Key step in national initiative toward adoption of electronic health records

The Certification Commission for Health Information Technology (CCHIT), Chicago, Ill. and the Drummond Group Inc. (DGI), Austin, Texas, were named today by the Office of the National Coordinator for Health Information Technology (ONC) as the first technology review bodies that have been authorized to test and certify electronic health record (EHR) systems for compliance with the standards and certification criteria that were issued by the U.S. Department of Health and Human Services earlier this year.

Announcement of these ONC-Authorized Testing and Certification Bodies (ONC-ATCBs) means that EHR vendors can now begin to have their products certified as meeting criteria to support meaningful use, a key step in the national initiative to encourage adoption and effective use of EHRs by America’s health care providers.

“Less than two months following the issuance of final meaningful use rules, we have approved our initial ONC-ATCB certifiers.  EHR vendors can begin immediately to get their products certified.” said David Blumenthal, M.D., national coordinator for Health Information Technology.  This is a crucial step because it ensures that certified EHR products will be available to support the achievement of the required meaningful use objectives, that these products will be aligned with one another on key standards, and that doctors and hospitals can invest with confidence in these certified systems.”

Applications for additional ONC-ATCBs are also under review.

Certification of EHRs is part of a broad initiative undertaken by Congress and President Obama under the Health Information Technology for Economic and Clinical Health (HITECH) Act, which was part of the American Recovery and Reinvestment Act (ARRA) of 2009.  HITECH created new incentive payment programs to help health providers as they transition from paper-based medical records to EHRs.  Incentive payments totaling as much as $27 billion may be made under the program.  Individual physicians and other eligible professionals can receive up to $44,000 through Medicare and almost $64,000 through Medicaid.  Hospitals can receive millions.

To qualify for the incentive payments, providers must not only adopt, but also demonstrate meaningful use of, certified EHR systems.  The law envisions that defined meaningful use requirements will help ensure that the patient and provider benefits of EHRs are realized.  Initial meaningful use criteria were defined in a final rule issued by the Centers for Medicare & Medicaid Services (CMS) on July 28.

In addition to the CMS rule, ONC also issued standards and certification criteria for EHRs on July 28, aimed at ensuring that EHR systems will support the specific tasks required under meaningful use.  Also, through regulations issued on June 24, ONC created a system by which technology review organizations could also qualify as ONC- ATCBs that will certify EHR products as meeting the requirements necessary for meaningful use.

With the initial two ONC-ATCBs now named, EHR vendors can apply to them for certification of their products.  By purchasing certified products, providers will have assurance that the products will support achievement of the meaningful use objectives.

“Multiple steps are underway to carry out the intent of Congress in supporting rapid and effective adoption of EHRs throughout our health care system,” Dr. Blumenthal said.  “The naming of initial ONC-ATCBs is one important step.  Actual certification of multiple vendors’ systems by the ONC-ATCBs is an important next step.  CMS is also working to create an online system for providers to register and attest for the EHR incentive programs. The first incentive payments are targeted to be made in May 2011.  Meanwhile, ONC is also carrying out new programs of technical assistance and training, especially for smaller hospitals and physician practices.”

Dr. Blumenthal said the Health IT initiative “is on an aggressive schedule to meet the urgent targets set by Congress and the President toward realizing the quality and safety improvements that we can achieve through health information technology.”

To learn more about the ONC-ATCBs named today visit www.cchit.org  and www.drummondgroup.com.

For more information about the ONC certification programs visit http://healthit.hhs.gov/certification.

For more information about other HHS Recovery Act Health Information Technology funding and programs, visit http://www.hhs.gov/recovery/programs/index.html#Health.

This news is published on : http://www.hhs.gov/news/press/2010pres/08/20100830d.html

CHICAGO – The American Board of Medical Specialties (ABMS) is creating a new measurement tool to incorporate meaningful use into its Maintenance of Certification (MOC) program, which requires physician specialists to conduct an ongoing measurement of six core competencies.

ABMS officials said the not-for-profit organization will work with the three ABMS primary care Member Boards: the American Board of Family Medicine (ABFM), the American Board of Internal Medicine (ABIM) and the American Board of Pediatrics (ABP) to develop initial products.

ABMS officials say that incorporating meaningful use into MOC certification may include:

• Developing two new knowledge self-assessment modules to evaluate:

1. A physician’s knowledge of health IT for incorporating evidence-based medicine into their practice, decision support and data acquisition, and analysis and reporting related to correct use of the health IT.
2. A physician’s knowledge of the uses of health IT to promote patient safety such as computerized physician order entry, medication reconciliation, e-prescribing and coordination of care.

• Augmenting the knowledge self-assessment modules described above with the addition of simulation, creating patient scenarios that demonstrate EHR functionality, including the development and use of a registry for quality improvement that will provide “hands-on” experience for physicians in gaining the skills they need to apply health IT effectively in quality improvement efforts.
• Developing data interchange utilities to enable physician submission of Physician Reporting Quality Initiative (PQRI) and health IT meaningful use measures to the Boards in the same format used by the Centers for Medicare & Medicaid Services (CMS). This will enable certified physicians to satisfy both PQRI and MOC requirements, and qualify for the PQRI bonus and potentially meaningful use bonus without redundant data submissions.
• Expanding and enhancing practice improvement modules (PIMs), which are Web-based self-evaluation tools that guide physicians through collecting data from their own practice using medical chart reviews, patient surveys and a practice system survey to create a comprehensive assessment of current practice performance in a specific clinical area. Select PIMs will be enhanced to enable physicians to use EHRs to track their practice data and improve care.

According to ABMS, the meaningful use measures physicians will receive federal incentives for meeting overlap with core competencies that are continually measured through ABMS MOC: patient care, medical knowledge, practice-based learning and improvement, interpersonal and communications skills, professionalism, and systems-based practice.

“More than 750,000 U.S. physicians are certified by an ABMS Member Board, so it’s readily apparent that building meaningful use of health IT into MOC will benefit patients,” said Kevin B. Weiss, MD, ABMS president and CEO. “Aligning MOC and meaningful use of HIT will help to facilitate physicians’ knowledge, skill and use of health IT, and in turn can improve physician performance and patient outcomes.”

Source   :   http://www.healthcareitnews.com/news/american-board-medical-specialties-include-mu-certification-program

WASHINGTON – An alliance that claims more than 2,300 community-based hospitals as members is pressing Congress for a legislative fix to the final rule on meaningful use to ensure that every hospital receives its fair share of incentive payments under the HITECH Act.

After having tried in vain to have the issue addressed before the federal rule was final, the Premier healthcare alliance submitted its statement Tuesday to the House Committee on Ways and Means Subcommittee on Health at a hearing on meaningful use EHR. The panel chairman is Pete Stark (D-Calif.).

At issue: health systems with multiple inpatient facilities operating under one provider number.

The final meaningful use rule would allow only one Medicare incentive base payment per year for multiple inpatient facilities operating under the same Medicare provider number. By contrast, an identical health system whose inpatient facilities each operate under its own Medicare provider number would receive a base payment for each facility, Premier noted.

“This is a crucial issue for Premier alliance hospitals and could financially handicap co-located and multi-campus hospitals’ ability to implement EHRs in a timely manner,” the alliance wrote in its statement. “More than 50 Premier alliance hospital systems representing more than 100 inpatient facilities are affected by this methodological error by CMS, which will cost them millions of dollars in EHR incentive payments.”

“Despite receiving hundreds of comments on this specific issue in response to its proposed rule published on Jan.13, the Centers for Medicare & Medicaid Services (CMS) chose not to make any changes to its methodology for calculating a qualifying hospital’s Medicare and Medicaid EHR incentive payment,” Premier said. “By not modifying its methodology, CMS creates an arbitrary and inequitable distinction between identical hospital systems based solely on whether a system has multiple inpatient facilities operating under a single Medicare provider number.”

The government released the final rule on meaningful use on July 13. Initial industry reaction was mostly positive, with kudos given to CMS and the Office of the National Coordinator for Health Information Technology for having dropped an all-or-nothing approach and provided greater flexibility in the rule.

Source  :  http://www.healthcareitnews.com/news/alliance-calls-legislative-fix-meaningful-use

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.”

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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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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.”

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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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