Category Archives: Patients

FAQs on State Health Information Exchange Program Released By HHS: Sept 11 Deadline

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State HIE Cooperative Agreement Program: 
Frequently Asked Questions  (Main FAQ Page)
      General Questions
      Questions for Potential Applicants
      September 11, 2009 deadline for State HIE Letter of Intent was reconfirmed in the 10 Questions and Answers about the State HIE Program posted in the FAQs on the ONC site as of September 1, 2009. ONC encourages users to check its FAQ page frequently since regular changes are expected.

      GENERAL QUESTIONS include purpose and goal of State HIE agreement, state role in “meaningful use” of EHRs by 2014, working relationship of states to federal government and private sector, and addressing differences in levels of HIE and EHR adoption between and within states.
      QUESTIONS FOR POTENTIAL APPLICANTS are used to explain who is eligible, describe application process; clarify deadline for Letter of Intent–September 11, 2009; explain rolling schedule for grant awards, describe ONC-State integration of existing State HIE plans within new HIE grants framework, and confirm that all states and territories will be funded for HIEs.

Facts-in-Brief
Deadline: ONC reconfirmed that the  deadline for each state’s Letter of Intent is September 11, 2009.
Fund: ONC intends to provide each state and US territory an exclusive grant as an individual state or as part of a multi-state application that succesfully fufills the application requirements. Total of $564 million will be awarded on a rolling basis beginning in January 2010, including for planning purposes where necessary.
Exclusive: Only the State or a State-Designated Entity in each state or territory, either individually or as part of a multi-state program, will receive an award.  ONC will only accept one application per state or territory, though multi-state initiatives may apply. To ensure every state and territory is covered, ONC may eventually make award to another entity if an application is not submitted.
Three Level Evaluation: States must determine where they are in the process of implementing health information exchange: “no existing plan; non-compliant existing plan; compliant existing plan.” ONC will work with each state to integrate existing state plans with the requirements of “meaningful use.”
ONC Web site on State HIE Cooperative Agreement Program: The ONC page contains links to Announcement, location for official documents, Facts-At-A-Glance, and FAQs.

Prior e-Healthcare Marketing post with ONC State HIE Deadlines

REGIONAL CENTERS PROGRAM FAQ UPDATES CONTINUE
As ONC promised, FAQs on Regional Extension Centers Program will continue to be updated. Updates for Sept. 2, 2009 are occurring today. See prior e-Healthcare Marketing post for links, and remember to check back for both sets of FAQs. Or go directly to ONC FAQs about Regional Extension Centers Program.

FTC final rule requires quick PHR breach notification

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FTC goes beyond HIPAA on security and privacy
Joseph Conn, of Modern Healthcare’s  HITS, reported on August 31, 2009, that “The FTC estimates that about 200 PHR vendors, 500 ‘PHR-related entities’ and 200 service providers will be covered by… new rules (based on ARRA of 2009) to protect the privacy and security of personally identifiable healthcare information stored on personal health-record systems offered by companies not covered by federal privacy rules under the Health Insurance Portability and Accountability Act (HIPAA) of 1996.” Conn produces a comprehensive story with links to previous articles and key documents.

Focus: Personal Health Records

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JHiM, Summer 2009 issue, focuses on Personal Health Records
Journal of Healthcare Information Managementm (JHiM), Summer 2009 issue, carries four articles on Personal Health Records. Note: Full text available to HIMSS members or by subscription only. You can link to JHiM summaries of Summer 2009 articles here. My summaries are below generally based on article subheads.

Editor’s Report: Personal Health Records—Ready for Prime Time? (pdf) (subscription only)
by Richard D. Lang, EdD
Defines 6 types of Personal Health Records: vendor-based, provider-based, payor-based, HIE-based, portable digital file, and hybrid. Reviews value, disadvantages, challenges, and technical issues. Lang says he “believes PHRs will reach their potential value only by fully implementing the EMR.”

Assessing HIE Stakeholder Readiness for Consumer Access:
Lessons Learned from the NHIN Trial Implementation (pdf) (subscription only) 
by Brian E. Dixon, MPA; Theda Miller, BS; and J. Marc Overhage, MD, PhD
Based on study of Indianapolis area participants in Indiana Network of Patient Care (INPC). Indiana has earned a reputation as one of the states with most advanced Health IT applications.

Personal Touch: Personal Health Records for Consumers of Healthcare (pdf) (subscription only)
by Mary N Gerard, MD; Mike Cohen; and Regina Greer-Smith FACHE
Based on review of key articles on PHRs and experiences in Chicago area. Includes case study of consumer user, examines patient control of information, patient portals in Chicago, and reviews content issues, disease management tools, exchange of information between patient and providers, and barriers and  strategies for consumer use.

Interoperability of Electronic Health Records and Personal Health Records: Key Interoperability Issues Assdociated with Information Exchange (pdf) (subscription only)
by Simone Pringle and Alex Lippitt
Based on Chicago area experiences, this article deals with data reconciliation, workflow, and implementation issues for interoperability. Summarizes roles of organizations involved in technical implementation connecting PHRs and EHRs including, HITSP, CCHIT, IHE, AHIC, The Markle Foundation Personal Health Working Group, and Health Record Banking Alliance.

BMC Medical Informatics and Decision Making
Integrated Personal Health Records:
Transformative Tools for Consumer-Centric Care
By Don Detmer, Meryl Bloomrosen, Brian Raymond and Paul Tang
Published in October 2008 by BMC Medical Informatics and Decision Making, article grew out of September 2006 roundtable convened by Kaiser Permanente Institute for Health Policy,  American Medical Informatics Association (AMIA), Robert Wood Johnson Foundation (RWJF) and the Agency for Healthcare Research and Quality (AHRQ) with three goals involving potential of integrated PHRs, barriers to realizing potential, and framework for action. The references can prove as interesting as the paper.
Link to html version: http://www.biomedcentral.com/1472-6947/8/45
Link to pdf version.

Kaiser’s Long and Winding Road

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Health Data Management  Reviews Kaiser’s EHR Lessons
In August 1, 2009 issue of Health Data Management Magazine, Executive Editor Howard J. Anderson reports extensively on lessons learned as “Kaiser Permanente is entering the home stretch in what’s turned out to be a seven-year drive to implement comprehensive EHRs, personal health records and related systems at all of its hospitals and clinics.” Lessons focus on cost centers, training, deployment, and ongoing process.
http://www.healthdatamanagement.com/issues/2009_69/-38718-1.html
Learned of story from daily AHIP Solutions SmartBrief e-newsletter published July 28, 2009.  AHIP is America’s Health Insurance Plans association.

Aligning Health IT and Health Reform

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On July 15, 2009, “Markle Connecting for Health, the Engelberg Center at Brookings, and the Center for American Progress co-host a forum in to explore critical junctures between current health reform efforts and health IT investments” at the Center for American Progress in Washington, DC.

Led off by ONC Coordinator, David Blumenthal, speakers are Zoe Baird and Carol Diamond of Markle Foundation; Mark McClellan, Director, Engelberg Center for Health Care Reform and Leonard D. Schaeffer Chair in Health Policy Studies at the Brookings Institution; and Todd Park, Center for American Progress. Panel discussion includes representatives from American Academy of Family Physicians, Consumers Union, National Partnership for Women & Families, Pacific Business Group on Health, and Vermont Health Access.
Archived video of two-hour session.        
Press release (pdf)

Key EHR and Health IT Documents/Reports

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Action and Implementation Manual (AIM) from ONC’s HISPC
How-to guide for state actions and multi-state cooperation for health care privacy and security issues, released in June 2009 by Health Information Security and Privacy Collaboration (HISPC). See these two links to access related stories and AIM report.
AIM: http://www.e-healthcaremarketing.com/archives/259
Articles: http://www.e-healthcaremarketing.com/archives/222
Provider Tool Kit: http://www.secure4health.org

          Background to Complicated Game of HISPC Privacy and Security Collaboratives:
          Written by Journal of AHIMA staff writer Chris Dimick, for May 2009 issue, article describes three years of work that culminated in handoff of Health Information Security and Privacy Collaboration (HISPC). 

Connecting for Health Common Framework
from Markel Foundation
“The Connecting for Health Common Framework: Resources for Implementing Private and Secure Health Information Exchange is a set of free resources for individuals and organizations interested and ready to create private and secure health information exchange. The approach is such that information exchange can take place among existing and future health care networks over the Internet if all participants adhere to a small set of shared rules.” Produced by public-private collaborative of over 100 organizations led by the Markle Foundation, Connecting for Health is led and managed by Markle staff, and funded by Markle and the Robert Wood Johnson Foundation.
Common Framework Pages:
Connecting Professionals: Private and Secure Information Exchange
Connecting Consumers: Network Personal Health Information
Connecting All Health Decision Makers: Population Data Analysis and Action

NGA /U. of Massachusetts Medical School Report on
Public Governance Models for a Sustainable Health Information Exchange Industry
John Thomasian, director of the National Governors Association Center for Best Practices, the organizing body for the State Alliance for e-Health said on February 24, 2009 “This report can serve as a valuable starting point for states as they consider governance strategies for building, sustaining, and protecting a system to support electronic health record.”

“The report details three conceptual models of public governance that could lead to the practice of sustainable HIE and delves into specific rationale and description, legal structure and financing and accountability considerations for each model.”
Press Release: “States Play Critical Role in Advancing Health Information Technology” February 24, 2009
Report to the State Alliance for E-Health (pdf)       Appendices (pdf)
Slides for February 24, 2009 State Alliance Meeting (pdf)
Conference Webcast

An Information Infrastructure for New Jersey Healthcare:
A Vision for 21st Century Health Care System (pdf)
Section V, Chapter 16 from the 2008 Final Report of  New Jersey
Commission on Rationalizing Health Care Resources
“This chapter briefly explores the reasons for the lack of adequate information systems in health care, sketches the vision of a 21st Century health-care information system, examines how much of that vision  has been achieved by now in New Jersey or is actively being pursued, and finally offers some recommendations to move New Jersey health care towrd an information platform that adequately serves the state’s people.”
Final Subcommittee Report with List of its Members (pdf)

Action and Implementation Manual (AIM) from ONC’s HISPC

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AIM Manual pdf from HISPC

Action and Education Manual

Action and Education Manual

Heading and the front page of Action and Implementation Manual link to pdf of the 45-page how-to guide produced from the 7 Collaborations among 42 states and territories referred to in the June 9, 2009 posting below.
http://healthit.hhs.gov/html/hispc/AIMReport.pdf

Patient Centered Computing and eHealth

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Transforming Healthcare Quality
A CME Course from Harvard for nurses, physicians, public health, Information Technology
May 1-3, 2009

Boston, Massachusetts
Offered by Center for Information Technology Leadership
and Partners HealthCare System

http://partnerscird.blogspot.com/2009/04/please-consider-joining-us-for-harvard.html
“This practical course presents the work of national experts in patient‑centered computing and eHealth using a format that will enable acquisition of knowledge and skills. Through presentations, panel discussions and workshops, participants will interact with these experts about the opportunities and challenges that arise from the implementation and use of patientcentered computing.”
Course Director: Blackford Middleton,MD, MPH, MSc
Course Co‑Directors: Patricia C. Dykes, DNSc, MA, RN and Douglas Johnston 
Patient-Physician Relationships: Emails, PHRs, and Communication
Blackford Middleton reported on one panel from the course “Two providers from the Partners Healthcare System (both MGH docs as it turns out), and two of their patients shared the stage for a bit to each offer their perspectives on doctor-patient email, use of the PHR, and what does it all mean in terms of the e-enabled doctor-patient relationship, and more.”