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 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

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.”

Above article published on

http://www.healthcareitnews.com/news/hhs-releases-28m-arra-funding-accelerate-health-it

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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By: Roy Mark

While the Obama administration’s drive to dramatically increase health IT spending portends a financial bonanza for vendors, the boom will not come without risks, says Input.

The U.S. health IT market is set for disruptive change, predicts a report by Input released Sept. 10. The key drivers of the change will occur “as the American Recovery and Reinvestment Act and national health care legislation increase the need for innovative health care technology that also reduces costs,” according to Input’s statement. Compounding the change will be the addition of the baby boomers to the swelling ranks of Medicare and Medicaid recipients.

“As the federal government begins analyzing the data collected through EHR [electronic health records] systems, a wide array of new health care IT market opportunities will emerge for vendors,” Tim Dowd, Input’s CEO, said in the statement. “This includes companies supplying health information systems, decision support automation, data warehousing, data mining tools and middleware to connect EHRs to regional information exchange organizations and other internal systems.”

According to Input, the federal budget combined with the deficit “will drive growth opportunities in the health care IT market as technology offers the ability to dramatically cut health care costs. Simultaneously, the stimulus package is setting the groundwork for the next stages of IT investment by making $2 billion available for the Office of the National Coordinator of Health IT (ONC). Input’s research also predicts that the Obama administration’s push for greater adoption of … [EHR] systems will open up adjacent IT market opportunities.”

Disruptive change, though, also brings risks, among them possible public and provider backlash over “the costs of buying and maintaining systems, and training staff to manage and oversee a new federal health care program; … the additional work needed to ensure security and privacy of data, since it will be transferred among different providers; and … building IT systems that track health outcomes to satisfy the federal government’s desired method of compensating providers,” Input said in its statement.

“The Obama administration’s efforts to forge ahead with an aggressive health care IT improvement plan are not without their challenges,” Dowd said. “Whatever form the country’s health care reform legislation ultimately takes, it will create the need for more technology innovation, which will require planning and insight to remain ahead of the curve.”

Input predicts that U.S. state and local government health organizations will increase their investments in health IT systems and services from $7.6 billion in 2009 to $9.6 billion by 2014.

Above article published on

http://www.eweek.com/c/a/Health-Care-IT/Disruptive-Change-Predicted-for-Health-IT-Market-481673/

Bernie Monegain, Editor

CHICAGO – The Obama adminstration’s chief for healthcare IT technology David Blumenthal, MD, was on the healthcare IT message from dawn to dusk Thursday - a part of the White House campaign to save its troubled healthcare reform plans.

The day started with an open letter from Blumenthal about the benefits of electronic health records and ended with another open letter from him on the $1.2 billion HITECH grants that had been announced earlier in the day.

Blumenthal joined Vice President Joseph Biden and Health and Human Services Secretary Kathleen Sebelius at Mt. Sinai Hospital on Chicago’s West Side for a roundtable discussion with nurses, doctors and administrators.

At the forum, the trio announced $1.2 billion in HITECH grants would be released - $598 million to create 70 health information technology extension centers across the country to help physicians and hospitals implement electronic health records and $564 million to help states support the development of health information exchanges.

“This is just the first wave of resources invested in health technology aimed at really transforming our paper-driven system to an electronic system over the next several years, providing help and support for hospitals and doctors as they make this conversion,” Sebelius said.

“It’s no coincidence that these two grant programs are leading the way,” Blumenthal said in this open letter at the end of the day. “Key to the successful adoption and meaningful use of EHRs is the assurance that providers have the help and guidance they need to select, implement and maintain a certified EHR system. In addition, we need the various and often disparate local, statewide and regional systems to work together, regardless of location and differing state and federal standards or policies, to enhance patient care.”

After the roundtable at Mt. Sinai, Sebelius introduced Blumenthal on a teleconference with the media. Blumenthal spoke briefly and responded to questions about concerns over data security and the definition of meaningful use of healthcare IT, a measure that will determine which providers are eligible to receive extra payments from Medicare and Medicaid.

He said the definition would be completed by the end of the year. On the security issue, he said the Health Information Technology Policy Committee would be asked to take up the topic of security soon.

“We understand that is critical,” he said. “The information that is passed within the healthcare system has to be secure or the public won’t have confidence in those electronic health records.”

Above article published on

http://www.healthcareitnews.com/news/blumenthal-healthcare-it-message-dawn-dusk

The Georgia Department of Community Health has begun a series of meetings for the state Medicare Electronic Health Records Community Partnership, a program aimed at increasing EHR adoption among small- and medium-sized physician practices statewide, the department announced on Friday (Department of Community Health press release, 3/28).

The five-year program aims to provide financial incentives to physician groups that use certified EHRs to meet clinical quality measures, according to the Georgia DCH. The state will pay physicians annual bonuses for each year they score on a standardized survey assessing EHR use to support care delivery.

The state’s Medicare EHR Demonstration Project is part of Georgia Gov. Sonny Perdue’s (R) goal of establishing a statewide strategy for health information to be readily accessible and transparent

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http://www.ihealthbeat.org/articles/2008/3/31/Georgia-Begins-Planning-for-Incentive-Program-for-Doctor-EHR-Use.aspx?topicID=54

By Gautham Nagesh

The Centers for Medicare and Medicaid Services will reimburse states that issue incentive payments to health care providers to encourage adoption of electronic medical records, according to guidance released on Sept. 1.

A letter from CMS Director Cindy Mann to state Medicaid directors details a program under the 2009 American Recovery and Reinvestment Act that offers financial incentives for eligible Medicare and Medicaid providers to adopt interoperable electronic health records. Approximately $20 billion will be distributed to providers by 2014, mostly in the form of grants.

The payments will help defray the costs of deploying electronic health record systems and can be used to pay for hardware, software, support services and training. But the grants will not necessarily cover the entire cost of installing such systems.

“The incentive payments are not direct reimbursement for such activities. Rather they are intended to serve as an incentive for eligible providers to adopt and meaningfully use certified EHR technology,” Mann said in her letter.

The funds can be used only for electronic health records technology that is certified and interoperable with state or federal administrative management systems.

“Therefore, states risk making unallowable incentive payments prior to receiving guidance on how to make these systems compatible,” Mann wrote.

States are immediately eligible to request 90 percent reimbursement for administrative costs associated with planning and issuing the payments. But that money comes with significant conditions attached. For administrative reimbursement, states must obtain prior approval from CMS for any planning activities or expenditures. They also must provide documentation demonstrating adequate oversight of their incentive programs.

Under the Recovery Act payments would be limited, based on average costs of setting up electronic health record systems, which have yet to be determined. Mann said the secretary of Health and Human Services will establish guidance on those limits.

CMS plans to issue a proposed rule by the end of the year that will contain more detailed information, and will work with states to determine when they are ready to begin issuing payments.

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http://www.nextgov.com/nextgov/ng_20090904_7905.php?oref=topnews

Analyst predicts a steady rise, fueled by stimulus funds

By Alice Lipowicz

State and local governments, using money provided under the economic stimulus law, will increase spending on health care information technology over the next few years, according to a report from the market research firm Input. The state and local market for the technology is expected to grow to $9.6 billion by 2014, from $7.6 billion in 2009, a compound growth rate of 4.6 percent, the report states.

State and local agencies also are investing in electronic health records systems, which are a primary component of health IT. Their spending on such systems is projected to expand from $850 million this year to $1.85 billion in 2014, according to Input’s “Health IT Transformation: FY2009-FY2014 State and Local Market Forecast,” which was released Aug. 26.

The agencies’ electronic health record spending will spike from 2009 to 2013 due to the economic stimulus law funding and then will level off, with a 17 percent compound growth rate over the period, Input said.

The flow of money for state and local health IT is complicated, with at least three federal sources of funding — the stimulus law, Medicaid supplemental payments and annual budgets — and spending from 11 different types of state and local agencies, including hospitals, clinics, mental health facilities, prisons, regional health organizations, Medicaid, children’s health programs and IT departments.

State and local agencies are buying 14 different types of health IT products and services, including software and systems for EHRs, decision support, clinical data, pharmacy, lab, patient tracking, health information exchange, telehealth, and disease outbreak management, Input said.

The State Alliance for eHealth, which the National Governors Association sponsors, recently encouraged state and local governments to prepare strategies and plans for health information exchange and other components of the economic stimulus law.

Above article published on

http://fcw.com/articles/2009/08/27/state-and-local-agencies-spending-more-on-health-it-input-says.aspx

By Asrat Kebede

Nearly $1.2 billion in economic stimulus law funds are now available as grants for health information technology, Vice President Joe Biden announced today. About half of the funding will go to establish dozens of regional education centers across the country, and the other half will help state agencies set up health information exchange systems.

Congress approved the funding as part of the economic stimulus law to promote the adoption of electronic health record (EHR) systems. Lawmakers included $45 billion in incentive payments to doctors’ offices and hospitals that buy and meaningfully use digital health records, and $2 billion to promote health information exchange.

The Health and Human Services Department will issue rulemaking later this year to define the terms of certification and meaningful use.

“With electronic health records, we are making health care safer; we’re making it more efficient; we’re making you healthier; and we’re saving money along the way, ” Biden said in a statement today.

Grants totaling $598 million will be used to get 70 Health IT Regional Extension Centers up and running. The centers will give hands-on help to doctors and hospital staff in selecting, acquiring and deploying certified EHR systems.

An additional $564 million in grants is available to states to support the development of mechanisms for sharing of patient medical information within a framework of an “emerging nationwide system of networks,” the statement said.

Both sets of grants will be issued starting in fiscal 2010. The extension program grants will be awarded on a rolling basis: 20 in the first quarter of the fiscal year, 25 in the third quarter, and the remainder in the fourth quarter.

HHS will dedicate $50 million to creating the Health IT Research Centers will help the regional extension center identify and share best practices and collaborate with each other, the statement said.

The centers together will support at least 100,000 primary care providers, through participating nonprofit organizations, in achieving meaningful use of EHRs, the statement said.

The health information exchange grants will be awarded through the State Health Information Exchange Cooperative Agreement Program. States may choose to enter multistate arrangements. State agencies will be required to provide matching funds starting in 2011.

A group sponsored by the National Governors Association recently advised state agencies to begin their planning on health information exchanges, which will be required to achieve meaningful use of digital health records.

Above article published on

http://www.ethiopianreview.com/scitech/1620