Edition Sixty-Eight (5/2/11)

Rule Sets Value-Based Purchasing
Health Data Management, 4/29/11
The CMS issued a final rule to establish the Hospital Value-Based Purchasing program, which ties acute care Medicare payments to quality of care beginning in fiscal year 2013. CMS estimates $850 million in Medicare payments to hospitals during FY 2013 to be based on meeting a set of quality measures. The size of the value-based payments fund increase over time as Medicare shifts from payment-based on the quantity of services provided to performance-based payments.

HRSA Announces $12 Million Rural Health I.T. Grant Program
Modern Healthcare, subscription required, 4/28/11
The Health Resources and Services Administration (HRSA) unveiled details of a $12 million grant program designed to assist rural health care providers qualify for incentive payments under ARRA. HRSA will distribute up to 40 grants through the Rural Health Information Technology Network Program to rural providers who work in formal networks, alliances, coalitions, or partnerships to help them achieve Meaningful Use.

Meaningful Use: 'Bridge to Main Event'
Health Data Management, 4/28/11
The Meaningful Use EHR adoption incentive program is merely the beginning phase of a long-term shift in how health care is reimbursed. That was the message delivered by Todd Park, the chief technology officer at HHS, who addressed a gathering of community health leaders. "Meaningful Use is a bridge to the main event—health reform," he said.

CORE Seeks Broader Representation
Health Data Management, 4/27/11 
The Council for Affordable Quality Healthcare has formed a committee to develop recommendations on expanding stakeholder governance of its Committee on Operating Rules for Information Exchange (CAQH). CAQH is an alliance of health plans and trade associations. Its CORE seeks to standardize rules for administrative and financial transactions under HIPAA. The federal health reform law mandates the use of such operating rules between 2013 and 2016.

With a Little Cash, Health I.T. on the Way
Nextgov, 4/26/11
The new federal center set up to launch U.S. health care into the digital age has already certified more than 600 new HIT products and is ready to start helping providers set these systems up. Farzad Mostashari, just two weeks into his new job as national coordinator for HIT, said his office has opened 62 regional extension centers, which aim to help providers understand and set up health I.T. programs.

Health Care Groups Release e-Prescribing Guide
Modern Physician, subscription required, 4/26/11
Six health care organizations have teamed up to develop a how-to guide on e-prescribing. The guide includes information on meeting the federal criteria for Meaningful Use, as well as details on new Medicare e-prescribing requirements and frequently asked questions about adopting HIT.

ATA Urges Removal of 'Outdated' Restrictions on Telemedicine
Healthcare IT News, 4/26/11
The American Telemedicine Association (ATA) called on the CMS to use its authority to waive what the ATA calls the “restriction-riddled” Medicare telemedicine statute for the new ACOs. Removing the restrictions is key to the success of ACOs, the ATA contends.

NIST, ONC Plan Measures, Testing to Improve Health I.T. Usability
Government Health IT, 4/25/11
Health care providers may soon have guides which describe the usability of EHRs—designed to make the steps to adopt and use health I.T. clear and transparent and in the process, improve patient safety. Among the efforts, the National Institute for Standards and Technology (NIST) is developing a set of procedures which are objective and repeatable for evaluating, testing, and validating the usability of EHRs and other health I.T. systems.

Meaningful User: Attestation Easy, Registration Not
Health Data Management, 4/25/11
Successfully attesting to Meaningful Use of EHRs when attestation opened on April 18 was easy for some hospitals, the difficult part was getting registered for the Meaningful Use program in early January—a process which because of Medicare bureaucracy didn't actually finish until mid-March.

Health I.T. Chief Mostashari Details What's Next for ONC
iHealthBeat, 4/25/11
In an interview with iHealthBeat, Farzad Mostashari—the country's new national coordinator for health I.T.—discussed his top priorities, why some health care organizations might delay attestation of Meaningful Use, the importance of engaging patients in health I.T. efforts, and the balancing act required to ensure Stage 2 of the Meaningful Use program is ambitious yet achievable.

CMS Quality Reporting System Improve Outcomes, Quality of Care
Cardiovascular Business, 4/25/11
A report issued by the CMS shows quality reporting systems and e-prescribing incentives have improved outcomes and the quality of care delivered to Medicare beneficiaries. Two pay-for-performance initiatives, the 2009 Physician Quality Reporting System and e-prescribing Experience Report found 119,804 physicians and professionals in 12,647 practices who reported quality measures to Medicare received incentive payments under the Physician Quality Reporting System which totaled to more than $234 million. In 2007, the first year of the program, the incentives paid equated to $36 million.

ONC Plans Efforts to Develop Patient Consent for Exchange
Government Health IT, 4/22/11
ONC intends to conduct a consumer electronic consent pilot as part of advancing HIE. The ability for patients to decide whether they should provide electronic consent in situations which would trigger it is a step which can build trust in sharing their health data and accelerate exchange. ONC is gauging vendor interest and experience in managing such a pilot.

Health I.T. Work Group Considers EHR Usability Testing
Modern Healthcare, subscription required, 4/22/11
A work group of the federally chartered HIT Policy Committee tackled the question of whether and how it's possible to test the usability of EHR systems and opinions on the viability of such testing ranged from outright skepticism to absolute confidence. The committee's adoption and certification work group heard testimony from an array of EHR experts, including providers, developers, testers, and market watchers.

CMS Says More Docs Opting for Evidence of Effectiveness in Treatments
Government Health IT, 4/21/11
More physicians are participating in “pay for reporting” programs which focus on using quality measures and e-prescribing, according to the CMS. Its data also shows physicians are increasingly turning to treatments which offer the best evidence of effectiveness.

Obama Touts Health I.T. During Town Hall Meeting at Facebook
Washington Post, 4/21/11
During a town hall meeting at Facebook headquarters, President Obama discussed the benefits of health I.T. and adoption incentives. Obama made the stop at Facebook as part of a three-day, three-state tour to drum up support for his plan to reduce the federal deficit.

Tiger Team Asks Public for Feedback on Exchange Trust Issues
Government Health IT, 4/21/11
An advisory panel has asked for public feedback on issues it should take up next, as it continues to flesh out a comprehensive privacy and security policy framework for electronic HIE. The framework builds on current law, specifically HIPAA, and is based on fair information practice principles, according to Deven McGraw, chair of the Privacy and Security Tiger Team, a work group of the advisory Health I.T. Policy Committee. McGraw is also director of the health privacy project at the Center for Democracy and Technology.

EMRs Speed Genetic Health Studies
Healthcare IT News, 4/21/11
Recruiting thousands of patients to collect health data for genetic clues to disease is expensive and time consuming. But the arduous process of collecting data for genetic studies could be faster and cheaper by instead mining patient data which already exists in electronic medical records, according to new Northwestern Medicine research.

ONC to Fine Tune Technical Guides for Standards in Stage 2
Government Health IT, 4/20/11
ONC intends to fine tune standards involved in realizing Stage 2 Meaningful Use recommendations and fill in where missing details exist during the next four months. ONC plans to “refresh and reload” adopted certification criteria and new or updated technical descriptions to guide vendors to establish standards, said Dr. Doug Fridsma, ONC director of standards and interoperability. He described it as ONC’s health I.T. “summer camp.”

Policies on Digital Certificates Urged
Modern Healthcare, subscription required, 4/20/11
A federal standards work group on privacy and security of health information is recommending the government develop a set of policies on how to certify organizations which issues “digital certificates” to identify users of the federally developed Direct Project exchange profile.

CHIME Weighs In on ONC Federal HIT Strategic Plan
HealthLeaders, 4/19/11
CHIME submitted comments to ONC on the proposed federal HIT strategic plan, supporting the plan's goals but wanting to see refinements which increases the likelihood for effective and widespread adoption of I.T. CHIME asked ONC to provide standardized approaches and to allow sufficient time to encourage the adoption of EHR systems and supporting technologies by providers.

Meaningful Use Attestation Starts
Health Data Management, 4/18/11
On April 18, the CMS began the attestation process for demonstrating Meaningful Use of EHRs to qualify for Medicare incentive payments. The EHR Incentive Programs website now has a new attestation page for information on the process and to actually attest to compliance with Meaningful Use criteria. The website includes a Meaningful Use attestation calculator, enabling providers to confirm they meet criteria before attesting to it and print a summary. Eligible professional and hospital user guides on the site walk providers through the attestation system prior to attesting.

EHR Reminders Can Help Docs Avoid Unnecessary Treatments
Modern Healthcare, subscription required, 4/18/11
Electronic clinical decision support reminders can successfully steer physicians away from ordering unnecessary treatments, according to results of a new study published in the journal Pediatrics. Researchers determined the reminders prevented 460 unnecessary procedures, for a total cost savings of $165,000 over one year.

Move Gradually on PCAST Report Recommendations: ONC Work Group
Modern Healthcare, subscription required, 4/18/11
A work group of the federally chartered HIT Policy Committee concluded in a presentation delivered to ONC that it was feasible to move in the direction pointed to by a White House technology advisory council, but ONC should proceed by making incremental changes from its present technological course. In December, the President's Council of Advisors on Science and Technology issued a report which called on ONC to use its leverage to create and adopt a universal exchange language and use so-called meta-data tagging to facilitate records search and retrieval. The tags also could host privacy and security constraints which would follow the data from user to user.

Mississippi HIE Gets Federal Approval
Health Data Management, 4/26/11
ONC approved the strategic and operational plan for Mississippi's HIE. The HIE is a statewide expansion of the Mississippi Coastal Health Information Exchange, a proof-of-concept pilot program established after Hurricane Katrina to provide a medical information system across six hard-hit counties.

States Eye Savings in Using Medicaid Funds for Telehealth Services
The Courier-Journal, 4/24/11
More states are seeking federal approval to use Medicaid funds for telehealth services as they work to address persistent budget deficits and a growing shortage of in-home care providers. Indiana already provides Medicaid reimbursements for telehealth. Meanwhile, Kentucky's Cabinet for Health and Family Services recently asked for federal permission to use Medicaid funds for such services.

Maine Civil Liberties Union, State Senator Seek HIE Opt-in Law
Healthcare IT News, 4/18/11
In an effort to maximize people's control over how their health information is disseminated, the Maine Civil Liberties Union, alongside privacy advocates and care providers, gathered to call on the state legislature to pass a medical patient privacy and consent bill. The bill, “An Act to Ensure Patient Privacy and Control with Regard to Health Information Exchanges," is sponsored by State Senator Roger Katz.

The Rise of Social Media & Participatory Medicine
iHealthBeat, 4/28/11
The growing use of social media and participatory medicine is allowing patients to take greater control of their own health care. Social media enhances the search for health information, while on-line communities empower patients and providers to interact at new levels. 

What’s Your ACO Gripe?
H&HN, 4/25/11
In the month since the proposed rule for Medicare's ACO program has gone public, and with a little more than eight months remaining until the program starts in earnest in 2012, concerns from observers and interested parties have unsurprisingly piled up, a natural response to a major initiative hailed by its supporters as one of the keys to reducing long-term health care costs at the same time it improves overall health care outcomes.

Green I.T. a Growing Opportunity for Vendors
Healthcare IT News, 4/21/11 
Green I.T. initiatives take on added importance in the next few years as more organizations commit financial resources and develop comprehensive strategies, according to a study. Among organizational priorities, green I.T. initiatives tend to rank around the middle, but the study suggests the trend line is headed upward. In 2009 only nine percent of firms rated green I.T. as an upper half organizational priority.

For Doctors, Social Media a Tricky Case
Boston Globe, 4/20/11
An incident in which a Rhode Island physician was disciplined for discussing a patient on Facebook highlights growing concern about physicians' use of social media. The physician was fired from Westerly Hospital in Rhode Island last year after posting information about a trauma patient.

CD Import for ED Transfers Could Cut CT Imaging by 484,000 Exams
CMIO, 4/18/11
Brigham and Women’s Hospital cut subsequent diagnostic imaging by 17 percent and subsequent CT imaging by 16 percent after implementing CD import to PACS among ED transfer patients, according to a study. The authors characterized the CD import system as a partial success and noted the need for more reliable, health I.T. based image transfer mechanisms.

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