Edition Thirty-Two (11/10/09)

HL7 Offers Standard for Clinical Research in an EHR
Healthcare IT News, 11/6/09
HL7 has published a standard for clinical research in an EHR system, approved by the American National Standards Institute. The profile is a resource for the CCHIT Clinical Research Work Group, as it defines new clinical research certification criteria for EHR systems. It will be complemented by the EHR-clinical research interoperability specification, now being developed by HITSP.

HHS to Award Health-Data Network Contracts by Year's End
Federal Computer Week, 11/6/09
HHS is planning to award a series of competitive contracts to bring the NHIN to full production. ONCHIT announced it was seeking to award a sole-source bridge contract to prepare for the upcoming series of competitive contracts for the NHIN. Under the bridge contract, the goal is to continue ongoing work on developing a strategy, program governance, technical requirements, program artifacts, and facilitation processes to move the NHIN to production readiness and production status.  

Survey: U.S. Physicians Lag Behind Those in Other Countries in I.T. Use
Healthcare IT News, 11/5/09
U.S. doctors are far less likely to use HIT, which helps reduce errors and improve care, than those in other countries, according to the 2009 Commonwealth Fund International Health Policy Survey. The survey finds only 46 percent of U.S. doctors use EMRs, compared to 99 percent of doctors in the Netherlands and 97 percent of doctors in New Zealand and Norway. Many of the areas in which the U.S. lags would be addressed by health reform legislation currently under consideration in Congress.

Survey: Health Care Organizations' Security Not up to HITECH Standards
Healthcare IT News, 11/4/09
Health care organizations aren't prepared to meet privacy and security standards associated with ARRA, according to a new survey. The HIMSS survey of 196 HIT and security professionals indicated health care organizations aren't using available security technologies to keep patient data safe. Reasons given include stretched budgets and lack of a chief security officer or chief information security officer.

Survey: EHR Expectations Increase with Use
Chiroeco, 11/3/09
As medical practices nationwide focus on “meaningful use” of EHRs, the American Medical Group Association reports encouraging findings from a survey of AMGA member medical groups. Although few groups have yet to fully achieve all the benefits they anticipated when they began implementation, virtually all groups now have even higher expectations for the potential of health I.T., as a result of their experience.

CMS Encourages EHR Use for Medicare Quality Reporting
Government Health IT, 11/2/09
Health care providers will have the option to use EHR systems to report Medicare quality and e-Prescribing measures to CMS in some of its pay-for-performance programs next year. The revisions are designed to promote adoption and use of EHRs and to provide both eligible professionals and CMS with experience on EHR-based reporting.

Electronic Medical Records Critical to Better Health Care
Fort Worth Business Press, 11/2/09
In a perfect world, an EMR system tracks a patient’s entire health and medical history in a computerized, electronic format which are more easily retrievable than manual systems, and can make a patient’s navigation through the health care system much safer and more efficient. But it’s hardly a perfect world. Even though ARRA has made the promotion of a national, interoperable HIT system a priority, EMRs have not been adopted nearly as quickly as one might expect.

What “Meaningful Use” of Electronic Health Records May Mean to Psychiatrists
Psychiatric Times, 11/2/09
With billions of dollars for EHR technology purchases hanging in the balance, psychiatrists need to be paying attention to HHS deliberations on the definition of “meaningful use.” At meetings with HHS officials, the American Psychiatric Association pointed out the elements of the meaningful use definition were shaped for generalists—not specialists such as psychiatrists, for whom some of the requirements might pose serious adherence problems.

Drummond Group Wants to Certify EHRs
Health Data Management, 11/2/09
Drummond Group Inc., which operates a test laboratory offering interoperability/conformance testing and certification, intends to apply to become a certifying body for EHR systems. HHS expects to publish proposed rules governing the certification of EHR vendors as part of the meaningful use provisions of ARRA, which will include requirements for certifying companies.

EHR Firms: Go with Existing Standards
Health Data Management, 10/30/09
A coalition of EHR vendors is urging the HIT Standards Committee to focus its efforts on achieving implementation of data standards, which the committee already has recommended to federal officials, rather than reopening decisions already made. To speed and simplify implementation of key standards, the industry needs clarity and vendors need a clear understanding of how to implement the standards designated under ARRA, according to the HIMSS EHR Association.

Health I.T. Incentives on HHS IG’s Radar Screen
Government Health IT, 10/30/09
The auditor for HHS will scrutinize a number of the department’s HIT projects over the next 12 months, with a sharp eye toward programs funded by the stimulus law for the adoption of HIT. The HHS Office of Inspector General will check plans by CMS for financial oversight of the incentives and reporting mechanisms CMS will use to determine if providers meet meaningful use requirements.

Norman Digital Health Records Ahead of the Curve
The Norman Transcript, 10/30/09
When Obama proposed a revival of health care by converting outdated paper-based records into modern electronic systems in five years, hospitals around the country began the shift. But Norman Regional Health System foresaw the limitations of paper files a year earlier. Norman digitized its records years ago to improve care and cut costs, by installing a comprehensive MEDITECH EHR system, allowing providers to look at a patient's medical history over a span of time rather than individual encounters.

Breach Rule ‘Not Consistent with Congressional Intent'
Modern Healthcare, subscription required 10/30/09
HHS has pleased some, infuriated others, and stepped into a congressional buzz saw with the imaginative interpretation of statutory language it wrote into an administrative rule to flesh out the federal data breach notification provisions of ARRA. The public-comment period ended on HHS' interim final and obscurely titled rule, “Breach Notification for Unsecured Protected Health Information.”

Blumenthal Doesn't Tip Hand on Meaningful Use, Highlights Non-Financial Aspects of ARRA
Fierce EMR, 10/29/09
At the CHIME Fall CIO Forum, Blumenthal highlighted four things which flow from HITECH: "meaningful use" of EMRs, the Health I.T. Policy Committee and Health I.T. Standards Committee to advise HHS, privacy and security of health data, and the federal subsidy program. Blumenthal said his office is talking with other federal agencies with experience encrypting and securing sensitive electronic data, something which will be hugely important in health care as more patient information is computerized.

Federal CTO: Smart Grid, e-Health Records, and Broadband Need CIO Input
Government Technology, 10/29/09
Federal CTO Aneesh Chopra challenged state CIOs to work more innovatively and collaboratively—and he ticked off a laundry list of issues where state I.T. professionals will play a key role in Obama's innovation strategy. Speaking at a meeting of the National Association of State Chief Information Officers, Chopra said state and local technology executives should be involved in planning for HIEs, smart grids, and broadband initiatives. They also should be helping to spur entrepreneurship and ensure schools can continue to teach in the event of flu pandemic.

Federal Health Information Technology Push to Include Extension Centers
San Bernardino County Sun, 10/29/09
The push to develop a nationally compatible system of EHRs will include aid to states and the creation of a new federal extension service, patterned after the one created for agriculture nearly a century ago. Just as the agricultural extension service centers for decades have helped farmers deal with pesticide, crop, and land use issues, the new health care extension service would help health providers not just get computers, not just store the information, but use the information, according to David Blumenthal.

Panel Seeks Rx for Secure Health Data Exchange
Federal Computer Week, 10/29/09
Health care providers and vendors face many obstacles in implementing a common set of standards for electronically exchanging patient health data nationwide, according to testimony before a federal advisory workgroup. The Health I.T. Standards Committee’s Implementation Workgroup heard from several large and small health plans, hospitals, doctors' practices, and vendors gathering information on how to set standards for secure health data exchange systems.

Doc to Feds: Tighten Standards
Health Data Management, 10/29/09
National standards for health data exchange permit too much variability and must be tightened, a family practitioner told a federal advisory board. The implementation workgroup of the HIT Standards Committee is taking testimony from providers, vendors, quality measures experts, and others on the challenges of implementing health information systems and exchanging data.

ONC Seeks Consumer Views on HIE
Health Data Management, 10/28/09
ONCHIT wants a better idea of how health care consumers feel about the national drive toward HIE. ONC is asking the Office of Management and Budget for approval to conduct computer-assisted telephone interviews with a representative sample of nearly 2,600 individuals across the nation.

Blumenthal Speaks
H&HN, 10/28/09
You can say this about Dr. David Blumenthal: He is certainly passionate about his work and his belief I.T. can transform health care. Blumenthal says the meaningful use rulemaking is focused on three areas, as required by law: e-Prescribing, information exchange, and quality reporting. He also refers to the importance privacy and security will play.

Providers Skeptical of Meaningful Use Reimbursement Process
Healthcare IT News, 10/28/09
Health care providers should be gearing up for reimbursements for meaningful use of health care data under ARRA, but many argue health care I.T. adoption may not be worth the effort. Many of the complaints centered on financial and time barriers to HIT adoption. Providers have asked ONCHIT and CMS to consider expanding and clarifying the requirements for "meaningful use." 

NHIN, Privacy Front and Center at HIT Policy Meeting
Modern Healthcare, subscription required 10/28/09
The head of federal efforts to boost the use of HIT told members of an I.T. advisory panel they need to step back and take a second look at the proposed national health information network, and also come up with some advice on a national policy framework for I.T. privacy and security.

EHR Data Valuable Health System Commodity
AAFP, 10/28/09
According to a report "Transforming Health Care Through Secondary Use of Health Data," secondary patient data gathered in the aggregate from EHRs can help identify health trends, predict outcomes, and influence patient care, drug development and therapy choices. The difficulty is a lack of standards, privacy concerns, and technology limitations may hold back progress.

AHA Stands by Harm Clause in Breach Notification Rule
Modern Healthcare, subscription required 10/28/09
Contrary to assertions from its critics, the AHA says the law requiring hospitals to notify patients of breaches of their confidential health information allows hospitals to gauge the level of potential harm to patients before deciding whether to send out notices. Consumer Watchdog, a Washington consumer advocacy group, says such an interpretation of the law is flawed and too permissive for hospitals, which allow patient information to be breached.

Physicians' Foundation Releases Updated EHR Guide
Modern Healthcare, subscription required 10/27/09 
The Physicians' Foundation has released an updated version of its physician's guide to the installation of EHR systems. “Electronic Medical Record: The Link to a Better Future, 2nd Edition,” includes an extensive updated section backgrounding newbie physicians on the benefits of EHR systems and pending EHR subsidy programs under ARRA.

Electronic Health Record Systems will Require 'Some Form of Oversight,' Government Advisor Says
Genome Web, 10/27/09
As more health care providers move to implement EHRs by 2011, the technologies for storing and managing these vast data sets will need to be regulated, according to John Glaser, senior advisor of ONCHIT. The regulatory oversight for EHR systems is a looming question as hordes of health care providers will be moving to EHR systems in the next five years, urged by the promise of federal funding.

I.T. Loan Guarantees on House Floor
Health Data Management, 10/27/09 
Legislation reported to the floor of the U.S. House of Representatives would authorize $10 billion in federal loan guarantees to aid providers and other health care small businesses in buying HIT products. These would include EHRs to meet meaningful use requirements in ARRA. The health I.T. loan program is part of the Small Business Financing and Investment Act, which would offer a variety of aid to entities in multiple industries.

Hospitals Serving Indigent Have Less Robust I.T.: Study
Modern Healthcare, subscription required 10/26/09
As might have been suspected, there is a digital divide between hospitals disproportionately serving the poor and those hospitals serving the rest of the population, according to the findings of a team of federally supported researchers looking into adoption rates of HIT. Also not surprisingly, hospitals which serve a poorer clientele tend to have lower adoption rates of health I.T.



Wichita Officials Concede Push for Health Exchange to State 
Wichita Business Journal, 11/5/09
HHS is issuing funding to help state’s pay for the transition to HIEs. The goal is to have a complete EHR by 2014. Kansas expects to receive $9 million for the four-year project. Wichita is a key piece of the HIE puzzle because it is a medical hub which draws patients from all over Kansas. While Wichita is not longer leading the charge for a HIE, it still will be a player.

CAeHC, CalRHIO on Short List to Oversee State's HIE 
Healthcare IT News, 11/3/09
California is expected to choose which organization will be the state-designated entity tasked to create a statewide HIEs with ARRA funding. The California eHealth Collaborative believes it's in the best position to deliver connectivity for a state this large. Founded in 2005, CalRHIO is probably most well known in the industry for its work in providing EDs with relevant medical data, an ideal base for the statewide project.

Federal, State Officials Debate Health Care
The Press-Enterprise, 10/29/09
HIT and health care delivery legislation could improve medical treatment and quality and save money, representatives of the nation's leading agencies said. Dr. David Blumenthal and Anne Haddix, chief policy officer of the CDC, discussed steps their agencies are taking to improve health care nationwide.



Medicare Changes PQRI, e-Script Programs 
Health Data Management, 11/2/09
CMS has made several changes in the Physician Quality Reporting Initiative pay-for-performance program and the Electronic Prescribing Incentive Program. CMS will publish the final rule, with a comment period, in the Federal Register.

Officials Cite I.T. as Key to Monitoring the Real-Time Spread of H1N1 Flu
NextGov, 10/28/09
Senior health officials in the Obama administration told a House panel they do not have a real-time picture of the spread of the H1N1 flu strain, a comprehensive view which I.T. could provide to minimize the number of infections from the contagious virus. The nation tracks flu outbreaks through systems at the Centers for Disease Control and Prevention, as well as through networks set up by state and local governments.

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