Edition Twenty-Two (6/30/09)

HITrust Forms Leadership Roundtable
Modern Healthcare, 6/29/09
The Health Information Trust, or HITrust, a coalition led by major health insurance companies, manufacturers, wholesalers, and retailers of prescription drugs, information technology developers, and provider organizations, has announced the formation of what it is calling the Leadership Roundtable to “support the growing role of the health care chief information security officer in handling computerized health care information,” according to a news statement.

Hospitals Should Review Their HIPAA Sanctions Policy
HealthLeaders, 6/29/09
The Health Information Technology for Economic and Clinic Health (HITECH) Act changed the ballgame for sanctions related to HIPAA violations. The Act provides a tiered system for assessing the level and penalty of each violation. CMS, which enforces the HIPAA Security Rule, and the Office for Civil Rights, which enforces the HIPAA Privacy Rule, can supersede the following limits, but with a cap of $50,000 per violation and $1.5 million for the calendar year for the same type of violation.

CIO Group Comments on Meaningful Use
Health Data Management, 6/29/09
The initial proposal of a workgroup of the HIT Policy Committee to define meaningful use of electronic health records includes a matrix of about 55 functions, or elements, that should be phased in over several years. But under the proposal, 22 of the functions have to be achieved to some degree during the first year in 2011. CHIME's full comment letter is available on-line [PDF].

Docs to Feds: Go Slow on Meaningful Use
Health Data Management, 6/29/09
More than 80 physician organizations, in general, support the objectives and vision outlined in the initial proposal of a workgroup of the HIT Policy Committee to define meaningful use of electronic health records, according to a comment letter to federal officials. The American Medical Association joined the other organizations in sending the letter [PDF] to David Blumenthal, national coordinator for health information technology. They called for a reasonable, scaleable, and flexible starting point for EHR adoption that takes into account the ability of a solo practitioner versus a large group practice.

AHA: Stretch Meaningful Use Timeline
Health Data Management, 6/29/09
The federal government should extend the transition to a fully functional electronic health records system beyond 2015, according to the American Hospital Association. The AHA has sent a comment letter on the initial proposal of a workgroup of the HIT Policy Committee to define meaningful use of electronic health records to David Blumenthal, national coordinator for health information technology. The AHA's comment letter is available on-line [PDF].

AMA Meeting: Doctors Object to Penalties for Avoiding EHRs
AMA News, 6/29/09
Physician-delegates at the AMA Annual Meeting in June formally came out against planned penalties included in this year's federal stimulus bill that would dock Medicare pay for physicians who do not have a qualifying electronic health record. The "adjustments" start at 1% of the physician's Medicare fee schedule and are set to begin in 2015, after four years of available incentives for adoption. The penalties are set to increase each subsequent year to a maximum of 5%.

First Draft of EHR "Meaningful Use" Definition Unveiled
amednews.com, 6/29/09
President Obama's point man on health care information technology has asked a key working group to revise its recommendations on what constitutes "meaningful use" of electronic health records, a pivotal term that will decide which physicians can obtain billions in federal EHR money. David Blumenthal, MD, national coordinator for health information technology, declined to specify why he asked the Health IT Policy Committee's meaningful use working group to amend the recommendations it released June 16. The panel is tasked with advising the government on a policy framework for the development and adoption of a nationwide health I.T. infrastructure.

AMDIS: Delay CPOE as "Meaningful Use"
Health Data Management, 6/26/09
When the meaningful use workgroup of the HIT Policy Committee on June 16 released its initial draft look at a definition, the first objective listed for possible criteria in 2011 was the use of computerized physician order entry for all order types including medications. That's too tall an order too quickly, and should be deferred to 2013 or beyond, says the Association of Medical Directors of Information Systems in a comment letter [PDF] to the Office of the National Coordinator for Health Information Technology.

New Class of Professionals Needed for Health Care I.T. Transformation
HealthLeaders, 6/26/09
While there is almost universal agreement on the need to transform our nation's health care system, few stakeholders agree on specific solutions. From pundits to politicians, everyone has recommendations on to how to fix health care, including expansion of access, increased individual responsibility, more competition, less competition, more government control or less government control. One area of growing consensus, however, is that the information technology infrastructure underlying our health care system is woefully inadequate to the task of transformation.

HIPAA 5010 Requires I.T. to Do More with Fewer Resources
HealthLeaders, 6/25/09
A hospital's I.T. project list is most likely an exponential one: Convert to an EHR, transition to HIPAA 5010, coordinate vendor and health plan testing, train staff members on new technology, prove meaningful use, and qualify for incentive payments under the American Recovery and Reinvestment Act. It's enough to make anyone's head spin. The transition to HIPAA 5010 is perhaps the most pressing issue because its compliance deadline is little more than two years away (January 2012).

EHRs, Disaster Planning Seen as Key Help for Seniors
Modern Healthcare, 6/25/09
Continued disaster-planning drills, improved communication among federal, state and local providers, and the use of electronic health records are some best practices that could help seniors during disasters, experts told lawmakers at a hearing of the U.S. Senate Special Committee on Aging.

I.T. Tools for Consumers Needed for Reform: Coalition
Modern Healthcare, 6/25/09
Information tools to help consumers better manage their own health should be part of any health care reform, said 56 organizations, employers, and providers in a joint statement. The organizations have all endorsed the Markle Foundation’s set of practices to improve consumer access to HIT and protect privacy.

AHRQ Seeks I.T. Workflow Options
Health Data Management, 6/25/09
The Agency for Healthcare Research and Quality has issued a request for information on how clinics and physician practices redesign workflow when they adopt information technology. AHRQ is considering development of an electronic toolkit, made available on the Internet, to assist small- and medium-sized practices in changing their workflow either before or after I.T. implementation. Comments are due by Aug. 24.

Comment: The Missing Pieces in Meaningful Use
Government Health IT, 6/25/09
With the initial definition of “meaningful use” offered by the Health Information Technology Policy Council, we can finally see the broad contours of the administration’s plan for the health I.T. portion of the economic stimulus legislation. In terms of promoting electronic health records, the influx of substantial funds and the advancement of privacy regulations are significant and welcome. But in terms of promoting the health outcomes that this investment should achieve, several pieces are still missing.

Small Practices Lack Resources for Quality Upgrades
HealthLeaders, 6/24/09
Small medical practices provide nearly 75% all ambulatory care in the United States, yet many lack the resources to improve the quality of care delivered or install electronic health records to serve an increasingly diverse patient mix, according to a report released today by the National Committee for Quality Assurance.

CMS Fact Sheet Lays Out Stimulus Work
Health Data Management, 6/24/09
A fact sheet recently posted on the Centers for Medicare and Medicaid Services Web site explains steps that federal officials will take over the next year to implement the health information technology provisions of the federal stimulus package. The fact sheet summarizes the Medicare and Medicaid incentive programs for meaningful use of electronic health records and gives timelines for implementation activities.

Home Health CEO: Expand 'Meaningful Use'
Health Data Management, 6/24/09
Meaningful use of electronic health records goes way beyond using systems certified as meeting certain functionality requirements, the proprietor of a home health agency serving Northwestern Pennsylvania testified before Congress on June 24. James Fetzner, CEO at Comfort Care and Resources in Erie, and representatives of other organizations discussed the challenges of small health practices adopting health information technology during a hearing of the House Committee on Small Business' subcommittee on regulations and health care.

HIT Policy Group to Focus on Efficiency: Blumenthal
Modern Healthcare, 6/24/09
National Healthcare Information Technology Coordinator David Blumenthal said a work group of the federal Health Information Technology Policy Committee will be looking to add more immediate efficiency measures to its next draft definition of “meaningful use” under the American Recovery and Reinvestment Act of 2009. Blumenthal’s comment came during a presentation on June 16th before the newly formed and Republicans-only Congressional Health Care Caucus, which is led by fellow physician Rep. Michael Burgess of Texas.

Study: Despite EHR, Patients in Dark on Test Results
Health Data Management, 6/23/09
A study of more than 5,400 patient records from 23 physician practices across the nation shows that physicians often fail to inform patients of abnormal test results, or to document that their patients were informed. Use of an electronic medical record did not improve reporting rates, and even increased failure rates if the practice did not have good processes for managing test results, according to researchers at Weill Cornell Medical College in New York.

Group Advocates Electronic Medical Records
Los Angeles Times, 6/23/09
Accessing your own medical records should be as easy as checking your on-line bank account, a new health-data group contends, and it launched a Web site to promote better access. The site, HealthDataRights.org, was established by a group that is boosting greater personal use of electronic medical records. Only 15% of physicians track the records electronically, said James Heywood, a group founder.

High Stakes for Providers Who Wait to Adopt HIT
Modern Healthcare, 6/23/09
The stakes are high as a work group of the newly formed Health Information Technology Policy Committee continues its work this month on defining the “meaningful use” criteria to be used under a federal I.T. subsidy plan under the American Recovery and Reinvestment Act of 2009. EHR subsidy payments under the stimulus law could run up to $48,400 per physician over a five-year payment period and, at base, $2 million per hospital over a four-year payout program. The law makes those payments contingent upon an office-based physician practice or hospital using a “certified” EHR in a “meaningful manner.” Congress, meanwhile, only loosely defined what it was looking for in meaningful use.

Panel Meets to Map Meaningful Use Standards
Government Health IT, 6/23/09
The Department of Health and Human Services Health Information Technology Standards Committee took aim at a moving target as it began to discuss how to apply specifications and certification criteria to the definition of “meaningful use” of health information technology. “Meaningful use” is the formula used in the American Recovery and Reinvestment Act of 2009 to describe criteria for qualifying hospitals and practices for Medicare incentive payments for adopting health I.T. systems.

Health Data Rights Declaration Gets Push
Boston Globe, 6/23/09
More than 30 bloggers from the medical, technology, and patient advocacy worlds are rallying to support patients’ right to obtain copies of their computerized health records from their doctors in the electronic format. The Declaration of Health Data Rights—arriving just in time for Independence Day—says that patients should have the right to obtain “a complete copy of their individual health data, without delay, at minimal or no cost,’’ in computerized form, if it exists.

Health I.T. Under ARRA: It's Not the Money, It's the Message
iHealthbeat, 6/19/09
In the new health I.T. environment created by the American Recovery and Reinvestment Act, you could conclude that money talks: extra payments approaching $45,000 per physician and several million dollars per hospital for prompt electronic health record adoption and meaningful use, and penalties for foot-dragging beyond 2014 that can knock up to 5% off government reimbursements. But more important than the money itself is the message implicitly conveyed along with it.



Medical Charts ‘You Never Get to See’ Now On-line
The Buffalo News, 6/30/09
When you go in for your annual physical, the doctor sits by your side and scans a thick chart filled with a record of your office visits, test results, and any medicine you’re taking. It’s your entire medical history, but it has been kept in your doctor’s hands—until now. The Buffalo Medical Group, the largest physician group practice in the area, has started a pilot program that provides patient access to health records and is believed to be the first of its kind locally.

Maryland Hospitals Use Software to Assess Complications
Modern Healthcare, 6/25/09
Maryland hospitals are warily eyeing the July start date of a new reimbursement program by the state that takes the concept of not paying for hospital-acquired adverse medical conditions to a much larger scale. Naming its plan the Maryland Hospital Acquired Conditions, or MHAC, program, the state is pressing providers to demonstrate they are reducing complication rates on 52 potentially preventable conditions, otherwise they risk losing a percentage of their reimbursements.

Doctors Say Electronic Data Sharing is Saving Lives, Money
Kaiser Health News, 6/23/09
The Memphis, TN, area is one of a growing number of regions or states with a health information exchange, which enables electronic patient data to be shared among hospitals and physicians. Nearly all of the hospitals and public clinics in the Memphis region participate, which allows their emergency department doctors and other authorized personnel to call up patients' blood tests, imaging scan reports, and hospital discharge summaries. The three-year-old exchange is helping doctors make better decisions and avoid wasting money on duplicative tests, say those involved.



The Doctor Will Text You Now
The Wall Street Journal, 6/30/09
This year, 39% of doctors said they’d communicated with patients on-line, up from just 16% five years earlier, according to health information firm Manhattan Research, a unit of Decision Resources Inc. So far, the most common digital doctor services are the simplest ones, like paying bills, sending lab results and scheduling appointments.

Who's the Best? Web site Ranks Most States in Quality Measures
HealthLeaders, 6/30/09
The Agency for Health Research and Quality recently expanded its "State Snapshots" to illustrate with colorful graphics the wide variation in care provided from state to state across the country. Hospitals, state health officials and other providers can now see both how their states are performing relative to data collected in previous years as well as how they compare with other states. The expansive data file is available in Excel under the heading "All state data tables for all measures."

Reporter's Notebook: Tracking System Dreams Come Down to Earth
Modern Healthcare, 6/25/09
The anticipated benefits of a universal tracking system for medical products have long loomed grand. For about two decades now, early advocates of electronic tracking technology have painted pictures of a symbiotic global supply-chain process capable of proffering dossier-like information on the history of a bed pan should it be needed. But as the roughly 250 supply-chain executives attending the GS1 Healthcare US Conference held June 16-18 in Washington heard, arriving at that stage of information nirvana isn’t going to come without glitches.

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