologies available to more than 100,000 hospitals and primary care physicians by the year 2014 while helping train thousands of people for careers in health care and information technology.

The grants come from two federal agencies.

Health and Human Services Secretary Kathleen Sebelius announced $386 million in grants to advance electronic health records at the state level. Sebelius is also granting $375 million to 32 nonprofits for regional training of health care workers on these technologies.

Labor Secretary Hilda Solis announced around $225 million to support 55 job-training programs in 30 states. The administration says around 15,000 people should get training in the health records technology field. Solis said the training will lead those people to jobs offering career-track employment and good pay and benefits.

Above article publish on http://www.startribune.com/business/84237597.html

Healthcare IT News in this article published the list of 25 meaningful use objectives that professionals and hospitals must meet in order to receive stimulus funds from the government provided through Recovery Act. This list was taken from the proposed rule: “Medicare and Medicaid Programs; Electronic Health Record Incentive Program.

[1] Objective: Use CPOE

Measure: CPOE is used for at least 80 percent of all orders

[2] Objective: Implement drug-drug, drug-allergy, drug- formulary checks

Measure: The EP has enabled this functionality

[3] Objective: Maintain an up-to-date problem list of current and active diagnoses based on ICD-9-CM or SNOMED CT®

Measure: At least 80 percent of all unique patients seen by the EP have at least one entry or an indication of none recorded as structured data.

[4] Objective: Generate and transmit permissible prescriptions electronically (eRx).

Measure: At least 75 percent of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology.

[5] Objective: Maintain active medication list.

Measure: At least 80 percent of all unique patients seen by the EP have at least one entry (or an indication of “none” if the patient is not currently prescribed any medication) recorded as structured data.

[6] Objective: Maintain active medication allergy list.

Measure: At least 80 percent of all unique patients seen by the EP have at least one entry (or an indication of “none” if the patient has no medication allergies) recorded as structured data.

[7] Objective: Record demographics.

Measure: At least 80 percent of all unique patients seen by the EP or admitted to the eligible hospital have demographics recorded as structured data

[8] Objective: Record and chart changes in vital signs.

Measure: For at least 80 percent of all unique patients age 2 and over seen by the EP, record blood pressure and BMI; additionally, plot growth chart for children age 2 to 20.

[9] Objective: Record smoking status for patients 13 years old or older

Measure: At least 80 percent of all unique patients 13 years old or older seen by the EP “smoking status” recorded

[10] Objective: Incorporate clinical lab-test results into EHR as structured data.

Measure: At least 50 percent of all clinical lab tests results ordered by the EP or by an authorized provider of the eligible hospital during the EHR reporting period whose results are in either in a positive/negative or numerical format are incorporated in certified EHR technology as structured data.

[11] Objective: Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, and outreach.

Measure: Generate at least one report listing patients of the EP with a specific condition.

[12] Objective: Report ambulatory quality measures to CMS or the States.

Measure: For 2011, an EP would provide the aggregate numerator and denominator through attestation as discussed in section II.A.3 of this proposed rule. For 2012, an EP would electronically submit the measures are discussed in section II.A.3. of this proposed rule.

[13] Objective: Send reminders to patients per patient preference for preventive/ follow-up care

Measure: Reminder sent to at least 50 percent of all unique patients seen by the EP that are 50 and over

[14] Objective: Implement five clinical decision support rules relevant to specialty or high clinical priority, including for diagnostic test ordering, along with the ability to track compliance with those rules

Measure: Implement five clinical decision support rules relevant to the clinical quality metrics the EP is responsible for as described further in section II.A.3.

[15] Objective: Check insurance eligibility electronically from public and private payers

Measure: Insurance eligibility checked electronically for at least 80 percent of all unique patients seen by the EP

[16] Objective: Submit claims electronically to public and private payers.

Measure: At least 80 percent of all claims filed electronically by the EP.

[17] Objective: Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, and allergies) upon request

Measure: At least 80 percent of all patients who request an electronic copy of their health information are provided it within 48 hours.

[18] Objective: Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, allergies)

Measure: At least 10 percent of all unique patients seen by the EP are provided timely electronic access to their health information

[19] Objective: Provide clinical summaries to patients for each office visit.

Measure: Clinical summaries provided to patients for at least 80 percent of all office visits.

[20] Objective: Capability to exchange key clinical information (for example, problem list, medication list, allergies, and diagnostic test results), among providers of care and patient authorized entities electronically.

Measure: Performed at least one test of certified EHR technology’s capacity to electronically exchange key clinical information.

[21] Objective: Perform medication reconciliation at relevant encounters and each transition of care.

Measure: Perform medication reconciliation for at least 80 percent of relevant encounters and transitions of care.

[22] Objective: Provide summary care record for each transition of care and referral.

Measure: Provide summary of care record for at least 80 percent of transitions of care and referrals.

[23] Objective: Capability to submit electronic data to immunization registries and actual submission where required and accepted.

Measure: Performed at least one test of certified EHR technology’s capacity to submit electronic data to immunization registries.

[24] Objective: Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice.

Measure: Performed at least one test of certified EHR technology’s capacity to provide electronic syndromic surveillance data to public health agencies (unless none of the public health agencies to which an EP or eligible hospital submits such information have the capacity to receive the information electronically).

[25] Objective: Protect electronic health information maintained using certified EHR technology through the implementation of appropriate technical capabilities.

Measure: Conduct or review a security risk analysis in accordance with the requirements under 45 CFR 164.308 (a)(1) and implement security updates as necessary.

Above article publish on http://www.healthcareitnews.com/news/eligible-provider-meaningful-use-criteria