By Wendy Johnson

Physician practices and hospitals that have yet to select or implement an EMR system should get a move on. Those who wait until next year will face a “high risk” of failing to achieve “meaningful use” of health IT in time for the 2011-12 federal incentives, Mark Leavitt, chairman of the Certification Commission for Healthcare Information Technology, warned at the annual AHIMA conference on Monday in Grapevine, Texas.

“You’re dreaming if you think you can achieve it in less than a year,” Leavitt said, referring to hospitals. Achieving meaningful use of an EMR system will take at least 18 months, if not two years, he warned.

HHS expects to publish its criteria for certification of EMRs under the American Recovery and Reinvestment Act, as well as its definition of “‘meaningful use” for qualifying for ARRA Incentives, by the end of the year. Both measures should be finalized by spring 2010 after a public comment period. All told, the federal government will pony up $34 billion in incentives for meaningful use of certified EMR technology–the equivalent of what the U.S. spent to send the first man to the moon, Leavitt said.

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HHS Secretary Kathleen Sebelius today announced awards totaling $27.8 million to health center-controlled networks and large multi-site health centers to implement electronic health records (EHR) and other health information technology (HIT) innovations. The funds are part of the $2 billion allotted to HHS’ Health Resources and Services Administration (HRSA) under the American Recovery and Reinvestment Act of 2009 (ARRA) to expand health care services to low-income and uninsured individuals through its health center program.

“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 health care generally while also cutting waste out of the system,” said Secretary Sebelius.

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

“Broad use of health information technology has the potential to improve health care quality, prevent medical errors, and increase the efficiency of care provision,” added David Blumenthal, 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.”

Eighteen grants totaling more than $22.6 million will support EHR implementation. Grants totaling more than $2.6 million will help four grantees implement a variety of HIT innovations, including the creation of health information exchanges among different providers and the incorporation of HIT at dental delivery sites. Another five grants totaling over $2.5 million will help health centers devise plans to use existing EHRs to improve patient health outcomes.

HRSA received $2 billion through the Recovery Act to expand health care services to low-income and uninsured individuals through its health center program. To date, more than $1.3 billion of these funds have been awarded to community-based organizations across the country. HRSA-supported health centers treated 17 million patients in 2008, 40 percent of whom have no health insurance.

In addition, HRSA received $500 million in Recovery Act workforce funds—$300 million to expand the National Health Service Corps (NHSC) and another $200 million for other health care workforce programs. The NHSC funds will pay for student loan repayments for primary care medical, dental, and mental health clinicians who will practice for a minimum of two years in NHSC sites that treat underserved and uninsured people. Recently, awards totaling $33 million—part of the $200 million total—were announced to expand the training of health care professionals.

The list of grant recipients follows:

alth Resources and Services Administration (HRSA), part of the U. S. Department of Health and Human Services, is the primary Federal agency for improving access to health care services for people who are uninsured, isolated, or medically vulnerable.  For more information about HRSA and its programs, visit www.hrsa.gov.

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By the Associated Press

President Barack Obama, faced with falling approval ratings and increasingly impatient with Senate negotiations over health care, is weighing a shift in strategy that would offer more details of his goals for overhauling the nation’s healthcare system.

The president is considering a speech in the next week or so in which he would be “more prescriptive” about what he feels Congress must include in a bill, top adviser David Axelrod said Tuesday in an interview. The speech might occur before the Sept. 15 deadline the White House gave to Senate negotiators to seek a bipartisan bill, Axelrod said. He suggested that two key Republicans have not bargained in good faith.

Congress reconvenes next Tuesday after an August recess in which critics of Obama’s health proposals dominated many public forums.

Some Obama allies, watching his approval ratings tumble in polls along with support for a healthcare overhaul, have urged the president to take a more hands-on approach. They feel he gave too much leeway to Congress, where one bill has passed three House committees, another has passed a Senate committee and a third has been bogged down in protracted negotiations in the Senate Finance Committee.

Axelrod indicated that Obama would not offer new proposals but would be more specific about his top priorities.

“The ideas are all there on the table,” Axelrod said. “Now we are in a new phase, and it’s time to pull the strands of these together.”

He said there is serious discussion in the White House of Obama “giving a speech that lays out in specific ways what he thinks” about the essential elements of a healthcare bill.

Axelrod said it was possible that the speech could occur before a planned Sept. 15 Obama address on healthcare in Pittsburgh.

Obama has called for innovations such as a public health insurance plan to compete with private insurers, but he has not insisted on it. It was not clear Tuesday the degree to which he might press for various proposals in a new speech.

Obama also plans to meet with Democratic congressional leaders on Tuesday.

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http://www.modernhealthcare.com/article/20090902/REG/309029973/-

By Neil Versel

There’s a lot more going on with the health IT portion of the stimulus than just the back-and-forth over defining “meaningful use” of EMRs. For example, there’s the Medicaid option for physicians, who can earn up to $63,750 each, rather than the $44,000 maximum through Medicare, if they have a large Medicaid patient pool.

CMS is prepping for the Medicaid incentives by informing states that they can apply now for federal funding to cover 90 percent of their administrative planning. A letter that went to state Medicaid directors this week also says that states must take steps to make sure provider EMRs are compatible with state or federal administrative systems for electronic claims submission, that states should consider Medicaid planning in the context of statewide health IT programs and that states should coordinate any incentive-related activities with regional CMS offices.

CMS promises additional guidance as it becomes available and says the federal agency before the end of the year will publish proposed regulations addressing the issues raised in the letter.

To learn more about federal-state collaboration on Medicaid EMR incentives:

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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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By Neil Versel

Dr. David Blumenthal, the national coordinator for health information technology, gave a strong indication of how HHS ultimately will define “meaningful use,” the standard that providers must meet to be eligible for Medicare and Medicaid EMR bonuses, by warning that hospitals unwilling to share data with others risk being shut out of the stimulus funding. “There’s a fair amount of money in the law for hospitals that adopt interoperability,” the Dallas Morning News quotes Blumenthal as saying. “If they don’t, they’re not likely to be eligible for payment.”

Although the three largest hospital operators in the Dallas-Fort Worth are implementing EMRs, there is no means for health information exchange between the systems or with smaller providers. The Dallas-Fort Worth Hospital Council is only now working on an HIE feasibility study, and is seeking grant funding to lay the groundwork for data sharing, the newspaper reports.

In McAllen, TX, recently named the second-most-expensive healthcare market in the country, one physician executive believes that interoperability could help rein in some of the spending.

Let me know for further assistance.

http://www.fierceemr.com/story/blumenthal-must-share-data-get-stimulus-money/2009-06-25

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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As the Obama administration works to garner support for healthcare reform, about $1.2 billion in grants were announced on Friday to help hospitals and healthcare providers implement and use electronic health records.

Announcing the grants in Chicago, US Vice President Joe Biden said the $1.2 billion would be funded by the $787 billion economic stimulus plan.

“With electronic health records, we are making health care safer; we are making it more efficient; we are making you healthier; and we are saving money along the way. These are four necessities we need for healthcare in the 21st-century,” Biden said during an appearance at a hospital with Health and Human Services secretary Kathleen Sebelius.

Expanding the use of electronic health records is fundamental to reforming the country’s healthcare system, Sebelius said, adding that electronic health records would help reduce medical errors, make healthcare more efficient and improve the quality of medical care for all Americans.

“You are going to be able to save a lot more lives and save tens of billions of dollars,” Biden told about 100 medical professionals.

Of the total money, $598 million would be used to establish 70 health information technology regional extension centers, which would help hospitals select and implement electronic health record systems.

Grants totalling $564 million would go to States and Qualified State Designated Entities to support the development of mechanisms for information sharing within an emerging nationwide system of networks.

The grants would be awarded beginning fiscal year 2010. Biden also expressed confidence that the healthcare legislation would be passed.

“Soon we are all going to get much better health care at a more rationale price…We are not taking the system that works away from any American. We are making the stuff that doesnt work, work better,” he added.

Pointing out that the economic stimulus package is working to improve the economy, Biden said, “We stopped the free fall. Now we are beginning to ascend again”.

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http://business.rediff.com/report/2009/aug/21/us-1-point-2-bn-dollar-grant-for-electronic-health-records.htm

President Obama held a town hall meeting in New Hampshire today, Tuesday, August 11, in an effort to calm fears over the Democrats’ legislative initiatives to reform healthcare in this country. The meeting was structured, and no visible emotional outbursts were seen as in other meetings with lawmakers across the country.

Obama answered questions posed by attendees, emphatically telling the audience that the current healthcare system solely benefits the insurance industry. With 46 million in the country without health insurance, he tried to reassure his audience that they would be able to keep their current coverage and doctor and that the government would not be “in charge”. Obama hammered on the fact that the government and insurance bureaucrats should not be meddling, that pre-existing conditions will be covered and that insurance companies would not be able to drop or deny coverage or water down coverage. Many of the questions on voter’s minds that were expected to be answered, especially with respect to employers and small businesses, were not addressed.

Numerous recent polls show support for healthcare reform is eroding, and the President’s numbers are dropping as well over fears that a government takeover of our healthcare system in the U.S. will lead to a Canadian style system with long waits for treatments and referrals.

The President’s message today was supposed to address people who already have insurance through their employers and highlight how his proposals would affect them. HAI monitored the town hall meeting and didn’t find the retool of the White House message to have answered those questions. Another town hall meeting with Obama is scheduled for Bozeman, Montana on Friday, and on Saturday, Obama will be in Grand Junction, Colorado.

Meanwhile, the White House has opened a Reality Check website with a viral tool aimed at online healthcare combat on everything from rationing to euthanasia. The website incorporates lessons learned from the Obama presidential campaign, and shows the White House is becoming more aggressive in dispelling what they call misinformation in the healthcare debates.

The August Congressional Recess is not even half over, and Democratic lawmakers are very much at risk of losing control of the public debate over healthcare reform, facing wary constituents and facing a barrage of accusations and criticism over their writing of the legislation prior to leaving Washington. Powerful groups on both sides of the debate are using the August recess to hammer home to lawmakers that there are very serious political consequences to the healthcare issue.

Senators working on a yet to be released draft bill said earlier this week that President Obama would like to get something passed for healthcare reform and then start negotiating in a House-Senate conference committee. Some Democrats support the public option, but it will be a tough sell for Republicans if they want to get a bill through the Senate. The flashpoint in the debate has become the question of whether a healthcare overhaul should include a public option. As the debate rolls on, Americans are questioning what the shape and size of the government’s role in the economy should be, especially on the heels of Congress passing three massive economic stimulus bills.

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State governments around the country are working to facilitate, and in some cases, enhance, Washington’s stimulus-funded incentives for doctors and hospitals that adopt new health information technology. “A group of the nation’s governors and state officials has released a guide for state implementation of the Health Information Technology for Economic and Clinical Health Act,” the formal name for the portion of the stimulus bill, McKnight’s Long-Term Care News reports. A key recommendation is that state leaders create health information exchanges so providers can readily share information to improve coordination of care (8/7).

Meanwhile, members of the National Lieutenant Governors Association called for support of “advance interoperable health IT and its adoption among providers” in a resolution this week, Modern Healthcare reports. They call on states to adopt systems with the stamp of approval of the Certification Commission for Health Information Technology, a group affiliated with an e-health industry association (DerGurahian, 8/6).

Louisiana went a step further with “a bill that would create a loan program for physicians and hospitals hoping to buy an electronic health record system,” American Medical News reports. The state health department will seek other stimulus funding to seed the loans. The bill also will create the Louisiana Rural Health Information Exchange (Dolan, 8/6). (Other states, such as Maryland, have taken similar action in recent weeks).

At the local level, Florida officials are reviving two e-health projects in the Miami and Palm Beach areas to pursue the stimulus funding, the Sun-Sentinel reports. One project, run by the South Florida Health Information Exchange, had succeeded in digitizing the records for dozens of clinics and setting up protocols to share them with a local hospital, before funding dried up and the program became dormant (LaMendola, 8/6).

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August/07/Health-IT-Fri.aspx