Edition Forty-Nine (7/20/10)

HHS Addresses Privacy, Security Concerns in EHR Program
HealthLeaders, 7/16/10
HIPAA privacy and security concerns with the government's EHR certification program are so great that hundreds of practitioners have called for the program's cancellation. Through its technology standards final rule, HHS addresses privacy and security concerns by requiring organizations to perform risk analyses and correct security deficiencies, and by requiring the EHR technology to include among other security functions. 

ONC's Mostashari Defends Meaningful Use Regulations
Modern Healthcare, subscription required 7/16/10
Farzad Mostashari, deputy national coordinator for programs and policy within ONC, was the featured guest at the Association of Medical Directors of Information Systems' Physician Computer Connection Symposium. Mostashari said criteria laid out in December in the CMS' notice of proposed rule-making, which were left out of the Stage 1 final rule, will be included in the Stage 2 rule.

FCC Seeks to Boost Rural Health Care Program Use
ABC News, 7/15/10
Federal regulators are proposing changes to expand use of the $400 million government program which subsidizes Internet services at hospitals, clinics, and other health care facilities in rural areas. The FCC voted unanimously to consider changes to its rural health care program, one of four programs paid for by the $8 billion federal fund which subsidizes telecommunications services in poor and rural areas.

AMDIS Members Take on Meaningful Use
Modern Healthcare, subscription required, 7/15/10
The new rules on Meaningful Use dominated the discussion during the opening day of the Association of Medical Directors of Information Systems' annual Physician Computer Connection Symposium. The federal funding for EHR systems will launch a new era in the widespread adoption of health care informatics practices, but AMDIS President William Bria thinks we're at the very beginning in so many ways of connecting these tools, these educational environments, to what we do in practice. We need to start to focus, not on the most exotic examples of information sharing, but the more simplistic ones.

CDC to Track State Efforts to Prevent Chronic Disease
Government Health IT, 7/15/10
A new system at the CDC will track the progress state health departments are making in chronic disease prevention and control by integrating the reports currently produced by separate systems. The management information system will monitor data about tobacco control, diabetes prevention and control, healthy communities, and surveillance of state-based behavioral risk factors in all states and territories.

What Final Meaningful Use Rules on EMRs Mean for Doctors, Hospitals
Business Week, 7/14/10
The federal government has lowered the bar for physicians and hospitals to receive reimbursement for implementing EMRs, while also retaining the fundamental measures to maintain quality and safety, experts say. There wasn't much to promote HIE in the proposed rule, but they scaled it back even further in the final rule—state HIEs will likely be addressed in phase two and three of the rules.

AHA: Mixed Reaction to Meaningful Use Rule
Health Data Management, 7/14/10
Multiple industry associations and organizations quickly issued statements on July 13 responding to the release of the Meaningful Use rule. While some organizations issued generic reactions, likely written beforehand, the American Hospital Association sent out its statement late in the day and made points based on what the rule says.

Pharmacist Group Calls on CMS to Bolster e-Prescribing Safeguards in New Meaningful Use Rule
The Hill's Healthwatch, 7/13/10
The Pharmaceutical Care Management Association (PCMA) is asking CMS to enhance the patient safeguards in the Meaningful Use rule. Doctors, for instance, should be required to perform safety checks before receiving incentive payments for e-Prescribing, the group said. Additionally, PCMA President and CEO Mark Merritt is urging the e-Prescribing rules governing Part D also apply to certified EHRs.

The Meaningful Use Regulation for EHRs
New England Journal of Medicine, 7/13/10
The widespread use of EHRs in the U.S. is inevitable. EHRs will improve caregivers' decisions and patients' outcomes. Once patients experience the benefits of this technology, they will demand nothing less from their providers. Hundreds of thousands of physicians have already seen these benefits in their clinical practice, but inevitability does not mean easy transition.

A First Look at Final Meaningful Use Criteria
Health Data Management, 7/13/10
HHS has released the final rule establishing Medicare and Medicaid incentive programs for the Meaningful Use of EHRs. Also released was an accompanying final rule to establish initial data standards, implementation specifications, and certification criteria for EHRs. Meaningful Use criteria in the final rule are substantially relaxed from what was previously proposed, but still comprehensive and a challenge to meet.

CMS Abandons Absolutes, Adds Flexibility to Meaningful Use
Government Health IT, 7/13/10
In its final Meaningful Use rule, CMS has abandoned its original all-or-nothing approach to offering incentives for EHR adoption and opted for flexibility. One of the major changes in the final rule now requires providers to meet a “core” group of objectives, such as e-Prescribing, providing patients who request it an electronic copy of their health information and maintaining an active medication list. Physicians must meet 15 of those core requirements, and hospitals must meet 14.

Public Comments Reshaped CMS Final Rule
Government Health IT, 7/13/10
CMS received some 2,000 comments after it published its proposed Meaningful Use rule in January, and they were key both to changes in the scope of the final rule published, and to the speed with which it was adopted. “We have sought and received extensive input from the health care community, and we have drawn on their experience and wisdom to produce objectives which are both ambitious and achievable,” Dr. David Blumenthal said.

Winners and Losers in HHS Final Meaningful Use Rule
HealthLeaders, 7/13/10
The HHS Meaningful Use final regulations specify what physicians and hospitals will have to do to receive a share of up to $27 billion in bonus Medicare payments for adoption of EHRs over the next ten years. This big pile of money aside, as with all efforts which result from compromise, there are reasons to cheer and reasons to jeer.

Preserving Public Trust in Personal Health Records
iHealthbeat, 7/13/10
PHRs have great potential to empower patients to manage their own health care. Through PHRs, people can monitor chronic conditions, explore treatment and insurance options, ensure their health information is correct, share data with others to gain insight and support, and hold health care providers to high standards of accountability. However, as a 2010 California Health Care Foundation survey demonstrates, the success of PHRs will depend in substantial part on whether consumers trust their sensitive information is protected.

Blumenthal: 'Our Nation is Poised to Harness the Power of I.T. to Improve Health Care'
Executive Gov, 7/12/10
As HHS promotes the advancement of health I.T., one of the department’s guiding principles is the benefits of health I.T. can only be fully realized if patients and providers are confident in electronic health information being kept private and secure. In a July 8 blog post David Blumenthal and Georgina Verdugo, director of Office for Civil Rights at HHS, wrote about how ONC and the OCR are collaborating on various projects to ensure the electronic exchange of health information is built on a foundation of privacy and security.

New OCR Rule Boosts Privacy, Security
Health Data Management, 7/8/10
HHS' Office for Civil Rights has released a proposed rule to modify and strengthen provisions of the HIPAA privacy, security, and enforcement rules. The proposed rule, on a fast early read, does not appear to mandate encryption of protected health information.

Berwick Now Leads CMS
Health Data Management, 7/7/10
Obama has appointed Donald Berwick, M.D., president and CEO at the Institute for Health Care Improvement, to serve as administrator of CMS. Berwick's appointment is effective until the Senate adjourns at the end of 2011.

Uncle Sam Wants Usability
Government Health IT, 7/7/10
Federal policymakers and the health I.T. community are converging rapidly around the need to agree on standard practices for clearly communicating information contained in EHRs and making it easier for clinicians to navigate their way around tasks in an EHR. Health care researchers, technology experts, and EHR user advocates, bolstered by a new government commitment, are championing the idea that the “usability” of EHR systems is critical to efforts to get the nation’s clinicians to effectively use the software in daily health care practice.

The Federal Electronic Health Record Strategy
H&HN, 7/7/10
The HITECH Act's financial incentives for EHR implementation will create a challenge for many health care organizations, but will lead to more effective use and better care. The federal EHR strategy will transform HIT and profoundly impact the delivery of health care in this country.

CDC Awards Lab Group $2M to Boost Health Data Exchange
Healthcare IT News, 7/6/10
The Association of Public Health Laboratories (APHL) has received $2 million from the CDC to provide technical assistance to advance electronic exchange of laboratory data. The cooperative agreement will support technical assistance to state health departments, public health laboratories, and hospitals to help them link disparate laboratory reporting systems. 

Health I.T. Panel Scrutinizes 2013 Quality Measures
Healthcare IT News, 7/6/10
Even before health care providers begin to demonstrate the first set of Meaningful Use requirements next year, federal health I.T. policymakers are already working on how high to set the bar for providers to qualify for the next round of financial incentive payments in 2013. One set of criteria—providers show the use of health I.T. to achieve health care quality outcomes—will appear in progressively more sophisticated stages. A tenet of Meaningful Use, quality measures are expected ultimately to help providers both hone their treatment protocols and lower health care costs.

$795 Million Awarded to Boost Broadband
Modern Healthcare, subscription required, 7/6/10
Obama has announced $795 million in ARRA funds for new loans and grants to aid in expanding broadband telecommunications capabilities to hospitals, schools, and homes. The Commerce and Agriculture departments will oversee the 66 projects.

Risky Business
Government Health IT, 7/5/10
The HITECH Act toughened the rules and enforcement penalties health information handlers must follow to protect patient privacy. Under the new policy regime, providers will have to pay more attention to the confidentiality and safety of patient information as they move more of their operations toward EHR-keeping. One of the most basic requirements is providers must now perform a security assessment, a first step in understanding systems and electronic data over which they are temporary stewards.

Professors Help Digitalize Health Care
The Battalion, 7/18/10
Arun Sen, information and operations management professor, is working with Dr. Robert Morrow of the Texas A&M Health Science Center and industrial engineering professor Amarnath Banerjee to create a digitized health care information resource to improve patient care. The team received a $5.2 million grant from the federal government to develop one of the four RECs appointed to the state of Texas. The project is a joint effort between Mays Business School, the Texas A&M Health Science Center Rural and Community Health Institute, and the Dwight Look College of Engineering.

eRx Rate in NY State to See 'Explosive Growth'
Healthcare IT News, 7/15/10
The e-Prescribing rate in upstate New York increased from 12 percent in 2009 to 17 percent in the first quarter of 2010, representing 3.6 million new and renewed prescriptions on an annual basis. This report suggests the number will grow significantly as the result of the technology becoming more affordable, due in part to the government's incentives for health I.T. adoption. 

Verification of Infection Data Seen as Key Step
Modern Healthcare, subscription required 7/14/10
More states have begun to mandate reporting of health care associated infection rates, and new findings from New York state's health department suggest auditing infection data to ensure its validity is a necessary step. New York requires hospitals to submit health care associated infection, or HAI, data to the CDC's National Health Care Safety Network, its on-line surveillance system. Based on those audits, state officials determined some New York hospitals were making mistakes which could potentially skew infection rates.

Kansas Health Care Provider Groups Join to Boost Health Data Exchange
Kansas City Business Journal, 7/12/10
Four Kansas health care provider organizations announced a collaborative effort to get a statewide HIE up and running. The Kansas Hospital Association, the Kansas Medical Society, the Kansas City Bi-State Health Information Exchange, and the Wichita Health Information Exchange have agreed to work together to create the EHR exchange. The exchange will operate under the direction of Kansas Health Information Exchange Inc., a nonprofit Gov. Mark Parkinson established to oversee the distribution of EMRs and ensure the patients' privacy is protected.

Missouri Closing in on Health Information Exchange
St. Louis Globe-Democrat, 7/9/10
Missouri passed several milestones in its efforts to promote HIE among health care professionals, the Missouri Department of Social Services reports. This new exchange is hoped to improve the quality of medical care, reduce costs and medical errors, and empower citizens to take a more active role in their own health care. Missouri has access to about $13.8 million in federal funds to underwrite the planning and implementation process.

MU Researchers Refine EHR Technology to Efficiently Meet Increasing Health Care Demands
The Medical News, 7/9/10
An interdisciplinary team of University of Missouri researchers is refining EHR technology to more efficiently meet increasing health care demands due to the growing elderly population. The MU researchers are developing an EHR system which encompasses standard health assessments and those obtained through new technologies. The goal is to increase efficiency and accuracy, improve patient outcomes, and reduce costs for long-term care.

HHS Grants Fund Hospital Preparedness
Health Data Management, 7/8/10
HHS awarded grants totaling $390.5 million to all states, territories, and four major metropolitan areas to improve medical surge capability in the event of an emergency. Metropolitan areas receiving a share of the 2010 Hospital Preparedness grants are New York City, Chicago, Los Angeles County, and Washington, D.C.

Feds to Spend $144M to Train Health I.T. Workers
Computer World, 7/16/10
Beginning this fall, more than 80 community colleges and universities in the U.S. will begin training health care I.T. workers under a government grant program created to help fill an estimated 50,000 jobs needed to assist doctors and hospitals as they roll out EMRs. The agency estimates it will spend $144 million in grant money to develop and implement EHRs.

Should Prescribers Be Able to Use e-Prescribing Technology for Controlled Substances?
iHealthbeat, 7/14/10
Ninety-three percent of health I.T. professionals believe clinicians should be able to use e-Prescribing technology to prescribe controlled substances, according to a survey. One-third said the DEA's recent interim final rule addressing e-Prescribing for controlled substances would significantly increase the use of e-Prescribing, while 55% said it would slightly increase e-Prescribing.

New Standard Aids Asset Tracking
Health Data Management, 7/13/10
The American National Standards Institute has approved the Health Industry Bar Code Provider Applications Standard, which recently was enhanced to support in-hospital patient tracking functions. The standard is a framework for identifying and tracking assets, such as patients, employees, test results, and medical records. It can be used in conjunction with the Health Industry Supplier Labeling Standard to track medical products.

Computerized Monitoring Systems Linked to Use of Best Practices in War on Infections
Fierce Healthcare, 7/13/10
Hospitals which adopt more advanced computerized monitoring systems to identify health care associated infections (HAIs) are more likely to have implemented best practices to prevent such infections, according to a study. Only one-third of hospitals use computers to identify infections in a timely and accurate way. Those hospitals which use automated surveillance systems to identify HAIs were more likely than those who still rely on manual methods to have fully implemented research-based best practices to reduce MRSA infections, ventilator-associated pneumonia, and surgical care infection practices.

Study: e-Mail Improves Outcomes
Health Data Management, 7/9/10
A Kaiser Permanente study shows patients with diabetes and/or hypertension who use secure e-mail to communicate with their physicians control their diseases better those who don't electronically communicate. The top topics in the messages addressed changes in a health condition, lab results, a new condition, drug dosage adjustments, and the need for a new prescription.

The Art Of Being A Medical CIO
InformationWeek, 7/8/10
Today's health care CIOs are adept in the use of "soft" power, wielding the tools of consensus building, persuasion, and coalition creation. They aren't judged according to their ability to select a technologically sound system, get it up and running, and ensure infrastructure stability. Of course, they must do all of those things, but they don't get gold stars. Today's CIOs are judged according to only one measure: Are the physicians using the organization's EMR and CPOE systems?

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