Edition Twenty-Seven (9/01/09)

Report: Governments Boosting I.T. Buying
Health Data Management, 8/31/09
Health I.T. investments by local and state governments will increase from $7.6 billion this year to $9.6 billion in 2014, according to a new report. This is a compound annual growth rate of 4.6% spurred by health care reform and I.T. provisions of ARRA, states the report, from INPUT, a Reston, Va.-based market research firm for government agencies.

MGMA: Encourage EHR for PQRI
Health Data Management, 8/31/09
The Medical Group Management Association is calling on CMS to accelerate the reporting of data via EHRs for the Physician Quality Reporting Initiative P4P program. The association concurs with CMS' concerns of the limitations of claims-based reporting of quality data, according to a comment letter on Medicare's proposed physician fee schedule for 2010.

FTC Final Rule Requires Quick PHR Breach Notification
Modern Healthcare, subscription required 8/31/09
The FTC weighed in with new rules to protect the privacy and security of personally identifiable health care information stored on PHR systems offered by companies not covered by federal privacy rules under HIPAA. The FTC rulemaking on breach notification by vendors of PHRs comes under the authority of ARRA. Broadly, the new FTC rule calls for customer notification in the event of a breach of identifiable health information. Notification must occur “without unreasonable delay” but no later than 60 days after the breach is discovered.

NQF, HL7 Join to Develop e-Quality Measure Sharing
Modern Healthcare, subscription required 8/31/09
NQF and HL7 along with several other organizations have developed a new format for more effectively sharing quality measures electronically. The health quality measure format, or HQMF, standardizes the structure, metadata, definitions, and logic of a quality measure. This standardization will make electronic data capture across computer systems easier.

CMS Readies EHR Data Collection Test
Health Data Management, 8/28/09
CMS is taking additional action to pave the way for hospitals to transmit clinical quality measures to the agency via EHRs systems. The agency is seeking public comment on voluntary testing with up to 55 facilities, with comments due by Oct. 27. The data measures collected via EHRs would not substitute for submission of data elements required under RHQDAPU under current processes.

Assessing Demand for EHRs
Health Data Management, 8/28/09
The Medicare and Medicaid incentives for adopting EHRs will lead to a gradual build in demand for the software, rather than a surge, says Raymond Falci, managing director of Cain Brothers & Co., New York, who tracks public health care I.T. firms. Falci speculates the federal government might wind up pushing back all the deadlines called for under ARRA, much as it did when creating the rules to carry out HIPAA. 

HHS Briefs Funding Hopefuls on Extension Center Competition
Government Health IT, 8/28/09
In a 90-minute Web conference, ONC senior advisor Dr. Farzad Mostashari laid out the parameters of the grant program, designed to lend providers technical assistance on using health I.T. in ways which will not only make their businesses more efficient but will lift health care quality nationwide.

FAH Asks HHS to Drop Pay, Quality Improvement Req
Modern Healthcare, subscription required 8/27/09
In a letter sent by The Federation of American Hospitals' President Chip Kahn, the trade association of for-profit hospital corporations said ARRA requires providers to submit quality information as a condition of meaningful use and those quality measures are to be determined by HHS. However, the stimulus law does not call for providers to meet any specific quality improvement thresholds to qualify for EHR funding.

Programmers to Fix Connect Bugs in Washington
Modern Healthcare, subscription required 8/26/09
Dozens of programmers with some free time on their hands and the ability to travel to Washington, have signed up to contribute code and commentary to the open-source federal software which HHS is developing to provide an interface between federal health care organizations and the proposed national health information network.

CCHIT Schedules 'Town Call’ on New Approaches to Certification
Healthcare IT News, 8/25/09
CCHIT has slated a “town call” Web conference on Sept. 3 to gather input from the vendor and developer communities on the commission’s planned new paths to certification for EHRs. The commission plans to launch a more limited, modular inspection program for EHR technology, focusing solely on compliance with ARRA-required standards.

CCHIT Revamping EHR Certification
Health Data Management, 8/25/09
CCHIT is moving forward with plans to launch a new, less comprehensive EHR software certification program in light of the federal economic stimulus package. In October, the commission plans to launch a more limited, modular inspection program for EHR software, focusing only on compliance with standards required for “meaningful use” of EHRs under ARRA.

Are Personal Health Records the Right Path?
HealthLeaders Media, 8/25/09
Given the emphasis on PHRs in the "meaningful use" recommendations by the HIT Policy Committee, it seems PHRs are here to stay. However, not everyone is convinced PHRs are the right path for health care to take. Some physicians are concerned about how the "art" of medicine is being replaced by templates and checklists and EHRs along with PHRs could suffer from the quality of data which is entered and exchanged.

Electronic Medical Records Grants Face Challenges
The Hill, 8/24/09
Medical technologists and lobbyists say a number of challenges stand in the way of the health care industry’s move toward widespread use of EHRs, despite a billion-dollar commitment from Obama for the effort. Health specialists and trade groups hailed the administration move to provide $1.2 billion in grants to the program as a big step forward in helping doctors and hospitals adopt new technology to save money, reduce errors and increase efficiency.

More than 50% of State CIOs Working on HIT: Report
Modern Healthcare, subscription required 8/24/09
Many state information technology officers are already involved in building exchanges within their jurisdictions, which may be an indication of states—not regions—being the cornerstones of health information exchanges. In a recent report, “Profiles of Progress III: State Health I.T. Initiatives,” NASCIO concluded more than half of state CIOs were involved at some level with state-driven health I.T. initiatives.

No Push for National Medical Errors Database
San Francisco Chronicle, 8/23/09
While the White House acknowledges hospital medical errors are a serious problem, a senior administration official says President Obama does not favor a mandatory reporting system for all medical mistakes, just for infections acquired in hospitals. White House officials say Obama supports a provision in the House legislation to mandate the reporting of hospital-acquired infections, but they acknowledge he is not pushing to require hospitals and doctors to report all errors—something sought by consumer groups and some lawmakers.

Administration Defends Security of Health I.T.
NextGov, 8/21/09
Privacy and security issues are priorities for the administration when it comes to EHRs, said government officials and members of a HIT panel this week. The privacy and security work group of a health I.T. standards advisory committee to HHS, which is tasked with recommending HIT security specifications, called for keeping disclosures of electronic health information to a minimum, providing an account of all disclosures and allowing consumers to obtain copies of their electronic health records.

Obama's e-Health Agenda Receives Cash Infusion
NextGov, 8/21/09
The White House's unveiling of $1.2 billion in grants for programs to expand the use of EHRs represents the first major investment in Obama's health I.T. agenda. About half the grants will go toward creating 70 regional centers which will offer hospitals and clinicians hands-on experience in meaningful use of e-health records systems. The other half of the funding will go to states to help them roll out policies and networks for exchanging information electronically within and across state lines.

HHS to Industry: Help Assess Health I.T. Networks
Federal Computer Week, 8/21/09
HHS wants industry help to identify the current scope of HIEs and how best to foster a nationwide exchange for quality and outcome reporting. CMS published a RFI for the National Gap Analysis and Readiness Assessment for the Health Information Technology Infrastructure. The project’s goal is to support the adoption of EHRs in the near term and lay the groundwork for broad exchange of patient data.

U.S. to Dole Out $1.2 Billion for Health Records Technology
Washington Post, 8/21/09
The Obama administration unveiled $1.2 billion in federal grants for EHR systems, the first wave of funding under a health care reform plan to create vast records-sharing networks aimed at cutting costs and improving care in the coming decade. The administration has described such computer systems as a crucial step in overhauling the nation's increasingly expensive health care system.

Obama's Big Idea for Saving $100 Billion
CNNMoney.com, 8/21/09
Experts say EHRs will slash health care costs, but hospitals wonder when and how they'll be able to realize those savings. The health care industry is poised to realize huge savings by implementing EHRs systems, but who really benefits is up for debate. A recent Congressional Budget Office report said the health reform bills wouldn't sufficiently rein in costs nor would they trickle down savings to the average American with employee-sponsored insurance.

HIE Data Standards Get Initial Approval
Health Data Management, 8/21/09
The HIT Standards Committee, a federal advisory body, has approved recommendations for data standards which support the exchange of patient information among disparate entities. Such data exchange will be a requirement for meaningful use of electronic health records under the economic stimulus law. The approval is the first step in requiring EHRs to support these standards and for providers to use them to facilitate health information exchange.

Biden: ‘Modernizing the System' Crucial to Reform
Modern Healthcare, subscription required 8/21/09
Health information technology and health care reform were the two topics under discussion at a round-table discussion led Vice President Joe Biden in Chicago with fellow panelists HHS Secretary Kathleen Sebelius, HHS National Coordinator for Health Information Technology David Blumenthal, and five Chicago-area health care workers. Biden used the opportunity to ballyhoo the apportionment of nearly $1.2 billion from ARRA for health I.T. funding.

Biden at Mount Sinai: U.S. Will Give $1.2B to Computerize Medical Records
Chicago Tribune, 8/20/09
Cash-strapped Mount Sinai Hospital on Chicago's West Side where Hamilton and colleagues care for thousands of uninsured patients acted as the backdrop for Vice President Joe Biden's announcement of $1.2 billion to be allocated to modernize hospital and state government record-keeping systems aimed at improving patient care. As debate rages across the country on how to fund health care reform, Biden and top White House health officials took steps to distance the Obama administration from critics who charge they are trying to hijack the health care system with a government-run program.

Blumenthal: I.T. Made Me a Better Doctor
Health Data Management, 8/20/09
David Blumenthal, M.D., national coordinator for health information technology, has released a letter updating the industry on the government's activities to accelerate the use of I.T. He also makes a personal pitch to physicians, telling them I.T. made him a better doctor.

SNOMED CT Will Be Required by 2015 for Bonuses Under Economic Recovery Law
Healthcare IT News, 8/20/09
The federal advisory panel on health I.T. standards has approved refined recommendations on how providers may electronically record a physician's observations to qualify for federal recovery bonuses. The HIT Standards Committee endorsed recommendations to call for SNOMED CT for physician's clinical observations by 2015. In 2010, providers must use ICD-9 or SNOMED CT to qualify, and in 2013 they must use ICD-10 or SNOMED CT.

Blumenthal Offers ‘Meaningful Use’ Timeframe
Health Data Management, 8/20/09
The final definition of the “meaningful use” of EHRs which will be used to determine eligibility for incentive payments under the economic stimulus program will not be available until the middle or end of spring 2010. This is the prediction of David Blumenthal, M.D., national coordinator for health information technology.

HHS Issues Rule on Patient Privacy Breaches
Modern Healthcare, subscription required 8/19/09
HHS has issued an interim final rule regulating when and how patients must be notified if their health care information has been exposed in a security breach by hospitals, physician offices and other health care entities. The new rule is part of heightened privacy and security protections under the stimulus law. It is a companion to regulations released by the FTC covering breaches involving vendors of PHR systems and certain of their associated businesses not covered by the privacy and security provisions of HIPAA.

Should EHRs Be Able to Create Legal Paper Records?
Modern Healthcare, subscription required 8/19/09
The tricky and intertwined issues of legal record reproduction and the privacy requirements under new and old federal laws were frequent topics of discussion through day two of a conference on the legal e-health record hosted by AHIMA. Donald Mon, vice president of practice leadership at AHIMA, led a group discussion on AHIMA policy going forward, including whether the association should lobby the industry on including certification of the ability of EHRs to produce legal records as part of the “meaningful use” requirements now being defined under federal rulemaking pursuant to ARRA.

HIT Certification Committee Still in Play
InformationWeek, 8/18/09
CCHIT will continue to be the certification body for health I.T. systems at least until December when the U.S. government finalizes its definition of "meaningful use" of e-health products. After the meaningful use definition is finalized, multiple organizations will be allowed to perform testing and certification of products for meeting the evolving criteria and standards of U.S. and HHS certification rules. Vendors would need certification from only one certification body.

Sebelius Boosts Blumenthal's Authority
Health Data Management, 8/18/09
Kathleen Sebelius has delegated administrative responsibility to the National Coordinator for HIT for most of the grant and loan funding sections of the HITECH Act. The action does not cover the Medicare/Medicaid incentive programs for meaningful use of EHRs. National Coordinator David Blumenthal, M.D., now has administrative authority for all but one part of Sections 3011 through 3017 of Subtitle B, "Incentives for the Use of Health Information Technology."

Health Care's Progressive Transformation, by John Glaser
H&HN Magazine, 8/17/09
The pace of I.T. adoption in health care may trouble outsiders, but leaders and clinicians understand why a more measured approach makes sense. Health care is often accused of lagging behind other industries in applying I.T. Statistics, such as percentage of revenue spent on I.T., are used to justify this indictment, but health care's annual spend of 2.7 percent is the same as the average percentage across all industries.

Attorney: ARRA Impact on HIPAA Minimal
Health Data Management, 8/18/09
Health care provider organizations which comply with existing HIPAA privacy and security regulations shouldn’t be too concerned about the updates in the rules called for under the stimulus, because ARRA does not call for “wholesale changes” in the HIPAA rules. But ARRA sets tougher penalties, ranging from $25,000 to $1.5 million, for violating a patient’s privacy. It also will lead to dramatically stepped-up enforcement of privacy and security regulations.

NAHIT to Close Doors
Health Data Management, 8/17/09
Saying its mission has been accomplished, the National Alliance for Health Information Technology will cease operations on Sept. 30. During the past seven years, NAHIT co-founded CCHIT; formed the Health Care Supply Chain Standards Coalition which later merged with GS1 Health Care US; created a public directory of health I.T. standards; successfully pushed for mandated bar codes to identify medications; and developed consensus-based definitions for core health I.T. terms under a federal government contract.

FTC's PHR Breach Rule = Confusion
Health Data Management, 8/17/09
The FTC has released a final rule requiring vendors of PHRs to notify consumers when the security of their data is breached. Despite efforts of the FTC and HHS to harmonize separate rules governing notification of breaches, the FTC rule takes confusion to a new level and will require considerable study. The FTC final rule and HHS' forthcoming rule, which covers a variety of data breaches including PHRs, were mandated under ARRA.

Third Time's the Charm: Committee Accepts ‘Meaningful Use' Criteria
Modern Healthcare, subscription required 8/17/09
Another month, another matrix in the development of definitions of “meaningful use,” the key criteria providers must meet to unlock tens of billions of dollars of federal HIT subsidies under the ARRA. The HIT Policy Committee received a third set of recommendations from its meaningful-use work group. The recommendations were again detailed, as were their predecessors handed over by the group in June and July, in a spreadsheet or “matrix” format.



Nebraska HIE as 'Shovel-Ready' as They Get
Healthcare IT News, 8/17/09
The Nebraska Health Information Initiative (NeHII) is gearing up for the next level of work with its sights set on statewide implementation, after celebrating the success of its pilot at its annual meeting in July. Reduction of mistakes and medical errors has been the first benefit gleaned, with impact to quality to come over time. NeHII operates a hub to which participants can connect and is in discussions with four surrounding states to use its infrastructure as a central hub for a multi-state HIE.

Blumenthal: States Are ‘Ground Zero’ for Heath Info Exchange
Government Health IT, 8/18/09
David Blumenthal spoke to state Medicaid I.T. directors to remind them of where they stood in the HIE policy and technology hierarchy: “ground zero,” he said. States and local jurisdictions will be responsible for building the infrastructure on which HIEs will operate. This means states also bear the burden of solving policy conflicts which will arise when health exchange transactions cross state lines.

NASCIO: State CIOs Play Key Role in Health I.T.
Modern Healthcare, subscription required 8/18/09
The National Association of State Chief Information Officers, or NASCIO, produced a guide to help state CIOs play a role in helping states navigate opportunities and responsibilities under the HIT provisions of ARRA. NASCIO's “HITECH in the States: Action List for State CIOs” explains how states must work quickly, but carefully, and state CIOs can play an important role, by convening I.T. stakeholders, assessing existing infrastructure, and determining readiness for large-scale HIE.

Health Information Technology Powers Debate on National Health Care Reform
Kansas City Business Journal, 8/21/09
Local employers are heaping praise on the expansion of HIT to be financed by pending national health care reform legislation. This doesn’t quite compute: The bills being debated call for little health I.T. expansion beyond a proposed on-line marketplace to shop for plans. Still, employers who think health I.T. will drive any successful reform effort can stay juiced. It’s just that health I.T.’s multibillion-dollar jolt will come from another source.



AHRQ Readies ARRA Research Grants
Health Data Management, 8/19/09
AHRQ is getting ready to dole out $300 million in stimulus funds to support comparative effectiveness research. The agency expects to issue grant and contract solicitations this fall, with funding to start in the spring of 2010. $100 million will be used to create a new, coordinated national effort to establish a series of studies which measure the benefits of treatment in routine clinical practice. Another $48 million will go for establishing or enhancing national patient registries to research the longitudinal effects of different interventions.

On-line Patient Data May Open New Doors In Medical Research
Kaiser Health News, 8/25/09
The LAM Treatment Alliance hopes to speed research on the fatal respiratory disease which afflicts young women. The group created LAMsight, a Web site which allows patients to report information about their health, then turns those reports into databases which can be mined for observations about the disease.

Blumenthal Named Sixth on 100 Most Powerful List
Modern Healthcare, subscription required 8/24/09
Washington reigned supreme in this year's voting for the 100 Most Powerful People in Health Care. With health care reform holding center stage in our nation's capital—and even across the country—it's not surprising the top six named to Modern Healthcare's eighth annual list all have their offices in the gray and white buildings which run along Pennsylvania, Constitution, and Independence avenues. David Blumenthal, national coordinator for health information technology, came in at No. 6 on this year's list, boosting the ONC's top position from 2008, when Robert Kolodner, then-national coordinator, came in at 56. 

Archives