On Tuesday, federal officials announced the release of the final rule defining how hospitals and health care providers can demonstrate “meaningful use” of electronic health records to qualify for federal incentive payments, Reuters reports (Lentz, Reuters, 7/13).

Officials also released the final rule describing the required standards and certification criteria for EHR technology. The new regulation updates the interim final rule on EHR certification that ONC released in January (Mosquera, Government Health IT, 7/13).

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified EHRs will qualify for incentive payments through Medicaid and Medicare.

HHS Secretary Kathleen Sebelius, new CMS Administrator Donald Berwick, National Coordinator for Health IT David Blumenthal and Surgeon General Regina Benjamin announced the rules during a news conference (Health Imaging & IT, 7/13).

Core Meaningful Use Objectives

Blumenthal said the final meaningful use rule offers health care providers more flexibility than the proposed regulations released in January.

The final rule requires physicians to meet a set of 15 core objectives during the first stage of the incentive program. Hospitals are required to meet 14 core objectives for Stage 1. In addition, all health care providers will need to comply with five objectives out of a “menu” of 10 options (Manos, Healthcare IT News, 7/13).

The earlier proposed rule included 25 objectives for physicians and 23 objectives for hospitals.

One of the core objectives requires health care providers to transmit 40% of prescriptions electronically. The requirement was relaxed from the earlier proposed regulations, which called for a 75% electronic prescribing rate.

Health care providers also will need to enact a single measure to meet the clinical decision support requirement, down from five measures in the previous proposal.

In addition, CMS reduced the number of quality measures that health care providers must report on, deferring some measures to Stage 2 meaningful use requirements (Versel, FierceEMR, 7/13).

Another core objective requires hospitals and physicians to use computerized physician order entry systems to capture at least 30% of medication orders. Under the earlier regulations, hospitals would need to use CPOE systems for 10% of medication, laboratory and diagnostic orders, while doctors would need to use the systems for 80% of such orders (Robeznieks, Modern Healthcare, 7/13).

‘Menu’ of Additional Options

In addition to the core objectives, the final rule requires doctors and hospitals to comply with five objectives out of the menu of 10 options. Health care providers will need to comply with the remaining objectives as part of Stage 2 meaningful use requirements (Healthcare IT News, 7/13).

One of the new objectives in the menu calls for health care providers to offer patients condition-specific educational resources.

Clarifications on Eligibility

The final meaningful use rule defines a hospital-based eligible professional as someone who performs nearly all services in an inpatient hospital setting or emergency department.

The rule also expands the definition of acute-care hospital to include designated Critical Access Hospitals for the Medicaid incentive program (Health Imaging & IT, 7/13).

Additional Information in NEJM Piece

Blumenthal and Marilyn Tavenner, principal deputy administrator of CMS, offered additional explanations of the final meaningful use rule in a New England Journal of Medicine perspective piece.

In the perspective piece, Blumenthal and Tavenner explain that HHS weighed 2,000 outside comments before deciding on “significant changes” to the earlier meaningful use regulations.

The piece also includes a full list of the core objectives and the menu of options for the new final rule (Hobson, “Health Blog,” Wall Street Journal, 7/13).

In addition, Benjamin authored a companion piece that also appeared in the journal (FierceEMR, 7/13).

Next Steps

In January 2011, eligible health care providers and hospitals can begin registering for the EHR incentive program. CMS will manage the registration for both the Medicaid and Medicare incentive programs from one virtual location.

Federal officials expect to release additional information on the Stage 2 and Stage 3 meaningful use requirements over the next few years (Mearian, ComputerWorld, 7/13).

Source:http://www.ihealthbeat.org/articles/2010/7/13/final-rules-on-meaningful-use-ehr-standards-released-today.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#

Last Monday, CMS launched a new website intended to help health care providers better understand the criteria to meet federal requirements for the “meaningful use” of electronic health record systems, Government Health IT reports.

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of EHRs will qualify for Medicare and Medicaid incentive payments (Mosquera, Government Health IT, 6/21).

Website visitors can download fact sheets detailing the proposed program requirements and the proposed definition of meaningful use.

The site also clarifies various terms, such as “eligible professional” and “certification,” that are included in the HITECH Act (McKinney, Modern Healthcare, 6/21).

In addition, the site includes:

• An overview of the incentive program;
• Information about what health care providers are eligible for incentive payments;
• Information on how to register for the program; and
• Guidance on what health care providers can do to prepare for meaningful use.

CMS also said that it would use the website to publicize EHR training and events related to the incentive program (Government Health IT, 6/21).

According to Modern Healthcare, the website will offer more specific information about the incentive eligibility requirements after CMS issues the final rule on the EHR incentive programs later this summer (Modern Healthcare, 6/21).

Source: http://www.ihealthbeat.org/articles/2010/6/22/cms-unveils-new-website-on-meaningful-use-incentives.aspx

By, Diana Manos

CHICAGO – Officials of HIMSS Analytics, the not-for-profit subsidiary of the Healthcare Information and management System Society (HIMSS), announced Wednesday they would be adding new questions to their annual study on meaningful use to gauge hospitals’ readiness.

With hospitals expected to complete the first phase of deadlines for meaningful use by 2011 to qualify for bonuses under the American Recovery and Reinvestment Act of 2009, HIMSS Analytics will ask hospitals about their inclusion of structured document standards to convert narrative data to a structured format importable to an electronic medical record (EMR).

HIMSS Analytics tracks the EMR implementation status of more than 5,000 U.S., non-governmental hospitals through its annual study with hospital CIOs. The data gathered provides a detailed look at the clinical and financial application environments in U. S. hospitals.

HIMSS Analytics also developed the Electronic Medical Record Adoption ModelSM - or EMRAM - to score hospitals in the HIMSS Analytics Database on their .progress in completing the eight stages to creating a paperless patient record environment.

“In our evaluation of EMR Adoption Model scores over 2008-2009, we found that hospitals are continuing to advance the care delivery capabilities of their EMR environment,” said John Hoyt, vice president of HIMSS Healthcare Organizational Services.

“ARRA funding incentives are driving EMR implementation,” Hoyt said. “With this expanded arsenal of data, HIMSS Analytics can help healthcare providers better understand and follow the Meaningful Use requirements while moving higher on the EMRAM scale.”

According to Liora Alschuler executive committee representative of the Health Story Project, which helped write the new questions for HIMSS Analytics, much of the information in a patient’s medical record may be entered by the physician or nurse in chart form, such as notes taken during a clinic visit, lab reports or other information that contributes to the completeness of individual health history.

Health Story produces data standards for the flow of information between common types of healthcare documents and electronic medical records, Alschuler said.

Alschuler, principal, at Alschuler Associates, LLC, said the Health Story standards are based on HL7 Clinical Document Architecture reusing templates from the Continuity of Care Document. The Health Story Project, founded a little over two years ago, is a nonprofit collaborative of healthcare vendors, providers and associations.

“The members of Health Story believe that all of the clinical information required for good patient care, administration, reporting and research should be readily available electronically, including information from narrative documents,” Alschuler said. “With the data gathered from the HIMSS Analytics Study, we will know how hospitals are using document standards to enrich the flow of information to their EMRs.”

Officials at HIMSS Analytics said they expect to begin reporting on hospital readiness for meaningful use in September 2010.

Source: http://www.healthcareitnews.com/news/himss-analytics-gauge-hospital-readiness-meaningful-use

Last week, National Coordinator for Health IT David Blumenthal published an open letter touting the Nationwide Health Information Network as a model to help health care providers meet the “meaningful use” requirements of the 2009 federal economic stimulus package, Modern Healthcare reports.

Under the stimulus package, health care providers who demonstrate meaningful use of electronic health records will qualify for Medicare and Medicaid incentive payments (Conn, Modern Healthcare, 5/17).

Blumenthal wrote that NHIN is “not a network per se, but rather a set of standards, services, and policies that enable the Internet to be used for the secure exchange of health information to improve health and health care.”

NHIN Direct

He also acknowledged that some health care providers “may have simpler needs for information exchange, or perhaps less technically sophisticated capabilities.” He said such health care providers could benefit from NHIN Direct, which still is under development (Blumenthal letter, 5/14).

NHIN Direct is a basic version of NHIN that offers health care providers open-source software to develop a network for the electronic transmission of health information (Modern Healthcare, 5/17).

Blumenthal wrote that NHIN Direct “is meant to enhance, not replace, the capabilities offered by other means of exchange.” He added that the model could “complement existing NHIN exchange capabilities and strengthen our efforts toward comprehensive interoperability across the nation” (Blumenthal letter, 5/14).

In addition, Blumenthal wrote that ONC is “on an aggressive timeline” to develop standards for NHIN Direct so health care providers can use the framework to qualify for incentive payments.

He also called for greater public participation in the NHIN Direct project through blogs and a community wiki, which are available on the project’s website (Modern Healthcare, 5/17).

Above article publish on http://www.ihealthbeat.org/articles/2010/5/17/blumenthal-nhin-nhin-direct-offer-paths-to-meaningful-use.aspx

By Neil Versel

If nothing else, it should at least be easy to register to receive federal incentive payments for meaningful use of EMRs.

CMS has awarded a $1.6 million contract to CGI Federal, a Fairfax, Va.-based unit of Montreal-based technology consulting firm CGI Group, to revise the existing Provider Enrollment Chain Ownership System (PECOS) so physicians and hospitals can attest to meeting the requirements for meaningful use that will qualify them for Medicare bonuses. PECOS currently manages and verifies enrollment of Medicare providers and vendors.

Build-out of the online system to accommodate EMR incentive enrollment should take about 10 months, CMS says. Hospitals, however, could be eligible for the bonuses as soon as the end of December, since the rules for meaningful use, as currently proposed, only requires providers to meet the standards for 90 consecutive days in 2011. Medicare Part A, which applies to inpatient care, follows the federal fiscal year, which begins Oct.1.

For more information:
- see this Government Health IT story
- read this CMS notice about the contract award

Above article publish on http://www.fierceemr.com/story/providers-will-attest-meaningful-use-cms-registration-system/2010-04-22

Yesterday, Reps. Patrick Kennedy (D-R.I.) and Tim Murphy (R-Pa.) introduced a bill (HR 5025) that would allow behavioral, mental health and substance abuse treatment providers to qualify for incentive payments for the “meaningful use” of electronic health records, Healthcare IT News reports.

Under the 2009 federal economic stimulus package, hospitals and physicians who demonstrate meaningful use of EHRs can qualify for incentive payments through Medicaid and Medicare.

The new Health Information Technology Extension for Behavioral Health Services Act of 2010 would extend eligibility for the incentive payments to:

• Behavioral and mental health professionals and clinics;
• Substance abuse professionals and treatment facilities;
• Psychiatric hospitals; and
• Licensed psychologists and clinical social workers (Merrill, Healthcare IT News, 4/16).

Above article publish on http://www.ihealthbeat.org/articles/2010/4/16/bill-would-expand-eligibility-for-meaningful-use-incentives.aspx

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/

By Andrea Kraynak

Hospitals with electronic health records (EHR) may be eligible for meaningful use incentives as early as October 2010, and physicians follow soon after. What if a provider is hoping to take advantage of the incentives, but is still fully paper-based? Waiting for the release of final rules on the incentive program and EHR certification before moving forward may not be wise.

Providers should begin by looking into the reasons their facility doesn’t have many of the components that make up an EHR, or lacks an electronic system altogether. For example, if providers haven’t begun to invest in a system because of high up-front costs, they may be able to obtain funding that can help.

“Right now, there is a significant amount of money that is being funneled through the states for health IT,” says Chris Apgar, CISSP, president of Apgar & Associates, LLC, in Portland, OR. Depending on their location, healthcare providers may be able to take advantage of it.

“Go to the medical association in your state that you’re a member of, and put a little pressure on them,” he says.

If your state has grant or loan funding available, remind your association that there is money available and encourage them to lobby and partner with others to push your state to start allocating EHR funding, whether it happens to be low- or no-interest loans or outright grants.

If your state is not offering funding, there may be other programs you can find that offer no- and low-cost loans and other programs to provide support and consultative assistance, especially for small hospitals and physicians, says Margret Amatayakul, RHIA, CHPS, CPHIT, CPEHR, FHIMSS, president of Margret\A Consulting in Schaumburg, IL.

Smaller providers may also want to look into independent physicians associations (IPA), some of which are purchasing EHRs and making them available through a subscription fee. With this option, you have your own Web-based version, and you pay the IPA a certain amount annually to host the EHR, explains Apgar.

“This can be affordable because you don’t have to go out and buy a brand-new system and implement it and have someone administer it and all that,” he says. “You’re paying a subscription fee to use it, in essence, so you don’t have the cost of ownership.”

Remember, however, that subscription-based EHRs may end up costing more in the end, even though they are becoming more common, Apgar says.

If you are still searching for an EHR vendor, don’t forget about the big picture. With additional requirements coming soon, whether additional meaningful use measures or other capabilities your EHR will need to be ICD-10 compliant, look for a product and vendor that will be able to keep up.

“If you are in the position of buying a product today, you want to be buying a product that is going to take you through those stages,” Amatayakul says. “My sense is that you approach this by trying to address the long haul. Otherwise, you’re going to be faced with pieces of things that don’t work together real well.”

And avoid vendors who don’t have a sense of the upcoming changes and how they plan to address them.

“If there is little to no understanding on the part of the vendor as to what this means, or the vendor can’t describe for you what they plan to do, I would avoid that vendor,” Amatayakul says. “That means they’re not going to be able to keep up.”

Above Article Publish on http://www.healthleadersmedia.com/page-1/TEC-247509/Get-Moving-to-Catch-Early-EHR-Meaningful-Use-Incentives

The Health IT Standards Committee’s implementation work group is considering the development of an online collection of resources to help health care providers and vendors meet proposed “meaningful use” criteria for electronic health records, Government Health IT reports.

Earlier this year, CMS published a notice of proposed rulemaking describing how health care providers can demonstrate meaningful use of certified EHRs to qualify for incentive payments under the 2009 federal economic stimulus package.

At a recent work group meeting, health care providers asked for more guidance on how to comply with the meaningful use rules.

Aneesh Chopra — chair of the panel and U.S. Chief Technology Officer — said the work group could generate a digital library that would enable health care providers to access details about requirements for each meaningful use provision.

He said the panel’s blog could serve as an initial source of information. He added that the work group also could pass along user feedback to the Office of the National Coordinator for Health IT.

The work group is scheduled to offer recommendations to the full Standards Committee on April 28. The panel might propose a formal resource Web site as part of its recommendations (Mosquera, Government Health IT, 3/31).

Above article publish http://www.ihealthbeat.org/articles/2010/4/1/panel-mulls-creation-of-resource-web-site-for-meaningful-use-rules.aspx