Edition Fifty-One (8/18/10)

Managing EHR Privacy: Scan and Deliver
Modern Healthcare, subscription required 8/13/10
Amid the continuing HIT debate about when and to what extent patients should have control over the release of their medical information, one big issue—whether providers' I.T. systems would even allow for granular release of the information contained in EHRs—has fallen more or less by the wayside. In a recent meeting, the Privacy & Security Tiger Team of HHS' Health I.T. Policy Committee sought to address critical I.T. capability questions.

CMS Awards $5.5M Deal for Incentive Payment Services
Government Health IT, 8/12/10
CMS is readying a set of electronic accounting and processing tools which will help authenticate, track, and manage payments to health care providers participating in the federal Meaningful Use financial incentive program. To support its efforts, CMS awarded a $5.5 million five-year contract to National Government Services Inc., a large Medicare contractor in 20 states, to assist in preparing and processing incentive payments, beginning in fiscal 2011. 

Managing EHR Privacy: Sensitivity Training
Modern Healthcare, subscription required, 8/12/10 
HIT in current use is incapable of providing the level of privacy protection some patients may desire, so it is important for federal policymakers, as well as health care providers, not to oversell the limited protections which are available. In fact, providers should consider discussing privacy limitations with patients instead.

Medicare Seminar Reveals Uncertainly on Meaningful Use
Information Week, 8/12/10
As part of an effort to clear up lingering questions about its program to financially reward Meaningful Users of certified EHR technology, CMS held a session of its Education Series for Providers, this time for hospitals. Questions posed to CMS prove the agency still has many details to iron out about how hospitals will be reimbursed. 

EHRs Neglecting Preventative Care, Health Promotion
Information Week, 8/11/10
As doctors increasingly extract more data from the health I.T. they've deployed, a new study finds software which tracks population health at physician practices is very limited. The report, "Practice-Based Population Health: I.T. to Support Transformation to Proactive Primary Care," tried to find out if physicians are using technology which collects data on practice-based population health (PBPH). 

Bill Seeks EHR Incentives for Mental Health Facilities
HealthLeaders, 8/11/10
Senators Sheldon Whitehouse (D-RI) and Jack Reed (D-RI) introduced a bill which calls for inclusion of mental health professionals and facilities, which were originally excluded from receiving financial incentives for EHR adoption. The bill, called the Health I.T. Extension for Behavioral Health Services Act of 2010, calls for extending eligibility for HITECH financial incentives to behavioral health, mental health, and substance abuse treatment professionals and facilities.

ONC Prepares NHIN ‘Governance’ Rulemaking
Government Health IT, 8/10/10
ONC is preparing to launch a formal rulemaking to establish rules of the road for the NHIN, a process policymakers hope will clear the way for large and small organizations to use the NHIN. By completing a rulemaking on NHIN governance, ONC hopes to work through some of the remaining legal and policy questions which stand in the way of its plan to rapidly expand HIE among health care organizations and information exchange providers.

Private Sector Picks Up Baton to Help Drive Meaningful Use
iHealthBeat, 8/9/10
Federal officials are looking to the private sector to help drive health I.T. adoption and propel the country's health care providers to becoming Meaningful Users of EHRs. At a briefing sponsored at Brandies University, David Blumenthal said changing the health care system is a team sport, and now is the time for the private sector to pick up the baton and run with it.

Leapfrog Group Expresses "Grave Concerns" Over Meaningful Use
CMIO, 8/5/10
The Leapfrog Group has “grave concerns” over the final Meaningful Use rule because it omits system checks for CPOE systems. Although the organization applauds the federal government for including CPOE as part of the final regulations, it also warns the regulations do not require hospitals to reassure taxpayers the technology is safe.

Payers Make Moves Toward Meaningful Use Incentives
Health Data Management, 8/5/10
Federal incentive payments for Meaningful Use became more meaningful as four major commercial insurers announced programs which could result in additional private sector incentives. All four insurers will align their pay-for-performance programs with federal Meaningful Use criteria. In some cases, physicians who meet a payer's P4P criteria and demonstrate Meaningful Use will receive a higher P4P payment, in other cases the payment won't rise, but demonstrating Meaningful Use will become a criteria for getting the P4P payment.

Health I.T. Proficiency a Priority for Medical Board
Modern Healthcare, subscription required 8/5/10
The American Board of Medical Specialties announced it will incorporate tools to promote the Meaningful Use of HIT into its maintenance-of-certification program. More than 750,000 U.S. physicians are certified by an ABMS member board, and building health I.T. proficiency and use can help to facilitate physicians' knowledge, skill, and use of health I.T., and in turn can improve physician performance and patient outcomes.

Bill Would Change Some Meaningful Use Payments
Health Data Management, 8/5/10
Legislation introduced in the U.S. House would increase incentive payments for multi-campus hospitals demonstrating Meaningful Use. Bi-partisan sponsors of the EHR Incentives for Multi-Campus Hospitals Act of 2010 include the chairs of the Ways and Means and Energy and Commerce Committees, as well as their health subcommittees.

Bill Would Allow EHR Incentives for Uncertified Programs
DOTmed News, 8/4/10
Sen. Michael C. Burgess (R-Texas) introduced a bill which would let hospitals qualify for Medicare incentive payments, starting in 2011 and carrying on to 2012, if their software helps them meet Meaningful Use requirements, even if it's not certified, according to the American Hospital Association. 

HHS Panel Mulls Patient Control Over Select Data
Government Health IT, 8/4/10
The Privacy and Security Tiger Team began exploring how current technologies can help patients make decisions on consent and access to their EHRs when more sensitive patient data is involved. Although the direct exchange of patient data between providers for treatment purposes does not require patient consent beyond what is covered in existing law and fair information practices, some patients may want to exercise more choice in consultation with their providers about how their sensitive data is handled. 

Pennsylvania Ramps Up Incentive Payment System
Government Health IT, 8/11/10
Pennsylvania’s Office of Medical Assistance Programs will launch an application it hopes will streamline and secure the tracking of payments to Medicaid providers which meet criteria for financial incentives outlined in the federal Meaningful Use rule. The Medical Assistance Provider Incentive Repository will link with the state’s Medicaid Management Information System, the state’s central system for administering the Medicaid program. 

Indiana Gets $2.3M for Electronic Health Records
Business Week, 8/5/10
Indiana's Medicaid director says the state will receive $2.3 million in federal funds to prepare for creating EHRs. Medicaid Director Pat Casanova says the money will be used for necessary state steps to create an incentive program for medical providers and hospitals to move from paper records to electronic ones. She says the funds will allow the state Medicaid program to develop plans and the technology needed to provide incentive payments for providers and hospitals making the switch.

Six States Get EHR Matching Funds from CMS
Modern Healthcare, subscription required 8/3/10
The CMS has awarded $5.75 million in federal matching funds to six states and the District of Columbia to help Medicaid providers expand the use of EHRs. Meaningful and interoperable use of EHRs in Medicaid will increase health care efficiency, reduce medical errors, and improve quality outcomes and patient satisfaction within and across the states.

Utah Health Info Network Wins Certification
Modern Healthcare, subscription required 8/2/10
The Utah Health Information Network, a statewide HIE organization which provides electronic data interchange services for administrative transactions, clinical information exchange, and credentialing services, has received certification from the not-for-profit Electronic Health Care Network Accreditation Commission.

HITRUST: HIPAA Breaches Near $1 Billion
HealthLeaders, 8/12/10
Covered entities and business associates reporting breaches of unsecured personal health information (PHI) affecting 500 or more individuals to the Office for Civil Rights together could spend nearly $1 billion because of those breaches. According to a report from the Health Information Trust Alliance (HITRUST), 108 entities submitting the breach reports to OCR since September 23, 2009 could spend up to $834.3 million in total costs to address violations of HIPAA.

Study: CPOE with Targeted Alerts Cuts Inappropriate Drug Ordering for Seniors
Fierce Health IT, 8/12/10
A properly implemented CPOE system with specific, appropriate alerts can dramatically yet selectively reduce the ordering of potentially inappropriate medications for hospitalized senior citizens, according to a new study in the Archives of Internal Medicine.

VA Making Progress on Lifetime EHR System
Federal Computer Week, 8/11/10
The Veterans Affairs and Defense departments have taken a major step forward in developing a joint lifetime record system by the VA’s recent adoption of DOD’s personal identifier system for each service member. Meanwhile, the VA expects to make a decision by year’s end about modernizing its Veterans Health Information Systems and Technology Architecture (VistA) record system, and will issue several requests for information from industry before the decision.

Infection Rate Reports Start in 2011
Health Data Management, 8/5/10
Hospitals accepting Medicare patients must start in 2011 to report hospital-acquired infection rates to the CDC and Prevention's National Health Care Safety Network under a final rule setting Medicare inpatient and long-term care payment rates for next year. For 2011, hospitals must report central line associated bloodstream infections on a quarterly basis. Reporting of additional types of infections will be required in subsequent years. The Centers for Medicare and Medicaid Services will post hospital infection rates on its consumer-oriented Hospital Compare Web site.

What Types of Physician Practices Have Access to e-Prescribing Systems?
iHealthbeat, 8/4/10
In 2008, 30% of solo practice physicians reported access to e-Prescribing systems, compared with 37% of physicians in practices with two to five doctors, 44% of physicians in practices with six to 10 doctors and 49% of physicians in practices with 11 to 100 doctors, according to a recent report. Of all physicians who have access to e-Prescribing systems, 77% said they e-Prescribe regularly. 

Commentary: CPOE Requires Long-Term View
Modern Healthcare, subscription required 8/4/10
Many hospitals have made major investments in time, talent, and resources to gain the many advantages of CPOE, only to encounter barriers and difficulties, along with greater safety and efficiency. The reason is simple: too few CPOE systems are monitored regularly and improved over time. The result: potential harm to patients from missed errors and wasted resources.

e-Prescription Use Grows, But Some Hurdles Remain
Post-Tribune, 8/2/10
By 2012, physicians who do not electronically prescribe medications—instead of hand-writing them—will be penalized financially by the federal government. CMS has employed this carrot and stick approach to encourage complete adoption of e-Prescribing to improve health care quality and cut costs. While e-Prescribing has grown dramatically in recent years, local doctors said there continue to be barriers to widespread acceptance of a technology which could save thousands of lives. 

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