Edition Seventy-Nine (10/31/11)

Bill Would Set Limits on EHR Lawsuits
Health Data Management, 10/28/11
Rep. Tom Marino (R-PA) introduced legislation which would grant limited legal protection to Medicare and Medicaid providers in the event of an error which occurs while using EHRs. The Safeguarding Access for Every Medicare Patient Act would limit electronic discovery in a legal action to information related to the EHR-related adverse event and information from the period in which the event occurred. This limits attorneys from using EHRs to go on "fishing expeditions" and looking for other information, Marino says.

Survey: Hospitals Have High Hopes for Information Exchanges
Health Data Management, 10/27/11
A survey of more than 340 hospitals finds almost 80 percent have or plan to join a health information exchange. 32 percent of respondent hospitals already are part of an HIE while 47 percent plan to join such an initiative. The primary driver toward HIE is meeting Meaningful Use criteria, cited by 48 percent of respondents.

Q&A: Blumenthal Talks EHRs, Health Care Reform
InformationWeek, 10/26/11
A InformationWeek Healthcare writer caught up with David Blumenthal at the recent Partners Healthcare's Connected Health Symposium in Boston to discuss the HIT industry.

Mostashari to MGMA: Time is Right to Adopt EHRs, Show Meaningful Use, Move to ACOs
Healthcare IT News, 10/25/11
To all those health care CIOs out there worried about ICD-10, Meaningful Use, ACOs, patient-centered medical homes, and a host of other government-backed efforts to reform health care, Farzad Mostashari, MD, has some words of advice: Don’t stay on the sidelines. In other words, HHS' National Coordinator for HIT says, “it’s never going to be an easier time than now” to adopt an EHR, meet Meaningful Use guidelines, and move toward an ACO. 

ONC Appoints Judy Murphy to Mostashari's Old Post
Government Health IT, 10/25/11
Judy Murphy, Aurora Health Care vice president and member of AMIA and the HIMSS boards of directors, has been named deputy national coordinator for programs and policy.

Despite ACO Rule, EHRs Still Key to Clinical Decisions
Government Health IT, 10/25/11
The final rule for ACOs relieved providers from some of the immediate pressures of establishing health I.T., but EHRs and other technologies will be critical to coordinate care to improve quality and lower costs. The rule still contains significant language for evidence-based medicine and processes as the way to deliver patient care in an ACO.

Survey: Most Physicians Require More EHR Training
CMIO, 10/24/11
Physicians do not receive adequate training to effectively use their EHRs, according to a report. Almost half of respondents received three or fewer days of training. However, three to five days of EHR training was necessary to achieve the highest level of overall satisfaction, according to the report.

Medicare Eases Final Rules for Accountable Care Organizations
InformationWeek, 10/24/11
The long-awaited final rule for ACOs contains just 33 quality measures, half of what an earlier proposal called for, divided into four domains: patient/caregiver experience; care coordination and patient safety; preventive health; and caring for at-risk populations. The idea is to "create a more feasible and attractive onramp for a diverse set of providers and organizations to participate as ACOs," according to CMS administrator Dr. Donald M. Berwick.

EHR Best Practices: Who's Winning and Why?
InformationWeek, 10/24/11
It may be hard to believe, but the first year of the federal Meaningful Use program to encourage the adoption of EHRs is winding down. Health care practitioners who hadn't started compliance by October 3, and hospitals that waited until after July 1, have already missed out on the first year of payments. Fear not, though. Providers can start as late as 2014 for Medicare and 2016 for Medicaid and still earn a share of an estimated $27 billion in incentive payments—though maximum incentives could be lower after 2013. Anyone who doesn't achieve Meaningful Use by 2015 risks Medicare penalties. 

CHIME Survey Tracks Meaningful Use Progress
Health Data Management, 10/20/11
A recent survey of CIO members of CHIME finds 26 percent of respondents say their organization has qualified for Meaningful Use funding during the first year of the program. Thirteen percent of respondents report their organization has received incentive payments, most under a state Medicaid program. Four percent of respondents had received payments under the far more stringent Medicare Meaningful Use criteria. About 93 percent of 198 respondents expect their organization to achieve Stage 1 Meaningful Use during the first three years of the program. More than half of respondents have registered for the program, compared with only 15 percent in a March 2011 CHIME survey.

ONC Adds Senior Position to Oversee Daily Workload
Government Health IT, 10/20/11
ONC added the position of principal deputy as its activities to drive Meaningful Use of EHRs and HIE have multiplied. ONC’s principal deputy will be responsible for day-to-day operations, decision making, and staff management, duties similar to that of a COO in the private sector, and report to the national coordinator, Dr. Farzad Mostashari. 

CMS Releases Final ACO Rules
Health Data Management, 10/20/11
The move toward ACOs kicks in high gear with the October 20 issuance of final Medicare ACO rules from the CMS. These include a final Medicare Shared Savings Program: Accountable Care Organizations rule, and an interim final rule, removing certain barriers to ACO participation by establishing waivers to federal physician self-referral, and anti-kickback laws.

CMS Gives New EHR Meaningful Use Guidance
Health Data Management, 10/19/11
The CMS released guidance covering some of the nuances of attesting for Meaningful Use.

Joint Commission Advocates I.T. to Counter Racial Disparities in Health Care
Healthcare IT News, 10/18/11
A new study published in the Joint Commission Journal on Quality and Patient Safety finds differences in the quality and safety of medical treatment received by minorities could be reduced through the better use of HIT.

Spotty I.T. Adoption Limits Quality Aims
Modern Healthcare, subscription required, 10/18/11
A new report from the Commonwealth Fund says the nation's uneven adoption of HIT has hindered quality improvement efforts. But the authors also said that recent changes, including those in the health reform law, could boost I.T. use. The Affordable Care Act and investments in I.T. offer the potential for rapid programs in areas like adoption and use of HIT, safer care, and premature deaths from preventable complications, said David Blumenthal.

Report: Number of Sustainable HIEs Increases 33 Percent
Becker's Hospital Review, 10/18/11
An eHealth Initiative report showed the number of self-sustaining HIE initiatives has increased 33 percent since 2010. The report, "Health Information Exchange: Sustainable HIE in a Changing Landscape," found 24 of the 196 initiatives which responded reported being self-sustaining, compared to 18 in 2010.

ACOs Can't Survive without HIT
InformationWeek, 10/17/11
Health care organizations which reject the ACO model—and who fail to implement the necessary technology and practices to support better patient outcomes and quality across the full continuum of care—risk long-term clinical and financial failure, concludes a new report. The report, Preparing for Accountable Care: The Role of Health I.T. in Building Capability, also reiterates what health I.T. managers and clinicians already know—ACOs will require a plethora of HIT to operate and support the new ACO model, which is based on pay-for-performance where providers will receive payments for the quality and not the quantity of care they offer. 

Many Patients Love EHRs, Fear Storing Data Themselves
InformationWeek, 10/17/11
Nearly half of consumers have viewed or would be interested in seeing their EHRs, according to a new survey. But so far, that interest has not translated into a leap in the use of PHR applications to store that data.

Stakeholders Brainstorm on Improving Health Care Transitions with I.T.
Healthcare IT News, 10/17/11
Health care I.T. stakeholders gathered in Washington for a work meeting, discussing ways I.T. could help improve transitions in care. The invitation-only meeting's attendees included federal officials, EHR vendors, entrepreneurs, grantees, leaders from ONC’s Beacon Communities, and foundation funding organizations.

Medicare Releases Patient Safety Ratings for Hospitals
Kaiser Health News, 10/17/11
Medicare has begun publishing patient safety ratings for thousands of hospitals as the first step toward paying less to institutions with high rates of surgical complications, infections, mishaps, and potentially avoidable deaths. The new data, available on Medicare's Hospital Compare website, evaluate hospitals on how often their patients suffer complications such as a collapsed lung, a blood clot after surgery, or an accidental cut or tear during treatment.

CMS on Track to Pay $1 Billion in Meaningful Use Incentives by Year's End
Government Health IT, 10/13/11
In September, the CMS paid out $25 million to 1400 eligible providers and $61 million to 30 dually eligible hospitals under the Meaningful Use EHR incentive program. Since the program began January 1, 2011, CMS has paid out $870 million in incentives, and say they are on track to pay out $1 billion by the end of this year.

14 Rural Hospitals Join Nebraska Health Data Exchange - State
InformationWeek, 10/13/11
The Nebraska Health Information Initiative has signed 14 critical access hospitals to its statewide HIE in recent weeks, with others expected to join as more hospitals roll out EHR systems. Nebraska, which has a population of about 1.8 million, is one of the most rural states in the U.S., and with 65 critical access hospitals, or CAHs, has more of these facilities than most other states. 

More States LIVE on Medicaid Meaningful Use; CMS Updates FAQs on Program
Health Data Management, 10/13/11
Six more states have recently launched their Medicaid EHR Meaningful Use incentive programs, and the CMS posted an important frequently asked question on Medicaid patient volume under Meaningful Use. California, Maine, Maryland, Massachusetts, Utah, and Vermont Medicaid now are up on Meaningful Use, bringing the total to 33 states LIVE.

GOP Claims Obama Administration Wants Your Medical Records
Healthwatch, 10/13/11
House Republicans are alleging the health care reform law would turn over everyone's private medical records to the federal government. The latest broadside against Democrats' signature domestic achievement is pegged to an arcane regulation requiring insurers to provide claims data. The data will be used to justify extra payments to plans which cover more people with serious illnesses such as cancer, in order to keep those plans from going out of business.

Study: 56M Patients Viewed Their Medical Records via EHRs, But Many Not Interested
Becker's Hospital Review, 10/13/11
A study found 56 million U.S. patients have accessed their medical information on an EHR system maintained by their physician and 41 million other patients are interested in doing so. The study also revealed 140 million consumers have not used and are not interested in using an EHR to view their medical information. The consumers who did not express interest in using an EHR were generally older, less educated, and less likely to use the Internet or own sophisticated electronic devices, such as smartphones and tablets.

Fed Advisors: Too Soon to Add EHR Metadata to Meaningful Use
Health Data Management, 10/13/11
ONC's plan to require use of EHR metadata in Stage 2 of the Meaningful Use program is premature, according to the National Committee on Vital and Health Statistics, a federal advisory body. Adoption of EHR metadata standards, which the President's Council of Advisors on Science and Technology has advocated, could help improve data exchange and would enable patients to segregate parts of their medical records, such as self-paid treatment for sensitive conditions.

Facebook and EHRs: a Very Fine Line Just Got Even Finer
iHealthbeat, 10/13/11
The popularity of social networking can blur the line between the public and private domains. In response to the industry's growing reliance on electronic health records, health care facilities must step up their privacy standards.

Federal Advisors Seek Easier Secondary Use of EHR Data
Health Data Management, 10/12/11
The HIT Policy Committee has issued recommendations to ease secondary uses of EHR data. In particular, use of EHR data for treatment purposes or to evaluate the safety, quality, and effectiveness of prevention and treatment activities should not require patient consent, institutional review board approval, or even minimal registration, according to the federal advisory body.

SAMHSA Announces $25 Million in Health I.T. Grants
Modern Healthcare, subscription required, 10/12/11
HHS' Substance Abuse and Mental Health Services Administration announced 29 grant recipients will receive a total of $25 million to expand the use of HIT and improve access to behavioral health services. As part of SAMHSA's Strategic Initiative on Health Information Technology, the grants are intended to use technology to improve access and coordination in treating mental and substance-use disorders especially among underserved populations and in rural areas. 

The Next Five Years in Health I.T.: ONC's Plan for the Future
iHealthbeat, 10/11/11
On Sept. 12, the Office of the National Coordinator for Health I.T. released an updated strategic plan for implementing a nationwide health information network. iHealthbeat outlined an overview of the Strategic Plan and some of the federal government's newest initiatives, including the Query Health initiative, the EHR data segmentation initiative, and various initiatives to drive consumer engagement in health care, such as the recent proposed regulation affording individuals direct access to laboratory results.

ONC, Health 2.0 Launch popHealth App Challenge
Government Health IT, 10/10/11
ONC and the Health 2.0 entrepreneurial organization have opened a contest for developers to innovate with the popHealth tool beyond its reporting functions so health care providers can learn more about their patient populations and improve their care.

ONC's Path Forward: 'Patient Engagement'
Government Health IT, 10/9/11
Now that ONC has the attention of physicians and hospitals to improve care through the Meaningful Use of EHRs, ONC intends this autumn to emphasize strategies for reaching out to consumers to participate more in their health care. To introduce consumers to this cultural shift, ONC is slated to launch a campaign to develop videos and ads to educate and demonstrate the value of health I.T. and what it means to individuals, and the agency also plans to work with consumer organizations to get the message out.

Privacy, Security Not as High-priority as Meeting Meaningful Use
Healthcare IT News, 10/7/11 
Eighty percent of respondents to a survey of hospital and health system I.T. professionals cited compliance as the highest expectation of achieving Meaningful Use. Only 38 percent, however, are in the process of enterprise-wide adoption of secure EHRs.

Shared Savings/ACO Final Rule May be Out Soon
Health Data Management, 10/6/11
The CMS sent a Shared Savings/Accountable Care Organizations final rule to the Office of Management and Budget for review. The rule would establish the Medicare Shared Savings Program authorized in the health reform law. Under Shared Savings, provider organizations are encouraged to form ACOs to tightly coordinate the care of chronically ill patients across the continuum of care, and to share in the savings that may result.

Provider EHR Incentive Registrations Exceed 100,000
Government Health IT, 10/6/11
The number of physicians and hospitals which have registered for the EHR incentive program has surpassed 100,000, according to the CMS. As of the end of September, 88,399 physicians and hospitals have signed up for the Medicare program, 24,030 for the Medicaid program and 2,215 hospitals that are eligible for both incentive programs, for a total of 114,644 registrants.

Could Stage 2 of Meaningful Use be a Two-Step Process?
Health Data Management, 10/5/11
Stage 2 starts in October 2012 for hospitals and January 2013 for eligible professionals, just when providers will be struggling to meet the ICD-10 deadline in October 2013. So Stage 2 could start in January 2013 with minor changes from Stage 1, such as raising Meaningful Use quality measures a bit. But any major changes or new requirements, such as requiring the use of SNOMED CT in certain parts of the medical record, would wait until 2014.

AMA Warns Docs of Looming eRX Deadline
Healthcare IT News, 10/5/11
The American Medical Association urged physicians who are not able to meet the requirements of the Medicare e-prescribing program to apply for a hardship exemption before the November 1 deadline to avoid monetary penalties in 2012. Some 100,000 care providers could be hit with e-prescribing penalties next year. But the CMS is offering docs a chance to use an expanded list of exemptions to help dodge a one percent pay decrease in 2012.

Group: Streamline Rules, Standardize Data for Docs
Modern Physician, subscription required, 10/4/11
The Measure Applications Partnership, an initiative of the National Quality Forum, released two reports outlining ways to enhance patient safety and health care provider performance by improving the collection of health care quality data. One of the reports calls for a unified health I.T. platform to integrate quality data from various sources.

AHIMA: ICD-11 on Horizon, But Providers Must Get Through ICD-10 First
CMIO, 10/4/11
During the American Health Information Management Association conference in Salt Lake City, a World Health Organization official urged health care organizations to move forward with the transition to ICD-10 code sets. T. Bedirhan Ustun—team coordinator of classification, terminology, and standards in the department of health statistics at WHO—delivered a keynote address in which he discussed ICD-10.

Health Information Exchanges Need A Better Business Model
InformationWeek, 10/4/11
The National Association of State Chief Information Officers is urging state CIOs who are developing HIEs to improve their business strategy. That strategy has to generate revenue to cover operational costs and provide sustainability for these exchanges, before the public funds they have already received run out.

AHIMA Goal: 40,000 More HIM Jobs
Health Data Management, 10/3/11
A new initiative from the American Health Information Management Association seeks to create at least 40,000 HIM jobs to build and maintain EHRs. Under a demonstration program, AHIMA is working with the HHS Office of Minority Health and North Shore Medical Labs in Williston, N.Y., to bring health I.T. to 100 small-practice physicians in under-served communities in Alabama, Mississippi, and North Carolina.

Advice from a Michigan HIE: Be Practical
Health Data Management, 10/25/11
The Michigan Health Connect, an HIE which spans 49 hospitals, is a rare bird in the industry. It is entirely funded by its hospital members, who pay a base rate depending on their size, then pay additional fees depending on what services are needed.

Rural Grant Helps Link Entities in South Dakota
Healthcare IT News, 10/24/11
Brookings Health System and Avera Medical Group Brookings (part of the Avera Health System) are poised to put a $900,000 federal grant to work by creating a community health information network which make it possible for them to share patient information via EHRs.

California Could Realize Big Savings from Expanded Telehealth
CMIO, 10/19/11
California could achieve significant Medi-Cal cost savings by expanding telehealth services through legislation which Gov. Jerry Brown (D) signed into law earlier this month, according to a report prepared for the Center for Connected Health Policy. Medi-Cal is California's Medicaid program.

Telehealth Services to Reach More Rural Californians
Healthcare IT News, 10/11/11
A bill signed recently in California aims to greatly increase access to health care in rural areas by providing more telehealth services, through more providers, in more care settings. Governor Jerry Brown signed Assembly Bill 415, the Telehealth Advancement Act of 2011, on October 7. 

IBM Launches Health Care Analytics Software to Reduce Hospital Readmissions
eWeek.com, 10/26/11
IBM's new Content and Predictive Analytics software uses technology similar to that of the Watson supercomputer to help doctors spot patient trends and improve care.

Text Messaging Among Providers Prevalent Despite HIPAA Compliance, Security Concerns
BNA, 10/19/11
The majority of physicians use text messages to exchange patient information with other health care providers. Experts say such communication could boost health care quality and reduce costs, but they warn some text messages could contain information that violates HIPAA privacy and security rules.

26 Percent are Mobile Health Users
Mobile Health News, 10/19/11
A new study finds the percentage of U.S. adults who use their mobile phones to access health data more than doubled from 12 percent in 2010 to about 26 percent in 2011. Use of mobile phones for health care or treatment management also grew.

Telehealth Touted for Native American Health Care Delivery
InformationWeek, 10/14/11
Developing policies which eliminates barriers to the adoption of telehealth technology, such as expanding broadband services and providing resources to help implement the technology, enable more American Indians and Alaska Natives to access health care in a cost effective and efficient way.

Public Health and HIE: MPI Synchronization
Government Health IT, 10/7/11
One of the key elements of an HIE is the Master Patient Index (MPI), which associates records from multiple sources accurately with a single patient.

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