Edition Forty-One (3/30/10)

Health Information Exchanges—To Lead or To Follow
iHealthbeat, 3/26/10
CMS' recently proposed Meaningful Use definition does not require hospitals to participate in HIEs to demonstrate Meaningful Use in Stage 1. However, future stages of Meaningful Use will not offer such concessions—hospitals aiming to collect the federal incentives associated with Meaningful Use will have to actively participate in HIEs.

Reform Act Offers I.T. Help for Long-term Care
Modern Healthcare, subscription required 3/26/10
When ARRA became law last year, its HIT subsidy program had provisions for hospitals, doctors, and even some dentists, but not long-term-care facilities. The Patient Protection and Affordable Care Act addressed that dearth of I.T. subsidies to long-term care, but only just barely, given the size of the long-term-care industry.

Reform Law Closes Some HIPAA Loopholes
Modern Healthcare, subscription required 3/25/10
On the HIT front, the health reform law has an entire section on “administrative simplification,” as did HIPAA. The section in the new law deals with the technology of medical claims processing and other insurance-related transactions—and it addresses other HIPAA loopholes.

Rule OKs e-Scripts for Controlled Rx
Health Data Management, 3/25/10
The DEA has published a long-delayed interim final rule to permit electronic prescriptions for controlled substances. Controlled substances account for up to 20 percent of all prescriptions, according to various studies, which has forced providers who have adopted e-Prescribing to still maintain paper processes.

ONC Puts 'NHIN Direct' on Fast Track
Healthcare IT News, 3/25/10
ONC plans to release a set of draft standards for "NHIN Direct," an abridged set of specifications for the National Health Information Network, which would give providers a simple way to exchange health information securely over the Internet.

Feds Want Input on HIT Strategic Plan
Health Data Management, 3/24/10
The HIT Policy Committee's Strategic Plan workgroup will hold a three-hour "listening session" on April 6 to get feedback on a draft update to the Federal Health I.T. Strategic Plan.

DOD/VA Health Records Project Yielding Important Lessons
Federal Computer Week, 3/24/10
The joint health data exchange pilot project between the Defense and the Veterans Affairs departments, The Virtual Lifetime Electronic Record (VLER) Health Communities Program, created by Obama, has taught valuable lessons about interoperability.

ONC Names Managers for 'Beacon' Grants Program
Healthcare IT News, 3/24/10
ONC has named two health care policy experts to manage its "Beacon" communities project, a $200 million grant program designed to showcase how health I.T. can improve population health. ONC has not said when it anticipates awarding the Beacon Community grants.

I.T. Measures Scattered through Reform Law
Modern Healthcare, subscription required 3/24/10
References to HIT are found throughout the Patient Protection and Affordable Care Act, the health care reform legislation Obama signed into law. In fact, "information technology" was mentioned 44 times in the law, and it is laced with additional references for EHRs and I.T. standards.

Can Electronic Clinical Documentation Help Prevent Diagnostic Errors?
New England Journal of Medicine, 3/24/10
Although clinical documentation plays a central role in EHRs and occupies a substantial proportion of physicians’ time, documentation practices have largely been dictated by billing and legal requirements. Yet the primary role of documentation should be to clearly describe and communicate what is going on with the patient.

I.T. Plays Critical Role in Health Care Reform
Federal Computer Week, 3/23/10
HIT and EHRs underpin many of the provisions in the comprehensive health reform legislation passed by Congress, especially in improving efficiency, transparency, and quality of care, and reducing fraud.

EHRs a “Strong Priority” for U.S. Government
CMAJ, 3/23/10
Two years after Obama’s presidential campaign pledge to vastly increase usage of EHRs, the White House is following through. The Obama administration is implementing aggressive and expensive plans rooted in the president’s belief that EHRs are crucial to health care modernization and cost containment.

Feds to Rely on Technology to Make Health Reform Law a Reality
NextGov, 3/23/10
The historic health care reform bill Obama signed into law calls for development of state HIEs which will eventually allow Americans to compare insurance through Web portals as easily as they price and book airline tickets.

A New Era in I.T.'s Strategic Importance
H&HN, 3/23/10
Changes to the payment system and the growing need for EHRs have major ramifications for providers. I.T. is strategic when the technology becomes an essential contributor to the organization's strategies and its ability to thrive in an environment which brings new opportunities and threats.

Commentary: Your Plate Just Spilled Over
Health Data Management, 3/22/10
In public comments to federal officials about the proposed Meaningful Use criteria, one message came through loud and clear: there are already a lot of regulatory deadlines on our plate and the Meaningful Use criteria are too much, too soon.

As Health Data Goes Digital, Security Risks Grow
Businessweek, 3/22/10
Over the next four years, the amount of personal medical information on-line will increase exponentially, opening up new avenues for hackers to expose personal data which, unlike financial information, can result in a permanent violation of privacy.

NIST Readies EHR Testing
Health Data Management, 3/19/10
The National Institute of Standards and Technology has released the first of four installments, called Waves, of new test methods for ensuring EHRs systems comply with Meaningful Use requirements.

Conference Focuses on Security Rule
Health Data Management, 3/19/10
HHS' Office for Civil Rights and NIST will host a conference to discuss the HIT security landscape, particularly the HIPAA security rule.

Officials Begin Sifting through Comments on Meaningful Use
iHealthbeat, 3/18/10
Federal officials say they are starting to identify trends in the 2,700 public comment letters submitted in response to proposed rules and certification standards for the Meaningful Use of EHRs. 

249 House Members Join Call for Modifications to Meaningful Use Rules
iHealthbeat, 3/18/10
A letter signed by 249 members of the House of Representatives calls for CMS to revise proposed regulations on the Meaningful Use of EHRs.

Letter Tells CMS to Set More Specific EHR Goals
Modern Healthcare, subscription required 3/18/10
To successfully implement the broad use of EHRs, the CMS needs to make its health goals and targets more explicit, according to public comments submitted by health care leaders from 56 organizations.

Fed Advisors Set April Meetings
Health Data Management, 3/17/10
The HIT Policy Committee and HIT Standards Committee have set their workgroup meeting schedules for April. These groups are doing the bulk of work for recommendations to ONC on the Meaningful Use rules and other health I.T. initiatives.

Hospitals as Software Service Providers 
HealthLeaders, 3/17/10
It's no secret small physician groups and community hospitals are going to be hard-pressed to meet the Meaningful Use requirements in 2011. Health systems are stepping into a new role, offering software as a service to realize value from EMRs.

Vendors: Ease Meaningful Use Criteria
Health Data Management, 3/16/10
The HIMSS EHR Association, a trade group of vendors, has joined many other stakeholders in asking CMS to significantly streamline Meaningful Use requirements and change unrealistic compliance timetables.

AHA Recommends Changes to EHR Standards, Implementation
HealthLeaders, 3/16/10
Adding its voice to the EHR standards debate, the American Hospital Association asked for changes to proposed EHR standards, implementation, and certification.

Consumer Groups Rally for Patient Focus in Meaningful Use
Government Health IT, 3/15/10
The government should not water down the patient and consumer provisions of its proposed health I.T. Meaningful Use rule to focus narrowly on simple adoption of HIT, a group of consumer organizations warned.

Funds Awarded to Expand Medical I.T. Use
UPI.com, 3/15/10 
An additional $162 million in economic stimulus funds will help push broad use of HIT, HHS said. The awards Kathleen Sebelius announced were part of a $2 billion effort to achieve widespread and Meaningful Use of health I.T. and to provide use of EHRs to every citizen by 2014.

Physicians Reluctant to Implement EHRs
ADVANCE, 3/15/10 
NPR held a discussion with physicians about the implementation of EHRs, the progress made so far, and why some doctors are reluctant to make the switch.

Six States Receive Federal Funds for EHR Incentives
Healthcare IT News, 3/25/10
CMS announced six states which will receive federal matching funds for EHRs: Colorado will receive $798,000, Utah will receive $396,000, Wyoming will receive $596,000, Nevada will receive $1.05 million, Mississippi will receive $1.47 million, and North Carolina will receive $2.29 million.

New Jersey Awarded $11.4 Million for EHRs
News Room New Jersey, 3/25/10
The New Jersey state government will receive $11.4 million in federal funds over the next four years to finance four HIE projects designed to allow hospitals, doctors, and health insurance companies to share EMRs in real time over secure networks.

State to Get Funds for Electronic Health Records
Clarion Ledger, 3/24/10
Mississippi will receive approximately $1.47 million in federal matching funds for planning activities necessary to implement the EHR incentive program. Mississippi will use its funds for conducting a comprehensive analysis to determine the current status of HIT activities in the state.

Virginia Bill Mandates Telemedicine Coverage; Barriers Remain
iHealthbeat, 3/22/10
The Virginia Legislature unanimously approved a bill which would require private health insurers, health care subscriptions plans, and HMOs to cover for the cost of health care services provided through telemedicine technology.

Maryland Wins $9.3M in Stimulus Funds for e-Health Records
Washington Business Journal, 3/15/10
The Maryland Health Care Commission will receive $9.3 million in stimulus money toward an ongoing project to develop an HIE. 

Patients Need Data Control, Google Exec Says
Modern Healthcare, subscription required 3/26/10
Patients should decide who gets to see their health care data, said Alfred Spector, Google vice president of research and special initiatives, during a question-and-answer session held after his presentation at the American College of Healthcare Executives' annual congress.

Remote Health Management Market is Growing Fast, But Reimbursement Lags
Healthcare IT News, 3/24/10
The remote health management market is the smallest, but fastest growing segment of the home health management market, but to reach its full potential health insurers must broaden their reimbursement practices to encourage greater physician adoption.

Do Consumers Like HIEs?
Health Data Management, 3/23/10
ONC plans to survey more than 2,500 households across the nation to assess consumer attitudes toward HIEs. The survey will permit ONC to better understand individuals' attitudes toward electronic health exchange and its associated privacy and security aspects as well as inform policy and programmatic objectives.

ISO Reports Cover Patient Archives
Health Data Management, 3/23/10
The International Organization for Standardization has published two documents which provide internationally harmonized guidelines for archiving patient information.

Report: Mobile Health Market Expected to Reach $4.6B by 2014
iHealthbeat, 3/22/10
The mobile health technology market is expected grow by 25% annually, reaching $4.6 billion by 2014, up from $1.5 billion currently. Adoption could accelerate if certain health care reform proposals, such as pay-for-performance, are implemented.

FCC: Broadband Key to Health Care I.T. Initiatives
InformationWeek, 3/17/10
Extending the U.S. broadband infrastructure would significantly improve the development of EHRs, while reducing costs and saving hundreds of billions of dollars in the coming decades, a federal report shows. 

e-Prescriptions Cut Medication Errors: Study
Reuters Health, 3/16/10
Researchers found among 12 New York State primary care practices, the six who had adopted e-Prescribing reduced errors by nearly seven-fold over one year.

Ten Ways to Increase Nurses' Time at the Bedside 
HealthLeaders, 3/16/10
Bedside nurses are occupied in non-patient care tasks for a quarter of their shifts, according to a survey. The report shows nurses lose three hours of patient care every 12-hour shift to redundant paperwork and regulatory requirements.

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