Archive for the ‘Health’ Category
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 15, 2009
Diana Manos, Senior Editor
The Department of Health and Human Services issued new regulations Wednesday requiring healthcare providers, health plans and other entities covered by the Health Insurance Portability and Accountability Act (HIPAA) to notify patients if their electronic health information has been breached.
The regulations are mandated by the Health Information Technology for Economic and Clinical Health (HITECH) Act, passed as part of American Recovery and Reinvestment Act of 2009 (ARRA) last February.
Developed by the HHS Office for Civil Rights, they require healthcare providers and other HIPAA “covered entities” to promptly notify people whose health records have been breached, as well as the HHS Secretary and the media in cases where a breach affects more than 500.
Covered entities include doctors, clinics, psychologists, dentists, chiropractors, nursing homes and pharmacies – if they transmit any information in an electronic form using a standard that HHS has adopted.
According to the OCR, the rule also applies to health insurance companies, HMOs, company health plans and government programs that pay for healthcare, such as Medicare, Medicaid and the military and veterans’ health care programs. It includes healthcare clearinghouses that process non-standard health information received from another entity into a standard electronic format or data content, or vice versa.
“This new federal law ensures that covered entities and business associates are accountable to the department and to individuals for proper safeguarding of the private information entrusted to their care,” said Robinsue Frohboese, acting director and principal deputy director of the OCR. “These protections will be a cornerstone of maintaining consumer trust as we move forward with meaningful use of electronic health records and electronic exchange of health information.”
HHS officials said they developed the regulations after taking public comment last April and under “close consultation” with the Federal Trade Commission). The FTC has issued its own breach notification regulations that apply to vendors of personal health records and certain others not covered by HIPAA.
To help providers to determine when information is “unsecured” and notification is required by the HHS and FTC rules, HHS is also issuing an update to its guidance on encryption and destruction of technologies that are no longer usable. Providers that are subject to the HHS and FTC regulations that secure electronic health records according to HHS guidance through encryption or destruction are relieved from having to notify in the event of a breach. This guidance will be updated annually.
The HHS interim final regulations on breach notification will be effective 30 days after they are published in the Federal Register and will include a 60-day public comment period.
Above article published on http://www.healthcareitnews.com/news/hhs-issues-rule-ehr-breach-notification
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 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
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
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 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 12, 2009
Bernie Monegain, Editor
An EHR program that cut cardiac deaths by 73 percent has also kept patients healthy two years later, according to a new study.
The Kaiser Permanente program in Denver linked coronary artery disease patients and teams of pharmacists, nurses, primary care doctors and cardiologists with an electronic health record to help keep the patients healthy two years after they left the program by keeping them in touch with their caregivers electronically, according to a randomized study.
The study, which was funded by the American College of Clinical Pharmacy, is published in The American Journal of Managed Care this month. It is the first randomized study to evaluate a follow-up system for patients discharged from a cardiovascular risk reduction service, researchers said.
The Clinical Pharmacy Cardiac Risk Service at Kaiser Permanente Colorado combines Kaiser Permanente’s HealthConnect EHR with patient outreach, education, lifestyle adjustments and medication management.
The two-year randomized trial of 421 patients found that patients discharged from the program kept their lipid and blood pressure levels at controlled, healthy levels by receiving electronic reminders.
“Because lack of adherence to medications and failure to maintain treatment goals are so high among heart disease patients, we wanted to find out what would happen to the patients after they were discharged from the program but remained in contact with the healthcare system through our electronic health record,” said the study’s lead author, Kari L. Olson, a clinical pharmacy specialist with Kaiser Permanente Colorado’s Cardiac Risk Reduction program. “The takeaway message here is that we can help support patients in maintaining treatment goals and medication adherence, which is often a challenge with most chronic conditions. Using technology and integrated systems already in place, we can help keep patients healthy for longer and deliver continuity of care in a cost-efficient manner.”
In the study, the patients in the Clinical Pharmacy Cardiac Risk Service with well-controlled blood pressure and cholesterol levels were randomized so that 214 continued to receive intensive direct counseling from the care team. The other 207 patients were discharged from the program back to their primary care physician.
The mean age of the trial participants was 72 years old, and 74 percent were male. Patients who were discharged from the program had electronic reminders in their chart to ensure their lipid panels were ordered annually, with the results sent directly to their primary care physician. The discharged patients also received reminders generated by KP HealthConnect indicating they were due for a lab test.
The study found that patients discharged from the program maintained control of their risk factors with the help of electronic reminders. The EHR intervention was as effective at keeping cholesterol and blood pressure in check, compared to the more intensive counseling approach offered to those patients who stayed enrolled in the program.
The Clinical Pharmacy Cardiac Risk Service cares for 13,000 cardiac patients with integrated nursing and pharmacy teams that work collaboratively with patients and their doctors using technology tools and activities such as lifestyle modification, medication management, patient education, laboratory results monitoring and management of adverse events.
The program also achieved these results:
Above article published on http://www.healthcareitnews.com/news/study-places-ehrs-core-saving-cardiac-patients-lives
August 07, 2009
By Jean DerGurahian / HITS staff writer
Providers looking to make decisions about technology will find the revised “meaningful use” definition helpful, but the implementation timeline might still be challenging, professionals say.
The federal Health Information Technology Policy Committee approved updated recommendations from its meaningful use work group during a conference. The revised definition for the meaningful use of electronic health records includes changes to computer physician order-entry criteria and speeds up the schedule for granting real-time access to patient information through personal health records. The 2011 measures are being established with a focus on data capture and sharing, according to the work group’s recommendations.
Overall, the revisions “have some nice granularity to them,” said Brian Jacobs, a critical-care physician and chief medical information officer of 230-bed Children’s National Medical Center, Washington. As the medical center finishes components of its EHR, the revised measures will serve as guidelines for what it needs to focus on, he said. The medical center is already available for the full, first-year IT adoption incentive payment under the American Recovery and Reinvestment Act of 2009 because it meets the 2011 criteria now.
The American Hospital Association said that it is reviewing the revisions and the deadline for meeting criteria. “We remain concerned that many hospitals that haven’t already adopted health IT systems may find the proposed timelines unachievable,” said Don May, AHA vice president for policy, in a written statement Above article published on http://www.modernhealthcare.com/article/20090717/REG/307179990/1153 |
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