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

One part of President Obama’s healthcare agenda that has been nudged out of the spotlight is the push to create a nationwide network of electronic health records (EHR) by 2014. McKnight’s will hold a webcast on this issue later this month.

Even though a deadline is in place, EHR faces significant challenges toward implementation. One of the main factors holding back EHR adoption is the sheer cost of the undertaking, according to CNNMoney.com. Depending on the size of the facility, an EHR system can cost tens of millions of dollars to implement, and take years to get off the ground. One Kentucky hospital system will require $80 million and three years to fully implement an effective EHR system, CNN reported. Convincing physicians to change their long-held practices can be a challenge as well, according to the report. Smaller rural facilities face other challenges, including lack of training and resistance to change. The long-term care industry has long been considered ahead of the curve in EHR adoption practices.

Above article published on

http://www.mcknights.com/Electronic-health-records-overlooked-in-healthcare-debate/article/141021/

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:

• Maintaining an active medication list.
• Incorporating lab test results into the EHR as structured data.
• Generating lists of patients by specific conditions to use for quality improvement, reduction of disparities and outreach.
• Reporting ambulatory quality measures to the Centers for Medicare & Medicaid Services.
• Sending reminders to patients for preventive and follow-up care.
• Documenting a patient progress note for each encounter.

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

http://www.ama-assn.org/amednews/2009/08/03/gvsb0803.htm

The requirements for how healthcare providers would demonstrate meaningful use of health information technology have gotten a little clearer.

The HIT Policy Committee, led by national health IT coordinator David Blumenthal, adopted July 16 a list of health IT objectives and measures for 2011, 2013 and 2015. It also agreed to give providers more time to adopt electronic health records.

The committee’s meaningful use work group revised some of the health IT objectives for 2011 that were presented at its June meeting, separating out goals by hospital and physician, essentially by inpatient and outpatient environments.

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 health IT.

The committee’s recommendations allow providers who need more time to get started to accomplish the health IT objectives based on “adoption year” instead of specifically in either 2011 or 2012.

In effect, said Paul Tang, chair of the Palo Alto Medical Foundation and co-chair of the meaningful use work group, it lets providers push out to 2013 or 2014 the 2011 foundation criteria.

Providers who do that will be eligible for less incentive money, but will at least have the opportunity to participate in the program. But the first adoption year will be still be considered as 2011, no matter when the provider comes in to the program through 2014.

“We thought there was a kind of double jeopardy in that, if a provider couldn’t make the 2011 or 2012 criteria, and coming into 2013 the bar would be raised higher, it’s almost like you can’t get into the game at all” Tang said. “We’re trying to find a way for people to participate even if it’s a little bit delayed.”

CMS will need to consider the recommendation and its implications for the development of future regulations, Blumenthal said.

The goals for meaningful use are for providers to electronically capture data, report quality measures and use the data to track patients’ medical conditions. Providers must steadily meet more stringent goals with increasing health IT functions, and link them with outcome measures for quality and efficiency improvement in 2013 and 2015.

The work group added measures for 2011, such as providers reporting quality measures to CMS, checking insurance eligibility electronically and submitting claims electronically.

It revised some of the health IT objectives introduced in the June meeting, including implementing drug reaction checks and alerts, problem diagnoses lists based on standards, electronic prescribing and computerized physician order entry (CPOE) for all orders, though interfaces for CPOE are not necessary. Hospitals would have to generate 10 percent of their orders through CPOE.

The committee also endorsed the use of disease registries, which could be used for many purposes, but specifically as a way for specialists to report quality data and demonstrate meaningful use.

Blumenthal will publish an interim final rule by the end of December for the meaningful use of health IT. CMS will also issue a rule by December on provider incentives.

Above article published on

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The Health IT Policy Committee’s recent revised recommendations on “meaningful use” of electronic health records could be too daunting for health care providers to adopt by 2011, according to health IT experts, Medical Economics reports.

John Moore, managing partner of Chilmark Research, said, “The bar has been set too high, and the recommendations put forth will be virtually impossible to implement within the aggressive time schedule” of the federal economic stimulus package.

Under the stimulus package, hospitals and physicians who demonstrate meaningful use of EHRs will qualify for Medicaid and Medicare incentive payments.

Moore suggested that officials should pay more attention to processes and workflows when issuing final rules on meaningful use (Lewis, Medical Economics, 7/24).

John Haughom — senior vice president of clinical quality and patient safety at the PeaceHealth hospital system in Washington state — also said certain providers could encounter difficulty in implementing EHR systems by the 2011 benchmark.

He said the current recommendations might “discourage organizations that aren’t as far along” in implementing EHR systems. He said rural hospitals, small group practices and solo practitioners could be in that group.

To address these challenges, Haughom called for the Policy Committee to scale back the meaningful use objectives in three categories:

• CPOE: Haughom said officials should require health care providers to use computerized physician order entry systems for 5% of all orders of any type, down from the 10% requirement included in the revised recommendations.
• Electronic problem list: Haughom also said officials should provide sufficient time for hospitals to work out management issues before requiring physicians to maintain up-to-date lists of current and active diagnoses.
• PHRs: In addition, Haughom suggested that health care providers roll out patient portals before meeting a requirement to provide patients with electronic copies of their personal health records.

Hospitals and physicians both are pleased that the Policy Committee’s recent recommendations allow health care providers to meet the meaningful use criteria on a shifted timeline depending on when they begin implementation, according to HealthLeaders Media.

Haughom said further flexibility and revisions to the meaningful use recommendations could help spur health IT adoption and ensure the success of the federal stimulus package (Vaughan, HealthLeaders Media, 7/21.

Above article published on http://www.ihealthbeat.org/Articles/2009/7/22/Experts-
Say-Timeline-for-Meaningful-Use-Might-Be-Prohibitive.aspx

By DAVE MICHAELS and JASON ROBERSON The Dallas Morning News

Dave Michaels reported from Washington, and Jason Roberson from Dallas.

An unprecedented effort to computerize the nation’s hospitals and physician offices could be the key to reducing crippling health care costs – or a giveaway to technology vendors whose sales will be subsidized by taxpayers.

Computerizing the paper-based world of medicine was a significant component of this year’s $787 billion stimulus package, which reserved $45 billion for hospitals and physicians to adopt electronic health records.

The Obama administration argues that electronic records will allow doctors to coordinate care for the sickest patients, eliminate errors such as adverse drug reactions and avoid duplicate lab and imaging tests. Medical errors alone cost the country $37.6 billion each year, according to the Institute of Medicine.

Despite years of technology development, most hospitals and physician offices, including those in North Texas, can’t electronically share information or even record patient data.

Data sharing confronts age-old assumptions that providers, not patients, own health records, which are valuable assets that can be used to obtain grants and market hospitals. It requires the government to decide what kinds of systems will improve care and how providers should use the systems to achieve that.

‘Meaningful use’

Congress dubbed that exercise “meaningful use,” and the government is taking most of this year to set the standards. The exercise is being closely watched by North Texas hospitals, vendors and consultants such as Plano-based Perot Systems and Addison-based MedHost Inc.

Some observers are concerned that the stimulus investment could be a bonanza for software vendors if the rules for “meaningful use” are too rigid and simply tied to buying software.

“Meaningful use is the whole shooting match,” said Richard Kneipper, a lawyer who co-founded Dallas health care information technology firm PHNS Inc. “The guts of the discussion will be how fast do you go?”

The first draft of “meaningful use,” produced by a federal advisory panel, resembled an approach advocated by the Healthcare Information and Management Systems Society. The government’s draft, however, was more aggressive.

Hospitals, physician groups and technology vendors have said the draft would require them to do too much too soon. Only 1.5 percent of U.S. hospitals have the comprehensive electronic records envisioned by the Obama administration, according to the New England Journal of Medicine.

The American Hospital Association, for instance, wants to put off one of the most important functions of electronic health records – having physicians enter all their orders electronically – until after 2015. “We don’t want to rush to do something just to chase money – and endanger patients’ lives,” said Rod Piechowski, senior associate director of policy for the hospital association.

The stimulus established a carrot-and-stick approach to lure providers into the electronic age. Physician practices could be paid up to $44,000 over five years, and hospitals could get a maximum of $15.9 million to install systems that comply with meaningful use rules.

The government would penalize providers that don’t participate, reducing their Medicare and Medicaid payments by 1 percent, beginning in 2015. In later years, the penalty grows to 3 percent.

“The penalties … are far more significant than the incentives,” said H. Stephen Lieber, president and CEO of the Healthcare Information and Management Systems Society.

But if hospitals think the schedule is too aggressive, they may sit out – and the government would have failed to achieve its goal, said Pamela McNutt, chief information officer for Methodist Health System in Dallas.

Dallas efforts

Many hospitals, including several in Dallas, have made big investments in electronic records, which they say can help prevent errors and reduce some costs. Methodist’s $25 million system allows physicians to order medicine from patients’ rooms. Nurses can scan a bar code to make sure patients have been given the right medication.

“Why would you want to set up a system and spend millions of dollars now, with all the questions surrounding it?” McNutt said.

Kneipper is urging a more expansive approach. He advocates not just a timeline that applies to everyone, but also extra incentives for providers that have shown they can use technology to improve care.

“The purpose isn’t just some idle technology,” he said. “It’s technology that is going to save people’s lives.”

The Obama administration is keenly aware of the high stakes of meaningful use. The goal isn’t just spreading technology – it’s using the technology to improve care and reduce costs.

“Not everyone may want to, not everyone will execute on the task,” said David Blumenthal, a Boston physician appointed by Obama as national coordinator for health information technology. “There is no guarantee in the law that people will be paid, even if they work hard.”

To qualify for incentives, providers must purchase “certified” systems.

So far, certification has been a voluntary, industry-led effort that identified the features and functions of a good system. But the stimulus law set a new standard, requiring providers to purchase certified systems to be eligible for the incentives.

Under the Bush administration, certification duties were outsourced to a commission founded by the Healthcare Information and Management Systems Society.

Kneipper and other critics argue that the commission has too many ties to industry groups to be the lone gatekeeper. The commission’s leaders contend that they are independent from the industry. But after three years of certification, most systems still don’t – and can’t – communicate easily with one another, according to health care technology experts.

“I don’t think the certification process has been particularly relevant so far,” Kneipper said. “It’s going to be very relevant for the purpose of having a toll gate for who gets into the stimulus money or not.”

The commission’s leaders acknowledge that certification has failed to achieve widespread interoperability. But they say the commission is now focused on making sure systems are compatible and is certifying systems that are homegrown, not just made by big software vendors.

“The missing piece is the government also envisioned what they called health information exchanges, which are sort of the switchboards to route data between doctors and hospitals,” said Mark Leavitt, the commission chairman. “They came up with a concept, but there wasn’t any money behind it.”

Progress in Texas

Texas has only a few small health information exchanges – in Austin, San Antonio and Fort Worth. Dallas and Houston, the two biggest health care markets in the state, don’t have exchanges up and running.

One exchange has popped up in North Texas, where Fort Worth-area doctors pay $150 to $200 per month to access SandlotMD.com, which supplies patient demographic data, lab results and patient history. Sandlot CEO Telly Shackelford says it serves 1.2 million patients.

In June, Arlington-based Texas Health Resources Inc. contracted with Epic Systems, a global supplier of electronic health records, to sync its records with those of UT Southwestern, Children’s Medical Center Dallas and Parkland Health & Hospital System. The Dallas-Fort Worth Hospital Council has begun a study of an exchange and is hoping to get stimulus funds to support it.

Shackelford expects the region will have several independent exchanges that can share data.

But in Texas, hospitals and providers have struggled to justify the money they would invest in such efforts. Competition among hospitals for patients has also stifled attempts to exchange data across numerous providers.

Two years ago, the Texas Legislature created an entity that was supposed to oversee the development of the exchanges – but lawmakers didn’t fund it. “For large institutions, many of them regard the aggregated data on their patients as a resource for grants – it’s worth something,” said Joseph M. Heyman, immediate past board chairman of the American Medical Association.

Three years ago, Kneipper, a former Parkland board member, tried to persuade three Dallas hospitals to share information about indigent patients. The homeless often bounced between emergency rooms, but each time physicians confronted their problems as if the patient were being seen for the first time.

The effort ultimately failed because the hospitals weren’t willing to devote money to it.

“If the stimulus monies were around [then], I believe that would have been the stimulus to make it happen,” he said.

Above article published on http://www.dallasnews.com/sharedcontent/dws/bus/stories/DN-healthrecords_14bus.ART0.State.Edition2.4bb476e.html

Rick Weinhaus

Dr. David Blumenthal, the new National Coordinator for Health Information Technology, has stressed that the goal of the ARRA/HITECH initiative is to improve patient care, not to mindlessly adopt health information technology. In this regard, he wrote that many CCHIT-certified EHRs “are neither user-friendly no designed to meet HITECH’s ambitious goal of improving quality and efficiency in the health care system.”

It is therefore disconcerting that the Association of Medical Directors of Information Technology (AMDIS) just weighed in on the issue of meaningful use with their letter to Dr. Blumenthal, recommending that the new national HIT Policy Committee use the 2008 CCHIT certification criteria to determine which hospitals and physicians get HITECH incentive dollars.

Even more disturbing is the AMDIS recommendation that meaningful adoption (their newly coined term) substitute for meaningful use until at least 2013.

We see placing the reporting of quality measures in advance of reporting measures of meaningful EHR adoption as akin to putting “the cart before the horse” — the fields that form the basis for automated quality reporting must first be populated on a regular basis . . .

What’s going on here? As I read it, AMDIS is acknowledging that CCHIT-certified EHR technology is so difficult for hospitals and physicians to use that it will take years of training before meaningful use can even be addressed. AMDIS states that process of EHR adoption and use must follow a ‘crawl-walk-jog-run’ progression requiring continuous cycles of training and practice that ‘cannot be skipped or shortened’ [italics mine] without risking failure, introducing errors, and causing the frustrated physicians to give up.

Most disquieting of all is the AMDIS recommendation to exempt hospitals (but note, not office-based physicians) from HITECH’s computerized physician order entry (CPOE) requirement until 2013 or beyond. AMDIS states that even in the hands of its most experienced members, working with EHRs that are already up and running (most inpatient EHRs are CCHIT-certified according to HIMSS) successful implementation of CPOE is a challenging, multi-year undertaking.

AMDIS therefore recommends that inpatient CPOE be deferred for an indefinite time period because “it requires more advanced planning, building, testing, training, experience, data capture, data sharing, and decision support than many practices and hospitals can successfully achieve in the next 2-3 years.” Ironically, CCHIT makes CPOE a cornerstone of its inpatient certification.

AMDIS is warning us about the risk of EHR and CPOE system failures on a national scale. These software system failures have real life consequences. To list just one example, physicians from the Children’s Hospital of Pittsburgh reported a highly statistically significant increase in mortality after implementation of a CCHIT-certified CPOE system.

The first step in fixing a system failure is to acknowledge that there is a problem. Although AMDIS clearly is aware that a problem exists, they continue to promote the flawed CCHIT model. I doubt, however, that their solution (try harder, you can do it!) is what most physicians and patients would choose.

What happens after 2 or more years? Where is the evidence that most physicians will ever be able to ‘jog’ or ‘run’ with EHRs built on the CCHIT model? Where is the evidence that these CCHIT-certified EHRs will be any more usable after causing 2 or more years of inefficiency, error, and potential harm to patients?

As I have written in a previous post, the CCHIT certification model is fatally flawed because it mandates hundreds of required features and functions, which take precedence over good software design.

Fortunately, the situation is not nearly as bleak as it seems. EHR technology can begin to improve patient care right away if we adopt the right model. There is no reason that it should take 2 or more years for physicians to train to use EHR technology. With well-designed, user-friendly EHR software, physicians can be up and running with core functions in 2-3 weeks, not 2-3 years.

We need to remember that Congress and the Obama administration have entrusted the national HIT Policy Committee, not CCHIT, with the mandate to shape our new HITECH policies. The national HIT Policy Committee needs to keep EHR certification rules simple and focused on standards for data, interoperability, and privacy. Keeping certification rules simple will allow physicians and hospitals to select well-designed, user-friendly EHR software that can be used meaningfully from the start.

Rick Weinhaus practices clinical ophthalmology outside Boston. He trained at Harvard Medical School, the Massachusetts Eye and Ear Infirmary, and the Neuroscience Unit of the Schepens Eye Research Institute.

Above article published on

http://www.healthcareitnews.com/blog/meaningful-use-vs-meaningless-adoption-electronic-health-records

Show me the technology! That is the conclusion of a study from the Beth Israel Deaconess Medical Center (BIDMC) to be released in the Journal of General Internal Medicine (JGIM) in June. The study reveals that consumers who are defined as “internet-savvy” are ready to take a chance on electronic health records (EHR) despite warnings of potential privacy risks.

The study, supported by the Robert Wood Johnson Foundation (RWJF), investigated whether or not patients were comfortable making the leap with their health care providers to the digital age through the adoption of EHRs. In the tech-savvy cities where they held focus groups, the answer was a resounding ‘yes.’ Not a terrible surprise given that they investigated consumers in Boston, Portland, Tampa and Denver—some of the more tech-educated spots in the country. However, investigators did attempt to include a diverse group of people, drawn from both urban and rural areas. Additionally, they included health professionals in their study to compare their perspectives about health technology relative to consumers.

The findings should not come as a major surprise since an estimated 60 percent of households across all states have a home internet connection. Citizens are increasingly interested in managing their lives via computer—EHRs seems a natural progression in this evolution.

Yet, the study findings echo a sense of surprise at the willingness of consumers to give up some of their privacy in order to obtain greater transparency with respect to their health information. In actuality, it may be more of a reflection of the distrust and frustration with the current patient-physician/health care provider relationship where one may deem transparency of much greater importance than whether or not someone uncovers that they have kidney stones…

Above article published on

http://ohmygov.com/blogs/general_news/archive/2009/05/28/edit-me-patients-cheer-on-ehr-technology.aspx

HDM Breaking News,

The federal government should extend the transition to a fully functional electronic health records system beyond 2015, according to the American Hospital Association.

The AHA has sent a comment letter on the initial proposal of a workgroup of the HIT Policy Committee to define meaningful use of electronic health records to David Blumenthal, national coordinator for health information technology.

“Our members believe that the functional abilities of the EHR that would result from implementation of the draft definition are correct, but that the proposed sequence for adoption is overly aggressive and unrealistic for most,” according to the AHA. “Increasing the requirements for being considered a meaningful user every two years should provide enough time for adoption, but only if the initial requirements are set at an achievable level. The AHA encourages the committee, ONC and the Centers for Medicare and Medicaid Services to develop a ‘meaningful use’ adoption timeline that begins with fewer functional requirements and extends the transition to a fully functional EHR beyond 2015.”

Computerized physician order entry, for instance, should not be required until after 2015 or beyond, the AHA contended in the comment letter. “Most hospitals are not prepared to make such significant advancements under the proposed implementation timeline, so rushing to adopt could compromise patient safety and the success of this effort,” the letter states. “Our members, including those with significant previous HIT investments and CPOE, consider a 2011 CPOE requirement to be unrealistic.”

The AHA calls for the definition of meaningful use in 2011 to focus on getting the majority of hospitals running with a basic EHR. Appropriate functions for 2011 should include clinical documentation of patient demographics, problem lists, medication lists, discharge summaries, and results viewing for lab reports, radiology reports and diagnostic tests, the AHA advises.

The association, mirroring comments of the American Medical Association and some 80 other physician organizations in a separate comment letter, also noted that providers must work during the same time period to migrate to the HIPAA 5010 transaction sets and ICD-10 code sets.

Above article published on

http://www.healthdatamanagement.com/news/meaningful_use-38560-1.html

by Julekha Dash Contributing Writer

Maryland Gov. Martin O’Malley will sign legislation Tuesday that provides incentives for health care organizations to implement electronic health records.

House Bill 706 allows the state to make use of federal stimulus dollars available for electronic health records and coordinate those efforts with the state’s own plan to create a state wide health information exchange.

The federal stimulus money provided $19 billion toward electronic health records. State health officials do not know how much of that money will flow to Maryland.

State and federal health officials are pushing electronic health records because they believe they will reduce medical errors and lower costs by eliminating the need for running multiple tests.

The stimulus package enables physicians to receive incentives between $44,000 and $64,000 over the next five years through Medicare and Medicaid.

It costs, on average, $50,000 for a physician practice to implement electronic health records. The incentive payments begin in 2011, and physicians who do not adopt an electronic health records will be penalized through lower Medicaid and Medicare payments starting in 2015.

In the past, the biggest obstacle in getting physicians to install an electronic health record was cost. The federal stimulus money and the state’s health information exchange overcomes that obstacle by providing incentives to adopt health records.

“It’s trying to create a business model to make [health IT] work,” Department of Health and Mental Hygiene Secretary John Colmers said.

While the federal money provides payments to physician practices, the state is taking its own steps to ensure that hospitals can share electronic information. The legislation requires the Maryland Health Care Commission and the Health Services Cost Review Commission to designate a state health information exchange by Oct. 1. State health insurers will provide incentives to hospitals, which include a lump sum payment or increased reimbursement, to adopt electronic health records.

Erickson Retirement Communities, Johns Hopkins Medicine, University of Maryland Medical System and more than a dozen companies and health care institutions have submitted their own plan to the state’s health care commission to create a health information exchange, known as the Chesapeake Regional Information System for our Patients.

Above article published on

http://www.bizjournals.com/washington/stories/2009/05/18/daily1.html