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.

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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.

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

HDM Breaking News

The Centers for Medicaid and Medicaid Services has sent a letter to all state Medicaid directors to provide initial guidance on upcoming Medicaid EHR incentive payments. Under the American Recovery and Reinvestment Act, hospitals and physicians that treat a qualifying number of Medicaid patients can apply for incentive payments based on their meaningful use of electronic health records.

The letter points out that states may immediately apply for federal funds to pay for 90% of administrative planning activities. It spells out criteria to receive the funding.

“This letter, including the enclosures, will provide preliminary guidance on state expenses related to activities in support of the administration of incentive payments to providers,” CMS states. “More information will be forthcoming through guidance and rulemaking regarding state administrative expenses and provider incentive payments. We intend to published proposed regulations to address the steps outlined in this letter by the end of the year.”

Other points of interest in the letter include:

• States should coordinate activities with their CMS regional office to reduce confusion of the Medicare and Medicaid incentive programs and maximize the ability to advance health I.T.;
• States should view Medicaid planning activities as part of larger evolving state health I.T. efforts; and
• States must settle a range of issues before they can begin making incentive payments. For instance, providers using certified EHRs are not eligible for Medicaid incentive payments unless the EHR is compatible 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.”

The letter and accompanying documents are available at cms.hhs.gov/Recovery/11_HealthIT.asp.

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http://www.healthdatamanagement.com/news/stimulus-38922-1.html

Market research firm INPUT has just released a report, forecasting an increase in health information technology use among state governments from FY2009 through FY2014. The expected growth rate for the state and local market will be around 4.6 percent, increasing the health IT market value from $7.6 billion to $9.6 billion.

According to INPUT’s “Health IT Transformation: FY2009-FY2014 State and Local Market Forecast,” electronic health records (EHRs) at public hospitals and health organizations will be the primary driver for growth opportunity. Spending on EHR systems is projected to expand from $850 million this year to $1.85 billion in 2014. But EHRs are not the only health IT tools state and local agencies are interested. INPUT found there are at least fourteen different types of health IT products and services, including software and systems for clinical data, labs and pharmacies, patient tracking, decision support, telehealth, health information exchange, and disease outbreak management.

The American Recovery and Reinvestment Act will also push the health IT vertical market and EHR adoption, INPUT found, increasing agencies’ use from 2009 to 2013 with a 17 percent compound growth rate over the period. Other forces shaping the market include the states’ budget crunch, President Obama’s healthcare reform and other national health initiatives, EHR standards and certification rulings, as well as Health IT interoperability standards.

INPUT’s report also painted a complex picture for the market’s funding. There are at least three federal sources of funding, including the Recovery Act, Medicaid supplemental payments and annual budgets. And to complicate matters further, there are eleven or more different open hands asking for those funds at the state and local level, including hospitals, clinics, regional health organizations, mental health facilities, Medicaid, children’s health programs, prisons and IT departments.

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http://civsourceonline.com/2009/08/28/state-and-local-health-it-market-to-reach-9-6b-in-2014/

Money would go toward setting up key infrastructure to help physicians choose and use the right EHR.

By Chris Silva, AMNews staff..

Washington — The Obama administration will make available nearly $1.2 billion in federal grants to create a large network of regional health information technology centers and state-based entities to support physicians and hospitals as they acquire and implement electronic health records systems that meet federal standards.

Physicians and hospitals need to have an EHR system in place that meets “meaningful use” standards if they hope to be eligible for the billions in Medicare and Medicaid bonuses available starting in 2011 through the economic stimulus package adopted earlier this year. The grants announced Aug. 20 by the Dept. of Health and Human Services and Vice President Joe Biden are designed to provide a supportive framework to help entities meet those standards, which will be proposed before the end of the year.

David Blumenthal, MD, the national health information technology coordinator, said the new money is intended to help create a national, private and secure EHR system.

“The grants are designed to help doctors and hospitals acquire electronic health records and use them in meaningful ways to improve the health of patients and reduce waste and inefficiency,” he said. “They will also help states lead the way in creating the infrastructure for health information exchange, which enables information to follow patients within and across communities, wherever the information is needed to help doctors and patients make the best decisions about medical care.”

Helping small practices

Under the first of the two new grant programs, nearly $600 million will be used to establish approximately 70 health IT regional extension centers. The entities will offer technical assistance, guidance and information on best practices to help physicians and hospitals more quickly become meaningful EHR users.

The regional centers will focus on helping primary care clinicians, with a particular emphasis on individual and small-group practices. Clinicians in such practices deliver the majority of primary care services but have the lowest rates of EHR adoption, and the least access to resources to help implement and use such systems, according to HHS.

“Expanding the use of electronic health records is fundamental to reforming our health care system,” said HHS Secretary Kathleen Sebelius. “Electronic health records can help reduce medical errors, make health care more efficient and improve the quality of medical care for all Americans.”

The performance of each regional center will be evaluated every two years by an HHS-appointed panel of experts. EHR industry observers are encouraged by the centers, which they say will help physicians and hospitals select certified paperless records systems that offer the best value for their needs.

“That guidance definitely needs to be there, because most providers are struggling with what they need to do, and how to do it,” said Bruce Taffel, MD, vice president and chief medical officer for SharedHealth, a vendor of health information products and solutions based in Chattanooga, Tenn. “I think these extension centers will be a helpful piece of this.”

The regional extension center grants will be awarded on a rolling basis, with the first awards issued in fiscal 2010, HHS said.

Focus on interoperability

The second grant program will provide more than $560 million to states starting next fiscal year through cooperative agreements to create a widespread and sustainable health information exchange.

Legal, financial and technical support is necessary to enable secure exchange of sensitive patient data across health care systems, according to HHS. The program will help fund efforts at the state level to implement directories and technical services to enable interoperability within and across states. Some health IT experts say such assistance is vital in helping physician practices become meaningful users.

“I think this has tremendous potential to help improve the health IT infrastructure of the country,” said Marc Probst, chief information officer with Intermountain Healthcare, a nonprofit system of hospitals and clinics based in Salt Lake City.

“A large concern is clearly the ability for people who don’t have technical expertise to implement these systems,” said Probst, who also is a member of the Health Information Technology Policy Committee, an advisory board established this year that makes recommendations to Dr. Blumenthal and his staff. “In just about every interview I’ve had with doctors, physician groups and even hospital chains, the ability to exchange data between systems was high on everyone’s list.”

Probst said he’s very concerned about physician groups and hospitals who may not have the resources to implement an EHR that meets meaningful use standards, though he believes the policy committee’s recommendations approved by Dr. Blumenthal earlier in August will be very close to what the Obama administration proposes in regulation later this year.

Dr. Blumenthal said more announcements will be made within months regarding additional grant programs to assist with EHR implementation.

Above article published on

http://www.ama-assn.org/amednews/2009/08/31/gvsb0831.htm

Source: US National Governors’ Association

As the national dialogue on health care reform continues, health information technology (IT) and health information exchange (HIE) have emerged as critical means to ensuring a health care system that is affordable, effective, safe and transparent. A new report from the State Alliance for e-Health, Preparing to Implement HITECH: A State Guide for Electronic Health Information Exchange, aims to help states lead the way in using health IT and HIE and guide them as they begin instituting the federal Health Information Technology for Economic and Clinical Health (HITECH) Act.

The State Alliance for e-Health, a consensus-based, executive-level body composed of governors, state legislators, attorney generals and state commissioners, was created by the NGA Center for Best Practices in 2006 to address the unique role states can play in facilitating adoption of health IT and HIE. The HITECH Act, enacted as part of the 2009 American Recovery and Reinvestment Act, expands the role of states in fostering health information exchange and adoption of electronic health records over the next five years.

“Governors understand that swift and thoughtful action is needed at the state level to plan and implement a national system of health information exchange, “said Tennessee Gov. Phil Bredesen, co-chair of the State Alliance. “Widespread adoption and use of electronic health records provide a critical foundation for improving health outcomes and cost-effectiveness.”

The report recommends actions states should begin undertaking now to successfully implement the HITECH Act, including:

• Preparing or updating the state plan for HIE adoption;
• Engaging stakeholders;
• Establishing a state leadership office to manage the different phases of HIE implementation;
• Preparing state agencies to participate; implementing privacy strategies and reforms;
• Determining the HIE business model;
• Creating a communications strategy; and
• Establishing opportunities for health IT training and education.

“States already have taken the lead in modernizing the health care system by advancing the use of health IT, electronic health records, e-prescribing and electronic exchange of health information,” said Vermont Gov. Jim Douglas, NGA Chair and co-chair of the State Alliance. “We now have an opportunity to accelerate adoption of health IT across the states and create a truly comprehensive health care system that is effective, affordable and accountable.”

The report and state initiatives to implement health IT and electronic HIE will provide a central focus for the State Alliance for e-Health’s semi-annual conference, to be held August 7 in Burlington Vermont.

The State Alliance – supported by funding from the U.S. Department of Health and Human Services – provides a nationwide forum through which governors, state policymakers and other stakeholders can work together to identify effective HIT policies and best practices and explore solutions to challenges related to the exchange of health information.

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http://www.egovmonitor.com/node/27565

Looks like Big Brother is finally coming to the Bluegrass State. Governor Steve Beshear announced last week that state government would begin compiling the health records of all Kentuckians in a central computer data base. What could possibly go wrong?

To coincide with the Obama administration’s plan to implement a system of health information technology (HIT), Gov. Beshear has created the Governor’s Office of Electronic Health Information within the Cabinet for Health and Family Services (CHFS), to serve as single point of contact on Kentucky’s health information technology efforts

In anticipation of congressional action on proposals to establish a national health care system, Obama’s administration is calling for universal adoption of electronic health records by 2014. To access stimulus funds to support HIT, states are being forced to have the technology and other infrastructure in place to support electronic health records (EHR) and HIT. “President Obama has made health care reform one of his top priorities, and health information exchange is a cornerstone of a national goal to improve health care quality,” Gov. Beshear said. “Many of our health care providers practice independently or in small groups and are located in rural areas. Our challenge is to bring together Kentucky’s stakeholders to assure that the development and use of health information exchange meets federally defined standards for privacy and security and to assure stakeholders that health information exchange is interoperable, sustainable and dependable.”

hose “stakeholders” include the state’s three regional health information organizations (RHIOs), hospitals, physicians, heath care practitioners and other providers, consumers, private insurance companies, and all others who participate in the exchange of health information. In other words, the state will control access to the medical records of every man, woman, and child in the Commonwealth.

The Kentucky E-Health Network Board (EHNB), which is administratively attached to the Cabinet for Health and Family Services, will also serve as an integral resource to the Office as it moves forward. The EHNB will compile a central database of all physician, hospital, pharmacy and medical insurance records, and will control access to this database. As yet, the EHNB will have no authority over distribution of medical services, or eligibility determination. Nothing in the Governor’s proposal empowers the EHNB to limit end-of-life health care services.

“The Governor’s action will allow the Commonwealth to be in a position to apply for federal stimulus funds for planning and implementation of health information exchange to support infrastructure and build resource capacity, particularly for underserved communities, said CHFS Secretary Janie Miller. “Initially, the office will be created by assigning existing resources within the Cabinet. Once efforts are underway it is expected that all states will receive federal stimulus dollars to expand our activities to fully plan and implement health information technology.”

“Kentucky has established a strong vision for the future of e-health in our state. The new Governor’s Office of Electronic Health Information can effectively take that vision to reality,” Gov. Beshear said. “We will respond quickly to opportunities that will afford our important health industry to take full advantage of incentive funds available under ARRA.”

Naturally, the Cabinet for Health and Family Services and the Kentucky E-Health Network Board, will limit access to the confidential information in this database; just as the FBI and the IRS closely guard their databases. After all, these files will contain detailed information about the health of each Kentuckian; along with everything a citizen tells his physician or psychiatrist, and everything the doctor tells his patients.

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http://www.examiner.com/x-3747-Louisville-City-Hall-Examiner~y2009m8d16-Kentucky-government-to-compile-citizens-health-records

By Neil Versel

Vice President Joe Biden, HHS Secretary Kathleen Sebelius and national health IT coordinator Dr. David Blumenthal are in Chicago today to announce $1.2 billion in federal grants to promote EMR use and interoperability. The money represents the bulk of the $2 billion in stimulus funds allocated to the Office of the National Coordinator for Health Information Technology.

Of the $1.2 billion, the administration plans to spend $589 million on health IT extension centers to assist hospitals physician practices in selecting and implementing EMRs. The other $564 million will go to encourage health information exchanges and help build the Nationwide Health Information Network. “Electronic health records can help reduce medical errors, make healthcare more efficient and improve the quality of medical care for all Americans. These grants will help ensure more doctors and hospitals have the tools they need to use this critical technology,” Sebelius says.

The administration officials are speaking at Mount Sinai Hospital, an aging facility in an impoverished West Side neighborhood, where just 7 percent of patients have commercial insurance. Biden is leading a roundtable discussion on comprehensive healthcare reform, focusing, in part, on health IT infrastructure, his office says.

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http://www.fierceemr.com/story/biden-sebelius-blumenthal-announce-funding-emr-extension-centers-hie/2009-08-20