Archive for the ‘Electronic Health Records’ Category
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
September 04, 2009
If the state’s governor gets his way, Kentucky will soon be home to a statewide electronic health records system. To foster that goal, State Gov. Steve Beshear (D) has created the Governor’s Office of Electronic Health Information.
The state is creating the office to make sure it gets its share of the Obama administration’s stimulus funding package for EHRs, which goes to states who adopt them by 2014.
To get those funds, states are required to create a department that oversees its EMR project. These state offices serve as single points-of-contact for federal and state agencies helping to get the EMR ball rolling. In this case, the office will also work with the state’s three regional health information organizations, healthcare providers, consumers, insurers and the whole kit and kaboodle involved in sharing health data.
It will be interesting to see if any of this comes to fruition. Despite some big talk, RHIOs aren’t going great guns, and getting a state’s worth of EMRs in place by 2014 sounds a tad optimistic at best. But hey, press releases wouldn’t exist if people weren’t optimistic!
Above article published on
September 01, 2009
By Ken Terry While the debate over “meaningful use” of electronic health records rages on, it has been easy to forget the other half of the requirement for getting government health IT subsidies: Physicians and hospitals must use “qualified” EHRs.
Since the passage of the HITECH Act, part of last spring’s stimulus package, there has been speculation that a qualified EHR would have to be certified by the Certification Commission for Health Information Technology (CCHIT), which so far has been the only game in town. But the Health IT Advisory Committee, which advises the Department of Health and Human Services on information technology matters, has decided that there should be multiple certification bodies. All of them would have to certify EHRs under criteria developed by HHS.
According to the work group that made the recommendations approved by the whole committee, CCHIT’s criteria for certification are too detailed and the organization is too close to the industry to be the only certifying entity. Other observers have pointed out that CCHIT is very close to the Healthcare Information and Management Systems Society (HIMSS), a trade association for health IT professionals that include many software vendors among its members. In addition, Mark Leavitt, MD, chair of CCHIT, used to be a HIMSS executive and, before that, led an EHR company. However, there is no evidence that CCHIT’s ties with HIMSS have influenced its approach to certification, which has been implemented by workgroups that include a wide range of industry professionals.
In any case, CCHIT plans to certify EHRs under the criteria that will be established by HHS. Meanwhile, the advisory committee has asked CCHIT to submit a proposal for developing a “Preliminary HHS Certification” process that would allow it to provide preliminary certification to EHR vendors so that providers can begin purchasing qualified products, perhaps as early as October. In addition, the committee approved a plan to grandfather in vendors that have 2008 CCHIT certification, with the proviso that they upgrade their products later.
In a signifier of what this debate is really about, the committee has approved the certification of “open-source” EHRs, which contain non-proprietary code that is available to anyone who wants to use it. The best-known example in the healthcare arena is the VA system’s Vista EHR, which has been available to software developers for a number of years. In addition, the comment about CCHIT’s criteria being too detailed suggests that the committee wants to use looser criteria under which less advanced (and less expensive) EHRs could qualify for government aid.
I applaud this decision on a couple of grounds: First, continuing to tighten criteria for “qualified” EHRs would help a dozen or so vendors consolidate their hold on the market as providers sought EHRs that could garner government aid. Second, physicians don’t need all of the bells and whistles in current EHRs to improve health care. Relaxing the criteria in certain respects would help the development of nontraditional community EHRs, including those linked to disease registries, that might serve the purpose better. But as HHS develops its criteria, it should bear in mind that the EHRs that are qualified for government subsidies must also help doctors demonstrate meaningful use.
Above article published on http://industry.bnet.com/healthcare/10001008/hhs-will-choose-criteria-for-ehr-certification/
September 01, 2009
The Certification Commission for Health IT is moving forward on plans to launch a less comprehensive certification program that will focus solely on compliance with the “meaningful use” requirements of the federal economic stimulus package, Health Data Management reports.
Under the stimulus package, hospitals and physicians who demonstrate meaningful use of electronic health records will qualify for Medicare and Medicaid incentive payments.
Although the federal government is not expected to issue a final definition for meaningful use until next spring, CCHIT aims to launch its new certification program in October.
CCHIT Chair Mark Leavitt said the commission will base its new program on preliminary recommendations from federal health IT advisory committees. He said this will allow health care organizations to purchase and implement EHR systems in time to receive the maximum incentive payments.
Leavitt added that CCHIT also plans to update and expand its current comprehensive EHR certification system for ambulatory, emergency department and inpatient settings (Anderson, Health Data Management, 8/25).
Recent Certification Changes
Earlier this month, the Health IT Policy Committee adopted recommendations that called for multiple entities to certify EHR systems. The certification and adoption work group said it envisions the establishment of 10 to 12 different EHR certification groups, in addition to CCHIT.
The Policy Committee also proposed a transition plan to help health IT vendors develop products that meet the 2011 meaningful use requirements.
Under the “Preliminary HHS Certification” process, CCHIT likely would provide interim certification for EHR vendors. The plan would invite CCHIT to submit a proposal for developing the preliminary certification process (iHealthBeat, 8/17).
Above article published on
September 01, 2009
By Neil Versel
Lest the health IT industry be stuck with competing standards yet again, National Coordinator for Health IT Dr. David Blumenthal says he intends to harmonize standards for “meaningful use” of electronic health records within the framework of the planned Nationwide Health Information Network. Speaking at a users group for NHIN-Connect, the open-source software that supports NHIN development, Blumenthal said that federal standards for “meaningful use” of EHR software must be compatible with the national network. Meaningful use is the benchmark by which healthcare organizations will qualify for federal health IT subsidies beginning in 2011.
“NHIN can provide a path for meaningful use,” Blumenthal said, according to Federal Computer Week. The stimulus law requires meaningful use to include the ability to exchange patient-specific data. “Given the federal investment in health IT, and the definition of meaningful use, it is clear there is a vibrant future for the NHIN,” Blumenthal said. “Our hope is that it will support health information exchange and meaningful use at the federal, state and local levels.”
Above article published on http://www.fierceemr.com/story/blumenthal-wants-meaningful-use-standards-work-nhin/2009-07-02
August 26, 2009
The Certification Commission for Health Information Technology is moving forward with plans to launch a new, less comprehensive electronic health records software certification program in light of the federal economic stimulus package.
In October, the commission plans to launch a more limited, modular inspection program for EHR software, focusing only on compliance with standards required for “meaningful use” of EHRs under the American Recovery and Reinvestment Act.
Rather than wait for the federal government’s final rule defining “meaningful use” of EHRs next spring, CCHIT is moving forward with its new certification efforts based on preliminary definition recommendations from federal HIT advisory committees, says Mark Leavitt, M.D., the commission’s chair. That’s because providers will have limited time to select and implement EHRs by 2011 to qualify for maximum Medicare and Medicaid incentive payments under ARRA.
CCHIT also will continue to update and enhance its existing, more comprehensive, EHR certification system for ambulatory, inpatient and emergency department settings, Leavitt said.
The Chicago-based commission will hold an online “town hall” meeting at noon September 3, when electronic health records vendors can learn about and discuss the two CCHIT certification efforts.
The commission’s action comes after the federal HIT Policy Committee’s certification/adoption workgroup recently recommended that multiple organizations offer “HHS Certification” testing of EHRs for the incentive program. The workgroup, in making its recommendation, said that CCHIT’s existing, comprehensive certification of EHRs should not be a requirement for incentive payments. Instead, software should be certified solely for achieving the minimum set of criteria to meet ARRA’s “meaningful use” standard, according to the workgroup.
But federal regulators have yet to make a final decision on a certification approach, much less designate whether CCHIT, or other organizations, will be the government’s recognized certification bodies.
Above article published on http://www.healthdatamanagement.com/news/CCHIT-38877-1.html
August 21, 2009
By Ken Congdon, Healthcare Technology Online
In my coverage of the healthcare technology industry, I’ve noticed that many software and hardware vendors, clinicians, and even some analysts tend to use the terms EMR (electronic medical record) and EHR (electronic health record) interchangeably. However, according to the National Alliance for Health Information Technology (NAHIT), there is a distinct difference between the two.
The NAHIT defines EMR and EHR as follows:
EMR — The electronic record of health-related information of an individual that is created, gathered, managed, and consulted by licensed clinicians and staff from a single organization who are involved in the individual’s health and care.
EHR — The aggregate electronic record of health-related information of an individual that is created and gathered cumulatively across more than one healthcare organization and is managed and consulted by licensed clinicians and staff involved in the individual’s health and care.
In other words, an EMR is a somewhat siloed record of a single diagnosis or treatment, most likely used by a single practice or specialist. Meanwhile, an EHR is a more comprehensive record that is interoperable with and compiles information from multiple medical providers’ systems.
Don’t Judge A Software Package Based On Name Alone
Despite the NAHIT definitions, it’s obvious that the industry is still unclear on how to delineate EMRs from EHRs. For example, some software vendors brand their technologies as EHR platforms when, in reality, they don’t provide interoperability capabilities and would therefore be more accurately marketed as EMRs. At the same time, other vendors brand their products as EMR packages when they actually provide more comprehensive EHR frameworks. In fact, analysis of software packages currently on the market indicates that the latter is more likely to be the case, as most clinical records software vendors tend to brand their products as EMRs as opposed to EHRs. However, the term EHR does seem to be gaining popularity as it is the phrase used by President Obama in his healthcare stimulus talks and is the prominent terminology used in the American Recovery and Reinvestment Act of 2009 (ARRA).
Knowing that the terms used to brand clinical records software aren’t always accurate, you must dig deeper to ensure a software platform you’re assessing is equipped to meet the needs of your facility and your patients. Criteria to consider when evaluating EMR/EHR software include:
If you purchase a system that matches your requirements, it should provide a speedy ROI regardless of whether or not it is “technically” branded correctly.
Above article published on http://www.ecmconnection.com/article.mvc/EMR-Or-EHR-Whats-In-A-Name-0001
August 21, 2009
Filed Under (EHR, Electronic Health Records) by admin
By David Blumenthal, National Coordinator for Health Information Technology
A Message from Dr. David Blumenthal, National Coordinator for Health Information Technology
In my role as National Coordinator for Health IT, I have the privilege to be part of a transformative change in health care that will help to extend the benefits of health information technology (HIT) to all Americans. With the passage earlier this year of the Health Information Technology for Economic and Clinical Health (HITECH) Act, we have the tools to begin a major transformation in American health care made possible through the creation of a secure, interoperable nationwide health information network.
Of course, this system is not an end in itself. Rather, it will enable countless other improvements in the quality and efficiency of health care that will make Americans healthier and their economy stronger.
My personal belief in this transformation is not based on theory or conjecture. As a primary care physician for over 30 years, I spent the first twenty shuffling papers in search of missing studies and frequently hoping, during middle-of-the-night emergencies, that I knew enough about patients’ medical histories to make good decisions. All that changed when I began to have access to patients’ electronic medical records. It made me a much better doctor. I would never go back, and neither would the vast majority of American physicians who have made the leap into the electronic age.
In fact, it would be hard for any health professional today to escape the conclusion that the antiquated, paper-dominated system we now have in place isn’t working well for patients, creates added costs and inefficiencies, and isn’t sustainable. As we look at our nation’s annual health care expenditures of approximately $2.5 trillion, there are many ways our current system fails both patients and providers. It is clear that change is necessary.
But how and why is nationwide electronic health information exchange so critical to achieving such change? Most importantly, because it provides the best opportunity for each patient to receive optimal care. The technology will make patients’ complete medical information securely and reliably available to health care providers where and when it is needed – when clinician and patient are together facing medical decisions that can make a lasting difference.
Better, faster, more reliable and efficient care also ultimately reduces system-wide costs by delivering results that help to avoid expensive or prolonged hospitalization from delayed or ineffective treatment, avert costly and sometimes fatal adverse events and unnecessary procedures, and can help to eliminate the onset of disease by better informed management of each patient’s health.
The goal of assuring an electronic health record for every American is daunting. We at the Office of the National Coordinator for Health Information Technology (ONC) do not pretend otherwise. We know this will be hard for some clinicians and hospitals, and we stand ready to help with resources provided by the Congress and the Administration.
We also recognize that we cannot achieve the benefits of a nationwide health information system unless we can assure all Americans that their personal health information will remain private and secure when this system exists. Putting into place safeguards for the privacy and security of this information, when it is in electronic form, will be an ongoing priority that influences and guides all of our efforts.
In the days, weeks, and months ahead, we will be rolling out a number of pivotal initiatives called for under the HITECH Act. I urge you to join and support us as we lay the foundation for every American to benefit from an electronic health record, as part of a modernized, interconnected, and vastly improved system of care delivery. We at ONC will be making every effort to keep you updated and fully engaged in all the steps of this national journey.
Above article published on
August 21, 2009
Filed Under (EHR, Electronic Health Records) by admin
Health care providers and health IT vendors should consider legal issues as they begin to transition to electronic health record systems, experts said at the American Health Information Management Association’s third annual Legal EHR Summit, Modern Healthcare reports.
Health Record Ownership
EHR technologies have started to alter discussions on health record ownership, experts said.
In the past, health care providers generally had exclusive ownership of a patient’s paper medical record. However, state and federal regulations are beginning to grant patients greater rights to access and modify their health records.
George Schroeder, director of risk management and medical network services at Cedars-Sinai Health System, said legal constructs for EHR ownership are similar to a trustee model. He explained that health care providers can function as trustees because they act on behalf of themselves and their patients. He said, “You have to have a balance between competing rights and competing responsibilities.”
Legally Defensible EHRs
Experts at the conference also noted that most EHR systems on the market cannot produce a legally defensible health record because they do not track when people access and modify the records.
Linda Kloss, AHIMA CEO, said many vendors have not focused on developing legally defensible EHR systems. In addition, health care providers have not created a demand for such functionality.
Kloss said the annual summit aims to counter vendor inattention to the importance of legal EHRs. She added that AHIMA will pressure policymakers to include auditing requirements in certification criteria for EHRs (Conn, Modern Healthcare, 8/18).
HIPAA Enforcement
Kirk Nahra, an attorney in Washington, D.C., said the federal economic stimulus package imposes stricter enforcement guidelines for the HIPAA privacy and security rules.
Nahra said the stimulus package sets penalties of $25,000 to $1.5 million for violations of patient data restrictions. The stimulus package also grants state attorneys general the authority to enforce HIPAA rules.
Nahra noted that the stimulus law also requires software vendors and other health care business partners to alert consumers about security breaches. He said he expects health care providers to revise vendor contracts to reflect the new provisions (Anderson, Health Data Management, 8/18).
Above article published on
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