Category Archives: ‘Meaningful Use’

ONC Awards 10 Challenge Grants to 8 State HIEs: Totals $16 Million

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Health Information Exchange Challenge Grant Program
Excerpted from ONC site on 1/27/2011.
The Office of the National Coordinator for Health Information Technology (ONC) has awarded $16 million in new Challenge Grants to encourage breakthrough innovations for health information exchange that can be leveraged widely to support nationwide health information exchange and interoperability.
The Health Information Exchange (HIE) Challenge Grant Program is providing 10 awards between $1 and $2 million to State HIE Cooperative Agreement Program grantees to develop innovative and scalable solutions in five key areas:

  1. Achieving health goals through health information exchange
  2. Improving long-term and post-acute care transitions
  3. Consumer-mediated information exchange
  4. Enabling enhanced query for patient care
  5. Fostering distributed population-level analytics
The ONC-funded State HIE Cooperative Agreement Program promotes secure exchange of health information to enable patient-centered care and providers’ achievement of meaningful use requirements.
State/SDE Previous Award Amount Amount Awarded
January 2011		 Challenge
Theme
Colorado Regional Health Information Organization $9,175,777 $1,718,783

2
Georgia Department of Community Health $13,003,003 $1,686,989

3
Indiana Health Information Technology, Inc. $10,300,000 $1,718,439

4
Indiana Health Information Technology, Inc. $1,267,970

3
Massachusetts Technology Park Corporation $10,599,719 $1,717,610

2
Massachusetts Technology Park Corporation $1,675,019

5
Maryland Department of Health & Mental Hygiene $9,313,924 $1,683,171

2
HealthShare Montana $5,767,926 $1,400,802

5
NC Dept of State Treasurer $12,950,860 $1,708,693

1
Oklahoma Health Care Authrity $8,883,741 $1,719,086

2
TOTAL $79,994,950 $16,296,562

Learn more about the funding opportunity for this important initiative.

eHI Finalizes Jan 19-20 Annual Conference Agenda, Washington, DC.

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eHealth Initiative Annual Conference,
Turning Policy into Action
Washington, DC  

Featuring David Blumenthal and Joy Pritts from ONC, Keynote from Cokie Roberts.

Panels on CMS Innovation, Looking Ahead to Stage 2 Meaningful Use, Outlook for Health Care Policy with New Congress, eHI Awards, Privacy and Health IT, Care Coordination in Real Word, Creating Accountable Care Organizations, Data for Quality Improvement, and Progress and Barriers at State Level: HIT Coordination Panel.

For more information and registration, click here.

AGENDA
DAY ONE: Wednesday, January 19, 2011
9:30 a.m. – 1:30 p.m.
eHI Members Only

1:30 p.m. – 2:00 p.m.
Conference Registration 

2:00 p.m. – 2:15 p.m.
Welcome and Overview of the Day
–Jennifer Covich Bordenick, Chief Executive Officer, eHealth Initiative
–William F. Jessee, MD, FACMPE, FACPM, President and Chief Executive Officer, Medical Group Management Association, 2011 eHealth Initiative Board Chair

2:15 p.m. – 3:00 p.m.
A Discussion with the Center for Medicare and Medicaid Innovation
Guest Speakers:
–Moderator: Steve Stack, MD, Member, Secretary, American Medical Association
– Mandy Krauthamer Cohen, MD, MPH, Senior Advisor, Center for Medicare and Medicaid Innovation

3:00 p.m. – 4:00 p.m.
Meaningful Use: A Look Ahead to Stage 2
–Moderator: Larry Yuhasz, Director, Strategy and Business Development, Thomson Reuters
–Mark Bell, Chief Information Officer, North Carolina Hospital Association
–Hank Fanberg, Technology Advocacy, Christus Health
–Charles Jarvis, Vice President of Healthcare Services and Government Relations, NextGen Healthcare
–Harry F. Laws, MD, FAAP, Chief Medical Information Officer, Community Health Network, Clinical Professor of Pediatrics, Indiana School of Medicine

4:00 p.m. – 4:45 p.m.
The New Congress in 2011: Outlook for Health Care Policy
–Introduction: Leigh Burchell, Allscripts, and 2011 eHI Policy Steering Committee Vice Chair
–Democrat Perspective: David Thomas, Principal, Mehlman Vogel Castagnetti Inc.
–Republican Perspective: Alex Vogel, Partner, Mehlman Vogel Castagnetti Inc.

4:45 p.m. – 7:00 p.m.
Awards Ceremony & Welcome
–Presented by: William F. Jessee, MD, FACMPE, FACPM, President and Chief Executive Officer, Medical Group Management Association, 2011 eHealth Initiative Board Chair

DAY TWO: Thursday, January 20, 2011

7:30 a.m. – 8:30 a.m.
Registration & Breakfast

8:30 a.m. – 9:00 a.m.
Conference Overview Welcome Back

9:00 a.m. – 9:30 a.m.
Privacy and Health IT: A Conversation with the Chief Privacy Officer
–Introduction: Gerry Hinkley, Co-Chair, Health Care Industry Team, Pillsbury Winthrop Shaw Pittman LLP
–Joy Pritts, Chief Privacy Officer, Office of the National Coordinator for Health Information Technology, US Department of Health and Human Services

9:30 a.m.- 10:30 a.m.
Care Coordination in the Real World
–Moderated by: Bruce Henderson, National Leader, EHR/HIE Practice, PricewaterhouseCoopers
Guest Speakers:
–Robert Fortini, Chief Clinical Officer, Bon Secours Medical Group from Bon Secours Health System
–Dr. Bruce Hamory, MD, Executive Vice President, Managing Partner, Geisinger Consulting Services, Geisinger Health System
–Charles Kennedy, MD, Vice President for Health Information Technology, WellPoint

10:30 a.m – 10:45 a.m.|
Networking Break

10:45 a.m.- 11:45 a.m.
Creating Accountable Care Organizations (ACOs)
–Moderated by: John Edelblut, Senior Executive, Accenture
–Andrew Ziskind, Partner and Senior Executive, Accenture
–Dick Salmon, MD, PhD, National Medical Director for Quality, CIGNA HealthCare
–Mike Flammini, Head of Strategy, Aetna
–James Walton, DO, MBA, Vice President of Health Equity and Chief Equity Officer, Baylor Health Care System

11:45 a.m.- 12:45 p.m.
Lunch and Networking

12:45 p.m. – 2:00 p.m.|
Data for Quality Improvement
–Moderator: Daniel Carmody, CPA, ChFC, Operations Director, Information Strategy and Solutions, CIGNA HealthCare
–Janet Corrigan, President and CEO, National Quality Forum
–Scott Cullen, MD, Lead for Clinical Analytics, Accenture
–Tracey Moorhead, President & CEO, Care Continuum Alliance
–Gurvaneet Randhawa, MD, MPH, Senior Advisor on Clinical Genomics & Personalized Medicine, Agency for Healthcare Research and Quality

 2:00 p.m. – 2:15 p.m.
Networking Break

2:15 p.m. – 3:30 p.m.
HIT Coordination Panel: Progress and Barriers at State Level
–Moderator: Rebecca Little, Senior Vice President, Medicity
–Doug Dietzman, Executive Director, Michigan Health Connect
–Gina Bianco Perez, Executive Director, Delaware Health Information Network
–John K. Evans, MHA, FACHE, President, S2A Consulting
–Liza Fox-Wylie, Policy Director, Colorado Regional Health Information Organization 
–Tom Liddell, Executive Director, Michiana Health Information Network
–Vikas Khosla, President and CEO, BluePrint Healthcare IT, NJ HIN Privacy and Security Committee Subject Matter Expert

3:30 p.m. – 4:15 p.m.
Keynote Address:
–Introduction by Diane Jones, Vice President of Policy and Government Affairs, eHealth Initiative
–David Blumenthal, MD, MPH, National Coordinator for Health Information Technology, US Department of Health and Human Services

4:15 p.m. – 5:00 p.m
Keynote Address:
–Introduction by Jennifer Covich, Chief Executive Officer, eHealth Initiative
–Cokie Roberts Cokie Roberts, ABC Congressional Correspondent and Senior News Analyst for National Public Radio

5:00 p.m. – 5:15 p.m
Closing Remarks
Jennifer Covich Bordenick, Chief Executive Officer, eHealth Initiative

For more information and registration, click here.

New Jersey: 20th State to Receive ONC Approval for HIE Operational Plan

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ONC Approves 20th Strategic and Operational State HIE Plan: New Jersey
On January 13, 2011, the Office of the National Coordinator for Health IT approved the operational portion of the State of New Jersey’s Strategic and Operational Plan for Health Information Exchange. This should lead soon to a release of funding for the first of four years of the plan. Previously only planning funds were released. Total Award Amount for New Jersey is $11,408,594. NJ-HITEC, New Jersey’s Regional Extension Center (REC), has already been awarded $23,048,351. Funds for HIE and REC programs are released based on reaching specific milestones.

List of Approved Plans on ONC’s State HIE Program site
New Jersey Strategic and Operational Plan–ONC Summary [PDF]

Following are excerpts from the first five of six pages ONC released summarizing the NJ program. The sixth page is an HIE Inventory, enabling easier comparisons with other state programs.

Health Information Exchange
Strategic and Operational Plan Profile

Overview
The State of New Jersey is committed to building on existing health information technology and exchange investments in developing a strategy for providers in the state to meet the EHR Incentive Program meaningful use requirements. It has developed a strategy for health information exchange that includes first strengthening exchange in local nodes and then creating a “network-of-networks” linking four regional health information exchange organizations (RHIOs) to create statewide coverage.

Model and Services
The New Jersey plan builds the capacity of local/regional exchange efforts. The state will use a large portion of the funds to support four local RHIOs in increasing data liquidity and supporting providers in achieving meaningful use. The work to strengthen the capacity of local exchange will be paired with strategic policy and operational interventions to increase lab data liquidity and e-prescribing participation statewide:
• Enable lab results delivery from Quest Diagnostics using the NHIN Direct specifications.
• Implement regulations that will require commercial and private laboratories to make electronically interfaced laboratory result transactions available to physician EHRs and regional HIEs at no extra cost to physicians.
• Implement a statewide education program on e-prescribing that targets the 15% of pharmacies not currently enabled for this functionality. This includes identification and monitoring of the targeted pharmacies.
In a later phase, that state will support node to node exchange and other services. The planned statewide services will include:
• Statewide broker/backbone that will connect HIEs
o Record locator services to find location of patient records across the state
o Patient health record services
• State-provided data from key registries (Immunization, Lead, Public Health, etc.)
• State-provided data on Medicaid Medication History
• State-provided Master Patient Index/Master Client Index (MPI/MCI)
• NJHIN stored “master” Record Locator Service for Standalone
EHRs and out-of-state provider access

Highlights
• Supporting Innovation: New Jersey has a special focus on incentivizing creative innovation within the state. They have established the HIT Innovation Center which is a partnership between the St. Barnabus healthcare system and the New Jersey Institute of Technology. There is a program under development to use NJIT students to create and develop HIT applications as well. The HIT Coordinator Office, the NJ-HITEC and the Innovation Center will be sponsoring an Innovation Summit in early 2011 to feature pilot projects already in place as well as special projects for future consideration. They also continue to emphasize and support a number of innovative projects currently in place across the state including:
o Meridian Home Health Pilot
o Bergen Regional Center Behavioral Health Pilot
o Virtua – Personal Health Records
o St Joe’s – Telemedicine

• Advancing Multi-State Collaboration: New Jersey has expressed an interest in leading new multi-state coordination activities for the mid-Atlantic region. All multi-state HIE coordination initiatives New Jersey is exploring will be in accordance with NHIN standards for communication and interaction. These include:
o Hosting a multi-state collaboration event – New Jersey plans to host its own multi-state collaboration event with surrounding states, to focus on sharing of plans and establishing an interstate approach for secure HIE.
o Project Management focus on multi-state pilots – New Jersey plans to assign full-time project management support to oversee and coordinate several interstate secure HIE pilot initiatives.
o Regional HIE data exchange – Three regional HIEs (South Jersey HIE, the Virtua HIE, and the South Jersey Health System HIE) have plans to exchange data in late 2010/early 2011 with Fox Chase Cancer Center’s HIE, located in Philadelphia, Pennsylvania.

MEANINGFUL USE
[ONC issued new guidance to State HIE Programs on July 6, 2010, in the form of a Program Information Notice, which established "The immediate priority of the State HIE Program is to ensure that all eligible providers within every state have at least one option available to them to meet the HIE requirements of meaningful use in 2011... (and therefore) states and SDEs shall outline in their State Strategic and Operational Plans (state plans) a concrete and operationally feasible plan to address and enable these three HIE capabilities in the next year:
1. E-prescribing
2. Receipt of structured lab results
3. Sharing patient care summaries across unaffiliated organizations]

NJ E-Prescribing Landscape
As of the end of 2009, there are 1,609 community active pharmacies capable of filling e-prescriptions. This figure excludes hospital pharmacies, but includes both chain and independent facilities (both retail and closed) and represents an 85% adoption rate across pharmacies in New Jersey. A total of 2,696 physicians routed prescriptions electronically in New Jersey, representing a 15% e-prescribing adoption rate for physicians in New Jersey.
NJ E-Prescribing Strategy
The State HIT Coordinator’s office, working NJ-HITEC, the NJ Dept of Health and Senior Services, and state associations, will develop a new program tentatively titled “ePrescribing New Jersey” to target pharmacists, clinicians, and consumers. In January, the state will develop the list of pharmacies who do not offer ePrescribing by matching Surescripts’ list of ePrescribing pharmacies against the NJ Board of Pharmacy’s list of all licensed pharmacies in the state. In February, the Coordinator’s office, working with the Department of Health and Board of Pharmacy will develop information on ePrescribing in the form of a course, handouts, and Web pages (part of the state HIT Coordinator’s Web site). In March, the state and REC will coordinate the start of a series of educational sessions with the HIEs to target non-eRx pharmacies, consumers, and clinicians.

NJ Structured Lab Results Landscape
New Jersey has 5,703 Clinical Laboratory Improvement Amendments (CLIA)-recognized laboratories with various certifications. Of these, there are 85 CLIA-accredited independent clinical laboratories, 4,079 recognized physician office laboratories, and 134 CLIA-accredited hospital-based clinical laboratories in the State.

Electronic sharing of laboratory orders and results within hospitals is already a generally accepted practice for all hospitals in New Jersey.

National laboratories have a large presence in New Jersey. These laboratory companies provide connectivity solutions to many state hospitals and healthcare providers for the exchange of electronic lab orders and results. Three of the largest independent clinical laboratories in New Jersey (Quest Diagnostics Inc., Laboratory Corporation of America, and Bio-Reference Laboratories) are able to directly interface with numerous electronic health record (EHR) systems. These interfaces allow for EHR systems to send lab orders electronically and receive results that can be downloaded directly into the EHR. Other connectivity solutions offered by laboratory companies in the State include proprietary portals for requesting lab orders and receiving results.

While the capability to exchange lab orders and results exists within the State, healthcare providers and regional health information exchange organizations have had varying levels of success incorporating laboratory data from commercial laboratory companies into their electronic health information exchange environments. Hospitals and health information exchange organizations that want to exchange lab data with independent laboratories are required to build custom interfaces to support these integration points and to incur ongoing transaction costs. The resulting drain on monetary and human resources for these point-to-point interfaces for electronic laboratory data exchange continues to be an adoption-limiting factor in the State.
NJ Structured Lab Results Strategy
New Jersey will approach the adoption of electronic transmission of lab results by leveraging the NJHINT law S323 and the regulations already in place for the electronic reporting of medical data to the NJ Department of Health and Senior Services. The Office of Statewide HIT Coordinator will pursue statutory and regulatory avenues in 2010/2011 that will require commercial and private laboratories to make electronically interfaced laboratory result transactions available to physician EHRs and regional HIEs at no extra cost to physicians (replacing traditional means such as faxing of results).

NJ Patient Care Summary Landscape
There is minimal current activity in the state related to the sharing of patient care summaries.
NJ Patient Care Summary Strategy
New Jersey is taking several approaches to enable this requirement. The primary mechanism is to pursue certification processes and participation agreements with the HIEs that will require them to support the exchange of Patient Care Summaries (PCS) with Physician EHRs and other HIEs in order to be eligible for state-sponsored funding and related state benefits.

ONC and CMS: Blog Post on Resources to Become ‘Meaningful User’

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Becoming a Meaningful User of EHRs: Resources from ONC and CMS
Wednesday, January 12th, 2011 | Posted by: Julie Franklin CMS and Peter Garrett ONC on ONC’s Health IT Buzz blog and republished here by e-Healthcare Marketing.

The Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare & Medicaid Services (CMS) want to help you on your journey to becoming a meaningful user of certified electronic health record (EHR) technology.  Here are resources about meaningful use, Medicare and Medicaid EHR Incentive Programs, and the EHR certification process to help guide you:

Meaningful Use and Medicare and Medicaid EHR Incentive Programs

1) Meaningful Use Overview
https://www.cms.gov/EHRIncentivePrograms/01_Overview.asp

2) Path to Payment
https://www.cms.gov/EHRIncentivePrograms/10_PathtoPayment.asp

3) PowerPoint Presentation: Medicare and Medicaid EHR Incentive Programs Final Rule
https://www.cms.gov/EHRIncentivePrograms/Downloads/EHR_Incentive_Program_Agency_Training_v8-20.pdf

4) Timeline: Medicare and Medicaid EHR Incentive Programs
https://www.cms.gov/EHRIncentivePrograms/Downloads/EHRIncentProgtimeline508.pdf

5) Being a Meaningful User of Electronic Health Records
http://healthit.hhs.gov/meaningfuluse/provider

6) Meaningful Use Specification Sheets
https://www.cms.gov/EHRIncentivePrograms/Downloads/EP-MU-TOC-Core-and-MenuSet-Objectives.pdf

7) Flow Chart – Determine Eligibility for Medicare and Medicaid EHR Incentive Programs
https://www.cms.gov/EHRIncentivePrograms/downloads/eligibility_flow_chart.pdf

Certification

1) Certification Programs Overview
http://healthit.hhs.gov/certification

2) Standards and Certification Criteria Final Rule Fact Sheet
http://healthit.hhs.gov/standardsandcertification/factsheet

3) HITECH Temporary Certification Program for EHR Technology Fact Sheet
http://healthit.hhs.gov/tempcert/factsheet

4) Temporary Certification Program Final Rule Frequently Asked Questions
http://healthit.hhs.gov/tempcert/faqs

5) Permanent Certification Program
http://healthit.hhs.gov/permcert/factsheet

6) Certified Health IT Product List
http://healthit.hhs.gov/chpl

Privacy and Security

1) Building Trust in Health Information Exchange
http://healthit.hhs.gov/buildingtrust

2) Health Information Privacy and Information on HIPAA
http://www.hhs.gov/ocr/privacy/

For additional resources on certification and meaningful use check out ONC’s Meaningful Use resources:
http://healthit.hhs.gov/meaningfuluse/resources.

ONC has also funded 62 Regional Extension Centers, located across the country, to offer customized, on-the-ground assistance for providers who need help adopting and meaningfully using certified EHR technology.

You can also stay up to date on ONC and CMS activities by:

What resources or tools from ONC, CMS, or other organizations have you or your practice used to help you become a meaningful user? What challenges have you faced on your road to meaningful use? We encourage you to start a dialogue and share your comments [on the ONC site].
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Please share your comments directly on the ONC Health IT Buzz blog post.

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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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.

Blumenthal Reviews ONC’s 2010 Accomplishments on ONC Blog

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2010 ONC Update Meeting: Advancing the Dialogue on Health IT
Monday, December 27th, 2010 | Posted by: Dr. David Blumenthal on ONC’s Health IT Buzz blog and republished here by e-Healthcare Marketing.

Thank you to everyone who participated in the 2010 ONC Update on December 14-15, 2010 where we had the opportunity to discuss ONC’s strategies and programs, hear about your experiences in the field, assess progress to date, and get caught up on HITECH’s implementation. Video-recordings of the webcast are now available through the ONC website at http://healthit.hhs.gov/ONCMeeting2010.

The 2010 ONC Update was held in conjunction with 2010 ONC Grantee Meeting which brought together for the first time the awardees of all of the ONC programs , including the Beacon Communities Program, Regional Extension Center Program, SHARP Program, State Health Information Exchange Program, and the many Workforce Development Programs.

This year, significant strides were made in health information technology. And for us, information technology has always been a means to an end, the end of improving health, improving the health system, making the lives of our fellow Americans better, making our nation’s health professionals and institutions able to live up to their aspirations, empowering Americans to have and take control of their own health and lives. These are the reasons why the Congress and the President enacted the HITECH Act and the reason that the Office of the National Coordinator exists today.

But, of course, there are many organizations and groups that have those high aspirations. Our unique contribution comes from a core insight that good intentions have to be powered by strong capabilities. And science and technology have created for us an enormously powerful new set of tools in the form of health information technology.

We are here to make sure that those tools are used fully to realize our collective aspirations. Information is the lifeblood of medicine. As health professionals and institutions, we are only as good as the information we have about the patients that we care for. Health IT is destined to be the circulatory system for that information in the decades to come.

The last several months have been a whirlwind of activity. And it is easy to forget how much we’ve accomplished. We established the meaningful use framework, one that I think is unprecedented in the history of electronic health information systems. No other country has laid out a similar framework for what can and should be accomplished using health information technology. And on January 3, the Centers for Medicare & Medicaid Services will launch the registration process for those who wish to participate in the Medicare and Medicaid EHR Incentive Programs.

We’ve issued a standards and certification regulation. As of this week, we have five certifying bodies that are available to certify electronic health records. They’ve certified more than 200 records and modules in the several months since they’ve been in existence.

Regional extension centers – 62 of them are working hard to provide hands-on assistance to those providers that need the most help in making this transition. As of this week, 30,000 physicians have already enrolled in these extension programs across the United States.

The State Health Information Exchange Program has provided 56 states and territories with planning grants. More than 20 of these states and territories have approved implementation plans, and new implementation plans are being approved every day.

Seventeen Beacon Communities are now in place. They didn’t exist a year ago. They are paving the way toward real improvements in health and health care in the communities they serve, leveraging health information technology. The SHARP Program is tackling new challenges through research and development.

And ONC’s Workforce Development Programs are preparing a whole new workforce and creating new jobs to support the transformation of our health care system through the use of information technology. To date, we have seen almost 2,300 new enrollees in community college programs and close to 400 in University‑based Training Programs focused on health information technology. And we are well on our way in these very early stages toward meeting that target of 10,000 new health professionals trained annually during the lifetime of the program.

In addition to our grants, we have dozens of contracts that are supporting programs like the Nationwide Health Information Network. And our Health IT Policy Committee and Health IT Standards Committee continue to provide enormously valuable guidance on the many policies and standards that are needed to support execution against our mission.

All of these efforts not only play a critical role in our strategy related to the improvement of health and health care through information technology, but also provide the foundation for health systems change and upcoming reforms in how we deliver and pay for care.

As we look to 2011, there will be many challenges. Driving change is hard. And it takes leadership, commitment and the ability to move forward – despite the many obstacles that each of you will encounter. I hope your sense of contributing something unique to health care and the American people – for most certainly you are – balances the incredibly hard work that you are undertaking. Someday you will look back and realize that you were present at the creation of something big.

Thanks again, and we look forward to our continued collaboration in the new year.
###To comment directly on ONC’s Health IT Buzz Blog, click here.
See Blumenthal Letter #22 on e-Healthcare Marketing.

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.