Archive for the ‘Health IT’ Category
December 18, 2009
By Shrinivas Kanade
Do you think 24 hour accessibility to your patients’ data is one of the advantages of electronic medical records? Yes! To know more about the advantages of electronic medical records, Read on…
One of the main advantages of electronic medical records is that it helps in centralizing the data of your patient. Not long in the past, a receptionist working in a clinical practice could leave for the day, only after finding and arranging the records, that are committed to the papers of the patients on the next day’s appointments’ list. If she failed to do so, or if she failed to turn up on time due to some kind of emergency, then what would rule the medical practice. Confusion! She is the one who knew, precisely, which stack of records contains the bunch of papers that represents so and so patient. The use of electronic medical records gets over this problem. Let’s go over the other electronic medical records benefits.
What are the Advantages of Electronic Medical Records?
In its digital form, the electronic medical records offer you an opportunity to run a clean and paperless clinic. If you decide to go digital, you may find that there are two options available to you.
Standalone Software The first option is to ask a computer programmer to develop a standalone software for you, which you could install in the computer in your office. In this case, your patients’ data, in its electronic form, will be stored on the computer system in your office. You will have to take care of the data. The data safety, proper backing of the data to protect it from getting lost and virus problems will be the responsibility of your clinic, since the data is present at your end.
Online Software Else, you could use an online EMR software. If you choose this option, your patients’ data will be stored on the Internet. It will be stored in the computers maintained by the IT company which is providing their online software to you, naturally for a monthly fee. This IT company and the computer experts employed by it, will take care of the data and deal with your problems while using it.
Electronic Medical Records Electronic medical records, which are also referred to as EMR, contains private and medical data related to your patients. It may also contain information, such as their past medical history, substances or drugs they are allergic to, the treatments or medical procedures they underwent in the past. The data may also inform you which medications the patient is currently on and the transcription notes etc. Comprehensiveness in the patients’ data is one of the advantages of electronic medical records.
Speed of Retrieval of Electronic Medical Records You can retrieve your patient’s records within a few seconds. All you have to do, is to type his or her name in the form that the EMR software has presented to you. Bingo! the records are right in front of you within no time. And the most important thing is that you are not struggling to decipher someone else’s handwriting, in order to read what kind of therapy or treatment your patient underwent in the past. The availability of your patient’s medical records in one place, which can be viewed in detail, is also one of the advantages of electronic medical records.
If you decide to go for online EMR software, you will find that you can access your patient’s data not only by sitting at your office but from anywhere in the world through the Internet. Of course, you must provide it with proper passwords and identify yourself. You can download electronic medical records to your PDA or palmtop and can refer to it as and when it suits you.
Safety Your patient’s data is important and you have every right to worry about it. Will it be safe in its digital format? Yes, it will be. You must have heard about the computer system crashes and the computer viruses causing damage to the data. These may have made you suspicious about the reliability and safety of the electronic medical records. With proper backup systems and latest anti-virus, you can overcome this obstacle.
Data Format When you use papers to commit your patients records on it, you do so in the fixed format. The format that is printed on the paper. It is not the case with the electronic medical records. You can key in data in one format and can retrieve it in another, in a form more suitable to you.
Integration and EMR Software You can digital form of your patients data to the reference information which can be stored on your computer or on the Internet. The EMR software can help you by providing additional information about a drug, such as dosages for children and adults. Which drugs are contraindicated in which conditions and so on. The EMR software can not only help you out with your patient’s data but it can also provide information on the ICD.9, HIPAA, HCFA 1500, and the latest CPT code books. It may also help you in studying a condition by producing a 3-D images for you, by taking input of 2-D images that are already present in your patient’s data. The software also handles the medical transcription notes, as well as SOAP notes, which you can use to your own advantage. The customer support to medical billing services can also be made available to you and your patient by the EMR software. This may result in the speedy settlement of medical billing and claims for you because of the proper co-ordination with the insurance companies over medical insurance. In short, the ability of EMR software helps you centralize your resources can be counted as one of the advantages of electronic medical records.
Electronic Data and EMR Software Electronic data generated by the systems monitoring your patient, is processed and analyzed for errors by the the EMR software. This software can sound or raise an alert, if it comes across an event needing immediate medical intervention. It can transmit the relevant data in the form of an email or warn you by sending a message to your pager or mobile. It can also accept data from the laboratory analyzer in a electronic form directly and thus, avoiding the chance of erroneous data being fed to it by a computer operator. In case of online EMR software, which you will use the database to store your patients’ data in, and support to it will be provided by the IT company.
Primarily, it is you who is going to benefit by converting to electronic medical records. It will help your staff to be more efficient by saving their time. Your patients’ data in its digital form will always be at your fingertips and not be dependent on the mindless activity of searching for it every day. It seems that the benefits of an electronic medical record (EMR) are nothing but a bag of goodies. But, are they real for you? The decision is yours. With the world going digital, it is up to you to decide, whether to take heed of the advantages of electronic medical records.
Above article published on http://www.buzzle.com/articles/advantages-of-electronic-medical-records.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 (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 17, 2009
Time to take a look at the costs associated with the 2011 CCHIT Certification programs. If you’re not sure which programs I’m talking about, you need to go read my post about Preliminary ARRA Certified 2011 and CCHIT Certified 2011.
The following are the costs that CCHIT plans to charge for their 2011 EHR certifications: CCHIT Certified 2011 Ambulatory EHR – $37,000 with a $9,000 annual renewal CCHIT Certified 2011 Inpatient EHR – $49,000 with a $9,000 annual renewal CCHIT Certified 2011 Emergency Department – $37,000 with a $9,000 annual renewal CCHIT Certified 2011 ePrescribing – $18,000 with a $9,000 annual renewal
Preliminary ARRA Certified 2011 1-2 modules – $6,000 with a $1,000 annual renewal Preliminary ARRA Certified 2011 3-5 modules – $10,000 with a $2,000 annual renewal Preliminary ARRA Certified 2011 6-10 modules – $15,000 with a $3,000 annual renewal Preliminary ARRA Certified 2011 11-20 modules – $24,000 with a $4,000 annual renewal Preliminary ARRA Certified 2011 >20 modules – $33,000 with a $5,000 annual renewal *These are estimates subject to final approval
Of course, the ones that matter most are the CCHIT Certified 2011 Ambulatory EHR for $37,000 and the Preliminary ARRA Certified 2011 >20 modules for $33,000. Why? These are the two certifications that most people care about. If you’re an EHR vendor, then you’re going to want to do one of these two options (Assuming you’re going to go with CCHIT certification. More on that later.). These are the two options which should eventually be recognized as the certified EHR requirement for the ARRA EHR stimulus money.
Which CCHIT Certification Should I Do? The question an EHR vendor has to make is which of these two certifications make sense. Will having CCHIT Certified 2011 help you to sell more EHR software than just being Preliminary ARRA Certified? I’m guessing that it probably won’t. Most people I’ve seen really just want to make sure they get the ARRA stimulus money to pay for their EHR. Plus, with either certification you’ll be able to honestly tell a clinic that you have a “certified EHR.” Most doctors won’t know or care about the difference in the certification types.
Many might think that it’s only a $4,000 difference between the Preliminary ARRA 2011 certification and the CCHIT Certified 2011 so why not just get the later. It is interesting that the costs are so close to each other. However, remember that this isn’t the only cost associated with becoming certified. One EMR vendor I talked to put the software development costs to become CCHIT Certified in the six figures. We won’t know for sure until CCHIT publishes the final certification criteria, but I project that the CCHIT Certified requirements will number close to 300 while the Preliminary ARRA requirements will be close to 100. That’s a huge difference in development costs to meet 200 more requirements which your customers may or may not find useful.
Some might use the CCHIT Certified 2011 to try and assure potential buyers that they’ll have a more successful EMR implementation because of this certification. Many might actually believe it, but unfortunately there’s no evidence to prove this is actually the case.
EHR vendors should also be aware that CCHIT is looking at doing a site certification as well. This might be a better option for some EHR vendors who work with people who have few people actually interested in the EHR stimulus money.
Other EHR Certification Options Beyond CCHIT It’s still too early to know for sure if other EHR certifying bodies are going to be created to handle the HHS certification requirements for EHR. However, I’m willing to bet that at least a couple will be created.
Basically, CCHIT has set the price for EHR ARRA certification at $33,000 with a $5,000 annual renewal. I could be wrong, but that seems like a lot of money to certify a piece of software. I’m guessing that some entrepreneurial folks will find a way to do it for cheaper. Could you certify 100 EMR vendors for less than $3.3 million? We’ll see what ONC/NIST requires from a certification organization, but seems like a pretty nice business model to me.
For EMR vendors, this is important because competition amongst certifying bodies will most certainly drive the cost of EMR certification down. Then, the PR battle between CCHIT and the new certifying bodies will begin. Basically, this could be really interesting to watch if someone else decides to join the EHR certifying fray.
Above article published on http://www.emrandhipaa.com/emr-and-hipaa/2009/09/14/cost-of-new-cchit-ehr-certifications/
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 01, 2009
By Pamela Lewis Dolan, AMNews staff.
When it comes to electronic health records, functionality has had its time in the spotlight. Now, the buzz term is usability. What’s the difference? Functionality is what a system does. Usability is how easily you and your staff can operate the system.
Usability is coming into the spotlight as vendors and consultants are learning that a lack of it has been a major reason many implementations have failed. The push is now on for practices (and vendors and consultants) to pay less attention to the bells and whistles and more to whether physicians and support staff can figure out how to make them work.
Determining what usability means to you will require a hard look at not only the system but also your practice — how it works now, how you want it to work, and how ready and able employees are to adapt to technology.
Ron McNamara, PhD, a certified usability analyst who runs the EMR Usability Group, a consulting firm, said that despite the seemingly relative nature of usability, there is some science to it. But at its most basic level, usability means everyone will be able to use the records system to electronically complete tasks in the same or less time as it takes on paper.
McNamara has developed a nine-point assessment that practices can use to help determine a system’s usability:
Dictation: A good system will accommodate doctors accustomed to dictating their notes as well as those who are comfortable typing.
Prescriptions: Sending a prescription electronically should be just as fast as writing it on paper.
Ability to receive faxes: Allowing faxes to be imported directly into the EHR should not negatively impact work flow.
Appointment/scheduling integration: With good integration staff will not have to toggle between two systems.
Scanning: Your system should allow documents to be scanned directly into a patient file.
Vital signs: Support staff should be able to enter vitals directly into the patient’s file at the time of care, with a touch screen, tablet or laptop in the exam room.
Interface design: Is it customizable to match each physician’s current work flow? Can information that is not needed on a regular basis be hidden? Can it be customized according to user (whether physician, nurse, physician assistant)? Is it intuitive and easy enough that a novice can learn to use it?
Office work flow: Is your vendor willing to define current work flow and match the system to it as closely as possible and/or help identify current work flow problems that can be fixed with technology?
Application performance: Does the system take a long time to load? Does it go from screen to screen quickly? Does it crash often? Hardware, as well as software, will be a factor.
Can your staff adapt? The other important task is assessing your employees’ ability to learn a new system.
Jeffrey Linder, MD, MPH, director of the Brigham and Women’s Primary Care Practice-Based Research Network in Boston, said there is no test to assess an employee’s tech-savviness. So you mostly have to rely on self-reporting.
Allen Wenner, MD, a family physician in Columbia, S.C., said that when he interviews potential employees at his practice, he addresses their tech-savviness with two basic questions.
The first is, “What is your e-mail address?” It must be a personal address, not a current or former work e-mail. The second is, “What operating system do you use?” A response of “Windows” is not adequate. He wants to know what version.
“If a person doesn’t know the answer to those things,” he said, “then you can’t teach the level of technology that is necessary to operate an EMR in a live environment while you are seeing patients.” Dr. Wenner is also the co-founder of the High Performance Physician Institute, an EMR training organization.
But that’s not to say everyone should be able to program the next best thing to Microsoft Windows. A good EHR system will meet people where they are and allow them to learn as they go along, McNamara said.
Dr. Linder said that during the implementation projects in which he has participated, there was an effort to get diversity on the teams charged with picking a system. The strategy was to form a group with the widest spectrum in terms of age, self-reported tech-savviness and job requirements to test-drive potential systems.
Dr. Linder compared a good EHR to Microsoft Word. He said most anyone can figure out how to use the program, but most users don’t use 92% of what’s in it. Likewise, a good EHR system will be easy enough for novices to use, but offer more options for a “power user.”
The caveat is that if all of the EHR’s functionalities aren’t being used by the majority of people in the office, the practice is not realizing the system’s full potential. That’s where incentives come in, Dr. Linder said.
As payment moves from fee-for-service toward pay-for-performance, practices will have the time and motivation to learn and utilize more of the EHR’s functionalities, he said. Incentives built around the patient-centered medical home model, for example, will be practice wide, not physician-specific, which means every employee in the practice will have an incentive to learn — and take their own steps — to increase the system’s usability.
Above article published on
August 13, 2009
The requirements for what health IT users need to do to meet the meaningful use dictates of the stimulus law are now clearer, with the focus apparently swinging to how the IT certification process will handle them.
Healthcare providers finally have some certainty about what they need to do to be meaningful users of health IT, said Dr. Bruce Taffel, chief medical officer of SharedHealth, an healthcare information exchange and application provider.
Dr. David Blumenthal, the national health IT coordinator, and the HIT Policy Committee, a public/private organization, approved July 16 a list of 28 health IT functions and corresponding quality and efficiency improvement measures for 2011 that become progressively more rigorous in 2013 and 2015.
The schedule is aggressive and the criteria will be difficult for some to achieve.
“The recommendations provide more clarity at this stage, although there’s still a lot more work to be done,” Taffel said today.
The goals for meaningful use are for providers to electronically capture data, report quality measures and use the data to track patients’ medical conditions. Under the American Recovery and Reinvestment Act, providers will be eligible for increased Medicare and Medicaid payments beginning in 2011 if they demonstrate meaningful use of their certified health IT. The payments end after 2015 when health IT should be broadly adopted.
“The committee shaped their recommendations on meaningful use and the progression to achieve that on the basis of what we can do today, what the current condition is and with a fairly reasonable explanation of how you begin phasing in much of this,” Taffel said.
The policy committee also made its first recommendations on the certification process of electronic health records. Currently, the Certification Commission for Health IT (CCHIT) is the sole certifying and testing organization. The HIT Policy Committee wants more competition.
Multiple groups will be needed to perform certifications because so many more providers will seek to have the service conform to the stimulus, said Paul Egerman, retired businessman and chair of the committee’s certification and adoption work group.
The certification process should also accommodate a scaled-down version of certification process for systems or applications that still allows providers to prove they are meaningful users with components of comprehensive electronic health records, EHRs from multiple sources or self-developed applications, he said.
“If comprehensive certification is important, say for vendor marketing, it’s a positive thing that should continue to exist,” Egerman said.
The committee agreed to focus certification on a minimal set of requirements for meaningful use, and not on features and functions. The national coordinator’s office would review CCHIT certification criteria for gaps in assuring meaningful use.
“We could have the meaningful use gap certification process decided by Labor Day,” Blumenthal said.
Those products that are currently CCHIT-certified will be certified for meaningful use under the Health and Human Services Department definition for 2011, “subject to completing a special meaningful use gap certification,” according to the work group’s transition plan.
The work group also urged that the certification process be used to improve progress on security, privacy and interoperability and provide a tighter link with standards. Above article published on
August 03, 2009
The recommendations, which will help determine who receives federal stimulus funding, have been revised from an initial draft.
By Chris Silva, AMNews The Obama administration’s national health information technology coordinator has approved recommended definitions for what constitutes “meaningful use” of electronic health records, about a month after asking a key working group to revise its initial recommendations.
The green light from David Blumenthal, MD, means that the recommendations now will be sent to the Dept. of Health and Human Services, which by the end of the year must issue a rule with final definitions. Meaningful use is a key term that ultimately will determine which physicians and hospitals are eligible for billions in federal EHR money made available through the economic stimulus package approved earlier this year.
Recommendations from Dr. Blumenthal and the Health IT Policy Committee provide the first look at a policy framework for the development and adoption of a nationwide health information infrastructure. The committee said it received nearly 800 comments after unveiling a first draft of the recommendations June 16, though policy experts say few major changes were made since then.
“To say Dr. Blumenthal sent the working group back to the drawing board really is inaccurate,” said Erica Drazen. a managing partner in the health care group at Computer Sciences Corp., a technology firm in Waltham, Mass. “There weren’t really too many surprises or changes made from the initial draft. If anything, it’s slightly more aggressive.”
Drazen pointed out, for example, how the final recommendations specified that only 10% of all orders entered by an authorizing physician at a hospital must be made via computerized physician order entry. The initial draft did not provide an exact percentage. But the requirement for physician practices remains the same — they must use CPOE for all orders, according to the final version. Doctors also received several additional recommended standards to meet by 2011.
HHS must finalize EHR meaningful use guidelines by year’s end.
Some health care policy experts praised the quick work by Dr. Blumenthal, the committee and the working group.
“They have laid out these big, achievable goals that are central and critical, and the way meaningful use needs to be implemented is with an eye toward achieving these objectives,” said Carol Diamond, MD, managing director of the health program at the Markle Foundation, a health IT policy organization based in New York. Markle teamed up with two other health care policy organizations — the Center for American Progress and the Engelberg Center for Health Care Reform at Brookings — to comment on the working group’s report.
The organizations called the measures ambitious but achievable. Dr. Diamond cautioned, however, that HHS should not try to add new goals or tasks for physicians. “Rather than try to expand these even more and add more requirements, there’s a real opportunity for HHS to define within these goals how each specific provider group can achieve these measures.”
2011 objectives Despite some revisions, most of the initial recommended requirements for physicians receiving EHR stimulus money remain the same. By 2011, physicians will be considered meaningful EHR users if the practice meets multiple objectives, including:
The Health IT Policy Committee also recommended objectives for 2013 and 2015.
The medical community has tracked the committee’s work and the meaningful-use debate with much interest, as the stimulus package provides approximately $19 billion in net Medicare and Medicaid EHR incentives for physicians, hospitals and others. The incentives begin as bonuses for early adopters but turn into penalties for those who don’t adopt quickly enough.
Meaningful users have been defined generally as physicians who have demonstrated to the government that they are using electronic prescribing and that their systems are connected to other entities in a way that provides for the exchange of health data to improve care quality. But the working group was asked to specify exactly what objectives and measures physicians would need to meet for stimulus incentives.
Health IT and policy experts say the recommendations approved by Dr. Blumenthal are a significant benchmark for physicians.
“This is a good time for physicians to check in, because the first wave of the draft was more about moving it out of the political process, and this development certainly moves it toward rule-making,” said Jana Skewes, president and CEO of SharedHealth, a provider of health information products and solutions based in Chattanooga, Tenn. “I would say now there are enough signs and pillars of requirements that physicians would be using their time wisely to determine what the requirements are.”
Skewes advised doctors who already have EHRs to check with their vendors to see if systems are up to date with the most current recommendations.
Now that the medical community has a pretty good idea of what to expect from the government, Drazen said, practices shouldn’t wait to start upgrading or adding EHRs.
“The market has been waiting, and people have been afraid to make investments, because they weren’t sure what was required,” she said. “But big capital investments shouldn’t have to be made to at least get started.” Above article published on
July 20, 2009
By Ken Terry The Health IT Policy Committee, which advises the U.S. Department of Health and Human Services, has adopted the revised recommendations of its workgroup on the “meaningful use” of electronic health records. Physicians will have to show meaningful use to qualify for government financial incentives that are scheduled to start flowing in 2011.
The revised definition is apparently more lenient to physicians than the one presented to the committee about a month ago. Among the requirements for 2011:
Physicians will be expected to participate in the National Health Information Network by 2015, and will have to give patients access to personal health records to qualify for incentives in 2013. The PHR deadline is two years earlier than the one that was originally proposed.
Another big change from the earlier version is that physicians who apply for government subsidies for the first time after 2011 will only have to meet the 2011 criteria for meaningful use in the year when they apply. That will make it much easier for physicians who are just learning how to use their EHRs.
The government will use the recommendations in shaping its requirements for EHR incentives. HHS is expected to publish a final rule by the end of the year.
On another front, the HIT Policy Committee is also considering how EHRs should be certified for functionality. Earlier this week, it heard testimony concerning whether the Certification Commission for Health Information Technology (CCHIT) should continue to the be sole body that certifies EHRs. This is an important question, since only “qualified” EHRs—which many have interpreted as “certified”—will be eligible for government subsidies.
The committee members listened to hospital executives and others complain about the lack of interoperability among EHRs from different vendors. CCHIT chair Mark Leavitt, MD, noted that CCHIT is requiring that certified products be able to import and export the Continuity of Care Document (CCD), which includes key medical data. But he added, “There are not standardized HIEs [health information exchanges] and almost none of them is using the standardized format that the government approved.”
Meanwhile, in a letter to the HIT Policy Committee’s certification/adoption workgroup, an important organization of health IT professionals said that the CCHIT approach to certification should not continue. The American Medical Informatics Association stated, “We believe that highly prescriptive and detailed, one-size-fits-all requirements will ultimately be counterproductive.”
CCHIT has drawn a great deal of fire of late, mainly from those who fear that continuing to raise the bar on certification criteria will cull down the health IT business to a handful of vendors that can bear the expense of continuing software development and certification fees. But I would ask CCHIT’s critics a question that paraphrases Voltaire: If CCHIT did not exist, would it not have to be invented? How are EHRs going to meet the rising requirements for “meaningful use” unless someone sets standards that apply to all? Above article published on http://industry.bnet.com/healthcare/1000927/round-2-of-meaningful-use-lets-up-a-bit-on-physicians/
July 02, 2009
By Joseph Conn Only 1.5% of nonfederal U.S. hospitals use a comprehensive electronic health record system, according to HHS-funded researchers in a report released by the New England Journal of Medicine and mirroring preliminary survey results released by the same researchers this past November.
Lead author Ashish Jha, an associate professor at the Harvard School of Public Health and a staff physician at staff physician at Veterans Affairs and Brigham and Women’s hospitals in Boston, said in a news conference that just 7.6% of hospitals had a “basic” EHR that included the capability to record and store physician and nursing notes. The survey found that 10.9% of hospitals had a basic system without those clinical note-keeping functions.
“Very few hospitals in America have a comprehensive electronic health record,” Jha said. In addition, Jha said, “We didn’t get into effective use of these technologies. And we don’t have information right now with the notion of sharing data with other providers. Just because they have these systems doesn’t mean they are sharing that information with other doctors or hospitals down the street.”
That said, not all was gloom and doom. For one thing, if data from the VA hospitals, which were gathered but excluded from the final survey totals, were added back in, the comprehensive EHR adoption numbers would nearly double to 2.9% and the national numbers for the basic adoption rates would be driven up as well.
“All VA hospitals now have adoption of comprehensive medical records,” said Jha, who is serving as VA advisor. “There are as many VA hospitals with comprehensive medical records as there are non-VA hospitals (with those systems) if you look at it numerically.”
Also, he said, “There is no suggestion here that 90% of hospitals don’t have a computer in the hospital,” Jha said. In fact, some component parts of an EHR are in widespread use. For example, the survey found that 75% of hospitals surveyed reported having electronic lab and radiology systems.
What hospitals don’t have is “a constellation of functionalities” that help doctors and nurses provide the best care possible, Jha said, but the relatively high levels of adoption of some components “suggests we have a good place to start.”
Information about the study was under embargo until Wednesday, but its authors and other healthcare luminaries were available to reporters via a telephone conference Tuesday. One of those was David Blumenthal, the physician founder of the Institute for Health Policy, who spoke briefly about the research report and an article he had written for the New England Journal of Medicine on the federal role for health IT promotion.
Last week, Blumenthal was named as President Barack Obama’s choice to be the national coordinator for health information technology. Blumenthal said he will take over the post in mid-May.
Speaking of the impact the American Recovery and Reinvestment Act of 2009 would have on healthcare information technology, Blumenthal said that for physicians, “This whole project was conceived by the Congress as a building block as a pillar of healthcare reform.”
“One of the key elements is to support behavior change,” he said. “IT is one important and ultimately critical way to do that. I think it would be wrong to see it as a technology that can be adopted on its own, but as a technology to support that.” The study and Blumenthal’s article are scheduled to appear Thursday in the journal’s online edition. Above article published on http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20090325/REG/303259966&AssignSessionID=373357728181706 |
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