Empowering Consumers: ONC Reviews Feedback from Health IT Buzz blog

Posted on November 22, 2010 by Mike Squires

Strategy for Empowering Consumers, Round Two – Continuing the Discussion
Friday, November 19th, 2010
Posted by: Jodi G. Daniel JD MPH Director of the Office of Policy and Planning of Office of National Coordinator (ONC) for Health IT on ONC’s Health IT Buzz blog and reposted here by e-Healthcare Marketing.

Thank you for the thoughtful discussion in response to my blog post “Strategy for Empowering Consumers.” As has consistently been ONC’s experience with the Health IT Buzz Blog, the points made in your responses have both broadened and sharpened our thinking. The blog itself highlights a lesson that has become clear for our communication efforts: we should take greater advantage of social networking tools (and this means much more than blogging) when bringing our policy conversations outside of the walls of HHS.

I said in the last post that we would do more thinking about consumers as part of our strategic planning process. We had a workshop-style meeting last week at ONC, with both ONC folks and some leading thinkers on this topic from around the country (many of whom have also posted on the blog). At that meeting, we used the blog as a discussion guide while talking through each of the objectives.

Now, we would like to continue the conversation online. First, a recap of what we learned from you. Second, revisions to the goal and objectives based on feedback, this time with strategies included.

Please comment freely.

An aside: We have been reconsidering the label “consumer” and thinking about using “individual” instead. Calling people consumers implies that they are necessarily consuming something, whereas an individual may not need to consume anything (health care or otherwise) to manage his/her health more effectively. What do you think?

GOAL

Previous version: Empower consumers to better manage their health through health IT

What we learned from you: It is not just about changing the behavior of consumers. Health IT offers a tremendous opportunity to change the health care system to become more “consumer-centered.” Yes, consumers should be empowered with health IT to better manage their health; but providers, too, should use health IT to become more collaborative with their patients.

New proposal: Empower consumers with health IT to improve their health and the health care system

Objective A

Previous version: Engage consumers in federal health IT policy and programs

What we learned from you: In order to include consumers in the health IT policymaking process, we cannot expect them to come to Washington or to find this blog online (although the ones that do are amazing!). To truly be representative, we must go to consumers’ conversations. These conversations are already taking place, whether it is in online forums serving specific demographics, community-based faith groups, or disease advocacy groups. Our job should be to seek out the existing conversations and participate in them, both to solicit input into our policies and programs, and to communicate our health IT messages to consumers.

New proposal: Engage consumers with health IT

Objective B

Previous version: Accelerate consumer access to electronic health information

What we learned from you: Getting consumers access to their health information is the government’s primary lever in encouraging consumer use of health IT, innovation in the industry, and consumer-centered approaches to care. The meaningful use requirements are a great opportunity to change the incentive structure and make information sharing attractive for providers. Meaningful use requirements, however, need to be complemented by other policies related to consumer information access, such as privacy and security policies (e.g., identification assurance policies). There was also general support for the Blue Button Initiative – a way the government, through the Veterans Health Administration and the Centers for Medicare & Medicaid Services, is providing consumers with access to their information – as a starting point.

New proposal: Accelerate consumers’ and caregivers’ access to their electronic health information in a format they can use and reuse

Objective C

Previous version: Foster innovation in consumer health IT

What we learned from you: Data liquidity, including consumer access to their health information, is the first step to fostering innovation. Innovation is not just about technology; there is also a real need for innovation on implementation, replicating successes, and using data in advanced ways. But it is the industry that will be leading any such innovation, not the government. Besides liberating data, the government should provide clear regulatory direction and focus promotion activities on specific innovation hurdles.

New proposal: Encourage innovation in the capture and usefulness of consumer health information

Objective D

Previous version: Drive consumer-provider electronic communications

What we learned from you: There are a number of established and emerging technologies that take health care beyond the walls of the provider setting. Along with the information access made possible by EHRs, these technologies have real potential for making health care more consumer-centered. In future stages of meaningful use and other efforts that are part of health care reform, the government should be taking advantage of these technologies and the ways they can change patient-provider interactions for the better.

New proposal: Integrate consumer health information and consumer health IT with clinical applications to support consumer-centered care

The overall structure would now look like this:

Goal: Empower consumers with health IT to improve their health and the health care system

Objective A: Engage consumers with health IT
- Strategy A.1: Listen to consumers and implement health IT policies and programs to meet their interests
- Strategy A.2: Communicate with consumers openly and take advantage of existing communication networks to reach people where they are
Objective B: Accelerate consumers’ and caregivers’ access to their electronic health information in a format they can use and reuse
- Strategy B.1: Through meaningful use incentive payments, encourage providers to give consumers access to their health information in an electronic format
- Strategy B.2: Act as a model for sharing information with consumers and make available tools to do so
- Strategy B.3: Establish policies that foster consumer and caregiver access to their health information while protecting privacy and security
Objective C: Encourage innovation in the capture and usefulness of consumer health information
- Strategy C.1: Liberate health data that will enable consumer health IT innovation
- Strategy C.2: Make targeted investments in consumer health IT research
- Strategy C.3: Employ government programs and services as test beds for innovative consumer health IT
- Strategy C.4: Monitor and promote industry innovation
- Strategy C.5: Provide clear direction to the consumer health IT industry on the government’s role and policies in protecting consumers
Objective D: Integrate consumer health information and consumer health IT with clinical applications to support consumer-centered care
- Strategy D.1: Establish meaningful use requirements and other government mechanisms that encourage use of consumer health IT to move toward consumer-centered care
- Strategy D.2: Support the development of standards and tools that make EHR technology capable of interacting with consumer health IT, and build requirements into EHR certification
- Strategy D.3: Identify effective uses of consumer health IT that support consumer-centered care, and develop process changes and payment models that encourage their adoption

To post comments directly, go to post on Health IT Buzz blog.
See initial Health IT Buzz blog post–Empowering Consumers–Discussion Part One.

Regional Extension Centers: Helping Physicians Meaningfully Use Health IT

Posted on November 21, 2010 by Mike Squires

ONC Produces Nov 16, 2010 article for Annals of Internal Medicine
The regional extension center program: helping physicians meaningfully use health information technology.
The value of the Regional Extension Center (REC) Program in supporting physicians moving into meaningful use of Electronic Health Records (EHRs) is summarized in this five-page article, plus related charts, published November 16, 2010 in American College of Physicians’ Annals of Internal Medicine. Tables show the three stages of implementing ‘meaningful use’ of EHRs and the specific types of help that will be offered to physicians for each of six major challenges: EHR selection, price negotiation for EHRs, training and implementation, achieving and reporting meaningful use, achieving a rate of return on IT investment, and addressing privacy and security concerns.

The article describes two models that have demonstrated how support programs work for implementing EHRs–Massachusetts eHealth Collaborative and Primary Care Information Project (PCIP) of New York City. In 18 months the Massachussetts helped about 600 physicians implement EHRs, and as of June 2010, PCIP signed up more than 2,000 providers “to implement or improve their EHR systems.” While these two programs purchased EHRs for their clinicians, purchases of EHRs in the REC program will be done by the individual providers. The REC will select “supported” EHR vendors and negotitate volume discounts and implementation and service agreements.

62 Regional Extension Centers were selected with the majority statewide, several multi-state, and about a third covering part of a state. After the first two years, the RECs will need to develop revenues to make them self-sustaining.

HITRC, the national Health Information Technology Research Center, has been setup to leverage learnings across the entire REC system by sharing best practices.

Lead authors are Emily Maxson, BS, Research Fellow, and Sachin Jain, MD, MBA, Special Assistant to the National Coordinator. Co-authors include Mat Kendall, MPH, Director, Provider Adoption Support; Farzad Mostashari, MD, MPH, Deputy National Coordinator for Programs and Policy; and David Blumenthal, MD, MPP, National Coordinator for Health Information Technology. All authors are associated with the ONC.

See a directory of Regional Extension Centers organized by state on e-Healthcare Marketing.

Informatics Experts Call for New Practices by Health IT Vendors to Protect Patient Safety

Posted on November 14, 2010 by Mike Squires

Fortify HIT Contracts With Education and Ethics to Protect Patient Safety,
Say Informatics Experts
AMIA takes position on HIT vendor contracts
For full Position Paper see home page of JAMIA http://jamia.bmj.com and look for Position Paper heading, which is in section below “Read JAMIA for free” ed block. Links to position paper and related references are provided there.

Released by AMIA on November 11, 2010 in conjunction with Annual Meeting.
Bethesda, MD–An original and progressive report on health information technology (HIT) vendors, their customers and patients, published online today, makes ground-breaking recommendations for new practices that target the reduction or elimination of tensions that currently mar relationships between many HIT vendors and their customers, specifically with regard to indemnity and error management of HIT systems. In light of the Obama Administration’s $19 billion investment in HIT, paid out in ARRA stimulus funds, these recommendations are particularly significant in helping to foster greater use of electronic health records and other tools in the transition from paper records, largely understood to be a hindrance to quality patient care.

The recommendations, adopted by AMIA— the association of informatics professionals and a trusted authority in the HIT community—strive to imbue the HIT vendor-customer relationship with transparency, veracity, and accountability through collaborative education focused on the installation, configuration and use of HIT systems, in combination with enterprise-wide ethics education to support patient safety. The recommendations are the result of deliberations by an AMIA Board-appointed Task Force. The position statement will appear in the January/February 2011 print edition of JAMIA, the scholarly peer-reviewed journal of informatics in health and biomedicine, co-published by AMIA and the BMJ Group.

“There was a need to consider, study and analyze questions of appropriate oversight,” said AMIA Board Chairwoman Nancy M. Lorenzi, PhD, Assistant Vice Chancellor for Health Affairs and Professor of Biomedical Informatics, Vanderbilt University. “With as much interest and investment in HIT as there is today, AMIA—an unbiased third party—wanted to take a fresh look at gray areas that currently exist between vendors and their customers to see where new practices could be implemented to better support patient outcomes and protect patients, who these systems ultimately serve. We think these recommendations do an excellent job of addressing fairness and balancing accountability in the HIT marketplace and in the health sector.”

The report, titled “HIT Vendors, their customers and patients: New challenges in ethics, safety, best practices and oversight,” makes specific recommendations on Contract Language, Education and Ethics, Ethical Standards, User Groups, Best Practices, and Marketing. An additional section addresses Regulation and Oversight of the HIT Industry and next steps.

The report’s first author is Kenneth W. Goodman, PhD, FACMI, director of the University of Miami Bioethics Program. Dr. Goodman chaired the Task Force responsible for the report, a group of AMIA members comprising nationwide representatives of academia, industry, and leading healthcare institutions.

“AMIA provided an important forum in which complex and sometimes conflicting positions were candidly discussed, analyzed and balanced,” said Dr. Goodman. “HIT systems are ubiquitous these days and need better oversight. These recommendations demonstrate a high-value commitment to patient safety, quality care, and innovation—healthcare goals sometimes difficult to reconcile. These recommendations,” he added, “can help individual institutions do more to support successful HIT implementation.”

Among the recommendations is contract language specified to protect patient safety and to spell out the shared responsibility that vendors and their customers have for successful implementation. “Hold harmless” clauses in contracts between vendors and purchasers or clinical users, that absolve vendors for errors or defects in their software, are declared unethical by AMIA.

The AMIA position states that “safe and successful HIT systems further require ethics education, which has become a standard part of professional development in the corporate world.” HIT vendors and their clients are urged to adopt enterprise-wide ethics education to parallel what accrediting healthcare organizations require. Standards for corporate conduct and subsequent education about such standards are also recommended. A variety of informational tools, many aimed for post-market use, are cited among best practices to assist institutions and clinical practices in achieving optimal HIT implementation.

AMIA President and CEO Edward H. Shortliffe, MD, PhD, praised the Task Force and its accomplishment. “This group of informatics and industry leaders recognized the need to meld business ethics into successful adoption of HIT. Their recommendations balance the forces that drive the competitive HIT marketplace with the practical needs of clinicians, patients, researchers, public health workers and officials. AMIA stands by their work and hopes these recommendations will be embraced by the HIT community.”

Full text of the AMIA position on HIT vendors, their customers and patients is available online at www.jamia.org as an open-access document. Its co-authors are Eta Berner, EdD, FACMI, professor of health informatics at University of Alabama at Birmingham; Mark A. Dente, MD, GE Healthcare IT; Bonnie Kaplan, PhD, FACMI, lecturer at Yale University School of Medicine, and Bioethics Center Scholar at the Interdisciplinary Center for Bioethics at Yale’s Institution for Social and Policy Studies; Ross Koppel, PhD, professor in the Sociology Department and in School of Medicine at University of Pennsylvania; Donald Rucker, MD, vice president and chief medical officer at Siemens Healthcare U.S.A.; Daniel Z. Sands, MD, MPH, FACMI, director of medical informatics at Cisco Internet Business Solutions Group, and clinical assistant professor of medicine at Harvard Medical School; and Peter Winkelstein, MD, MBA, chief of the Division of General Pediatrics at Women & Children’s Hospital of Buffalo, and chief medical informatics officer at UB/MD, the University of Buffalo Physicians Group.

AMIA, the leading professional association for informatics professionals, serves as the voice of the nation’s top biomedical and health informatics professionals and plays an important role in medicine, health care, and science, encouraging the use of data, information and knowledge to improve both human health and delivery of healthcare services.

Real-Time Availability
The AMIA position paper will be the topic of discussion at a late-breaking scientific session to be led by Dr. Goodman and two co-authors at AMIA’s 34th Annual Symposium on Biomedical and Health Informatics, on Wednesday, November 17, 2010, at 10:30 a.m.–12 p.m., at the Washington Hilton, in Washington, D.C.

Certified Health IT Product List: Ambulatory, Inpatient Tables — Alpha by Vendor as of 11/12/2010

Posted on November 13, 2010 by Mike Squires

49 Complete EHRs for Physicians and 10 for Hospitals;
Plus 17 Modular EHRs for Physicians and 14 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 90, including 49 complete EHRs for clinician office settings and 10 for inpatient hospital settings. Another 31 EHRs have been categorized as modular EHRs with 17 for clinical office settings and 14 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.

Selected Fields from
ONC’s Certified Health IT Product List as of Nov 12, 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 11/13/2010
“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.

“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 12, 2010.

Ambulatory

Vendor	Product	Product Classification	Product Ver. #
ABEL Medical Software Inc.	ABELMed EHR – EMR / PM	Complete EHR	11
Allscripts	Allscripts PeakPractice	Complete EHR	5.5
Allscripts	Allscripts Professional EHR	Complete EHR	9.2
Aprima Medical Software, Inc	Aprima	Complete EHR	2011
athenahealth, Inc	athenaClinicals	Complete EHR	10.1
BioMedix Vascular Solutions	TRAKnet Practice Management Software	Complete EHR	2
BizMatics Inc	PrognoCIS	Modular 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	2010.01.07 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 PowerWorks, Healthe Exchange, IQHealth, Health Sentry, Cerner Health Record and P2 Sentinel	Complete EHR	2007.19.12 and P2 Sentinel v4.2.1
ChartLogic, Inc.	ChartLogic EMR	Complete EHR	7
Compulink	Advantage/EHR	Complete EHR	10
CureMD Corporation	CureMD EHR	Complete EHR	Version 10
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
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
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
HealthFusion	MediTouch EHR	Complete EHR	3
ifa united i-tech Inc.	ifa EMR	Modular	6
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
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
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
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
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	Modular	10.2
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
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 Patient Registry	Modular	Version 2.0
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
EDIMS, LLC	EDIMS	Modular	2.6
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
Health Care Systems, Inc.	HCS eMR	Modular	4
MEDHOST, Inc.	EDIS	Modular	4.2
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	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
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.

CMS Organizes FAQs on EHR Incentive Payments

Posted on November 10, 2010 by Mike Squires

Electronic Health Record Incentive Payment FAQs, all 106 so far, reorganized in eleven categories.
CMS FAQs plus three sets of ONC FAQs related to Certification
Accessed from CMS and ONC sites on 11/10/2010.

ALL Electronic Health Records (EHR) FAQs

FAQS from ONC site related to Certificiation

ONC Regulations FAQs Related to Certification
PDF Version of ONC Regulations FAQs

Standards and Certification Criteria Final Rule: Frequently Asked Questions

Temporary Certification Program: Frequently Asked Questions

ONC Seeks Public Comments on PHRs by Dec 10 Re: Security & Privacy

Posted on November 1, 2010 by Mike Squires

Office of the National Coordinator (ONC) for Health IT:
Public Comments Sought on Personal Health Records
by Dec 10, 2010
Emailed by ONC on Nov 1, 2010

In conjunction with ONC’s upcoming PHR Roundtable, ONC is seeking public comments on issues related to personal health records. The public comment period is open now through December 10. ONC would like the public’s input on the following topics:

Privacy and Security and Emerging Technologies
Consumer Expectations about Collection and Use of Health Information
Privacy and Security Requirements for Non-Covered Entities

Visit the ONC website to submit your comment by December 10:
http://healthit.hhs.gov/blog/phr-roundtable/?page_id=18.
This link goes to an ONC page with the content that’s posted below.

ONC Seeks Public Comments on PHRs
Excerpted from ONC site on 11/1/2010.

[Click here for ONC Public Comments Page on PHRs]
The Office of the National Coordinator for Health Information Technology is seeking public comments on issues related to personal health records. Please submit comments by visiting one or more of the following questions. Please note that your name and comment will be placed on the public record of this roundtable, including on the publicly accessible HHS/ONC website (links below).

Thank you for your submission. (Note: The links below will take you directly to the ONC blog pages for posting.) 1. Privacy and Security and Emerging Technologies
What privacy and security risks, concerns, and benefits arise from the current state and emerging business models of PHRs and related emerging technologies built around the collection and use of consumer health information, including mobile technologies and social networking?

2. Consumer Expectations about Collection and Use of Health Information
Are there commonly understood or recognized consumer expectations and attitudes about the collection and use of their health information when they participate in PHRs and related technologies? Is there empirical data that allows us reliably to measure any such consumer expectations? What, if any, legal protections do consumers expect apply to their personal health information when they conduct online searches, respond to surveys or quizzes, seek medical advice online, participate in chat groups or health networks, or otherwise? How determinative should consumer expectations be in developing policies about privacy and security?

3. Privacy and Security Requirements for Non-Covered Entities
What are the pros and cons of applying different privacy and security requirements to non-covered entities, including PHRs, mobile technologies, and social networking?

4. Any Other Comments on PHRs and Non-Covered Entities
Do you have other comments or concerns regarding PHRs and other non-covered entities?

Event Details | Register for the Event by Webinar
###

See previous e-Healthcare Marketing post for Event Details. In-person participation is now closed due to capacity, but registration for the Webinar is available.

Certified Health IT Product List: Alpha by Vendor as of 11/1/2010

Posted on November 1, 2010 by Mike Squires

Selected Fields from
ONC’s Certified Health IT Product List as of Nov 1, 2010
Alpha Ordered by Vendor
Excerpted from ONC CHPL List on 11/1/2010.
“Certified HIT Product List (CHPL) provides a 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 Authorized Testing and Certification Body (ATCB) and reported to ONC. Certified products are identified with the name of the certifying ATCB, the ONC certification number, vendor information, product information, and product version number. Please note that only the product versions included on the CHPL are certified EHR products under the ONC Temporary Certification Program. The CHPL is a snapshot of the current list of certified products, this list is updated frequently as newly certified products are reported to ONC.”

Using the CHPL
“The product table below contains two types of EHR product certification classifications, one for Complete EHRs and EHR Module technologies.

“EHR products classified as Complete EHR are certified to meet all the mandatory certification criteria as identified in the Standards and Certification Criteria Final Rule (45 CFR Part 170 Part III). 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.

“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, EHR Modules will be certified to more than one of the regulatory criteria. To determine which criterion a particular module is certified to meet, select a product Certification Status for a listed product. The table below will change to indicate which of the Certification Criteria a particular EHR Module technology has been certified to meet.

This list was last modified on November 1, 2010.

Selected Fields from ONC CHPL Product Certification Overview
Not included are Certifying ATCB, ONC Certification #, and the five modular units that are ambulatory.
On current CHPL list otherwise, products are not listed as either in-patient or ambulatory.
Please see official CHPL List on ONC site for complete listing.
As of November 1, 2010.

Vendor	Product	Product Class- ification	Product Version #
ABEL Medical Software Inc.	ABELMed EHR – EMR / PM	Complete EHR	11
Allscripts	Allscripts PeakPractice	Modular	5.5
Allscripts	Allscripts Professional EHR	Complete EHR	9.2
Allscripts	Allscripts ED	Modular	6.3 Service Release 4
Aprima Medical Software, Inc	Aprima	Complete EHR	2011
athenahealth, Inc	athenaClinicals	Complete EHR	10.1
BioMedix Vascular Solutions	TRAKnet Practice Management Software	Modular	2
Cerner Corporation	Cerner Millennium Powerchart, Cerner Millennium FirstNet, Cerner Millennium ProFile, Health Sentry, Cerner Health Exchange and P2 Sentinel (Powered by Sensage)	Modular	Version 2007.19.12, P2 Sentinel Version 4.2.1
Cerner Corporation	Millennium Powerchart, Healthe Exchange, IQHealth and P2 Sentinel	Complete EHR	2007.19.12 and P2 Sentinel v4.2.1
ChartLogic, Inc.	ChartLogic EMR	Complete EHR	7
Compulink	Advantage/EHR	Complete EHR	10
CureMD Corporation	CureMD EHR	Complete EHR	Version 10
DocPatientNetwork	Doctations	Complete EHR	2
eClinicalWorks LLC	eClinicalWorks	Complete EHR	8.0.48
EDIMS, LLC	EDIMS	Modular	2.6
Emdeon Inc.	Emdeon Clinician	Complete EHR	7.4
empowersystems	empowersystems (ambulatory)	Complete EHR	1.1.57
empowersystems	empowersystems (inpatient)	Complete EHR	1.1.57
Enable Healthcare Inc., (EHI)	Mdnet	Modular	3
Epic Systems Corporation	EpicCare Inpatient – Core EMR	Complete EHR	Spring 2008
Epic Systems Corporation	EpicCare Ambulatory – Core EMR	Complete EHR	Spring 2008
GE Healthcare	Centricity Advance	Complete EHR	10.1
GE Healthcare	Centricity Practice Solution	Complete EHR	9.5
gloStream, Inc.	gloEMR	Complete EHR	6
Greenway Medical Technologies, Inc.	PrimeSuite	Complete EHR	2011
Health Care Systems, Inc.	HCS eMR	Modular	4
HealthFusion	MediTouch EHR	Complete EHR	3
ifa united i-tech Inc.	ifa EMR	Modular	6
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
MCS – Medical Communication Systems, Inc.	iPatientCare	Complete EHR	10.8
Medical Informatics Engineering	WebChart EHR	Complete EHR	Version 5.1
Meditab Software, Inc.	IMS	Complete EHR	v. 14.0
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	Modular	1.5
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
PeriGen	PeriBirth	Modular	4.3.51
Practice Fusion	Practice Fusion	Modular	2
PriMedx Solutions, LLC	PriMedx EHR	Complete EHR	10.8
Prognosis Health Information Systems	ChartAccess	Complete EHR	4
Pulse Systems	2011 Pulse Complete EHR	Complete EHR	2011
QRS, Inc.	PARADIGM	Modular	8.3
RelayHealth, a division of McKesson Corporation	RelayClinical Platform	Modular	10.2
Sage	Sage Intergy Meaningful Use Edition	Complete EHR	6.2
Sammy Systems	SammyEHR	Modular	5.1.1
StreamlineMD, LLC	StreamlineMD	Complete EHR	10.8
SuccessEHS	SuccessEHS	Complete EHR	6
SuiteMed	Intelligent Medical Software (IMS)	Complete EHR	V14
SuiteMed	Intelligent Medical Software (IMS)	Complete EHR	V14
T-System Technologies, Ltd.	T SystemEV	Modular	2.7
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 Patient Registry	Modular	Version 2.0
Wellsoft Corporation	Wellsoft EDIS	Modular	v11
Workflow.com, LLC	workflowEHR	Complete EHR	2.5

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

Strategy for Empowering Consumers with Health IT: ONC Wants Your Feedback

Posted on November 1, 2010 by Mike Squires

Strategy for Empowering Consumers
Monday, November 1st, 2010 | Posted by: Jodi G. Daniel JD MPH, Director of the Office of Policy and Planning, Office of National Coordinatator for Health IT and reposted here by e-Healthcare Marketing.

For the past few months, ONC has been reviewing the government’s role in empowering consumers to better manage their health through information technology (IT). As we work toward a future of widespread electronic health record adoption and meaningful use, and as we continue to see rapid technology advancements in this industry, there is opportunity for consumers to take fuller advantage of the benefits of health IT.

Last week, we hosted a meeting with representatives from some of the leading consumer advocacy organizations in the country, including consumer protection agencies, disease advocacy groups, clinical innovation think tanks, and consumer health web designers. This particular meeting was focused on building a dialogue between the government, consumer organizations, and their members about the nation’s transition to electronic health records. It further validated our belief that public input is critical to the process of focusing our work on areas where the federal government has an important role to play, and away from areas best left to others.

ONC is currently drafting a five-year Federal Health IT Strategic Plan, which is scheduled for publication in early 2011. In the plan, our proposed framework for consumer empowerment takes into consideration our existing activities. But it also provides a unique opportunity to set forward-looking direction and do more for consumers over the next five years. We hope you will assist us.

First, do you agree with the four objectives listed below?
Second, what specific activities would you like to see the federal government take on? See the bullet points below each objective for some starting ideas of possible activities.

We will be unable to respond to every post but we will follow-up with another entry to reflect on the discussion.

The Goal: Empower Consumers to Better Manage Their Health through Health IT

Objective A. Engage consumers in federal health IT policy and programs: In order for federal health IT policy and programs to be successful, consumers must both understand the impact of those policies and programs and have direct involvement in shaping them. Ideas for possible activities:
- Fund a communication campaign to engage with consumers about the benefits of health IT
- Host consumer listening sessions designed to get consumers’ input on programs and policies
- Solicit consumer input to Federal Advisory Committees and into rulemaking processes
Objective B. Accelerate consumer access to electronic health information: Consumers will be better able to manage their health when they have timely and electronic access to their own health information. Ideas for possible activities:
- Develop tools like the “Blue Button,” an application that enables veterans to download their health information online from My HealtheVet
- Require electronic access of consumer health information by patients and address privacy protections for this information through federal regulations and policies
- Create meaningful use incentives for physicians to share health information with patients
Objective C. Foster innovation in consumer health IT: Innovative tools will make electronic health information more useful to consumers and make managing their healthcare more convenient. Ideas for possible activities:
- Fund research into innovative technologies
- Launch pilots (such as the Beacon Community Program) that show ways to improve outcomes through the use of consumer health IT
- Set up “technology test beds” that could define needs for new technologies in the clinical setting
Objective D. Drive consumer-provider electronic communications: Consumers can become more active participants in their health and care if providers encourage electronic communications and tools, such as secure e-mail and remote monitoring. Idea for possible activity:
- Develop quality improvement initiatives that encourage providers to help empower consumers through their use of health IT

Please post your comments directly on ONC Health IT Buzz blog.

NHIN Governance: Learn to Speak NHIN on Nov 4 & Have Your Say Too!

Posted on November 1, 2010 by Mike Squires

1. National eHealth Collaborative (NeHC) Presents
NHIN 202: NHIN Governance Authorities
2. FACA Blog Seeks Governance Feedback Nov 3

NHIN 202:
Thur, Nov 4, 2010, 3:00pm to 4:00pm
Excerpted/summarized from National eHealth Collaborative on 11/1/2010.
You will learn about the initial recommendations of the Health IT Policy Committee’s Governance Workgroup and the process of turning them into rules. ONC and Advisory Committee/Workgroup leaders will serve as faculty and will respond to your feedback.

Faculty:

Mary Jo Deering, PhD – Senior Policy Advisor, Office of Policy and Planning, Office of the National Coordinator for Health IT (ONC)
John Lumpkin – Chair, Health IT Policy Committee Governance Workgroup; Senior VP and Director, Robert Wood Johnson Foundation
Michael Matthews – Chair, NHIN Exchange Coordinating Committee; Member, Health IT Policy Committee Governance Workgroup; CEO, MedVirginia

MODERATOR:

Aaron Seib – Interim CEO and NHIN Program Director, National eHealth Collaborative

PHASE 1 Recommendations of Workgroup from FACA Blog Post
Or see FACA Blog post reposted below.

WEBINAR: Click here

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: 665 557 547

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

National eHealth Collaborative Relationship with NHIN
“The Nationwide Health Information Network (NHIN) is a collection of standards, specifications and policies that enable the secure exchange of health information over the internet. Today, a group of federal and private entities known as the NHIN Exchange have implemented those standards, specifications and policies as one operational model for exchanging health information nationwide. As part of this model, those entities established a committee structure to administer and support their operational approach.

“Through its cooperative agreement with ONC, NeHC is supporting that committee structure, and supports ONC’s efforts to disseminate information about the work of these committees to interested parties and the broader stakeholder community.”
###

Federal Advisory Committee Blog Post:
Feedback Requested by Nov 3
Governance Workgroup Seeks Comments
on Roles and Responsibilities for Governance
Monday, October 25th, 2010 | Posted by: John Lumpkin on FACA Blog and reposted here by e-Healthcare Marketing.

The Governance Workgroup (Workgroup) is developing recommendations on governance mechanisms for the nationwide health information network. The Workgroup identified overarching objectives, key principles and core functions for governance in its Preliminary Report and Recommendations on the Scope of Governance [PDF – 94 KB] presented to the HIT Policy Committee on October 20^th. The Workgroup is now preparing final recommendations on how governance functions should be implemented and by whom. As a first step, the Workgroup would like to identify existing mechanisms that might be appropriate, with or without modifications, and with or without some added coordination; and whether new mechanisms are needed, and if so, which? The Workgroup would like public input on these issues and has created a table listing the core functions and questions to frame the input. The table is available at here [DOC – 81 KB]. A short version of the table is presented below, for your comments. If you prefer, you can download and complete the table and email it to onc.request@hhs.gov. Please put “Governance Workgroup Recommendations” in the Subject Line.

We would appreciate receiving comments as soon as possible and no later than November 3.

Recommended Governance Functions include:

(For more details, see the Recommendations report [PDF – 94 KB] presented to the HIT Policy Committee)

I. Establish policies for privacy, security, interoperability and to promote adoption of the NW-HIN.

a. Privacy and Security

b. Interoperability, Eligibility Criteria and Compliance Expectations

c. Address gaps; coordinate stakeholder input

d. Coordinate with technical and validation bodies

II. Establish technical requirements to assure policy and technical interoperability.

a. Adopt requirements

b. Coordinate with policy setting body

c. Change and transition process

d. Recognize or authorize shared technical services

III. Establishing appropriate mechanisms to assure compliance, accountability and enforcement.

a. Determine eligibility

b. Evaluate compliance

c. Assure accountability

d. Enforce

IV. Oversight of the governance mechanisms.

a. Track issues

b. Monitor ongoing compliance

c. Assess risks and benefits to prevent harm

d. Evaluate effectiveness

e. Resolve disputes

While all comments are welcome, we would specifically like input on these questions for each of the four recommended governance functions listed above:

What existing entity or process could be leveraged NW-HIN governance? How does it function?
What is the jurisdiction for its functions and under what authority does it operate?
What level of formality is used (e.g. self-regulated, state regulated)?
Can it scale to satisfy NW-HIN needs (w/ or w/out changes)?
Does it satisfy NW-HIN governance objectives (w/ or w/out) changes? If yes, provide rationale.
Are additional mechanisms or processes necessary? Why?

Thank you,
John Lumpkin, MD, MPD, Chair, Governance Workgroup
###
To comment directly, go to the FACA Blog post.

ONC Listens: BluePrint at ONC Innovations Seminar

Posted on October 28, 2010 by Mike Squires

ONC Listens: BluePrint at ONC Innovations Seminar
Note: On October 25, 2010, the ONC Innovations Seminar was led by BluePrint Healthcare IT in Washington, DC. The one-hour seminar entitled “HITECH in New Jersey: A View from the Private Sector” was part of a series featuring people from outside the Office of National Coordinator (ONC) for Health IT sharing their experiences and ideas with the Office. This post reports on how three of my BluePrint colleagues and I got to speak with about twenty members of ONC (including several on a conference line) and share our experiences.

ONC Innovations Seminar
Sachin Jain MD, MBA, Special Assistant to David Blumenthal; and Wil Yu, Special Assistant for Innovation to the National Coordinator, invited the BluePrint team to Washington, DC to lead Monday’s ONC Innovation Seminar. Members of BluePrint had previously worked with the New Jersey and Delaware Valley HIMSS chapters to invite Jain and Yu to speak and meet with attendees at the chapters’ joint fall conference in Atlantic City in September.

Jain initiated the ONC Innovations Series, which in its official description took “place every one to two weeks (for members of the ONC staff) and will bring in noted experts from the health IT community including technologists, patient and community advocates, grantees, academic researchers, government officials and others.”

Seminar leaders have included Michael Porter (Harvard Business School and thought leader on Competitive Advantage), Mark McClelland (former head of FDA and CMS, now heading the Engleberg Center for Health Care Reform at Brookings), Peter Pronovost (Johns Hopkins physician and leader in patient safety), Lonny Reisman (Aetna’s chief medical officer), Richard Baron (Philadelphia area physician with Greenhouse Internists) and Rushika Fernandopulle (an Atlantic City physician).

Case Studies
Speaking with ONC members at its October 25 seminar, BluePrint used three case studies to illustrate health IT challenges and how it was helping hospitals solve them: fast-tracking meaningful use security risk assessments; developing and implementing a workflow software tool to manage access to enterprise-wide software; and setting up a five-stage security and privacy framework at a community hospital to strengthen physician relationships and foster greater trust with patients. It also described its two-hour seminars offered to hospital leadership to prepare for meaningful use and readiness to receive EHR incentive payments.

BluePrint’s Public Policy Role—New Jersey and beyond
The seminar pointed out the new momentum fostered by New Jersey’s health IT leadership—statewide Health IT Coordinator Colleen Woods and Bill O’Byrne, executive director of NJ-HITEC, the state’s regional extension center. New Jersey submitted its HIE operational plan to ONC in August, and NJ-HITEC kicked off its clinician sign-up program for meaningful use support in October.

Based on working with hospital CIOs, Vikas Khosla, the President and CEO of BluePrint, described the transformation of hospital and multi-hospital system CIOs from systems implementation and management executives to leaders of healthcare change management. Founded in 2003 to advise hospitals and multi-hospital systems on security and privacy issues, BluePrint has taken on a public policy role as well, including producing a series of workshops on HITECH Breach Enforcement in collaboration with NJ HIMSS and having Vikas serve as a subject matter expert for the state HIT Committee on Privacy and Security.

The ONC’s Listening Continues
This seminar series demonstrates one way ONC listens and learns. Another example, for which registration just opened this week, is the Personal Health Record Roundtable on December 3 in Washington, DC, to be chaired by HHS Chief Privacy Officer Joy Pritts. The roundtable will hear panels of “researchers, legal scholars, and representatives of consumer, patient, and industry organizations” in order to prepare recommendations, as stipulated in HITECH Act, “related to the application of privacy and security requirements to non-HIPAA Covered Entities, with a focus on personal health record vendors and related service provider.”

To the readers of e-Healthcare Marketing, who are used to seeing this blogger’s collections of information and reports about Health IT and EHRs, thank you for taking the time to read about the Washington trip of Vikas Khosla, President and CEO; Gregory Michaels, Director, Security and Compliance Solutions; Mohit Pasricha, Chief Solutions Architect, and me, Mike Squires, Vice President, Strategic Development and Public Policy, BluePrint Healthcare IT www.blueprinthit.com .
– Mike Squires

ONC Seeks Public Comments on PHRs Excerpted from ONC site on 11/1/2010.

ONC Seeks Public Comments on PHRs
Excerpted from ONC site on 11/1/2010.