Monthly Archives: March 2010

HIT Standards Committee Mtg: Consumer Permissions, Consent Mgmt- March 24, 2010

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HIT Standards Committee–Consumer Permissions, Consent Management
March 24, 2010
9:00 a.m. to 2:15 p.m. [Eastern Time]
Below agenda, key points are excerpted from Privacy and Security Workgroup about consumer permissions and consent management, including schedule for educational sessions.

A G E N D A (pdf)
Washington, DC

9:00 a.m. CALL TO ORDER – Judy Sparrow
Office of the National Coordinator for Health Information Technology
9:05 a.m. Opening Remarks – David Blumenthal, MD, MPP
National Coordinator for Health Information Technology
9:15 a.m. Review of the Agenda – John Halamka, Vice Chair
9:20 a.m. Priority Setting & Synchronization with the HIT Policy Committee
John Halamka, Vice Chair
9:45 a.m. Implementation Workgroup Report on Implementation Starter Kit Hearing
Aneesh Chopra, Chair
Liz Johnson, Workgroup member
Cris Ross, Workgroup member
10:30 a.m. NHIN Direct Interoperability Framework
Doug Fridsma, Office of the National Coordinator
11:15 a.m. Clinical Operations Workgroup/Vocabulary Task Force Update
Jamie Ferguson, Chair
11:45 a.m. Clinical Quality Workgroup Update
Janet Corrigan, Chair
Floyd Eisenberg, Workgroup member
12:15 p.m. LUNCH
1:00 p.m. Privacy & Security Workgroup Update (PPT)
Dixie Baker, Chair
Steve Findlay, Co-Chair
1:30 p.m. Report on Certification NPRM (PPT)
Carol Bean, Office of the National Coordinator
Steven Posnack, Office of the National Coordinator
2:00 p.m. Public Comment
2:15 p.m. Adjourn

To Participate
Webconference
Audio:
You may listen in via computer or telephone.
US toll free:   1-877-705-6006
International Direct:  1-201-689-8557
Confirmation Code: HIT Committee Meeting  

Key Notes Excerpted from
Privacy and Security Workgroup Slides
Focus on Consumer Permissions, Consent Mgmt
PPT Slides
Progress
–Updated IFR Review to incorporate comments from the HIT Standards Committee – submitted to HITSC Chairs
–Supporting HIT Policy Committee’s Privacy and Security Policy Workgroup, and aligning our standards efforts to their priorities
          Consent management
          Review of existing security policy inherent in HIPAA Security Rule
–Launching educational sessions on standards activities around consent management

Consumer Health Permissions
–Privacy Consent (or Consent Directive) – Consumer’s written or verbal permission to collect, use, and/or disclose individually identifiable health information (IIHI)
–Privacy Authorization – A signed, written document that contains all of the elements required by the HIPAA Privacy Rule and that gives a covered entity permission to use or disclose specified IIHI for specified purposes
–Informed Consent – Consumer’s written permission to perform a specific medical procedure, or to participate in a specific research study or clinical trial, that is given only after the consumer has been fully informed of the purposes, risks, benefits, confidentiality protections, and other relevant aspects of the activity

Consent Management Today
–Consumer permissions captured as manual signature on paper form
–Paper forms filed in each organization who holds consumer’s private health information

Consent Management Tomorrow
–Consent/Authorization: Consumer digitally signs consent or authorization
–Permissions and updates captured as part of health record
–Permissions interpretable by humans & computers
–Permissions cross-validated & translated into consent rules enforced by security access control mechanisms
–Rules inexorably tied to information exchanged – updates propagated to all data instances throughout life cycle

Standards Needed
–Digital signatures
–•Privacy policies •Data model & schema •Permission syntax & vocabulary
–•Cross-validation of consumer permissions •Maintaining and retrieving permissions •Translating permissions into access-control rules •Enforcement and auditing of permission-related activities
–•Exchanging permissions & access rules •Propagating permission revocations & modifications

Educational Sessions Re: Standardization Efforts Relating to Consent Management
•April 1, 2:00-4:00pm ET:  Organization for the Advancement of Structured Information Standards (OASIS) / International Security Trust and Privacy Alliance (ISTPA) Privacy Management Reference Model (PMRM); Speakers – John Sabo, Michael Willett
•April 23, 2:00-4:00pm ET:  Integrating the Healthcare Enterprise (IHE) Basic Patient Privacy Consents (BPPC) Profile; Speaker – John Moehrke
•[Schedule TBD]:  Health Level 7 (HL7) Version 3 Domain Analysis Model: Medical Records; Composite Privacy Consent Directive – Speaker (TBD)
•[Schedule TBD]:  OASIS Cross-Enterprise Security and Privacy Authorization (XSPA) and eXtensible Access Control Markup Language (XACML) – Speaker (TBD)

ONC names managers for ‘Beacon’ grants program

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ONC names managers for ‘Beacon’ grants program
Mary Mosquera of Government HealthIT News reported on March 23, 2010, that “ONC named Aaron McKethan, a research director at the Brookings Institution’s Engelberg Center for Health Reform as the Beacon program director.”

“Craig Brammer, a project director at Cincinnati’s Aligning Forces for Quality, an initiative of the Robert Wood Johnson Foundation, was named deputy director,” and will report to McKethan.

Which Medical Dictionary? Vocabulary Task Force Meets March 23

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Vocabulary Task Force Meeting
Clinical Operations Workgroup of  HIT Standards Committee
March 23, 2010
9:00am to 4:30pm EDT   Webconference/Audio (see access below)
Meeting focuses on Best Practices and lessons learned from stakeholders in vocabulary infratructure as well as governance values for various vocabularies.

Questions for Vocabulary Owners/Custodians
1. What vocabulary subset or value set creation and distribution services do you provide?
2. Who uses your services and what is the level of use?
3. What, if any, additional services and capabilities are in active development?
4. If applicable, what process is used to establish and revise any subsets or value sets that you distribute?
5. Based on your experience, what advice would you offer regarding best practices and pitfalls to avoid?

Questions for those involved in Governance Value Sets
1. Who should determine which value sets are needed?
2. Who should produce the value sets?
3. Who should review and approve value sets?
4. How should value sets be described, i.e., what is the minimum set of metadata needed?
5. In what format(s) and via what mechanism should value sets be distributed?
6. How and how frequently should value sets be updated, and how should updates be coordinated?
7. What support services would promote and facilitate their use?
8. What best practices/lessons learned have you learned, or what problems have you learned to avoid, regarding value set creation, maintenance, dissemination, and support services?
9. Do you have other advice or comments on value sets and their relationship to meaningful use?
10. What must the federal government do or not do with regard to the above, and/or what role should the federal government play?
11. Some have expressed concerns about intellectual property with respect to the specific value sets (i.e., the effort and expertise required to create them), and regarding the specific codes used (i.e., value sets developer from proprietary code sets). How do you envision sharing value sets while accounting for these intellectual property issues?

  • Agenda [PDF - 415 KB]
  • Welcome, Purpose of the Meeting
              – Jamie Ferguson, Chair
  • Summary & Key Points from February Hearing
            – Jamie Ferguson, Chair
            – Betsy Humphreys, Co-Chair
  • Panel 1: Office of the National Coordinator, Interoperability Framework
    • Douglas Fridsma, MD
  • Panel 2:  Federal Provider Organizations
  • Panel 3:  Best Practices & Lessons Learned: Vocabulary Infrastructure
  • Panel 4:  Best Practices & Lessons Learned, con’t
  • Panel 5:  Level 1 Governance Value Set
    • Sharon Sprenger, The Joint Commission [PDF - 229 KB]
      “While The Joint Commission has its roots in hospital accreditation, over the years it has developed evaluation programs for a diverse array of health care settings. Today, The Joint Commission evaluates and accredits more than 17,000 health care organizations and programs in the United States, including ambulatory care, behavioral health services, durable medical equipment providers and suppliers, home care, hospices, hospitals and critical access hospitals, laboratories and long term care facilities.” –From Joint Commission Statement
    • Karen Kmetik, American Medical Association
    • Greg Pawlson, National Committee for Quality Assurance (NCQA) [invited]
    • Janet Corrigan, National Quality Forum (NQF)

    You may participate
    Webconference
    Audio:
    You may listen in via computer or telephone.
    US toll free:   1-877-705-2976
    International Direct:  1-201-689-8798

    “Safeguarding Health Information: Building Assurance through HIPAA Security”– Conference Sponsored by HHS/OCR and NIST

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    “Safeguarding Health Information: Building Assurance through HIPAA Security”– Conference Sponsored by HHS/OCR and NIST
    May 11-12, 2010
    Excerpts from NIST site on March 22, 2010
    Sponsors: Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) and National Institute of Standards and Technology (NIST).

    Audience:     “CIOs & Information Security Officers of HIPAA covered entities & business associates; others responsible for the security of electronic health info; HIT consultants & attorneys.”

    Purpose: “The HHS Office for Civil Rights (OCR) enforces the HIPAA Privacy Rule, which protects the privacy of individually identifiable health information; the HIPAA Security Rule, which sets national standards for the security of electronic protected health information; the confidentiality provisions of the Patient Safety Rule, which protect identifiable information being used to analyze patient safety events and improve patient safety; and, the Breach Notification regulations requiring HIPAA covered entities and their business associates to notify individuals when their health information is breached.”

    “NIST’s mission, as a non-regulatory federal agency within the U.S. Department of Commerce, is to promote U.S. innovation and industrial competitiveness by advancing measurement science, standards, and technology in ways that enhance economic security and improve our quality of life.”

    “This conference will provide a forum to discuss the current HIT security landscape, as well as practical strategies, tips, and techniques for implementing the requirements of the HIPAA Security Rule.”

    Topics: “Plenary sessions will discuss a variety of current and important HIT and HIPAA Security Rule topics, including updates on OCR’s administration and enforcement of the HIPAA Security Rule, risk assessments and contingency planning, logging and auditing in a healthcare context, security of health devices, and security considerations for mobile/wireless technologies and new media in healthcare, industry panels discussing breach notification rules and the state of compliance with the Security Rule and much more.”

    Location:
    Voice of America
    Wilbur Cohen Building, Auditorium
    330 Independence Avenue, SW
    Washington, DC 20237
    (Public Entrance on C Street, SW)

    Website:
    http://csrc.nist.gov/news_events/HIPAA-May2010_workshop/
    Agenda Draft
    Registration:     On-Line Registration
    Registration Fee: $75
    Registration closes on 05/04/2010
    Refund requests must be submitted in writing by 05/04/2010 

    Joseph Goedert, HealthDataManagement, broke story on March 19, 2010.

    Health Reform Bill References to Health Information Technology–Part I

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    Health Reform Bill References to Health Information Technology–Part I
    Plus: Roundup of Health IT articles on Reform         (Link to Part II)
    Through the first 1,050 pages of the “Patient Protection and Affordable Care Act” approved by the House of Representatives on March 21, 2010 and passed by the Senate in December 2009, here are the references to health information technology and the Office of the National Coordinator for Health IT with page numbers from Senate pdf:
    [PDF of Senate version which was approved by House]

    1. Table of Contents: “Sec. 1561. Health information technology enrollment standards and protocols.” p. 5
    2.  Table of Contents:  “Sec. 6114. National demonstration projects on culture change and use of information technology in nursing homes.” p. 13
    3. QUALITY REPORTING.—‘‘(1) IN GENERAL.—Not later than 2 years after the date of enactment of the Patient Protection and Affordable Care Act, the Secretary, in consultation with experts in health care quality and stakeholders, shall develop reporting requirements for use by a group health plan, and a health insurance issuer offering group or individual health insurance coverage, with respect to plan or coverage benefits and health care provider reimbursement structures that… (C) implement activities to improve patient safety and reduce medical errors through the appropriate use of best clinical practices, evidence based medicine, and health information technology under the plan or coverage;” p. 31
    4. Administrative Simplification: Operating Rules for Health Information Transactions…(9) OPERATING RULES.—The term ‘operating rules’ means the necessary business rules and guidelines for the electronic exchange of information that are not defined by a standard or its implementation specifications as adopted for purposes of this part.’’  p. 60
    5. ‘‘REVIEW AND RECOMMENDATIONS.—The National Committee on Vital and Health Statistics shall…(D) evaluate whether such operating rules are consistent with electronic standards adopted for health information technology;” p. 65
    6. ‘‘(B) COORDINATION OF HIT STANDARDS.—In developing recommendations under this subsection, the review committee shall ensure coordination, as appropriate, with the standards that support the certified electronic health record technology approved by the Office of the National Coordinator for Health Information Technology.” p. 73
    7. American Health Benefit Exchanges…”(C) the implementation of activities to improve patient safety and reduce medical errors through the appropriate use of best clinical practices, evidence based medicine, and health information technology.” p. 149
    8. ESTABLISHMENT OF PRIVATE PURCHASING COUNCIL.—(1) “IN GENERAL.—Qualified nonprofit health insurance issuers participating in the CO–OP program under this section may establish a private purchasing council to enter into collective purchasing arrangements for items and services that increase administrative and other cost efficiencies, including claims administration, administrative services, health information technology, and actuarial services. p. 178
    9.  SEC. 1561. HEALTH INFORMATION TECHNOLOGY ENROLLMENT STANDARDS AND PROTOCOLS. ‘‘(a) IN GENERAL.—
     ‘‘(1) STANDARDS AND PROTOCOLS.—Not later than 180 days after the date of enactment of this title, the Secretary, in consultation with the HIT Policy Committee and the HIT Standards Committee, shall develop interoperable and secure standards and protocols that facilitate enrollment of individuals in Federal and State health and human services programs, as determined by the Secretary.
    ‘‘(2) METHODS.—The Secretary shall facilitate enrollment in such programs through methods determined appropriate by the Secretary, which shall include providing individuals and third parties authorized by such individuals and their designees notification of eligibility and verification of eligibility required under such programs.
    ‘‘(b) CONTENT.—The standards and protocols for electronic enrollment in the Federal and State programs described in subsection (a) shall allow for the following:
    ‘‘(1) Electronic matching against existing Federal and State data, including vital records, employment history, enrollment systems, tax records, and other data determined appropriate by the Secretary to serve as evidence of eligibility and in lieu of paper based documentation.  ‘‘(2) Simplification and submission of electronic documentation, digitization of documents, and systems verification of eligibility. ‘‘(3) Reuse of stored eligibility information including documentation) to assist with retention of eligible individuals. ‘‘(4) Capability for individuals to apply, recertify and manage their eligibility information online, including at home, at points of service, and other community-based locations.‘‘(5) Ability to expand the enrollment system to integrate new programs, rules, and functionalities,  operate at increased volume, and to apply streamlined verification and eligibility processes to other Federal and State programs, as appropriate. ‘‘(6) Notification of eligibility, recertification, and other needed communication regarding eligibility, which may include communication via email and cellular phones.‘‘(7) Other functionalities necessary to provide eligibles with streamlined enrollment process.’
    ‘‘(c) APPROVAL AND NOTIFICATION.—With respect to any standard or protocol developed under subsection (a) that has been approved by the HIT Policy Committee and the HIT Standards Committee, the Secretary— ‘‘(1) shall notify States of such standards or protocols; and ‘‘(2) may require, as a condition of receiving Federal funds for the health information technology investments, that States or other entities incorporate such standards and protocols into such investments.
     ‘‘(d) GRANTS FOR IMPLEMENTATION OF APPROPRIATE ENROLLMENT HIT.—‘‘(1) IN GENERAL.—The Secretary shall award grant to eligible entities to develop new, and adapt existing, technology systems to implement the HIT enrollment standards and protocols developed under subsection (a) (referred to in this subsection as ‘appropriate HIT technology’).
    ‘‘(2) ELIGIBLE ENTITIES.—To be eligible for a grant under this subsection, an entity shall—‘‘(A) be a State, political subdivision of a State, or a local governmental entity; and ‘‘(B) submit to the Secretary an application at such time, in such manner, and containing—‘‘(i) a plan to adopt and implement appropriate enrollment technology that includes–‘‘(I) proposed reduction in maintenance costs of technology systems; ‘‘(II) elimination or updating of legacy systems; and ‘‘(III) demonstrated collaboration with other entities that may receive a grant under this section that are located in the same State, political subdivision, or locality; ‘‘(ii) an assurance that the entity will share such appropriate enrollment technology in accordance with paragraph (4); and Title XXX of the Public Health Service Act (42 U.S.C. 10 300jj et seq.) is amended by adding at the end the following:‘‘Subtitle C—Other Provisions ‘‘SEC. 3021. HEALTH INFORMATION TECHNOLOGY ENROLLMENT STANDARDS AND PROTOCOLS. ‘‘(iii) such other information as the ecretary may require.
    ‘‘(3) SHARING.—|
    ‘‘(A) IN GENERAL.—The Secretary shall ensure that appropriate enrollment HIT adopted nder grants under this subsection is made available to other qualified State, qualified political subdivisions of a State, or other appropriate qualified entities (as described in subparagraph (B)) at no cost.
    ‘‘(B) QUALIFIED ENTITIES.—The Secretary
    shall determine what entities are qualified to receive enrollment HIT under subparagraph (A)taking into consideration the recommendations of the HIT Policy Committee and the HIT Standards Committee.’’ p.368
    10. SEC. 2703. STATE OPTION TO PROVIDE HEALTH HOMES FOR ENROLLEES WITH CHRONIC CONDITIONS…‘‘(f) MONITORING.—A State shall include in the State plan amendment—‘‘(1) a methodology for tracking avoidable hospital readmissions and calculating savings that result from improved chronic care coordination and management under this section; and ‘‘(2) a proposal for use of health information technology in providing health home services under this section and improving service delivery and coordination across the care continuum (including the use of wireless patient technology to improve coordination and management of care and patient adherence to recommendations made by their provider).”
    11. ‘‘(g) REPORT ON QUALITY MEASURES.—As a condition for receiving payment for health home services provided to an eligible individual with chronic conditions, a designated provider shall report to the State, in accordance with such requirements as the Secretary shall specify, on all applicable measures for determining the quality of such services. When appropriate and feasible, a designated provider shall use health information technology in providing the State with such information.
    12. Subtitle J—Improvements to the Medicaid and CHIP Payment and Access Commission(MACPAC): ‘‘(A) IN GENERAL.—The membership of MACPAC shall include individuals who have had direct experience as enrollees or parents or caregivers of enrollees in Medicaid or CHIP and individuals with national recognition for their expertise in Federal safety net health programs, health finance and economics, actuarial science,health plans and integrated delivery systems, reimbursement for health care, health information technology, and other providers of health services, public health, and other related fields, who provide a mix of different professions, broad geographic representation, and a balance between urban and rural representation.” p. 555
    13. PART II—NATIONAL STRATEGY TO IMPROVE HEALTH CARE QUALITY…”‘‘(2) REQUIREMENTS.—The strategic plan shall include provisions for addressing, at a minimum, the following:…‘‘(F) Incorporating quality improvement and measurement in the strategic plan for health information technology required by the American Recovery and Reinvestment Act of 2009 (Public Law 111–5).” p. 686
    14.  SEC. 3012. INTERAGENCY WORKING GROUP ON HEALTH CARE QUALITY…”(1) IN GENERAL.—The Working Group shall be composed of senior level representatives of—…(G) the Agency for Healthcare Research and Quality; (H) the Office of the National Coordinator for Health Information Technology;” p. 689
    15. ‘SEC. 931. QUALITY MEASURE DEVELOPMENT…‘‘(c) GRANTS OR CONTRACTS FOR QUALITY MEASURE DEVELOPMENT.—‘‘(1) IN GENERAL.—The Secretary shall award grants, contracts, or intergovernmental agreements to eligible entities for purposes of developing, improving, updating, or expanding quality measures identified under subsection (b).‘‘(2) PRIORITIZATION IN THE DEVELOPMENT OF QUALITY MEASURES.—In awarding grants, contracts,or agreements under this subsection, the Secretary shall give priority to the development of quality measures that allow the assessment of—…‘‘(D) the meaningful use of health information technology;” p. 694
    16. “PART III—ENCOURAGING DEVELOPMENT OF NEW PATIENT CARE MODELS SEC. 3021. ESTABLISHMENT OF CENTER FOR MEDICARE AND MEDICAID INNOVATION WITHIN CMS”(models include)‘‘(v) Supporting care coordination for chronically-ill applicable individuals at high risk of hospitalization through a health information technology-enabled provider network that includes care coordinators, a chronic disease registry, and home telehealth technology.” p. 716
    17. ”SEC. 3024. INDEPENDENCE AT HOME DEMONSTRATION PROGRAM…‘‘(vi) uses electronic health information systems, remote monitoring, and mobile diagnostic technology;” p. 755
    18. ‘‘(4) PREFERENCE.—In approving an independence at home medical practice, the Secretary shall give preference to practices that are—‘‘(A) located in high-cost areas of the country;‘‘(B) have experience in furnishing healthcare services to applicable beneficiaries in the home; and‘‘(C) use electronic medical records, health information technology, and individualized plans of care.” p. 761
    19. ”SEC. 3201. MEDICARE ADVANTAGE PAYMENT.‘‘(viii) Health information technology programs, including clinical decision support and other tools to facilitate data collection and ensure patient-centered, appropriate care.” p. 871
    20. The Center for Quality Improvement and Patient Safety of the Agency for Healthcare Research and Quality (shall) ‘‘(G) expand demonstration projects for improving the quality of children’s health care and the use of health information technology, such as through Pediatric Quality Improvement Collaboratives and Learning Networks, consistent with provisions of section 1139A of the Social Security Act for assessing and improving quality, where applicable…”(2) LINKAGE TO HEALTH INFORMATION TECHNOLOGY.—The Secretary shall ensure that research findings and results generated by the Center are shared with the Office of the National Coordinator of Health Information Technology and used to inform the activities of the health information technology extension program under section 3012, as well as any relevant standards, certification criteria, or implementation specifications…PRIORITIZATION.—The Director (of the Agency) shall identify and regularly update a list of processes or systems on which to focus research and dissemination activities of the Center,taking into account—…‘‘(6) the evolution of meaningful use of health information technology, as defined in section 3000…(f) COORDINATION.—The entities that receive a grant or contract under this section shall coordinate with health information technology regional extension centers under section 3012(c) and the primary care extension program established under section 399W regarding the dissemination of quality improvement, system delivery reform, and best practices information.’’” p. 1040
    21. SEC. 3502. ESTABLISHING COMMUNITY HEALTH TEAMS TO SUPPORT THE PATIENT-CENTERED MEDICAL HOME…‘‘(f) COORDINATION.—The entities that receive a grant or contract under this section shall coordinate with health information technology regional extension centers under section 3012(c) and the primary care extension program established under section 399W regarding the dissemination of quality improvement, system delivery reform, and best practices information.’’…(2) support patient-centered medical homes, defined as a mode of care that includes,(A) personal physicians; (B) whole person orientation; (C) coordinated and integrated care; (D) safe and high-quality care through evidence-informed medicine, appropriate use of health information technology, and continuous quality improvements; (E) expanded access to care; and (F) payment that recognizes added value from additional components of patient-centered care; quality improvements;” p. 1050

    Part Two of these references will follow later this week. Please share any additional references or comments with e-Healthcare Marketing blog. Thank you.

    Roundup of Health IT articles
    Joseph Goedert on March 22, 2010 reported in HealthDataManagement on revamping of EDI requirements noting the bill has “language to significantly revamp the HIPAA transaction standards.  The bill also has significant new administrative simplification provisions.”

    Diana Manos of Healthcare IT News reported on March 22, 2010, “The new law builds on a platform of pay-for-performance and includes provisions to simplify healthcare administration, calling for the widespread use of healthcare IT.”

    Marianne McGee of InformationWeek posted a column on March 22, 2010, titled “Healthcare Reform Already Underway” about the role Health IT is already playing in changing healthcare .

    Joseph Conn, HITS staffer for ModernHealthcare.com, reported March 22, 2010, on feedback from HIT industry leaders, who were not yet clear on what was and was not included in final bill.

    iHealthBeat’s Roundup on March 22, 2010: “House OKs Senate Health Reform Bill With Health IT Measures.”

    Erik Sherman, of BNET.com, wrote a post on March 22, 2010, titled “Healthcare Reform May Trigger Big Tech Spending” highlighting more than a dozen references to health information technology in the bills passed by the house. It’s a quick check list though points to government units or processes already in place, and does not acknowledge the specialized role of Health IT vendors.

    ONC Plans National Survey on Attitudes on HIE and Privacy and Security

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    ONC Plans National Survey on Attitudes about HIE and Privacy and Security
    From the Federal Register on March 19, 2010
    Proposed Project: Attitudes Toward Electronic Health Information
    Exchange and Associated Privacy and Security Aspects
    OMB No. 0990-NEW-Office of the National Coordinator for Health Information Technology.

    Abstract: “Electronic health information exchange promises an array of potential benefits for individuals and the U.S. health care system through improved health care quality, safety, and efficiency. At the same time, this environment also poses new challenges and opportunities for protecting health information. Health information technology and electronic health information exchange may also provide individuals with new, more effective methods to engage with their health care providers and affect how their health information may be exchanged. Based on findings from a comprehensive literature review, little is known about individuals’ attitudes toward electronic health information exchange and the extent to which they are interested in determining by whom and how their health information is exchanged. The proposed information collection will permit us to better understand individuals’ attitudes toward electronic health information exchange and its associated privacy and security aspects as well as inform policy and programmatic objectives.

    “The Office of the National Coordinator for Health Information Technology (ONC) is proposing to conduct a nationwide survey which will use computer-assisted telephone interviews (CATI) to interview a representative sample of the general U.S. population. Data collection will take place over the course of eight weeks. The data will be analyzed using statistical methods and a draft report will be prepared. ONC will hold a Web seminar prior to the publication of the final report to convey the findings to the general public. A final report will be posted on http://healthit.hhs.gov which will include the results and analysis.”

    Mary Mosquera of Government HealthIT reported the story on March 19, 2010.

    HIT Policy and Standards Committees’ Recommendations for CMS Incentive Programs, ONC Implementation, Certification

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    HIT Policy Committee Recommendations — March 2010
    “The HIT Policy Committee has made recommendations to the National Coordinator on (1) the Centers for Medicare & Medicaid Services’ (CMS) Notice of Proposed Rulemaking regarding CMS’ incentive program for the meaningful use of EHRs; and (2) the Interim Final Rule (IFR) on Initial Set of Standards, Implementation Specifications, and Certification Criteria for EHRs. The recommendations, from the Meaningful Use, Certification/Adoption, Privacy & Security Policy, and Information Exchange Workgroups, were approved by the HIT Policy Committee at its February 2010 meeting. The HIT Policy Committee recommendations have been transmitted to the National Coordinator and to CMS.”

    HIT Standards Committee Recommendations–March 2010
    “The HIT Standards Committee has made recommendations to the National Coordinator on (1) the Centers for Medicare & Medicaid Services’ (CMS) Notice of Proposed Rulemaking regarding CMS’ incentive program for the meaningful use of EHRs; and (2) the Interim Final Rule (IFR) on Initial Set of Standards, Implementation Specifications, and Certification Criteria for EHRs. The recommendations, from the Clinical Operations, Clinical Quality, and Privacy & Security Workgroups, were approved by the HIT Standards Committee at its February 2010 meeting. The HIT Standards Committee recommendations have been transmitted to the National Coordinator.”

    Key Issues Designing/Developing Statewide Technical Infrastructure Webinar: State HIE Toolkit Part Two

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    “Key Issues in Designing and Developing Statewide Technical Infrastructure” Webinar
    [ONC’s State HIE Toolkit: Part Two
    “Execution: The Discipline of Getting Things Done”]
    The March 15, 2010 Webinar on  State HIE Technical Infrastructure was the third in the “2010 State HIE Leadership Forum Webinar Series Presented by the State Level HIE Consensus Project under the auspices of the ONC State HIE Program.” The series is listed on the Presentation and Webinars Archive Page of the State Health Information Exchange Leadership Forum, and is associated with the State HIE Toolkit. (For more on the Toolkit, see earlier post on e-Healthcare Marketing.) Additional presentations from the Archives section of the State Leadership Forum are listed below Webinar series.

    Archived Technical Assistance Webinars

    Key Issues in Designing and Developing Statewide Technical Infrastructure – March 15, 2010 

    • Webinar Slides
    • Webinar Recording (you will need the recording id and attendee key below to access this recording)
      • Recording ID: NRNB59
      • Attendee Key: 3!_zQGc

    Addressing Key Issues in Effective Strategic and Operational Planning & Establishing Governance – March 5, 2010

    • Webinar Slides
    • Webinar Recording (you will need the recording id and attendee key below to access this recording)
      • Recording ID: 5JJ6B7
      • Attendee Key: qC7X_(W

    State HIE Program Webinar – January 5, 2010

    Archived SLHIE Project Presentations & Webinars

    These are additional 2010 presentations below from SLHIE project.
    “HIT and HIE Transforming the Health Care Landscape–States at the Forefront,”     CHIMA-HIMSS Advocacy Day, January 20, 2010

    “HIE Governance for Arkansas — Key State-level Roles and Functions, Strategic and Operational Considerations,” presentation to Arkansas Governance Work Group, January 15, 2010

    “eHI Connecting Communities about Leadership Forum,” presentation at eHI, January 11, 2010

    “HIE Governance for Arkansas — Key State-level Roles and Functions, Strategic and Operational Considerations, ” Arkansas HIT Executive Committee Meeting, January 8, 2010

    Certification Programs for HIT Webinar on Rulemaking NPRM Mar 25, 4pm EDT

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    Certification Programs for Health IT Webinar
    Focus on Proposed Rulemaking NPRM
    March 25, 2010 4:00 – 5:00 p.m. EDT
    Sent via email on March 19, 2010
    On March 25, 2010 from 4:00 – 5:00 p.m. EDT, The Office of the National Coordinator for Health Information Technology (ONC), with the National Institute of Standards and Technology (NIST), will present a webinar on the recently released Certification Programs for HIT Notice of Proposed Rulemaking (NPRM).  Public comments on the NPRM are now being accepted.  The temporary certification program’s comment period ends April 9 and the permanent certification program’s comment period ends May 10.  Because this NPRM is currently in the comment period phase, this webinar will be solely informational and seeks to help listeners better understand the proposals included in the NPRM.  

    Background
    Eligible professionals and eligible hospitals who seek to qualify for incentive payments under the Medicare and Medicaid EHR Incentive Programs are required by statute to use Certified EHR Technology.  This webinar will discuss the proposals included in the NPRM that would enable eligible professionals and eligible hospitals to adopt health IT that meets the definition of Certified EHR Technology.   

    Learn more about the NPRM at http://healthit.hhs.gov/CertificationNPRM

    To Participate
    There is limited space on this webinar. For those unable to join, there will be a transcript posted to the ONC website, http://healthit.hhs.gov, by March 29, 2010.

    Join the meeting

    Audio Information
    Dial-In: 1-888-673-9805
    Participant Passcode: 9033671

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    ONC Web site on Certification Programs NPRM
    –Certification NPRM | [PDF - 463 KB]
    –Submit a comment on the certification NPRM
    –Facts-at-a-Glance
    –Frequently Asked Questions
    –ONC HIMSS Town Hall (3/2/2010) Slides [PDF - 1.31 MB]
    –Certification NPRM Webinar

    What’s Broadband have to do with HITECH and Healthcare?

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    National Broadband Plan: Connecting America
    FCC broadband plan targets e-health expansion
    Brian Robinson of Government HealthIT reported on March 16, 2010 “The Federal Communications Commission     formally adopted and forwarded to Congress a plan to significantly upgrade U.S. broadband connections that could greatly boost the adoption rate of health IT.” 

    FCC Unveils U.S. Broadband Plan Promoting Health IT, Telehealth
    On March 17, 2010, iHealthBeat cited Robinson’s article and noted “The plan includes 11 recommendations for using broadband networks to spur greater use of electronic health records, health data exchanges and telemedicine” in  Chapter 10 on Health Care. 

    White House Blog Post by US CTO Aneesh Chopra
    In a post on the White House blog on March 16, 2010, Aneesh Chopra wote that the Obama administration     “has also undertaken initiatives to bring the efficiencies and innovations of broadband to many sectors of the economy. These initiatives include the Department of Health and Human Services’ commitment to facilitating the movement of healthcare information safely and securely from where it is collected to where it is needed in order to reduce costs and improve patient care.” 

    Executive Summary: National Broadband Plan
    The  Executive Summary, notes that the federal government is the largest health care payor in the country and  the Broadband “plan includes recommendations designed to unleash increased use, private sector investment and innovation” in broadband to support healthcare in addition to other sectors of the economy. 

    “Broadband can help improve the quality and lower the cost of health care through health IT and improved data capture and use, which will enable clearer understanding of the most effective treatments and processes. To achieve these objectives, the plan has recommendations that will: 

    • Help ensure health care providers have access to affordable broadband by transforming the FCC’s Rural Health Care Program.
    • Create incentives for adoption by expanding reimbursement for e-care.
    • Remove barriers to e-care by modernizing regulations like device approval, credentialing, privileging and licensing.
    • Drive innovative applications and advanced analytics by ensuring patients have control over their health data and ensuring interoperability of data.”

    The Promise of Health IT and the Role of Broadband
    “Health IT plays a key role in advancing policy priorities that improve health and health care delivery. Priorities set forth by HHS include the following: 

    • Improving care quality, safety, efficiency and reducing disparities
    • Engaging patients and families in managing their health
    • Enhancing care coordination
    • Improving population and public health
    • Ensuring adequate privacy and security of health information

    “Health IT supports these priorities by dramatically improving the collection, presentation and exchange of health care information, and by providing clinicians and consumers the tools to transform care. Technology alone cannot heal, but when appropriately incorporated into care, technology can help health care professionals and consumers make better decisions, become more efficient, engage in innovation, and understand both individual and public health more effectively. 

    “Analysis of information gathered through health IT can provide a basis for payment reform. Payors, providers and patients are focusing increasingly on value. However, data to measure the effectiveness of prevention and treatment on individual and population-wide bases are lacking. This hampers attempts to shift from a volume-focused system that pays for visits and procedures to a value-based regime that rewards cost-effective health improvements. 

    “Broadband is necessary for these transformations in three ways. First, it enables efficient exchange of patient and treatment information by allowing providers to access patients’ electronic health records (EHRs) from on-site or hosted locations. Second, it removes geography and time as barriers to care by enabling video consultation and remote patient monitoring. Third, broadband provides the foundation for the next generation of health innovation and connected-care solutions.” 

    RECOMMENDATIONS
    Create appropriate incentives for e-care utilization.     

    Modernize regulation to enable health IT adoption.

    Unlock the value of data.

    Ensure sufficient connectivity for health care delivery locations.

    NATIONAL BROADBAND PLAN: Connecting America
    Broadband.Gov Web site
    The Plan
    Broadband and Healthcare
    Chapter 10: Health Care PDF