Category Archives: Digital Physicians

Regional Extension Centers Funding Explained by HHS Webcast & FAQs

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HHS’s Office of National Coordinator (ONC) Briefs and Posts FAQs
Regional Extension Centers Grants Webcast reaches 1,250
The August 27, 2009 “Technical Assistance” briefing by ONC senior advisor Dr. Farzad Mostashari about the $598 million grants program for Regional Extension Centers reached an unexpectedly large audience of 1,250 via Webcast and phone connection. The regional centers will be expected to train and provide on-site technical support to primary care providers. Questions that came in digitally and by phone were answered. FAQs were posted the next day.
Webcast  materials (slides and transcript) archived on ONC site August 31, 2009.

Frequently Asked Questions on Regional Program Posted by ONC on August 28, 2009 (Main FAQ page) (As of Oct 1, 2009, additional categories have been added and/or updated.)
      A. BACKGROUND/GENERAL FAQs
      B. FUNDING FAQs (updated Oct 1, 2009)
      C. ELIGIBILITY FAQs
      D. APPLICATION SUBMISSION FAQs  (updated Oct 1, 2009)
      E. APPLICATION REVIEW FAQs
      F. AWARD ADMINISTRATION FAQs
      G. OTHER/MISCELLANEOUS FAQs
     As of August 30, 2009, 29 Questions and Answers were posted in the FAQs on the ONC site, and regular changes are expected, so ONC advises to check back frequently. (Updates going on during Sept. 2, 2009.) 
     
      Note: The section below was written prior to September 2, 2009 updates.
     GENERAL QUESTIONS refer to statutory authority for Regional Centers, Health Information Technology Research Center (HITRC), relationship between HITRC and Regional Centers, role of Regional Centers, “meaningful use” requirements, eligible providers, selecting EHR vendors, HIE, independence from vendors, provider prioritization, definition of primary care providers and number of providers per regional center.
      FUNDING QUESTIONS refer to funding levels, budget periods, evaluation process and criteria, matching funds, program income, budget structure, terms and conditions, and basic Regional Center responsibilities.
     ELIGIBILITY QUESTION concerns for-profit firms teaming with non-profit organizations.     
     POTENTIAL APPLICANTS QUESTIONS refer to types of organizations eligible for grants, screening criteria for preliminary application, definition of geographic areas, application process, deadlines, and award dates.

Per the  iHealthBeat round up stories, ”ONC said it hopes each (of estimated 70+) extension center(s) will train about 1,500 primary care providers on electronic health record adoption, with the goal of helping 100,000 primary care providers demonstrate ‘meaningful use’ of health IT.”
Here are the two reports quoted by iHealthBeat on the Webcast from
–Joseph Conn, of Modern Healthcare’s HITS, on August 28, 2009.
       Modern Healthcare reader corrects revenue stream explanation.

–Paul McCloskey, of Government Health IT, on August 28, 2009.

Mostashari served as assistant commissioner of  the New York City Department of Health. The program he led in New York has brought 1,000 physicians, serving one million people primarily in underserved areas, on to electronic health records in the past two years, as reported in the New York Times by Steve Lohr on February 28, 2009.

Facts-in-Brief
Plan: Fund 70 regional extension centers in three waves in the federal fiscal year which begins October 1, 2009.
National Goal: Enable 100,000 of 240,000 primary care physicians in US to provide “meaningful use” via EHRs by 2013.
Regional Goal: Each regional extension center will be expected to train at least 1,000 primary care physicians by 2013 on using EHRS to deliver “meaningful use,” with an average of 1,500 physicians per center.
Regional Center Job: “To deliver the outreach, education, and (on-site) technical assistance services necessary to provide “meaningful use” by primary care providers.
Primary Care Providers Definition: “Any doctor of medicine or osteopathy, any nurse practitioner, nurse midwife, or physician assistant with prescriptive privileges…who is actively practicing one of the following specialties: family, internal, pediatric, or obstectrics and gynecology.”
“Meaningful Use” : “Meaningful Use” activities for Medicare providers will include “meaningful use” of certified EHRs, ability to demonstrate the electronic exchange of information to improve quality of health, and reporting of clinical quality measures.
EHR Selection: Regional Centers will offer “unbiased advice on the EHRs and other HIT products that will enable achievement of the meaningful use requirements…,” while avoiding “actual or apparent conflict of interest,” though Regional Centers may offer group purchasing arrangements with mutliple vendors.
States: “States or other government organizations may partner with a nonprofit institution or organization to apply for an award.”
First Mover Advantage: Dr. Mostashari explained on the Webcast that since each regional center will have an exclusive geographic territory, the first non-profit entities to win awards will carve out their territories subject to negotiation with  ONC and will maintain those territories going forward. Those first regional centers to be funded are probably already in the process of supporting EHR implementation.
Key Dates for Submissions:  Preliminary applications are due Sept. 8, 2009 for first wave, Dec. 22, 2009 for second wave, and June 1, 2010 for third wave. See prior post for remainder of schedule: http://www.e-healthcaremarketing.com/archives/897

Webcast  materials (slides and transcript) archived on ONC site August 31, 2009.

Meaningful Use Pushes Physician Adoption to the Top of Community Hospital IT Requirements

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Disruption in Community HIS Purchases:
It’s All About Physician Adoption
“Unlike past purchase decisions where cost and resource requirements dominated, community hospital (fewer than 200 beds) executives now consider physician adoption the number-one criterion when purchasing a hospital information system (HIS) solution, according to a report from KLAS” titled “Disruption in Community HIS Purchases: It’s All About Physician Adoption.” From August 25, 2009 Press Release from KLAS, the Utah-based  research firm which follows healthcare vendors.

iHealthBeat did a roundup on August 25, 2009 stories “Report: Small Hospitals Value Clinician Adoption of IT Systems” on latest KLAS Research.
Bernie Monegain of HealthcareIT News on August 25, 2009, wrote “Small hospitals shop for big hospital IT.”
In article,“Federal funding key to HIT acceleration: report,” Joseph Conn, HITS Staff Writer, wrote on August 25, 2009,“Purchase decisions are being made right now,” reads a subhead of the KLAS report, which followed up saying, “Half of those interviewed plan to make an HIS selection in the next 12 months.”

Facts-At-A-Glance: ONC Grant Programs

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HIT Extension Program and State HIE Program Facts-At-A-Glance
It’s worth rereading the two-page PDF (one page html) for each of these programs to gain perspective.

HIT Extension Program for Regional Centers:
20 Grants to Be Awarded in Oct-Dec 2009
With the 2010 federal fiscal year starting October 1, 2009, 20 grants are expected to be awarded in Q1 FY2010, 25 in Q3 FY2010, Balance (25 or more) in Q4 FY2010.
Facts-At-A-Glance  (html version)  (pdf version)

State Health Information Exchange Program
“The private sector will play an important role in providing innovative technological solutions to initiate, establish and maintain appropriate and secure HIE among health care providers at the state and national levels.”
Facts-At-A-Glance  (html version)  (pdf version)

HIT Extension Program Webcast: Aug 27, 2009

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Webcast on HIT Extension Program: Regional Centers
Thursday, August 27, 2009  Note Corrected Audio #s Below
Webcast  materials archived on ONC site August 31, 2009 = Slide Set.

The Office of the National Coordinator for Health Information Technology hosted a Technical Assistance call/web presentation to answer questions related to the Health Information Technology Extension Program: Regional Centers Cooperative Agreement Program Funding Opportunity Announcement.

WEBCAST: To connect, go to ONC Extension Program Webcast page.
First-time users should test/install software prior to meeting.
Software is Microsoft LiveMeeting.
NEW AUDIO: Toll-free: +1-800-619-2472   
Participant code: 3122
ONC Issued above corrected Audio #s on August 26, 2009.

HITECH Priority Grants Program Rollout Announced by ONC

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Second Blumenthal Letter: Grants Program Rollout
News on Next Steps Toward Nationwide Health Information Exchange
August 20, 2009
A Message from Dr. David Blumenthal, National Coordinator for Health Information Technology:

Today’s announcement from the White House regarding the rollout of the first two in a series of HITECH priority grant programs represents a critical step forward in laying the groundwork for meaningful use of electronic health records (EHRs). These programs will offer valuable help to health care providers in the selection and incorporation of EHRs into clinical practice, and for States and their designates to assure that statewide information exchange is developed with an eye toward nationwide connectivity across the health care system.   See full letter.

Blumenthal’s letter goes on to describe
1. Health Information Technology Extension program funding “dozens” of centers across the country to give technical assistance to physicians and hospitals, along with a national Health Information Technology Research Center (HITRC) to coordinate best practices among the regional centers, and
2. State Health Information Exchange Cooperative Agreement program to encourage and guide health information exchange among States and Qualified State Designated Entities (SDEs) and on a national level.

See Overview: ONC Releases Grants Program Details

DETAILS
1. Health Information Technology Regional Extension
Tune in to  August 27, 2009 Webcast from ONC on this program.
http://healthit.hhs.gov/extensionprogram
–Funding Opportunity Announcement: Health Information Technology Extension Program: Regional Centers  Cooperative Agreement Program
                    Attachment 1
–Facts-At-A-Glance [PDF]

2. State Health Information Exchange Cooperative Agreement Program
–Funding Opportunity Announcement: State Health Information Exchange Cooperative Agreement Program
–Facts-At-A-Glance  [PDF]

Additional Articles on Blumenthal’s Action-Packed 24+ Hours on August 19-20, 2009
Healthcare IT News’s Bernie Monegain reports on August 21, 2009 on HIT “from dawn to dusk.”
Washington Post’s Robert O’Harrow, Jr. report on  August 21, 2009 headlined “U.S. to Dole out $1.2 Billion for Health Records Technology” describes the announced grants as the “first wave of funding under a health-care reform plan to create vast records-sharing networks aimed at cutting costs and improving care in the coming decade.” In addition to quoting Vice President Joe Biden’s announcement, O’Harrow interviewed H. Stephen Lieber, the president and chief executive of HIMSS, and Carol Diamond, managing director of health at the nonprofit Markle Foundation.
Government HealthIT’s Mary Mosquera reported additional details from a teleconference Blumenthal held with media on August 20, 2009, “The regional centers will support at least 100,000 mostly small, and primary care practices through participating non-profit organizations, HHS said in its description of the grants.”

Biden, Sebelius, Blumenthal announce funding for EMR extension centers, HIE

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Funding announced for EMR extension centers, healthcare information exhanges
Neil Versel of FierceEMR reports on August 20, 2009, “Vice President Joe Biden, HHS Secretary Kathleen Sebelius and national health IT coordinator Dr. David Blumenthal are in Chicago today to announce $1.2 billion in federal grants to promote EMR use and interoperability” out of the $2.0 billion allocated to ONC from the HITECH Stimulus funds. That’s $589 million funding allocated for grants supporting Health IT extension centers (built on Agriculture model) to assist physicians and hospitals to put EHRs in place, and $564 million to support HIEs and the national exhange network.

U.S. Grants $1.2 Billion For Electronic Health Records
Debra Sherman, reporting for Reuters and appearing in New York Times on August 20, 2009, wrote “National Coordinator for Health IT David Blumenthal said these funds will likely be granted in three cycles over the course of 2010.” “‘This is just the first wave of resources invested in health technology aimed at transforming our paper-driven system to an electronic system over the next several years,’ said (Secretary HHS Kathleen) Sebelius, who was in Chicago to unveil the grants with (Vice President Joe) Biden.”

70 Health Technology Regional Extension Centers to be Funded
How to apply for funds to be announced August 20, 2009
Bernie Monegain, Editor of Healthcare IT News, reported on August 20, 2009, “The grants include $598 million to establish 70 health information technology regional extension centers to help hospitals and clinicians and $564 million to help states improve information sharing – expected to be made available to states for developing and supporting health information exchanges (HIEs).”  Monegain also reported that details will be announced August 20, 2009 ”how to apply for the money.”

Nine Lessons Learned From EMR Veterans

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Electronic Medical Records  systems: huge challenges;
Payoff much larger: improving people’s health and saving lives
Marianne Kolbasuk McGee, of Information Week, reported on August 15, 2009 (Aug. 17 issue), on “nine lessons learned the hard way during real-world implementations of EMRs.”  Valuable topics include sticker shock, need to get doctors and nurses on board, need for expert help, thinking about tomorrow, and managing expectations. People interviewed range from large health organization Health IT leaders (Intermountain Healthcare) to 17-clinician practice in four locations (Hot Springs Health Program, North Carolina).

Social Security to Fund $24 Million in Contracts for Electronic Medical Records

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Social Security to Fund $24 Million in Contract for EMRs
Proposals due September 18, 2009
Questions about RFP due August 26, 2009
Detailed project description: http://www.fbo.gov.
Solicitation Number: SSA_RFP_10_1001
Michael J. Astrue, Commissioner of Social Security, announced  on Friday, August 7, 2009 “the availability of $24 million in contracts to provide the agency with electronic medical records to improve the efficiency of its disability programs…Social Security is looking for health care providers, provider networks, and health information exchanges to participate in its Medical Evidence Gathering and Analysis through Health Information Technology (IT) program.”

As Social Security Administration describes the program “MEGAHIT automates the process of requesting and receiving electronic health records from health care providers. In August 2008, we successfully partnered with Beth Israel Deaconess Medical Center in Boston to provide a patient-authorized electronic health record release and accept an electronic health record response. In February 2009, we partnered with MedVirginia on the first production use of the NHIN to request and receive electronic health records. These highly successful initiatives, improved the speed and consistency of our disability decisions at our pilot offices. MEGAHIT generates administrative cost savings and may produce a significant reduction in costs of uncompensated care for our provider partners.”

Archived Federal Webinar on
“Social Security and Health IT: Get the Benefits you Deserve”
Introduction by Jim Borland, Special Advisor for Health IT, Office of the Commissioner, Social Security Administration
(Originally webcast on August 11, 2009) 
Above link to Webinar and background materials including
AmMedNews article (June 24, 2009) by Pamela Lewis Dolan: “Social Security says test proves benefits of health data exchange.”

Physicians in Small & Medium Sized Practices: Tell us Your Workflow

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Small & Medium Sized Practices: AHRQ Seeks Information on Tools for Redesigning Health IT Workflow by August 24, 2009
Agency for Healthcare Research and Quality (AHRQ) says “Information is needed from small- and medium-sized physician practices/clinics that have implemented or are considering implementing health IT about how they study or redesign their workflow, including information on the use of tools, methods or data reports for studying workflow.” 

AHRQ Web site notice.
Read the full notice published in the Federal Register. pdf Version
For additional information on the project, visit the project Web site: CQPI: Center for Quality & Productivity Improvement at University of Wisconsin-Madison. Comments should be submitted on or before August 24, 2009.  Electronic responses are preferred and should be addressed to WorkflowRFI@ahrq.hhs.gov.

EXCERPT FROM FEDERAL REGISTER:
“SUMMARY: This notice announces the intention of the Agency for
Healthcare Research and Quality (AHRQ) to request information from (1) small- and medium-sized practices about how they study or redesign their workflow, including information on the use of tools and methods for studying workflow, and (2) others (e.g., experts, vendors, professional associations) that have developed, implemented and used tools and methods for studying workflow in the context of health IT implementation and use. Workflow is defined as the way work is performed and patient-related information is communicated within small-and medium-sized practices and between those practices and external 0rganizations such as community pharmacies and local hospitals. It is our understanding that there is currently no standard description of workflows for care processes that can be used to guide decisions of where and how to incorporate health information technology.”

“This Request for Information is part of a three-pronged effort to scan the environment, the literature and knowledgeable and interested parties to produce a useful list of resources that may assist small- and medium-sized medical practices and clinics to consider the utility and potential effectiveness of incorporating health IT into the way they practice and communicate patient information. The responses to this request for information will be considered for reference and possible incorporation into an electronic toolkit to be made available on the Internet to assist small- and medium-sized practices in analyzing or redesigning workflow either before or after implementation of one or more health IT applications. All responses to this request for information are voluntary.”

BMC Medical Informatics and Decision Making
How to successfully select and implement
electronic health records (EHR) in small ambulatory practices
By Nancy M. Lorenzi, Angelina Kouroubali, Don E. Detmer and Meryl Bloomrosen
Published in February 2009 by BMC Medical Informatics and Decision Making, paper focuses “on small ambulatory practices” and “outlines the benefits and barriers to EHR use in this setting, and provides a ‘field guide’ for these practices to facilitate successfull EHR implementation.” This paper was produced as part of the AHRQ National Resouce Center on Health Information Technology (NRC). Valuable references included.
Link to html version: http://www.biomedcentral.com/1472-6947/9/15
Link to pdf version.