By Liv Osby

Stimulus money to the tune of $5.6 million was awarded to Health Sciences South Carolina with a goal of getting 1,000 primary care doctors in the state to adopt the new electronic medical records system.

The funds will be used to set up a regional program called the Center for Information Technology Implementation Assistance. HSSC worked with the state Department of Health and Human Services to develop a statewide strategy for forging ahead with EMR.

“CITIA-SC will play a key role in supporting medical professionals throughout the state as they adopt and expand health information technologies in their practices,” said DHHS Director Emma Forkner.

DHHS spokesman Jeff Stensland said the University of South Carolina estimates about 60 percent of physician practices and 42 percent of hospitals have fully-integrated EMRs.

DHHS recently got a $9 million grant for its statewide health information exchange, which gives hospitals, doctors, clinics and other health care providers access to medical records.

HSSC is a partnership between universities and hospitals in the state to foster economic growth and improve health.

Above article publish on http://www.greenvilleonline.com/article/20100426/NEWS/304260003/1004/NEWS01/Medical-records-system-benefits–from-stimulus-funds-

One of the keys to achieving meaningful use and thus being able to qualify for federal incentive payments for the implementation of EMRs is the use of Computerized Physician Order Entry. What exactly is CPOE and how can it be implemented successfully?

CPOE is a program that physicians use to place orders for medications, lab tests, radiology exams, admissions, referrals and other tasks. A CPOE replaces written orders, phone calls and faxes, because it is linked to every other department in the hospital.

The Agency for Health Research and Quality (AHRQ), a unit of the federal Department of Health and Human Services (HHS) awarded ten grants to various health care providers to implement CPOE, and studied what happened. Their results show that there are certain things that providers can do to help improve the chances of a successful implementation.

The ten contracts were spread across both urban and rural hospitals in various parts of the country, and were intended for use in implementing inpatient programs. Some CPOE systems were implemented with EMRs, or in addition to existing EMRs, and all of them were put in place in conjunction with a decision support system.

Interviews with the grant recipients revealed that certain factors were critical to the success of a CPOE implementation. Here is a brief summary:

• Training – Frequent training and retraining is critical to a successful implementation.
• Staffing – Staff who understand both IT and clinical science are important. If you don’t have them, hire them or train existing personnel.
• Workflow – CPOE is by nature disruptive, so plan to redesign your workflow to accommodate these changes.
• Resources – Be sure to allocate enough resources (money, time and people) for planning, training, implementation and maintenance.
• Work With Vendors – Have good relations with vendors, but don’t allow them to delay your implementation program. Write penalties into contracts.
• Committees – Create and use Clinical Steering Committees early and often.
• Order Sets – Involve as many clinicians as possible in the creation of order sets, but strike a balance between filled-in fields and default values.
• Interoperability – Good luck with this one. Most of the grantees faced challenges integrating CPOE with other programs. Vendors did not want to cooperate in connecting to other company’s products.
• Support – Support should be available 24/7, especially at the beginning of the implementation. Address problems quickly and completely. Make support easy to access.
• Alert Fatigue – Expect a lot of alerts when you go live, and expect clinicians to find it annoying. Grantees had to develop new techniques to eliminate unnecessary alerts.

The conclusions reached here show that implementing the CPOE component of an EMR will pose challenges that will require creativity and tenacity while you design workarounds, but a successful implementation is possible. It seems to be true that what works for CPOE will work for other components of an EMR implementation.

Above article publish on http://blog.pchealthstop.com/?p=926

By, Rich Silverman

Massachusetts, long a leader in the delivery of quality medical care to its citizens, has just received more than $24 million from the federal government to speed the adoption of electronic medical records (EMRs) throughout the Commonwealth.

According to a report in govmonitor .com, the Office of the National Coordinator (ONC) has authorized the release of the $24 million, the maximum that Massachusetts is entitled to under the American Recovery and Reinvestment Act (ARRA) of 2009. According to the report, $13.4 million will go to support the adoption of EMRs throughout the Commonwealth, and another $1.6 million will go toward creating a statewide high-speed communications system for medical data and records.

According to Massachusetts Governor Deval Patrick, “This federal funding will help reduce health care costs and improve patient care using proven technologies, many of which are developed right here in Massachusetts.” Lieutenant Governor Timothy Murray added that in addition to streamlining health care, the money would help create jobs.

The grants, given in furtherance of the adoption of EMRs, will be administered by the Massachusetts e-Health Institute, the state agency created for that purpose. One if its key goals, according to an article in MassHighTech.com, will be to ensure the privacy of all medical records in the state.

Couple the release of this funding with recent news that meaningful use has finally been defined and that ONC is taking definitive steps to develop a certification, and it looks like providers in Massachusetts are finally getting the tools they need to fully implement EMRs.

Above article publish on http://blog.pchealthstop.com/?p=849

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.

Above article published on

http://www.fierceemr.com/story/dont-wait-until-next-year-implement-emr-leavitt-warns/2009-10-06#ixzz0TiG540KQ

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:

Above article published on http://www.fierceemr.com/story/states-can-seek-federal-money-now-medicaid-emr-incentive-planning/2009-09-03

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.

Above article published on

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

By Neil Versel

The highly anticipated second draft of a definition for “meaningful use” of health IT to qualify for federal stimulus funding came out as promised last week, and proposes loosening some of the original standards and injecting some competition into EMR certification.

The Health IT Policy Committee, an HHS advisory group, spelled out a list of, and a timetable for, various health IT objectives for 2011, 2013 and 2015. It also effectively gives healthcare providers until 2014 to achieve meaningful use based on initial criteria for 2011, though latecomers may not be eligible for all possible funding. “We thought there was a kind of double jeopardy in that, if a provider couldn’t make the 2011 or 2012 criteria, and coming into 2013 the bar would be raised higher, it’s almost like you can’t get into the game at all,” committee member Dr. Paul Tang said. “We’re trying to find a way for people to participate even if it’s a little bit delayed.”

Also, the committee rebuked longstanding claims that the Certification Commission for Healthcare Information Technology bestowed a sort of “Good Housekeeping seal” to certified EMRs, and recommended that there be other certification entities.

As the Health IT Policy Committee was issuing its plan, the Clinical Quality Workgroup of the affiliated Health IT Standards Committee was recommending 31 standards for performance and data capture that can help demonstrate meaningful use. Most already have the endorsement of the National Quality Forum.

Above article published on

http://www.fierceemr.com/story/meaningful-use-proposal-would-extend-deadlines-open-certification/2009-07-23

The Social Security Administration plans to make wider use of electronic medical records to process disability applications.

By Marianne Kolbasuk McGee

The Social Security Administration is planning to award $24 million in contracts to implement electronic medical records that would improve its disability program’s application process.

Under the agency’s new Medical Evidence Gathering and Analysis Through Health IT program, Social Security will electronically receive clinical information from healthcare providers treating patients who are seeking disability benefits. Currently, the bulk of the information the agency receives about applicants’ medical conditions is provided manually, using paper-based medical records and other documents.

Social Security has been testing the use of EMRs in the application process for about a year. In pilot programs with Beth Israel Deaconess Medical Center in Boston and MedVirginia, a health information exchange in Virginia, the agency says it has significantly reduced processing time for those applications.

Now, Social Security is looking to expand that program. It wants to electronically collect disability applicants’ clinical information–with patients’ authorization–and apply a business rules engine to help it make benefits determinations, said Social Security officials at a webinar on Tuesday about the program.

During the current recession, the Social Security Administration says it has seen a significant increase in disability applications. Officials said they expect to receive more than 3.3 million applications in fiscal year 2010, a 27% increase over fiscal 2008. To process these applications, the agency sends more than 15 million requests for medical records to health care providers. EMRs will “vastly improve the efficiency of this process,” the agency said in a statement.

Under the new program, medical record data will be securely transmitted through the National Health Information Network, an initiative of the Dept. of Health and Human Services.

The new contracts are among health IT programs being funded through the American Recovery and Reinvestment Act. More details are available on the Social Security Administration’s Web site about its request for proposal, in which it’s seeking healthcare providers, provider networks, and health information exchanges to participate in the program.

Above article published on

http://www.informationweek.com/news/healthcare/EMR/showArticle.jhtml?articleID=219200230

Ever since the government announced it would offer financial rewards of $44,000 to $64,000 to each physician who could show “meaningful use” of a qualified electronic health record, doctors have been wondering what meaningful use means. Today the Health IT Policy Committee, which advises the U.S. Department of Health and Human Services, took a major step toward providing a definition of this term.

The recommendations released by the HIT Policy Committee are not the final word. In fact, they are simply the product of a workgroup, and the committee’s discussion today made it clear that the provisions are subject to change and will be tweaked over the next couple of months. After the committee adopts a definition, it will be submitted to CMS, which will put the definition through its formal rule making process. Even when that’s completed, probably by the end of the year, it will apply only to 2011 and 2012 requests for government subsidies. In 2013 and 2015, the requirements will be significantly expanded.

To what end? The HIT Policy Committee has very grand ambitions. As it states in the preamble to its report, “We recommend that the ultimate goal of meaningful use of an Electronic Health Record is to enable significant and measurable improvements in population health through a transformed health care delivery system.” In other words, the committee members are not just trying to make sure that physicians are using the EHRs for which they’re seeking subsidies; they want to make sure they’re using them to “transform healthcare.”

The pertinent questions are whether what the committee is considering bears any resemblance to 1) the EMRs currently on the market; and 2) the environment in which physicians and hospitals (which will also be subject to the definition) operate. The answer to the first question is Maybe: most of the requirements for 2011 can be satisfied by the leading certified EMRs, but it’s unclear whether more than a handful of them will be able to keep up with future requirements. As for the second question, the ability of physicians to exchange information with providers that use different systems is very limited right now, and some of the other requirements in the future may discourage physicians from acquiring EMRs.

During the discussion period at the committee meeting today, committee member Neil Calman, of the Institute for Family Health, noted that it takes a while for physicians to get up to speed on EHRs and begin to use various components of them. “You can’t open up a patient portal on the day your EMR goes live,” he pointed out. So if the meaningful use criteria for 2013 are too advanced, he said, “A non-adopter will look at those criteria and say, ‘This is not achievable.’”

Calman suggested that as the bar is raised for meaningful use, first-year applicants for government subsidies be allowed to meet the original criteria in that year, and then go through the process of using their EMRs to reach higher goals. David Blumenthal, the national coordinator of health IT, said, “That’s more realistic in some ways.” But a CMS official stepped in and said the law doesn’t allow it. “The meaningful use criteria in 2013 have to be the same whether you’re a first-year or third-year user,” he stated.

That strikes me as a way to guarantee the program will fail. If the law doesn’t make sense, Congress should amend it.

Other committee members expressed reservations about the report. Gayle Harrell, a committee member and former Florida state legislator, pointed out that “this is a very aggressive model.” Some hospitals are taking a long time to roll out health IT to their physicians, she pointed out, and the degree of interoperability varies dramatically from one region to another. “Are we setting goals that are not achievable?” she asked. “I’m afraid we will set ourselves up for failure if we’re not specific and take smaller bites of the apple.”

After the meeting, Blumenthal announced he was asking the workgroup to revise their recommendations over the next month. I just hope that the HIT Policy Committee–perhaps with some input from practicing physicians–considers the issues raised by its members today before it issues its final definition of meaningful use.

Above article published on

http://industry.bnet.com/healthcare/1000806/is-
government-health-it-program-overreaching/

By now you’ve heard about the $850 billion American Recovery and Reinvestment act of 2009 - the stimulus bill recently passed by Congress. The bill is aimed at spurring economic growth across multiple industries by way of government spending.

What’s in it for you?

Well if you are a healthcare provider, you can take advantage of the $51 billion that has been allocated to the health care industry, $19 billion of which will be used to incentivize medical practices to adopt and implement Electronic Health Records (EHRs), also known as Electronic Medical Records (EMRs).

How does the subsidy work?
Starting in 2011, providers deemed to be “meaningful users” of EHR systems will be eligible to receive $40,000 - $60,000 in incentive payments paid out over five years in the form of increased Medicare and Medicaid premiums.

For the first year a physician is deemed to be a meaningful user, he or she will be eligible for payments of 75% of that year’s Medicare and Medicaid charges, up to a maximum of $15,000. The maximum payment is increased to $18,000 if the first year is 2011 or 2012. The incentive payments decline for each subsequent year within the five year period; $12,000 will be paid in year two, $8,000 in year three, $4,000 in year four, and $2,000 in year five.

No incentive payments will be available after 2015, and no payments will be offered to physicians who first become eligible after 2014. This creates a decreasing incentive for late adopters.

What is a “meaningful user”?
To qualify as a “meaningful user,” eligible providers must demonstrate use of a “qualified EHR” in a “meaningful manner.” The bill defers to the secretary of Health and Human Services (HSS) to set specific guidelines for determining what constitutes a “qualified EHR”; however, it does specify that e-prescribing, electronic exchange of medical records, and interoperability of systems will be determining criteria.

HSS will be working throughout 2009 to set the necessary criteria for certifying systems, and is expected to have a final report by January of 2010. Many expect CCHIT certification to play a major role in setting standards of interoperability. (See “Should CCHIT Influence Your EHR Selection” for more information). After all, HHS funded the creation of CCHIT to start certifying EHRs a few years ago.

How do I qualify for the maximum payment?
In order to receive the maximum payment, physicians must qualify as a meaningful user in 2011. Eligible physicians will receive a first year bonus of $18,000 (up from $15,000) and will max out the payment schedule over the next five years.

The table below illustrates the amount of a subsidy paid each year (columns) based on the year the provider first becomes eligible (rows):

No payments will be offered to physicians who first become eligible after 2014.

Practices with multiple physicians will be eligible to receive incentive payments for each provider. Remember that payments will be based on 75% of the correlating year’s Medicare and Medicaid charges. Therefore, in order to qualify for the maximum payment of $18,000 in the first year, each provider must bill Medicare or Medicaid a minimum of $24,000.

Should I purchase an EHR now or wait until 2010?
An obvious concern is whether an EHR implemented in 2009 will meet the standards set by HHS in 2010. Although a legitimate concern, waiting until 2010 to implement a system may be a mistake. Researching and selecting the right EMR can be a lengthy process, and many providers who wait may find it difficult to have a system in place in time.

Practices would be well-served to begin the research process now, allowing ample time to create a short-list of systems, perform demos with several vendors, check references, meet with vendors in person, negotiate terms, and complete the implementation and training process. To alleviate buyers’ concerns, vendors may provide binding agreements, guaranteeing their system will comply with all emerging standards.

Furthermore, buyers’ should consider CCHIT an important Certification relative to the requirement for “qualified EHRs.” While we have discussed the many opinions for and against CCHIT, we expect it to play a critical role in the EHR subsidy qualification.

What if I choose not to purchase an EHR?
Unfortunately, for physicians who choose not to implement an EHR, the stimulus bill is a double-edged sword. Not only will they forego thousands in incentive payments, but starting in 2015, they will be penalized by way of decreased Medicare and Medicaid payments. Physicians who fail to qualify as meaningful users will face decreases of 1% in 2015, 2% in 2016, and 3% in 2017, with a maximum reduction of 5% by 2020.

Above article published on

http://www.softwareadvice.com/articles/medical/
the-stimulus-bill-and-meaningful-use-of-qualified-emrs-1031209/