Additions to Regional Extension Centers: Orange County, CA; New Hampshire: Florida

Posted on September 28, 2010 by Mike Squires

Received via email on Sept 28, 2010
The Office of the National Coordinator for Health Information Technology (ONC) announced today the selection of two final awardees for the Regional Extension Center (REC) program:

CalOptima Foundation, covering Orange County, California ($4,662,426)
Massachusetts eHealth Collaborative, covering the state of New Hampshire ($5,105,495)

ONC also announced expanded coverage areas for two existing RECs in Florida:

Community Health Centers Alliances will cover additional areas in Glades and Hendry counties
Health Choice Network of Florida will cover additional areas in Indian River, Palm Beach, St. Lucie, Martin and Okeechobee counties

These additional awards complete a nationwide system of RECs that will help providers move from paper-based medical records to electronic health records (EHRs).

For more information about the awards and a complete listing of RECs, visit http://www.HealthIT.hhs.gov/programs/REC.

Atul Gawande Keynotes AHRQ Annual Conference

Posted on September 28, 2010 by Mike Squires

Second Plenary Session of AHRQ 2010 Annual Conference
Tue, Sept 28

Clancy Addresses AHRQ

Dr. Carolyn Clancy, Director of AHRQ, the health research arm of Health and Human Services, introduced the second plenary session of AHRQ 2010 Annual Conference in Bethesda, Maryland on September 28, 2010.

Clancy introduced Atul Gawande, MD, MPH, Boston surgeon, author, and New Yorker writer as this morning’s keynote speaker. Gawande said he insists that members of his research team read Michael Lewis’s Money Ball about the man who introduced metrics (stats) into choosing the best baseball talent.

If the metrics baseball innovator, Billy Dean, were a government man, the title of Lewis’s book would have been Baseball Services Research. Gawande went on to describe how research had been used to improve the medical support for US troops in the field including achieving the actual use of kevlar in the field, redesigning sunglasses that previously looked uncool, and conducting partial surgery right in the field, and leaving the remainder to be done elsewhere.

Atul Gawande, MD prior to keynote

After speaking about comparative effectiveness research, Gawande mentioned the work of Jeffrey Brenner, MD, of Camden, NJ, without naming him in his talk. This “Camden physician” has studied and set up services that help the most vulnerable, chronically ill patients, mostly with drug and alcohol problems, many homeless. This project is being performed under the umbrella of Camden Coalition for Healthcare Providers.

As a New Jersey resident, this blogger first heard about Dr. Brenner’s project from a presentation he gave at a New Jersey Health IT Commission meeting. Dr. Brenner’s work is now forming the foundation for the Camden Health Information Exchange in a partnership between three highly competitive hospital systems–Cooper University Hospital, Virtua Health System, and Lady Of Lourdes Health System, with support from the Merck Company Foundation. Camden HIE is one of the four HIEs within the state which will receive funding via the state from the Office of the National Coordinator (ONC) for Health IT, as part of the State’s HIE Cooperative plan with ONC.

AHRQ has so many research areas, including Health IT. There will be additions to this post over the next few days about some of those other areas.

ONC Regulations FAQs Related to Certification

Posted on September 25, 2010 by Mike Squires

ONC Regulations FAQs Related to Certification
Posted on ONC site on 9/22/2010.

Download all 20 Questions and Answers [PDF - 79 KB]

1. Question [9-10-001-1]: What certification criteria will ONC-ATCBs use to certify EHR technology for purposes of the “deeming” provision of the Physician Self-Referral Prohibition and Anti-Kickback Electronic Health Record (EHR) Exception and Safe Harbor Final Rules?

Answer: Both the Physician Self-Referral Prohibition EHR Exception and the Anti-kickback EHR Safe Harbor regulations, at 42 CFR 411.357(w) and 42 CFR 1001.952(y), respectively, provide that software “is deemed to be interoperable if a certifying body recognized by the Secretary has certified the software within no more than 12 months prior to the date it is provided to the recipient.” The “recognition” of certification bodies process referred to in these regulations, as discussed in the Temporary Certification Program Final Rule (the Final Rule) (75 FR 36185) has been superseded or folded into the ONC-ATCB and ONC-ACB “authorization” processes. Consequently, the ONC-ATCB and ONC-ACB “authorization” processes will constitute the Secretary’s “recognition” of a certification body. With that said, as further explained in the Final Rule, ONC-ATCBs are required to test and certify EHR technology to all applicable certification criteria adopted by the Secretary at 45 CFR part 170, subpart C. We believe that the certification criteria adopted by the Secretary specify essential interoperability requirements and build the foundation for more advanced interoperability in the future. Any questions regarding compliance with the exception or safe harbor should be directed to the Centers for Medicare & Medicaid Services (CMS) and the HHS Office of Inspector General (OIG), respectively.

2. Question [9-10-002-1]: If my EHR technology is capable of submitting batch files to an immunization registry using the adopted standards (HL7 2.3.1 or 2.5.1 and CVX), is that sufficient for demonstrating compliance with the certification criterion specified at 45 CFR 170.302(k)?

Answer: The certification criterion at 45 CFR 302(k) does not specify, and is not intended to specify, when submissions should be made or the periodicity of the submissions. Consequently, submitting batch files to an immunization registry, provided that they are formatted according to one or both of the adopted standards, is not prohibited by this certification criterion and would be acceptable.

3. Question [9-10-003-1]: In the “Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology” Final Rule published on July 28, 2010, the Secretary adopted the following implementation specifications at 45 CFR 170.205(d)(2) for HL7 2.5.1 – Public Health Information Network HL7 Version 2.5 Message Structure Specification for National Condition Reporting Final Version 1.0 and Errata and Clarifications National Notification Message Structural Specification. We believe that these implementation specifications may have been adopted in error because they only provide direction to public health agencies on how to report to the Centers for Disease Control and Prevention (CDC). Therefore, their adoption does not appear to either provide the appropriate or requisite implementation guidance for the adopted standard, HL7 2.5.1, or more importantly, to enable the user to “electronically record, modify, retrieve, and submit syndrome-based public health surveillance information…,” as required by the adopted certification criterion, 45 CFR 170.302(l). Please clarify whether these implementation specifications are appropriate for the intended capability specified by the public health surveillance certification criterion at 45 CFR 170.302(l)?

Answer: We have received numerous requests seeking clarification regarding these adopted implementation specifications. Based on additional discussions with various stakeholders, input from public health agencies, and the CDC, and after further review of the implementation specifications, we have determined that these implementation specifications were adopted in error. As questioners correctly point out, the implementation specifications are not appropriate for the intended capability specified by the adopted certification criterion. They provide guidance to public health agencies on the structure and methodology for using HL7 2.5.1 to report Nationally Notifiable Conditions to CDC and do not provide additional clarity for how EHR technology would need to be designed to implement the adopted standard or enable compliance with the capability identified in the certification criterion adopted at 45 CFR 170.302(l).

Accordingly, we anticipate issuing an interim final rule in the near future to remove the implementation specifications adopted at 45 CFR 170.205(d)(2). We also intend to issue compliance guidance to ONC-Authorized Testing and Certification Bodies to clarify how they may continue to test and certify EHR technology in accordance with the related certification criterion until publication of the interim final rule removing “Public Health Information Network HL7 Version 2.5 Message Structure Specification for National Condition Reporting Final Version 1.0 and Errata and Clarifications National Notification Message Structural Specification.”

4. Question [9-10-004-1]: I currently use EHR version 1.3 which I purchased from EHR technology developer XYZ. EHR technology developer XYZ has informed me that it is not going to seek certification for EHR version 1.3. Can I seek certification for EHR version 1.3 or can I partner with a group of other health care providers that also use version 1.3 to split the cost of certification? Additionally, if EHR version 1.3 becomes certified can anyone else using EHR version 1.3 rely on the certification issued to EHR version 1.3?

Answer: In response to your first question, yes, any individual health care provider, group of health care providers, other type of affiliation, or organization is permitted to seek to have EHR technology tested and certified. The Temporary Certification Program regulations do not specify who may ask an ONC-ATCB to test and certify EHR technology. However, we note that any party that seeks testing and certification for the EHR technology would typically assume the associated costs. We would also note that prior to presenting EHR technology for testing and certification, it may be prudent to conduct an analysis of the certification criteria with which, for example, EHR version 1.3 would be compliant (i.e., it may only be capable of meeting some, but not all, adopted certification criteria and could therefore only be certified as an EHR Module). Additionally, if the purchaser and EHR technology developer have entered into an agreement, the purchaser may want to review the terms and conditions of the agreement to see what, if any, restrictions have been placed on either of the parties in seeking certification of the EHR technology.

In response to the follow-up question, yes, regardless of who seeks (and/or incurs the costs) to have the EHR technology tested and certified by an ONC-ATCB, once the EHR technology is certified, the certification associated with that EHR technology is applicable to all identical copies (for example, all identical copies of EHR version 1.3). In addition, the ONC-ATCB would report to ONC that the particular EHR technology had been certified, and we would make this information available on our website through the Certified HIT Products List (CHPL).

5. Question [9-10-005-1]: I am an EHR technology developer. I have sought and achieved certification for the Complete EHR that I sell. The Complete EHR, however, is also designed to be sold in separate components so that I can offer my customers different prices based on the capabilities they seek to implement. Is it possible for me to sell components of my certified Complete EHR separately as certified EHR Modules, or do I need to seek testing and certification for each of the separate components that I plan to sell as certified EHR Modules?

Answer: Stand-alone, separate components of a certified Complete EHR do not derive their own separate certified status based solely on the fact that they were included as part of the Complete EHR when it was tested and certified. The separate component(s) would no longer meet the definition of a Complete EHR, nor would it have independently demonstrated that it can still properly perform capabilities for which certification is required in the absence of the capabilities with which it was previously certified as part of the Complete EHR. Additionally, the separate component(s) would not satisfy the requirements of 45 CFR 170.450(c) related to the privacy and security testing and certification of EHR Modules.

This concept is similar to our treatment of integrated bundles of EHR Modules. We clarified in the Temporary Certification Program final rule (75 FR 36191) that EHR Modules, once certified as part of a bundle, would not each separately inherit a certification just because they were certified as part of a bundle.

Therefore, EHR technology developers must have the separate components of a certified Complete EHR tested and certified as EHR Modules before the components may be sold separately as certified EHR Modules. Because ONC-ATCBs that are authorized to test and certify Complete EHRs are also, by default, authorized to test and certify all types of EHR Modules, such ONC-ATCBs are not precluded from issuing separate certifications for the separate components of a Complete EHR as EHR Modules at the same time the Complete EHR is presented for testing and certification, provided that the ONC-ATCB satisfies its responsibilities under 45 CFR 170.450 as well as other such responsibilities related to EHR Modules (e.g., 45 CFR 170.423 the Principles of Proper Conduct for ONC-ATCBs).

6. Question [9-10-006-1]: I submitted a Complete EHR for certification, but it has not passed a test for one or more of the certification criteria. Can I request that the ONC-ATCB certify the EHR technology that I submitted as an EHR Module instead (i.e., certify only those capabilities that have been tested successfully)?

Answer: Yes, an ONC-ATCB that is authorized to test and certify Complete EHRs has the discretion to change the type of certification it would issue based on an EHR technology developer’s request. Whether the ONC-ATCB would choose to honor a request for a change, as well as any costs associated with a change, would depend upon the arrangement between the EHR technology developer and the ONC-ATCB. Along those lines, if an ONC-ATCB permits a developer or presenter to request a different type of certification for the EHR technology it has submitted, the ONC-ATCB should be cognizant of other responsibilities it may need to satisfy for EHR Modules (e.g., 45 CFR 170.450).

7. Question [9-10-007-1]: My hospital purchased a certified EHR Module that provides approximately 75% of the capabilities we need to meet the definition of Certified EHR Technology. The other 25% are provided by our own self-developed system(s). Can we have our self-developed system tested and certified as an EHR Module and then subsequently use the combination of our self-developed certified EHR Module with the certified EHR Module we purchased to meet the definition of Certified EHR Technology? As a follow up, do we need to have the combination of the purchased certified EHR Module and our self-developed certified EHR Module tested and certified together as a Complete EHR (above and beyond the certifications they have already been issued)?

Answer: Yes, you may seek testing and certification for only those systems that have not been certified as an EHR Module (in this case, the self-developed system), and no, you do not need to have the combination of certified EHR Modules certified again as a Complete EHR in order to meet the definition of Certified EHR Technology. In relation to this question, we reiterate paragraph two of the definition of Certified EHR Technology at 45 CFR 170.102. “Certified EHR Technology means: … (2) A combination of EHR Modules in which each constituent EHR Module of the combination has been tested and certified in accordance with the certification program established by the National Coordinator as having met all applicable certification criteria adopted by the Secretary, and the resultant combination also meets the requirements included in the definition of a Qualified EHR.” As we discussed in the Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology” Final Rule (75 FR 44597), only proper combinations of EHR Modules would meet the definition of Certified EHR Technology. We encourage eligible health care providers who seek to implement certified EHR Modules to consider ahead of time the types of certified EHR Modules that may be needed to ensure that all applicable criteria will be met.

8. Question [9-10-008-1]: If an EHR Module addresses multiple certification criteria (thus providing multiple capabilities), does it need to be tested and certified to the applicable privacy and security certification criteria as a whole or for each capability?

Answer: EHR Module means any service, component, or combination thereof that meets at least one certification criterion adopted by the Secretary. An EHR Module could provide a single capability required by one certification criterion or it could provide all capabilities but one required by the certification criteria for a Complete EHR. In other words, for example, we would call HIT tested and certified to one certification criterion an “EHR Module” and HIT tested and certified to nine certification criteria an “EHR Module,” where ten certification criteria are required for a Complete EHR.

If an EHR Module addresses multiple certification criteria the EHR Module as a whole would be tested and certified to all privacy and security certification criteria unless the EHR Module is presented for testing and certification, and the presenter can demonstrate and provide documentation to the ONC–ATCB that a privacy and security certification criterion is inapplicable or that it would be technically infeasible for the EHR Module to be tested and certified in accordance with such certification criterion (see 45 CFR 170.450(c)(2)).

9. Question [9-10-009-1]: I’m an EHR technology developer and I’ve had my Complete EHR certified. I work with business partners/distributors and permit them to sell my (unmodified) certified Complete EHR under their own brand/name/label. Is this business practice permitted? Is there anything that I should do or be aware of?

Answer: Yes, this business practice is permitted. However, the ONC-ATCB that certified your Complete EHR is required to ensure that you adhere to the terms and conditions of the certification it issues, including communication of the information specified at 45 CFR 170.423(k). Thus, if you permit business partners/distributors to re-brand or rename your certified Complete EHR and represent that it has been certified, the ONC-ATCB that issued the certification for your Complete EHR may require you (consistent with Section 14 of Guide 65) to ensure that your business partners/distributors adhere to the requirements of 170.423(k) that apply to you. We encourage you to make arrangements with your business partners/distributors to ensure that they appropriately convey the information specified at 170.423(k).

Additionally, an ONC-ATCB is responsible for reporting to ONC a current list of the EHR technology it has tested and certified. Only EHR technologies reported by ONC-ATCBs to ONC will appear on ONC’s “Certified HIT Products List (CHPL).” Therefore, if you are an EHR technology developer that expects to work with business partners/distributors that will re-brand or rename your certified Complete EHR and represent that it has been certified, we encourage you to work with your ONC-ATCB to identify (up front, if possible, or on an ongoing basis) the different names under which your certified Complete EHR may be distributed. Otherwise, those re-branded or renamed Complete EHR(s) will not appear on the CHPL.

An ONC-ATCB is permitted to report information to ONC related to re-branded or renamed Complete EHRs that it has certified. We anticipate that we would list the re-branded or renamed Complete EHR(s) on the CHPL using the same unique certification identification that is assigned to your certified Complete EHR.

10. Question [9-10-010-1]: My EHR technology is designed to receive demographic data from a registration system or a practice management system. The data from these other IT systems is then used by my EHR technology to demonstrate compliance with one or more certification criteria. Do these other IT systems that act as data sources to my EHR technology need to be certified?

Answer: No, other IT systems that act as data sources and are not intended to perform required capabilities in accordance with adopted certification criteria do not need to be certified simply because they supply data to a Complete EHR or EHR Module. Obviously, if the other IT systems have not been developed to, and cannot, perform required capabilities in accordance with adopted certification criteria then certification of those other IT systems would not be available.

For the purposes of certification, an EHR technology developer must be able to demonstrate to an ONC-ATCB that its Complete EHR or EHR Module can perform the capabilities specified by all applicable certification criteria. Thus, in circumstances where the Complete EHR or EHR Module is designed to be implemented in multiple ways, including the ability to receive data from a different IT system, the EHR technology developer would need to demonstrate during testing that regardless of the source from which the Complete EHR or EHR Module receives data, it is compliant with all applicable certification criteria for which testing and certification has been sought.

11. Question [9-10-011-1]: I’ve identified that I am using two different EHR technologies to meet a single certification criterion (my document management system receives and displays summary records (45 CFR 306(f)(1)) and my EHR technology from EHR technology developer XYZ transmits summary records (45 CFR 306(f)(2)). Do both EHR technologies need to be certified?

Answer: Yes, in order to possess EHR technology that meets the definition of Certified EHR Technology, both the document management system and the EHR technology from EHR technology developer XYZ together need to meet this certification criterion in its entirety. As a result, (assuming you are not implementing a certified Complete EHR) you could elect to seek testing and certification yourself for these two systems as an EHR Module or implement a certified EHR Module that meets this certification criterion in its entirety.

12. Question [9-10-012-1]: How many clinical quality measures must EHR technology be capable of calculating in order to get certified?

Answer: It depends on whether the EHR technology is designed to be used in an ambulatory setting or in an inpatient setting as we have adopted a specific certification criterion for each setting to correspond to the correlated meaningful use requirements for which eligible professionals and eligible hospitals and critical access hospitals must satisfy (45 CFR 170.304(j) and 45 CFR 170.306(i), respectively).

For EHR technology designed for an ambulatory setting, it must be tested and certified as being compliant with all 6 of the core (3 core and 3 alternate core) clinical quality measures specified by CMS for eligible professionals as well as at a minimum 3 of the additional clinical quality measures CMS has identified for eligible professionals.

For EHR technology designed for an inpatient setting, it must be tested and certified as being compliant with all of the clinical quality measures specified by CMS for eligible hospitals and critical access hospitals.

The HIT Standards and Certification Criteria final rule provides a more detailed discussion of this issue at 75 FR 44610. Additionally, eligible health care providers should be aware that ONC–Authorized Testing and Certification Bodies (ONC-ATCBs) are required to report to the National Coordinator (among other data) the clinical quality measures to which a Complete EHR or EHR Module has been tested and certified, and further, that the Complete EHR or EHR Module developer would need to make sure this information is available and communicated to prospective purchasers as part of the Complete EHR or EHR Module’s certification.

13. Question [9-10-013-1]: I plan on sending/transferring meaningful use quality reporting data from my EHR technology to my “data warehouse” and have the data warehouse submit/report out the data to CMS. Does my data warehouse need to be certified?

Answer: Yes, if you plan to use your data warehouse to submit calculated clinical quality measures to CMS or States for meaningful use, your data warehouse would need to be certified in order for you to meet the definition of Certified EHR Technology. This is so because your data warehouse would be performing a capability for which the Secretary has adopted a certification criterion (45 CFR 170.304(j) or 45 CFR 170.306(i)) and for which you as an eligible health care provider have a correlated meaningful use requirement to satisfy.

14. Question [9-10-014-1]: I’ve selected a certified Complete EHR [or certified EHR Module] from EHR technology developer XYZ. That being said, I prefer the certified CPOE EHR Module designed by EHR technology developer ABC over the CPOE capability included in EHR technology developer XYZ’s Complete EHR. Can I use the certified CPOE EHR Module from EHR technology developer ABC instead of the CPOE capability included in EHR technology developer XYZ’s certified Complete EHR? Alternatively, can I use both of the certified CPOE capabilities included in EHR technology developer XYZ and ABC’s EHR technologies at the same time? In other words, can I use duplicative or overlapping certified capabilities of different certified EHR technologies without jeopardizing my ability to meaningfully use Certified EHR Technology?

Answer: Meeting the definition of Certified EHR Technology can be achieved in numerous ways; including using EHR technologies that perform duplicative or overlapping capabilities (if that is what an eligible health care provider chooses to do) so long as all of the applicable certification criteria adopted by the Secretary have been met and those EHR technologies are certified. Consequently, an eligible health care provider could use both certified capabilities (e.g., CPOE) at the same time in two different sections/departments of its organization. The eligible health care provider would however be responsible for reconciling the data between those two certified capabilities for purposes of reporting to CMS or the States.

Eligible health care providers who take such an approach should use ONC’s “Certified HIT Products List (CHPL)” webpage to generate a unique certification combination identification in order to accurately attest to CMS or the States the aggregate of certified EHR technologies used during the EHR reporting period.

15. Question [9-10-015-1]: I am an EHR technology developer preparing my EHR technology for certification. I am relying on a 3rd party software program to demonstrate my compliance with a specific certification criterion. Does this 3rd party software program need to be independently certified?Answer: No, the 3^rd party software program that your EHR technology relies upon does not need to be independently certified. In principle, when presenting your EHR technology to an ONC-ATCB you must be able to demonstrate that your EHR technology is in compliance with the certification criterion regardless of whether your EHR technology natively performs the specified capability or relies upon a 3^rd party software program. Thus, in practice, if you rely upon a 3^rd party software program to successfully demonstrate compliance with a certification criterion, the certification you are issued encompasses the 3^rd party software program.

In the context of relied upon software, we require ONC-ATCBs:

To include certain information about software that is relied upon when reporting your certification to the National Coordinator, which will result in your EHR technology’s entry on the Certified HIT Products List (45 CFR 170.423(h)(6)); and
To ensure that you convey this information on your website and in all marketing materials, communications statements, and other assertions related to your EHR technology’s certification (45 CFR 170.423(k)(1)(ii)).

16. Question [9-10-016-1]: I’m in the process of implementing EHR technology developer XYZ’s certified Complete EHR [or certified EHR Module] “E-HealthSystem2010.”

Scenario 1: I have determined that E-HealthSystem2010 needs to be reconfigured in order to connect with one of my patient registration systems. Can I reconfigure E-HealthSystem2010 without compromising the certified status of my implementation of E-HeatlhSystem2010?

Scenario 2: EHR technology developer XYZ communicated to my organization that they relied upon a 3rd party software program “PatientInfoTracker 2.0” for the purposes of demonstrating compliance with the “generate patient lists” certification criterion specified at 45 CFR 170.302(i) in achieving E-HeatlhSystem2010’s certification. I have already implemented, use, and would like to continue using “SuperListGenerator 7.0.” I have determined that I can reconfigure SuperListGenerator 7.0 to work with E-HeatlhSystem2010. Can I use SuperListGenerator 7.0 in lieu of PatientInfoTracker 2.0 without compromising the certified status of my implementation of E-HeatlhSystem2010?

Answer: With respect to Scenario 1, yes, you can reconfigure your implementation of E-HealthSystem2010 without compromising its certified status, but you assume the risks associated with modifying a certified capability after it has been certified. You are also responsible for ensuring that these modifications do not adversely affect the performance of E-HealthSystem2010 and, as a result, your ability to demonstrate meaningful use. We encourage eligible providers to use caution when modifying certified Complete EHRs or EHR Modules.

With respect to Scenario 2, no, you cannot use a different 3^rd party program to perform a certified capability unless:

EHR technology developer XYZ already has a separate certification for E-HealthSystem2010 that identifies SuperListGenerator 7.0 as a relied upon software program; or
You seek certification for SuperListGenerator 7.0 as an EHR Module.

17. Question [9-10-017-1]: Under the Medicare and Medicaid EHR Incentive Programs Final Rule, eligible health care providers are permitted to defer certain meaningful use objectives and measures and still receive an EHR incentive payment. However, it is our understanding that in order for us to have our EHR technology certified, we must implement all of the applicable capabilities specified in the adopted certification criteria regardless of whether we intend to use all of those capabilities to qualify for our EHR incentive payment. Is our understanding correct?

Answer: Yes, this understanding is correct. The flexibility offered as part of the Medicare and Medicaid EHR Incentive Programs Final Rule is not mirrored in the Initial Set of Standards, Implementation Specifications, and Certification Criteria Final Rule because we believe that it is important to accommodate eligible health care providers’ ability to achieve meaningful use. We recognize that in some circumstances an eligible health care provider may not know which meaningful use measures they will seek to defer until they begin implementation and in others an individual provider (even within a specialty) will want to choose different measures to defer based on their local situation and implementation experience. Thus, in order to possess EHR technology that meets the definition of Certified EHR Technology, it must be tested and certified by an ONC-ATCB to all applicable certification criteria adopted by the Secretary.

18. Question [9-10-018-1]: I use or would like to use an “interface” to submit data to a public health agency/registry. Does this interface need to be certified?

Answer: It depends. We recognize that the term “interface” has several different meanings depending on the context in which it is used, the IT infrastructure of which it is a part, and the capability it performs. Consequently, depending on various factors, an interface may or may not need to be certified.

“NO”

The answer to your question would be “no,” if the interface provided a user with the ability to directly enter data to the public health agency/registry. In that scenario, the interface would not be providing a capability for which the Secretary has adopted a certification criterion and that Certified EHR Technology must include.
Similarly, if the interface would solely be serving as a conduit between your EHR technology and the public health agency/registry and providing the underlying communication protocol to transport data from point A to point B, it would not need to be certified. In this case, the interface would simply be providing the connection between you and the public health agency/registry and the means for the submission to occur. The interface would not be providing the capability specified in the certification criterion adopted by Secretary, which Certified EHR Technology must include.

“YES”

If, however, the interface were to perform a capability specified in an adopted certification criterion and the interface was intended to satisfy a correlated meaningful use requirement, it would need to be certified. Why? Because you are required to use Certified EHR Technology to qualify for your respective EHR incentive program. As an example, if the interface was intended to provide the capability of electronically recording, modifying, retrieving and submitting immunization information in a standardized format (45 CFR 170.302(k)), it would need to be certified.

19. Question [9-10-019-1]: The “electronic copy of health information” certification criteria (45 CFR 170.304(f) and 45 CFR 170.306(d)) each require that Certified EHR Technology “enable a user to create an electronic copy of a patient’s clinical information… in: (1) Human readable format; and (2) On electronic media or through some other electronic means….” Is there more than one way to demonstrate compliance with these certification criteria?

Answer: Yes, as discussed in the Initial Set of Standards, Implementation Specifications, and Certification Criteria Final Rule, there is more than one way to demonstrate compliance with this certification criterion. For this certification criterion, Certified EHR Technology must be capable of generating two outputs to produce an electronic copy (i.e., a copy in human readable format and a copy as a CCD or CCR). If the Certified EHR Technology is capable of generating one copy that could meet both of these requirements, we would also consider that to be a compliant implementation of this capability.

20. Question [9-10-020-1]: The certification criterion at 45 CFR 170.302(n) specifies that “[f]or each meaningful use objective with a percentage-based measure, electronically record the numerator and denominator and generate a report including the numerator, denominator, and resulting percentage associated with each applicable meaningful use measure.” Is it possible for the action of “record” in the certification criterion to be implemented in different ways and still remain in compliance with the certification criterion? For example, could “record” comprise the ability of a centralized analytics EHR Module to accept or retrieve raw data from another EHR Module or EHR Modules, and upon receipt of this raw data, the centralized analytics EHR Module would calculate the numerator, denominator, and the resulting percentage as specified by 45 CFR 170.302(n)?

Answer: Yes, it is possible for the action of “record” in this certification criterion to be implemented in different ways. The example in this question appears to be one possible way to demonstrate compliance with this certification criterion. Other possible methods could include a Complete EHR that accepts or retrieves raw data, analyzes the data, and then generates a report based on the analysis; a Complete EHR that separately tracks each capability with a percentage-based meaningful use measure and later aggregates the numbers and generates a report; or an integrated bundle of EHR Modules in which each of the EHR Modules that is part of the bundle categorizes relevant data, identifies the numerator and denominator and calculates, when requested, the percentage associated with the applicable meaningful use measure. In each of these examples, the action of “record” means to obtain the information necessary to generate the relevant numerator and denominator.

Additional FAQs

Dec 3 PHR Roundtable from ONC

Posted on September 25, 2010 by Mike Squires

Roundtable: Personal Health Records – Understanding the Evolving Landscape
Physician at laptop

Excerpted on 9/25/2010 from ONC Web site.
PHR Roundtable: December 3, 2010
The Office of National Coordinator for Health Information Technology (ONC) will host a free day-long public Roundtable on “Personal Health Records — Understanding the Evolving Landscape.” The Roundtable is designed to inform ONC’s Congressionally mandated report on privacy and security requirements for non-Covered Entities (non-CEs), with a focus on personal health records (PHRs) and related service providers (Section 13424 of the HITECH Act) .The Roundtable will include four panels of prominent researchers, legal scholars, and representatives of consumer, patient, and industry organizations. It will address the current state and evolving nature of PHRs and related technologies (including mobile technologies and social networking), consumer and industry expectations and attitudes toward privacy and security practices, and the pros and cons of different approaches to the requirements that should apply to non-CE PHRs and related technologies.Registration and public comment will open in October.

WHEN:
Friday, December 3, 2010

WHERE:
FTC Conference Center
601 New Jersey Avenue, NW
Washington, DC 20001

Scan for Health IT Innovation Pilot Programs in New Jersey: What Pilots Do You Know About in NJ? Due Sept 21

Posted on September 16, 2010 by Mike Squires

New Jersey: Are you involved with or know of Health IT Innovation Pilots Programs in NJ?
Tuesday noon, September 21, 2010 Deadline
New Jersey’s Statewide Health IT Coordinator, Colleen Woods, is asking for your immediate help in gathering a list of Innovative Health IT Pilot Programs in the state. Do you or your organization have an ongoing pilot program that involves health information technology? Are you planning a specific innovative pilot program involved with Health IT? Or do you have experience with a past program in NJ?

Think broadly: health IT pilot programs in hospitals, long-term and critical care facilities, physician and clinical offices, pharmacies, home health, remote monitoring and self-monitoring, electronic health records, personal health records, wireless, online and digital.

Please let us know. This will help pull together some additional information in time for next week’s NJ and Delaware Valley HIMSS Conference on Sept 22-24, 2010 in Atlantic City. You can add comments to this blog or email Mike Squires at msquires@e-healthcaremarketing.com with whatever information you can share. I’ll be sure to get it to Colleen Woods. Thank you very much!
–Mike Squires

ONC’s FACA Meeting Calendar for Sept 2010

Posted on September 11, 2010 by Mike Squires

Sept 2010 FACA Meeting Calendar
Emailed by ONC on Sept 10, 2010

Please be sure the following Federal Advisory Committee (FACA) meetings are on your calendars!

See the ONC Website, http://healthit.hhs.gov/FACAs, for information on how to participate via phone or web, or how to find the location of the public hearings (indicated with an asterisk *) which will be held at hotels in the Washington DC metro area.

HIT Policy Committee Meetings
Information Exchange Workgroup, Sept 13, 11 am to 2 pm/EDT

HIT Policy Committee*, Sept 14, 10 am to 3 pm/EDT
Crystal Gateway Marriott, Arlington, VA

Meaningful Use WG*, Sept 22, 8:30 am to 4 pm/EDT
Park Hyatt Washington, Washington, DC

Enrollment WG, Sept 24, 11 am to 2 pm/EDT

Privacy & Security Tiger Team, Sept 24, 3 pm to 5 pm/EDT

Governance WG*, Sept 28, 9 am to 5 pm/EDT
Washington Marriott Wardman Park Hotel, Washington, DC

Quality Measures WG, Sept 29, 2 pm to 5 pm/EDT

Information Exchange WG*, Sept 30, 9 am to 4 pm/EDT
Location to be determined.

HIT Standards Committee Meetings
Implementation WG, Sept 15, 12 pm to 2 pm/EDT

HIT Standards Committee*, Sept 21, 9 am to 3 pm/EDT
Washington Marriott Wardman Park Hotel, Washington, DC

Vocabulary Task Force, Sept 23, 10 am to 11:30 am/EDT

Clinical Operations WG, Sept 23, 12 pm to 1:30 pm/EDT

Health IT Regional Extension Centers Awarded $20 Mil to train Critical Access Hospitals

Posted on September 11, 2010 by Mike Squires

New funds support rural hospitals’ switch to electronic health records

Press Release from HHS; Friday, Sept 10, 2010:
HHS Secretary Kathleen Sebelius today announced nearly $20 million in new technical support assistance to help critical access and rural hospital facilities convert from paper-based medical records to certified electronic health record (EHR) technology. Some 1,655 critical access and rural hospitals in 41 states and the nationwide Indian Country, headquartered in the District of Columbia, stand to benefit from this assistance, which can help each of them qualify for substantial EHR incentive payments from Medicare and Medicaid.

“The benefits of health information technology can be especially important for patients and clinicians in small and rural health care facilities, yet these facilities face high hurdles as they look toward joining in the transition to electronic information,” Secretary Sebelius said. “The funding we are announcing today is a new category of support, aimed specifically at assisting critical access and rural hospitals with their particular needs and challenges. This new funding is added to the substantial base we have already built to provide assistance to health care providers throughout the country as they transition to EHRs.”

The new funding is provided under the Health Information Technology Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act of 2009. The HITECH Act created the Medicare and Medicaid EHR incentive programs, which will provide incentive payments to eligible professionals and hospitals that adopt and demonstrate meaningful use of certified EHR technology. Incentives totaling as much as $27.4 billion over 10 years could be expended under the program, which is administered by the Centers for Medicare & Medicaid Services. In addition, the HITECH Act provided $2 billion through the Office of the National Coordinator for Health Information Technology (ONC) to support technical assistance, training, and demonstration projects to assist in the nation’s transition to EHRs.

The funding announced today comes through one of the ONC programs, the Regional Extension Centers (RECs). RECs offer technical assistance, guidance, and information on best practices to support and accelerate health care providers’ efforts to become meaningful users of certified EHRs under the Medicare and Medicaid incentives programs. A total of 60 RECs are located throughout the country.

Today’s funding is being awarded to 46 of the RECs, serving providers in 41 states and the nationwide Indian Country. A total of 1,655 critical access and rural hospitals are in the areas covered by these RECs. The funding is part of the Critical Access Hospitals and Rural Hospitals (CAH/Rural Hospital) Project, a priority for the REC program. The intent of the project is to provide additional technical support to critical access and rural hospitals with fewer than 50 beds in selecting and implementing EHR systems primarily within the outpatient setting.

“Regional Extension Centers are poised to provide the hands-on, field support needed by health care providers to advance the rapid adoption and use of health IT,” said David Blumenthal, M.D., National Coordinator for Health Information Technology. “The added level of support we are announcing today will enable the RECs to offer greater field support to these communities as they deal with the financial and workforce constraints, and work to achieve access to broadband connectivity and to overcome other barriers that critical access hospitals and other rural hospitals may confront.”

RECs provide a resource for technical assistance, guidance, and information to local health care providers on best practices around EHR adoption and meaningful use. RECs are designed to address unique community requirements and to support and accelerate provider efforts to become meaningful users of certified EHR technology. Today’s round of awards builds on the funding that RECs are already receiving under the HITECH Act, bringing the total amount of funding awarded to date to support the efforts of RECs to over $663 million.

The awards announced today are:
To access sortable list, click here for ONC site chart.

Regional Extension Center (REC)	REC State Coverage	Award Amount
Alaska eHealth Network	Alaska	$168,000
Alabama Regional Extension Center	Alabama	$432,000
HIT Arkansas	Arkansas	$420,000
Arizona Health-e Connection (AzHeC)	Arizona	$240,000
California Regional Extension Center (North) – CalHIPSO (North)	California	$336,000
California Regional Extension Center (South) – CalHIPSO (South)	California	$180,000
Colorado Regional Extension Center (CORHIO)	Colorado	$456,000
National Indian Health Board (NIHB)	Serving the nationwide Indian Country, headquartered in the District of Columbia	$312,000
Rural and North Florida Regional Extension Center	Florida	$168,000
South Florida Regional Extension Center Collaborative	Florida	$ 36,000
Hawaii Health Information Exchange	Hawaii	$144,000
IFMC Health Information Technology Regional Extension Center (Iowa HITREC)	Iowa	$1,044,000
Illinois Health Information Technology Regional Extension Center (IL-HITREC)	Illinois	$720,000
Purdue University	Indiana	$396,000
Kansas Foundation for Medical Care, Inc. (KFMC)	Kansas	$1,140,000
University of Kentucky Research Foundation	Kentucky	$360,000
Louisiana Health Care Quality Forum	Louisiana	$768,000
Massachusetts Technology Corporation	Massachusetts	$132,000
HealthInfoNet	Maine	$264,000
Michigan Center for Effective IT Adoption (M-CEITA)	Michigan	$432,000
Regional Extension Assistance Center for Health Information Technology (REACH)	MinnesotaNorth Dakota	$1,488,000
Missouri HIT Assistance Center	Missouri	$660,000
Regional Extension Center for Health Information Technology in Mississippi	Mississippi	$540,000
Mountain-Pacific Quality Health Foundation (MPQHF)	MontanaWyoming	$816,000
Wide River Technology Extension Center	Nebraska	$120,000
LCF Research	New Mexico	$204,000
New York eHealth Collaborative (NYeC)	New York	$120,000
Health Bridge Inc.	Ohio	$288,000
Ohio Health Information Partnership (OHIP)	Ohio	$ 516,000
Oklahoma Foundation for Medical Quality (OFMQ)	Oklahoma	$744,000
O-HITEC.	Oregon	$384,000
Quality Insights of Pennsylvania, Inc. (East)	Pennsylvania	$180,000
Quality Insights of Pennsylvania, Inc. (West)	Pennsylvania	$144,000
South Carolina Research Foundation	South Carolina	$156,000
South Dakota Regional Extension Center (SD-REC)	South Dakota	$576,000
Qsource	Tennessee	$480,000
North Texas REC	Texas	$108,000
West Texas Health Information Technology Regional Extension Center (WT-HITREC)	Texas	$912,000
CentrEast Regional Extension Center	Texas	$384,000
University of Texas Health Science Center at Houston	Texas	$612,000
Health Insight	Utah Nevada	$480,000
VHQC (Virginia Health Quality Center)	Virginia	$ 84,000
Vermont Information Technology Leaders	Vermont	$108,000
WI-REC	Washington	$564,000
Wisconsin Health Information Technology Extension Center	Wisconsin	$828,000
West Virginia Health Improvement	WV	$204,000
	TOTAL ALL AWARDS	$19,848,000

A complete listing of REC grant recipients and additional information about the Health Information Technology Regional Extension Centers may be found at http://www.HealthIT.hhs.gov/programs/REC/.

For information about the Medicare and Medicaid EHR Incentive Programs, see http://www.cms.gov/EHRIncentivePrograms

For information about HHS Recovery Act Health Information Technology programs, see http://www.hhs.gov/recovery/announcements/by_topic.html#hit.

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ONC Background on critical access hospitals
Accessed from ONC site on Sept 11, 2010
The Medicare Rural Hospital Flexibility Program (Flex Program), created by Congress in 1997, allows small hospitals to be licensed as Critical Access Hospitals (CAHs) and offers grants to states to help implement initiatives to strengthen the rural health care infrastructure. To participate in the Flex Grant Program, states are required to develop a rural health care plan that provides for the creation of one or more rural health networks; promotes regionalization of rural health services in the state; and improves the quality of and access to hospital and other health services for rural residents of the state. Consistent with their rural health care plans, states may designate eligible rural hospitals as CAHs.CAHs must be located in a rural area (or an area treated as rural); be more than 35 miles (or 15 miles in areas with mountainous terrain or only secondary roads available) from another hospital; or be certified before January 1, 2006 by the state as being a necessary provider of health care services. CAHs are required to make available 24-hour emergency care services that a state determines are necessary. CAHs may have a maximum of 25 acute care and swing beds, and must maintain an annual average length of stay of 96 hours or less for their acute care patients. CAHs are reimbursed by Medicare on a cost basis (e.g., for the reasonable costs of providing inpatient, outpatient, and swing bed services).The legislative authority for the Flex Program and cost-based reimbursement for CAHs are described in the Social Security Act, Title XVIII, Sections 1814 and 1820, available at http://www.ssa.gov/OP_Home/ssact/title18/1800.htm.
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CMS Critial Access Hospital Fact Sheet

CAH Hospital: Web site funded by Federal government that contains current information on Critial Access Hospitals. This links to page with lists of CAHs by state in drop down menu and Excel spreadsheet.

CMS Web Site Buttons Link to its EHR Incentive Program Site

Posted on September 11, 2010 by Mike Squires

Four Buttons Created to Link Web Sites to EHR Incentive Programs
Plus Link to FAQs and Contacts
Centers for Medicare and Medicaid Services (CMS) created four buttons to use on Web sites to link to the official CMS EHR Incentive Program Web site:

Link here for official federal information about the EHR Incentive Programs: http://www.cms.gov/EHRIncentivePrograms/

Round Button

Square Button

Horizontal Button 1

Horizontal Button 2

Round, Square, or Horizontal, you get your choice as to which button to post on your Web site or blog to link directly to the CMS Official Web site for the EHR Incentive Program.

Per CMS Web site “Use these web buttons to post to your web site and have a direct link back to CMS’ EHR Incentive Program web page. We request that alternate text for the web button read: Link here for official federal information about the EHR Incentive Programs: http://www.cms.gov/EHRIncentivePrograms/ . The hyperlink to the EHR Incentive Program web site is: http://www.cms.gov/EHRIncentivePrograms/ ”

To download the buttons for use on Web sites:
EHR Incentive Program Web Button Round [JPG, 23KB]

EHR Incentive Program Web Button Square [JPG, 26KB]

EHR Incentive Program Web Button Horizontal 1 [JPG, 25KB]

EHR Incentive Program Web Button Horizontal 2 [JPG, 34KB]

CMS FAQs And Contacts on EHR Incentive Programs
Health IT Frequently Asked Questions

Contact Information for EHR Incentive Program Inquiries [PDF, 110KB]

Push Blue Button for Personal Health Information: Markle Foundation

Posted on September 3, 2010 by Mike Squires

Health IT Investments Should Enable People to Download Their Own Information …at the click of a blue button
Press Release from Markle Foundation on August 31, 2010
PDF Version

Blue Button

Markle Connecting for Health Collaboration Agrees on ‘How To’ Policies

Veterans, Medicare beneficiaries near ‘blue button’ access

Markle collaboration includes support from 48 organizations; recommends specific privacy practices

NEW YORK (Aug. 31, 2010)
Representing a wide array of providers, consumers, technology companies, insurers, and privacy advocates—48 organizations today declared their support for a specific set of privacy and security practices for the “blue button.”

The public-private collaborative group envisions the blue button as a common offering among secure websites for patients and beneficiaries by medical practices, hospitals, insurers, pharmacies, laboratories, and information services.

“By clicking the blue button, you could get your own health information electronically—things like summaries of doctor visits, medications you are currently taking, or test results. Being able to have your own electronic copies and share them as you need to with your doctors is a first step in truly enabling people to engage in their health care,” said Carol Diamond, MD, MPH, managing director at Markle.

“This capability is not common today, but we have the opportunity to make it a basic expectation—especially now that billions of public dollars will be flowing to help subsidize health information technology,” Diamond said.

The paper is being released as Medicare and the U.S. Veterans Administration (VA) prepare to implement a blue button this fall that will, for the first time, allow beneficiaries to electronically download their claims or medical information in a common format from the My Medicare.gov and My HealtheVet secure websites.

President Obama announced the blue button for veterans in an August 3 address. “For the first time ever, veterans will be able to go to the VA website, click a simple blue button and download or print your personal health records so you have them when you need them, and can share them with your doctors outside of the VA,” the President said.

The Markle collaboration’s recommendations are timely because the American Recovery and Reinvestment Act requires that individuals be able to receive electronic copies of their records from providers’ electronic health record systems. In addition, new federal economic stimulus rules require health care providers and hospitals to deliver electronic copies of things like lists of medications, after-visit summaries, and lab results if they choose to participate in federal subsidies for using health information technology.

The Markle policy recommendations reflect consensus on one means by which this can be accomplished today, securely and efficiently. The group details privacy policies and practices for implementing the download capability with sound authentication and security safeguards and suggests practices to help individuals make informed choices about downloading their information. For example, it recommends specific language to remind individuals not to download or store their personal health information on shared computers.

Christine Bechtel, vice president of the National Partnership for Women & Families, and a member of the federal Health IT Policy Committee, supported the Markle policy paper.

“People see a lot of different health care providers over time, so giving them a convenient option to securely assemble their health information from multiple sources will help them better manage and coordinate their own care,” Bechtel said. “This capability is one of the simplest and most direct ways of helping patients and families see the benefits of the federal health IT investments that they, as taxpayers, have helped fund.”

The proposed privacy policies build on the Markle Common Framework for Networked Personal Health Information, a set of recommended practices for individual access to information and privacy. The framework, first released in 2006, is widely supported by a range of technology companies, insurers, provider groups, and consumer and privacy advocates.

“We recommend specific privacy policies to help individuals make informed choices about downloading their personal health information, and to emphasize sound authentication and security practices,” said Josh Lemieux, director of personal health technology at Markle. “By supporting this set of policies, a wide range of leaders commit to practices that encourage individual access to information in a way that respects privacy and security.”

The following organizations declared their support for the policy paper,

—The simple, but rarely offered, ability for people to download their health records should be a priority in the nationwide push to upgrade health information technology, according to a policy paper released today by the Markle Foundation. Markle Connecting for Health Policies in Practice: The Download Capability:

AARP • Allscripts Healthcare Solutions • American Academy of Family Physicians • American College of Cardiology • American College of Emergency Physicians • American Medical Association • Anakam Inc. • Axolotl • BlueCross BlueShield Association • Center for Connected Health • The Children’s Partnership • Center for Democracy and Technology • Center for Medical Consumers • Children’s Health Fund • Chilmark Research • Computer Sciences Corporation • Consumers Union • Dossia

Consortium • DrFirst • Google • Initiate, an IBM Company • The Institute for Family Health • Intel Corporation • Intuit Health • Keas, Inc. • LifeMasters-StayWell Health Management • Markle Foundation • McKesson Technology Solutions/RelayHealth • MedCommons • Medical Group Management Association • MedicAlert Foundation • Meditech • Microsoft Corporation • National Coalition for Cancer Survivorship • National Committee for Quality Assurance • National Partnership for Women & Families • National Quality Forum • NaviNet • Pacific Business Group on Health • PatientsLikeMe • Prematics, Inc. • Press Ganey • PricewaterhouseCoopers LLP • RTI International • Vanderbilt Center for Better Health • Visiting Nurse Service of New York • Wal-Mart Stores, Inc. • Wellport

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Markle Foundation works to improve health and national security through the use of information and technology. Markle collaborates with innovators and thought leaders from the public and private sectors whose expertise lies in the areas of information technology, privacy, civil liberties, health, and national security. Learn more about Markle at www.markle.org .

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Markle Connecting for Health is a public-private collaborative with representatives from more than one hundred organizations across the spectrum of health care and information technology specialists. Its purpose is to catalyze the widespread changes necessary to realize the full benefits of health information technology while protecting patient privacy and the security of personal health information. Markle Connecting for Health tackles the key challenges to creating a networked health information environment that enables secure and private information sharing when and where it is needed to improve health and health care. Learn more about Markle Connecting for Health at www.connectingforhealth.org .
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KEY LINKS
President Obama Talks about the Blue Button Initiative (VIDEO)

See Department of Veteran Affairs for Blue Button Initiative.

See Centers for Medicare and Medicaid Services about Blue Button Initiative.

ONC’s McKethan Blogs on New Health IT Beacon Communities: Cincinnati and Detroit

Posted on September 2, 2010 by Mike Squires

Two New Communities Join the Beacon Family
Thursday, September 2nd, 2010 | Posted by: Aaron McKethan Director of Beacon Communities Program on ONC’s Health IT Buzz blog and republished by e-Healthcare Marketing here.

The Beacon Community program seeks to demonstrate how health IT-enabled improvements in health care quality, efficiency, and population health are possible, sustainable, and replicable in diverse communities across America. The program includes average three-year awards of $15 million to diverse communities with above-average electronic health record adoption rates and, in most cases, experience with information exchange. Collaborations of leaders from each of the 15 Beacon Communities that were awarded back in May have been busy operationalizing and implementing their health IT-enabled innovations that can support new ways of coordinating and streamlining health care and, ultimately, improving the health of local communities. We look forward to sharing more details about these initial activities in the near future.

Today, we are delighted to welcome two additional communities to the Beacon family. They are Greater Cincinnati HealthBridge, Inc. (Cincinnati, OH) and Southeastern Michigan Health Association (Detroit, MI).

The Greater Cincinnati HealthBridge, Inc., serving a 16-county area spanning three states, will work with its partners to build upon an advanced health information exchange to deploy new quality improvement and care coordination initiatives focusing on patients with pediatric asthma and adult diabetes. This program will use health IT tools and resources to provide streamlined and secure clinical information and decision support tools to physicians, health systems, federally qualified health centers, and critical access hospitals. The community collaboration will also provide patients and their families with timely access to data, knowledge, and tools to make more informed decisions and to manage their own health and health care.

The Southeastern Michigan Health Association and its community partners will focus its efforts on preventing and better managing diabetes using health IT tools and resources. Specifically, this effort will focus on coordinating care across health care settings by improving the availability of patient information at the point of care, redesigning patient care work processes, and applying quality improvement and other change management strategies to improve the quality and efficiency of diabetes care in the greater Detroit area.

The success of the Beacon Communities will not be judged by whether they are able to expand the adoption of health IT. Rather, they will be evaluated on the extent to which patients receive measurably better care at a lower overall cost. We are very proud to welcome these new partners representing two communities that are committed to lofty but important aims. We are confident they will demonstrate effective strategies for the nation in the coming years, and we look forward to integrating them into the forward-looking Beacon Community family.
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To comment on this blog post, please go directly to ONC’s Health IT Buzz blog directly.