Category Archives: Digital Physicians

Blumenthal Letter #23: EHR Adoption Set to Soar

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EHR Adoption Set to Soar
January 13, 2010 (accessed from ONC site on 1/13/2010)

Portrait of Dr. Blumenthal

The tide is turning.

An increasing number of office-based physician practices report having an electronic health record, according to a recent survey.  Survey respondents also reported high levels of interest in adopting electronic health records and health information technology.

The survey [PDF - 220 KB] was conducted by the National Center for Health Statistics (NCHS), an agency of the HHS’ Centers for Disease Control and Prevention.

More and more physicians are putting a private and secure electronic framework in place to realize long-term improvements in quality of care, efficiency, and health costs. But the presence of an EHR does not make a physician a meaningful user.

An electronic health record, as defined in the survey, could have been just a “basic” EHR—one that stores patient demographic information, patient problem lists, clinical notes, laboratory and imaging results, and orders for prescriptions. Basic EHRs are not capable of being used to meet the requirements of meaningful use.

Fortunately, additional data commissioned by the Office of the National Coordinator for Health Information Technology (ONC) and carried out in the course of regular annual surveillance by the NCHS and by the American Hospital Association (AHA) provide further encouragement that EHR adoption is about to pick up speed.

The NCHS survey found that 41 percent of office-based physicians are currently planning to achieve meaningful use of EHRs and apply for incentive payments. Four-fifths of these, or about a third of all office-based physicians (32.4 percent), plan to apply this year.

The AHA survey found that 81 percent of acute care non-federal hospitals plan to achieve meaningful use of EHRs and apply for incentive payments. About two-thirds of hospitals (65 percent) plan to enroll during Stage 1 of the Incentive Programs, in 2011-2012.

At ONC we are gratified that such sizeable percentages of physicians and hospitals intend to take the plunge—and to take the plunge sooner rather than later.

Acting early (in Stage 1) means obtaining maximum funding through the Medicare and Medicaid EHR Incentive Programs. Physicians and other eligible professionals can qualify for incentive payments totaling as much as $44,000 through Medicare or $63,750 through Medicaid. Hospitals can qualify for millions of dollars of incentive payments for implementing and becoming meaningful users of EHR technology.

The registration process is now open for health care providers to obtain significant incentive payments for the adoption and meaningful use of certified EHRs.

We recognize that EHR adoption and meaningful use are hard work and a big investment, especially for small primary care practices, where the vast majority of physicians work and where most of patient care is coordinated and documented. Many of these providers still need to learn about the opportunity they have.

Now is the time. Unprecedented resources, including the EHR incentive and technical assistance programs created under HITECH, are available. Sixty-two Regional Extension Centers (RECs) across the nation are prepared to offer customized, on-the-ground assistance. And the Health IT Workforce Development Program is training talented professionals to help providers implement and manage their health IT systems. Moreover, medical and hospital professional organizations are lighting the way.

Rest assured there are also regulations in place to make sure that information stored in an EHR is protected. The same Health Insurance Portability and Accountability Act (HIPAA) privacy and security protections that apply to paper records also apply to EHRs.

Never again will the same level of resources and talent be devoted to helping providers make the switch to health IT.

The incipient surge in EHR adoption is galvanizing, especially for those of us who are committed to making the transition from paper-based medical records to EHRs as seamless and as successful as possible for every provider. ONC will continue to offer encouragement and support.

For more information on the Medicare and Medicaid EHR Incentive Programs, visit http://www.cms.gov/EHRIncentivePrograms. Providers can also find REC contact information at http://healthit.hhs.gov/rec. Learn about the HIPAA Privacy and Security Rules by visiting http://www.hhs.gov/ocr/privacy/.

Warmest Regards,

David Blumenthal, MD, MPP
National Coordinator for Health Information Technology

The Office of the National Coordinator for Health Information Technology (ONC) encourages you to share this information as we work together to enhance the quality, safety and value of care and the health of all Americans through the use of electronic health records and health information technology.

For more information and to receive regular updates from the Office of the National Coordinator for Health Information Technology, please subscribe to our Health IT News list.

8 of 10 Hospitals, 4 of 10 Physicians Plan to Adopt Electronic Health Records; Reversal of Trends

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Surveys show significant proportions of hospitals and doctors already plan to adopt electronic health records and qualify for federal incentive payments
2/3 of Hospitals Plan to Enroll During Stage 1, 2011-2012
HHS Press Release
Thursday, January 13, 2010

Four-fifths of the nation’s hospitals, and 41 percent of office-based physicians, currently intend to take advantage of federal incentive payments for adoption and meaningful use of certified electronic health records (EHR) technology, according to survey data released today by the Office of the National Coordinator for Health Information Technology (ONC).  The survey information was released as the registration period opened for the Medicare and Medicaid EHR Incentive Programs.

David Blumenthal, M.D., M.P.P., the National Coordinator for Health Information Technology, said the survey numbers represent a reversal of the low interest in EHR adoption in previous years.  He credited leadership from the medical community and the federal government for the improved prospects for adoption and use of health information technology (health IT).

“For years we have known that electronic health records would improve care for patients and bring about greater cost effectiveness in our health sector, yet adoption rates by health care providers remained low,” Dr. Blumenthal said.  “In 2009, Congress and the President authorized major new federal support for EHR adoption and use, and in combination with medical professional and hospital leadership. I believe we are seeing the tide turn toward widespread and accelerating adoption and use of health IT.”

The data released today comes from surveys commissioned by ONC and carried out in the course of regular annual surveillance by the American Hospital Association (AHA) and the National Center for Health Statistics (NCHS), an agency of HHS’ Centers for Disease Control and Prevention (CDC).

The AHA survey found that 81 percent of hospitals plan to achieve meaningful use of EHRs and take advantage of incentive payments.  About two-thirds of hospitals (65 percent) responded that they will enroll during Stage 1 of the Incentive Programs, in 2011-2012.

The NCHS survey found that 41 percent of office-based physicians are currently planning to achieve meaningful use of certified EHR technology and take advantage of the incentive payments.  Four-fifths of these, or about a third of all office-based physicians (32.4 percent), responded that they will enroll during Stage 1 of the programs.  Only 14 percent of respondents said they were not planning to apply for meaningful use incentives.

Additional survey data from NCHS show that significantly increasing numbers of primary care physicians have already adopted a basic EHR, rising by 50 percent from 19.8 percent of primary care physicians in 2008 to 29.6 percent in 2010.  Basic EHRs provide a beginning point for use of electronic health records in physician offices, but most physicians would need to further upgrade their EHR systems or their use of the systems in order to qualify for meaningful use incentive payments.

Incentive payments for the adoption and meaningful use of certified EHR technology were authorized in the Health Information Technology Economic and Clinical Health Act (HITECH) in 2009.   Incentive payments will be made through the Medicare and Medicaid programs.  High rates of adoption and meaningful use could result in as much as $27 billion in incentive payments over 10 years.

Non-hospital-based physicians and other eligible professionals can obtain incentive payments of as much as $44,000 under Medicare or $63,750 under Medicaid.  Under both Medicare and Medicaid, eligible hospitals may receive millions of dollars for implementing and meaningfully using certified EHR technology.

Provider registration for the Medicare EHR Incentive Program and some Medicaid EHR Incentive Programs opened Jan. 3, 2011.  Most states will allow provider registration to begin for their Medicaid EHR Incentive Programs during the spring and summer of 2010.

“We are pleased to see this evidence of an enthusiastic early response, and we believe participation will continue to grow, especially as the Nation’s physicians become more familiar with this one-time opportunity to improve care while helping to offset the costs of adopting EHR systems,” said Donald Berwick, M.D., Administrator of the Centers for Medicare & Medicaid Services (CMS).

To qualify for incentive payments, under the Medicare EHR Incentive Program, providers must achieve meaningful use of certified EHR technology, under regulations issued by CMS and ONC.  Medicaid providers can receive their first year’s incentive payment for adopting, implementing, and upgrading certified EHR technology but must demonstrate meaningful use in subsequent years in order to qualify for additional payments.

Dr. Blumenthal said the meaningful use process has contributed to the increased willingness of providers to adopt EHR systems, especially because it guides providers through staged objectives for the productive use of EHRs, and because providers can now be assured that Complete EHRs and EHR Modules certified under ONC criteria by ONC-authorized testing and certification bodies can be relied upon to support the meaningful use objectives.

He also pointed to the technical support programs created under the HITECH Act and now operating under ONC, which offer support to providers as they switch from paper records to EHRs.  In particular, 62 Regional Extension Centers (RECs) across the nation will offer customized, on-the-ground assistance, especially for smaller-practice primary care providers and for small hospitals and clinics.

“We know that adoption of EHRs and conversion to EHR-based care is expensive and challenging, especially for smaller providers,” Dr. Blumenthal said.  “With HITECH, we are able to provide unprecedented funding and technical support programs to help providers make the transition and to help our nation achieve the improvements in health care quality, safety and cost effectiveness EHRs will bring about.”

Dr. Blumenthal also praised medical professional organizations and hospital leaders, who have encouraged members to act soon in taking advantage of HITECH support programs and adopting EHR systems.

Survey results from NCHS  and AHA can be obtained at :

http://www.cdc.gov/nchs/data/hestat/emr_ehr_09/emr_ehr_09.htm

http://www.ahadata.com/ahadata/html/AHASurvey.html

Information about the incentive payments program is available on the CMS website at http://www.cms.gov/ehrincentiveprograms.

Information about Regional Extension Centers (RECs) and technical assistance is available on the ONC website at http://healthit.hhs.gov/REC.

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State Medicaid EHR Programs’ Expected Rollout Dates Released by CMS

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Going Beyond the January and February 2011 State Medicaid EHR Incentive Program Rollout Dates and Web sites
Beyond the rollout dates of January and February 2011 for 14 state Medicaid EHR Incentive Programs, Centers for Medicare and Medicaid Services (CMS) released the anticipated dates for the program to go live in the balance of the states and territories as of December 15, 2010. State and territory Medicaid information sites are also shown.

The CMS EHR Incentive Programs Spotlight Page listed the states that will have their State EHR Medicaid programs ready in the first two months of 2011.

Registration opens in the following states on January 3, 2011:

  • Alaska
  • Iowa
  • Kentucky
  • Louisiana
  • Oklahoma
  • Michigan
  • Mississippi
  • North Carolina
  • South Carolina
  • Tennessee
  • Texas

Registration opens in the following states in February 2011:

  • California
  • Missouri
  • North Dakota

List of all states and territories with expected dates they reported to CMS when they anticipate their state/territory Medicaid EHR programs to be ready. [The list in PDF form was dated December 15, 2010, and was included in 1/3/2011 update of a CMS FAQ on how dual eligible (Medicare and Medicaid) hospitals should register.]

“The Medicaid EHR Incentive Program is a voluntary program established by Congress, but administered individually by each State and territory. While we currently estimate that every State will have an Incentive Program in the future, the preparation for the program varies from State to State. Below is the estimated date each State [and territory] intends to begin accepting registrations for their Medicaid EHR Incentive Program. These dates are provided to CMS by the States, and this list is updated monthly. Even States that are listed as “Unknown” are progressing toward program launch; however, they have not provided CMS with an estimated launch date [as of December 15, 2010].”

State EHR Medicaid Registration Dates and Web sites

State Expected Launch Date Program URL
AK January 2011 http://hss.state.ak.us/hit/
AL March 2011 http://www.onehealthrecord.alabama.gov/
AR Spring 2011 https://www.medicaid.state.ar.us/provider/arra.aspx
AS Unknown No State URL Known
AZ Unknown http://www.azahcccs.gov/HIT/about/Incentives.aspx
CA February 2011 http://medi-cal.ehr.ca.gov/
CO Unknown http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1251581838726
CT Unknown http://www.ct.gov/dph/cwp/view.asp?a=3936&q=462912&dphNav_GID=1993
DC Unknown No State URL Known
DE Spring 2011 http://dhss.delaware.gov/dhss/dmma/ehr_summary.html
FL Unknown http://fhin.net/FHIN/MedicaidElectronicHealthRecordIncentiveProgram.shtml
GA Unknown http://dch.georgia.gov/00/article/0,2086,31446711_154959664_156789923,00.html
GU Unknown http://dphss.guam.gov
HI Unknown http://www.med-quest.us/providers/ElectronicHealthRecordIncentiveProgram.html
IA January 2011 http://www.ime.state.ia.us/Providers/EHRIncentives.html
ID Fall 2011 http://www.MedicaidEHR.dhw.idaho.gov
IL late Spring 2011 http://www.hie.illinois.gov/ehrincentives/
IN Mid-2011 http://provider.indianamedicaid.com/general-provider-services/ehr-incentive-program.aspx
KS June 2011 http://www.khpa.ks.gov/hite/default.htm
KY January 2011 http://chfs.ky.gov/dms/EHR.htm
LA January 2011 http://www.lamedicaid.com/provweb1/EHR/EHRIndex.htm
MA Unknown No State URL Known
MD Unknown http://mhcc.maryland.gov/electronichealth/electronichealth.html
ME August 2011 http://www.maine.gov/dhhs/oms/HIT/index.html
MI January 2011 http://michiganhealthit.org/
MN Fall 2011 http://www.health.state.mn.us/e-health/hitech.html
MO February 2011 http://www.dss.mo.gov/mhd/ehr/
MP Unknown No State URL Known
MS January 2011 http://ms.arraincentive.com/
MT Spring 2011 http://medicaidprovider.hhs.mt.gov/providerpages/ehrincentives.shtml
NC January 2011 http://www.ncdhhs.gov/dma/provider/ehr.htm
ND February 2011 http://www.healthit.nd.gov/medicaid
NE Fall 2011 http://www.dhhs.ne.gov/med/EHR.htm
NH Winter 2011/2012 http://www.NHMedicaidHIT.org
NJ Unknown No State URL Known
NM Unknown http://www.hsd.state.nm.us/mad/MeiPP.html
NV Summer 2011 https://dhcfp.nv.gov/EHRIncentives.htm
NY September 2011 http://www.health.ny.gov/regulations/arra/department_of_health_programs.htm#health_it
OH Unknown http://grc.osu.edu/MPIP
OK January 2011 http://www.okhca.org/EHR-incentive
OR Summer 2011 http://www.oregon.gov/DHS/mhit/incentive.shtml
PA Unknown http://www.dpw.state.pa.us/provider/healthcaremedicalassistance/medicalassistancehealthinformationtechnologyinitiative/index.html
PR Unknown
RI June 2011 http://www.dhs.ri.gov/Portals/0/Uploads/Documents/Public/MA_Providers/ehr_incentive_prg.pdf
SC January 2011 http://hit.scdhhs.gov/hit/
SD Fall 2011 http://www.dss.sd.gov/medicalservices/incentiveprogram/
TN January 2011 http://www.tn.gov/tenncare/hitech.html
TX January 2011 http://www.tmhp.com/Pages/HealthIT/HIT_Home.aspx
UT September 2011 http://health.utah.gov/medicaid/provhtml/HIT.htm
VA Fall 2011 http://dmasva.dmas.virginia.gov/Content_pgs/pr-arra.aspx
VI Unknown No State URL Known
VT Unknown http://hcr.vermont.gov/cms_meaningful_use
WA April 2011 http://hrsa.dshs.wa.gov/MedicaidHealthCareReform/IT.shtml
WI Unknown http://www.dhs.wisconsin.gov/ehrincentive/
WV Unknown No State URL Known
WY Summer 2011 http://www.wyominghit.com/

As of December 15, 2010.

Blumenthal Blogs on HIT Taskforce Guidance on Federal Health IT

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HIT Taskforce Guidance on Health IT
Friday, January 7th, 2011 | Posted by: Dr. David Blumenthal, National Coordinator for Health IT on ONC’s Health IT Buzz blog and reposted here by e-Healthcare Marketing.

In September 2010, Vivek Kundra, the Federal Chief Information Officer, and I issued guidance articulating five key health IT policy and technology principles for Federal health IT projects. The goal of these principles is to encourage better strategic alignment of health IT investments by guiding modernization strategies for existing systems, as well as new investment decisions. Agencies were asked to demonstrate how they plan to incorporate the following policy and technology principles into future health IT investments and to provide specific examples from their fiscal year (FY) 2012 budget submissions:

  • Improving health and health care: Agencies should design their health IT systems to support clinical decision-making and to measurably improve long term outcomes. For FY 2012, agencies will be asked to demonstrate their support for the universal attainment of Meaningful Use either by, if eligible, becoming Meaningful Users themselves or by assisting and encouraging others that are eligible, to become Meaningful Users.
  • Promoting open government: Agencies should share information with their clients/patients, when possible and practicable. An FY 2012 priority is providing clients/patients a secure, timely, electronic copy of their own information in a format they can use and reuse.
  • Securely sharing health information between providers for treatment purposes to enable better care: Agencies should ensure Federal HIT systems are interoperable.  In FY 2012, agencies should use standards and specifications adopted under the HITECH Act in communicating between applications and organizations.
  • Being a trusted steward of taxpayer dollars: Agencies should incorporate interoperable voluntary consensus standards and terminologies where available, and contribute to their ongoing development, as their missions provide for and their resources permit. To this end, FY 2012 investments should use and re-use common, interoperable voluntary consensus standards and terminology, as well as employ modular, flexible solutions to ensure health IT systems are built for re-use and evolution.
  • Protecting privacy and security: Agencies should align their health IT investments with the Fair Information Practice Principles and demonstrate this alignment in FY 2012.

Following submission, agency plans underwent a rigorous peer review process, and representatives from HHS, Department of Agriculture, Department of Commerce, Department of Defense, Department of Veterans Affairs, Social Security Administration, and Office of Personnel Management took an active role in evaluating the investments of the various Federal counterparts.

The development of principles and the use of peer review to review Federal health IT expenditures constitute a novel basis for coordinating these expenditures and providing the best possible advice to sister agencies.  In the future, we hope that this process will result in valuable learning for managers of health IT in the Federal Government, and lead to better value for patients and taxpayers.
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To comment directly on this post, please go to ONC’s Health IT Buzz blog.

ONC Presents “Spotlight on Health IT in the News”

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Spotlight on Health IT in the News
Excerpted this new feature from Office of the National Coordinator (ONC) for Health IT  site, first  published on 1/5/2010 and updated on 1/6/2010.

  1. Blumenthal Looks Back at 2010, Offers Peek Into Plans for 2011
    Q&A with David Blumenthal, M.D., M.P.P., National Coordinator for Health Information Technology
    iHealthBeat, January 3, 2011

    Dr. Blumenthal discusses the challenges ONC faced in 2010, plans for 2011, and the importance of health information technology (health IT) to the implementation of federal health reform law.

  2. Electronic Health Records: Potential to Transform Medical Education
    By Sachin H. Jain, M.D., M.B.A., Special Assistant to the National Coordinator for Health Information Technology, and Bryant A. Adibe, B.S., Executive Director, Young Achievers Foundation
    The American Journal of Managed Care, December 22, 2010

    Dr. Jain and Bryant Adibe examine the ways in which EHR adoption can lead to improved patient-centered approaches to physician training.

  3. Healthcare Information Technology Interventions to Improve Cardiovascular and Diabetes Medication Adherence
    By Sachin H. Jain, M.D., M.B.A., Special Assistant to the National Coordinator for Health Information Technology, et al.
    The American Journal of Managed Care, December 22, 2010

    This literature review discusses health IT interventions designed to improve medication adherence in cardiovascular disease and diabetes.

  4. Alternative Measures of Electronic Health Record Adoption Among Hospitals
    By Melinda J. Beeuwkes Buntin, Ph.D., Director, Office of Economic Analysis and Modeling, and Charles P. Friedman, Ph.D., Chief Scientific Officer, ONC
    The American Journal of Managed Care, December 22, 2010

    This study examines the type of EHR functions that hospitals have adopted.

  5. Using Electronic Prescribing Transaction Data to Estimate Electronic Health Record Adoption
    By Farzad Mostashari, M.D., Sc.M., Deputy National Coordinator for Programs and Policy; Melinda J. Beeuwkes Buntin, Ph.D., Director, Office of Economic Analysis and Modeling; and Emily Ruth Maxson, Duke University School of Medicine
    The American Journal of Managed Care, December 22, 2010

    This study investigates whether electronic prescribing transaction data can be used to accurately and efficiently track national and regional electronic health record adoption.

  6. Health Information Technology Is Leading Multisector Health System Transformation
    By David Blumenthal, M.D., M.P.P., National Coordinator for Health Information Technology and Sachin H. Jain, M.D., M.B.A., Special Assistant to the National Coordinator for Health Information Technology
    The American Journal of Managed Care, December 17, 2010

    Dr. Blumenthal and Dr. Jain discuss the impact of the HITECH Act on health information technology (health IT) adoption and provide an overview of the content found in the journal’s special issue on health IT.

  7. Uniting the Tribes of Health System Improvement
    By Aaron McKethan, Ph.D., Program Director, and Craig Brammer, Deputy Director, Beacon Community Program
    The American Journal of Managed Care, December 17, 2010

    Dr. McKethan and Craig Brammer discuss how multiple interventions and simultaneously implemented tools are required to transform the U.S. health care system.

  8. Regional Quality Initiatives: Expanding the Partnership
    Blog post by David Blumenthal, M.D., M.P.P., National Coordinator for Health Information Technology; Carolyn Clancy, M.D., Director of the Agency for Healthcare Research and Quality (AHRQ); and Risa Lavizzo-Mourey, President of The Robert Wood Johnson Foundation (RWJF)
    Health Affairs Blog, December 9, 2010

    This joint ONC, AHRQ, and RWJF blog post discusses how dozens of diverse regions of the country are benefiting from an unprecedented commitment of resources and technical expertise to help local leaders improve the quality of health care provided in their region.
  9. Perspective: Dr. David Blumenthal on Health Information Technology
    Q&A with David Blumenthal, M.D., M.P.P., National Coordinator for Health Information Technology
    MDNews.com, November 19, 2010

    Dr. Blumenthal discusses provider involvement in implementation of health IT as part of a videotaped interview during the Medical Group Management Association 2010 conference, held October 24-27.

10.  Fed Health Tech Chief Talks about E-Medical Records
Q&A with David Blumenthal, M.D., M.P.P., National Coordinator for Health Information Technology
The Texas Tribune, October 21, 2010

Dr. Blumenthal discusses the benefits of electronic health records and protections for patient privacy. 

11.  Beacons for Better Health
By Aaron McKethan, Ph.D., Program Director, and Craig Brammer, Deputy Director, Beacon Community Program
Health Affairs Blog, September 23, 2010

Dr. McKethan and Mr. Brammer discuss how Beacon Communities will showcase ways that health information technology is being used to support providers in delivering improved patient care.

12.  This Doctor’s Task: Get Hospitals to Go Digital
Q&A with David Blumenthal, M.D., M.P.P., National Coordinator for Health Information Technology
Federal Times.com, September 13, 2010

Dr. Blumenthal elaborates on ONC’s efforts to encourage the electronic transformation of health care delivery on the national and local levels.

13.  The Push for Electronic Medical Records (listen to audio file)
Interview with David Blumenthal, M.D., M.P.P., National Coordinator for Health Information Technology
Vermont Public Radio, September 9, 2010

Dr. Blumenthal speaks to Vermont Public Radio about the Vermont Information Technology Leaders Summit and how the state’s hospitals and providers can increase their electronic health records adoption.

14.  Beaconology for Beginners: A Chat with ONC’s Aaron McKethan
Aaron McKethan, Ph.D., Program Director, Beacon Community Program
CMIO Blog, September 7, 2010

Dr. McKethan chats with CMIO about producing community-level clinical performance measures as modeled by the Beacon Community Program.

15.  Strengthening the Gulf’s Health-Care Infrastructure for Generations to Come
By Kathleen Sebelius, Secretary, U.S. Department of Health and Human Services
Huffington Post, August 27, 2010

HHS Secretary Kathleen Sebelius discusses rebuilding the health-care infrastructure to meet the Gulf communities’ long-term medical needs, including efforts by Beacon Communities to help providers move from paper files into the digital age.

16.  The New Momentum Behind Electronic Health Records
By Kathleen Sebelius, Secretary, U.S. Department of Health and Human Services
KHN Blog, Kaiser Health News, August 26, 2010

HHS Secretary Kathleen Sebelius details the benefits of health IT adoption for the entire health care system. 

17.  Health Information Technology Program Receives $2.7 Million in Federal Funding, Graduates First Class of Students This Summer
University of Texas at Austin Website, August 26, 2010

University of Texas at Austin graduates the nation’s first class of students from its federally funded health IT workforce development program.

18.  Adoption and Meaningful Use of EHRs – The Journey Begins
By David Blumenthal, M.D., M.P.P., National Coordinator for Health Information Technology; and Don Berwick, M.D., Administrator, Centers for Medicare & Medicaid Services
Health Affairs Blog, August 5, 2010

Dr. Blumenthal and Dr. Berwick explain the need for federal leadership in helping providers nationwide to adopt and utilize health IT for better quality of care.

19.  Perspective: The “Meaningful Use” Regulation for Electronic Health Records
By David Blumenthal, M.D., M.P.P., National Coordinator for Health Information Technology, and Marilyn Tavenner, R.N., M.H.A., Principal Deputy Administrator, Centers for Medicare & Medicaid Services
New England Journal of Medicine, July 13, 2010

Dr. Blumenthal and Marilyn Tavenner summarize the core objectives of the CMS “Meaningful Use” regulation and how it ties payments to the achievement of advances in health care processes and outcomes.

20.  Perspective: Finding My Way to Electronic Health Records
By Surgeon General, Vice Admiral Regina M. Benjamin, M.D., M.B.A.
New England Journal of Medicine, July 13, 2010

Surgeon General Regina Benjamin shares her personal story about understanding the value of electric health records in preserving patient records when disaster strikes.

21.  Health Information Technology: Laying the Infrastructure for National Health Reform [PDF - 146 KB]
By David Blumenthal, M.D., M.P.P., National Coordinator for Health Information Technology; Sachin H. Jain, M.D. M.B.A., Special Assistant to the National Coordinator for Health Information Technology; and Melinda Beeuwkes Buntin, Ph.D., Senior Economic Advisor, ONC
Health Affairs, June 2010

  1. Drs. Blumenthal, Jain, and Buntin discuss the key ways in which health IT is critical to the implementation of national health reform.

22.  Perspective: Launching HITECH
By David Blumenthal, M.D., M.P.P., National Coordinator for Health Information Technology
New England Journal of Medicine, February 4, 2010

Dr. Blumenthal outlines the HITECH Act as the groundwork for an advanced electronic health information system.

CMS Opens EHR Incentive Program Registration, Issues Guides to Registration

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Registration for the Medicare and Medicaid EHR Incentive Programs is now open.
State Medicaid EHR Readiness appears to delay registration completion in those states at least for Medicaid
CMS has issued three step-by-step guides to registration  for the EHR Incentive Programs, each about 20 pages long, for Eligible Hospitals, Professionals Eligible for Medicare, and Professionals Eligible for Medicaid. For hospitals in states which are not yet ready with their Medicaid programs, the guide indicates “your file will be placed into a pending status until your state’s program is launched.” For eligible professionals in states which are not yet ready for Medicaid, they may not be able to register until those states are ready. (The EHR Information Center phone line said eligible professionals in non-ready states would not be able to register for Medicaid programs yet.) Dual-eligible hospitals, who potentially may apply for both Medicare and Medicaid are advised to indicate they will be applying for both Medicare and Medicaid EHR Incentives, even if they are not ready at this point.

We strongly recommend reading the applicable guide thoroughly and have all the information required prior to going to register. We expect more clarity to come on some issues noted above in the next few days.

CMS EHR Registration and Attestation Page
Excerpted from CMS site on 1/3/2010:
We encourage providers to register for the Medicare and/or Medicaid EHR Incentive Program(s) as soon as possible. You can register before you have a certified EHR. Register even if you do not have an enrollment record in PECOS.

Register for the Medicare and/or Medicaid EHR Incentive Programs.

Below are step-by-step guides to help you register for EHR Incentive Programs. Choose the guide that fits your needs:

Please Note: Although the Medicaid EHR Incentive Programs will begin January 3, 2011, not all states will be ready to participate on this date. Information on when registration will be available for Medicaid EHR Incentive Programs in specific States is posted at Medicaid State Information.

Eligible Professionals:

Eligible professionals eligible for both the Medicare and Medicaid EHR Incentive Programs must choose which incentive program they wish to participate in when they register. Before 2015, an eligible professional may switch programs only once after the first incentive payment is initiated. Most eligible professionals will maximize their incentive payments by participating in the Medicaid EHR Incentive Program.
Editor’s note: We anticipate that this comment on professionals will be updated regarding Medicaid, since it appears Medicaid registration may be delayed until a state’s Medicaid program is ready.

Hospitals:
Editor’s note: Please note this is new language since registering for a state’s Medicaid program appears that it will be delayed until that state’s Medicaid program is ready. Unclear how this impacts dual-eligible hospitals.

If you represent a hospital that meets all of the following qualifications, you are dually-eligible for the Medicare and Medicaid EHR Incentive Programs:

  • You are a subsection(d) hospital in the 50 U.S. States or the District of Columbia, or you are a Critical Access Hospital (CAH); and
  • You have a CMS Certification Number ending in 0001-0879 or 1300-1399; and
  • You have 10% of your patient volume derived from Medicaid encounters.

Hospitals that are eligible for EHR incentive payments under both Medicare and Medicaid should select “Both Medicare and Medicaid” during the registration process, even if they plan to apply only for a Medicaid EHR incentive payment by adopting, implementing, or upgrading certified EHR technology. Dually-eligible hospitals can then attest through CMS for their Medicare EHR incentive payment at a later date, if they so desire.

If you fall into this category, when registering for the program you must choose “Both Medicare & Medicaid”. Please select your state from the drop-down menu on the registration screen. If your state’s program has not yet launched at the time of your registration, your file will be placed into a pending status until your state’s program is launched. That means you will not be able to complete your registration or receive an EHR incentive payment until your state’s program launches. For a list of expected program launch dates, please visit the Medicaid State Information page.

Hospitals that register only for the Medicaid program (or only the Medicare program) will not be able to manually change their registration (i.e., change to “Both Medicare and Medicaid” or from one program to the other) after a payment is initiated and this may cause significant delays in receiving a Medicare EHR incentive payment.

If you represent a hospital that falls into one of the categories below, you are eligible only for the Medicaid EHR Incentive Program:

  • Children’s hospitals;
  • Cancer hospitals; or
  • Acute care hospitals in the U.S. territories.

When registering for the program you should select “Medicaid-only” for your hospital type. You will see a list of states in a drop down menu and you must select a state. Please select your state from the drop-down menu on the registration screen.

If your state’s EHR Incentive Program has not yet launched at the time of your registration, your file will be placed into a pending status until your state’s program launches. That means you will not be able to complete your registration or receive an EHR incentive payment until your state’s program launches. For a list of expected Medicaid EHR Incentive Program launch dates, please visit the Medicaid State Information page.

The Electronic Health Record (EHR) Information Center is open to assist the EHR Provider Community with inquiries.

EHR Information Center Hours of Operation: 7:30 a.m. – 6:30 p.m. (Central Time) Monday through Friday, except federal holidays.
1-888-734-6433 (primary number) or 888-734-6563 (TTY number)

Submit an Inquiry to the EHR Information Center

ONC: CAHs and Rural Hospitals to gain add’l support from RECs–Jan 12 Deadline

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Regional Extension Centers Apply for Supplemental Funds
to Support CAHs and Rural Hospitals
from Office of National Coordinator for Health IT
REC Applications Due January 12, 2011
According to a December 28, 2010 ONC announcement, Regional Extension Centers, which support the process of achieving ‘Meaningful Use’ for eligible professionals, Critical Access Hospitals, Community Health Centers and Rural Health Clinics, may be able to receive supplemental funds to bring total to $18,000 per CAHs or Rural Hospitals under 50 beds per  facility.

Posted December 28, 2010 on ONC Site
Synopsis: “This supplement will be available to recipients of the REC awards and is intended to ensure the provision of services to CAHs and Rural Hospitals in the REC’s service area. This award will be supplemental to the REC’s existing award, and the plans, metrics and reporting requirements will be included in the REC’s cooperative agreement. It is anticipated that each REC will need a total of $18,000 per CAH and Rural Hospital that it supports through this program, beyond the funding awarded in the base REC grant. RECs in Group A will be awarded $18,000/eligible CAH and Rural Hospital approved for funding. RECs in Group B will be awarded $6,000/previously approved CAH and Rural Hospital to bring the total amount of CAH/Rural Hospital supplemental funding from $12,000/hospital to $18,000/hospital. The supplemental funds will be used to ensure the delivery of the support services for CAH and Rural Hospitals and will be tied to the same milestones that are identified in the original REC FOA (EP-HIT-09-003). As with other funding milestones identified in the original FOA, recipients will be required to use the customer relationship management tool to help in meeting the milestones associated with this project.”

Key Links:
ONC Funding Announcement
Funding Announcement PDF
List of Eligible Hospitals [XLS – 175 KB]
Grants.gov Announcement and documents

Supplemental Funding Opportunity for Regional Extension Centers to assist eligible Critical Access Hospitals (CAH) and Rural Hospitals in adopting electronic health records and using them in a meaningful way

  • Funding Opportunity Number: 2010-ONC-REC-S-01
  • Closing Date for Applications: January 12, 2011, 11:59 p.m. EST
  • Estimated Total Program Funding: $12,228,000

Excerpted from Funding Announcement Dec 28, 2010:
After the initial REC awards were made, the RECs recognized the challenges of serving CAH and Rural Hospitals were significant and therefore required greater resources than were provided. ONC recognized the unique needs of these hospitals and funded this project as a supplement to the REC funding (Funding Opportunity Number: EP-HIT-09-003). Supplemental funding can only be made available to entities with existing REC cooperative agreement awards. The purpose of the supplement was to ensure the provision of services to Critical Access Hospitals (CAH) and Rural Hospitals already defined within the scope of the cooperative agreements funded under FOA No. EP-HIT-09-003, as CAHs and Rural Hospitals are vital components of the rural health care system in the United States. These hospitals were included on the priority list for the RECs. The intent of the CAH/Rural Hospital Project is to provide additional support for staffing and expertise to assist rural CAHs and Rural Hospitals with less than 50 beds in selecting and implementing meaningful electronic health record (EHR) systems. These additional staff will work in coordination with other REC staff that will be supporting the primary care providers in the REC Service Areas.

The original cooperative agreement award was comprised of a four year project period, consisting of two budget periods. The first budget period (years 1 and 2) had a 90/10 cost share requirement and the second budget period (years 3 and 4) had a 10/90 cost share requirement. For the first budget period the grantee was responsible for contributing 1 dollar for every 9 federal dollars. For the second budget period, the grantee was responsible for contributing 9 dollars for every 1 dollar of federal funds.

In December 2010, the Secretary approved additional changes to the REC program under the authority of the cost-sharing waiver per the HITECH Act, stating that “The Secretary may provide financial support to any regional center created under this subsection for a period not to exceed four years. The Secretary may not provide more than 50 percent of the capital and annual operating and maintenance funds required to create and maintain such a center, except in an instance of national economic conditions which would render this cost share requirement detrimental to the program and upon notification to Congress as to the justification to waive the cost-share requirement.” This waiver provided changes to the REC program timeline and cost-sharing requirements. The timeline was modified to lengthen the first budget period from two years to four years. The cost-sharing requirement will now reflect a 90/10 federal/grantee cost share for all four years with the execution of a revised Notice of Grant Award (NGA).

As stated in original FOA, a positive biennial evaluation will be required for grantees to continue work in years 3 and 4 of the grant; this requirement is unchanged by the December 2010 waiver. The scope of work of the REC program also remains unchanged.

The purpose of this supplement is to further ensure the provision of services to Critical Access Hospitals (CAH) and Rural Hospitals, as described above and will make available funding to the following:

Group A: Regional Extension Centers which did not apply for supplement funding under the first supplemental funding announcement or were not funded under the first supplemental funding opportunity announcement.

Group B: Regional Extension Centers which did receive supplemental funding, and are applying for an additional $6,000 per eligible Critical Access Hospital (CAH) and Rural Hospital already defined within the scope of its cooperative agreement funded under FOA No. 2010-ONC-REC-S.

Scope of Services
Each applicant has already developed a plan for supporting priority setting (including providers at CAHs and Rural Hospitals) primary care providers in their service area to achieve meaningful use of an EHR system as part of their original application. This supplement is designed to provide support to the RECs, to ensure they can provide assistance to CAH and Rural Hospitals in their service area. In their original application, RECs stated that they were planning to work with CAH and Rural Hospitals. However, it was made known that the RECs may not have sufficient resources to carry out this endeavor.

For Group A, each funded REC will plan and implement the outreach, education, and technical assistance programs necessary to meet the objective of assisting CAHs and Rural Hospitals with less than 50 beds in its geographic service area to improve the quality and value of care they furnish by attaining or exceeding meaningful use criteria established by the Secretary of the Department of Health and Human Services (HHS). On-site technical assistance will be a key service. Selected RECs will modify their operating plans that were approved upon initial award to include specific plans for the CAH and Rural Hospital projects and will report their activities through the quarterly reporting process.

Group B will be required to modify their current operating plans, that were revised and approved per the first round of the Supplement Funding Opportunity Announcement and modify their plan to account for the additional funds ($6,000 per CAH and Rural Hospital) to further meet the objectives of assisting CAHs and Rural Hospitals with less than 50 beds in its geographic service area to improve the quality and value of care they furnish by attaining or exceeding meaningful use criteria established by the Secretary of the Department of Health and Human Services (HHS).

RECs are expected to work with both CAHs and Rural Hospitals who have not yet adopted EHR systems, and those with existing EHR systems, to assist them in achieving meaningful use of certified EHR technology. The milestones for this work will be the same as those identified in the original REC FOA (Funding Opportunity Number: EP-HIT-09-003); funds are for direct assistance only.

Subject to the limitations of eligible applicants described below in Section III, there are two types of CAHs and Rural Hospital organizations that are eligible for support through this application: (1) acute care hospitals (as defined in the SSA Section 1886(d)) with 50 or fewer beds located in a rural area and (2) a critical access hospital as defined in the SSA Section 1820(c) of the Social Security Act.

Blumenthal Letter #22: Ready for Jan 3 EHR Incentives Registration?

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Registration for EHR Incentive Programs
Starts January 3, 2011: Are You Ready?

Dr. David Blumenthal

Dr. David Blumenthal

A Message from Dr. David Blumenthal, the National Coordinator for Health Information Technology
December 27, 2010
Published by ONC on 12/27/2010 and republished here.

The New Year is just around the corner, and so is another milestone in our nation’s work to improve health care through health information technology. Starting on January 3, 2011, eligible health care professionals, hospitals, and critical access hospitals may register to participate in the Medicare and Medicaid EHR Incentive Programs.

This is an auspicious time. Nearly two years ago, the Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act of 2009, was signed into law. Since then Department of Health and Human Services (HHS) agencies like the Office of the National Coordinator for Health Information Technology (ONC), the Centers for Medicare & Medicaid Services (CMS), the Office for Civil Rights (OCR), and others have implemented HITECH policies and programs to help providers adopt and achieve meaningful use of certified electronic health record technology and ensure that electronic health information remains private and secure.

[See Blumenthal's review of 2010, originally posted on ONC's Health IT Buzz blog.]

Why Become a Meaningful User?

Qualify for financial incentives from the federal government
Eligible professionals who demonstrate meaningful use have the opportunity to receive incentive payments through the Medicare and Medicaid EHR Incentive Programs—up to $44,000 from Medicare, or $63,750 from Medicaid.  Under both Medicare and Medicaid, eligible hospitals may receive millions of dollars for implementing and meaningfully using certified EHR technology. Providers can get started now with the help of financial incentives from the federal government. If they wait, those incentives may not be available. And financial penalties are scheduled to take effect in five years. 

Build a sustainable medical practice
The next generation of health care professionals will expect and demand that their own medical facility home have a state-of-the-art information system.  Becoming a meaningful user of electronic health records will allow providers who are building their practices to recruit and retain talented young clinicians.

Improve the safety and quality of health care 
The meaningful use of electronic health records will help health care providers and hospitals offer higher quality and safer care. By adopting electronic health records in a meaningful way, providers and hospitals can:

  • See the whole picture. All of a patient’s health information—medical history, diagnoses, medications, lab and test results—is in one place. Providers don’t have to settle for a snapshot when they can have the entire album.
  • Coordinate care. Providers involved in a patient’s care can access, enter, and share information in an electronic health record.
  • Make better decisions. With more comprehensive health information at their fingertips, providers can make better testing, diagnostic, and treatment decisions.
  • Save time and money. Providers who have implemented electronic health records say they spend less time searching for paper charts, transcribing, calling labs or pharmacies, reporting, and fixing coding errors.

ONC and CMS: Here To Help

Registration for the incentive programs may be close at hand, but so is assistance. If you need help in registering for the Medicare and Medicaid EHR Incentive Programs or selecting a certified EHR system, ONC and CMS have resources and services to help you.

  • The Medicare and Medicaid EHR Incentive Programs website contains educational resources and fact sheets with information to help eligible professionals and hospitals adopt, implement, and upgrade certified EHR technology and demonstrate meaningful use to receive EHR incentive payments.
  • Regional Extension Centers, which cover every region of the country, provide on-the-ground technical assistance to health care providers working to adopt and meaningfully use certified EHR technology.
  • The Health IT Workforce Development Program prepares skilled workers for new jobs in health IT.

Connecting to Your Community
ONC also has other programs in place to help advance the meaningful use of certified EHR technology and health information exchange:

As 2010 comes to a close, we are well on our way as a nation to achieving the benefits of widespread adoption of EHRs. If you haven’t made any preparations to register to receive incentive payments, I encourage you to get started now. Resolve today to become a meaningful user in 2011.

Sincerely,
David Blumenthal, MD, MPP
National Coordinator for Health Information Technology 
The Office of the National Coordinator for Health Information Technology (ONC) encourages you to share this information as we work together to enhance the quality, safety and value of care and the health of all Americans through the use of electronic health records and health information technology.

For more information and to receive regular updates from the Office of the National Coordinator for Health Information Technology, please subscribe to our Health IT News list.

Directions for CMS EHR Incentives Registration

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Registration and Attestation Begins January 3, 2011
Program Directions
Excerpted from CMS EHR Incentives Program on 12/26/2010.

Registration for the Medicare and Medicaid EHR Incentive Programs opens on January 3, 2011. We encourage providers to register for the Medicare and/or Medicaid EHR Incentive Program(s) as soon as possible. You can register before you have a certified EHR. Register even if you do not have an enrollment record in PECOS.

A link to Registration will be available on CMS EHR Incentives Program site.

Please Note: Although the Medicaid EHR Incentive Programs will begin January 3, 2011, not all states will be ready to participate on this date. Information on when registration will be available for Medicaid EHR Incentive Programs in specific States is posted at Medicaid State Information.

“It is important for a dually-eligible hospital to select “Both Medicare and Medicaid” from the start of registration in order to maintain this option.” Hospitals and Eligible Professionals should read the notes below under the heading “What else do I need to know about registration?”

[Registration for state Medicaid programs opens in the following states on January 3, 2011:

* Alaska
* Iowa
* Kentucky
* Louisiana
* Oklahoma
* Michigan
* Mississippi
* North Carolina
* South Carolina
* Tennessee
* Texas

Registration for state Medicaid programs opens in the following states in February 2011:

* California
* Missouri
* North Dakota

Other states likely will launch their Medicaid EHR Incentive Programs during the spring and summer of 2011.]

e-Healthcare Marketing note: It’s important for hospitals and eligible professionals in ALL STATES to register when registration opens and not delay registering on the CMS site until their state Medicaid programs are ready. See further note below in red under the heading “What else do I need to know about registration?

What can you do now for the Medicare and Medicaid EHR Incentive Programs?

Make sure you have enrollment records in the appropriate systems. You’ll need:

  • A National Provider Identifier (NPI)
    • All eligible professionals, eligible hospitals, and critical access hospitals (CAHs) must have a National Provider Identifier (NPI) to participate in the Medicare and Medicaid EHR Incentive Programs.
  • An enrollment record in the Provider Enrollment, Chain and Ownership System (PECOS)
    • All eligible hospitals and Medicare eligible professionals must have an enrollment record in PECOS to participate in the EHR Incentive Programs. (Note: Eligible professionals who are only participating in the Medicaid EHR Incentive Program are not required to be enrolled in PECOS.)
    • If you do not have an enrollment record in PECOS, you should still register for the Medicare and Medicaid EHR Incentive Programs.

CMS Identity and Access Management (I&A) User ID and Password

  • Eligible Professionals:
    • Eligible professionals can use the same User ID and Password they use for the National Plan and Provider Enumeration System (NPPES). This is also the same User ID and Password that is used to access PECOS.
    • If you do not have an active User ID and Password for NPPES or PECOS, request them via Identity & Access Management. You will need your type 2 NPI, your Taxpayer Identification Number (TIN), and your address from IRS Form CP-575. You will also need to mail a copy of IRS Form CP-575 as directed.
  • Hospitals/Critical Access Hospitals:
    • Authorized Officials can use the same User ID and Password they use to access PECOS.
    • If you do not have an Authorized Official with access to PECOS, request a User ID and Password via Identity & Access Management. You will need your type 2 NPI, your Taxpayer Identification Number (TIN), and your address from the IRS Form CP-575. You will need to mail a copy of the IRS Form CP-575 as directed.
    • Additional hospital staff will need to request access to the “EHR Incentive Programs” application through Identity & Access Management and be approved by the Hospital’s Authorized Official.

What information will you need when you register?

Registering for the Medicare and Medicaid EHR Incentive Programs is easy when you have the following information available during the process:

Eligible Professionals

  • National Provider Identifier (NPI).
  • National Plan and Provider Enumeration System (NPPES) User ID and Password.
  • Payee Tax Identification Number (if you are reassigning your benefits).
  • Payee National Provider Identifier (NPI)(if you are reassigning your benefits).

Hospitals

  • CMS Identity and Access Management (I&A) User ID and Password.
  • CMS Certification Number (CCN).
  • National Provider Identifier (NPI).
  • Hospital Tax Identification Number.

NOTE: You do not have to provide information on the certified EHR technology you are using when you register. However, this information is required when you attest.

What else do I need to know about registration?

Hospitals:
Hospitals that are eligible for EHR incentive payments under both Medicare and Medicaid should select “Both Medicare and Medicaid” during the registration process, even if they plan to apply only for a Medicaid EHR incentive payment by adopting, implementing, or upgrading certified EHR technology. Dually-eligible hospitals can then attest through CMS for their Medicare EHR incentive payment at a later date, if they so desire. It is important for a dually-eligible hospital to select “Both Medicare and Medicaid” from the start of registration in order to maintain this option.

Hospitals that register only for the Medicaid program (or only the Medicare program) will not be able to manually change their registration (i.e., change to “Both Medicare and Medicaid” or from one program to the other) after a payment is initiated and this may cause significant delays in receiving a Medicare EHR incentive payment.

Eligible Professionals:
Eligible professionals eligible for both the Medicare and Medicaid EHR Incentive Programs must choose which incentive program they wish to participate in when they register. Before 2015, an eligible professional may switch programs only once after the first incentive payment is initiated. Most eligible professionals will maximize their incentive payments by participating in the Medicaid EHR Incentive Program.

The Electronic Health Record (EHR) Information Center is open to assist the EHR Provider Community with inquiries.
Hours of operation are:

8:30 a.m. – 4:30 p.m. (Central Time) Monday through Friday (except federal holidays)
1-888-734-6433 (primary number) or 888-734-6563 (TTY number)

Submit an Inquiry to the EHR Information Center

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Downloads
Medicare EP PECOS Notification [PDF, 119KB]
Hospital PECOS Notification [PDF, 160KB]
Related Links Inside CMS
Frequently Asked Questions (FAQs)
Excerpted from CMS Page Modified on 12/23/2010 8:41:41 AM

See e-Healthcare Marketing post for December 23, 2010 press release from ONC and CMS.

Health IT Special Issue of The American Journal of Managed Care: Dec 2010

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AJMC Publishes Health Information Technology Special Issue Online Dec 20, 2010
“Featuring scholarly articles and perspectives from policymakers, payers, providers, pharmaceutical companies, health IT vendors, health services researchers, patients, and medical educators, this [December 2010 special] issue of  The American Journal of Managed Care is a reflection” of  “the  dramatic growth of interest in the potential for HIT to improve health and healthcare delivery,” writes Sachin H. Jain, MD, MBA and David Blumenthal, MD, MPP in their introductory article titled “Health Information Technology Is Leading Multisector Health System Transformation.”  Both Jain and Blumenthal are with the Office of the National Coordinator for Health Information Technology.

Authors of 23 Articles in Special Issue
Sachin H. Jain, MD, MBA; and, David Blumenthal, MD, MPP; Cynthia L. Bero, MPH; and Thomas H. Lee, MD; Aaron McKethan, PhD; and Craig Brammer; John Glaser, PhD; Pete Stark; Newt Gingrich, PhD, MA; and Malik Hasan, MD; James N. Ciriello, MS; and Nalin Kulatilaka, PhD, MS; Seth B. Cohen, MBA, MPA; Kurt D. Grote, MD; Wayne E. Pietraszek, MBA; and Francois Laflamme, MBA; Amol S. Navathe, MD, PhD; and Patrick H. Conway, MD, MSc; Reed V. Tuckson, MD; Denenn Vojta, MD; and Andrew M. Slavitt, MBA; Marc M. Triola, MD; Erica Friedman, MD; Christopher Cimino, MD; Enid M. Geyer, MLS, MBA; Jo Wiederhorn, MSW; and Crystal Mainiero; Nancy L. Davis, PhD; Lloyd Myers, RPh; and Zachary E. Myers; Bryant A. Adibe, BS; and Sachin H. Jain, MD, MBA; Spencer S. Jones, PhD; John L. Adams, PhD; Eric C. Schneider, MD; Jeanne S. Ringel, PhD; and Elizabeth A. McGlynn, PhD; Jeffrey L. Schnipper, MD, MPH; Jeffrey A. Linder, MD, MPH; Matvey B. Palchuk, MD, MS; D. Tony Yu, MD; Kerry E. McColgan, BA; Lynn A. Volk, MHS; Ruslana Tsurikova, MA; Andrea J. Melnikas, BA; Jonathan S. Einbinder, MD, MBA; and Blackford Middleton, MD, MPH, MS;Alexander S. Misono, BA; Sarah L. Cutrona, MD, MPH; Niteesh K. Choudhry, MD, PhD; Michael A. Fischer, MD, MS; Margaret R. Stedman, PhD; Joshua N. Liberman, PhD; Troyen A. Brennan, MD, JD; Sachin H. Jain, MD, MBA; and William H. Shrank, MD, MSHS; Amir Dan Rubin, MBA, MHSA; and Virginia A. McFerran, MA; Fredric E. Blavin, MS; Melinda J. Beeuwkes Buntin, PhD; and Charles P. Friedman, PhD Robert D. Hill, PhD; Marilyn K. Luptak, PhD, MSW; Randall W. Rupper, MD, MPH; Byron Bair, MD; Cherie Peterson, RN, MS; Nancy Dailey, MSN, RN-BC; and Bret L. Hicken, PhD, MSPH; Jeffrey A. Linder, MD, MPH; Jeffrey L. Schnipper, MD, MPH; Ruslana Tsurikova, Msc, MA; D. Tony Yu, MD, MPH; Lynn A. Volk, MHS; Andrea J. Melnikas, MPH; Matvey B. Palchuk, MD, MS; Maya Olsha-Yehiav, MS; and Blackford Middleton, MD, MPH, MSc; Emily Ruth Maxson, BS; Melinda J. Beeuwkes Buntin, PhD; and Farzad Mostashari, MD, ScM; Daniel C. Armijo, MHSA; Eric J. Lammers, MPP; and Dean G. Smith, PhD; Katlyn L. Nemani, BA.

Look for an upcoming post on e-Healthcare Marketing reviewing this special issue of AJMC.