More than 80 community colleges and universities this fall will begin training nearly 50,000 health IT workers as part of an HHS grant program that aims to help physicians and hospitals adopt electronic health records, ComputerWorld reports (Mearian, ComputerWorld, 7/16).

Source of Funding

HHS in April announced $144 million in grants to target health IT research and work force development.

Funding was disbursed through the 2009 federal economic stimulus package (iHealthBeat, 4/5).

Breakdown of Plans

For the training, HHS has designed a curriculum to educate individuals with a health care or IT background for 12 specific roles.

The programs fall into two groups:

• A six-month program; and
• A one- to three-year training program for more advanced administrative and technical roles, such as senior clinician leaders and privacy and security specialists.

Graduates will receive a certificate in their specialties, and each school will receive approximately $1 million to implement the curriculum.

Regional Extension Centers

A large focus of the effort will be dedicated to training staff to work at 60 regional extension centers, which will help rural institutions and small physician practices install EHR systems.

The centers are expected to employ up to 30 trained workers, who will:

• Assist health care providers with reimbursement procedures;
• Assess a facility’s health IT infrastructure;
• Suggest compatible EHR systems;
• Oversee system installation;
• Analyze workflow; and
• Determine if EHR deployment meets federal “meaningful use” standards (ComputerWorld, 7/16).

Source: http://www.ihealthbeat.org/articles/2010/7/16/groups-preparing-ways-to-use-hhs-grants-for-it-training-programs.aspx

By Joseph Conn

HHS has sent its final meaningful-use rules and certification criteria for electronic health-record system testing to the Office of Management and Budget—typically one of the last bureaucratic hurdles before rules are released. The criteria are called for under the EHR subsidy program established by the American Recovery and Reinvestment Act of 2009.

OMB received a copy of the final rule of the “meaningful use” criteria from the CMS Monday, according to the posting on the website of its Office of Information and Regulatory Affairs.

The White House budget authority also received a copy of the final rule on an initial set of standards, implementation specifications and certification criteria from HHS on July 2.

Under the Medicare provisions of the stimulus law, to receive an estimated $14 billion to $27 billion in federal subsidies for EHR purchases, hospitals and qualifying office-based physicians must use certified EHRs in a “meaningful manner.”

Robert Tennant, the Washington, D.C.-based senior policy adviser to the Medical Group Management Association, Englewood, Colo., said he expects a quick turnaround on both rules.

“By law, they have 90 days in which to review, but I think in all practicality, OMB has been involved in the drafting of the final rules, so it’s no surprise when they get them,” Tennant said.

OMB has had HHS’ controversial final rule on the federal requirement on public and patient notification in the event of a breach of personally identifiable health information since May 15. Tennant said he expects both recently submitted rules to be released in a week or so, possibly even later this week.

Tennant also said a proposed healthcare IT privacy rule just left the OMB review list, so “it should be published in the next couple of days.”

Source:http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20100706/NEWS/307079976/1153#

According to recommendations from a large collaboration of organizations, the success of the new federal incentives program for health information technology (“HIT”) largely depends on a specific set of health improvement goals, a prioritized set of metrics, and the widespread participation of health care providers and patients.

Health care leaders from 56 different organizations filed a joint public comment on the program, which is part of the economic stimulus in the American Recovery and Reinvestment Act (“ARRA”). The Markle Foundation, the Center for American Progress, and the Engelberg Center for Health Care Reform at Brookings coordinated the collaborative comments on the Centers for Medicare & Medicaid Services’ Notice of Proposed Rulemaking for the Electronic Health Record Incentive Program.

The joint public comment recommends priorities to the U.S. Department of Health and Human Services (“HHS”), which will manage the new Medicare and Medicaid subsidies to doctors and hospitals for “meaningful use” of HIT starting in 2011.

The comment requests that HHS make clear a set of health improvement goals such as improving medication management and reducing readmissions to hospitals, so that everyone can contribute to these priorities.

Peter Basch, MD, senior fellow at the Center for American Progress, said: “As a practicing physician who has gone through the process of implementing health IT, I can say that it’s critical to set a bar that is ambitious but also achievable for the many diverse practices and hospitals that might participate in this program. We point out areas in which HHS can lower burdens on physicians without losing focus on the important goals of using health IT in ways that improve the patient’s experience and outcomes.”

Among other things, the collaborative letter stressed that the HIT program should encourage broad participation of providers by prioritizing the requirements necessary to receive payments and should enhance the ability of patients to obtain electronic copies of their health information.

Above article publish on http://pvwlaw.wordpress.com/2010/03/21/56-organizations-agree-on-priorities-for-%E2%80%9Cmeaningful-use%E2%80%9D-program/

Final awards of state health information exchange cooperative agreement program work to build health information exchange infrastructure throughout the states

U.S. Department of Health and Human Services Secretary Kathleen Sebelius today announced awards to help states facilitate health information exchange and advance health information technology (health IT).  Funded by the American Recovery and Reinvestment Act of 2009, today’s  awards are part of the $2 billion effort to achieve widespread meaningful use of health IT and provide use of an electronic health record by every citizen by the year 2014.  Every state and eligible territory has now been awarded funds under this program.

“These critical investments will help unleash the power of health information technology to cut costs, eliminate paperwork, and help doctors deliver high-quality, coordinated care to patients,” said Secretary Sebelius. “States are important partners in improving and expanding our electronic health records system.  By improving the secure exchange of electronic health records between providers and hospitals within and across states, these awards mark a significant step in bringing our health system into the 21^st century.”

The health information exchange HIE awards announced today provide approximately $162 million to 16 states and qualified state designated entities (SDEs) to facilitate non-proprietary health information exchange that adheres to national standards.  Health information exchange is critical to enabling care coordination and improving the quality and efficiency of health care.

“Today’s announcement of awards to 16 states and SDEs marks a significant milestone with all states now empowered to start their journey towards identifying innovative ways to break down theses barriers that prevent the seamless exchange of information, so that we can give patients the access to care they deserve and expect,” stated Dr. David Blumenthal, national coordinator for health information technology.  “States play a critical leadership role in advancing the development of the exchange capacity of healthcare providers and hospitals within their states and across the nation. Health information exchange will enable eligible healthcare providers to be deemed meaningful users of health IT and receive incentive payments under the Medicare and Medicaid electronic health record (EHR) incentive program.”

These cooperative agreements were awarded under the authority of Title XIII of ARRA, the Health Information Technology for Economic and Clinical Health (HITECH) Act which amends Title XXX of the Public Health Service Act by adding Section 3013, State Grants to Promote Health Information Technology. Section 3013 provides for the awarding of competitive grants to promote health information technology.  On February 12, 2010, HHS awarded $385 million to 40 states and SDEs.  The awards announced today complete the awarding of cooperative agreements funded by this program.

A listing of the state HIE competitive agreements announced today follow:

Additional information about the state HIE program may be found at http://healthit.hhs.gov/portal/server.pt?open=512&objID=1488&parentname=CommunityPage&parentid=2&mode=2&in_hi_userid=10741&cached=true

And http://www.whitehouse.gov/the-press-office/sebelius-solis-announce-nearly-1-billion-recovery-act-investment-advancing-use-heal

Above article publish on http://www.hhs.gov/news/press/2010pres/03/20100315a.html

The Healthcare Information Technology Standards Panel has extended its contract with HHS through April 30, 2010, the panel announced Tuesday, Healthcare IT News reports.

The panel and HHS have collaborated to expand the adoption and interoperability of electronic health records since HITSP’s creation in 2005, according to Fran Schrotter, HITSP’s project director and senior vice president and chief operating officer of the American National Standards Institute, which administers HITSP.

During the extension period, Schrotter said HITSP will:

• Collaborate with CMS on a project on quality demonstration;
• Conduct monthly informational update calls; and
• Take part in the Healthcare Information and Management Systems Society’s annual conference and exhibition.

The contract extension ensures that HITSP volunteers remain engaged until the next phase of standards harmonization, which will be funded by the Office of the National Coordinator, is announced, Schrotter added (Manos, Healthcare IT News, 2/16

Above Article Publish On http://www.ihealthbeat.org/articles/2010/2/16/hhs-extends-hitsp-contract-pushes-ahead-with-ehr-adoption.aspx

HHS is gearing up to award $50 million in task orders to establish a national Health IT Research Center, Federal Computer Week reports.

Joshua Seidman — acting director of the “meaningful use” division at the Office of the National Coordinator for Health IT — discussed HHS’ plans for the research center this week during a conference sponsored by the eHealth Initiative.

He said the Health IT Research Center will provide a virtual learning community through an online portal. The center also will help users develop communities around research subjects that support the meaningful use of electronic health records.

Support for Regional Extension Centers

Seidman said the research center will serve as a resource for about 60 regional health IT extension centers.

HHS is awarding nearly $600 million in stimulus funding to establish the extension centers in communities across the country. Officials are expected to select about half of the extension centers within the next few weeks, Seidman said.

The regional extension centers aim to offer health care providers guidance on:

• Best practices in health IT privacy and security;
• EHR vendor selection and group purchasing;
• Health data exchange and interoperability;
• Health IT project implementation and management;
• Workflow redesign and work force support (Lipowicz, Federal Computer Week, 1/26).

Above article publish on http://www.ihealthbeat.org/articles/2010/1/27/hhs-to-award-50m-to-set-up-national-center-for-health-it-research.aspx

Department of Health and Human Services (HHS) Secretary Kathleen Sebelius and National Health IT Coordinator David Blumenthal, MD, this week announced the availability of $235 million in grants for “beacon communities” to act as models for health IT implementation.

Funded by the American Reinvestment and Recovery Act (ARRA), the Beacon Community Program plans to build and strengthen health IT infrastructure and health information exchange capabilities, including strong privacy and security measures for data exchange, within 15 communities.

At a press conference, Sebelius stated that these beacon communities are on the forefront of health IT and that they will help answer the question: “What health benefits will we get when we make significant, concentrated investments in health IT?”

Blumenthal clarified that $220 million is set for cooperative agreements, $10 million for evaluation funds and $5 million for technical assistance to communities.

In response to a question concerning the nature of the evaluation funds, Blumenthal stated that “[w]e want to learn from these examples, so we want to know who’s succeeding and why, [and] derive lessons that can be communicated to other communities that will accelerate their progress towards improving healthcare using EHRs.”

Cooperative agreements will be awarded to qualified nonprofit organizations or government entities representing diverse geographic areas, including rural and underserved communities. To qualify for the Beacon Community Program, applicants are expected to:

• Build on existing health IT infrastructure to demonstrate care and cost savings;
• Have rates of EHR adoption that are significantly higher than published national estimates; and
• Coordinate with recently announced Office of the National Coordinator for Health Information Technology (ONC) programs for Regional Extension Centers and State Health Information Exchanges to develop and disseminate best practices for adoption and meaningful use of EHRs to support national goals for widespread use of health IT

Above article published on http://www.healthimaging.com/index.php?option=com_articles&view=article&id=19770:hhs-announces-235-million-in-grants-available-for-qbeacon-communitiesq

Stephen Barlas

With billions of dollars for electronic health record (EHR) technology purchases hanging in the balance, psychiatrists need to be paying attention to the Department of Health and Human Services (HHS) deliberations on the definition of “meaningful use.” HHS Secretary Kathleen Sebelius is supposed to set an interim definition in a few months. This is important to all office-based physicians because it will set the requirements they will have to meet for proving they are making meaningful use of EHR software and hardware they previously purchased. If they can make the case, starting in 2011, they would qualify for federal grants to partially compensate them for those previous software and hardware purchases.

Those grants are available for 5 years, and if obtained starting in 2011, they could amount to as much as $64,000 per practice for psychiatrists whose patient mix is at least 30% Medicaid recipients. That figure falls to $44,000 for physicians who cannot meet the Medicaid percentage and who see Medicare patients, with no specific percentage of the latter being designated.

There is also a penalty for physicians who do not meet the meaningful use definition. It comes into play after 2016; the Medicare fee schedule for professional services is reduced by 1% in 2015, by 2% in 2016, by 3% for 2017, and by between 3% to 5% in subsequent years.

The grants were authorized by the American Recovery and Reinvestment Act (ARRA)—which is the stimulus bill Congress passed last winter. Sebelius will set interim requirements based on recommendations from 2 new advisory committees that were established by the ARRA: a health information technology policy and a standards committee. The meaningful use requirements will be different, in part, for office-based physicians and hospitals, but they will have escalating requirements in 2011, 2013, and 2015.

The ARRA gave HHS some guidelines as to what the meaningful use definition should include. The overriding requirement is that a physician be able to exchange certain categories of patient data electronically with other providers and to report quality measures to the HHS and Centers for Medicare and Medicaid Services (CMS).

Complying with a meaningful use definition may have some general and specific challenges for psychiatrists. To begin with, it looks likely that all physicians would have to use computer physician order entry (CPOE) for all patients. In 2011, CPOE would have to perform certain basic tasks. For example, it would need to be able to implement drug-drug, drug-allergy, drug-formulary checks; maintain an up-to-date problem list of current and active diagnoses; and generate and transmit permissible prescriptions electronically. In addition, certain quality measures would have to be reported to the CMS. Those would include, on the basis of the policy committee’s final recommendations, percentages of:

• Diabetic patients whose glycosylated hemoglobin levels are under control

• Hypertensive patients whose blood pressure is under control

• Patients with dyslipidemia whose LDL levels are under control

• Smokers to whom smoking cessation counseling and other measures are offered

At meetings with HHS officials this summer, and in comments, the American Psychiatric Association (APA) pointed out that the elements of the meaningful use definition were shaped for generalists—not specialists such as psychiatrists, for whom some of the requirements might pose serious adherence problems. For example, about the reporting of quality measures, none of those endorsed by the policy committee included mental illnesses. “Additionally, there are some quality measures which could be incorporated into primary care and some specialty settings which were not included on the committee’s proposal, such as those pertaining to major depressive disorder,” said James Scully Jr, MD, medical director and chief executive officer of the APA in a letter to HHS this summer.

It is not that quality measures for psychiatrists do not exist. They do. The New York State Office of Mental Health has developed a decision support and quality improvement system for what in that state are called “Article 31” hospitals, which are for psychiatric patients. The Psychiatric Services and Clinical Knowledge Enhancement System affects only psychiatrists at those hospitals.

According to Hao Wang, PhD, deputy commissioner, chief information officer, office of mental health, state of New York, the state weeds through Medicaid data for indications that psychiatrists at Article 31 hospitals may be outside the boundaries of good practice in 2 areas in which the state has developed quality indicators: polypharmacy and cardiometabolic syndrome indicators. Psychiatrists who appear to need some help in those 2 areas are required to report to the state office of mental health to ensure they are improving their stats. Wang suggests that those 2 quality indicators have utility beyond psychiatrists and could be used by HHS if it wanted to make its quality measures reporting definition more relevant to psychiatric practice.

Wang stated what everyone already knows: that psychiatrists—and physicians more broadly—have not exactly flocked to EHRs. But psychiatrists may have a particular disincentive, Wang explained, “because they can’t find a good behavioral health care product.” He added that hospitals are more concerned about patients with physical conditions, because they generate more revenue. And EHR vendors have responded to that by producing systems that have little utility for physicians who see high percentages of patients with mental health conditions.

Above article published on http://www.psychiatrictimes.com/display/article/10168/1482754?verify=0

Health and Human Services Secretary Kathleen Sebelius released a report Thursday on how information technology can improve healthcare for Americans living in rural communities.

The report examines how the Columbia Basin Health Association in Othello, Wash., uses IT to improve healthcare quality and patient safety as well as promote care coordination and continuity.

“The Columbia Basin Health Association is just one place in America where health information technology and electronic health records have helped ensure patients get better care,” said Sebelius. “Health information technology can reduce paperwork, make care more efficient and let doctors spend more time practicing medicine and less time filling out forms.”

The CBHA provides 25,000 patients with access to a variety of medical, dental, prescription and other services at four sites and was one of the first health centers in the United States to fully transition from paper-based charts to an electronic health record system.

In response to the growing prevalence of diabetes in rural communities, the CBHA used its EHR system to track 1,302 diabetic patients, monitoring whether they received recommended exams and providing feedback to healthcare providers on their performance.

In January 2008, 31 percent of patients at the CBHA had received a foot exam and 37 percent had received an eye exam during the previous year. By June 2008, 86 percent of patients had received a foot exam and 63 percent had received an eye exam over the previous year.

According to the report, since the CBHA’s implementation of EHRs, the community health center has consistently ranked above the 95th percentile nationally in total medical and dental team productivity.

Approximately 65 million Americans live in communities with shortages of primary care providers and nearly 50 million live in rural areas. Sebelius said health information technology, and specifically EHRs, can improve care for patients and assist in clinical decision-making and the use of evidence-based guidelines. EHRs can also decrease administrative hassle, increasing workplace satisfaction and productivity.

The American Recovery and Reinvestment Act encourages greater use of health information technology through significant new investments, Sebelius said. Through incentive payments to providers and hospitals, she said, the ARRA will accelerate the adoption of health information technology and creation of an interoperable, nationwide network, and health insurance reform will build on this investment by simplifying and streamlining administrative procedures, investing in telehealth and improving the quality of healthcare.

Above article published on

http://www.healthcareitnews.com/news/hhs-secretary-speaks-power-healthcare-it-rural-communities

Health and Human Services Secretary Kathleen Sebelius has awarded grants totaling $27.8 million to health center-controlled networks and large multi-site health centers to implement electronic health records and other health information technology.

“The increased use of health information technology is a key focus of our reform efforts because it will help to improve the safety and quality of healthcare generally while also cutting waste out of the system,” she said.

The funds are part of the $2 billion allotted to HHS’ Health Resources and Services Administration under the American Recovery and Reinvestment Act of 2009 (ARRA) to expand healthcare services to low-income and uninsured individuals through its health center program.

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

Eighteen grants totaling more than $22.6 million will support EHR implementation, and another $2.6 million will help four grantees implement a variety of health IT innovations. This includes the creation of health information exchanges and the incorporation of health IT at dental delivery sites. Another five grants, totalling more than $2.5 million, will help health centers devise plans to use existing EHRs to improve patient health outcomes.

“Broad use of health information technology has the potential to improve healthcare quality, prevent medical errors and increase the efficiency of care provision,” said David Blumenthal, the national coordinator for health information technology. “This program supports the department’s overall efforts to assist physicians and hospitals in adopting and becoming meaningful users of health information technology.”

Above article published on

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