Category — HITECH Act

Practices that have been waiting for CMS to define the term “meaningful use” are finally in luck. But as is always the case when the feds are involved, don’t look for a quick one-sentence definition.

The American Recovery and Reinvestment Bill of 2009 (ARRA) offers annual bonuses to practices that show “meaningful use” of electronic health records, and in 2015, practices that aren’t showing meaningful use will face penalties.

On Dec. 29, CMS and the Office of the National Coordinator for Health Information Technology announced that the definition was finally available for public comment. “CMS’s proposed regulation would define and specify how to demonstrate ‘meaningful use’ of EHR technology, which is a prerequisite for receiving the Medicare incentive payments,” said Charlene Frizzera, CMS’s acting administrator, in a Dec. 30 statement.

25 measures: Stage 1 of the meaningful use criteria (which begins in 2011) includes 25 objectives/measures for eligible professionals (most Part B practices fall under this category) and 23 objectives/measures for eligible hospitals. To be considered a meaningful EHR user, you must meet all of the criteria set forth.

For example: The following includes just a sampling of what you’ll find in the list of 25 meaningful use criteria for stage one of the incentive program. To read the complete list, check out the proposal in the Federal Register.

• Use a computer physician order entry (CPOE)
• Implement drug-drug, drugallergy, drug-formulary checks
• Maintain an up-to-date problem list of current and active diagnoses based on ICD-9 or SNOMED CT
• Generate and transmit permissible prescriptions electronically
• Maintain an active medication list
• Maintain an active medication allergy list
• Record demographics (preferring language, insurance type, gender, race, ethnicity, and date of birth)
• Record and chart changes in vital signs
• Record smoking status for patients age 13 and older
• Incorporate clinical lab test results into EHR as structured data
• Generate lists of patients by specific conditions
• Report ambulatory quality measures to CMS
• Send reminders to patients for preventive follow-up care (per patient preference)
• Implement five clinical decision support rules relevant to specialty or high clinical priority
• Check insurance eligibility electronically from payers
• Submit claims electronically.

Keep in mind: You can not only qualify for a financial bonus if you use EHRs — but you could also boost your practice’s efficiency, CMS says. “Widespread adoption of electronic health records holds great promise for improving health care quality, efficiency, and patient safety,” said David Blumenthal, MD, national coordinator for health information technology, in a Dec. 30 statement.

CMS will accept public comments on the rule for 60 days, either electronically or by mail (CMS, Department of Health and Human Services, Attention: CMS-0033-P, P.O. Box 8013, Baltimore, MD 21244-8013). If you do submit comments, refer to ID CMS-0033-P.

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HDM Breaking News, By - Joseph Goedert

The meaningful use workgroup of the HIT Policy Committee has released its initial recommendations for a definition of “meaningful use” of electronic health records. The definition is important because under the economic stimulus law, providers must “meaningfully use” EHRs to receive financial incentives from Medicare and Medicaid.

These initial recommendations do not include a formal definition of meaningful use. But they are the initial recommendation of the functionalities that will be required by 2011 when incentives start. “This is the beginning of a conversation that will continue for some time,” said David Blumenthal, M.D., the national coordinator for health information technology, during a meeting of the HIT Policy Committee, a public-private advisory group. Blumenthal added that “there is a long way to go” before a final definition of meaningful use is achieved.

The workgroup’s initial recommendations include 22 objectives–most covering inpatient and outpatient care–for EHRs in 2011. These include, among others:

• Use CPOE for all order types including medications;
• Implement drug-drug, drug-allergy and drug-formulary checks;
• Maintain an up-to-date problem list;
• Generate and transmit permissible prescriptions electronically;
• Maintain an active medication allergy list;
• Send reminders to patients per their preference for preventive and follow-up care;
• Document a progress note for each encounter;
• Provide patients with an electronic copy or electronic access to clinical information such as lab results, problem list, medication lists and allergies;
• Provide clinical summaries for patients for each encounter;
• Exchange key clinical information among providers of care;
• Perform medication reconciliation at relevant encounters;
• Submit electronic data to immunization registries where required and accepted;
• Provide electronic submissions of reportable lab results to public health agencies;
• Provide electronic surveillance data to public health agencies according to applicable law and practice; and

• Comply with federal and state privacy/security laws and the fair data sharing practices in HHS’ Nationwide Privacy and Security Framework, released in December 2008.

The HIT Policy Committee will make the final recommendations on meaningful use definitions to the Department of Health and Human Services and the Centers for Medicare and Medicaid Services.

HHS is mandated to publish an interim final rule for standards, implementation specifications and certification criteria of EHRs that qualify for financial incentives by the end of 2009. CMS will develop the formal definition of meaningful use to support the incentive programs. CMS will go through the full administrative rules process with a proposed rule, public comment period and a final rule. A timetable was not given.

The recommendations from the meaningful use workgroup include a matrix of objectives for 2011, plus enhanced objectives for 2013 and 2015. The workgroup will refine the initial recommendations for 2011 and 2013 within three months.

The meaningful use workgroup also has laid out an “achievable vision” for benefits to be realized by 2015. These include reductions in heart attacks, medical errors, and preventable hospitalizations.

For more information, click here. Scroll down and click on “meaningful use preamble” and “meaningful use matrix.” Updates from certification/adoption and information exchange workgroups also are available.

Above article published on http://www.healthdatamanagement.com/news/meaningful_use-38487-1.html

Health and Human Services Secretary Kathleen Sebelius has awarded grants totaling $27.8 million to health center-controlled networks and large multi-site health centers to implement electronic health records and other health information technology.

“The increased use of health information technology is a key focus of our reform efforts because it will help to improve the safety and quality of healthcare generally while also cutting waste out of the system,” she said.

The funds are part of the $2 billion allotted to HHS’ Health Resources and Services Administration under the American Recovery and Reinvestment Act of 2009 (ARRA) to expand healthcare services to low-income and uninsured individuals through its health center program.

“These funds to expand and upgrade electronic health records systems will make a huge difference for health centers struggling to provide healthcare to the growing number of people in need,” said HRSA Administrator Mary Wakefield.

Eighteen grants totaling more than $22.6 million will support EHR implementation, and another $2.6 million will help four grantees implement a variety of health IT innovations. This includes the creation of health information exchanges and the incorporation of health IT at dental delivery sites. Another five grants, totalling more than $2.5 million, will help health centers devise plans to use existing EHRs to improve patient health outcomes.

“Broad use of health information technology has the potential to improve healthcare quality, prevent medical errors and increase the efficiency of care provision,” said David Blumenthal, the national coordinator for health information technology. “This program supports the department’s overall efforts to assist physicians and hospitals in adopting and becoming meaningful users of health information technology.”

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JMolly Merrill, Associate Editor

First Lady Michelle Obama announced the release of $851 million in grants to Community Health Centers on Monday.

The Recovery Act Capital Improvement Program (CIP) grants will support the construction, repair and renovation of more than 1,500 health center sites nationwide. More than 650 centers will use the funds to purchase new equipment or health information technology systems, and nearly 400 health centers will adopt and expand the use of electronic health records.

“For centers around the country, these Recovery Act grants will mean new diagnostic equipment, renovation of facilities that need repair, expanding computer centers to help manage electronic medical records, adding on new staff (and) expanding programs that work. And over the next two years, Recovery Act dollars for community health centers will expand desperately-needed services to more than 2.8 million people,” said Obama, who made the announcement while visiting Unity’s Upper Cardozo Health Center in Washington.

The CIP grant awards are the third set of health center grants provided through the American Recovery and Reinvestment Act.

“And there’s another part of this equation beyond health,” continued Obama. “When Unity builds those 20 new exam rooms, they’ll be creating jobs and putting people to work in construction and renovation. When a health center in rural Illinois purchases a new computer center, it’s going to keep a programmer in the Silicon Valley on the job. So as we provide quality healthcare to more people, there will be this multiplier effect that will also provide more jobs to more workers.”

“Just think about the impact of all these Recovery Act grants all over the entire country. Every single health center that applied for a grant will receive at the very least $200,000. And every dollar of every grant is going to make a difference in the life of someone in need,” Obama said

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Diana Manos, Senior Editor

Getting healthcare IT up and running in doctors’ offices is not the main objective behind the incentives provided by the federal government under the American Recovery and Reinvestment Act, according to David Blumenthal, MD, national coordinator of health information technology.

Improving health is.

At the 17th Annnual National HIPAA Summit held Sept. 15-18 in Washington, D.C., Blumenthal called the HITECH Act — included in ARRA — “brilliant” and “a visionary piece of legislation.” With $20 billion allotted to the advancement of healthcare IT, he said, the law would lay the foundation for health reform in the nation.

The United States has never spent this kind of money on sharing health information and protecting it, he said.

Blumenthal told attendees at the summit how he came to embrace the importance of healthcare IT. He had never been a technologically oriented person, he said, but was asked seven years ago by the hospital where he worked to learn how to use an electronic health record.

“It wasn’t easy,” he said. “But I soon learned it was an enormous boon to me to be able to access my patients’ records outside of the office.”

Blumenthal said he started using EHRs in his practice and noticed it changed the way he was able to take care of his patients. He could access specialists’ reports, lab results and medications. “I knew more about my patients. I could tell my patients things they needed to know and couldn’t know in a timely way from their specialists,” he said. “Those are things that had real value to me as a clinician and to my patients. That is the value that made me convinced that these technologies were going to benefit me as a clinician.”

Privacy is critical, Blumenthal added, and “absolutely foundational” to realizing the vision that the Obama administration has for improving healthcare through healthcare IT. The advancement of healthcare IT through ARRA will only be successful, he said, if the public has confidence in the privacy and security of their personal health information and if physicians buy in.

“The use of IT has professional competence at its core, ” he said. “I believe in the future my colleagues will see value in healthcare IT. Treating medicine is about information. Part of competence will be knowing how to protect (personal health) information, and another part will be knowing how to access it.”

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