Category — Health IT Policy

By Neil Versel

The highly anticipated second draft of a definition for “meaningful use” of health IT to qualify for federal stimulus funding came out as promised last week, and proposes loosening some of the original standards and injecting some competition into EMR certification.

The Health IT Policy Committee, an HHS advisory group, spelled out a list of, and a timetable for, various health IT objectives for 2011, 2013 and 2015. It also effectively gives healthcare providers until 2014 to achieve meaningful use based on initial criteria for 2011, though latecomers may not be eligible for all possible funding. “We thought there was a kind of double jeopardy in that, if a provider couldn’t make the 2011 or 2012 criteria, and coming into 2013 the bar would be raised higher, it’s almost like you can’t get into the game at all,” committee member Dr. Paul Tang said. “We’re trying to find a way for people to participate even if it’s a little bit delayed.”

Also, the committee rebuked longstanding claims that the Certification Commission for Healthcare Information Technology bestowed a sort of “Good Housekeeping seal” to certified EMRs, and recommended that there be other certification entities.

As the Health IT Policy Committee was issuing its plan, the Clinical Quality Workgroup of the affiliated Health IT Standards Committee was recommending 31 standards for performance and data capture that can help demonstrate meaningful use. Most already have the endorsement of the National Quality Forum.

Above article published on

http://www.fierceemr.com/story/meaningful-use-proposal-would-extend-deadlines-open-certification/2009-07-23

By Neil Versel

Dr. David Blumenthal, the national coordinator for health information technology, gave a strong indication of how HHS ultimately will define “meaningful use,” the standard that providers must meet to be eligible for Medicare and Medicaid EMR bonuses, by warning that hospitals unwilling to share data with others risk being shut out of the stimulus funding. “There’s a fair amount of money in the law for hospitals that adopt interoperability,” the Dallas Morning News quotes Blumenthal as saying. “If they don’t, they’re not likely to be eligible for payment.”

Although the three largest hospital operators in the Dallas-Fort Worth are implementing EMRs, there is no means for health information exchange between the systems or with smaller providers. The Dallas-Fort Worth Hospital Council is only now working on an HIE feasibility study, and is seeking grant funding to lay the groundwork for data sharing, the newspaper reports.

In McAllen, TX, recently named the second-most-expensive healthcare market in the country, one physician executive believes that interoperability could help rein in some of the spending.

Let me know for further assistance.

http://www.fierceemr.com/story/blumenthal-must-share-data-get-stimulus-money/2009-06-25

The U.S. healthcare system works better for insurance companies than it does for citizens, President Barack Obama wrote in a New York Times op-ed piece Sunday.

Obama said Congress must pass healthcare reform this year to weaken the power of insurance companies and protect the millions of U.S. residents who lack insurance or pay too much for it.

“If we maintain the status quo, we will continue to see 14,000 Americans lose their health insurance every day,” Obama wrote. “Premiums will continue to skyrocket. Our deficit will continue to grow. And insurance companies will continue to profit by discriminating against sick people.”

Under his administration’s plan, those without health insurance would have a choice of affordable coverage whether they move, change jobs or lose their job, he said.

Healthcare costs would be reduced by cutting hundreds of billions of dollars in waste from Medicare and Medicaid while eliminating unwarranted subsidies to insurance companies, Obama wrote, adding Medicare would be made more efficient by ensuring tax dollars go directly to care for seniors instead of going to insurance companies.

“I don’t believe anyone should be in charge of your healthcare decisions but you and your doctor — not government bureaucrats, not insurance companies,” Obama said.

Above article published on

http://www.upi.com/Top_News/2009/08/16/Obama-Urgent-need-for-healthcare-reform/UPI-89131250438328/

President Obama held a town hall meeting in New Hampshire today, Tuesday, August 11, in an effort to calm fears over the Democrats’ legislative initiatives to reform healthcare in this country. The meeting was structured, and no visible emotional outbursts were seen as in other meetings with lawmakers across the country.

Obama answered questions posed by attendees, emphatically telling the audience that the current healthcare system solely benefits the insurance industry. With 46 million in the country without health insurance, he tried to reassure his audience that they would be able to keep their current coverage and doctor and that the government would not be “in charge”. Obama hammered on the fact that the government and insurance bureaucrats should not be meddling, that pre-existing conditions will be covered and that insurance companies would not be able to drop or deny coverage or water down coverage. Many of the questions on voter’s minds that were expected to be answered, especially with respect to employers and small businesses, were not addressed.

Numerous recent polls show support for healthcare reform is eroding, and the President’s numbers are dropping as well over fears that a government takeover of our healthcare system in the U.S. will lead to a Canadian style system with long waits for treatments and referrals.

The President’s message today was supposed to address people who already have insurance through their employers and highlight how his proposals would affect them. HAI monitored the town hall meeting and didn’t find the retool of the White House message to have answered those questions. Another town hall meeting with Obama is scheduled for Bozeman, Montana on Friday, and on Saturday, Obama will be in Grand Junction, Colorado.

Meanwhile, the White House has opened a Reality Check website with a viral tool aimed at online healthcare combat on everything from rationing to euthanasia. The website incorporates lessons learned from the Obama presidential campaign, and shows the White House is becoming more aggressive in dispelling what they call misinformation in the healthcare debates.

The August Congressional Recess is not even half over, and Democratic lawmakers are very much at risk of losing control of the public debate over healthcare reform, facing wary constituents and facing a barrage of accusations and criticism over their writing of the legislation prior to leaving Washington. Powerful groups on both sides of the debate are using the August recess to hammer home to lawmakers that there are very serious political consequences to the healthcare issue.

Senators working on a yet to be released draft bill said earlier this week that President Obama would like to get something passed for healthcare reform and then start negotiating in a House-Senate conference committee. Some Democrats support the public option, but it will be a tough sell for Republicans if they want to get a bill through the Senate. The flashpoint in the debate has become the question of whether a healthcare overhaul should include a public option. As the debate rolls on, Americans are questioning what the shape and size of the government’s role in the economy should be, especially on the heels of Congress passing three massive economic stimulus bills.

Above article published on

http://www.rotor.com/Default.aspx?tabid=510&newsid905=61983

Today, the Health IT Policy Committee approved a work group’s revised recommendations for defining “meaningful use” of electronic health records, Health Data Management reports.

The federal economic stimulus package requires hospitals and physicians to demonstrate meaningful use of EHRs to qualify for Medicare and Medicaid incentive payments.

The work group released its initial draft recommendations last month.

Revised Benchmarks

For the new recommendations, the work group revised objectives for EHRs to meet by certain deadlines. The revised 2011 criteria call for qualified health care providers to:

• Allow patients to access their health records in a timely manner;
• Develop capabilities to exchange health information where possible;
• Implement at least one clinical decision support rule for a specialty or clinical priority;
• Provide patients with electronic copies of discharge instructions and procedures;
• Submit insurance claims electronically; and
• Verify insurance eligibility electronically when possible.

The group also called for health care providers to allow all patients to access personal health records by 2013, two years earlier than under the initial recommendations.

In addition, the revised recommendations include an objective for all providers to participate in a national health data exchange by 2015.

Sliding Scale

For the new recommendations, the work group suggested that health care providers could meet the EHR adoption benchmarks on a shifted timeline.

For example, if a health care provider first started implementing health IT processes in 2012, the 2011 criteria would apply to the provider’s first adoption year. The 2013 criteria then would apply to the provider’s third adoption year.

CPOE

The work group also clarified criteria related to computerized physician order entry systems.

The new recommendations call for health care providers to use CPOE systems for 10% of all orders of any type.

However, the work group did not offer guidance on whether the 10% requirement would apply to each individual order type or all orders in total.

HIPAA

In addition, the new recommendations clarify how violations of the HIPAA medical privacy rule could affect incentive payments.

The work group recommended that CMS withhold incentive payments from health care providers until HIPAA violation charges are resolved.

Next Steps

The revised meaningful use recommendations now go to the Office of the National Coordinator for Health IT and other HHS units.

HHS will use the recommendations to help shape regulations regarding the federal incentive programs.

The federal government is expected to release a proposed rule by the end of 2009 (Goedert, Health Data Management, 7/16).

Blumenthal Notes Progress on Health IT

In related news, National Coordinator for Health IT David Blumenthal on Wednesday said HHS is moving forward on efforts to promote health IT adoption among medical providers nationwide.

Speaking during an event at the Center for American Progress, Blumenthal said ONC is prioritizing efforts to define meaningful use of EHRs.

Blumenthal said his office will publish a notice of proposed rulemaking on meaningful use within several months. Stakeholders then will have an opportunity to submit public comment before officials finalize the definition in early 2010, he added.

Coming Up

Next week, the Health IT Standards Committee will meet to discuss criteria for relating meaningful use to equipment and manufacturing decisions. HHS aims to release certification criteria by the end of the year, Blumenthal said.

Blumenthal added that ONC will unveil its plans for a health IT infrastructure this summer. He said the office also will release a blueprint for developing a health data exchange (Noyes, CongressDaily, 7/15).

Above article published on

http://www.ihealthbeat.org/Articles/2009/7/16/Health-IT-Policy-
Panel-Approves-Revisions-on-Meaningful-Use.aspx