By Brian Robinson,

The Centers for Medicare and Medicaid Services is still on target to publish by the end of the year a proposed rule on the meaningful use of electronic health records, despite growing fears from industry about the possible impact of the regulation.

Tony Trenkle, director of the Office of e-Health Standards and Services at CMS, said he had been spending a lot of time with health industry folks who have expressed “concerns and fears” about what will be in the regulation.

Those include how high the bar will be set for meeting meaningful use targets during the first year of implementation, and whether the industry will be able to meet them, he told a meeting today of National Committee on Vital and Health Statistics (NCVHS).

Other concerns include whether hospitals outpatient clinics would be eligible to receive separate payments, whether quality measures will disadvantage specialty health providers, and worries particularly by the states about whether CMS would be able to harmonize Medicare and Medicaid requirements.

Under the HITECH Act, a part of the American Recovery and Reinvestment Act, health care providers can receive payments from both the Medicare and Medicaid programs if they can demonstrate meaningful use of certified EHRs. Payments are due to begin in 2011.

One of the major outcomes of the Nov. 19-20 NCVHS meeting is expected be a letter setting out recommendations to the Secretary of the Health and Human Services for measures that can be applied to decide on just what meaningful use is.

They include commissioning a “fast track” study from the Institute of Medicine on a national strategy for quality measurement development, to begin a process to identify essential data elements, to require EHR vendors to use defined quality data elements, and to require that any certified EHR be able to add data elements that may be defined in the future.

The NCVHS expects to release the final version of the letter at the Nov. 20 conclusion of its meeting.

Above article published on http://www.govhealthit.com/newsitem.aspx?tid=10&nid=72449

By Brian Robinson,

The Centers for Medicare and Medicaid Services is still on target to publish by the end of the year a proposed rule on the meaningful use of electronic health records, despite growing fears from industry about the possible impact of the regulation.

Tony Trenkle, director of the Office of e-Health Standards and Services at CMS, said he had been spending a lot of time with health industry folks who have expressed “concerns and fears” about what will be in the regulation.

Those include how high the bar will be set for meeting meaningful use targets during the first year of implementation, and whether the industry will be able to meet them, he told a meeting today of National Committee on Vital and Health Statistics (NCVHS).

Other concerns include whether hospitals outpatient clinics would be eligible to receive separate payments, whether quality measures will disadvantage specialty health providers, and worries particularly by the states about whether CMS would be able to harmonize Medicare and Medicaid requirements.

Under the HITECH Act, a part of the American Recovery and Reinvestment Act, health care providers can receive payments from both the Medicare and Medicaid programs if they can demonstrate meaningful use of certified EHRs. Payments are due to begin in 2011.

One of the major outcomes of the Nov. 19-20 NCVHS meeting is expected be a letter setting out recommendations to the Secretary of the Health and Human Services for measures that can be applied to decide on just what meaningful use is.

They include commissioning a “fast track” study from the Institute of Medicine on a national strategy for quality measurement development, to begin a process to identify essential data elements, to require EHR vendors to use defined quality data elements, and to require that any certified EHR be able to add data elements that may be defined in the future.

The NCVHS expects to release the final version of the letter at the Nov. 20 conclusion of its meeting.

Above article published on http://www.govhealthit.com/newsitem.aspx?nid=72449

By: Howard Anderson, HDM Breaking News

Although the federal economic stimulus package will spur an increase in spending on clinical applications in the months ahead, many hospitals and clinics are now taking their time studying their options, two researchers say.

“The steady drumbeat of inevitability is changing the debate from not ‘if’ we’ll get an electronic health record but ‘when’,” says Eric Brown, research director at Forrester Research Inc., Cambridge, Mass. “There’s a tipping point at which we’ll see big growth, but we’re not there yet.”

Because of the conservative nature of health care organizations, the growth in demand will be “a slow, steady progression” rather than a spike, Brown contends. “Health care rarely meets pundits’ expectations for growth.”

Under the American Recovery and Reinvestment Act, hospitals and physician group practices can qualify for billions of dollars in extra payments from Medicare and Medicaid if they make meaningful use of qualifying electronic health records systems. But to achieve maximum payments, they must hit certain deadlines. For example, physician groups must have a qualifying EHR system in place by 2012.

“What we’re seeing now is a lot of intense research going on” at hospitals and clinics, says Chris O’Neal, director of corporate reporting at KLAS Enterprises, an Orem, Utah-based research firm that rates provider satisfaction with software. “The spike in demand is coming.”

A KLAS survey in May of 155 health care CIOs and other executives regarding the stimulus incentives found that 43% had no plans for immediate changes but were watching the market, while 30% said the stimulus likely would speed up their I.T. investments.

Providers are doing careful research on EHR vendors, O’Neal believes, because “they cannot afford a misstep” which might cause them to miss a critical deadline for qualifying for a stimulus payment.

Among hospitals, O’Neal expects strong demand for computerized physician order entry systems, which most organizations lack, as well as clinical documentation for nurses. The stimulus program likely will require both of these components for hospitals to qualify for EHR incentive payments, he notes.

Brown says many hospitals will face a difficult challenge when persuading physicians to actually use CPOE. “Will they pay physicians a percentage of the money they get from the stimulus if they use CPOE?” Brown asks. “I’m not sure.”

O’Neal says many smaller clinics will consider using remotely-hosted EHRs accessible over the Internet. Brown says this model could prove attractive to risk-averse small practices with limited budgets that want to get a piece of the stimulus action.

Above article published on

http://www.healthdatamanagement.com/news/stimulus-38773-1.html