Fact Sheet: Chartered Value Exchanges: Local Collaboratives Driving Health Care Reform

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Fact Sheet on Community Quality Collaboratives from AHRQ
Excerpted from Agency for Healthcare Research and Quality (AHRQ) on 12/12/2010

Community quality collaboratives are community-based organizations of multiple stakeholders, including health care providers, purchasers (employers, employer coalitions, Medicaid and others), health plans, and consumer advocacy organizations, that are working together to transform health care at the local level. The Agency for Healthcare Research and Quality offers these organizations many tools to assist in their efforts.

Background

Community quality collaboratives are key drivers of health care reform at the local level. These collaboratives, including 24 Chartered Value Exchanges, are implementing a bold vision for health care reform built on four cornerstones. are built on four cornerstones. These cornerstones are:

  • Measuring and publishing quality information to enable consumers to make better decisions about their care.
  • Measuring and publishing price information to give consumers information they need to make decisions on purchasing health care.
  • Promoting quality and efficiency of care.
  • Adopting interoperable health information technology.

AHRQ offers a compendium of tools and resources for other community quality collaboratives who want to follow paths similar to Community Leaders and Chartered Value Exchanges.

Tools for Collaborative Leadership and Sustainability

Sustainability Toolkit for Community Quality Collaboratives: An Overview of the Art & Science of Building Staying Power
Tools to help collaboratives build, maintain, and refine an infrastructure that supports and advances the mission of the organization as market and stakeholder expectations change

Go to: http://www.ahrq.gov/qual/value/suscqcollab.htm (PDF File, 150 KB; PDF Help)

Multi-stakeholder Community Inventory Modules
Tools to assess strengths and goals of Community Quality Collaboratives along 8 areas: collaborative leadership, public at-large engagement, quality and efficiency measurement, public reporting, provider incentives, consumer incentives, strategy for improving quality, health information technology/health information exchange.

Go to: http://www.ahrq.gov/qual/value/cimodules.htm (PDF File, 407 KB; PDF Help)

Regional Coalition Collaboration Guide
Assists community leaders in creating and sustaining a regional coalition based on lessons and tips from six pilot quality initiatives

Go to: http://www.ahrq.gov/qual/value/collabguide.htm

Tools to Engage Consumers

The Community Quality Collaborative Leader’s Guide to Engaging Consumer Advocates
Guide for including consumer advocates in Community Quality Collaboratives

Go to: http://www.ahrq.gov/qual/value/caguide.htm (PDF File, 175 KB; PDF Help)

AHRQ Publications for Consumers
Easy-to-understand publications for health care consumers

Go to: http://www.ahrq.gov/consumer/

Tools on Measures, Data, and Reports on Quality and Efficiency

Selecting Quality and Resource Use Measures: A Decision Guide for Community Quality Collaboratives
Tool to help community-based organizations striving to improve the quality of health care in their communities select quality of care and resource use measures.

Go to: http://www.ahrq.gov/qual/perfmeasguide/index.html (PDF File, 777 KB; PDF Help)

Consumer Assessment of Healthcare Providers and Systems (CAHPS®)
Public-private initiative to develop standardized surveys of patients’ experiences with ambulatory and facility-level care

Go to: https://www.cahps.ahrq.gov/default.asp

HCUPnet
Online query system that provides access to health statistics and information on hospital inpatient utilization and quality—at the national and state levels—and thereby can inform local quality agenda…

Go to: http://hcupnet.ahrq.gov/

National Healthcare Quality Report and National Healthcare Disparities Report
Annual, comprehensive overviews of the state of quality and disparities in health care in the United States

Go to: http://www.ahrq.gov/qual/qrdr09.htm

AHRQ Preventable Hospitalization Costs, a County-Level Mapping Tool
Downloadable software that can be used with administrative data on hospital admissions to assess the number and cost of “preventable admissions” in State or communities.

Go to: http://www.qualityindicators.ahrq.gov/mappingtool.htm

Identifying, Categorizing, and Evaluating Health Care Efficiency Measures
Rand report that identifies, analyzes, and classifies current definitions of efficiency, lays out a roadmap to help illuminate discussions, and identifies next steps.

Go to: http://www.ahrq.gov/qual/efficiency/index.html

AHRQ Quality Indicators
Downloadable software that can be used with hospital administrative data to assess quality of care. Software includes four modules: inpatient quality indicators; patient safety quality indicators; prevention quality indicators; and pediatric quality indicators.

Go to: http://www.qualityindicators.ahrq.gov/

Tools for Public Reporting

Best Practices in Public Reporting
The purpose of the Best Practices in Public Reporting series is to provide practical approaches to designing public reports that make health care performance information clear, meaningful, and usable by consumers.

Go to:

  1. How To Effectively Present Health Care Performance Data To Consumers
    http://www.ahrq.gov/qual/pubrptguide1.htm
  2. Maximizing Consumer Understanding of Public Comparative Quality Reports: Effective Use of Explanatory Information
    http://www.ahrq.gov/qual/pubrptguide2.htm
  3. How to Maximize Public Awareness and Use of Comparative Quality Reports Through Effective Promotion and Dissemination Strategies
    http://www.ahrq.gov/qual/pubrptguide3.htm

Health Care Report Card Compendium
Searchable directory of over 200 sample report cards that show formats and approaches for providing comparative information on the quality of health plans, hospitals, medical groups, individual physicians, nursing homes, and other providers of care.

Go to: https://www.talkingquality.ahrq.gov/compendium/

Model Public Report Elements: A Sampler
An illustrative menu of public report elements from health care provider performance reports from around the country.

Go to: http://www.ahrq.gov/qual/value/pubrptsampler.htm

Quality Indicators Draft Model Reports
Model reports designed to report comparative information on hospital performance based on the AHRQ Quality Indicators

Go to: http://www.qualityindicators.ahrq.gov/downloads.htm#DraftModelReports

Talking to Consumers about Health Care Quality
Site designed for people and organizations trying to educate consumers about health care quality

Go to: https://www.talkingquality.ahrq.gov/

Tools on Incentives for Quality

Pay for Performance: A Decision Guide for Purchasers
An evidence summary organized around 20 questions that span four phases of purchaser decisionmaking: contemplation, design, implementation, and evaluation.

Go to: http://www.ahrq.gov/qual/p4pguide.htm

Decision Guide on Consumer Financial Incentives
An evidence summary organized around 21 questions that span incentive design and implementation decisions identified by user-stakeholders. It reviews the application of incentives to five types of consumer decisions: selecting a high value provider, selecting a high value health plan, deciding among treatment options, reducing health risks by seeking preventive care, and reducing health risks by decreasing or eliminating high-risk behavior.

Go to: http://www.ahrq.gov/qual/value/incentives.htm

Tools to Improve Preventive Services

U.S. Preventive Services Task Force
Expert recommendations for clinical preventive services

Go to: http://www.ahrq.gov/clinic/uspstfix.htm

A Purchaser’s Guide to Clinical Preventive Services: Moving Science into Coverage
Information source for employers on clinical preventive service benefit design

http://www.businessgrouphealth.org/benefitstopics/topics/purchasers/index.cfm Exit Disclaimer

Current as of September 2010

HHS Fact Sheet 2007: Medicare Physician Performance Measures

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HHS Fact Sheet: Medicare Physician Performance Measures: 2007
HHS Press Release from September 28, 2007
HHS Secretary Leavitt Announces Plan To Share Medicare Physician Performance Measures Through Local Value Exchanges

Today, HHS Secretary Mike Leavitt announced a plan to make Medicare performance measurement information available at the community level.

Release of Physician Performance Information Supports Value-Driven Health Care Initiative

  • The Centers for Medicare & Medicaid Services (CMS) will use Medicare data to generate physician quality performance measurement results.  These will be consensus-based quality measures adopted by the Ambulatory Care Quality Alliance (AQA) and endorsed by the National Quality Forum (NQF).
  • This ensures that this information is available on a local level, signifying the continued importance of collaboration and helping pave the way toward creating a comprehensive, unified, and effective approach to physician quality measurement.
  • The release of this quality measurement information also supports the efforts of the Value-Driven Health Care (VHC) initiative that aims to create a system of better care at lower costs.  VHC is based on Four Cornerstones: standardized, interoperable electronic health records; ways to measure and compare quality; ways to measure and compare cost; and incentives to improve quality and lower cost.

Local Value Exchanges Will Disseminate Results in Communities

  • The Agency for Healthcare Research and Quality (AHRQ) is developing a process to recognize organizations that support the vision of fostering health care reform at the local level by engaging providers, consumers and other key stakeholders.  These organizations will be called Value Exchanges.
  • This fall, AHRQ will begin accepting applications for Chartered Value Exchanges (CVEs) from existing organizations that have been recognized as Community Leaders for Value-Driven Health Care.
  • CMS will provide the results information to CVEs, which can make information available on a local or regional level.
  • It is anticipated that CMS will begin providing the Medicare results by the summer of 2008. 

Combining Public and Private Data to Provide a Comprehensive Picture of Physician Quality

  • CVEs will act as catalysts to bring together public- and private-sector physician measurement results to stimulate quality improvement and consumer choice in their communities.
  • These organizations will be able to combine the Medicare results they receive with private-sector information generated using the same methodology, producing all-payer physician performance measurement results. 
  • Ultimately, this will provide a more comprehensive picture of physician quality for use by consumers, providers, and other stakeholders.

Learn more about Value-Drive Health Care online at http://www.hhs.gov/valuedriven/.

CMS offers two choices in counting ED patients toward ‘meaningful use’

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CMS FAQ plus Outpatient Observation Services and Place of Service Defined
Which Emergency Department patients should be included in the denominators of meaningful use measures?
Published 09/15/2010 11:48 AM   |    Updated 12/01/2010 10:54 AM   |    Answer ID 10126
Excerpted from FAQs on CMS site on 12/5/2010.A number of measures for Meaningful Use objectives for eligible hospitals and critical access hospitals (CAHs) include patients admitted to the Emergency Department (ED). Which ED patients should be included in the denominators of these measures for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs? 

On September 17, 2010, we issued an FAQ that explained that our intent to include in the denominator visits to the emergency department (ED) of sufficient duration and complexity that all of the Meaningful Use objectives for which the ED is included would be relevant.  Therefore we explained that eligible hospitals and CAHs should count in the denominator patients admitted to the inpatient part of the hospital through the ED, as well as patients who initially present to the ED and who are treated in the ED’s observation unit or who otherwise receive observation services.  

Since that response was issued, we have received questions regarding which observation services should be included.  We have also received responses noting that the plain language of the regulation would allow for a reading that counts all emergency department visits, and not just those identified in our September 17th FAQ.  

Therefore, we are revising our FAQ to allow eligible hospitals and CAHs, as an alternative, for Stage 1 of Meaningful Use, to use a method that is consistent with the plain language of the regulation.  There are two methods for calculating ED admissions for the denominators for measures associated with Stage 1 of Meaningful Use objectives. Eligible hospitals and CAHs must select one of the methods below for calculating ED admissions to be applied consistently to all denominators for the measures. That is, eligible hospitals and CAHs must choose either the “Observation Services method” or the “All ED Visits method” to be used with all measures. Providers cannot calculate the denominator of some measures using the “Observation Services method,” while using the “All ED Visits method” for the denominator of other measures. Before attesting, eligible hospitals and CAHs will have to indicate which method they used in the calculation of denominators.  

Observation Services method.
The denominator should include the following visits to the ED: 
          –The patient is admitted to the inpatient setting (place of service (POS) 21) through the ED.  In this situation, the orders entered in the ED using certified EHR technology would count for purposes of determining the computerized provider order entry (CPOE) Meaningful Use measure.  Similarly, other actions taken within the ED would count for purposes of determining Meaningful Use.

          –The patient initially presented to the ED and is treated in the ED’s observation unit or otherwise receives observation services. Details on observation services can be found in the Medicare Benefit Policy Manual, Chapter 6, Section 20.6. Patients who receive observation services under both POS 22 and POS 23 should be included in the denominator.

All ED Visits method. An alternate method for computing admissions to the ED is to include all ED visits (POS 23 only) in the denominator for all measures requiring inclusion of ED admissions. All actions taken in the inpatient or emergency departments (POS 21 and 23) of the hospital would count for purposes of determining meaningful use.

For more information about the Medicare and Medicaid EHR Incentive Program, please visit http://www.cms.gov/EHRIncentivePrograms.
###

Related Excerpts  from Medicare Benefit Policy Manual 

1.  Outpatient Observation Services Defined

Chapter 6 – Hospital Services Covered Under Part B
(Rev. 128, 05-28-10)
[PDF VERSION]

20.6 – Outpatient Observation Services
(Rev. 107, Issued: 05-22-09, Effective: 07-01-09, Implementation: 07-06-09)
A. Outpatient Observation Services Defined 
Observation care is a well-defined set of specific, clinically appropriate services, which include ongoing short term treatment, assessment, and reassessment before a decision can be made regarding whether patients will require further treatment as hospital inpatients or if they are able to be discharged from the hospital. Observation services are commonly ordered for patients who present to the emergency department and who then require a significant period of treatment or monitoring in order to make a decision concerning their admission or discharge.  Observation services are covered only when provided by the order of a physician or another individual authorized by State licensure law and hospital staff bylaws to admit patients to the hospital or to order outpatient tests. In the majority of cases, the decision whether to discharge a patient from the hospital following resolution of the reason for the observation care or to admit the patient as an inpatient can be made in less than 48 hours, usually in less than 24 hours. In only rare and exceptional cases do reasonable and necessary outpatient observation services span more than 48 hours. Hospitals may bill for patients who are directly referred to the hospital for outpatient observation services. A direct referral occurs when a physician in the community refers a patient to the hospital for outpatient observation, bypassing the clinic or emergency department (ED) visit. Effective for services furnished on or after January 1, 2003, hospitals may bill for patients directly referred for observation services.  

See, Pub. 100-04, Medicare Claims Processing Manual, chapter 4, section 290, at http://www.cms.hhs.gov/manuals/downloads/clm104c04.pdf  for billing and payment instructions for outpatient observation services.

Future updates will be issued in a Recurring Update Notification.

B. Coverage of Outpatient Observation Services
When a physician orders that a patient receive observation care, the patient’s status is that of an outpatient. The purpose of observation is to determine the need for further treatment or for inpatient admission. Thus, a patient receiving observation services may improve and be released, or be admitted as an inpatient (see Pub. 100-02, Medicare Benefit Policy Manual, Chapter 1, Section 10 “Covered Inpatient Hospital Services Covered Under Part A” at http://www.cms.hhs.gov/manuals/Downloads/bp102c01.pdf ). For more information on correct reporting of observation services, see Pub. 100-04, Medicare Claims Processing Manual, chapter 4, section 290.2.2.)  All hospital observation services, regardless of the duration of the observation care, that are medically reasonable and necessary are covered by Medicare. Observation services are reported using HCPCS code G0378 (Hospital observation service, per hour). Beginning January 1, 2008, HCPCS code G0378 for hourly observation services is assigned status indicator N, signifying that its payment is always packaged. No separate payment is made for observation services reported with HCPCS code G0378. In most circumstances, observation services are supportive and ancillary to the other separately payable services provided to a patient. In certain circumstances when observation care is billed in conjunction with a high level clinic visit (Level 5), high level Type A emergency department visit (Level 4 or 5), high level Type B emergency department visit (Level 5), critical care services, or direct referral for observation services as an integral part of a patient’s extended encounter of care, payment may be made for the entire extended care encounter through one of two composite APCs when certain criteria are met. For information about billing and payment methodology for observation services in years prior to CY 2008, see Pub. 100-04, Medicare Claims Processing Manual, Chapter 4, §§290.3-290.4. For information about payment for extended assessment and management under composite APCs, see §290.5.Payment for all reasonable and necessary observation services is packaged into the payments for other separately payable services provided to the patient in the same encounter. Observation services packaged through assignment of status indicator N are covered OPPS services. Since the payment for these services is included in the APC payment for other separately payable services on the claim, hospitals must not bill Medicare beneficiaries directly for the packaged services.

2. Place of Service (POS) Codes Defined

Chapter 26 – Completing and Processing
Form CMS-1500 Data Set
(Rev. 1970, 05-21-10)
(Rev. 1974, 05-21-10)
[PDF VERSION]10.5 – Place of Service Codes (POS) and Definitions
(Rev. 1869; Issued: 12-11-10; Effective/Implementation Date: 03-11-10)  

21 Inpatient Hospital
A facility, other than psychiatric, which primarily provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services by, or under, the supervision of physicians to patients admitted for a variety of medical conditions.

22 Outpatient Hospital
A portion of a hospital which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization.

23 Emergency Room-Hospital
A portion of a hospital where emergency diagnosis and treatment of illness or injury is provided. 
###

 

ONC Presents Personal Health Records Roundtable: Report from Washington, DC

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Day in Washington, DC at PHR Roundtable
This post was blogged during the meeting, and may be reviewed and corrected in the next few days. Please see links to the videos at the end of this post.

PHR Roundtable, Washington, DC
PHR Roundtable, Washington, DC

Washington, DC, (December 3, 2010)–The meeting is getting started today with introduction by Joy Pritts, Chief Privacy Officer, HHS/Office of National Coordinator (ONC)  for Health IT, and welcoming remarks by the National Coordinator David Blumenthal, MD. Dr. Blumenthal is speaking about the process of innovation spurred by HITECH, and not directed by ONC. “The patient and consumer come first” is one of the guiding principles for ONC according to Blumenthal, and the consumer’s faith in the privacy and security of their patient information is critical to the HITECH initiatives. Part of the reason for this privacy and security hearing is to encourage innovation and transparency, one of the over 200 open meetings held already by ONC.

Pritts also notes that the Health IT initiatives are focused on patients as the center of healthcare. Now we’re on to role of “Meaningful Use,” providing patients with electronic version of their health records. HITECH Act requires that ONC study privacy and security with regard to those records, in addition to the current requirements. Pritts asks  how are we going to strike right balance of innovation and maintain the use of that information for intended purposes.

First panel will provide some historical perspective and is focused on origins, development, and security practices. Tim McKay, Kaiser Permanente, provides brief on Kaiser’s use of electronic health records and personal health records which began in ’90s as regional Kaiser initiatives, and took on national scope in late 90s. Currently Kaiser has roled out EHR and PHRs. Is this patient portal or PHR? And the answer is “yes.”

Lori Nichols, Director, HInet, is director of Whatcom Health Information Network in Whatcom County, Washington state. Per their Web site, “HInet is an inclusive, secure, community-wide, healthcare intranet in Whatcom County. Using various broadband technologies, it connects hospital, payors, physician offices, and community health services.  It also provides connection to the Internet.”

George Steinberg, MD, president and ceo of ActiveHealth Management, a company started with venture capital and now owned as separate company by Aetna. Started as decision support for physicians, and grew to consumer tool. Consumer PHR contains decision support to respond to consumer entering data dynamically.

Colin Evans, CEO of Dossia, a PHR company describes how the firm was founded for employers for use by their employees for safety and care coordination. Use by employees ranges from 10% to 80% based on whether company is offering incentives or not. Evans claims that data is owned by consumers. In some cases there are conflicts between HIPAA regulations and FTC regulations with regard to online protected health information.

George Scriban, Sr. Program Manager, Microsoft HealthVault, speaks about consumer interaction with healthcare as something that goes much beyond interaction with clinicians. HealthVault is cloud-based location for fragments of health information gathered from full-range of entities, improving the boxes of a patient’s information located throughout the house and clinical offices. HealthVault is not a PHR, but a personal health information platform, per Sriban, one of Microsoft’s constant refrains.

McKay of Kaiser Permanente is starting a large initiative to expand Identity Services, to maintain their information even if they leave Kaiser plans.

ONC moderator Kathy Kenyon asks “Do patients ever pay for a PHR?” of those represented. Panel answer is no.

Panel moves on to revenue sources and sustainability of consumers are paying.
Dossia: Support by employers.
Kaiser: From consumer dues. Savings comes from cost savings in employer time saved. In 2006, about 20% of Kaiser patient population used PHR, and risen to 60% in 2010. Patients viewing their patient information alone raises safety of patients.
HInet: no charge for consumers, currently grant-funded, but there will be a  charge for Smartphone use. Employers and payers are noticeably absent from financial support, and this is due in large part because consumers don’t want insurance companies and employers to view their personal health information.
Microsoft: HealthVault is a free service, that is part of the larger health services unit with services offered commercially, the revenue source.
ActiveHealth: Paying customers are the employers, with PHR one of services offered. ActiveHealth is offered to 8 million Aetna members and close to 2 million non-Aetna users, with another 700,ooo non-Aetna users expected to be announced shortly. Non-Aetna users are based on offering to employers (need to confirm who these non-Aetna users are).

Additional discussion on opportunity of health plan or employer viewing health information on PHRs. Dossia says no to employers. HInet users can see who has and has not accessed their share plan PHR  since the last time the consumer viewed their PHR.

Lack of physician support and interoperability of electronic health records appears to be a limiting factor to actual use of PHRs.

New Forms, New Audiences, New Challenges–Second Panel
Wil Yu, Special Assistant of Innovation and Research, ONC, is moderating panel on PHR’s new forms, audiences, and challenges. Stephen Downs, Asst. Vice President, Robert Woods Johnson Foundation, is responsible for Project Health Design, a 4 1/2 year old program to reinvent PHRs; Open Notes, where patients can view their physician’s notes; and Blue Button.  Downs offered three themes: separating apps from data, expanding definition of healthcare–ODL, observations of daily living, and sharing data.

Darcy Gruttadaro, Director, NAMI Child & Adolescent Action Center. NAMI is National Alliance on Mental Illness. Since launch of its social networking site in April 2010, NAMI has gained 1,300 users for social networking site, modeled somewhat after facebook. Realizes there are a lot more security issues than she initially realized. NAMI social networking site: http://www.strengthofus.org

Description of NAMI’s social networking site:
“StrengthofUs is an online community designed to empower young adults through resource sharing and peer support and to build connections for those navigating the unique challenges and opportunities in the transition-age years.  StrengthofUs provides opportunities for you to connect with your peers and offer support, encouragement and advice and share your real world experiences, personal stories, creativity, resources and ultimately, a little bit of your wonderful and unique self. It is a user-generated and user-driven community; so basically it’s whatever you make it. Everything here has been developed and created by and for young adults with you specifically in mind…because we think you’re worth it! We hope every time you visit, you find hope, encouragement, support and most of all, the strength to live your dreams and goals.”

John Moore, of Chilamrk Research, says the terms EHR and PHR create an artificial barrier. “People could care less” about PHR as file cabinet. Unified or collaborative health records need to be actionable Moore said. Moore made a great segue to Gail Nunlee-Bland, MD, interim chief of Endocrinology and Director of Diabetes Treatment Center, Howard University, referencing his Chilmark post “Smashing Myths & Assumptions: PHR for Urban Diabetes Care.” That post is certainly worth reading, and Nunlee-Bland mentioned that 85% of their inner-city patients have access to computer and Internet, which is not what the “general knowledge” says. While Howard’s PHR users are concerned about privacy, only about 5% of their potential users, have opted not to use it because of privacy issues.

Douglas Trauner, CEO, of TheCarrot.com, asked what do we need to do for overcoming healthcare, privacy and security issues. TheCarrott.com’s web site describes  itself: “TheCarrot.com provides easy-to-use tools for tracking your life for a variety of topics including health, nutrition, fitness, and medicines—all within a familiar calendar format. Through this free, anonymous service, you gain a comprehensive view of your health that helps you identify areas of improvement and goal-setting.”

There’s a lot of discussion about sharing information among consumer/patient users. Panelists offer range of views about how much consumers are concerned about privacy and security. There’s a great deal of discussion about trust, including Downs’ tale of a teenager being quite willing to share lots of personal information with their 80 friends, but not their parents.

Privacy and Security of Identifiable Health Information in PHRs and Related Technologies: Expectations and Concerns – Panel Three
Joy Pritts is moderating the first afternoon panel session. Tresa Undem, VP, Lake Research Partners, said consumers are generally unaware of PHRs, based on a year-old study when only 7% reported using a PHR. Lee Tien, from West-coast based Electronic Frontier Foundation, specializes in privacy laws, not healthcare privacy. New reports from recent FTC survey shows how little public knows about privacy issues. Josh Lemieux, director of Personal Health Technology, Markle Foundation, based on six surveys, said public likes the idea of personal health records, and also say they want privacy practices.

Robert Gellman, reported on privacy issues and concerns about data leakage based on long experience, starting with working on the Hill. Strong need to define of what we’re trying to do: http://www.bobgellman.com/

Key data research resources for this panel:
http://www.chcf.org/publications/2010/04/consumers-and-health-information-technology-a-national-survey
Conducted by Lake Research Partners

http://connectingforhealth.org/resources/surveys.html
Consumer surveys of privacy and personal health records

Tien says there is a basic ignorance among consumers and patients of actual privacy policies and implications. Based on work by Microsoft privacy expert, Tien cited the change of attitude or reality of public and private areas.  It used to be that privacy was the default reality for people and it was hard to get known publicly. Currently, public knowledge of details about people is the default reality, while maintaining privacy is a challenge.

Perspectives on Privacy and Security Requirements for PHRs and Related Technologies — Panel 4
Moderator is Leslie Francis, Distinguished Professor of Law and Philosophy at University of Utah.

Adam Greene, JD, Senior Health IT & Privacy Specialist, HHS Office of Civil Rights explained that HIPAA jurisdiction does not follow the data. OCR oversees three kinds of covered entities plus direct jurisdiction of business associates. Greene asked and answered:  Are PHRs covered by HIPAA? Sometimes–yes when furnished by covered entity or provided on behalf of covered entity.

Loretta Garrison, JD, Senior Attorney, Bureau of Consumer Protection, FTC uses unfairness and deceptive prongs to protect consumers. Bureau is claims driven. On December 1, 2010, FTC issued Privacy Report and recommended a privacy framework for consumers, businesses, and policymakers.
Here’s the link on press release.
Here’s link to actual report titled “Protecting Consumer Privacy in an Era of Rapid Change: A Proposed Framework for Businesses and Policymakers.” And it’s a preliminary FTC staff report.

Joanne McNabb, Chief, California Office of Privacy Protection, is “chief cajoler” and not a regulator.

Greene spoke about how HIPAA requirements are not really a check list but dependent upon the particular circumstances and business processes. Greene also wanted to disabuse people of the notion that they have 60 days to report a breach event of Protected Health Information (PHI). In fact, they are required to notify HHS of a breach on 500 individuals or more as quickly as possible, no later than 60 days.

FTC does not have specific rules about breach notification, except in case of PHRs, based on HITECH.

McNabb spoke of prohibition of marketing from data in PHRs, and also be careful about using mobile devices to move PHI. California’s Privacy office Web site is http://www.privacyprotection.ca.gov/

Garrison said we heard alot about trust today and trustworthiness. Per Ponemon report on security, that there was not enough support for healthcare privacy and issues in hospitals. Security is not a check list; it’s an ongoing process according to Garrison. Garrison also expressed concern about location of PHI on the 18 of 20 PHRs that had gone out of business since John Moore had studied them.

Second subpanel section
New group of panelists consists of three lawyers and law professors.

Robert Hudock, JD, Counsel, EpsteinBeckerGreen sees keysecurity issue is integrity. Sees smart phones as more secure than computers. Suggests that we let mobile devices and security evolve, and don’t restrict it while still developing. Hudock’s biggest privacy issue is for the average person being able to protect the confidentiality of  family’s information.

Frank Pasquale, JD, Schering-Plough Professor in Healthcare Regulation and Enforcement, Seton Hall Law School, lauded Markle Foundation’s emphasis on identification of versioning. There are many issues around research. He really worries when data is collected from various sources, and the digital self created from those sources. Pasquale identified several technological solutions and books.

Nicholas Terry, Chester A. Myers Professor of Law, Saint Louis University School of Law, asked what we mean by security. Data scraping is one of the issues of great concern to him. Trust is big at moment, but Terry said he doesn’t know what trust means.

Session ended with brief period with public comments.

Videos
Morning Session: Morning session video
Afternoon Session: Afternoon session video
*Please note: Apple QuickTime is required to view the video. To download and install QuickTime, visit www.apple.com/quicktime/download

For PHR Roundtable information on ONC site, click here.

Personal Health Records ONC Roundtable: Dec 3 Webcast

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Roundtable: Personal Health Records
Understanding the Evolving Landscape
December 3, 2010:
Now available without pre-registration!
See post reporting on roundtable on e-Healthcare Marketing.
Morning Session: 8:30 a.m. to 12:15 p.m. (EST)
http://bit.ly/feNIww

Afternoon Session
1:15 p.m. to 5:00 p.m. (EST)
http://bit.ly/gXagf1
Physician at laptop
December 3, 2010   

Please note that due to an overwhelming response to the PHR Roundtable, pre-registration for in-person attendance has reached its capacity. However, you may still participate in the Roundtable via webcast.  See information on webcast below.
Content excerpted from ONC site on 12/2/2010.  

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.

Public comment is open now through Friday, December 10.

WHEN:
Friday, December 3, 2010
WHERE:
(Must have pre-registered to attend in-person.)
FTC Conference Center
601 New Jersey Avenue, NW
Washington, DC 20001
Where to Eat | Where to Stay | Travel DirectionsMEETING MATERIALS:

HOW:
Morning Session
8:30 a.m. to 12:15 p.m. (EST)
http://bit.ly/feNIww 

The PHR Roundtable agenda includes time for public comments from 4:20 to 4:50 p.m. (EST). To provide comments by phone during this time, call toll-free: 1-866-363-9013 and enter the conference ID number: 28762819. An operator will assist you. 

Afternoon Session
1:15 p.m. to 5:00 p.m. (EST)
http://bit.ly/gXagf1 

2010/12/02

Texas brings to Nine, No. of Strategic & Operational Plans Approved by ONC; Six of which ONC has posted

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Plans Approved for California, Delaware, Maine, Maryland, New Mexico, South Carolina, Tennessee, Texas, and Utah
Versions of eight of nine state plans are publicly available.
See December 8, 2010 updated list with Nebraska and Michigan on e-Healthcare Marketing.
These plans and dates were excerpted on December 1, 2010 from Office of National Coordinator (ONC) for Health IT’s “State HIE Toolkit.” These are from section called “Planning Examples & Case Studies.”

“The State HIE Toolkit is a compilation of resources provided under the auspices of the State HIE Program sponsored by the Office of the National Coordinator for Health IT (ONC).”

Examples of ONC approved Strategic and Operational Plans:

  1. New Mexico Strategic and Operational Plan V2 (update posted 5/18/10) 
  2. Utah Strategic and Operational Plan (posted 5/18/10)
  3. Maryland Strategic and Operational Plan (posted 6/10/10)
  4. Tennessee Gap Analysis and Strategic and Operational Plans (posted 10/1/10) New!
  5. South Carolina Strategic and Operational Plans (posted 10/5/10) New!
  6. Texas Strategic and Operational Plan (posted 12/1/10)
       

States/SDEs with Approved Strategic and Operational Plans
Updated 12/1/10
Both California and Maine plans, while not yet posted by ONC, have been previously posted on e-Healthcare Marketing. (See link at bottom of this post.) Still need to ascertain if the California and Maine plans posted on e-Healthcare Marketing are final approved plans.

State Date Approved Date Posted Documents
California 6/16/2010 Will be posted soon  
Delaware 5/17/2010 Will be posted soon  
Maine 8/16/10 Will be posted soon  
Maryland 5/14/10 6/10/10

   S&O Plan
New Mexico 1/25/10 5/18/10

S&O Plan V2
South Carolina 8/30/10 10/5/10

Strategic Plan

Operational Plan
Tennessee 9/17/10 10/1/10

Strategic Plan

Operational Plan

Gap Analysis
Utah 5/12/10 5/18/10

S&O Plan
Texas 11/3/10 12/1/10

S&O Plan

See e-Healthcare Marketing post for 31 State Health Information Exchange Plans, last updated on November 21, 2010. The Nov 21 update still needs to be reviewed and revised based on plan revisions not yet captured in that post.

ONC’s Bean Blogs: Certified EHR Technology Now Available: The Road to Meaningful Use Just Got Easier

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Certified EHR Technology Now Available: The Road to Meaningful Use Just Got Easier
Tuesday, November 30th, 2010 | Posted by: Carol Bean on ONC’s Health IT Buzz Blog and reposted here by e-Healthcare Marketing.

Health care providers who are eligible to participate in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs now have a new tool to help them on their road to meaningful use. As of November, ONC’s official Certified Health IT Product List (CHPL) identifies EHR technologies that have been tested and certified as being technically capable of supporting those providers’ achievement of meaningful use based on Stage 1 criteria outlined in HHS rules published on July 28 of this year.

The CHPL now includes more than 90 certified EHR technologies, and the list continues to grow.

A couple of important points about the CHPL:

  1. ONC maintains the CHPL, which is the authoritative, comprehensive, aggregate list of all the EHR technologies certified by an ONC-Authorized Testing and Certification Body (ONC-ATCB). EHR technologies that have been certified by ONC-ATCBs and appear on CHPL are eligible to be used for the Medicare and Medicaid EHR Incentive Programs, and will be given a reporting number for that purpose. At the time of registration or attestation with the Centers for Medicare & Medicaid Services (CMS), eligible providers can use those reporting numbers as part of qualifying for EHR incentive payments. (This part of the process is shown on the CMS timeline for the Medicare and Medicaid EHR Incentive Programs milestones.)
  2. The Certified Health IT Product List is a snapshot of currently certified EHR technologies. Each Complete EHR and EHR Module on the CHPL has been certified by an ONC-ATCB and reported to ONC. This list is regularly updated as newly certified EHR technologies are reported to ONC.

HHS Resources for Successful Adoption of Certified EHR Technology

With certified EHR technologies now available, eligible health care providers can tap into the other resources HHS has developed to help them adopt and meaningfully use certified EHR technology.

Those resources include:

  1. Regional Extension Centers to provide on-the-ground technical assistance across the country
  2. The Health IT Workforce Development Program to prepare skilled workers for new jobs in health IT
  3. The Beacon Communities Program to highlight best practices
  4. The Medicare and Medicaid EHR Incentive Programs website. This CMS website contains educational resources and fact sheets with complete program information to help eligible providers adopt and demonstrate meaningful use and receive incentive payments.

These programs support certification policies and processes, all with the ultimate goal of improving the nation’s health through the use of EHR technology and other health information technology.

Re-Cap of ONC EHR Certification Policies and Programs

June to August

ONC established the Temporary Certification Program to authorize organizations to test and certify EHR technology and to establish the processes used for that purpose.

ONC published the Standards and Certification Criteria Final Rule. This rule outlined the capabilities EHR technologies must include to support achievement of meaningful use Stage 1 under the Medicare and Medicaid EHR Incentive Programs.

September

The first ONC Authorized Testing and Certification Bodies were named under the Temporary Certification Program and began testing and certifying EHR technologies based on criteria outlined in the Standards and Certification Criteria Final Rule.

October

ONC published the current Version 1.0 of the Certified Health IT Product List, which lists the EHR products that have been tested and certified under the Temporary Certification Program to the certification criteria adopted by the Secretary and that have been reported to and validated by ONC. In some cases EHR products will have been tested and certified to all applicable adopted certification criteria necessary to meet the definition of certified EHR technology (i.e., those designated Complete EHRs); in other cases they will have been tested and certified to a subset of all of the applicable adopted certification criteria (i.e., those designated EHR Modules), which do not on their own meet the regulatory definition of certified EHR technology.

Version 2.0 of the Certified Health IT Product List is under development and will be available in early 2011. It will provide both additional information, such as a list of the Clinical Quality Measures to which a given product was tested; as well as additional functionality, such as different ways to query and sort the data for viewing. It is also Version 2.0 of the CHPL that will be able to provide the number for reporting to CMS as described above.

As we move forward, we welcome your comments about our efforts and your experiences with implementing health IT.
###

To comment directly on this ONC Health IT Buzz Blog post, click here.

ONC’s McKethan Blogs on Beacon Communities, Diabetes and Use of Health IT

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on ONC’s Health IT Buzz Blog and reposted by e-Healthcare Marketing here:

In the month of November, many Beacon Communities across the country are marking American Diabetes Month by continuing to develop new health IT strategies that can help patients and doctors better prevent and manage the disease.

Improving diabetes care using every tool available, including health IT, is as important as ever. Approximately 24 million people in the United States—7.8 percent of the population—have diabetes.  Diabetes is the seventh leading cause of death for Americans and it increases the risk for heart disease, stroke, and a number of other serious health complications.[*]

Recently, the Centers for Disease Control and Prevention (CDC) released a new analysis indicating that the number of adults with type 2 diabetes in the United States is expected to double or triple by 2050.  Right now, one in ten U.S. adults has diabetes. If trends keep heading the way CDC expects, that figure will be one in three adults by 2050.

Health IT will be extremely beneficial for modernizing health care communications between doctors, nurses, and patients, and will disproportionately benefit patients with diabetes.

Diabetics see primary care physicians for overall management of the disease. They see ophthalmologists for necessary eye exams and podiatrists for necessary foot exams – both to avoid costly and invasive complications that can arise without careful management of the disease. Patients with diabetes also frequent pharmacies, see other specialists, and occasionally end up in the hospital.

Taken together, this means that it is as important as ever to ensure that the numerous health care professionals caring for patients living with diabetes have the means to communicate with each other and have the information necessary to ensure appropriate, high quality, and well-coordinated care. For diabetic care, this means monitoring blood sugar levels, lipid levels, kidney-function tests; ensuring that appropriate medications are available; and being aware on a timely basis of diabetes-related hospitalizations that require appropriate follow-up.

To this end, health IT can be extremely useful, and these are precisely the kinds of health IT-enabled innovations that many Beacon Communities are developing right now. For example, the Mississippi Beacon Community will be using health information exchange technologies to inform  providers delivering care to diabetic patients  about other services those same patients have received from other providers in the community (e.g., to make sure eye and foot exams have been received as appropriate); expanding a medication therapy management program to follow up with diabetic patients to ensure that they  understand their medicines; implementing effective strategies for following up with patients when they are discharged from the hospital; and providing shared care managers in physician practices to use clinical decision support systems, disease registries, and other tools to ensure highly coordinated, personalized care for diabetic patients.

In the Beacons for Better Health posting that my colleague Craig Brammer and I wrote for the Health Affairs blog, we included specific examples of how two other Beacons are leveraging health IT in their communities to improve diabetes care.  We will soon share much more information about these and other Beacon Communities, and follow their stories as they learn from their early experiences.

In the meantime, we are interested in hearing about how health IT has helped improve diabetes care in your community. We invite you to comment below and share your story with us.

To locate the Beacon Community nearest you, visit healthit.hhs.gov/Beacon.

SOURCES

CDC, http://www.cdc.gov/chronicdisease/resources/publications/AAG/ddt.htm,

National Diabetes Fact Sheet 2007 (CDC): http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2007.pdf

USA Today: http://www.usatoday.com/yourlife/health/medical/diabetes/2010-10-22-1Adiabetes22_ST_N.htm

*Centers for Disease Control and Prevention. National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2007. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2008.

###
Please post your comments directly on ONC Health IT Buzz Blog.

NHIN Direct: Renamed The Direct Project–Where is Direct Today? Nov 29 Webinar

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NHIN 203: “NHIN Direct: Where We Are Today” from National eHealth Collaborative
Monday, November 29, 2010, 1:00 – 2:30pm ET
Led by Arien Malec, Coordinator, The Direct Project
NHIN has been renamed (for now) the Nationwide Health Information Network (NW-HIN), and its counterpart program for provider to provider transfer of clinical information outside of NW-HIN has been renamed the Direct Project for now.

Per National eHealth Collaborative’s NHIN University, “Students will learn about the history of The Direct Project and how it fits within the framework of the Nationwide Health Information Network. The class will focus on current activities of The Direct Project and gain insight from its Coordinator, Arien Malec, on the success of the community-based, open approach to development and the future of the Project.”

COURSE OBJECTIVES of NHIN 203

  • “Understand the purpose and goals of The Direct Project, including its history and organizational structure
  • Gain insight into the collaborative process that is central to the mission of Direct
  • Learn about current activities of Direct and how they fit within the Nationwide Health Information Network and, eventually, the Standards and Interoperability Framework
  • Find out about the future of The Direct Project and how to get involved in the growing Direct community”

WEBINAR: https://nationalehealthevents.webex.com/nationalehealthevents/onstage/g.php?d=668619540&t=

AUDIOCONFERENCE: (866) 699-3239 or (408) 792-6300
(Please join the event with a computer system first and follow the audio instructions on the screen.)

ACCESS/EVENT CODE: 668 619 540

ATTENDEE ID: You will receive this number when you join the event first with a computer connection.

NHIN University Link to NHIN 203

CHPL Thanksgiving Update: Certified Health IT Product List: Ambulatory, Inpatient Tables — Alpha by Vendor as of 11/24/2010

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64 Complete EHRs for Physicians and 19 for Hospitals;
Plus 25 Modular EHRs for Physicians and 18 for Hospitals
Office of National Coordinator for Health IT’s validated list of tested and certified Electronic Health Records (EHR) units (complete and modular) has grown to 126, including 64 complete EHRs for clinician office settings and 19 for inpatient hospital settings. Another 43 EHRs have been categorized as modular EHRs with 25 for clinical office settings and 18 for inpatient hospital settings. The modular EHRs include EHRs that may lack certification in only one or more of the criteria, including security. The ONC table contains a field called “Certification Status,” which links to the approved criteria.

InfoGard has tested and certified it’s first two systems, one for ambulatory and one for inpatient–Healthcare Clinical Consultants, dba, Theronyx.

Selected Fields from
ONC’s Certified Health IT Product List as of Nov 24, 2010
Ambulatory and Inpatient Tables, Alpha Ordered by Vendor
ONC has added a field to CHPL list identifying each certified EHR as either ambulatory or inpatient. e-Healthcare Marketing has separated list into two tables, and alpha-ordered each table by vendor.

Excerpted from ONC CHPL List on 11/24/2010
“The Certified HIT Product List (CHPL) provides the authoritative, comprehensive listing of Complete EHRs and EHR Modules that have been tested and certified under the Temporary Certification Program maintained by the Office of the National Coordinator for Health IT (ONC). Each Complete EHR and EHR Module listed below has been certified by an ONC-Authorized Testing and Certification Body (ONC-ATCB) and reported to ONC. Only the product versions that are included on the CHPL are certified under the ONC Temporary Certification Program. Please note that the CHPL is a “snapshot” of the current list of certified products. The CHPL is updated frequently as newly certified products are reported to ONC.”

USING THE CHPL
“Certified products are identified with the name of the certifying ONC-ATCB, the ONC certification number, vendor information, product information, and product version number. The CHPL is currently sorted alphabetically, by Product Name.

“EHR products classified as Complete EHR have been certified to meet all the mandatory certification criteria as identified in the Standards and Certification Criteria Final Rule (45 CFR Part 170 Part III). Complete EHR products listed on the CHPL have been certified to meet all of the General Criteria listed in Section 170.302, plus all of the criteria applicable to a type of practice setting. (In the Final Rule, the certification criterion for Accounting for Disclosures (§ 170.302(w) ) is optional for systems or technologies seeking certification and may not appear.) The products identified as Inpatient EHR products and listed under the Inpatient Practice Setting additionally fulfill the specific criteria defined in 45 CFR Part 170.306. The Certified EHR products identified as Ambulatory EHR products and listed under the Ambulatory Practice Setting additionally fulfill all of the specific criteria defined in 45 CFR Part 170.304.

“EHR Modules are those technologies that are certified to at least one of the certification criteria as defined in the Standards and Certification Criteria Final Rule. Due to the regulatory requirement that EHR Module technologies be certified to the security criteria elaborated in the Final Rule, many EHR Modules will be certified to more than one of the regulatory criteria.

“To determine which criteria a particular product is certified to meet, click on the Certification Status link at the end of the row for that listed product. You will be taken to another table indicating which of the Certification Criteria a particular Complete EHR or EHR Module has been certified to meet.

“Please note: This is Version 1.0 of the Certified Health IT Product List (CHPL). Version 2.0 is under development and is expected to provide additional information, such as a list of the Clinical Quality Measures to which a given product was tested; and additional functionality, such as different ways to query and sort the data for viewing. The later version will also provide the above-mentioned reporting number that will be accepted by CMS for purposes of attestation under the EHR (“meaningful use”) incentives programs. Please send suggestions and comments regarding the Certified Health IT Product List (CHPL) to ONC.certification@hhs.gov, with “CHPL” in the subject line.”

Selected Fields from ONC CHPL Product Certification Overview
Not included in table below are Certifying ATCB, ONC Certification #, and Certification Criteria.
This list has been organized into two tables by e-Healthcare Marketing–Ambulatory and Inpatient.
Please see official CHPL List on ONC site for complete listing.
This list was last modified on November 24, 2010.

Ambulatory

Vendor Product Product Classification Product Version #
ABEL Medical Software Inc. ABELMed EHR – EMR / PM Complete EHR 11
ACOM Health RAPID Modular EHR 7
Addison Health Systems, Inc. WritePad EHR Modular EHR 7.8
Advanced Data Systems Corporation Medics DocAssistant Complete EHR Version 5.2
Allscripts Allscripts PeakPractice Complete EHR 5.5
Allscripts Allscripts Professional EHR Complete EHR 9.2
Altos Solutions, Inc. OncoEMR Complete EHR 2.6
Aprima Medical Software, Inc Aprima Complete EHR 2011
athenahealth, Inc athenaClinicals Complete EHR 10.12
athenahealth, Inc athenaClinicals Complete EHR 10.12
Benchmark Systems Benchmark Clinical Complete EHR Version 6.0
BioMedix Vascular Solutions TRAKnet Practice Management Software Complete EHR 2
BizMatics Inc PrognoCIS Complete EHR Version 2.0
Cerner Corporation Millennium Powerchart, Healthe Exchange, IQHealth, Health Sentry, Cerner Health Record and P2 Sentinel Complete EHR 2007.19.12 and P2 Sentinel v4.2.1
Cerner Corporation Millennium Powerchart, Healthe Exchange, IQHealth, Health Sentry, Cerner Health Record and P2 Sentinel Complete EHR 2010.02.01 and P2 Sentinel v4.2.1
Cerner Corporation Millennium Powerchart, Healthe Exchange, IQHealth, Health Sentry, Cerner Health Record and P2 Sentinel Complete EHR 2010.01.07 and P2 Sentinel v4.2.1
Cerner Corporation Millennium PowerWorks, Healthe Exchange, IQHealth, Health Sentry, Cerner Health Record and P2 Sentinel Complete EHR 2007.19.12 and P2 Sentinel v4.2.1
Cerner Corporation Powerchart, Cerner Healthe, IQHealth, HealthSentry, Cerner Health Record and P2 Sentinel Complete EHR 2010.02.01 and P2 Sentinel v4.2.1
Cerner Corporation Powerchart, Cerner Healthe, IQHealth, HealthSentry, Cerner Health Record and P2 Sentinel Complete EHR 2010.01.07 and P2 Sentinel v4.2.1
Cerner Corporation Powerchart, Cerner Healthe, IQHealth, HealthSentry, Cerner Health Record and P2 Sentinel Complete EHR 2007.19.12 and P2 Sentinel v4.2.1
ChartLogic, Inc. ChartLogic EMR Complete EHR 7
Community Computer Service, Inc. MEDENT Complete EHR 19.5
Compulink Advantage/EHR Complete EHR 10
CureMD Corporation CureMD EHR Complete EHR Version 10
Cyfluent, Inc. Cyfluent Chart Complete EHR 2
DocPatientNetwork Doctations Complete EHR 2
DrFirst Rcopia MU Modular EHR 3.x
eClinicalWorks LLC eClinicalWorks Complete EHR 9
eClinicalWorks LLC eClinicalWorks Complete EHR 8.0.48
eHealth Made EASY, LLC eHealth Made EASY Complete EHR 3
eHealth Made EASY, LLC eHealth Made EASY Modular EHR 3
Emdeon Inc. Emdeon Clinician Complete EHR 7.4
empowersystems empowersystems (ambulatory) Complete EHR 1.1.57
Enable Healthcare Inc., (EHI) Mdnet Modular 3
Epic Systems Corporation EpicCare Ambulatory – Core EMR Complete EHR Summer 2009
Epic Systems Corporation EpicCare Ambulatory – Core EMR Complete EHR Spring 2008
Eyefinity/OfficeMate OfficeMate/ExamWRITER Complete EHR 10
First Insight Corp MaximEyes SQL Electronic Health Records Modular EHR 1.1.0.0
Forte Holdings Chiro8000/ForteEMR Modular EHR 2.1
GE Healthcare Centricity Advance Complete EHR 10.1
GE Healthcare Centricity Practice Solution Complete EHR 9.5
GEMMS, Inc. GEMMS ONE Complete EHR 7.5.10
gloStream, Inc. gloEMR Complete EHR 6
Greenway Medical Technologies, Inc. PrimeSuite Complete EHR 2011
Health Innovation Technologies, Inc. RevolutionEHR Modular EHR 5.1.0
Healthcare Clinical Consultants, dba, Theronyx OPUS-RT Modular EHR 5.1.104
HealthFusion MediTouch EHR Complete EHR 3
ifa united i-tech Inc. ifa EMR Modular 6
iMedicWare, Inc iDoc Complete EHR 4.1.5
Ingenix Ingenix CareTracker Modular 7
Intivia, Inc. InSync Complete EHR 5.4
Intuitive Medical Software UroChartEHR Complete EHR 4
IO Practiceware, Inc. IO Practiceware Complete EHR 7
Kabot Systems VistA++ EHR Office Edition Complete EHR 2.0.0.1
Life Systems Software ChiroPad EMR Modular EHR 16
Life Systems Software ChiroSuite EHR Modular EHR 16
MCS – Medical Communication Systems, Inc. iPatientCare Complete EHR 10.8
Medical Informatics Engineering WebChart EHR Complete EHR Version 5.1
MedInformatix, Inc MedInformatix Complete EHR 7.5
MediRec, LLC MDrec Modular EHR 2011
Meditab Software, Inc. IMS Complete EHR v. 14.0
Medrium Inc. Complete Practice Management Modular MU Stage 1
Midwest Software, LLC Chiro QuickCharts Modular 2.5
Mighty Oak Technology, Inc. Chart Talk for Meaningful Use Modular EHR 1.0′
NeoDeck Software NeoMed EHR Complete EHR 3
Netsmart Technologies Avatar Modular 2011
Networking Technology dba RxNT RxNT EHR Modular 7
NexTech Systems Inc. NexTech Practice 2011 Complete EHR 9.7
nextEMR, LLC nextEMR, LLC Complete EHR 1.5
NextGen Healthcare NextGen Ambulatory EHR Complete EHR 5.6 SP1
Nortec Software Inc Nortec EHR Complete EHR 7
Office Ally EHR 24/7 Complete EHR 3.6.0
Practice Fusion Practice Fusion Modular 2
PriMedx Solutions, LLC PriMedx EHR Complete EHR 10.8
Pulse Systems 2011 Pulse Complete EHR Complete EHR 2011
QRS, Inc. PARADIGM Modular 8.3
RelayHealth, a division of McKesson Corporation RelayClinical Platform Complete EHR 10.3
Sage Sage Intergy Meaningful Use Edition Complete EHR 6.2
Sammy Systems SammyEHR Modular 5.1.1
Secure Infosys LLC MYEMR Complete EHR 2.4
Sequel Systems, Inc. Sequelmed EMR Complete EHR 8
StreamlineMD, LLC StreamlineMD Complete EHR 10.8
SuccessEHS SuccessEHS Complete EHR 6
SuiteMed Intelligent Medical Software (IMS) Complete EHR V14
T-System Technologies, Ltd. T SystemEV Modular 2.7
Universal EMR Solutions Physician’s Solution Complete EHR 5
Vision Infonet Inc., MDCare EMR Modular 4.2
WellCentive WellCentive Registry Modular EHR 2
Workflow.com, LLC workflowEHR Complete EHR 2.5


Inpatient

Vendor Product Product Classification Product Version #
Allscripts Allscripts ED Modular 6.3 Service Release 4
Cerner Corporation Cerner Millennium Powerchart, Cerner Millennium FirstNet, Cerner Millennium ProFile, Health Sentry, Healthe Exchange, Cerner Healthe Record, IQHealth and P2 Sentinel (Powered by Sensage) Complete EHR Version 2007.19.12, P2 Sentinel Version 4.2.1
Cerner Corporation Cerner Millennium Powerchart, Cerner Millennium FirstNet, Cerner Millennium ProFile, Health Sentry, Healthe Exchange, Cerner Healthe Record, IQHealth and P2 Sentinel (Powered by Sensage) Complete EHR 2010.02.01 and P2 Sentinel v4.2.1
Cerner Corporation Cerner Millennium Powerchart, Cerner Millennium FirstNet, Cerner Millennium ProFile, Health Sentry, Healthe Exchange, Cerner Healthe Record, IQHealth and P2 Sentinel (Powered by Sensage) Complete EHR 2010.01.07 and P2 Sentinel v4.2.1
Cerner Corporation Powerchart, FirstNet, Cerner ProFile, HealthSentry, Cerner Healthe, Cerner Health Record, IQHealth and P2 Sentinel (Powered by Sensage) Complete EHR 2010.01.07 and P2 Sentinel v4.2.1
Cerner Corporation Powerchart, FirstNet, Cerner ProFile, HealthSentry, Cerner Healthe, Cerner Health Record, IQHealth and P2 Sentinel (Powered by Sensage) Complete EHR 2010.02.01 and P2 Sentinel v4.2.1
Cerner Corporation Powerchart, FirstNet, Cerner ProFile, HealthSentry, Cerner Healthe, Cerner Health Record, IQHealth and P2 Sentinel (Powered by Sensage) Complete EHR Version 2007.19.12, P2 Sentinel Version 4.2.1
CPSI (Computer Programs and Systems), Inc. CPSI System Complete EHR 17
EDIMS, LLC EDIMS Modular 2.6
eHealth Made EASY, LLC eHealth Made EASY Modular EHR 3
EHR Doctors, Inc. MediBridge for VistA/CPRS Modular 2
empowersystems empowersystems (inpatient) Complete EHR 1.1.57
Epic Systems Corporation EpicCare Inpatient – Core EMR Complete EHR Summer 2009
Epic Systems Corporation EpicCare Inpatient – Core EMR Complete EHR Spring 2008
GE Healthcare IT Centricity Enterprise, including any combination of Enterprise Orders, Gemini Orders, Centricity Enterprise Medication Reconciliation, Centricity Enterprise Discharge Instructions, Menon™ Medication Reconciliation, and Menon™ Discharge Instructions Complete EHR 6.6.3.2
Healthcare Clinical Consultants, dba, Theronyx OPUS-RT Modular EHR 5.1.104
Health Care Systems, Inc. HCS eMR Complete EHR 4
Keane, Inc. Healthcare Solutions Division Optimum Complete EHR V3.1.0
McKesson Horizon Clinicals Complete EHR 10.3.1
McKesson Horizon Meds Manager Modular EHR 8.7.1
MEDHOST, Inc. EDIS Modular 4.2
MEDITECH, Inc. Magic Complete EHR 5.6.4
Netsmart Technologies Avatar Modular 2011
PeriGen PeriBirth Modular 4.3.51
Prognosis Health Information Systems ChartAccess Complete EHR 4
Siemens Medical Solutions USA Inc INVISION EHR Complete EHR 2010
Siemens Medical Solutions USA Inc INVISION EHR B2 Modular EHR 2010
Siemens Medical Solutions USA Inc INVISION EHR B3 Modular EHR 2010
Siemens Medical Solutions USA Inc INVISION EHR B4 Modular EHR 2010
Siemens Medical Solutions USA Inc MedSeries4 EHR Complete EHR 2010
Siemens Medical Solutions USA Inc MedSeries4 EHR B2 Modular EHR 2010
Siemens Medical Solutions USA Inc Soarian EHR Complete EHR 2010
Siemens Medical Solutions USA Inc Soarian EHR B2 Modular EHR 2010
Siemens Medical Solutions USA Inc Soarian EHR B3 Modular EHR 2010
Surgical Information Systems SIS Perioperative Modular EHR 5
T-System Technologies, Ltd. T SystemEV Modular 2.7
Wellsoft Corporation Wellsoft EDIS Modular v11

Please see official CHPL List on ONC site for complete listing.