Edition Twenty-Four (7/21/09)

Government Advisors Call for HIE Certification
Health Data Management, 7/20/09
The federal government should certify that networks and software facilitating health information exchange meet requirements for meaningful use of electronic health records, the Information Exchange Workgroup of the HIT Policy Committee recommends. Such certification would ease the burden on providers for meeting and demonstrating adherence with meaningful use requirements, the workgroup contends.

Dashboard Used to Tackle Disparities, ARRA Criteria
Modern Healthcare, subscription needed 7/20/09
As it has with most conversations about health care information technology these days, the American Recovery and Reinvestment Act of 2009 dominated the discussions at the 18th annual Physician-Computer Connection Symposium in Ojai, Calif., last week. One of those discussions involved health disparities.

Sharing CDS Is the Key to Quality Gains
Health Management Technology, July 2009
To achieve national goals for enhancements in quality, patient safety, and cost control, while qualifying for incentives under the American Recovery and Reinvestment Act, health care professionals in practices and organizations of all sizes should adopt and use electronic health records backed by sound clinical decision support (CDS), with particular attention to performance on evidence-based clinical guidelines. 

Administration Facing Tough Sell To Doctors On Health I.T.
Kaiser Health News, 7/17/09
Dr. David Blumenthal, the Obama Administration's national coordinator for health information technology, can recall the day he became a true believer in the potential of electronic health records. He was about to order a lung scan when the computer in his Boston hospital alerted him to a similar image already in the file. The patient was spared an unnecessary dose of radiation and the health care system was spared the cost of an unnecessary test.

'Meaningful Use' Revisions Receive Mixed Reviews
Modern Healthcare, subscription needed 7/17/09
Providers looking to make decisions about technology will find the revised "meaningful use" definition helpful, but the implementation timeline might still be challenging, professionals say. The revised definition for the meaningful use of electronic health records includes changes to computer physician order entry criteria and speeds up the schedule for granting real-time access to patient information through personal health records.

IOM Work Group Member Shares EHR Views at AMDIS
Modern Healthcare, subscription needed 7/17/09
As the Obama administration forms its information technology policies also shaped by Congress through the American Recovery and Reinvestment Act of 2009, HHS, and its Office of the National Coordinator for Health Information Technology are gathering input from various health care industry groups on where to take the federal I.T. program and, through it, the country. At the Physician-Computer Connection Symposium, Robert Warren provided a personal overview of the direction an organization sponsored by the Institute of Medicine advised federal I.T. leaders to take in the use of electronic health record systems.

Multiple EHR Certifying Entities Proposed
Health Data Management, 7/16/09
Initial recommendations of the federal HIT Policy Committee's certification/adoption workgroup could spell the end of the CCHIT's monopoly on certifying electronic health records systems. But the group leaves the door open to having existing systems certified under CCHIT criteria deemed certified in 2011. The workgroup recommends that multiple organizations be allowed to perform "HHS Certification" testing and provide certification.

Clinical Decision Support Gains Attention at AMDIS
Modern Healthcare, subscription needed 7/16/09
Quick quiz: How many times does the phrase “clinical-decision support” appear in the health information technology, or HITECH, section of the American Recovery and Reinvestment Act of 2009? Charles Friedman, deputy national coordinator in the Office of the National Coordinator for Health Information Technology at HHS, stumped a couple hundred physician informaticists when he asked that question during the opening session of the Physician-Computer Connection Symposium.

Meaningful Use Definition Gets Initial OK
Health Data Management, 7/16/09
The federal HIT Policy Committee has approved revised recommendations of a workgroup for an initial definition of "meaningful use" of electronic health records systems. Among the changes made in the recommendations are refinements in computerized physician order entry criteria and a shorter timeline for implementing personal health records.

CCHIT's Future in Spotlight During HIT Policy Meeting
Modern Healthcare, subscription needed 7/15/09
Not surprisingly, when a work group of the federally chartered Health Information Technology Policy Committee met Tuesday for a daylong discussion on certification and adoption of health care I.T. systems, the past, present, and future role of the federally supported Certification Commission for Healthcare Information Technology was on the agenda.

State Medical Records Laws Complicate White House Plans
Nextgov, 7/15/09
A patchwork of conflicting state regulations may hamper the Obama administration's plan to quickly cut health care costs by transitioning from paper to electronic medical records, say some vendors and hospital managers. The 2009 American Recovery and Reinvestment Act included about $20 billion to encourage doctors and hospitals to install e-records systems by 2014 as part of President Obama's larger health care agenda. But the planned migration to e-records still could cost hospitals billions of dollars annually because they also must retain paper records.

The U.S. Stimulus Program: Taking Medical Records On-line
The McKinsey Quarterly, 7/14/09
This article examines the Obama administration's plans to use electronic medical records to cut the cost and improve the quality of health care over the next decade. To meet these goals, the sector must undergo a wrenching shift from the current "silo-ridden and usually paper-based arrangements to a system that coordinates information more effectively and efficiently, with I.T. supporting a wide range of medical decisions."

Seven Ways to Get Value From Your EMR
HealthLeaders, 7/14/09
EMRs were thrust once again into the national spotlight when the Obama administration committed nearly $19 billion in stimulus funding for health I.T. as part of the American Recovery and Reinvestment Act of 2009. The objective is to use electronic medical records to make the health system more efficient, safer for patients, and, ultimately, to reduce costs and improve quality. While EMRs have the potential to meet those objectives, implementing the technology simply isn't enough.

NIST Chair Suggests Certification Oversight Process
Modern Healthcare, subscription needed 7/14/09
CCHIT may get a watchman. That was the gist of a presentation by Gordon Gillerman, chief of the standards division of the National Institute of Standards and Technology, at a meeting of the certification and adoption work group of the Health Information Technology Policy Committee Tuesday in Washington.

EHR Group to Feds: Keep CCHIT
Health Data Management, 7/14/09
CCHIT should be the sole certifying entity for EHRs, according to the HIMSS Electronic Health Record Association. The trade group of EHR vendors on July 13 sent a comment letter to the HIT Policy Committee's certification/adoption workgroup. The committee is developing recommendations to the Office of the National Coordinator for Health Information Technology on numerous issues related to provisions of the economic stimulus law, widespread adoption of EHRs, and development of a national health information network.

Health Care Stimulus Funding Process Picking Up Speed
iHealthBeat, 7/13/09
Since the American Recovery and Reinvestment Act was signed in February, the federal government has been moving relatively rapidly to get balls rolling on multiple fronts. In health care, the process is picking up speed in several areas as a result of recent efforts, including the release of the Office of the National Coordinator for Health I.T. implementation plan for health I.T.; ONC, CMS implementation plans; and defining 'Meaningful Use' for EHR incentives.

Medicare Eyes EHR Data for PQRI
Health Data Management, 7/13/09
The Centers for Medicare and Medicaid Services is considering expanding the Physician Quality Reporting Initiative to include data on quality measures submitted from electronic health records systems. The PQRI program presently includes Medicare incentive payments to physicians for submission of claims-based data. CMS has been testing with physicians the submission of EHR data without including incentive payments. Text of the Medicare physician fee schedule proposed rule is available on-line.

AHRQ to Develop Health I.T. Workflow Toolkit
Government Health IT, 7/9/09
When providers install electronic health applications, it changes how work is performed and information shared. Their customary paper-based processes need to be redesigned to fit new electronic workflows, the agency said. AHRQ plans to publish an on-line toolkit for small practices and clinics by January 2011, according to Dr. Jon White, AHRQ’s health I.T. director. Redesigning workflow is a critical first step in any effective health I.T. implementation, he said.

Guide Aids in Transferring PHR Data
Health Data Management, 7/9/09
The Accredited Standards Committee X12 of the American National Standards Institute has released an implementation guide with standardized requirements to facilitate transfer of personal health records data among insurers. Such transfers enable consumers to maintain longitudinal PHRs when their health coverage shifts to another payer. The Personal Health Record Transfer Between Health Plans Implementation Guide is available for purchase from Washington Publishing Company.

About 45,000 Docs Qualify for Medicaid HIT Money
HealthLeaders, 7/8/09
Approximately 45,000 physicians across the nation will qualify for as much as $63,750 in Medicaid stimulus money over the next six years to install health information technology, according to a new study released. The George Washington University School of Public Health and Health Services study found those 45,000 physicians—who represent 15% of the roughly 300,000 practicing office-based physicians in the country—will qualify for the Medicaid stimulus funding if they demonstrate meaningful use of HIT for a patient mix that includes at least 30% Medicaid beneficiaries.

In Retooled Health Care System, Who Will Say No?
Washington Post, 7/8/09
The query is emerging as the ultimate challenge in reining in health care costs that now consume $2.5 trillion per year, or 16% of the economy: How will tough decisions be made about what to spend money on? The question permeates all levels of medicine, according to the Washington Post: the use of tests that many argue are unnecessary; how early to intervene with common conditions such as heart disease and prostate cancer; how aggressively to treat patients nearing their life's end.

Where's the HIT in HCR (Health Care Reform)?
iHealthbeat, 7/8/09
Let's give credit where credit is due. From where I sit, Congress took a big step toward a digital health care system by including the HITECH provisions in the American Recovery and Reinvestment Act of 2009. Approximately $30 billion in new federal spending was authorized for various health I.T. activities, the bulk of which goes toward economic incentives for physicians and hospitals to be "meaningful users" of certified electronic health records. Monies were also allocated for extension services, state initiatives, loans and grants. But if we are to have real health care reform, a greater health I.T. effort is required than what was accomplished in ARRA.

Advice on Rapid EHR Rollouts Offered
Health Data Management, 7/7/09
Two sessions at Health Data Management’s Health I.T. Stimulus Summit will offer advice on implementing electronic health records in a brief timeframe. The conference will be held Sept. 17-18 in Boston.

CDC Launches Public Health Tracking Web Site
Modern Healthcare, subscription needed 7/7/09
The Centers for Disease Control and Prevention has launched a Web-based tool that allows scientists, health professionals, and members of the public to track environmental exposures and chronic health conditions. Known as the National Environmental Public Health Tracking Network, the site brings together environmental information from across the country—including air and water pollutants, as well as information for certain chronic conditions, including asthma, cancer, childhood lead poisoning and heart disease—in one resource.

Vermont Community Hospitals Form Shared Network
BurlingtonFreePress.com, 7/20/09
Three community hospitals have formed the not-for-profit Vermont Hospital Shared Service Network. The presidents and boards of trustees of Copley Hospital in Morrisville, Gifford Medical Center in Randolph, and Porter Medical Center in Middlebury created VEHSSN to enhance collaboration and the development of shared services among the three not-for-profit, rural Community Access Hospitals as permitted by law.

Digital Visits Slowly Gain Traction
Jacksonville Business Journal, 7/17/09
When Blue Cross and Blue Shield of Florida Inc. began covering digital doctor’s appointments, they were the first in the state to make an e-visit a billable service. Five years later, a handful of other insurance companies including Aetna Inc. and Cigna Corp. have followed suit. Adoption has been slow, but Blue Cross said more doctors and patients are considering e-visits. About 1,000 health care providers have signed up for the service through Blue Cross, and the number of patients who enrolled had grown to more than 600,000 last month, nearly doubling from a year earlier.

Minnesota Rule for Electronic Health Care Billing Starts
Modern Healthcare, subscription needed 7/14/09
Behind the scenes in the medical business in Minnesota, the handling of patients' bills will change on Wednesday. That's when a new state rule kicks in that will require all health care providers to submit their bills to institutional payers electronically. The Minnesota Health Department estimates that when about 60,000 providers go to e-billing, it will save about $60 million in administrative costs per year.

Stimulus Available to Digitize Medical Records
El Paso Times, 7/13/09
Health care workers are in the early stages of talks on how the city can get its share of federal stimulus money meant to spur the sharing of electronic health records. But challenges abound, including various formats for each hospital's digital records and federal standards that have yet to be determined. Most large hospitals in the region are well on their way to digitally storing most patient records, the benefits of which are acclaimed by hospital administrators.

State Helping to Shape U.S. Efforts to Digitize Health Records for All
Boston Globe, 7/12/09
Almost 50 years ago, a Harvard-educated president gave voice to a lofty ambition: to send men to the moon before the end of the 1960s. A collection of brainiacs at MIT and Raytheon designed and built the electronic navigation system that safely guided six Apollo spacecraft to the lunar surface. Earlier this year, another Harvard-educated president laid down another big challenge: By 2014, every American will have an electronic medical record, with the goal of cutting the cost—and improving the quality—of health care.

Louisiana Governor Jindal Signs Electronic Health Records Bill
BayouBuzz.com, 7/9/09
Louisiana again moved one step forward into the world of electronic medical records. Today, Governor Bobby Jindal signed a bill into law that will help improve health outcomes and reduce health care costs by establishing an “Electronic Health Records Loan Program” to jumpstart use of advanced health information technology systems by physicians and hospitals statewide.

Wisconsin Secretary to Gather Info on Medical Records
Associated Press, 7/7/09
Wisconsin health officials want to gather input on how to share electronic medical records. Department of Health Services Secretary Karen Timberlake plans to launch a series of summits to gather comments on e-record sharing at a meeting in Sauk City on Tuesday morning. The idea is to identify requirements and priorities for a sharing infrastructure for stakeholders across the medical world. State health officials plan to hold similar summits around Wisconsin throughout July.

Nashville: The New Hotbed for Health I.T. Innovation
HealthLeaders, 7/7/09
There are only a handful of regions in the United States that have the knowledge base, capital access, local leadership, and infrastructure to be the innovative leader in health I.T. And Nashville, TN, is a "tremendous contender," said David Brailer, MD, PhD, chairman of San Francisco, CA-based Health Evolution Partners, during the Nashville Health Care Council's forum on health information technology and the economic stimulus held nearly two weeks ago.

VA Halts 45 I.T. Projects
Health Data Management, 7/20/09
The Department of Veterans Affairs has announced it is temporarily halting 45 information technology projects that are either behind schedule or over budget. During the suspension, officials will determine whether each project should resume. Before any project can continue, the VA must create a new project plan that meets the requirements of the government’s Program Management Accountability System and is approved by the VA’s assistant secretary for information and technology, says Secretary of Veterans Affairs Eric Shinseki.

Senate Allocates $3.3 Billion in I.T. Funds for VA
Information Week, 7/14/09
Under a spending authorization bill approved by the Senate Appropriations Committee, the Veterans Administration would get $3.31 billion to spend on information technology in 2010. Much of that money would go toward electronic medical records projects at the VA, as well as the integration of those medical records with the medical records kept by the Department of Defense.

3.5 Million New Health Care Jobs Expected by 2016
HealthLeaders, 7/13/09
Health care will remain the largest source of job growth in the coming years, with 3.5 million new jobs across the sector expected by 2016, and perhaps even more jobs coming if universal health insurance is implemented, according to a new study released by the President's Council of Economic Advisors.

Comparative-Effectiveness Reports Set High Bar
Modern Healthcare, subscription needed 7/8/09
Two sweeping advisory committee reports providing guidance for creating a national comparative-effectiveness research program set an ambitious agenda and could mark the turning point for the delivery of patient care in the U.S., said health care industry experts familiar with the reports. Those same experts acknowledged, however, that the recommendations may have done little to quell concerns about the ultimate use of comparative-effectiveness research or answer questions about when providers and patients would be able to access such information to guide treatment decisions.

Data-Miners Claim Marketing Used to Improve Quality
Modern Healthcare, subscription needed 7/7/09
The courts delivered new setbacks to companies that mine prescribing data and sell information about the habits of individual physicians as a marketing tool for pharmaceutical companies, a practice banned by laws passed in three Northeast states. But the industry will continue to make its case that the bans are bad policy regardless of whether they ultimately prove constitutional.

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