Category — EHR

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 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

Vendors and users of electronic health record modules should monitor them closely for potential data security breaches, according to the Health IT Standards Committee, Government Health IT reports.

The suggestion was included in a summary of the committee’s recommendations on the interim final rule on standards and certification criteria for health IT under the 2009 federal economic stimulus package. The rule describes the requirements for certified EHR systems that physicians and hospitals must use to qualify for health IT adoption incentives.

John Halamka — vice chair of the committee, who published a summary of the recommendations in a March 9 blog post — said the committee “recommended that a list of acceptable technology standards be included in the certification process” in part because IT security standards change quickly, particularly for those strengthening encryption.

According to Halamka, the committee also recommended that the interim final rule “specify broad families of standards” for clinical operations, such as a major version of each standard that also includes a “detailed implementation guide that serves as a floor.”

The Office of the National Coordinator for Health IT has offered the interim final rule for public comment until Monday (Mosquera, Government Health IT, 3/11).

Above article publish on http://www.ihealthbeat.org/articles/2010/3/12/standards-panel-calls-for-increased-monitoring-of-security-in-ehr-modules.aspx

The Healthcare Information Technology Standards Panel has extended its contract with HHS through April 30, 2010, the panel announced Tuesday, Healthcare IT News reports.

The panel and HHS have collaborated to expand the adoption and interoperability of electronic health records since HITSP’s creation in 2005, according to Fran Schrotter, HITSP’s project director and senior vice president and chief operating officer of the American National Standards Institute, which administers HITSP.

During the extension period, Schrotter said HITSP will:

• Collaborate with CMS on a project on quality demonstration;
• Conduct monthly informational update calls; and
• Take part in the Healthcare Information and Management Systems Society’s annual conference and exhibition.

The contract extension ensures that HITSP volunteers remain engaged until the next phase of standards harmonization, which will be funded by the Office of the National Coordinator, is announced, Schrotter added (Manos, Healthcare IT News, 2/16

Above Article Publish On http://www.ihealthbeat.org/articles/2010/2/16/hhs-extends-hitsp-contract-pushes-ahead-with-ehr-adoption.aspx

The state of Kentucky will receive a $2.6 million in federal matching funds from the Centers for Medicare and Medicaid Services (CMS) to help fund the development of the state’s electronic health records incentive program.

The American Recovery and Reinvestment Act of 2009 provided a 90 percent federal match for state planning activities related to the creation of an incentive program that encourages Medicaid providers to establish electronic medical records systems, according to a CMS news release.

Electronic medical records give health care providers instant access to patients’ medical information over a secure network. When complete, the Kentucky system is expected to help health care providers coordinate patient care.

Kentucky will use the funding to analyze the progress state’s health information technology initiative, according to the release.

Officials will explore topics such as barriers to developing the records system, provider eligibility for participating in the electronic health records network and the creation of a state Medicaid health information technology plan, according to the release.

Above article publish on http://health-information.advanceweb.com/Web-Extras/EHR-Today/KY-to-Receive-Federal-Funds-for-EHR.aspx

The American Recovery and Reinvestment Act establishes an incentive program that provides incentive payments to eligible physicians (EP) and eligible hospitals for meaningfully using electronic health records (EHR). While many specialists are learning the conditions under which they can capitalize on these incentive payments, anesthesiologists will learn that they do not qualify as EPs, thus not able to receive incentive payments for their meaningful use of EHRs.

One requirement that a physician satisfy is that s/he is a non-hospital-based physician. “Hospital-based” physicians are defined to include those that provide 90% of their Medicare-covered services within a Place of Service (POS) of 21, 22, or 23–either an inpatient hospital, outpatient hospital, or emergency room hospital, respectively. Furthermore, the statute explicitly states that anesthesiologists–who furnish substantially all of their Medicare-covered services in a hospital setting, using the hospital’s facilities and equipment, and qualified EHRs–are not eligible to receive the incentive payments because they are not bringing their own equipment to the hospital in furtherance of the medical services they perform. If a hospital demonstrates is meaningful use of an EHR, it can qualify for incentive payments.

Above article publish on http://www.attorney-dwi.info/health/incentive-payments-for-meaningful-use-of-ehr-technology-does-not-apply-to-anesthesiologists/

HHS is gearing up to award $50 million in task orders to establish a national Health IT Research Center, Federal Computer Week reports.

Joshua Seidman — acting director of the “meaningful use” division at the Office of the National Coordinator for Health IT — discussed HHS’ plans for the research center this week during a conference sponsored by the eHealth Initiative.

He said the Health IT Research Center will provide a virtual learning community through an online portal. The center also will help users develop communities around research subjects that support the meaningful use of electronic health records.

Support for Regional Extension Centers

Seidman said the research center will serve as a resource for about 60 regional health IT extension centers.

HHS is awarding nearly $600 million in stimulus funding to establish the extension centers in communities across the country. Officials are expected to select about half of the extension centers within the next few weeks, Seidman said.

The regional extension centers aim to offer health care providers guidance on:

• Best practices in health IT privacy and security;
• EHR vendor selection and group purchasing;
• Health data exchange and interoperability;
• Health IT project implementation and management;
• Workflow redesign and work force support (Lipowicz, Federal Computer Week, 1/26).

Above article publish on http://www.ihealthbeat.org/articles/2010/1/27/hhs-to-award-50m-to-set-up-national-center-for-health-it-research.aspx

Dom Nicastro and Janice Simmons, for HealthLeaders Media,

With the release yesterday of its “meaningful use” definition and standards, government agencies have laid the foundation for an “evolutionary process in achieving and maintaining the meaningful use of certified EHR technology,” says Frank Ruelas, director of compliance and risk management at Maryvale Hospital and principal, HIPAA Boot Camp, in Casa Grande, AZ.

CMS and the Office of the National Coordinator for Health Improvement Technology (ONC) on Wednesday, December 30, released two anxiously-awaited regulations providing both the definition of “meaningful use” of electronic health records (EHRs) and the standards to improve the efficiency of health information technology used nationwide by hospitals and physicians.

“Both regulations are important in their own right, but they should be seen as part of a larger effort—a more comprehensive effort—to improve the health of the American people and the efficiency of its health system by equipping physicians, hospitals, and other health professionals with the best, most accurate, and most up-to-date information that they need and can use to help their patients, ” said David Blumenthal, MD, national coordinator for health information technology, at a briefing late Wednesday.

Ruelas cites the identification of three stages, each with its own set of objectives that support the meaningful use of an EHR. Providers can be eligible for thousands of dollars if they meet the criteria included in the three stages.

The initial set of criteria will focus on collecting data electronically, sharing this data with other healthcare providers and patients, and finally reporting the measures to the government. The second stage of criteria would be proposed by the end of 2011. This will focus on structured information exchange and continuous quality improvement. Stage 3, which will focus on decision support for “national high priority conditions” and population health, would come out in 2013.

For example, physicians must use computerized provider order entries (CPOEs) for 80% of their orders; hospitals 10%, according to CMS’ proposed rule.

“This was a very novel approach, in my opinion, because as is stressed in this document, the adoption of certified EHR technology and its meaningful use is more of a process to be developed and adopted over time versus an on/off proposition,” Ruelas says. “Oftentimes, people will use the phrase that some processes are more like running a marathon than a sprint. This interim rule certainly gives the impression that we going to be in a marathon mode.”

The ONC interim final rule begins to define standard formats for clinical summaries and prescriptions; standard terms to describe clinical problems, procedures, laboratory tests, medications and allergies; and standards for the secure transportation of this information using the Internet.

The American Recovery and Reinvestment Act of 2009 required HHS to adopt an initial set of standards for EHR technology by December 31, 2009. This regulation will go into effect 30 days after publication in the Federal Register, with an opportunity for public comment over the next 60 days. A final rule will be issued in 2010.

above article publish on : http://www.healthleadersmedia.com/content/TEC-244313/Marathon-of-Meaningful-Use-EHR-Standards-Just-Beginning

In February 2009, President Obama and the Congress launched a vast, ambitious program to improve the health of Americans, and the performance of their health system, by building a nationwide, interoperable, private and secure, electronic health information system. This vision – of health care empowered by a modern information system, serving each and every American according to their needs and preferences – reflects decades of study and thinking by health care experts, health professionals, and average citizens. Typical of the consensus underlying the nation’s new health information technology (HIT) program is this recommendation by the Institute of Medicine from its seminal 2001 report, Crossing the Quality Chasm:

“Congress, the executive branch, leaders of health care organizations, public and private purchasers…should make a renewed national commitment to building an information infrastructure to support health care delivery, consumer health, quality measurement and improvement, public accountability, clinical and health services research, and clinical education. This commitment should lead to the elimination of most handwritten clinical data by the end of the decade.”

Similar recommendations have come from many other non-partisan, independent authoritative sources such as the Commonwealth Fund, the Markle Foundation, and the Robert Wood Johnson Foundation. These recommendations reflect not only academic studies showing the benefits of HIT, but also experience and common sense. We live in a digital age. We have seen technology improve virtually every facet of our lives. But medicine still relies on cumbersome paper charts. We manage information the same way Hippocrates did 2400 years ago. It’s time to move medicine into the 21st century.

Many health care organizations, big and small, public and private, have installed electronic health record systems and are reaping their benefits daily. Examples include not only national systems like the Veterans Administration and Kaiser Permanente, but regional groups like Geisinger Health System, and individual hospitals like the Beth Israel Deaconess Hospital in Boston, and Lakeland Hospital, a 77-bed facility outside of Omaha Nebraska. These organizations show that the vision is feasible – health care can be made higher in quality and lower in cost through the best existing HIT.

From a common sense perspective, it is impossible to imagine a 21st century American health system deprived of the electronic methods of collecting, managing, and moving data that have revolutionized virtually every other area of human endeavor. Information is the lifeblood of medicine. HIT is its circulatory system. A health care system without an electronic health information system simply cannot achieve its potential, anymore than an Olympic athlete could compete with a failing heart. This is the vision that President Obama and the Congress embraced in February 2009.

Nevertheless, any bold new goal has to be reduced to practice, and skeptics are now asking appropriately whether the HIT program can succeed. A few recent studies have raised questions about whether health care organizations that have installed electronic health records are actually realizing the expected benefits. Perhaps existing examples of success are atypical, and can’t be reproduced in the rest of our health system? Perhaps we are moving too fast? Perhaps the risks are too great?

As a scientist myself, I take the academic literature very seriously. I believe that policy should be based on the best available information, carefully analyzed and considered. However, recent studies raising questions about the benefits of EHRs are informative, but limited in their applicability to our HIT program. To the extent that they accurately capture past experience with EHRs, these studies illustrate something that the Congress and the President understand and have allowed for: namely, that having an EHR alone is not sufficient. Doctors and hospitals have to use this technology effectively, have to employ its extraordinary power to improve clinical decisions, in order to achieve its potential benefits. The federal government’s new programs of incentives and penalties are totally focused on encouraging the meaningful use of EHRs. The resources set aside by the Congress to encourage the adoption of EHRs will go only to physicians, hospitals, and other providers who meet carefully designed new requirements for the use of EHRs that will translate into health improvements and cost reductions for the American people. And the plan passed by Congress includes new resources and support that will help make it possible for providers and hospitals to meet these requirements. We have already announced the availability of grants that will help providers adopt and use EHRs, and we will be making additional announcements in the weeks and months ahead.

Sometimes bold steps are required to improve the human condition. Among the most successful health and social programs in American history are Social Security, Medicare, Medicaid, the Community Health Center Program, and the State Children’s Health Insurance Program. It would have been a tragic mistake, costing untold thousands of lives and enormous suffering, if we had foregone or delayed these programs. I believe the HIT initiative will rank with these huge successes in the value it will bring to the American people over the years to come.

Above article published on http://www.healthcareitnews.com/blog/evidence-hit

By Rebecca Vesely / HITS staff writer

Proposed rules on the meaningful use of electronic health records will be made public by the end of the year or perhaps sooner, said David Blumenthal, national coordinator for health information technology at HHS.

In a speech before the American Medical Informatics Association’s annual symposium in San Francisco, Blumenthal stressed that health IT must be focused on the goal of making the healthcare system work better for patients and providers.

It’s not the technology that’s important, but its effect,” Blumenthal said. “That’s the purpose of the stimulus bill.”

The American Recovery and Reinvestment Act of 2009 included Medicare and Medicaid incentives to eligible providers such as physicians and hospitals to boost adoption of EHRs. To receive the incentive payments, providers must demonstrate “meaningful use” of a certified EHR. The CMS, in conjunction with Blumenthal’s office, is developing the proposed rule that provides greater detail on the incentive program and a definition of meaningful use. The stimulus law, enacted in February, appropriated $2 billion to Blumenthal’s office to create the infrastructure for meaningful use.

After a comment period, the final rule on meaningful use will be released in the spring, Blumenthal said.

While Blumenthal declined to give a specific definition of meaningful use, he offered some hints. People working in health IT should think about EHRs “not as a technology project, but as a change-management project,” he said. Components of meaningful use include sociology, psychology, behavior change and the “mobilization of levers to change complex systems and improve their performance,” he added.

Through the stimulus law, Congress mandated that meaningful use become more focused over time, with yearly benchmarks. There has been a “lively discussion” in the Obama administration of that timetable in the proposed rulemaking of meaningful use, Blumenthal said.

“We will be looking for your feedback,” Blumenthal told the assembled association of nearly 2,000 members who attended the conference held at the Hilton San Francisco Union Square this week. “Rulemaking is not the end of the conversation.”

Privacy and security are absolutely critical to the widespread adoption of health IT, Bluementhal said, adding that this is also on top of his agenda. “Without the trust of the public, we will not be successful in getting everything out of the potential of health informatics.”

In the next few months, his office will convene a working group on privacy and security to look at what else is necessary to ensure the public’s trust beyond what is instructed by Congress in the stimulus law, he said.

“We need to be extremely vigilant and aggressive in terms of developing standards around privacy and security,” Blumenthal said.

And his office is moving forward with its first grant programs under the stimulus law. Last summer, Blumenthal announced two grant programs mandated by the stimulus law. The first is $700 million in grants to establish up to 70 health IT regional extension centers nationwide, which will offer technical assistance, guidance and information on best practices to support and accelerate providers’ efforts to become meaningful users of EHRs. The second program offers $560 million in grants to states to develop health information exchange capacities among providers.

The first round of grant recipients will be announced soon, Blumenthal said. HHS received about 90 applications for the first 20 slots in the health IT regional extension center program, he said, adding that he was encouraged by the volume and quality of the grant applications.

“The grants to states, we believe, are another good bet,” he said.

Blumenthal also gave some hints on his office’s plans to develop and announce programs to increase the supply of trained health IT workers.

“The skills needed are not necessarily what our teenage children have,” Blumenthal said, which brought laughter from the crowd.

Specifically, the nation needs professionals who understand meaningful use and improved processes of care, the ability to redesign workplaces to integrate the new technology and to help providers use the technology to its full potential, he said.

“The training needed is well beyond the installation of information technology,” he said.

Blumenthal expressed great confidence that health IT can be a foundation for fundamental change in the healthcare system.

“I believe it will be a short time before EHRs are as common in medicine as the stethoscope, the cardiogram, the MRI and other core tools,” he said. “I think we’re already moving in that direction.”

Above article published on http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20091117/REG/311179986/1134