Edition Sixty-Six (4/5/11)

Role of I.T. Appears Key to ACO Push
Modern Healthcare, subscription required 4/1/11
The strong suspicion that providers will have to bulk up on HIT if they want to form ACOs was elevated to the realm of virtual certainty. CMS rule makers spoke often of the centrality of I.T. in their plans as well as also how they intend to stitch together the ACO initiative with the incentive payment program already under way to help providers adopt and Meaningfully Use health I.T. under ARRA.

HHS To Study I.T. to Reduce Disparities
Health Data Management, 3/31/11
HHS will soon launch the first national plan to eliminate disparities between the health status of minority and non-minority populations. The initiative, dubbed the National Partnership for Action, will include a Health Information Technology Disparities Workgroup, which will convene for six weeks starting on April 5 to create a strategic plan for I.T. to support the partnership's work.

CMS Sets the I.T. Bar Very High for Medicare ACOs
Health Data Management, 3/31/11
The I.T. capabilities ACOs will need under the proposed rule establishing a Medicare Shared Savings Program, could go far beyond what's necessary to prove Stage 1 EHRs Meaningful Use. Compliance with coordination of care requirements may include telehealth and the establishment and use of HIT, including EHRs and HIE, to enable the provision of a beneficiary's summary of care record during transitions of care both within and outside of the ACO.

National Health Groups Team Up for Quality
Healthcare IT News, 3/31/11 
Three major health organizations have collaborated to create a quality improvement program aimed at improving outpatient care nationwide. Working with EHR providers from around the country, the program will provide doctors with the ability to easily gather, access, and report on important data which can ultimately lead to improved care and outcomes for patients. The program, called The Guideline Advantage, targets four of the ten leading causes of death in the U.S. today—heart disease, cancer, stroke, and diabetes.

Health I.T. is Foundation for Medical Home, Accountable Care
Government Health IT, 3/30/11
Widespread adoption of HIT and changes in how primary care providers are paid for their services are critical to drive transformation of the U.S. health care system, according to a recent report. Neither is sufficient by itself, but both are necessary to fuel major delivery system reform, according to the report about the benefits of patient-centered medical homes and ACOs, and what’s needed to realize them. 

Generic Prescriptions May Cause EMR Headaches
Becker's Hospital Review, 3/30/11
Patients who pay cash for their generic drugs may be causing their own EHRs to be incomplete and inaccurate, according to a study. Researchers found patients who purchase generic prescriptions with cash, rather than through their insurance plan, are causing pharmacy claims data to be incomplete because the prescription update is filed under the pharmacy's retail database.

HIMSS, MGMA Develop Privacy Toolkit for Docs
Modern Healthcare, subscription required 3/29/11
In a joint effort to help small clinics and physician practices safeguard their patients' health information, HIMSS has partnered with the Medical Group Management Association to produce a specialized set of easily accessible informational tools. Called the HIMSS Privacy and Security Toolkit for Small Provider Organizations, the interactive on-line resource allows users to share best practices and submit new privacy and security-related tools for consideration.

Standards Panel Explores Path to Stage 2 Meaningful Use
Government Health IT, 3/29/11
The Health I.T. Standards Committee has begun exploring some of the functions EHRs should be capable of performing in Stage 2 of Meaningful Use, with the use of HIE by providers to send patients their information to a PHR as a prominent example. Health care providers will have a choice in HIE in later Stages of Meaningful Use now that different methods are taking shape. Certification and standards criteria in Meaningful Use Stages 2 and 3 should support various methods of exchange when they are coupled with standards and robust testing, according to committee members. 

Medicare Previews EHR Incentives Attestation System
InformationWeek, 3/29/11
Eligible hospitals, health care professionals, and critical access hospitals can begin applying for Medicare EHR incentive payments beginning April 18, when the CMS' Web-based EHR Incentive Program Registration and Attestation System will be made available.

Senior Citizens Jumping On-line to Monitor PHRs 
Senior Journal, 3/28/11
Senior citizens are not the age group lagging behind in an on-line endeavor. A study to measure participation on adopting the use of on-line PHRs finds those patients aged 65 and older are more likely to get involved than young adults between the ages of 18 and 35.

CMS Has Paid Out $37.6M in EHR Incentives So Far
Government Health IT, 3/25/11
The CMS has paid out nearly $37.6 million so far in EHR incentives, according to a CMS posting on its Twitter page. CMS has also registered 25,217 eligible health care physicians and hospitals for its incentive programs.

Medicare Meaningful Use Attestation Starts April 18
Health Data Management, 3/25/11
Attestation for the Medicare EHR Incentive Program begins on April 18, 2011. In order to receive your Medicare EHR incentive payment, you must attest through CMS' Web-based Medicare and Medicaid EHR Incentive Programs Registration and Attestation System.

ONC Issues Five-Year HIT Strategic Plan
Health Data Management, 3/25/11
ONC released the Federal Health I.T. Strategic Plan for 2011-2015 and will accept public comment through April 22. The plan reiterates ONC will issue regulations to establish a governance mechanism for a NHIN and will include "elements" of privacy and security. It acknowledges the ongoing work of the HIT Policy Committee to study the degree to which individuals may choose to participate in electronic HIE.

NEJM: ACOs Don't Show Quick Return on Investment
CMIO, 3/24/11
Although the ACO model could generate savings and lead to more coordinated care, many organizations which embrace the model could lose money in the first three years, according to the New England Journal of Medicine. The ACO has been touted as a possible model for restructuring traditional Medicare coverage from volume-based to value-based rewards. 

CMS to Host Meaningful Use Calls
Health Data Management, 3/24/11
The CMS in early April will hold 90-minute educational conference calls to explain to eligible professionals and hospitals the registration process for the Meaningful Use program. Registration for the program has been open since early January and attestation—the process of demonstrating compliance with Meaningful Use requirements—begins during April on a date not yet finalized.

Rule to Streamline Telemedicine Credentialing Coming Soon?
Health Data Management, 3/24/11
The CMS has transmitted to the Office of Management and Budget a final rule to streamline credentialing processes for physicians and other practitioners providing telemedicine services. The rule will revise conditions of participation for hospitals and critical access hospitals to permit a new credentialing and privileging process for telemedicine practitioners.

Glitch Has CIOs Targeting FY12 for Stage 1 Attestation
Health System CIO, 3/23/11
While 40% of CIOs had planned to report Meaningful Use Stage 1 compliance in FY2011, a recently identified timing glitch—which would have compressed their time to comply with Stage 2 measures—has about half of them now planning to join their colleagues on a FY2012 attestation schedule. When asked if they considered the glitch a “major mistake,” 45% said it was.

Small Providers Benefit from EHRs, Survey Shows
HealthLeaders, 3/22/11
Health I.T. has benefited even small physician practices, according to a new report which contradicts other recent findings claiming EHRs and other health I.T. do not yield the benefits most providers expect. Previous studies focused on the early years of EHR when functions were not as mature, according to one of the authors of the survey article, David Blumenthal.

The Direct Project: Accelerating Government Innovation in Health I.T.
iHealthBeat, 3/22/11
In February 2011, two pilots of a new standard for sending health information securely over the Internet were launched. The pilots—one in Minnesota and one in Rhode Island—are the first tests of the Direct Project, an HHS initiative designed to simplify the exchange of information within the health care industry. The most noteworthy aspect of this initiative is how quickly it happened. These initial pilots are taking place less than a year after the Direct Project was started.

ONC Releases Details on Direct Project
Modern Healthcare, subscription required 3/22/11
ONC released two sets of specifications and a draft compatibility statement on its Direct Project, a software development effort to facilitate the basic, provider-to-provider communications needed to meet Meaningful Use criteria. An applicability statement for secure health transport and a Direct Project compliance statement, as well as the XDR and XDM for Direct Project messaging specifications are now available on-line. 

CMS Innovation Website Will be Tool to Vet Delivery Models
Government Health IT, 3/22/11
The CMS formally launched its innovations website, where it plans to gather and test new ideas to improve the health care system for its Medicare, Medicaid, and Children’s Health Insurance Program (CHIP). The Center for Medicare and Medicaid Innovation will pilot models for coordinated care for patients, as well as shared payments for health care providers, in various real-world settings. 

Direct Project Gets Wide Support for Simple Exchange
Government Health IT, 3/22/11
More than 60 health care organizations have said they will support the protocols for the Direct Project, leading to near universal health I.T. vendor adoption of a method for a simple exchange of patient information via secure e-mail. The industry commitment represents 90% of the market share covered by the participating health I.T. vendors and also includes health care organizations, state-based and private sector HIEs, and several integrated delivery systems. 

CMS Beefs Up Meaningful Use FAQ Section With New Questions
Becker's Hospital Review, 3/21/11
The CMS updated its Meaningful Use "Frequently Asked Questions" section with new questions and updated answers. One new question which was recently posted to the FAQ section answers eligible professionals' concerns about whether they can simultaneously participate in the quality reporting, e-Prescribing incentive, and EHR incentive programs and obtain payments for each.

Stage 2 of EMR Bonus Program Seen as Too Onerous
American Medical News, 3/21/11
Medical associations are warning that overly strict Meaningful Use criteria proposed by HHS for the next phase of the Medicare and Medicaid EHRs incentive program could dissuade physicians from participating. The AMA and 38 other members of organized medicine sent a letter outlining their concerns to OC, which is developing the objectives for the program.

Group Will Expand on ONC’s Connect Tools for Exchange
Government Health IT, 3/21/11
Two former senior managers for the Connect gateway program in the ONC have started a foundation which will expand on the program’s open source technology for HIE. The Alembic Foundation will take on a custodial agent role for the open community around the Connect platform under a new name, Aurion. It also released the Connect code under the Aurion name and will update that version in May.

Clinical Workflow Integration Tops Health I.T. Priorities
InformationWeek, 3/21/11
Telemedicine and collaborative tools are also high on health I.T. professionals' project lists, reports Avaya survey. During the next three years, 95% of health care I.T. professionals believe communication and workflow integration into health care information systems will be a very important issue to address as health care delivery organizations prepare to meet Meaningful Use and accountable care requirements. 

Meaningful Use Could Include Steps Toward PCAST Exchange Goals
Government Health IT, 3/18/11
ONC could include some functions in the requirements for the next Stage of Meaningful Use which would build toward the comprehensive information exchange system which a presidential commission recommended last year. These functions could include a patient’s ability to download information to a PHR, simple search by providers, and sharing immunization data.

Database Tracks State Reform-Related Bills
Health Data Management, 3/17/11
The National Conference of State Legislatures has developed a free database of legislation introduced in the states related to the Affordable Care Act. As of March 10, at least 594 such bills had been introduced across the nation as states make preparations to implement provisions of the reform law. 

MGMA: Harmonize Meaningful Use and e-Prescribing
Health Data Management, 3/17/11
The Medical Group Management Association is urging federal officials to modify the e-Prescribing incentive program payment process to avoid unfairly penalizing eligible professionals and to harmonize the process with the EHR Meaningful Use program. Kathleen Sebelius believes failure to do so will have the unintended consequence of subjecting a significant number of e-Prescribing eligible professionals to payment adjustments in 2012 and 2013.

HHS' Office for Civil Rights Wants More Money to Investigate Data Breaches
Modern Healthcare, subscription required 3/17/11
HHS' Office for Civil Rights says its requested 13.7% budget increase for fiscal 2012—to $46.7 million compared with $41.1 million for 2011—will allow it to more effectively investigate breaches of sensitive health information, reduce health care disparities and address discrimination based on disability.

Panel Examines Information Exchange Goals for 2013 Meaningful Use
Government Health IT, 3/16/11
A panel of the Health I.T. Policy Committee is exploring gaps in the infrastructure of HIE, solutions for which will be critical to some of the proposed objectives for Stage 2 of Meaningful Use, such as incorporating lab results in structured data. The Meaningful Use work group wants to be sure technologies, policies, and standards will be in place in 2013 to support exchange goals. 

HHS Joins Federal Info Sharing Efforts
Federal Computer Week, 3/16/11
HHS recently joined a federal information sharing system which already includes law enforcement, intelligence, homeland security, and diplomatic officials. HHS added a representative to the steering committee for the National Information Exchange Model (NIEM). NIEM is a federal data model of standards, vocabularies, and processes for sharing data across domains. 

Half of Americans Distrust Privacy of EHRs
eWeek, 3/16/11
A study reveals half of the U.S. population believes EHRs will impact their health in a negative way. According to the report, "Elevated Heart Rates: EHR and I.T. Security," Americans don't trust EHRs, but they trust their doctors.

I.T. Everything: Info Technology Blog - Not so Fast
Modern Healthcare, subscription required 3/14/11 
The HHS policy apparatus is beginning to signal it may walk back its impossible and foolishly rushed timeline for enacting Stage 2 criteria for the Meaningful Use.

HRSA Plans to Revamp Immunization Systems, Birth Records
Government Health IT, 3/14/11
The Health Resources and Services Administration is looking to award grants for I.T. to support the exchange of maternal and child health information, such as immunizations. HRSA’s Maternal and Child Health Bureau will focus on projects to expand the technical infrastructure to enable information exchange about immunizations across organizations which serve the maternal and child populations, and to develop electronic birth records. 

Costs, Training Top Hospital EHR Concerns
InformationWeek, 3/14/11 
Three out of four hospital executives say their organizations have partly or fully implemented EHRs of some sort, and 83% have either selected or implemented an EHR which can fulfill federal Meaningful Use requirements, according to a survey.

GAO Echoes Physician Concerns on EMR, e-Prescribing Bonuses
American Medical News, 3/14/11
Physicians are duplicating efforts and wasting money to satisfy Medicare's mismatched requirements for e-Prescribing and EHR incentive programs, a recent government watchdog report found. The Government Accountability Office criticized the CMS for failing to align the two programs, which provide bonus money for physicians who implement the technology by a certain date and eventual Medicare penalties for those who don't. For example, the e-Prescribing program does not require the use of the kind of certified technology which is required in the EMR Meaningful Use program.

Reaping the Benefits of Health I.T.: Q&A With ONC's Dr. David Blumenthal
Becker's Hospital Review, 3/9/11
David Blumenthal discusses how providers can increase the positive impact of health I.T., recoup the expense of implementation, and assuage patient fears about privacy issues.

Medical Societies Comment on Stage 2
Health Data Management, 3/8/11
The AMA and 28 other medical societies recently submitted a joint comment letter on initial draft proposals for Stage 2 Meaningful Use criteria and some Stage 3 criteria. The organizations urged greater flexibility in meeting Meaningful Use requirements to accelerate use of EHRs. Inflexible, overly ambitious incentive program requirements will only hinder health I.T. transitions underway today, according to the letter.

Guidelines Issued for Medical Home Accreditation
Health Data Management, 3/8/11
Four medical associations representing more than 350,000 primary care physicians have issued new guidelines for patient-centered medical home recognition and accreditation programs. The joint guidelines seek to ensure some standardization among recognition and accreditations programs as they are developed.

New Survey Shows EHRs Benefit Even Small Providers
Government Health IT, 3/8/11
A survey of studies from recent years shows HIT has benefited health care providers, even small practices, refuting other recent findings which suggest EHRs and other HIT do not produce positive effects for patient care. Previous studies focused on the early years of EHRs when functions were not as mature..

Most Docs Eligible for EHR Money
Modern Healthcare, subscription required 3/8/11
About 76% of office-based physicians could qualify for federal incentives for purchasing an EHR system under ARRA, according to research published in Health Affairs. In addition, about 15% of office-based physicians could qualify for potentially higher EHR payments under federally subsidized state Medicaid incentive programs.

"The Race is on" for Hospitals to Consolidate, Integrate Care
Becker's Hospital Review, 3/8/11
More and more hospitals are involved in various transactions as part of their integration efforts to prepare for ACOs. Although specific rules regarding ACOs have not been released, many health care providers are looking for ways to consolidate care. In the rush to integrate, however, hospitals may ignore several key components hospitals need in order to succeed. 

CCHIT Survey: Providers Find Some Meaningful Use Objectives "Too Aggressive"
Becker's Hospital Review, 3/8/11
Results from a survey conducted by CCHIT showed health care providers find some Stage 2 Meaningful objectives too aggressive, according to a post by CCHIT Chair Karen Bell, MD. 

Survey Shows How Hospitals’ I.T. Uses Compare to Patients'
Healthcare IT News, 3/7/11
Hospital executives and patients agree health care needs a revamp, and they're looking to I.T. to make it happen, but when it comes to their technology desires and concerns, there are some differences.

Senate Democrats Giving up on Berwick Confirmation as CMS Head
Becker's Hospital Review, 3/7/11
Senate Democrats have given up on confirming Don Berwick, MD, as CMS administrator, now Republicans have demonstrated they have enough votes to block his nomination. At a meeting, Democratic staff of the Senate Finance Committee reportedly stated there won't be a confirmation hearing for Dr. Berwick and they will be discussing "next steps" for CMS.

Indiana Health Department Connects with Regional Info Exchange
Modern Healthcare, subscription required 3/30/11
The Indiana Health Department has successfully established connectivity with its first regional HIE to transmit comprehensive information about childhood vaccinations to health care providers using EHRs. The state's program, Children and Hoosiers Immunization Registry Program, or CHIRP, has established a live interface with the Michiana Health Information Network, a regional HIE accessed by 3,200 providers in southwestern Michigan and Northern Indiana.

Montana Gets its EHR Money Back
Healthcare IT News, 3/29/11
The Montana Senate voted to restore the $35 million in federal incentives for EHRs for hospitals and community health centers across the state. The Montana legislature initially denied the state's HHS the authority to accept and distribute the money to hospitals four times on party-line votes—making it the only state to do so.

Texas Hospitals Fight Health Care Cuts
Modern Healthcare, subscription required 3/29/11
The Texas Hospital Association, Austin, is urging members of the state House of Representatives to not cut state funding of health care, ahead of a probable vote on a budget bill this week. The THA opposes proposed budget cuts in the bill which include: a 10% cut in Medicaid reimbursement for hospitals, physicians and nursing homes; Medicaid cost containment measures of about $225 million; a $13 million reduction in funding of trauma centers; and an almost $35 million reduction in a nursing shortage fund, according to a THA news release.

Vermont Hospitals Transform Record Keeping 
Times Argus Online, 3/28/11
Through a combination of financing, government support, and the coordination of a nonprofit technology consultancy, Vermont is building an EHR system which will have a profound impact on the quality of health care. One of the driving forces behind this in Vermont is a nonprofit incorporated in 2005: Vermont Information Technology Leaders. Its immediate goal is to help medical practices and hospitals move from paper records to electronic record keeping, and then facilitate the sharing of those records between health providers.

Senate Bill Would Extend Incentives to Behavioral Health
Health Imaging, 3/15/11
Rhode Island U.S. Senator Sheldon Whitehouse introduced legislation to make health I.T. available to behavioral health, mental health, and substance abuse treatment professionals and facilities. Mental health care is a critical component of our health care safety net, and allowing these providers access to cost-saving, quality-enhancing advances in health I.T. will improve the care millions of Americans receive.

Insurers Pay New York Physicians to Become Medical Homes
Government Health IT, 9, 2011
Six health plans in a large scale project demonstrating patient-centered medical homes in New York’s Hudson Valley paid incentives of $1.5 million to 236 primary care physicians in 11 practices. These physician practices affect nearly half a million patients in the region.

California HIEs Getting HITECH Funds
Health Data Management, 3/9/11
Cal eConnect, the state-designated entity to manage and distribute $38.8 million in HITECH Act funds to HIE initiatives in California, is doling out $3.46 million to six HIE projects. Grants are being awarded to Orange County Partnership Regional Health Information Organization ($795,761), Los Angeles Network for Enhanced Services ($996,070), Redwood Mednet ($476,900), and North Coast Health Information Network ($200,105).

HHS Goes Live with Vaccines.gov
Health Data Management, 3/30/11
HHS has launched Vaccines.gov, a new consumer-focused website with content from agencies across HHS. The site covers vaccine recommendations, how vaccines work and diseases they prevent, tips on getting vaccinated, traveling tips, a guide to other government and private vaccine-related sites, and links to state information about vaccine requirements for school and child care.

AMA Launches Coding Mobile App
Modern Healthcare, subscription required 3/29/11
The American Medical Association unveiled a coding application for use on Apple iPhones, iPads, and iPod Touches—available for free on iTunes—and also announced a contest to find "the next great medical app."

'Power Tool' for Mapping Diabetes Launched
Healthcare IT News, 3/17/11
A national index for measuring and mapping diabetes in the U.S. has been launched to help prevent the disease and help determine outcomes and costs associated with it. The index is a ‘power-tool’ which provides the most comprehensive source of available data about diabetics, their care, and the trends which are shaping the U.S. diabetes market. It contains more than 30,000 tables, maps, charts and graphs by nation, state, county, city, congressional district, state legislative district, and zip code.

All About Accountable Care Organizations and Why they Matter
BNET, 3/15/11
If you don’t understand what ACOs are, you’re not alone. Since these relatively new organizations could play a key role in the ongoing restructuring of the $2.3 trillion U.S. health care industry, you probably ought to know more about them.

Hospitals Using Social Media to Engage With Community, Donors
iHealthBeat, 3/14/11
Hospitals across the country are starting to leverage social media tools to communicate with patients, raise funds, and connect with their local communities. Hospital employees who work in communications say social media platforms help them learn what patients, physicians, and business partners are saying about their facility. They say such feedback can help hospital administrators improve policies and processes.

Primary Care Group Launches Center for Accountable Care
Modern Physician, subscription required 3/14/11 
The Patient-Centered Primary Care Collaborative, a coalition of some 700 employers, consumer groups, and primary care organizations, has formed the Center for Accountable Care in an effort to ensure a strong, robust, patient-centered primary care model is at the foundation of ACOs. Among its activities, the center will identify and share best practices related to medical home-based ACOs and educate federal and state government officials, media members, and consumer organizations about the center's policy recommendations and advocate for those policies.

Boston Researchers Develop App Platform
Modern Healthcare, subscription required 3/9/11
Researchers at Children's Hospital Boston and Harvard Medical School released an interoperability platform and interface designed to support the development of innovative HIT Web applications.

Obama Appeals Health Reform Ruling
Health Data Management, 3/9/11
The Obama Administration through the Justice Department has filed a motion for an expedited appeal of a January 31 federal district court order which ruled the entire health care reform law unconstitutional.

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