Edition Sixty-Three (2/09/11)

HIT Workgroup Reports Meaningful Use Challenges
InformationWeek, 2/4/11
The HIT Adoption and Certification Workgroup presented the findings from two days of hearings. The intent was to better inform the HIT Policy Committee and Meaningful Use Workgroup about the real world challenges faced by organizations working to comply with their requirements.

ONC Panel Endorses Steps for Matching Patients with Exchange Data
Government Health IT, 12/3/11
An advisory panel of ONC endorsed broad proposals for accurately matching patients to their health information, a vital need in promoting confidential and secure exchange of patient data. It’s also a requirement when a patient is sent from one health care provider to another, since they both need to be able to correctly link the individual’s information in order to improve patient safety and outcomes. 

Blumenthal Leaving ONC in Spring
Health Data Management, 2/3/11
David Blumenthal, M.D., national coordinator for health information technology, announced he will leave his post this spring to return to Harvard University. Blumenthal has served as ONC leader for nearly two years since accepting the post in March 2009. Going back to Harvard was part of the plan when he accepted the position, he says.

Meaningless Talk of Repealing Meaningful Use Programs
InformationWeek, 2/3/11
Congressional threats to repeal HITECH funding are empty, but their potential to fuel confusion and mistrust among health care providers is real. Members of Congress looking to gut the $27 billion in funding which is set for the HITECH Act's Meaningful Use incentive program aren't accomplishing much besides creating more confusion, uncertainty, and excuses for the nation's already stressed out health care providers.

EHR Studies Need Another Look Post-Meaningful Use
InformationWeek, 2/1/11
Electronic health records don't necessarily bolster quality of care in ambulatory settings, reported a study by Stanford University researchers. This isn't the first study which is found EHRs disappointing in improving care or cutting costs. But isn't the success of EHRs—like big applications in other industries—closely dependent on how these systems are being used, the training users receive, and how robust and easy the products are to use?

Health I.T. Coordinator: EHR Incentives are ‘Once-in-a-lifetime Chance’
Executive Gov, 2/1/11
At the annual eHealth Initiative Annual Conference, David Blumenthal hailed the “era of Meaningful Use,” using the term to describe the significant adoption of EHRs. In a follow-up interview with FierceEMR, Blumenthal talked building interoperability into EHR systems and why even small health care providers shouldn’t wait any longer to adopt health I.T. practices.

EMR Spending Expected to Double in Four Years
American Medical News, 2/1/11
Government incentives for using EHRs will result in spending on systems doubling by 2015, according to a report by IDC Health Insights. However, the study notes much of the growth will come closer to end of the projected period, because vendors are having trouble keeping up with the orders.

NIST Considers Changes in Federal Role in Standards Development
Government Health IT, 1/31/11
The National Institute of Standards and Technology is considering changes in the role which government should play in driving and participating in standards development, including for health I.T., cyber security and other technologies which are of national interest. The U.S. has had a model of voluntary consensus standards activities driven by industry.

Survey: Docs, Patients on the Same Page When it Comes to I.T. Priorities
Healthcare IT News, 1/31/11
Increasing electronic access to patient records, support for Meaningful Use incentives, and privacy safeguards are some of the health I.T. priorities which doctors and patients can agree on, according to a national survey released Monday by the Markle Foundation.

'Confusion' from GOP Defunding Proposal
Modern Healthcare, subscription required 1/31/11 
Federal legislation introduced in the U.S. House to claw back unspent funds from the 2009 economic stimulus law would effectively defund federal health information technology incentive payment programs, but the bill has little chance of becoming law, according to a veteran I.T. bill watcher.

ONC: More Funds for College HIT Training
Health Data Management, 1/31/11
ONC awarded $32.3 million in second-year funding to five community college consortia offering health I.T. training programs through 81 colleges across the nation. The program, funded under the HITECH Act, is designed to provide intensive courses lasting up to six months, to train 50,000 I.T. specialists over five years.

NCQA Sets New Medical Home Standards
Health Data Management, 1/31/11
The National Committee for Quality Assurance (NCQA) will issue new standards for it's Patient-Centered Medical Home program. More than 7,700 clinicians at 1,500 sites use existing standards from Washington-based NCQA in their medical home initiatives. The initiatives call for substantially better coordination across the continuum of care, anchored by a primary care physician, and augmented with extensive use of information technology.

Health I.T. Could Power Era of Personalized Medicine
Healthcare IT News, 1/28/11
Health information technology has the power to drive advances in personalized medicine which will offer better-targeted treatments—and save the health system money—according to a new report from the Center for Technology Innovation at Brookings.

ONC Adds $80M to Extension Centers, HIEs and Workforce Programs
Government Health IT, 1/27/11
ONC awarded a total of $80 million more for its REC, state HIE, and community college workforce programs to boost their support of providers becoming Meaningful Users of EHRs. More funds will strengthen the momentum of these programs, which ONC launched last year, as physicians and hospitals begin to register for the Medicare and Medicaid EHR Incentive Programs. 

Top Health Care I.T. Predictions for 2011
InformationWeek, 1/27/11
The new year promises to be another busy one for health care organizations as industry reform and transformation continue to unfold. Doctor practices and hospitals in 2011 will be focused on EMRs and other systems tied to the federal government's Meaningful Use financial incentive program, as other mandates, health I.T. efforts, and challenges will compete for attention. 

GOP Bill Puts Meaningful Use, HITECH Act in Peril
Health Data Management, 1/27/11
Legislation introduced in the U.S. House and initially sponsored by nearly three-quarters of the Republican caucus clearly appears to seek repeal of the Medicare/Medicaid EHR Meaningful Use incentive payment programs. But whether the bill also would repeal all of the HITECH Act within the economic stimulus law is unclear.

Health Care Software Development Exposes Security Risks
InformationWeek, 1/26/11
According to a survey of I.T. managers at health delivery organizations, 51% of respondents said they don't protect patient data used in software development and testing. The report, "Health Data at Risk in Development: A Call for Data Masking," also revealed lost patient information can go undetected. A full 78% of respondents said they are not confident or else are undecided as to whether their organization could even detect the theft or accidental loss of real data in development or testing. 

HIMSS: Obama Advisors on Wrong Track
Health Data Management, 1/26/11
Inaccurate patient identification methods could sink the vision of the President's Council of Advisors on Science and Technology for establishment of a "universal exchange language" to accelerate HIE, according to HIMSS.

Obama Gives HIT the Nod in State of the Union Speech
Healthcare IT News, 1/26/11
In a broad State of the Union speech, President Obama hailed the information age in America and the need for the federal government to support HIT innovation.

Extension Centers to Get I.T. Grant Boost
Modern Healthcare, subscription required 1/26/11 
The federally sponsored regional HIT extension center program will receive a financial boost from HHS, David Blumenthal announced. Originally established with 90% federal dollars and 10% local matches, the RECs were to become largely self-funded after two years, with federal support reduced to just 10% and local funds covering the remaining 90% of operations.

Meaningful Use Rules Exempt Doctors, Not EMR Systems
American Medical News, 1/ 26/11
David Blumenthal posted a blog entry in hopes to clear up confusion about the level of flexibility built into Stage 1 Meaningful Use requirements to receive bonuses from Medicare or Medicaid. Under the final rules, physicians were given the flexibility to defer up to five of the 10 objectives on a menu set. But even if physicians have no plans to use certain functions of the EMR system, they must have a system which is certified to do them all.

Guerra on Health Care: Is HITECH a Bait and Switch?
InformationWeek, 1/25/11
Most hospitals say they expect to qualify for Meaningful Use incentive funds, but most shouldn't plan to see a return on their health I.T. systems investment. 

Health Systems Underestimate EMR Costs
InformationWeek, 1/25/11
According to a study, most health delivery organizations underestimate the time and costs associated with implementing advanced EMR functions, including clinical order entry, nursing and physician documentation, clinical decision support, and barcoding medications.

A New Health Care Model
Boston Globe, 2/6/11
Accountable care organizations are among the most talked about components of the new national health care law, and the Caritas Christi hospitals are in the process of becoming one. But what will ACOs look like and how will they operate?

5 Steps Toward Successfully Implementing CPOE
Becker's Hospital Review, 2/4/11
Staff members from Norman (Okla.) Regional Hospital, which successfully integrated evidence-based order sets into its own EHR system, share five steps the hospital took to achieve this integration. 

NEJM: Johns Hopkins Offers Advice on ACO Model
CMIO, 2/4/11
In response to the Patient Protection & Affordable Care Act (PPACA), academic medical centers will need to address both financial and cultural barriers to the implementation of new care and payment models such as ACOs.

Blumenthal, Chopra Announce ‘Milestone’ in EHR Sharing
Executive Gov, 2/3/11
Minnesota and Rhode Island became the first states to participate in pilot program for direct sharing of EHRs via the Internet, known as the Direct Project. The pilot program, which will soon expand to include New York, Connecticut, Tennessee, Oklahoma, Texas, and California, is the first step toward making the Health Information Exchange accessible to health care providers nationwide.

UNC Program Helps Doctors to Adopt Electronic Records
The Daily Tar Heel, 2/3/11 
A program headquartered at the UNC School of Medicine is helping more than 1,500 primary health care centers around the state adopt EHRs and other technology upgrades. The N.C. Area Health Education Centers program was awarded a $13.6 million federal grant last year as part of a national federal initiative to improve health care quality and efficiency. 

Massachusetts Adds $3.4M for Shared EHRs
Mass High Tech, 1/28/11
Massachusetts has been awarded a federal grant worth approximately $3.4 million to help establish an HIE which will help doctors at different hospitals share patients' health data. The goal is to reduce errors and duplicated care, which would improve health care quality and bring down costs.

Q&A: New York HIE Aims to Increase Access, Data Types
CMIO, 1/26/11
From its roots as a collaboration of the New York State Health Plan Association and Iroquois Health Care Alliance, the Health Care Information Xchange of New York (HIXNY) has grown to provide services in a 17-county region comprised of approximately 1.5 million health care consumers in the Greater Capital Region. Dominick Bizzarro, CEO of HIXNY, recently spoke with CMIO about the HIE’s continuing plans for expansion.

Core Elements of EHRs in Place for Almost Half of Canadians
Digital Journal, 2/3/11
As a result of investments made by Canada Health Infoway and its jurisdictional partners, Infoway President and CEO, Richard Alvarez reports the core elements of an EHRs are now in place for nearly half of the Canadian population (49.3%).

Person-Centered Health Data Management Systems: Key to Sustainable U.S. Health Care
iHealthBeat, 2/3/11
The U.S. health care system is a $2.5 trillion industry comprising multiple powerful stakeholder groups, often with competing interests. It is therefore crucial to identify guiding principles and priorities by which all stakeholders may be held accountable.

ACOs Can Work with Physicians in Charge
American Medical News, 1/31/11
A hospital partner may not be necessary for an accountable care organization to be effective, according to a report analyzing a primary care-led ACO. Physicians increasingly are selling their practices to hospitals, which are buying in preparation for the development of ACOs and other aspects of health system reform.

The Missing Ingredient in Accountable Care
New York Times, 1/27/11
For the last few years health care experts and policy analysts have been preaching the virtues of ACOs. While the details of these plans have yet to be worked out for Medicare, the enthusiasm for this model of payment and delivery has gone nearly viral, infecting and making strange bedfellows of third-party payers, state legislatures, and politicians on both sides of the aisle. In journals, round-table discussions, blogs, and most recently in the Department of Justice, the debate has focused not on whether ACOs should exist, but on how they might best be organized and put into action.

ACOs and Integrative Health Care
H&HN, 1/24/11
One of the hottest topics of debate on the health care blogosphere is the Medicare pilot program creating ACOs—19 of them—throughout the country. Models for ACOs vary and can be expected to morph further as the new concept is tested and refined.

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