Category — EMR

CMS soon will release modifications for certain provisions in the final rule for Stage 1 of the meaningful use ehr incentive program, Government Health IT reports.

Under the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health records can qualify for incentive payments through Medicaid and Medicare.

Tony Trenkle — director of the Office of e-Health Standards and Services at CMS — said the adjustments to the meaningful use criteria currently are undergoing a federal clearance process, which is the final step before publication. Trenkle spoke on Wednesday during a Health IT Policy Committee meeting.

Trenkle added that CMS also will release guidance for health care providers on how to meet quality measures in the incentive program.

Discussion of Stages 2, 3

During the meeting, the Policy Committee also considered what incentive requirements to include in the next stages of the meaningful use program.

Committee members discussed whether Stage 2 meaningful use requirements — which are expected to go into effect in 2013 — should be incrementally built on requirements from Stage 1, or if there should be a set of larger steps framed around measuring and improving patient outcomes.

Paul Tang — chair of the meaningful use work group and chief medical information officer at the Palo Alto Medical Foundation — said the committee would prefer to establish the Stage 3 goals for 2015 first and then backtrack to form Stage 2 requirements.

Committee member Latanya Sweeney — director of the data privacy lab at Carnegie Mellon University — said future meaningful use criteria should incorporate privacy regulations (Mosquera, Government Health IT, 10/20).

National Coordinator for Health IT David Blumenthal said that the rollout of Stage 1 of the meaningful use criteria “was very rushed” (Conn, Modern Healthcare, 10/21). He added that the next stages should focus on infrastructure and interoperability.

Time Frame

Tang said that the meaningful use work group aims to have draft requirements for Stages 2 and 3 by Nov. 19, adding that it will revise the draft after taking comments from the full Policy Committee.

He said final recommendations could be submitted to the Office of the National Coordinator for Health IT by the third quarter of 2011, while CMS could release a notice of proposed rulemaking on the next stages by the fourth quarter of next year (Manos, Healthcare IT News, 10/21).

Source  :  http://www.ihealthbeat.org/articles/2010/10/21/officials-preparing-adjustments-to-meaningful-use-final-rule.aspx

It was inevitable, given the short timeline and the apparent seat-of-the-pants nature of the rulemaking process, but CMS is preparing a guidance document intended to clarify several details and fix some inconsistencies in the final Stage 1 rule for meaningful use of EMR.

At last week’s meeting of the Health IT Policy Committee’s workgroup on meaningful use, Tony Trenkle, director of the CMS Office of e-Health Standards and Services, said the guidance will provide more detail on the objectives and measures in the rule and “should help clarify issues and help the [committee] plan for recommendations for future stages,” Government Health IT reports. The clarifications should be out “shortly,” Trenkle promised.

Meanwhile, the workgroup is looking ahead to Stage 2 of meaningful use, 2013-14, which will have higher thresholds of compliance than Stage 1, while trying not to deter hospitals and physicians from adopting EMRs. “We want to pay particular attention to smaller practices and hospitals,” workgroup chair Dr. Paul Tang said, according to Government Health IT. “We want to raise the tides but not sink the boats.”

For the next stage, the workgroup likely will attempt to find a happy medium between the initial standards for 2011-12 and the more rigorous requirements for Stage 3, which is set to begin in 2015. For example, Stage 1 requires physicians to write 30 percent of their prescriptions electronically and federal officials ultimately would like to see a 90 percent e-prescribing rate, so expect the Stage 2 standard to be 60 percent.

The Health IT Policy Committee would like to take some of the reporting burden off of providers, so Stage 2 probably will call for EMRs to have more standard and coded data for easier extraction. “”We hope that they are capturing the information as part of patient care and not a separate activity,” Tang said.

Expect the workgroup to have Stage 2 recommendations ready for public consumption by October, and to seek comments on its preliminary plan in December.

Source       :         http://www.fiercehealthit.com/story/cms-developing-meaningful-use-guidance-remove-contradictions/2010-09-27?utm_medium=nl&utm_source=internal

BOSTON – The Physicians Foundation, a national organization that supports the interests of physicians and their patients, announced Tuesday it awarded 15 individual grants in 13 states totaling nearly $2 million for numerous health IT projects that support high quality patient care.

Foundation officials said the grants are particularly relevant given the national push toward digital health records, and that they hope to “shape how those changes are implemented in the months and years ahead.”

“Our country’s healthcare workforce is already overworked, and as the government encourages a large scale move to digital records, that transition is going to have a significant impact on practicing physicians,” said Foundation Board Member Ripley Hollister.  “The Foundation has made HIT a specific focus, because it wants to ensure that the move to digital records and the use of other technologies is made in a constructive, positive fashion – specifically, one that preserves and supports the doctor-patient relationship.”

Projects receiving Foundation support in this round of grants include:

•    “Meaningful Use Achievement Toolkit,” a program to develop and disseminate tools that assist physicians with achieving meaningful use of certified electronic record systems.
•    “HIT in Practice,” a program to develop a series of supports and resources for implementation of electronic health records (EHR) in small practices.
•    Grants for assisting physicians in various states with implementing digital health records.

The health IT grants are part of a larger effort this year by the Physicians Foundation, totaling more than $4.2 million.

“Our fundamental goal in making these grants was simple,” said Lou Goodman the foundation’s president. “We want to help improve the practice environment for physicians so that they can more easily do what matters most to them: spend time taking care of patients.”

Source      :       http://www.healthcareitnews.com/news/physicians-foundation-awards-15-organizations-2m-it-projects

CMS has provided $6.9 million in federal matching funds to Medicaid programs in four states to support their efforts to manage the “meaningful use” incentive payment program, Government Health IT reports.

Background

Under the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health records can qualify for incentive payments (Mosquera, Government Health IT, 9/14).

Through the HITECH Act, which contains the health IT provisions of the stimulus package, eligible Medicaid providers can receive as much as 85% of $75,000 — or $63,750 — in incentive payments across six years for meaningful use of ehr systems (McKinney, Modern Healthcare, 9/14).

CMS Funding

The four states that were given funding are:

• Hawaii, which received $836,000;
• Massachusetts, which received $3.56 million;
• North Dakota, which received $226,000; and
• Ohio, which received $2.29 million (Goedert, Health Data Management, 9/14).

In total, CMS has provided $81.44 million in matching funds to:

• 49 states;
• The District of Columbia;
• The U.S. Virgin Islands; and
• Puerto Rico (Modern Healthcare, 9/14).

Territories and states had to submit plans to CMS for approval before receiving matching funds. The four states are the last to receive federal matching funds for Medicaid health IT efforts (Health Data Management, 9/14).

Using the Funds

States will use the funds to take inventory of their existing health IT status, which includes:

• Examining roadblocks to the use of EHRs;
• Determining health care provider eligibility for the incentive payments (Government Health IT, 9/14); and
• Creating a long-term plan for health IT use within the Medicaid program (Health Data Management, 9/14).

Source    :     http://www.ihealthbeat.org/articles/2010/9/15/cms-awards-69m-to-medicaid-programs-for-meaningful-use.aspx

In a recent survey, 90% of health care leaders said achieving “meaningful use” of Electronic Health Records to qualify for incentive payments made available by the 2009 economic stimulus package was one of their organization’s top two priorities, InformationWeek reports.

CSC, an IT services and consulting firm, surveyed 60 health care executives in June and July about critical concerns and goals. Roughly 50% of respondents were CIOs or IT leaders, while 50% were operational executives including CEOs, CFOs and COOs.

Meaningful Use Results

The survey found that compliance with meaningful use provisions was the top priority for:

• 84% of CIOs and other health IT leaders;
• 67% of all respondents; and
• 48% of non-IT executives.

In addition, 42% of all respondents said helping their networks of owned or affiliated physicians comply with meaningful use rules for ambulatory care EHR systems was their second highest priority.

Other Findings

One-tenth of respondents cited conversion to ICD-10 diagnosis coding by 2013 as their top priority (Kolbasuk McGee, InformationWeek, 7/22).

Two-thirds of respondents plan to participate in a health information exchange. Currently, 11% of respondents said their facilities take part in a statewide exchange (Manos, Healthcare IT News, 7/22).

Source     :     http://www.ihealthbeat.org/articles/2010/7/26/meeting-standards-for-meaningful-use-tops-goals-of-health-leaders.aspx

WASHINGTON – Federal officials released the final rule on meaningful use Tuesday, which will allow physicians and hospitals to qualify for thousands of dollars in stimulus funding incentives for the adoption of electronic health records.

The 864-page final rule, several weeks late from its anticipated delivery before June 21, outlines the specific qualifications providers must meet to achieve the meaningful use of electronic health records.

At a news conference Tuesday morning, federal healthcare officials praised the advance of electronic health records, while acknowledging the difficulties providers face at the onset of adoption.

According to David Blumenthal, MD, national coordinator for health information technology, the final rule differs from the proposed rule issued last January: It allows providers more flexibility in choosing which measures to use for qualifications.

According to Blumenthal, the proposed rule required doctors to comply with 23 measures, and hospitals 25 measures. The government received more than 2,000 comments on the rule, many of them asking for more flexibility in allowing clinicians to qualify.

Blumenthal said the final rule took those comments into account. The final rule requires doctors to comply with a set of 15 core objectives during the first year - or Stage 1- of adoption. Hospitals are required to comply with 14 core objectives. In addition to the core objectives, both hospitals and doctors will have to choose five more objectives from a “menu” of 10, he said. The remaining objectives will be deferred to Stage 2 of adoption.

The final rule also reduced the number of electronic prescriptions a doctor is required to make from 75 percent to 40 percent, Blumenthal said.

Kathleen Sebelius, Department of Health and Human Services Secretary, said the Federation of American Hospitals is an “enthusiastic supporter” of the new rule. The federal government hopes other groups will join them, she said.

Blumenthal, a physician, said he is confident the use of electronic health records will become a core professional competency among physicians, who will eventually lead the way in adoption. Until then, the government will encourage healthcare IT adoption through financial incentives, such as these set up under the meaningful use rule. The government will also supply “shoulder-to-shoulder” support for providers through the regional extension centers.

Key changes in the final CMS rule include:

• Greater flexibility with respect to eligible professionals and hospitals in meeting and reporting certain objectives for demonstrating meaningful use. The final rule divides the objectives into a “core” group of required objectives and a “menu set” of procedures from which providers may choose any five to defer in 2011-2012.  This gives providers latitude to pick their own path toward full EHR implementation and meaningful use.
• An objective of providing condition-specific patient education resources for both EPs (eligible providers) and eligible hospitals and the objective of recording advance directives for eligible hospitals, in line with recommendations from the Health Information Technology Policy Committee.
• A definition of a hospital-based EP as one who performs substantially all of his or her services in an inpatient hospital setting or emergency room only, which  conforms to the Continuing Extension Act of 2010
• CAHs (critical access hospitals) within the definition of acute care hospital for the purpose of incentive program eligibility under Medicaid.

A CMS/ONC fact sheet on the rules is available on the CMS Web site.

Source :  http://www.healthcareitnews.com/news/flexibility-built-final-rule-meaningful-use

By, Diana Manos

CHICAGO – Officials of HIMSS Analytics, the not-for-profit subsidiary of the Healthcare Information and management System Society (HIMSS), announced Wednesday they would be adding new questions to their annual study on meaningful use to gauge hospitals’ readiness.

With hospitals expected to complete the first phase of deadlines for meaningful use by 2011 to qualify for bonuses under the American Recovery and Reinvestment Act of 2009, HIMSS Analytics will ask hospitals about their inclusion of structured document standards to convert narrative data to a structured format importable to an electronic medical record (EMR).

HIMSS Analytics tracks the EMR implementation status of more than 5,000 U.S., non-governmental hospitals through its annual study with hospital CIOs. The data gathered provides a detailed look at the clinical and financial application environments in U. S. hospitals.

HIMSS Analytics also developed the Electronic Medical Record Adoption ModelSM - or EMRAM - to score hospitals in the HIMSS Analytics Database on their .progress in completing the eight stages to creating a paperless patient record environment.

“In our evaluation of EMR Adoption Model scores over 2008-2009, we found that hospitals are continuing to advance the care delivery capabilities of their EMR environment,” said John Hoyt, vice president of HIMSS Healthcare Organizational Services.

“ARRA funding incentives are driving EMR implementation,” Hoyt said. “With this expanded arsenal of data, HIMSS Analytics can help healthcare providers better understand and follow the Meaningful Use requirements while moving higher on the EMRAM scale.”

According to Liora Alschuler executive committee representative of the Health Story Project, which helped write the new questions for HIMSS Analytics, much of the information in a patient’s medical record may be entered by the physician or nurse in chart form, such as notes taken during a clinic visit, lab reports or other information that contributes to the completeness of individual health history.

Health Story produces data standards for the flow of information between common types of healthcare documents and electronic medical records, Alschuler said.

Alschuler, principal, at Alschuler Associates, LLC, said the Health Story standards are based on HL7 Clinical Document Architecture reusing templates from the Continuity of Care Document. The Health Story Project, founded a little over two years ago, is a nonprofit collaborative of healthcare vendors, providers and associations.

“The members of Health Story believe that all of the clinical information required for good patient care, administration, reporting and research should be readily available electronically, including information from narrative documents,” Alschuler said. “With the data gathered from the HIMSS Analytics Study, we will know how hospitals are using document standards to enrich the flow of information to their EMRs.”

Officials at HIMSS Analytics said they expect to begin reporting on hospital readiness for meaningful use in September 2010.

Source: http://www.healthcareitnews.com/news/himss-analytics-gauge-hospital-readiness-meaningful-use

Last week, National Coordinator for Health IT David Blumenthal published an open letter touting the Nationwide Health Information Network as a model to help health care providers meet the “meaningful use” requirements of the 2009 federal economic stimulus package, Modern Healthcare reports.

Under the stimulus package, health care providers who demonstrate meaningful use of electronic health records will qualify for Medicare and Medicaid incentive payments (Conn, Modern Healthcare, 5/17).

Blumenthal wrote that NHIN is “not a network per se, but rather a set of standards, services, and policies that enable the Internet to be used for the secure exchange of health information to improve health and health care.”

NHIN Direct

He also acknowledged that some health care providers “may have simpler needs for information exchange, or perhaps less technically sophisticated capabilities.” He said such health care providers could benefit from NHIN Direct, which still is under development (Blumenthal letter, 5/14).

NHIN Direct is a basic version of NHIN that offers health care providers open-source software to develop a network for the electronic transmission of health information (Modern Healthcare, 5/17).

Blumenthal wrote that NHIN Direct “is meant to enhance, not replace, the capabilities offered by other means of exchange.” He added that the model could “complement existing NHIN exchange capabilities and strengthen our efforts toward comprehensive interoperability across the nation” (Blumenthal letter, 5/14).

In addition, Blumenthal wrote that ONC is “on an aggressive timeline” to develop standards for NHIN Direct so health care providers can use the framework to qualify for incentive payments.

He also called for greater public participation in the NHIN Direct project through blogs and a community wiki, which are available on the project’s website (Modern Healthcare, 5/17).

Above article publish on http://www.ihealthbeat.org/articles/2010/5/17/blumenthal-nhin-nhin-direct-offer-paths-to-meaningful-use.aspx

By Joseph Conn

The CMS has announced the awarding of a total of just over $9 million in matching funds to be used by four states to plan for their Medicaid programs to subsidize provider purchases and the use of electronic health-record systems under the American Recovery and Reinvestment Act of 2009, also known as the stimulus law.

The states and their grant amounts are: New Jersey, $4.93 million; Louisiana, $1.85 million; Maryland, $1.37 million; and Minnesota, $1.04 million.

Since November 2009, 39 states, Puerto Rico and the U.S. Virgin Islands have shared nearly $67.6 million in planning grants, according to news release information on the CMS website.

The stimulus law provides a 90% federal match to cover the cost of state planning efforts for the Medicaid EHR subsidy programs. According to federal estimates, the government estimates it could spend as much as $27.3 billion on the EHR subsidies under Medicaid, Medicare and Medicare Advantage programs.

Above article publish on http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20100511/NEWS/100519988

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-