Edition Twenty-Six (8/18/09)

Tough Privacy Rules Could Hinder Exchange: Report
Modern Healthcare, subscription required 8/14/09
A new report from the State Alliance for e-Health warns more stringent state privacy policies could hinder health information exchange. The guide states the intent to give interim guidance to state leaders as they implement the I.T. provisions of ARRA. The report contains six recommended areas of state action. Dealing with privacy issues in general, and state authority to create more stringent privacy rules than HIPAA specifically, were among the six.

CCHIT Will Be Sole Health I.T. Certifier, for Now
Government Health IT, 8/14/09
The federal Health I.T. Policy Committee endorsed recommendations leaving the CCHIT in the short term as the sole organization authorized to certify health I.T. systems qualified for funding under ARRA. Certification of EHRs which, met federal criteria for "meaningful use" of health I.T., could start as early as October, according to HHS. Under the plan, CCHIT would provide a preliminary stamp of approval for health I.T. systems, which were HHS-qualified or certified until a final meaningful use regulation is published at the end of the year.

Certification Recommendations OK'd
Health Data Management, 8/14/09
Multiple entities could provide certification services, which attest an EHRs system meets meaningful use requirements under ARRA, according to recommendations adopted by the HIT Policy Committee. The recommendations now go to HSS for consideration as federal officials write the rules, which will implement the Medicare/Medicaid incentive programs for meaningful use of EHRs. CCHIT and other entities could develop accreditation programs which meet the HHS Certification criteria, and also could offer more advanced certification if there is demand for such a program.

Motivating the Unmotivated
Health Data Management, 8/13/09
The forthcoming Medicare/Medicaid incentives in the HITECH Act will help expand use of EHRs, but primarily among hospitals and physician practices already motivated to automate, according to a new report. "U.S. Health Care in the Year 2015," also looks at such issues as health care cost inflation, coverage expansion, capacity constraints, and changing expectations. 

Knowing Your HIM Department Could Help with EHR Implementation
HealthLeaders Media, 8/13/09
Hospitals achieving a successful EHR implementation are the ones in which the C-suite and HIM director work collaboratively to achieve the goal. At Hoag Memorial Hospital Presbyterian in Newport Beach, CA, HIM Director Leslie Scarborough, RHIA, says an open relationship with her CIO played a large role in her being able to serve as a major contributor in the hospital's successful EHR implementation. At McAlester Regional Health Center in McAlester, OK, e-mail is a vehicle used to keep the lines of communication open between the HIM department and CFO.

New Group Lobbies ARRA Policymakers
Health Data Management, 8/13/09
A handful of delivery systems and academic medical centers have formed a coalition to influence federal policymakers as they implement health I.T. provisions of ARRA. The Academic and Community Health Technology Alliance hopes to bring the I.T. expertise of its members to policymakers to ensure forthcoming policies reflect the realities of academic and community hospitals.

EHR Adoption Still a Top Concern for Physician Practices
Healthcare IT News, 8/12/09
EHR adoption and finances remain the top challenges facing medical practices, according to a new survey from the Medical Group Management Association. The 2009 survey "Medical practice today: What members have to say" reveals the top challenges of running a group practice remain the same as in 2008: dealing with operating costs rising more rapidly than revenues, maintaining physician compensation levels in an environment of declining reimbursement, and selecting and implementing a new EHR.

Doctors Need Reasons to Join Health Exchanges: HHS Official
Federal Computer Week, 8/12/09
The networks being developed to exchange patient medical information must give doctors who join them a positive return on investment for participating. Low cost of entry is important to participation in the NHIN and other health exchanges, according to David Riley, the NHIN Connect initiative lead for the Federal Health Architecture Program at HHS.

Coalition Forms Health Care I.T. Work Group With Eye on Reform
Healthcare IT News, 8/11/09
The National Transitions of Care Coalition has formed the Health Information Technology Work Group to focus on national efforts to develop EMRs and HIT exchanges and promote interoperability. The work group will begin a number of activities, including assessing the barriers and gaps in HIT related to transitions of care and developing a white paper to provide recommendations on how to close gaps or remove barriers.

Do You Qualify for a $63,750 Medicaid EHR Bonus?
AAFP, 8/10/09
A new report estimates as many as 45,000 office-based physicians who participate in Medicaid and use EHRs, could collect as much as $63,750 paid out over a six-year period as part of ARRA. Boosting Health Information Technology in Medicaid: The Potential Effect of the American Recovery and Reinvestment Act, was issued by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative.

Blumenthal Helps Rebut Health Reform Critics
Government Health IT, 8/10/09
Dr. David Blumenthal answered critics of the administration's health reform efforts and health I.T.'s role in accomplishing it in an Aug. 7 online presentation sponsored by HHS. Health I.T. will help provide physicians equipped with best practices and research data for treating many conditions to improve patient outcomes, he said. The administration also launched a Web site http://www.whitehouse.gov/realitycheck/ to provide information to the public to rebut claims it considers incorrect about health reform, which some groups have disseminated.

Cash Incentives Help Improve Hospital Quality
HealthLeaders, 8/10/09
CMS and Premier have been testing value based purchasing initiatives since 2003. Known as the Hospital Quality Incentive Demonstration P4P Project, the program was established to determine if hospitals could improve quality if they were properly incentivized and also recognized on the CMS Web site. The results for the first three years show the Composite Quality Score improved by an average of 15.8% and more than $24.5 million has been awarded to the top performers. CMS has extended the program through 2009 to include multiple conditions and test new incentive models.

States Urged to Start Now on Health Exchanges
Federal Computer Week, 8/10/09
State governments should start planning now to foster HIEs and adoption of EHRs in their states, according to new guidance released by the State Alliance for eHealth. The HITECH Act provides at least $2 billion for HIEs and up to $45 billion in incentive payments to doctors and hospitals for digitizing their patient records. To receive an implementation grant, a state must have a state plan approved by HHS.

Blumenthal Touts Health I.T. at HHS Health Reform Webcast
Healthcare IT News, 8/7/09
As part of a federal effort to dispel myths about health reform, David Blumenthal said HIT could reduce medical errors and improve the quality of health care. At a Webcast hosted by HHS, Blumenthal said Obama has made a commitment toward health I.T. in the stimulus package, and "I am quite confident we are going to make this transition. This is going to happen because it's the right thing to do."

Study: EHRs Aid in Cardiac Maintenance
Health Data Management, 8/7/09
Electronic reminders can help cardiac patients stay healthy while controlling costs, a new study confirms. Cardiac patients discharged from a formal treatment program back to their primary care physician but sent electronic risk maintenance reminders remained as healthy as patients who stayed in the formal program. The discharged patients had reminders in their EHRs, which annually sent letters to primary care physicians to ensure they ordered lipid panels. The EHR intervention was just as effective at keeping cholesterol and blood pressure in check as the more intensive counseling approach offered to those patients who stayed enrolled in the program.

Dr. Blumenthal: NHIN Architecture a 'Work in Progress'
Federal Computer Week, 8/7/09
Dr. David Blumenthal, the national coordinator for health information technology at the Health and Human Services Department, has a monumental mandate: It's he and his office who are most prominently leading the charge to put a national health network in place. He recently spoke to Federal Computer Week reporter Alice Lipowicz about his work and its future.

Park Joins Number of Newly Created CTO Ranks
Modern Healthcare, subscription required 8/7/09
With the announcement it was bringing on I.T. guru Todd Park as chief technology officer, HHS has started to look like many I.T. departments in providers across the country. In an internal e-mail to HHS staff, Deputy Secretary William Corr announced Park, co-founder of Athenahealth, would become CTO effective Aug. 26.

States' I.T. Alliance Co-Chairs to Meet with ONC Chief
Modern Healthcare, subscription required 8/7/09
Vermont Gov. Jim Douglas and his Tennessee counterpart, Phil Bredesen, will be meeting in South Burlington, Vt., to talk about health I.T. The two governors are the co-chairs of the State Alliance for e-Health, joined by David Blumenthal. Meeting topics include implementation of the Health Information Technology for the Economic and Clinical Health Act, or HITECH.

Is The Nation's Health Network Healthy?
Federal Computer Week, 8/7/09
Congress gave a big push to adopting EHRs this year by including $45 billion in incentive payments to doctors and hospitals in the stimulus. However, a critical piece might be missing: So far, there is no fully functioning national information exchange system which can securely collect and share patient medical data and then deliver the data when it's needed. Most likely, the Nationwide Health Information Network will be assigned the role. 

New York Lawmaker Calls for Spending on Rural Health I.T.
Government Health IT, 8/6/09
Sen. Kirsten Gillibrand (D-N.Y.) would like to see some of the federal stimulus' rural broadband dollars set aside for health I.T. projects. The Department of Agriculture's Rural Utilities Service will oversee the disbursement of $2.5 billion in ARRA funding for rural broadband initiatives. Gillibrand said hybrid healthcare/broadband initiatives are on track with ARRA's health care technology and broadband infrastructure aims.

Using NHIN, Social Security Cuts Wait-Time for Disability Benefits
Government Health IT, 8/5/09
The Social Security Administration significantly cuts the time it takes to process disability applications when it uses the nationwide health information network to collect medical records associated with the claims, according the SSA's inspector general. A recent report from the agency's IG found as of May, applicants received approval and benefits faster when their medical information was submitted through NHIN compared with all other disability cases.

When Will EHR Spending Ramp Up?
Health Data Management, 8/5/09
Although the stimulus will spur an increase in spending on clinical applications in the months ahead, many hospitals are now taking their time studying their options. Under ARRA, hospitals can qualify for billions of dollars in extra payments from Medicare and Medicaid if they make meaningful use of qualifying EHRs. Providers are doing careful research on EHR vendors because they cannot afford a misstep, which might cause them to miss a critical deadline for qualifying for a stimulus payment.

Governors Encourage States to Prepare for EHR Adoption
AHA News, 8/5/09
A National Governors Association alliance yesterday issued a guide to help states implement the federal HITECH Act, which expands the role of states in fostering HIE and adoption of EHRs over the next five years. "Preparing to Implement HITECH" recommends states prepare or update their plan for adopting an HIE and establish an office to manage its implementation; engage health care providers and other stakeholders in planning efforts; implement privacy and security strategies and reforms; determine an HIE business model; and establish opportunities for HIT training and education. 

States Preparing for Health Data Exchange Stimulus Money
iHealthBeat, 8/4/09
ARRA identifies about $36 billion to be used for health I.T. over the next several years nationwide. One of the first orders of business is determining whether states themselves want to coordinate the connections, which will allow physicians, hospitals, insurers, pharmacies and patients to share information electronically. Some small states may elect to take on health information exchange in-house but most large states are expected to contract the job to industry experts.

ARRA Grants Placed on Single Site
Health Data Management, 8/4/09
A new box on the home page of the federal government's Grants.gov Web site gives one-click access to all current grant opportunities under ARRA from all 26 federal grant-making agencies, listing 85 grant opportunities. Most of the health care opportunities currently on the site originate from the National Institutes of Health. HHS will host web seminars to explain the new features and how to find and apply for grants.

Health Care Reform Hinges on Technology
Nextgov, 8/3/09
Both the House and Senate are contemplating some sort of online marketplace, which would allow Americans to compare and buy insurance plans. The concept is referred to interchangeably as a health insurance exchange -- not to be confused with an electronic records exchange -- or gateway. A microcosm of this model already exists in Massachusetts, where the so-called Health Connector offers brand name and publicly subsidized health insurance options to state residents.

Getting A Handle on Your e-Health
Kentucky Post, 8/14/09
To coincide with the national priority of implementation of HIT, Kentucky Gov. Steve Beshear announced the creation of the Governor's Office of e-Health Information within the Cabinet for Health and Family Services (CHFS). The Governor's Office of e-Health Information will serve as the single point of contact with federal and state agencies involved with HIT. The Kentucky e-Health Network Board, which is administratively attached to CHFS, will also serve as an integral resource to the Office as it moves forward.

Five Lessons From Seattle on Adopting Electronic Medical Records 
Kaiser Health News, 8/10/09
For much of the country, linking the EHRs of doctors, hospitals and clinics remains an elusive goal. No one is quite there yet, says Jim Bender, medical director for health information at Seattle's Virginia Mason Medical Center. Among the reasons: cost, computer systems, which aren't compatible with rival systems, resistance among physicians and privacy concerns. Overcoming the obstacles will take federal will and money.

Medicine's Coming Superhighway, Tulsa Health Leaders Seeking Federal Stimulus Funds
Tulsa World, 8/9/09
A key component of Obama's health care reform initiative, EHR systems could save up to $77 billion a year by reducing hospital stays, cutting down on duplicative and unnecessary testing and ensuring appropriate drug utilization, according to one study. Tulsa is in many ways the perfect place to perfect HIEs because many groundbreaking activities already are in progress here. The evolving proposal, known as the Greater Tulsa Health Access Network or Greater THAN, has been in the works for several months and already is surprisingly far along.

State Alliance for e-Health Issues HIT Exchange Guidance
Healthcare IT News, 8/6/09
The State Alliance for e-Health issued new guidance on Tuesday for state health information exchanges. The executive-level organization composed of governors, state legislators, attorney generals and state commissioners, included information on how states can lead the way in using health I.T. as they begin instituting the federal HITECH Act. The report and state initiatives to implement health I.T. and electronic HIE will provide a central focus for the alliance's semi-annual conference.

Maryland OKs $10 Million for State HIE
Health Data Management, 8/6/09
The Maryland Health Services Cost Review Commission has levied a small surcharge on some hospital bills to raise $10 million in start-up funding to develop a statewide HIE, the Chesapeake Regional Information System for Our Patients. The commission sets the rates, which hospitals in Maryland can charge. The action will enable Maryland to apply for additional funds from ARRA, which appropriated $300 million to assist HIEs across the nation.

Mississippi Medicaid Offers EHRs
Health Data Management, 8/4/09
The State of Mississippi will offer physicians a free Web-based, payer-populated EHRs application to better serve the state's 600,000 Medicaid beneficiaries. Mississippi Medicaid will use the EHR and health information exchange software of Shared Health, Chattanooga, Tenn. Shared Health started in 2005 with support from the TennCare managed care Medicaid program and BlueCross and BlueShield of Tennessee.



A New Approach to 'Medical Homes' Will Transform the Relationship Between You and Your Doc
Idaho Statesman, 8/16/09
The "medical home" is coming to a doctor's office near you. The trend is nationwide. Idaho is just getting started, but many providers already have put some elements of medical homes in place. Several Idaho pilot and demonstration projects are under way, or soon will be. A new Idaho task force, the Patient-Centered Medical Home Partners Group, is a coalition of health care providers dedicated to creating medical homes in Idaho.

12 Ways Health Reform May Improve Care and Save Costs
HealthLeaders, 8/11/09
Uncle Sam is poised to spend $1.1 billion in stimulus funds to compare the effectiveness of 100 treatment categories in coming years, so providers, taxpayers, and insurance premium payers will stop wasting money on worthless care. But many experts say there's already enough evidence to start changing clinical practice to cut waste, improve outcomes, and save as much as 30% of what is being spent today.

Social Security Seeks EHR Data
Health Data Management, 8/10/09
The Social Security Administration has issued a request for proposals to use I.T. to obtain EHR data for individuals seeking disability benefits. Social Security has announced the availability of $24 million to expand its Medical Evidence Gathering and Analysis through Health Information Technology program. The funds are part of $40 million provided under the stimulus package to Social Security for health I.T. Under the request for proposals, the agency is looking for provider organizations, provider networks and HIEs to participate in the program.

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