By Brian Robinson,

The Centers for Medicare and Medicaid Services is still on target to publish by the end of the year a proposed rule on the meaningful use of electronic health records, despite growing fears from industry about the possible impact of the regulation.

Tony Trenkle, director of the Office of e-Health Standards and Services at CMS, said he had been spending a lot of time with health industry folks who have expressed “concerns and fears” about what will be in the regulation.

Those include how high the bar will be set for meeting meaningful use targets during the first year of implementation, and whether the industry will be able to meet them, he told a meeting today of National Committee on Vital and Health Statistics (NCVHS).

Other concerns include whether hospitals outpatient clinics would be eligible to receive separate payments, whether quality measures will disadvantage specialty health providers, and worries particularly by the states about whether CMS would be able to harmonize Medicare and Medicaid requirements.

Under the HITECH Act, a part of the American Recovery and Reinvestment Act, health care providers can receive payments from both the Medicare and Medicaid programs if they can demonstrate meaningful use of certified EHRs. Payments are due to begin in 2011.

One of the major outcomes of the Nov. 19-20 NCVHS meeting is expected be a letter setting out recommendations to the Secretary of the Health and Human Services for measures that can be applied to decide on just what meaningful use is.

They include commissioning a “fast track” study from the Institute of Medicine on a national strategy for quality measurement development, to begin a process to identify essential data elements, to require EHR vendors to use defined quality data elements, and to require that any certified EHR be able to add data elements that may be defined in the future.

The NCVHS expects to release the final version of the letter at the Nov. 20 conclusion of its meeting.

Above article published on http://www.govhealthit.com/newsitem.aspx?tid=10&nid=72449

By Brian Robinson,

The Centers for Medicare and Medicaid Services is still on target to publish by the end of the year a proposed rule on the meaningful use of electronic health records, despite growing fears from industry about the possible impact of the regulation.

Tony Trenkle, director of the Office of e-Health Standards and Services at CMS, said he had been spending a lot of time with health industry folks who have expressed “concerns and fears” about what will be in the regulation.

Those include how high the bar will be set for meeting meaningful use targets during the first year of implementation, and whether the industry will be able to meet them, he told a meeting today of National Committee on Vital and Health Statistics (NCVHS).

Other concerns include whether hospitals outpatient clinics would be eligible to receive separate payments, whether quality measures will disadvantage specialty health providers, and worries particularly by the states about whether CMS would be able to harmonize Medicare and Medicaid requirements.

Under the HITECH Act, a part of the American Recovery and Reinvestment Act, health care providers can receive payments from both the Medicare and Medicaid programs if they can demonstrate meaningful use of certified EHRs. Payments are due to begin in 2011.

One of the major outcomes of the Nov. 19-20 NCVHS meeting is expected be a letter setting out recommendations to the Secretary of the Health and Human Services for measures that can be applied to decide on just what meaningful use is.

They include commissioning a “fast track” study from the Institute of Medicine on a national strategy for quality measurement development, to begin a process to identify essential data elements, to require EHR vendors to use defined quality data elements, and to require that any certified EHR be able to add data elements that may be defined in the future.

The NCVHS expects to release the final version of the letter at the Nov. 20 conclusion of its meeting.

Above article published on http://www.govhealthit.com/newsitem.aspx?nid=72449

By Brian Robinson

Most hospital and physician offices have their work cut out for them to meet the health IT meaningful use requirements of the HITECH Act, according to a new study – and they will only do so by carefully architecting IT solutions to capture and manage data in a way that’s intuitive for clinicians.

The study from HIMSS Analytics maps the requirements of the stimulus law to the organization’s own seven-stage EMR Adoption Model (EMRAM). The results identify implementation gaps that need to be bridged if the health care industry is to meet the 2015 targets for meaningful use.

Certain parts of the process will be relatively easy. The study’s author, HIMSS Analytics’ vice president Michael Davis, points out that the 2011 HITECH measurements that require first stage EMRAM functionality – installation of laboratory, radiology and pharmacy information systems – can already be met by some 90 percent of the relevant hospital departments.

After that, however, things get progressively trickier. The only Stage 2 requirement for the 2011 measurements, for example, is the ability to store lab results in structured formats such as Logical Observation Identifiers Names and Codes (LOINC), but many hospitals can’t do that yet.

Measurements that require Stage 3 functionality is where the real challenges start to turn up. The higher levels of clinical decision support systems that will be needed have so far been implemented by less than a quarter of the healthcare market, for example, and there are broad differences among systems in the ease with which they allow data elements to be added.

The 2013 HITECH measures ratchet things up significantly. Orders will need to be tracked through a computer physician order entry (CPOE) system, an EMRAM Stage 4 capability, but less than half of U.S. hospitals have it, only some 11 percent of physicians managing patients in hospitals use it, and under five percent of hospitals require their doctors to use CPOE.

Similarly, the HIMSS study points out, hospitals are lagging in their ability to provide such things as portals that patients can use to get access to their medical records. Few hospitals have so far chosen to even participate in data sharing projects.

Measures for 2015 are not so well-defined yet, but at the least they suggest that substantial data sharing and reporting on defined metrics will be a major requirement, Davis writes. That means that the adoption of CPOE by physicians will have to increase substantially by then. Also, all hospitals will have to implement clinical data warehouses.

So, Davis concludes, though hospitals that have achieved the EMRAM stage 3 capabilities are well positioned to meet the 2011 ARRA requirements, by 2015 they will need to have the majority of their physicians using stage 6 applications, with completely electronic medical records in place.

Only those organizations that understand those needs will survive the upcoming healthcare delivery transformation, he said.

Government Health IT magazine is published by HIMSS.

Above article published on http://www.govhealthit.com/newsitem.aspx?tid=10&nid=72187

By Mary Mosquera

The National Institutes of Health awarded Kaiser Permanente $54 million in grants for projects that will tap clinical information from the provider’s mammoth electronic health record database to study links between genes and conditions such as heart disease, obesity, diabetes and aging.

The NIH funding originated with the HITECH Act, which allocated $400 million to NIH to support comparative effectiveness research.

The largest of the 22 awards provides $24.8 million to study the influence of genes and the environment on health, disease and longevity over time and across diverse groups of people. The grants will fund genotyping of 100,000 Kaiser members in Northern California. The University of California in San Francisco is also a partner in the research.

The analysis will link genetic information with historical clinical data taken from health surveys and Kaiser’s electronic health record database, according to Raymond Baxter, senior vice president for Kaiser. Researchers will add to the study environmental information, such as air and water quality and proximity to parks and healthy foods.

Dr. Richard Hodes, NIA director of the National Institute on Aging, said genetic information generated by the project may help researchers discover genetic factors that explain differences between people in response to medications.

“This would help doctors provide patients with the best medicines for them individually,” he said.

The grant package included $7.2 million in funding to develop a cardiovascular surveillance system for a collaborative of 14 different health plans across the U.S.

A $3.3 million grant will create a National Research Database to organize Kaiser Permanente’s electronic health records.

A $1,005,372 portion of the funding will be used to integrate the Kaiser Permanente electronic medical record to measure rehabilitation outcomes for stroke patients. Another $99,971 was allocated to study the use of natural language processing to extract data from the electronic medical record.

Above article published on

http://www.govhealthit.com/newsitem.aspx?tid=10&nid=72202

Diana Manos, Senior Editor

Getting healthcare IT up and running in doctors’ offices is not the main objective behind the incentives provided by the federal government under the American Recovery and Reinvestment Act, according to David Blumenthal, MD, national coordinator of health information technology.

Improving health is.

At the 17th Annnual National HIPAA Summit held Sept. 15-18 in Washington, D.C., Blumenthal called the HITECH Act — included in ARRA — “brilliant” and “a visionary piece of legislation.” With $20 billion allotted to the advancement of healthcare IT, he said, the law would lay the foundation for health reform in the nation.

The United States has never spent this kind of money on sharing health information and protecting it, he said.

Blumenthal told attendees at the summit how he came to embrace the importance of healthcare IT. He had never been a technologically oriented person, he said, but was asked seven years ago by the hospital where he worked to learn how to use an electronic health record.

“It wasn’t easy,” he said. “But I soon learned it was an enormous boon to me to be able to access my patients’ records outside of the office.”

Blumenthal said he started using EHRs in his practice and noticed it changed the way he was able to take care of his patients. He could access specialists’ reports, lab results and medications. “I knew more about my patients. I could tell my patients things they needed to know and couldn’t know in a timely way from their specialists,” he said. “Those are things that had real value to me as a clinician and to my patients. That is the value that made me convinced that these technologies were going to benefit me as a clinician.”

Privacy is critical, Blumenthal added, and “absolutely foundational” to realizing the vision that the Obama administration has for improving healthcare through healthcare IT. The advancement of healthcare IT through ARRA will only be successful, he said, if the public has confidence in the privacy and security of their personal health information and if physicians buy in.

“The use of IT has professional competence at its core, ” he said. “I believe in the future my colleagues will see value in healthcare IT. Treating medicine is about information. Part of competence will be knowing how to protect (personal health) information, and another part will be knowing how to access it.”

Above article published on

http://www.healthcareitnews.com/news/healthcare-it-means-not-end-says-blumenthal