Archive for the ‘Electronic Health Records’ Category
November 25, 2009
We’re in an unprecedented boom in health IT, thanks mostly to growth in the EMR/EHR sector.
A new report from Scientia Advisors says health IT is the fastest-growing segment of what the Cambridge, Mass., management advisory company calls a $1 trillion global healthcare products marketplace. Health IT currently is growing at an 11 percent annual rate, and solid growth should continue at least through 2013, which would be the third year of the federal EMR stimulus program here in the States, the Scientia report forecasts. In that time frame, health IT will increase its market share by a quarter, to 5 percent of global healthcare products sales from the current 4 percent.
In the U.S., according to Scientia, the bulk of the spending will come from inpatient and outpatient EMRs, thanks to the American Recovery and Reinvestment Act. “Clinical decision support systems (CDSS) will likely have a profound impact on clinical diagnostics and therapeutics,” the report says, according to InformationWeek. Some of the growth likely will be at the expense of specialty and departmental systems, however.
Established EMR vendors should benefit most from the increased spending. “Leading players with large installed bases, proven products, and streamlined routes to meaningful use of EHRs are likely to gain share,” Scientia says. However, the research firm says “disruptive innovations” like open-source software and new applications of software-as-a-service could drive down prices, as might new competition from emerging markets in Asia and elsewhere.
Above article published on http://www.medicexchange.com/EMR/emr-likely-to-boom-throughout-2013.html
November 25, 2009
By Neil Versel
Without EMRs, PHRs and health information exchange, the patient-centered medical home may not be bound to fail, but it certainly is difficult to establish and maintain. “IT is really the key to supporting the doctor/patient relationship and making it more efficient, safer and more effective,” Dr. Paul Grundy, president of the Patient-Centered Primary Care Collaborative, tells Health Data Management. The Washington-based organization advocates the medical home, under which a primary-care physician manages and coordinates care on behalf of patients, with an eye toward prevention and management of chronic diseases.
It may be a challenge to implement the medical-home model under current reimbursement systems, but until payers start rewarding physicians for keeping patients healthy, IT may be the best avenue. EMRs with clinical decision support, PHRs that help patients monitor their own conditions and health information exchange to support care coordination all can help establish a team approach to care and treatment, HDM reports.
“This is simply about restructuring the way healthcare is delivered to catch the efficiency of technology,” adds Grundy, who also is director of heathcare transformation at IBM.
Above article published on http://www.fierceemr.com/story/emrs-phrs-hie-necessary-support-patient-centered-medical-home/2009-11-12
November 13, 2009
By Kenneth Corbin
Sen. John Kerry is continuing his push to accelerate the adoption of electronic medical records.
The Massachusetts Democrat on Tuesday introduced legislation to spur family doctors and small-scale practitioners to migrate their paper records to digital format, a goal that most everyone agrees would improve care and lower costs, but one that entails a significant initial expense.
“Electronic medical records and prescriptions are the common sense solution to restricting costs, reducing errors and reforming a broken system,” Kerry said in a statement. “Doctors don’t need convincing — they’ve seen the results.”
Kerry’s bill, the Small Business Health Information Technology Financing Act, would make small-scale doctors eligible for grants from the Small Business Administration to move to electronic records.
“This legislation helps small practices acquire the technology that will allow them to be more efficient and to focus on patient care,” Kerry said.
The federal government has already made it clear that digital records are a priority, earmarking $19 billion for the cause in the February stimulus bill.
In 2007, Kerry introduced legislation to push doctors use digital systems when issuing prescriptions. The 2008 Medicare bill passed with provisions establishing a timetable offering bonus payments to early adopters of the technology, and eventually phasing in penalties for the laggards who continue issuing paper prescriptions.
Above article published on http://blog.internetnews.com/kcorbin/2009/11/kerry-backing-bill-to-boost-el.html
November 11, 2009
The healthcare IT marketplace is growing by 11% annually, which will likely continue through 2013, says a study from Scientia Advisors.
By Mitch Wagner, InformationWeek
Health information technology (HIT) is the fastest growing segment of the $1 trillion global health care marketplace, and is poised to continue its impressive growth through 2013, according to a study released Tuesday.
The health IT marketplace is showing 11% combined annual growth rate, which is likely to continue over the next four years, according to a study from Scientia Advisors, a management consulting firm.
To remain competitive, vendors must take into account government incentives, requirements for clinical decision-making and electronic health record systems, and emerging competitors in Asia and elsewhere in the developing world, the study said.
Health information technology will grow from 4% of the worldwide health care products market to 5% — a 25% increase in HIT market share, Scientia said.
HIT spending in the US will focus on inpatient and outpatient electronic health records systems, at the expense of specialty and departmental information systems and other capital investments, Scientia said.
“Leading players with large installed bases, proven products, and streamlined routes to meaningful use of EHRs are likely to gain share,” Scientia said.
Some small hospitals may choose lower risk, lower cost approaches such as remote hosting. Given the economic slowdown, vendors will lend hospitals capital to finance HIT investments.
“Clinical decision support systems (CDSS) will likely have a profound impact on clinical diagnostics and therapeutics,” Scientia said.
Also, “over the long term, disruptive innovations such as open source software and ’software as a service’ could lead to dramatically lower pricing,” the company said.
Above article published on http://www.informationweek.com/news/healthcare/EMR/showArticle.jhtml?articleID=221601057&subSection=News
September 17, 2009
Filed Under (CCHIT, EHR, EMR, Electronic Health Records, Electronic Medical Records, Health) by admin
By Joseph Conn / HITS staff writer
The Certification Commission for Health Information Technology is adopting a two-tier system of testing and certifying IT systems.
In a conference call with vendors and developers of health IT systems Thursday, CCHIT Chairman Mark Leavitt announced the not-for-profit organization’s new testing program, as the group readies itself for the new realities of the healthcare IT market since passage of the American Recovery and Reinvestment Act of 2009.
One testing and certification program, dubbed Preliminary ARRA 2011 Certification, will specifically test for compliance with what is expected to be—at least initially—a fairly limited set of criteria that HHS and the CMS will use to determine eligibility by hospitals and office-based physicians for an estimated $34 billion in federal subsidy payments for the purchase of EHRs under the stimulus law.
The other, the so-called CCHIT Certified 2011 testing program, will use an elaborate set of about 300 criteria, primarily developed by the organization since its founding, that will closely resemble previous CCHIT testing and certification programs. The core CCHIT criteria will be tweaked to ensure systems that pass muster for its more advanced testing program also will meet ARRA requirements.
When it began testing IT systems in 2006, and on through 2008, CCHIT had offered just one, gold-standard set of criteria for each type of EHR system it tested—ambulatory EHRs or inpatient EHRs, for example.
But by April, CCHIT announced it would halt further testing to adapt its systems to accommodate the stimulus law criteria, development of which remains a work in progress. At the time of the announcement, Leavitt said the organization would keep its full-featured certification program, but would add two new testing and certification regimes scaled down to meet the minimum requirements of the stimulus law.
One new program would have tested IT systems by “module” against the new criteria under the recovery act, which requires providers to put “certified” EHR systems to “meaningful use” in order to qualify for federal subsidy payments. The proposed new modular approach was expected to appeal to some physician office practices and, more commonly, to hospitals, that want to piece together a comprehensive IT system from component parts produced by multiple IT vendors.
The other new CCHIT regime would have offered “on-site” testing and certification of EHR systems—again, against the less stringent stimulus law criteria with an eye toward qualifying for federal subsidies. This form of testing would have been conducted on systems installed at physician offices or hospitals. It was an approach targeted to appeal to providers who have developed their own EHRs or planned to assemble an EHR from noncertified sources, and to the open source development community, according to CCHIT.
According to Leavitt Thursday, CCHIT’s testing scheme will be modified again, but only somewhat. While site certification has been dropped as a certification scheme in and of itself, “site certification is still there,” Leavitt said. “In Preliminary ARRA Certification 2011, you can get a product or a site certified.”
Leavitt said it’s unclear whether providers adopting EHRs that have passed the test under the more rigorous CCHIT Certified 2011 program would want on-site certification, but if there is demand for the service, CCHIT will provide it.
Starting in June and running through its latest report in August, the HIT Policy Committee, which was created under the recovery act, has issued three sets of recommended definitions of meaningful use. Some of those recommendations have been controversial. To have market relevance, however, any program of certification of EHR systems that CCHIT develops must take those meaningful use standards into consideration to ensure that certified systems will enable providers to meet meaningful use standards and qualify for federal subsidies. The meaningful use standards, ultimately, will be developed by the CMS, which is tasked with running the bulk of the EHR subsidy program through Medicare and Medicaid.
In addition, CCHIT has to keep an eye on the Office of the National Coordinator for Health Information Technology at HHS, which, on behalf of the HHS secretary, will issue its own certification criteria for EHR systems, since, to qualify for subsidies under the stimulus law, providers also have to use “certified” EHR systems. Leavitt said CCHIT is forecasting ONC will issue its final rule on certification standards by Dec. 31 this year and that they probably will be the same or perhaps even less stringent than the recommendations the HIT Standards Committee made to ONC in August.
“We believe the final requirements will be the same as or less stringent that the current recommendations,” Leavitt said.
Both CCHIT testing and certification programs will open for vendor applications Oct. 7. Duration of certification is expected to run though Dec. 31, 2012, when certification criteria under the ARRA are expected to be ratcheted up, becoming both more numerous and more stringent.
Fees for certifying systems will vary with the certification scheme and the product, according to CCHIT Executive Director Alisa Ray. Under the CCHIT Certified 2011 program, the fee to a vendor to certify an EHR is $37,000 for either an ambulatory-care or an emergency department system, $49,000 for an inpatient system and $18,000 for an electronic prescribing system. Annual renewal costs are $9,000 for each, except e-prescribing, which is $7,000.
For Preliminary ARRA 2011 Certification, costs are pegged to the number of modules being tested, with fees set at $6,000 for one or two modules, $10,000 for three to five, $15,000 for six to 10, $24,000 for 11 to 20 and $33,000 for more than 20. Annual updates range from $1,000 to $5,000.
According to EHR vendor representative Justin Barnes, who listened in on Thursday’s CCHIT call, CCHIT probably has hit on the right strategy by launching its new testing and certification program this fall, based on an educated guess at what the government’s criteria might be, but before the final rules are published. Barnes is the chairman of the Electronic Health Record Association, and a vice president overseeing corporate development, marketing and government affairs for Greenway Medical Technologies, a Carrolton, Ga.-based EHR system developer.
“The detail that we have right now around meaningful use, you really can’t write a product to it,” Barnes said. “The interim final rule will come down at the end of this year. I think that will be a fairly close definition that we could follow. I think it will be plenty to work off of. The certification process, I believe, will be tweaked a little bit as well.”
Barnes said he hopes Leavitt is right when he predicts the ONC and the CMS will not vary too far from the current recommendations in writing the preliminary rules. He also said he hopes they don’t dally in unveiling their preliminary rules so everyone involved, both EHR vendors and users, have time enough to act.
“If there are any discrepancies, that could pose an interest to some people if you have to do heavy product development,” Barnes said. “It takes 12-plus months for the product cycle to add functionality on the ambulatory side and 18-plus months on the inpatient side. There is a word of caution here. That’s why we’ve urged ONC to move on this as fast as they can.”
Above article published on http://www.modernhealthcare.com/article/20090904/REG/309049989/0
September 17, 2009
Filed Under (EHR, EMR, Electronic Health Records, Electronic Medical Records, Health, Health IT, Hospital) by admin
By Don A. Solberg, MD, Kathryn L Houck and Jim Roberts
Successful electronic health record (EHR) adoption not only improves quality of care by making patient information easily accessible, it also provides valuable clinical decision support. In addition, organizations benefit from streamlined operations — enabling physicians to spend less time on charting and documentation, and more time engaging in face-to-face interactions with patients.
Despite these obvious advantages, however, many physicians are resistant to adopting EHR systems.
A number of factors account for this resistance. First and foremost, organizations are leery of the cost and disruption that can sometimes accompany the conversion from manual to automated processes. Second, a portion of older physicians — who often serve as the leaders in an organization — are typically less comfortable with new technologies than their younger counterparts. And finally, some physicians believe that taking the time to electronically document patient visits will negatively impact patient interaction because it means spending time in front of a computer screen rather than with the patient.
Kittitas Valley Community Health Information Network is an electronic information-sharing partnership linking 30 providers — about 90 percent of all primary care providers in the county — from seven locations. When we implemented our EHR system in 2007, we utilized several strategies that proved instrumental in overcoming anticipated obstacles and ensuring successful adoption:
1) Locate a physician champion. When identifying champions, we looked for those physicians who had a track record of adopting new technologies, were able to maintain positive attitudes despite occasional setbacks and, most importantly, were well-respected by their peers. These champions could clearly articulate the goals and enthusiastically promote the benefits of a fully functioning EHR system to other physicians — helping to encourage even initially skeptical providers to get onboard.
2) Set honest, realistic expectations for physicians and their staffs. The more complex and sophisticated an EHR system, the more challenges a practice might experience in the early stages of implementation. However, we found the potential productivity gains and cost savings ultimately outweighed any inconveniences. By ensuring that everyone understands that there will be a learning curve and that they will experience some growing pains on the front end, you can alleviate frustration and set a positive tone post-implementation.
3) Ask each location to designate a physician, nurse and administrative user to participate in several days of training with the EHR vendor. These “super users” were then available to help others navigate the EHR system, reducing the need for support while building staff camaraderie.
4) Prepare for the transition. In our case, each location went to an abbreviated schedule for two weeks — scaling back patient volume so that physicians and administrative staff would have adequate time to train on the new system. In hindsight, we would recommend that organizations allow a full month for staff to get comfortable and then gradually add back patient visits each week. For example, a practice might take four patient slots out of both the morning and afternoon schedules during the first week, three slots during the second week, two during the third week, and so on. Providing staff members with the opportunity to use the system while performing their daily routines enables them to learn at a comfortable pace.
5) Use a staged rollout. We did not do this during our initial implementation, but have used it several times with processes and changes adopted since. Within each location, two to three physicians, who were committed to the EHR system and willing to work through any stumbling blocks, were selected for initial implementation. Working with fewer physicians at the onset enabled the implementation staff to provide a strong support system, and helped ensure that any issues or concerns were resolved early in the deployment process. Once the first few physicians went live in each location, other providers were added two at a time. That way, each successive group of physicians could seek guidance from colleagues who were already using the system and could witness firsthand the successful utilization of an EHR system.
As an increasing number of health care organizations take advantage of the dollars offered by the American Recovery and Reinvestment Act to deploy EHR systems, it will become even more important to ensure timely and successful adoption of these systems. By setting realistic expectations among key stakeholders, identifying hurdles early and putting plans in place to proactively deal with any challenges that may occur, the likelihood of a smooth transition is significantly increased.
Above article published on http://health-care-it.advanceweb.com/editorial/content/editorial.aspx?cc=202207&CP=2
September 15, 2009
Bernie Monegain, Editor
The Certification Commission for healthcare information technology has announced that it will launch new certification programs on Oct. 7.
CCHIT officials announced Tuesday they will offer an updated comprehensive electronic health record certification program, called CCHIT Certified 2011, as well as a modular certification program – called Preliminary ARRA 2011 – that is limited to the standards for qualifying EHR technology under the American Recovery and Reinvestment Act (ARRA).
“There is a high risk that providers would not achieve meaningful use to qualify for the ARRA incentives in 2011 and 2012 if they wait until late 2010 to implement certified EHR systems and technologies,” said Mark Leavitt, MD, chairman of the commission. “On our town call Sept. 3, which drew over 700 attendees, we received valuable feedback on our proposed programs and a strong indication of interest from health IT companies and developers in applying for timely certification under these programs.”
Leavitt said the commission has followed the recommendations of the health information technology advisory committees to the Office of the National Coordinator (ONC) and believes there is sufficient information to offer preliminary ARRA certification.
HHS criteria and standards are slated for publication by the end of 2009. Final rules on meaningful use are expected in the spring of 2010.
If that process results in the introduction of new requirements, the commission will offer vendors with preliminary certifications an incremental inspection at no additional fee to bring their certifications into alignment with the final rules.
The commission’s certification materials, including criteria, test scripts and certification policies for both programs, will be published Sept. 24 on the CCHIT Web site. Applications for certification will open online on Oct. 7.
To help HIT companies and developers to make 2011-certified EHR technology available to providers, the commission is offering a workshop in the Chicago area on Oct. 1. The workshop, Get Certified 2011, is designed to orient companies and developers to the new certification process and help them use the new certification program tools effectively.
Above article published on http://www.healthcareitnews.com/news/cchit-poised-begin-new-certification-programs
September 09, 2009
Experts say success hinges on the outcomes of these decisions
By Alice Lipowicz Former President George W. Bush urged doctors and hospitals to go digital on their own, with a few booster shots of federal help. Consequently, progress was slow. But the pace of change has been increasing since President Barack Obama has made health IT a priority and Congress put some real money on the table. Under the economic stimulus law passed earlier this year, as much as $45 billion will be distributed to health care providers who buy and use approved electronic health record systems.
The road ahead is still bumpy for EHRs, but experts say success hinges on the outcomes of five major decisions.
1. Strong standards or wiggle room? Officials at the Health and Human Services Department have the daunting task of creating a framework for certifying EHR systems that are capable of collecting and sharing patient data in ways that satisfy the broader goals of the stimulus law. A critical question is whether HHS can strike the right balance between strong rules and flexibility.
“There is always a trade-off between innovation and any kind of a certification process,” said Wes Rishel, a vice president and distinguished analyst at Gartner’s health care provider research practice.
2. Broaden the meaning of “meaningful use?” In the stimulus law, Congress said only doctors and hospitals that show meaningful use of EHRs can receive incentive payments. That language was meant to prevent the buying of systems that sit idle or are not used as intended. Key decisions for HHS are how broadly and stringently to apply the meaningful-use framework to meet major goals, such as cost savings, improved care and better public health.
3. Take baby steps or giant leaps forward? To help HHS meet its fast-approaching deadlines, an advisory committee urged the agency to immediately set up a temporary program that would allow an existing organization to certify vendors’ EHR systems until more permanent arrangements could be made.
Dr. Carol Diamond, managing director of the Markle Foundation’s Health Program, said HHS should allow the same sort of flexibility for providers to meet EHR-use goals. Some are already using EHRs, but others lag far behind, she added. “We still live in the real world,” she said. “You cannot get up to speed all at once.”
4. Let the states lead the way on data exchange? The ultimate goal of health information technology is the automatic sharing of patient data. The reasoning goes that if providers exchange patient data with government agencies and one another, analysts can identify trends and send the results back to doctors and hospitals to help them provide better care and reduce costs.
For now, a little sugar is making the medicine go down easier — such as the $564 million in state grants for health information exchanges that HHS announced in August. But the agency still has a key decision to make on the federal government’s role in creating that data network.
“You have to either grow the state exchanges that will be connected or try to seed from the top,” said Deven McGraw, director of the Center for Democracy and Technology’s Health Privacy Project.
5. Wait for broader health reforms or forge ahead? Dr. David Blumenthal, HHS’s national coordinator for health IT, said he hopes to strike a balance between incentives and penalties for EHR use. The rules must foster competitiveness, innovation, privacy and security, among other often-conflicting goals. But decisions are also looming about how hard HHS should push for health IT in advance of more comprehensive reforms that will affect health care access and payments.
“If we do not do the work on payment reforms, we will not really reap all the value of health IT,” McGraw said.
Above article published on http://fcw.com/Articles/2009/09/07/FEDLIST-5-steps-to-EHR-success.aspx?Page=1
September 09, 2009
ScienceDaily — A new framework of recommendations created by health informatics researchers may help doctors and hospitals prepare for a federal initiative to expand the use of electronic health records (EHRs).
The recommendations from faculty at The University of Texas Health Science Center at Houston, the Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine appear in a commentary in the Sept. 9 edition of JAMA, the Journal of the American Medical Association.
“With high-quality, well-designed, and carefully implemented systems, highly-reliable, safe health care will be achieved,” said Dean Sittig, Ph.D., commentary author, associate professor at The University of Texas School of Health Information Sciences at Houston and member of The University of Texas - Memorial Hermann Center for Healthcare Quality and Safety.
The American Recovery and Reinvestment Act of 2009 created approximately $20 billion in incentives for individuals and organizations to “meaningfully” use electronic health records beginning next year. Previous studies report that 4 percent of physicians in the outpatient setting and 1.5 percent of U.S. hospitals have a comprehensive electronic health record system.
“This framework can help make sure that electronic health records are used safely and effectively as doctors continue to adopt them,” said Hardeep Singh, M.D., M.P.H. co-author and assistant professor of medicine and health services research at the VA Health Services Research and Development Center of Excellence and Baylor in Houston.
This framework of recommendations proposed by Sittig and Singh provides guidance for key stakeholders who are either currently involved or who will soon be involved with electronic health records.
“While using electronic health records, we not only have to consider issues related to technology, but also issues related to people who use them, how they interact with technology and how the electronic health record fits with the work flow of the clinic or organization that adopts it,” said Singh, who noted that if the Computerized Patient Record System developed by the Department of Veterans Affairs was included in the EHR-use study, the percentage of U.S. hospitals with a comprehensive electronic health record system would nearly double to 2.9 percent.
VA’s electronic health record system covers many aspects of patient care, including reminders for preventive health care, electronic entry of orders, display of laboratory test results, consultation requests, and pathology and imaging studies.
“The American Recovery and Reinvestment Act stipulates that clinicians and healthcare organizations can receive incentive payments for ‘meaningful use’ of EHRs. Depending on the definition and timeline for ‘meaningful use,’ this legislation could result in a rush to implement sub-optimal systems,” said Sittig, co-author of a new book that addresses EHR issues and is titled “Clinical Information Systems: Overcoming Adverse Consequences.”
For Americans to realize the full potential of electronic health records, which include reduced cost, less duplication and greater quality, Sittig and Singh believe all eight essentials, which are based on a systems engineering model for patient safety, should be followed.
“These issues are essential to maximize patient care benefits and minimize unintended errors from technology,” Singh said.
The commentary is titled “Eight rights of safe electronic health record use.” The authors received support from the National Library of Medicine, the VA National Center of Patient Safety, the Houston VA Health Services Research and Development Center of Excellence and the Agency for Health Care Research and Quality.
Above article published on http://www.sciencedaily.com/releases/2009/09/090908193440.htm
September 07, 2009
By Mary Mosquera
The Centers for Medicare and Medicaid Services (CMS) plans to test its ability to accept selected clinical quality data directly from hospital electronic health record systems as early as July 2010.
CMS said it would seek volunteer hospitals to report stroke, blood clot and emergency department measures of care via EHR systems as part of the Reporting Hospital Quality Data for Annual Payment Update program, which provides higher Medicare payments to hospitals that report quality measures to the agency.
The agency detailed the plans in the Aug. 27 Federal Register in announcing changes to its rule for the Reporting Hospital Quality Data for Annual Payments Update. The program, a provision of 2003’s Medicare prescription drug legislation, required hospitals by 2010 to report on 42 quality measures to receive additional incentive payments.
Reporting to CMS is generally paper-based or through a mix of manual and automated systems.
Participating hospitals and their vendors will have to be able to transmit clinical EHR data that adhere to interoperability standards, such as cross document sharing, cross community access, clinical data architecture and Health Level 7 version 3, CMS said.
CMS has encouraged hospitals to adopt EHRs that can report quality data directly to a CMS data repository. Ideally, the use of EHR systems would improve the quality of care by providing physicians with pertinent clinical data as they were treating patients.
“The testing of EHR submission is an important and necessary step to establish the ability of EHRs to report clinical quality measures and the capacity of CMS to receive such data,” the agency said in the published interim rule.
The reporting of selected quality measures is also a key provision of the stimulus law. The Health IT Policy Committee, led by Dr. David Blumenthal, the national coordinator for health IT, has recommended that quality reporting be a part of the criteria providers must meet to demonstrate meaningful use of electronic health record systems, CMS said.
The stimulus law authorized Medicare and Medicaid incentive payments to providers who prove they are meaningful users of health IT starting in 2011.
Above article published on http://www.govhealthit.com/newsitem.aspx?nid=72031
|
|