Edition Fifty (8/3/10)

HHS Takes Breach-Alert Rule Off the Table
Modern Healthcare, subscription required 7/30/10
HHS has withdrawn from administrative review of a rule which requires hospitals, physicians, health plans, and other specified handlers of PHRs to notify patients in the event their personally identifiable health information is exposed by a data security breach. HHS said it was withdrawing the final breach-notification rule from review by the Office of Management and Budget to allow for further consideration, given the department's experience to date in administering the regulations.

CMS Keeps Original Payment Policy for Multi-Campus Hospitals
HealthLeaders, 7/29/10
Multi-campus hospitals should not anticipate additional incentive payments beyond what would be paid for one hospital under the Meaningful Use provisions. Tony Trankle said CMS based its payment decision on existing policy. "The provider number is based on how the hospitals choose to organize themselves for payment under Medicare program. So, what we did here—without clear statute intent—was to be consistent with payment policies which we have adopted for other programs."

Private HIE Market Growing
Health Data Management, 7/29/10
The federal government may be pouring $548 million of stimulus funding into state-level HIEs, but there are a growing number of private HIEs emerging, where an integrated delivery system may link its owned and affiliated providers, or, in some cases, local competitors, to cooperate on data exchange.

Behavioral Health Offers Cues for Privacy Control
Modern Healthcare, subscription required 7/29/10
As a federal policy battle looms over the extent to which patients will exercise control over the movement of their EHRs, one outstanding question is: Will EHR systems be able to give practitioners and patients the level of consent management they'll need or want? A possible answer might come from CCHIT, which has developed a new set of criteria against which EHRs can be tested for the special needs of behavioral health professionals.

CMS Will Start Incentive Payments in May 2011
Government Health IT, 7/29/10
CMS will begin to make Meaningful Use incentive payments to eligible physicians and hospitals as early as May 2011, according to Karen Trudel, deputy director of CMS’ Office of e-Health Standards & Services. CMS will open registration for the incentive program in January, and the first payments will go out in the middle of May.

Doc’s Plea: Keep Tabs on Incentive Program
Health Data Management, 7/28/10
The federal government’s Meaningful Use incentives are achievable, but will require significant effort by physicians to attain, says the president of the AAFP. Testifying before the House Commerce Subcommittee on Health about the Meaningful Use EHR incentive program, AAFP President Roland Goertz, M.D., urged lawmakers to keep close tabs on how well the program is managed. 

Will Meaningful Use Incentives Work?
Health Data Management, 7/28/10
Will tens of billions of dollars in forthcoming incentive payments for Meaningful Use of EHRs meet the HITECH Act’s goal of improving care quality and patient outcomes while bringing efficiencies to the health care industry? This is a question posed to attendees of the Institute for Health Technology Transformation’s Summer Health I.T. Summit in Denver, and responses were mixed.

CCHIT Launches Specialized Certification Programs
Modern Healthcare, subscription required 7/27/10
CCHIT launched several new certification programs under its "CCHIT Certified" brand, which aim to go beyond federal minimum requirements and meet longer-term goals for use of EHRs with integrated functionality, interoperability, and security. Although CCHIT applied to be an authorized testing and certification body as determined by ONC, vendors seeking to have their products designated as eligible for federal subsidies under the CMS Meaningful Use requirements will have to apply via a separate testing process.

How Hospitals are Helping Doctors Achieve Meaningful Use
Information Week, 7/26/10 
Many hospitals are assisting physician practices to get on board with EHRs even as those hospitals struggle with their own projects. A recent survey of 60 hospital executives found having their organizations help community doctors achieve Meaningful Use was among the top three priorities of 86% of the respondents in the near term.

AHA Presses CMS for Broader Credentialing Rules
Modern Healthcare, subscription required 7/26/10
The proposed changes to the CMS credentialing rules for telemedicine services are good, but not good enough, according to a letter from the AHA to CMS Administrator, Donald Berwick. The recommended revisions would allow hospitals receiving telemedicine services to accept the credentialing information from the hospital providing the services. The AHA supports this change but adds, these changes govern only telemedicine services provided by practitioners at other Medicare-participating hospitals, and would not apply to telemedicine service delivered by physician groups or other entities. 

Meaningful Use Training Targets Next Steps
Information Week, 7/26/10
After working for more than a year to develop its Meaningful Use and Certification rules, CMS and ONC are focused on ensuring health care providers know how to enroll in the soon-to-be-launched incentive program. In a "free training" session held by CMS on the final rules, officials from ONC covered eligibility issues, the relationship between HITECH and other government incentive programs, and how the states and federal government will harmonize the Medicare and Medicaid portions of the program. 

Guide Covers EHRs for C-Level
Health Data Management, 7/23/10
The AHA and CHIME have published a 22-page guidance document for hospital executives on issues related to implementation of EHRs. The guidance is designed to give a basic understanding of the challenges of EHR implementation, covering seven core areas to consider as an organization plans and implements the technology. These include developing an inclusive, role-based, and active executive team; developing a strategic plan; performing a gap analysis of existing I.T.; developing a high-level project plan; initiating culture change; redesigning workflow processes; and implementation.

Survey Gives the National HIE Landscape
Health Data Management, 7/22/10
An annual survey of the progress of HIEs across the nation has found 234 active HIEs in 2010, compared with 193 in 2009. The 234 active HIEs include 56 state-designated HIEs, which have been awarded federal funds under the HITECH Act. 73 HIEs are now operational, transmitting data that is being used by stakeholders, compared with 57 operational in 2009.

CCHIT Applies for Certification Work
Health Data Management, 7/22/10
CCHIT has submitted its application to become an Authorized Testing and Certification Body under the temporary EHR certification program. CCHIT expects to be one of the first entities authorized to provide certification which specific versions of EHRs support Stage 1 Meaningful Use criteria.

CMS Offers Insight on Meaningful Use Stage 2
Information Week, 7/22/10
Much of what will become Meaningful Use Stage 2 can be found in the recently released Stage 1, according CMS' Tony Trenkle. Meaningful Use Stage 2 will expand on Stage 1 by making the current "menu" set part of future core requirements. The organization also wanted to get certain administrative requirements—which were included in the proposed rule, but dropped from the final regulation—along with higher CPOE levels, into Stage 2. 

ONC Expects Multiple Temporary Certifiers of EHRs
Government Health IT, 7/21/10
ONC expects there will likely be multiple organizations to test and verify EHR products for the temporary certification program, leading to a faster, more open, and more competitive process. So far, ONC has received six or seven completed applications out of the 30 it sent to organizations.

AMA: Meaningful Use Criteria Still Too High
Health Data Management, 7/21/10
The AMA, while applauding many aspects of the final Meaningful Use rule, says barriers to EHRs adoption and implementation remain. While the volume of measures physicians are required to meet has been lowered, the final rule still requires physicians to meet 20 measures in the first year. This is still too many, especially for smaller practices new to using EHR technology, according to the AMA.

Tougher Meaningful Use Rules Promised
Modern Healthcare, subscription required 7/21/10
David Blumenthal told a House panel providers that would be held to much tougher standards in the coming years over the adoption and use of EHRs. The next rule-making, in 2013, will require much more robust exchange as a feature of Meaningful Use. Blumenthal said the Meaningful Use criteria allow for several stages of EHR adoption by providers, with each step more demanding than the last.

Come and Get I.T.: Multicampus Melee
Modern Healthcare, subscription required 7/21/10
The CMS' final Stage 1 rules for the Meaningful Use of EHR systems exacerbate health care's digital divide and penalize early adopters, according to Richard Umbdenstock, president and CEO of the AHA. CMS continues to place some barriers in the way of achieving widespread I.T. adoption by our nation's hospitals and physicians, Umbdenstock says.

Reluctant Prescribers are the Biggest Barrier to e-Prescribing Adoption
Fierce Healthcare, 7/21/10
After the DEA officially lifted the restrictions against the use of e-Prescribing for controlled substances, it eliminated the single greatest barrier to e-Prescribing in a decade. The next obstacle may be the prescribers themselves, according to a survey. 29 percent said the biggest barrier to implementing is prescribers' unwillingness to integrate the e-Prescribing technology into their work processes.

Come and Get I.T.: Ready to Reimburse
Modern Healthcare, subscription required 7/20/10
Physicians and hospitals are now able to chase freely after their share of some $27.3 billion in federal incentives to help them buy HIT systems—all in the name of improved efficiency and higher-quality patient care. Meanwhile, providers who don't participate— or who come up short—risk being declared meaningless and paying for it.

Republicans Attack New HIT Meaningful Use Rules
The Hill's Healthwatch, 7/20/10
House GOP leaders went after new White House rules designed to encourage health care providers to use new medical technologies, arguing they aren’t strict enough to promote quick adoption of the equipment. Much less is expected of health care providers receiving subsidies than what CMS initially proposed.

Certification Issues Remain, Providers Say
Modern Healthcare, subscription required 7/19/10
With the final rule on Meaningful Use of EHR systems out, there's one fewer item on the federal government's checklist. One looming potential problem for HIT executives is the government's long delay in establishing a procedure to recognize organizations to test and certify EHRs and their modular components.

State Officials Must Ensure Interoperability: Report
Modern Healthcare, subscription required 7/30/10
As 56 state-run and federally authorized entities develop their regional HIEs, state-level officials are responsible for ensuring the clinical information meets the info-sharing requirements of the NHIN. Much of the public discussion on networks' interoperability has focused on the challenges of data-sharing among providers, who can use different health I.T. systems in their hospitals and clinics, but must use the centralized exchange to qualify for federal grants to help pay for the system.

HHS Offers $51M for State Health Insurance Exchanges
Government Health IT, 7/29/10
HHS released $51 million in grants for states—up to $1 million per state—to help them begin to develop health insurance exchanges which would let consumers shop for health insurance on-line. The exchanges, called for the health reform law, will make purchasing health insurance easier by providing eligible persons and small businesses “one-stop-shopping” for comparing and purchasing health insurance coverage, said HHS Secretary Kathleen Sebelius.

Illinois Creates Health Info Exchange
Modern Healthcare, subscription required 7/28/10
Illinois health care providers moved one step closer to interoperable electronic data sharing as Gov. Pat Quinn signed a bill creating the Health Information Exchange Authority. Under the new law, the state authority will establish and oversee the Illinois HIE and will work to promote adoption of EHR systems and HIE participation, with the $18.8 million in federal funds from ARRA.

Utah Gets Pilot Health Program for Diabetes
The Salt Lake Tribune, 7/23/10
A new federal program will track the treatment of diabetics in three Utah counties in a bid to spur greater use of EHRs. The pilot programs, funded by $220 million in economic stimulus money, will use technology to coordinate specific types of medical care in 15 locations. 

Maryland Has Three-Step Plan for Getting Health I.T. Goals on Fast Track
Healthcare IT News, 7/21/10
Gov. Martin O'Malley outlined a new vision for positioning Maryland as a national leader for health I.T. during a roundtable discussing health care reform and innovation in the state. O'Malley's plan to continue to strengthen this sector is to create a statewide network of health information, encourage the adoption of EHRs, and maximize federal ARRA funding.

Finland's EMR System Shows Potential Pitfalls
Internet Evolution, 7/28/10 
In Finland, the entire public health care system has integrated EMRs into regular practice, making Finland a living example of how EMR works—and how it can be improved. Finnish political commitment to e-health dates back to the mid-1990s. In 2001, the use of EMR started to spread in the public health sector, and by 2008 the use of EMR reached 91.1 percent of all health care facilities here.

In Canada, Subsidies Don't Guarantee EHR Adoption
Modern Healthcare, subscription required 7/27/10
Seven of 13 Canadian provinces and territories offer subsidies to primary-care physicians for the purchase of EHR systems, according to a new report published in the Journal of Healthcare Information Management. But after nearly a decade of providing these subsidies, Canada still has not achieved majority adoption of EHR systems among its PCPs.

Docs Embrace Mobile Tools, Dislike Info Glut
Health Data Management, 7/26/10
A report shows increased physician adoption of smart phone technology, but physicians cite both an information glut and difficulty communicating with colleagues as barriers to efficient use of the technology. According to the study, 94 percent of physicians interviewed use smart phones to manage personal and business workflows, and access medical information. In 2006, a similar survey showed just under 60 percent of physicians were using the technology.

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