Edition Fifty-Two (8/31/10)

Authors Issue Reality Check on Health I.T.
Modern Healthcare, subscription required 8/27/10
Roughly 2% of U.S. hospitals in 2009 would have had a chance at meeting requirements under the new federal criteria for Meaningful Use of health I.T. Researchers conclude there is a discernable I.T. adoption gap between the digital haves and have-nots in this country, the divide is widening, and the jury is still out as to whether the I.T. incentives portion of the federal stimulus law will remediate or exacerbate the problem of I.T. inequality.

HIE Panel Pushes for State Provider Directories
Government Health IT, 8/27/10
The Health I.T. Policy Committee created a task force to pursue the use of directories across state HIEs to support provider and patient look-up, as well as to enhance public health reporting. For HIEs to gain a footing, states will have to make sure physicians can access provider directories. Without these electronic listings of providers and patients across a state or region, vital health records and messages might not get to its proper destination.

What are the Top Ten Meaningful Use Challenges?
Health Data Management, 8/26/10
The top two challenges for hospitals are implementing CPOE right the first time, and helping physicians transition to competent and willing users of the EHR. For eligible providers, the top two are capturing the data, and establishing effective workflows to reinforce data entry.

Sebelius: The New Momentum Behind EHRs 
Kaiser Health News, 8/26/10
HHS Secretary Kathleen Sebelius explains how federal health I.T. investments from the stimulus are helping to reduce many of the obstacles which limited the spread of EHRs in the past. Sebelius notes federal officials have invested in health I.T. by creating RECs to help health care providers select EHR systems, by offering training programs to strengthen the health I.T. work force, and by providing grants to states for HIE.

Biden Touts Impact of HIT Stimulus on Economy
Government Health IT, 8/25/10
The Obama administration used about half of a 50-page report on innovations targeted by ARRA to underscore the importance of health and medical I.T. to the nation’s economic future. In presenting the report, Vice President Joe Biden, who was put in charge of seeing billions of stimulus dollars reached its targets, highlighted how the funding is helping drive the use of EHRs, e-Prescribing, and the use of mobile devices to link remote patients and providers.

Fed Advisors Look to Stage 2
Health Data Management, 8/24/10
The HIT Policy Committee formed the Quality Measures Workgroup to produce initial recommendations for prioritizing quality measures for Stage 2 EHR Meaningful Use criteria.

Meaningful Use Criteria = Health I.T. Staff Gaps
CMIO, 8/24/10
ONC predicts 50,000 additional health I.T. workers will be needed during the next five years to satisfy EHR Meaningful Use criteria. Thus, providers, payors, and other stakeholders need to fill in workforce gaps with skill sets from other staff and focus on alternative ways to install and operate systems that realize economies of scale and therefore reduce health I.T. staff demands.

An EMR That Pays for Itself
H&HN Magazine, 8/23/10
While hospitals nationwide are taking a leading role in helping physicians implement EMRs, many do not have a clear plan for recouping the cost of their investment. The lack of a plan is unfortunate, as the total cost of rolling out an EMR outweighs any direct savings from improved information management. Many hospital leaders figure the cost is simply the price of keeping up with technology. The problem is an ongoing EMR cost imbalance could threaten a hospital's ability to make future I.T. investments.

Best Practices Using Health I.T. Could Create Significant ROI
CMIO, 8/23/10
A health care provider who creates a best practices I.T. platform to house and share medical records, manage hospital resources more transparently, and define precise guidelines for medically authorized tests and procedures, can generate significant operating efficiencies, according to analysis.

Chopra: Build Database of Health Program Business Rules
Government Health IT, 8/23/10
An HHS panel backed a plan to build a federal database of business rules states could use to help determine the eligibility of consumers for Medicaid and other federal health insurance programs. The collection of program eligibility rules in a single location would enable states to compare their enrollment processes with other states’ and find instances where systems could be re-used or merged.

Digital Hospital Records Tied to Higher Efficiency
The Arizona Republic, 8/20/10
Patients treated at hospital ERs using digital records systems are more likely to have shorter stays than at hospitals with paper or basic digital records systems, according to a study. The study found people spent 22.4 percent less time and were treated 13.1 percent more quickly at hospitals with complete EHR systems compared with other hospitals. It also found hospitals with basic computerized records were less efficient than other hospitals.

CHIME Publishes EHR Guide for CIOs
Modern Healthcare, subscription required 8/19/10
CHIME published The CIO's Guide to Implementing EHRs in the HITECH Era, aimed at assisting CIOs and other I.T. executives in EHR implementation and meeting the Meaningful Use requirements to qualify for federal health I.T. subsidies. The new guide contains information on the federal EHR subsidy program, assessing the subsidies and the costs of achieving Meaningful Use requirements, and offering tips on managing expectations and improving work flow, as well as advice from CHIME members on effective implementation training.

ONC Privacy Advisors Send Recommendations
Health Data Management, 8/19/10
The Privacy and Security Tiger Team of the HIT Policy Committee, which comprises industry stakeholders tackling certain privacy issues related to the exchange of protected health information, sent its letter of recommendations to David Blumenthal. The recommendations apply only to electronic exchange of information to meet Stage 1 Meaningful Use criteria. More study is needed, Tiger Team members say, in such areas as exchanging data with patients and researchers.

Certification Testing Procedures OK'd
Health Data Management, 8/18/10
NIST published approved procedures Authorized Testing and Certification Bodies will use as part of the process of certifying EHR products support Meaningful Use requirements under the HITECH Act. The test procedures help ensure EHRs function properly and work interchangeably across systems developed by different vendors. The set of 45 approved test procedures evaluate components of EHRs, such as their encryption, how they plot and display growth charts, and how they control access so only authorized users can access their information.

CMS Guides States on Medicaid EHR Programs
Modern Healthcare, subscription required 8/18/10
Providers gleaned new insights into how they will receive subsidy payments for the purchase and use of HIT as the CMS issued supplementary guidelines to earlier rules on the administration of the Medicaid portion of the federal EHR program under ARRA. The federal government will reimburse states for 100% of their expenditures for provider I.T. incentive payments and 90% of state administrative costs for the program.

ONC Finds Many States Use Similar Program Data 
Government Health IT, 8/18/10
A number of states use health and social program eligibility and enrollment data that could be a foundation for sharing information by electronic health insurance exchanges, according to an analysis by ONC. Certain pieces of information states collect, such as name, address, and gender, are close enough in definition and format they could be easily unified as common data elements, said Dr. Doug Fridsma, acting director of ONC’s office of standards and interoperability. Common data elements and technical standards are needed to share information across HHS programs to support the development of state insurance exchanges in 2014. 

Guerra on Health Care: Report EMR Meaningful Use Honestly
InformationWeek, 8/17/10
Integrity matters a lot when it comes to CIO leadership, and the slightest lapse can tarnish a hard-earned reputation. In the not-too-distant future, these executives will be faced with a moment when, like a CFO signing off on the books, they can claim to have achieved Stage 1 Meaningful Use. This stage, which is the only one not requiring electronic reporting straight from the EMR, will be unique in the opportunity to err it presents to CIOs. 

EMR Bonus Eligibility Could be Widened
American Medical News, 8/16/10
New legislation seeks to expand the types of medical professionals eligible for Medicare and Medicaid EHR incentives to include licensed psychologists and clinical social workers. The HIT Extension for Behavioral Health Services Act also would expand the Medicare hospital incentive to include inpatient psychiatric hospitals, and extend Medicaid hospital bonuses to community health centers, mental health treatment facilities, psychiatric hospitals, and substance abuse treatment facilities.

CMS Contracts Push HITECH Efforts
Health Data Management, 8/16/10
CMS awarded two multi-million dollar contracts, funded under the stimulus, for assistance in administering provisions of the HITECH Act. CMS has selected Indianapolis-based National Government Services Inc. to administer EHR Meaningful Use incentive payments under a contract worth nearly $5.5 million. CMS also awarded a $3.9 million contract to public relations firm Ketchum Inc. for help in promoting the HITECH Act to consumers.

EHRs Can't Measure Stage 1 Meaningful Use
InformationWeek, 8/16/10
As hospitals gear up to meet Stage 1 of the Meaningful Use requirements, EHRs will only be able to provide about a third of the data requirements for Stage 1 quality measures outlined in the final rule. Not only is time working against putting in place the necessary technology to meet the requirements for CPOE, problem list, and so forth, but the quality reporting requirement adds to the duties.

EMR Purchase Poses Dilemma for Doctors Near Retirement
American Medical News, 8/16/10
Investing in an EHR system was not something many physicians late in their careers were probably thinking about a few years ago. But the introduction of incentive pay for adopting an EMR—and the penalties for not adopting—have older physicians wondering if such an investment is worthwhile.

EMR Challenge: Tough Road to Reach Meaningful Use
American Medical News, 8/16/10
EHR systems have the true potential to transform the practice of medicine to improve patient care, but physicians must be secure in knowing they will have the necessary support when they make the leap into the paperless world. Congress and the White House have recognized the need for support by getting behind Medicare and Medicaid incentives for physicians who undertake the daunting and costly process of adopting EMR systems.

States Should Tap Fed Models for Enrollment Services
Government Health IT, 8/16/10
Members of the HIT Policy Committee’s enrollment workgroup said the IRS, the SSA, and the Homeland Security Department provide verification of personal income, citizenship, and legal residence through electronic interfaces and Web services for some federal programs. Instead of reinventing the wheel, states should use these tools to develop their insurance exchanges, which are intended to offer a convenient and economical way for people who do not qualify for Medicaid or employer-based insurance to purchase health insurance. 

Wisconsin Submits Health Info Exchange Plan
Modern Healthcare, subscription required 8/27/10
The Wisconsin Relay for Electronic Data for Health, also known as WIRED for Health, submitted its plan to HHS for a statewide electronic HIE network. It includes a suggested framework for the governance and financing of the network, the services it would provide, and the technical architecture it would require. Wisconsin providers are expected to receive between $500 million and $800 million in stimulus-law funds to help subsidize their purchase of EHR systems.

Health I.T. Work Abounds for State and Local Projects
Healthcare IT News, 8/27/10
Spending on state and local health I.T. systems will increase by 19 percent over the next five years, forecasts a new report. Researchers expect the health I.T. market's worth to rise from $8.3 billion in 2010 to $9.9 billion in 2015. Spending on EHRs will account for $2 billion of the $9.9 billion total.

Health Information Network Taking Shape
Morning Sentinel, 8/25/10
Maine received federal approval of a $6.6 million plan to expand and coordinate HIT, Gov. John Baldacci announced. Maine is the sixth state to have its implementation plan approved by ONC. The federal government also awarded $4.7 million in Recovery Act funds to HealthInfoNet, Maine’s designated HIE program.

N.Y. Info Exchange Uses Grant to Fight Diabetes
Modern Healthcare, subscription required 8/25/10
David Blumenthal recently visited HealtheLink, a RHIO in Buffalo NY, which received a nearly $16.1 million Beacon Community grant from ONC in May. The award, provided to help the region combat rising diabetes rates, was the largest of 17 Beacon Community grants distributed across the country.

VA to Use Indy Exchange for e-Records Pilot
Indy Star, 8/25/10
The VA announced a pilot program to link the VA's own EMRs with patient information from other hospitals and facilities where Indiana veterans seek treatment. The initiative will use the Indianapolis-based Indiana Health Information Exchange, known as IHIE, to securely make veterans' health information accessible to physicians at VA and non-VA facilities alike.

Providers Ready HIE in North Carolina
Health Data Management, 8/19/10
The North Carolina Hospital Association and North Carolina Medical Society are working with two delivery systems to pilot and launch a statewide HIE. The North Carolina Health Information Exchange will establish statewide policies, such as HIE standards and definitions for minimum data sets and role-based access.

Statewide California Telehealth Network Launches
PRNewswire, 8/17/10
Governor Arnold Schwarzenegger and U.S. Chief Technology Officer Aneesh Chopra joined a diverse group of statewide health care and technology agencies to launch the California Telehealth Network (CTN). A $30 million joint funding effort, the CTN is the largest single-state grant award of its kind. It will connect more than 800 California health care facilities to a statewide medical-grade network of health care and emergency services.

MGMA Urges Changes to CMS' e-Scripts Plans
Modern Healthcare, subscription required 8/25/10
In its comments on the proposed 2011 physician fee schedule, the Medical Group Management Association strongly urged the CMS to revise the penalties slated for its e-Prescribing incentives program. The CMS had implemented the eRX program in 2009, offering a 1% bonus payment starting in 2011 for physicians or group practices who would qualify as successful e-Prescribers, and impose penalties on providers who are not successful e-Prescribers.

Fifteen Organizations Receive $4M to Boost Telehealth Efforts
Healthcare IT News, 8/23/10
Kathleen Sebelius announced more than $32 million in funding aimed at boosting access to health care service in rural areas, including approximately $4 million for telehealth projects. The Telehealth Network Grant Program will receive more than $2 million of this rural health care funding. The program helps communities build capacity to develop sustainable telehealth programs and networks. 

CMSS Joins 'Red Flags Rule' Lawsuit Against FTC
HealthLeaders, 8/18/10
The Council of Medical Specialty Societies announced its participation in a lawsuit to exempt doctors from requirements of the "Red Flags Rule," scheduled to take effect by year end. Groups such as the AMA object to the FTC's requirement for physicians to verify the true identity of their patients before they agree to treat them if the patients are not paying in full at the time of the visit. The intention of the requirement is to prevent potential cases of identity theft.

Data Security Breach Bill Calls for Strict Notification Requirements
HealthLeaders, 8/17/10
A data breach bill requires entities holding consumers' sensitive information to create a robust data compliance protection plan and holds them to strict breach notification requirements. U.S. Senators Mark Pryor (D-AR) and Jay Rockefeller (D-WV) filed the "Data Security and Breach Notification Act of 2010," which would be regulated by the FTC. Health care entities and their business associates would be in the clear so long as they complied with the HITECH Act or any other federal laws which satisfy similar or stronger requirements.

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