Edition Twenty-Eight (9/15/09)

Optimizing EHRs Through Self-Service
Government Health IT, 9/10/09
While issues surrounding EHR incentives and certification have dominated the industry's attention related to ARRA, there has been little discussion about other technologies to further improve the quality, safety, and efficiency of care. Automating the patient registration process using kiosks and on-line applications presents an opportunity for health care providers to capture patient information electronically from the very beginning of an encounter, eliminating the need for duplicate data entry.

Tech Companies Push to Digitize Patients' Records
New York Times, 9/10/09
One proposal for health care reform is a rare bipartisan consensus: the push to computerize patient records. The goal of moving paper medical records into the digital age has been championed for years by health care policy makers across the political spectrum, from Hillary Rodham Clinton to Newt Gingrich. As a presidential candidate, Barack Obama, too, was an advocate, and the economic crisis opened the door for an ambitious step—$19 billion put into the recovery package to encourage doctors and hospitals to install and use EHRs.

CCHIT Readies Two 2011 Certifications
Health Data Management, 9/8/09
CCHIT will launch two 2011 EHR certification programs on Oct. 7. CCHIT for 2011 will offer an updated comprehensive certification program, priced pending final board approval at $37,000 for ambulatory and emergency department EHRs and $49,000 for inpatient EHRs. The organization also will offer a "Preliminary ARRA 2011" certification program, which focuses on the standards for qualifying for the Medicare and Medicaid incentives.

A Lower Bar for Computerized Physician Order Entry Adoption -- Is It Worth It?
iHealthbeat, 9/8/09
CPOE systems have long been touted as the I.T. solution for preventing medication errors by targeting the first step in the medication process—physician ordering—but adoption to date remains low. Recognizing both the potential for and the barriers to adopting CPOE, it is not surprising lawmakers included CPOE in the HITECH Act as a part of the meaningful use requirements for providers seeking Medicare and Medicaid incentives for EHR adoption. 

Medicaid Programs Must Prep for Federal Subsidies
Modern Healthcare, subscription required 9/8/09
States may immediately request federal matching funds for up to 90% of state expenses for planning on their end of the health information technology subsidy program, according to a letter from Cindy Mann, director of Medicaid and state operations at the CMS. To get started, states must submit and receive approval for their "HIT Advance Planning Document" before they initiate planning activities and start spending money.

NIH Research Database Gets a Makeover
Health Data Management, 9/8/09
The National Institutes of Health has added funding information for grants and contracts to its NIH Research Portfolio On-line Reporting Tool, called RePORT. The RePORT Web site is an on-line repository of reports, data, and analyses of research-related funding. Now, RePORT is augmented with a project search tool called RePORT Expenditures and Results, or RePORTER. It combines NIH project databases and funding records with articles from PubMed and information from the U.S. Patent and Trademark Office, along with a search engine. 

ONC Outlines Extension Center Grants
Health Data Management, 9/8/09
ONCHIT has published additional information on a $598 million grant program to fund creation of about 70 Health Information Technology Regional Extension Centers. Mandated under ARRA, the centers will help hospitals and physicians select, acquire, and use EHR systems. Preliminary applications for the first $189 million in funds are due on Sept. 8, with awards made in mid-December.

The Connected Health Care Community
H&HN Magazine, 9/7/09
While EHRs and e-Prescribing systems ultimately may receive the lion's share of financial support under ARRA, a significant amount of resources will be directed at interoperable networks and connected communities. These systems, which are much more dynamic than interfaces and Web-based portals, create a unified record from various sources of patient data. Health systems are in a unique position to advance these networks, as they can serve as a hub and collaborate with community physicians to facilitate the exchange of health care information. 

CCHIT Splits EHR Certification into Two Tiers
Modern Healthcare, subscription required 9/4/09
CCHIT is adopting a two-tier system of testing and certifying I.T. systems. The Preliminary ARRA 2011 Certification will specifically test for compliance with a set of criteria, which HHS and the CMS will use to determine eligibility for an estimated $34 billion in federal subsidy payments for the purchase of EHRs under the stimulus law. The second, the CCHIT Certified 2011 testing program, will use an elaborate set of about 300 criteria, which will closely resemble previous CCHIT testing and certification programs.

Pharmacists Ask HHS to Change HITECH Provisions
Modern Healthcare, subscription required 9/4/09
The National Community Pharmacists Association is asking HHS to consider its suggested changes to requirements under the HIT provisions of ARRA. Various disclosure requirements as they are currently written under HITECH are time-consuming and do not benefit patients, according to the NCPA. "Pharmacies could become entangled in a morass of new requirements which will do little to serve patients but will add costs and burdens to small businesses," the association wrote. 

Medicaid Incentives: Bureaucracy Will Reign
Health Data Management, 9/3/09
The federal government will reimburse states for 100% of Medicaid incentive payments made to providers for meaningful use of EHRs under the economic stimulus law, according to initial guidance from the CMS. But a sizable bureaucratic burden to justify state HIT initiatives—and coordinate those initiatives with federal efforts—will accompany the funds.

Feds Issue EHR Medicaid Incentive Guidance
Health Data Management, 9/2/09
CMS has sent a letter to all state Medicaid directors to provide initial guidance on upcoming Medicaid EHR incentive payments. Under ARRA, hospitals and physicians who treat a qualifying number of Medicaid patients can apply for incentive payments based on their meaningful use of EHRs. The letter points out how states may immediately apply for federal funds to pay for 90% of administrative planning activities, and spells out criteria to receive the funding.

Federal Advisory Committees to Meet
Health Data Management, 9/2/09
The HIT Standards Committee will meet on Sept. 15 to discuss a report from its privacy and security workgroup, and discuss implementation guidance issues. The HIT Policy Committee, meeting on Sept. 18, will hear testimony from health I.T. privacy and security experts. Both meetings are accessible over the Web.

'Risk of Harm' Breaches Require Notification: HHS
Modern Healthcare, subscription required 9/2/09
HHS last month issued a new rule under ARRA declaring a breach of patient health information may not be a breach which requires notification of patients if providers perform a risk assessment and determine there is a low risk of harm. In its rulemaking, HHS took a second stab at creating new federal guidelines on the notification of individuals affected by a privacy or security breach involving their medical information held or moved by hospitals, physician offices, and others.

5 Decisions Will Determine the Fate of e-Health Records
Federal Computer Week, 9/2/09
The pace of change towards digitizing health records has been increasing since Obama has made health I.T a priority and Congress put some real money on the table. Under the economic stimulus law, as much as $45 billion will be distributed to health care providers who buy and use approved EHRs. Experts say success hinges on the outcomes of five major decisions.

Will the HITECH Act be Effective or a Bust?
HealthLeaders, 9/1/09
When it comes to implementing EHRs and exchanging health information electronically, health care providers are being incentivized, nudged, or hit with a stick. The big question is will we spend this stimulus money in a way, which truly makes health care more cost effective and improves the quality of care for patients. A lot of questions still remain and the final definition of meaningful use and the certification criteria for vendors likely won't be finalized until the first quarter of 2010.

AHIMA Nails Major HIE Grant
Health Data Management, 9/1/09
ONCHIT has awarded a one-year, $1.2 million grant to AHIMA to continue work to help states implement HIEs. The foundation has managed the State-level Health Information Exchange Consensus Project under ONC contracts since 2006. The project provides forums for states to cooperate and share knowledge, and technical support for HIE efforts.

U.S. Public Health Failing as Records Resources Grow
Examiner, 8/31/09
In the midst of all the debate about health care, the public option and end-of-life counseling, there is the loud but hidden rumbling of a decades old engine of information infrastructure, called public health informatics. The organization, which coordinates the easy and secure exchange of medical care information—and the data systems, which support it—is known as the Public Health Information Network.

Implementing Electronic Medical Records Delivers Clinical, Administrative, and Financial Advantages
Health Management Technology, 9/09
As part of ARRA, the government will pay out $17 billion in incentives beginning in 2010 for hospitals and in 2011 to doctors who implement EHRs. While physician practices can receive up to $64,000 per doctor and hospitals can receive as much as $8 million in incentives, and—even with the knowledge they will be penalized beginning in 2015 for not implementing a certified solution—it may not be enough on its own to fuel adoption of EMR systems. For this to happen there needs to be a mindset shift among practitioners and hospital administrators.



State Forms Public-Private Pact for Paperless Medical Records Push
Business First of Columbus, 9/10/09
The state is hoping a public-private partnership with an eye on EHRs helps its chances in snagging a piece of more than $1 billion in federal stimulus dollars. Gov. Ted Strickland tapped the nonprofit Ohio Health Information Partnership, a subsidiary of Columbus group BioOhio, to work with the state Department of Insurance on a new collaboration to help the health care industry transition to EHRs and create a safe statewide network for accessing patient information.

Health Data Exchange Praised: Louisiana System Lets Hospitals Exchange Records On-line, Cut Costs
The Advocate, 9/5/09
The LSU and Bunkie hospitals are part of an EHR system, which exchanges patient information between LSU and 14 hospitals in Louisiana. The EHR system is improving patient care and saving money at the same time, helping hospitals operate more efficiently, and avoid medical errors and duplication of tests. The project is attracting national attention as a model for the type of HIE networks the federal government contemplates developing across the nation.

Disparate HIEs Start to Exchange Data
Health Data Management, 9/2/09
Three regional HIEs in the past week have started exchanging real-time data on real patients among themselves. According to the participating organizations, this is the nation's first LIVE, multi-region clinical information exchange. The participants include the Indiana Health Information Exchange in Indianapolis, HealthLINC in Bloomington, Ind, and HealthBridge in Cincinnati. IHIE, HealthLINC, and HealthBridge collectively serve more than 15,000 physician and 50 hospitals, and have more than 12 million patient records, according to the organizations.



The Patient of the Future
HealthLeaders, 9/14/09
In the future, patients will communicate with their doctors via e-mail, on-line chat room, Web portal, mobile device, remote monitoring technology (or some other method or medium which hasn't yet been invented), thus avoiding a long wait for a short appointment, which might not have been necessary anyway. Patients prefer providers who use Internet-based tools to augment care, according to Deloitte's 2009 survey of health care consumers.

Web Helps Strengthen Patient-Safety Movement
Modern Healthcare, subscription required 9/9/09
The Internet has been a contributing force to the effectiveness of the patient safety movement, through social-networking sites and Web pages which have allowed safety advocates to establish connections otherwise difficult to create. Medical errors and patient harm have led to providers and families taking sides in battles, when advocates say what the process needs is an injection of compassion and communication.

AHRQ to Survey Docs, Providers on e-Prescribing
Modern Healthcare, subscription required 9/4/09
AHRQ plans to survey physicians and pharmacists about their e-Prescribing habits to determine how those features are being used. While e-Prescribing has the potential to improve patient safety, physician adoption has been limited. The two-year survey will collect information from physicians and pharmacies in 110 organizations across 12 communities which are using e-Prescribing, and ask providers their perspectives on those systems as well as how they use patient formulary data and other third-party information.

Effort to Certify Health I.T. Security
Health Data Management, 8/31/09
The Health Information Trust Alliance, an industry consortium working to improve the understanding of information security issues in health care, is spearheading efforts to develop health I.T. security certification programs. The alliance unveiled its Common Security Framework for electronic health information. The framework is an attempt to standardize health I.T. security best practices, standards, and regulations in a single certifiable tool. 

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