Edition Forty-Four (5/11/10)

Panel Endorses Permanent EHR Certification Plan
Government Health IT, 5/7/10
The Health IT Policy Committee endorsed comments on a plan by ONC to offer permanent certification of EHRs, including a provision to monitor EHRs after they are purchased to ensure providers are installing the proper technology. The advisory panel okayed this and other features of permanent certification described in a proposed rule published by ONC in March. ONC is expected to finalize its plan for permanent certification of EHRs sometime before the end of the year.

Policy Committee Advises on Certification
Health Data Management, 5/6/10
The HIT Policy Committee sent David Blumenthal two letters of recommendations related to the proposed rule setting up EHR certification programs. The committee, an advisory body to Blumenthal, approved recommendations from its certification/adoption and privacy/security workgroups.

Bar Code Technology Cuts Medication Errors: Study
Modern Healthcare, subscription required 5/6/10
Using bar code verification technology for medication administration can significantly reduce error rates and decrease the likelihood of adverse events, according to a newly published study. The use of a bar code eMAR was associated with a 27% decrease in timing errors, such as late or early medication administration, and a 41% drop in the rate of errors not related to timing, which include incorrect dosages and administration without an order. 

EMRs Top Priority for 58% of Hospital CIOs
InformationWeek, 5/6/10
Among CIOs surveyed, 58% named EMR systems as their most important I.T. project over the next 24 months, while CPOE came in at a close second, named by 56%. Coming in third among top I.T. priorities was security initiatives, named by 47% of respondents, followed by database initiatives, with 42%.

Doctors Not in Stampede to Go Digital
Boston Globe, 5/4/10 
The federal government has allocated billions of dollars under the stimulus package to encourage physicians nationwide to adopt EHR systems, but some physicians remain reluctant to make the switch from their paper records systems. Physicians are concerned about the cost of adopting and managing EHRs, as well as the potential losses in productivity.

I.T. Included in Sebelius' Top Priorities for HHS
Federal Computer Week, 5/4/10
Kathleen Sebelius included several HIT elements as part of her department’s nine top strategic priorities in a report titled, “The Secretary’s Strategic Initiatives and Key Interagency Collaborations.” As part of its drive to implement health reform, HHS will work to encourage widespread adoption and Meaningful Use of HIT while ensuring the privacy and security of EHRs.

51 Health Care Groups Call for Changes of Federal EHR Adoption Proposal
HealthLeaders, 5/4/10
Health care providers need additional time and greater flexibility to meet criteria of CMS' proposed EHR rule published earlier this year, a coalition of 51 groups told Kathleen Sebelius in a letter. While they fully support the purpose of ARRA to encourage the adoption and use of EHRs, they are asking it be done in a manner which will remove barriers to and promote the widespread adoption of HIT.

Blumenthal Urges Physicians to Adopt EHRs Sooner Rather than Later
Executive Gov, 5/4/10
While using an EHR can be challenging at first, Blumenthal said his own experience with EHRs made him a better doctor. Citing a study in the New England Journal of Medicine, Blumenthal said 90 percent of physicians who decided to adopt EHRs were happy with their decision.

CMS Wants More HAI Data in 2011
Health Data Management, 5/4/10
The electronic specifications and interoperability standards for EHR-based collection and transmission of the data elements for the ED Throughput, Stroke, and Venous Thromboembolism measures have been finalized by HITSP and are available for review and testing. CMS anticipates testing the components required for the submission of clinical quality data extracted from EHRs for these measures.

New Health Care Law Might Make Your Doctor More Informed, Efficient, Responsive
Washington Post, 5/4/10
Fifty years from now, it is likely that almost all doctors will be parts of organizations which are responsible for patients in and out of the hospital, in sickness and in health, over decades. The records of what they do for a patient will be in electronic form, accessible from any computer. Software will gently remind them what to consider as they treat, and try to prevent, diseases.

Health Groups Unite for Meaningful Use Requirements
Modern Healthcare, subscription required 5/4/10
The American Hospital Association, Federation of American Hospitals, and American Medical Association have joined forces with a host of other medical specialty societies and health care industry organizations to submit a letter to Kathleen Sebelius asking HHS to dial back the eligibility requirements for federal subsidy payments to purchase EHR systems under ARRA.

Feds Release $220 Million for I.T.
Modern Healthcare, subscription required 5/4/10
HHS is distributing $220 million in ARRA funds to 15 communities to pilot test the adoption of emerging HIT. The pilot will offer insight into how health I.T. can make a real difference in the delivery of health care and tap the best ideas across America and demonstrate the enormous benefit health I.T. will have to improving health and care within our communities.

HHS Seeks Feedback on Stricter EHR Disclosure Reporting
Government Health IT, 5/3/10
To help guide HHS in tightening rules for health information privacy, HHS has asked providers, payers, and consumers to comment on the benefits and burdens of accounting for the disclosure of protected health information, even if the data is intended for treatment and billing purposes. 

Using High-Tech to Lower Costs
New York Times, 5/3/10
Health policy experts hope technology will become a tool for educating doctors about the cost of care. More widespread use of EMRs will help keep costs in check by providing doctors with precise information on the price of tests and drugs even as they are deciding what to order.

CHIME Comments on EHR Certification
Health Data Management, 4/30/10
EHR systems certified under the temporary certification program should have those certifications carry forward into the permanent certification program being established by 2012, according to the CHIME. The group believes carrying forward the certifications provides important protections to those vendors and providers which have installed applications under the temporary process.

Researchers Suggest EHR Systems Linked to Higher Costs
Modern Healthcare, subscription required, 4/30/10
Researchers from the business school at Arizona State University, Tempe, say their work suggests EHR systems in hospitals increase hospital costs, nurse staffing levels, and the incidence of complications, but lower mortality rates for some conditions. As a threatened nursing shortage looms, the ASU research team chose to test the assumption HIT might increase nurse productivity by improving workflow.

Health I.T. Funding to Create 50,000 Jobs
Computerworld, 4/30/10
Federal dollars being pumped into grant programs to spur students to enter I.T. careers in the health care industry should help to create between 45,000 and 50,000 jobs over the next five years. David Blumenthal said a portion of $2 billion in discretionary spending under ONC is being targeted at education and training for EHR implementation.

Policy Committee Member Scrutinizes Design of NHIN
Modern Healthcare, subscription required 4/30/10
Latanya Sweeney, professor and director of the Laboratory for International Data Privacy at Carnegie Mellon University, a nationally regarded HIT privacy and security expert, had some harsh words to say about the performance thus far of the federal government in designing a proposed NHIN.

Incentives for Health I.T. Could Include Home Monitoring Equipment
Federal Computer Week, 4/29/10
The next phase of federal incentives for EHR adoption could require providers to be able to transmit records into patients' accounts in real-time, and to accept transmissions of data from home monitoring equipment, according to proposals considered by a federal advisory group.

ONC Turns Its Attention to Health Reform I.T.
Government Health IT, 4/29/10
Blumenthal asked members of the Standards Committee to start to develop standards for exchanging eligibility and enrollment data electronically between what is now a hodgepodge of federal and state health and social health programs and services organizations.

ONC Gets Vocabulary Recommendations
Health Data Management, 4/29/10
The HIT Standards Committee is recommending both a single federal office or agency and the establishment of an authoritative infrastructure, to be responsible for ensuring the creation, development, maintenance, and dissemination of all vocabulary related to Meaningful Use.

I.T. Tab for Reform: $5 Billion+
Health Data Management, 4/29/10
Federal, state, and local governments will need to invest more than $5 billion in HIT to comply with provisions of the health care reform law, according to a new report, "I.T. Implications of Health Care Reform." The report covers start-up costs to implement health insurance exchanges, changes to Medicare and Medicaid systems, and the IRS' spending to support eligibility determination, documentation, and verification processes.

Computerized Medication Order Errors Studied
InformationWeek, 4/28/10
A new research study is looking to identify why CPOE mistakes occur, and how they might be prevented. The National Patient Safety Foundation recently awarded a nearly $100,000 grant to a research team from the Center for Patient Safety Research and Practice and Quantros Patient Safety Center to investigate nearly 200,000 reports of medication errors, which CPOE was listed as a contributing factor.

Report Finds 55 Percent of Hospitals Expect to Face Meaningful Use Penalties
DOTmed News, 4/28/10
More than half of responding hospitals believe they will incur penalties for failing to demonstrate Meaningful Use by 2015, according to a report from the American Hospital Association. 70 percent of hospitals surveyed said the upfront cost of EHR systems was a key barrier to achieving Meaningful Use. 

5 Key Barriers to Adopting Electronic Medical Records Today
Mass High Tech, 4/28/10
Talk to people in health care and it is clear there are myriad issues which need to be resolved before there is ubiquitous adoption of EHRs. Key challenges include financing the conversion from paper to computerized records, designing work flow, making systems easier to use, integrating files from multiple sources, and ongoing technical support.

Survey Puts Spotlight on Health Care Paper Jungle
Healthcare IT News, 4/28/10
The average patient's health in the U.S. is dependent on at least 200 pieces of paper in about 19 different locations, according to a new study. The study also found the vast majority of medical records in the U.S. are still on paper, with the average appointment taking 13 pages to document.

EMR Adoptions: What Role Will Regional Extension Centers Have?
Amednews, 4/28/10
About $640 million has been made available to establish regional extension centers intended to help small practices adopt and become meaningful users of HIT. But those centers might be too understaffed and underfunded to provide the help physicians need, according to a study in April's Health Affairs.

Extension Center Licenses Courses
Health Data Management, 4/27/10
The Wide River Technology Extension Center in Nebraska will offer to physician practices on-line HIT and EHR training courses from Health I.T. Certification, Pahrump, Nev. The courses cover the planning, adoption, and management of EHRs, HIE, and other I.T. components.

HITECH Privacy Rule to Be Released Next Month
Healthcare IT News, 4/27/10
HHS plans to release a proposed rule which strengthens existing privacy, security, and enforcement requirements for organizations which handle patients' health information. The rule also toughens related provisions in HIPAA as the adoption of EHRs and HIE expands the number of organizations which may have access to personal data.

Reform Mandates e-Enrollment
Health Data Management, 4/27/10
A section in the health reform law mandates development of interoperable and secure standards and protocols to facilitate electronic enrollment of individuals in federal and state programs. The federal government may require states, as a condition of receiving grant funds authorized in the law, to incorporate these standards in their HIT investments.

AHA Leaders Told Help is Coming for EHRs, Doc Fix Payments
HealthLeaders, 4/27/10
Attendees of the American Hospital Association's annual membership meeting were told hospitals are facing major challenges which need to be addressed right now to ensure quality care delivery will continue. Hospitals need to move to the forefront now to improve patient care quality, safety, and reliability; construct new integrated models of care; and stop medical mistakes.

Policymakers Explore Patient Consent Triggerpoint
Government Health IT, 4/27/10
The Health I.T. Policy Committee is wrestling with determining at what point in an health information exchange does it become necessary for providers to obtain consumer consent to approve the transaction. The line is not clear in situations where intermediary organizations help providers transport data in one-to-one exchanges with other providers.

AHA Targets EHR Subsidies, Medicare Update
Modern Healthcare, subscription required 4/26/10
The AHA hopes to reshape parts of a federal rule on what hospitals need to do with EHRs to qualify for federal dollars. AHA Executive Vice President Richard Pollack said the group wants to change the implementation timeline set out in the rule, and ensure hospital-employed physicians and multi-campus hospitals are also covered. 

FCC Takes Control of Public Safety Network
InformationWeek, 4/26/10
Bogged down for years in regulatory infighting and pigeonholed proposals, the fate of a public safety broadband network has been seized by the Federal Communications Commission, which is finally taking the proverbial bull by the horns and moving on several fronts to make a nation-wide public safety network a reality.

ACP: EHRs Critical to Effective Reporting of Quality Measures
Health Imaging & IT, 4/26/10
In order for an EHR-based quality measurement and reporting program to engage all health care stakeholders, it must use clinically relevant measures, accurate and trusted by a full range of stakeholders, particularly patients, physicians, and other health care providers, according to the American College of Physicians.

New York's Primary Care Providers to Get Help Implementing EHRs to Improve Patient Care 
News Blaze, 5/5/10
New York's primary care providers now can get technical assistance from the two newly designated RECs in the state which have received $48.2 million in federal grants to help them adopt EHRs to improve patient care. Beginning immediately, providers can get step-by-step help implementing EHRs in their practices, along with an opportunity to qualify for federal incentives of up to $63,750.

Buffalo Receives $16 Million Federal Grant for Health Initiative
WBFO News, 5/5/10
Western New York is one of just 15 communities across the country to receive Beacon Grants. The $16.1 million will go to a coalition called HEALTHeLINK, to help coordinate medical records and reduce emergency room visits by giving doctors immediate access to patient information.

Federal Program Spurs EHRs in Utah
Salt Lake Tribune, 5/4/10
A new federal grant should propel Utah's effort to bring doctor's offices into the 21st Century by expanding the use of computerized medical charts and electronic tracking of chronic diseases, such as diabetes. Utah received a $15.8 million grant from HHS to coordinate a multi-pronged program focused in Salt Lake, Tooele, and Summit counties.

AARP Urges Governor to Sign Health I.T. Bill
PRNewswire, 5/4/10
Legislation which will help modernize medical records, reduce errors, and improve quality of care for all Illinoisans, passed both houses of the Illinois General Assembly and is on its way to the Governor's desk. AARP, which backed the measure, is urging Gov. Quinn to sign it into law.

More Doctors Make House Calls—On-line
The Detroit News, 5/3/10
For Dr. Earlexia Norwood, a family physician in Troy, not every office visit begins with a patient hopping up on the exam table. Sometimes she just logs on to her computer. It's paying off for physicians as more Michigan health insurers reimburse them for this type of care, ushering in a new era when patients will no longer have to schedule an office visit to talk to their doctors about minor concerns.

Washington, New Mexico Awarded Federal Money for EHR Work
Healthcare IT News, 4/27/10
Washington and New Mexico will receive $967,000 and $405,000, respectively, for state planning activities necessary to implement the EHR incentive program established by ARRA. The stimulus provides a 90 percent federal match for state planning activities, to ensure their proper payments through audits and to participate in state-wide efforts to promote interoperability.

Puerto Rico to Receive Federal Matching Funds for EHR Incentives Program
Medical News Today, 4/27/10
In another key step to further states' and territories' role in developing a robust U.S. HIT infrastructure, CMS announced Puerto Rico's Medicaid program will receive approximately $1.80 million in federal matching funds for planning activities necessary to implement the EHR incentive program established by ARRA.

Policymakers Push for Telehealth Reimbursements
Government Health IT, 5/6/10
Mobile health devices and applications hold great promise for improving the cost and quality of care, but an outmoded system of reimbursement for physicians considering the technologies thwarts their adoption.

Research Correlates CPOE with Reduced Deaths
InformationWeek, 5/4/10
A study has found a correlation between the implementation of a CPOE system and improved patient outcomes, resulting in 36 fewer deaths over an 18-month period. The study, conducted by researchers at the Lucile Packard Children's Hospital and Stanford University School of Medicine, is the first study to date which has found an association with CPOE implementation and significant reductions in hospital mortality rates.

Will July 15 be a Dark Day for Telemedicine?
Health Data Management Blogs, 4/30/10
Health I.T. is marching forward on many fronts. But July 15 might be the day, barring Congressional intervention, telemedicine moves in the opposite direction. On this day the Joint Commission’s “privilege by proxy” program bites the dust, which could have serious ramifications for the industry.

VA Official Says Patient-Controlled Health Records Guard Privacy Better
Nextgov, 4/28/10
Paul Tibbits, VA's deputy CIO for strategy, architecture, and design, said health care providers should consider PHRs, which patients have access to and control, as the cornerstone of a national medical record system, as opposed to EHRs, which clinicians manage. By focusing on patient health records, individuals access and review their medical information, giving them the ability to oversee the privacy of their data, he argued.

Nearly One in 10 Adults Surveyed Report Using a Web Site to Record Health Information
InformationWeek, 4/27/10
A new survey by the California Health Care Foundation found people who use PHRs are likely to learn more about their health, have a better understanding of the care doctors give them, and those with two or more chronic illnesses ask more questions to improve their health compared to when they didn't use a PHR.

Personal Health Records Most Likely to Be Used When Doctors Recommend Them
Amednews, 4/26/10
The number of people using PHRs has doubled in the past year. But those users still account for only 7% of the American patient population, according to one recent survey. The survey also found if patients are going to be pushed toward greater PHR adoption by anyone, it's going to be by the health care system representatives they trust the most—their physicians.

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