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GE Healthcare Camden Group Insights Blog

ONC Outlines Timelines for Interoperability Goals (with Infographic)

Posted by Matthew Smith on Jan 30, 2015 10:05:00 AM

The Camden Group, Interoperability, Health IT, Population HealthThis morning, the Office of the National Coordinator for Health Information Technology ("ONC") released the first draft of its interoperability roadmap to deliver better care through the exchange and use of health information technology ("IT").

The roadmap lays out the plans for the next three years in order to meet the goals first laid out in ONC’s “Connecting Health and Care for the Nation: A 10-Year Vision to Achieve Health IT Infrastructure,” which was first issued in June 2014.
 
“Great progress has been made to digitize the care experience, and now it’s time to free up this data so patients and providers can securely access their health information when and where they need it,” HHS Secretary Sylvia M. Burwell said in a statement. “A successful learning system relies on an interoperable health IT system where information can be collected, shared, and used to improve health, facilitate research, and inform clinical outcomes.”
 
The roadmap will provide guidelines so the majority of individuals and providers can send, receive, find, and use a common set of electronic clinical information across the care continuum and at the nationwide level by the end of 2017.
 
The report also outlined four important actions for both public and private sector stakeholders to take to enable interoperability of electronic health information in the near term:

  1. Establish a coordinated governance framework and process for nationwide health IT interoperability
  2. Improve technical standards and implementation guidance for sharing and using a common clinical data set
  3. Enhance incentives for sharing electronic health information according to common technical standards, starting with a common clinical data set
  4. Clarify privacy and security requirements that enable interoperability

The roadmap also provides more detailed near-term actions for each high priority area, a common clinical data set of 19 basic elements, and an updated estimated timeline of select high-level critical actions.
 
The plan from ONC is open to the public for comment until April 3.
 
“While we have made great strides as a nation to improve [electronic health record] adoption, we must pivot towards true interoperability based on clear, defined, and enforceable standards,” Russell P. Branzell, FCHIME, CHCIO, president and chief executive officer of the College of Healthcare Information Management Executives, said. “This Roadmap incorporates a tremendous amount of stakeholder input and articulates a clear path towards interoperability. It is a cornerstone in the continuing evolution of federal health IT policymaking.”

Below is an infographic developed by HealthIt.gov which displays the Shared Nationwide Interoperability Roadmap: The Journey to Better Health and Care. The nation relies on Health IT to securely, efficiently and effectively share electronic health information with patient consent to achieve better care, smarter spending and healthier people. Interoperability will transform our health system from a static one to a learning health system that improves individual, community and population health.

To view a full-size version of this infographic, click on the image or click here

shared nationwide interoperability roadmap resized 600

Topics: Population Health, HIT, Health IT, Infographic, ONC, Interoperability Roadmap

New & Updated FAQs for the EHR Incentive Programs

Posted by Matthew Smith on Apr 4, 2014 10:45:00 AM

EHR, Meaningful Use, CMSTo keep you updated with information on the Medicare and Medicaid EHR Incentive Programs, CMS has recently added three new FAQs and five updated FAQs to the CMS FAQ system.

CMS encourages you to stay informed by taking a few minutes to review the new information below.

 

New FAQs:

  1. For Eligible Professionals (EP) in the Medicaid EHR Incentive Program using the group proxy method of calculating patient volume, how should the EPs calculate patient volume using the “12 months preceding the EP’s attestation” approach, as not all of the EPs in the group practice may use the same 90-day period. Read the answer.
  2. Can a hospital count a patient toward the measures of the “Patient Electronic Access” objective in the Medicare and Medicaid EHR Incentive Programs if the patient accessed his/her information before they were discharged? Read the answer.
  3. When demonstrating Stage 2 meaningful use in the EHR Incentive programs, would an eligible professional (EP) be required to report on the “Electronic Notes” objective even if he or she did not see patients during their reporting period? Read the answer.

Updated FAQ:

  1. Do States need to verify the "installation" or "a signed contract" for adopt, implement, or upgrade (AIU) in the Medicaid EHR Incentive Program? Read the answer.
  2. For Stage 1 and 2 meaningful use objectives of the Medicare and Medicaid EHR Incentive Programs that require submission of data to public health agencies, if multiple eligible professionals (EPs) are using the same certified EHR technology across several physical locations, can a single test or onboarding effort serve to meet the measures of these objectives? Read the answer.
  3. For the Stage 2 meaningful use objective of the Medicare and Medicaid EHR Incentive Programs that requires the successful electronic exchange of a summary of care document with either a different EHR technology or the CMS designated test EHR, if multiple eligible professionals (EPs) are using the same certified EHR technology across several physical locations, can a single test meet the measure? Read the answer.
  4. In calculating the meaningful use objectives requiring patient action, if a patient sends a message or accesses his/her health information made available by their eligible professional (EP), can the other EPs in the practice get credit for the patient’s action in meeting the objectives? Read the answer.
  5. When reporting on the Summary of Care objective in the EHR Incentive Program, which transitions would count toward the numerator of the measures? Read the answer.

Want more information about the EHR Incentive Programs?
Make sure to visit the Medicare and Medicaid EHR Incentive Programs website for the latest news and updates on the EHR Incentive Programs.

Meaningful Use, Stage 1, Stage 2, EHR, EMR

Topics: EHR, EMR, ONC, Electronic Health Record, Electronic Medical Record, Affordable Care Act

EHR Payments Edge Close to $20B

Posted by Matthew Smith on Jan 24, 2014 10:10:00 AM

EHR, EMR, Electronic Health RecordsElectronic health record incentive payments to eligible docs and hospitals continue to climb into the new year. The "inexorable progress" of the federal EHR incentive program continues, with payments to providers moving ever closer to $20 billion.

As of the end of November, more than 436,000 hospitals and health professionals have registered for the Medicaid andMedicare EHR incentive program, and the federal government has made more than $17.7 billion in payments, the Centers for Medicare and Medicaid Services told the Health IT Policy Committee in an update.

Of the $17.7 billion, almost $11 billion has gone to 4,300-plus hospitals who have achieved meaningful use status, while $4 billion has gone to about 210,000 physicians and health professionals qualifying under Medicare and $2.5 billion has gone to 107,000 professionals qualifying under Medicaid.

All of that has translated in a majority of American providers now using digital health record systems, the data showing the "inexorable progress made every month," as policy committee chair Paul Tang, MD, the chief innovation and technology officer at the Palo Alto Medical Foundation, said on Tuesday during the HIT Policy meeting.

CMS eHealth specialist Robert Anthony also highlighted some other data showing attestation rates for core objectives, with high percentages in many areas but lags for others, such as syndromic surveillance.

EHR Core Objectives, EMR,

Topics: EHR, EMR, ONC, Electronic Health Record, Electronic Medical Record, Affordable Care Act

New Study: EHR Incentive Program Continues Steady Growth

Posted by Matthew Smith on Jan 22, 2014 4:16:00 PM

EHR Study, Meaningful Use

We continue to see progress in improving the nation’s healthcare system, and a key tool to helping achieve that goal is the increased use of electronic health records by the nation’s doctors, hospitals, and other healthcare providers. These electronic tools serve as the infrastructure to implementing reforms that improve care – many of which are part of the Affordable Care Act.

Doctors and hospitals are using these tools to reduce mistakes and hospital readmissions, provide patients with more information that enable them to stay healthy, and allow for rewarding healthcare providers for delivering quality, not quantity, of care.

The adoption of those tools is reflected today in a release from the Centers for Disease Control and Prevention’s National Center for Health Statistics which provides a view of the Medicare and Medicaid EHR Incentive Program and indicates the program is healthy and growing steadily.

The 2013 data from the annual National Ambulatory Medical Care Survey are encouraging:

  • Nearly 80% of office-based physicians used some type of electronic health record system, an increase of 60 percentage points since 2001 and nearly double the percent in 2008 (42%), the year before the Health Information Technology and Economic and Clinical Health Act passed as part of the Recovery Act in 2009.
  • About half of office-based physicians surveyed said they use a system that qualifies as a “basic system,” up from just 11% in 2006.
  • Almost 70% of office-based physicians noted their intent to participate in the EHR incentive program.

Figure 1. Percentage of office-based physicians with EHR systems: United States, 2001-2013

EHR, ONC

The report also noted that 13% of physicians who responded said they both intended to participate in the incentive program and had a system that could support 14 of the Meaningful Use Stage 2 “core set of objectives,” ahead of target dates. This survey was performed in early 2013 – before 2014 certified products were even available.

The deadline to begin attesting for Meaningful Use Stage 2 is October 2014 for the earliest adopters of Meaningful Use Stage 1, so more than one in ten physicians decided on their own to participate  Meaningful Use Stage 2 capabilities more than a year earlier than necessary. These are early adopters who recognize the benefits of EHRs.

“From 2010 through 2013,  physician adoption of 7 of the 17 capabilities required for Stage 2 core objectives for meaningful use increased significantly,” according to National Center for Health Statistics health-policy researcher and lead author Chun-Ju Hsiao, PhD. Electronic prescribing through an EHR and adverse drug event/contraindication alerts had the largest increase among the stage 2 capabilities, Hsiao wrote.

In 2013, Meaningful Use related functionalities with the highest adoption rates included capabilities for recording key patient health information and functionalities related to medication management and safety. About three-quarters or more of physicians had these types of computerized capabilities.

Notably, physician respondents to another national survey also noted the clinical benefits in using EHRs, including that they helped physicians access records remotely (81%), and alerted providers of a critical lab value (62%). Most importantly, 78% of respondents said that EHRs “overall, enhanced patient care”.

Overall, we are encouraged to see that physician adoption of EHRs meeting Meaningful Use Stage 2 is increasing significantly and that physicians are recognizing the value of EHRs in the care setting. The report does also tell us there is more to do and we agree. Fewer than one in three respondents (30%) said their EHR facilitated a communication with a patient via e-mail/secure instant messaging.

At ONC we look forward to continuing to work on key issues such as usability and improving functionalities so we can all see the promise of EHRs and health IT to improve care and eventually health.

Figure 2: Percent of physicians with selected computerized capabilities related to Meaningful Use objectives, 2013

EHR, Meaningful Use, ONC

Topics: EHR, EMR, ONC, Electronic Health Record, Electronic Medical Record, Affordable Care Act

ONC: Meaningful Use Stage 2 Changes Unlikely

Posted by Matthew Smith on Nov 19, 2013 4:19:00 PM

ONC, Meaningful Use, EHR, HIT Health IT(via Healthcare IT News) Wish there could be a delay of Stage 2 meaningful use? Talk to the Centers for Medicare & Medicaid Services, not the Office of the National Coordinator for Health Information Technology. And don't hold your breath.

Responding to a written, anonymous question from an attendee at the American Medical Informatics Association Annual Symposium, Jodi Daniel, director of ONC Office of Policy Planning, would not explicitly discuss prospects for easing the Stage 2 compliance timeline.

"We are very focused on making Stage 2 work," Daniel said Monday during a town hall-style session with ONC leadership, and said any question of a possible delay should be directed to CMS, which wrote the rules for and administers meaningful use.

"They would have the authority to do that, but it would require a regulatory change," Daniel said. The regulatory process requires a notice of proposed rulemaking, followed by a mandatory public comment period, after which time CMS would review the comments and finalize the rule.

It could take a year or more, so the implication was that changes to Stage 2 are highly unlikely.

Acting national health IT coordinator Jacob Reider, MD, who led the town hall, said ONC is working especially hard to reach the "little folks" – independent community hospitals and small physician practices – that lack inside-the-Beltway contacts and don't "know how to interact with us." ONC is tasked with helping providers of all sizes and stripes achieve meaningful use, with the ultimate goal of producing safer, more effective care at lower cost – otherwise known as the "triple aim."

Reider discussed what he called ONC's "5+1 guiding principles": open, transparent inclusive decision-making; "eye on the prize" (the triple aim); "feet on the ground" (realism, rather than shooting for what Reider likened to "Star Trek"-esque science fiction); fostering market innovation; being open to all, including the "little folks" and – the "plus one" – putting patients and their interests at the center of all activities.

"People sometimes get a little jaded about patients from the physician side," he noted. He suggested clinicians think about the kind of care they want their own mother to have.

"The mom part is a good reminder," said Reider, who took over the ONC reins early last month, following the departure of Farzad Mostashari, MD.

"We're gonna get there," he continued. "We are on that trajectory. We're not there yet. I understand that, but we are gonna get there."

ONC devoted about half of the hourlong session to answering written audience questions. One questioner worried that meaningful use had taken on a life of its own, asking whether the original intent of the incentive program is getting lost as providers struggle to "check off boxes" on the attestation form.

"It's easy to lose sight of why we are implementing things," acknowledged Mat Kendall, director of the Office of Provider Adoption Support.

Kendall said ONC has been educating providers about the triple aim and trying to promote the true spirit of meaningful use by collaborating with other federal agencies. For example, he said, ONC has been working with CMS and the Centers for Disease Control and Prevention (CDC) to align quality measures in meaningful use with the Million Hearts initiative, a CDC-led effort to prevent 1 million heart attacks by 2017. (This, according to acting ONC Chief Medical Officer Amy Helwig, MD, includes a focus on controlling people's cholesterol levels.)

Kendall also was asked how subspecialty surgeons in academic settings would meet the Stage 2 requirement of engaging at least 5 percent of patients via online portals. He said it was really just a matter of making sure patient education is properly integrated into surgical workflows.

Privacy and security seemed top-of-mind for a good chunk of the medical informatics community.

ONC Chief Privacy Officer Joy Pritts said that, based on surveys about health information exchange, people at least want to know where information is being shared and what is being done with their data. "[They want] no surprises," Pritts said. "You don't want to establish a sense of distrust between a healthcare provider and a patient."

Chirs Muir, ONC's liaison to states on HIE, recommended that providers and HIEs make it clear exactly what information is protected when people opt in or out of sharing data.

Pritts also said there has been "a failure of the market somewhat" in terms of smaller healthcare organizations assessing security risks. "I can't overestimate the value of common sense in conducting a security risk assessment," Pritts said.

She added that ONC has been working with the HHS Office for Civil Rights, which enforces HIPAA privacy and security rules, for more than a year trying to develop a free security risk assessment tool for small providers. "It's a bit of a challenge because this is a legal thing that you have to do," Pritts said. Expect this resource to be out sometime in 2014.

EHR, Meaningful Use, Stage 2

Topics: EHR, Meaningful Use, ONC, HIT Health IT

Infographic: Realizing the Value of Health IT

Posted by Matthew Smith on Aug 1, 2013 11:56:00 AM

Health IT, HIT, H.I.T.

The value of health information technology is demonstrated in many ways.  Many organization are seeing the positive influence HIT can bring to their health system.

For instance, El Camino Hospital dropped readmission rates by 25% by combining the use of data analytics and telecommunications.  

The infographic created by HIMSS highlights the five kinds of values health IT creates for patients, healthcare providers and communities:

  1. Satisfaction
  2. Treatment/Clinical
  3. Electronic Information/Data
  4. Prevention/Patient Education
  5. Savings

Topics: EHR, EMR, Meaningful Use, CMS, HIT, HealthIT, ONC, HITECH, Eligible Providers

ONC to Congress: EHR Adoption, Meaningful Use Rising Steadily

Posted by Matthew Smith on Jun 28, 2013 3:52:00 PM

United States, Meaningful Use, EHRIn its latest official report to Congress, the Office of the National Coordinator (ONC) praises the nation’s progress in health IT adoption, including EHR implementation and participation in the EHR Incentive Programs.  Physician EHR adoption has increased from one in five in 2009 to more than 40% in 2012, due largely to meaningful use requirements and the availability of better technology.

“Information is widely recognized as the lifeblood of modern medicine,” the report says.  “By enabling health information to be used more effectively and efficiently throughout our health system, health IT has the potential to empower providers and patients, make health care and the health system more transparent, enhance the study of care delivery and payment systems, and drive substantial improvements in care, efficiency, and population health.”

As a result of the federal focus on speeding health IT adoption, nearly three-quarters of office-based physicians had started using some form of EHR system by 2012, up from 42% in 2009.  Forty percent used a “basic” EHR, which has advanced capabilities like patient history and demographics, problem and medication lists, and computerized order entry.  That figure is nearly double the 21% of physicians using a basic EHR in 2009.

Despite this measurable progress, the ONC notes that many barriers remain in the quest for universal EHR use.  “Expanding interoperability remains a challenge,” the report admits. “Enabling exchange will involve reducing the cost and complexity of electronichealth information exchange, ensuring trust among the key participants of exchange and encouraging exchange of information, particularly during transitions of care.”  The ONC has been working tirelessly to promote interoperability to vendors and providers, including releasing a request for information to the industry to gather new ideas for boosting health information exchange (HIE) and widely-adopted data standards.

In addition to addressing the technical challenges of HIE, the ONC and CMS have been making a concerted effort to illustrate the business case for data exchange, including the potential to reduce healthcare costs by eliminating repeated tests and procedures, reduce the administrative burden on providers, and foster more coordinated, accountable care.

“As both public and private payers take concrete steps to change the incentives for paying providers, health IT can provide the infrastructure and the data analytics necessary to improved care coordination, better quality, and lower costs,” the report concludes.  “Continued adoption of EHRs and health IT can enable the transformation of health care delivery in order to reduce health care costs and improve the well-being of Americans.”

In its latest official report to Congress, the Office of the National Coordinator (ONC) praises the nation’s progress in health IT adoption, including EHR implementation and participation in the EHR Incentive Programs.  Physician EHR adoption has increased from one in five in 2009 to more than 40% in 2012, due largely to meaningful use requirements and the availability of better technology.

“Information is widely recognized as the lifeblood of modern medicine,” the report says.  “By enabling health information to be used more effectively and efficiently throughout our health system, health IT has the potential to empower providers and patients, make health care and the health system more transparent, enhance the study of care delivery and payment systems, and drive substantial improvements in care, efficiency, and population health.”

As a result of the federal focus on speeding health IT adoption, nearly three-quarters of office-based physicians had started using some form of EHR system by 2012, up from 42% in 2009.  Forty percent used a “basic” EHR, which has advanced capabilities like patient history and demographics, problem and medication lists, and computerized order entry.  That figure is nearly double the 21% of physicians using a basic EHR in 2009.

Topics: EHR, Meaningful Use, Health IT, HealthIT, ONC, Congress, IT

Infographic: Federal Health IT Activity

Posted by Matthew Smith on Jun 14, 2013 3:50:00 PM

HealthIT, Infographic, Health DirectionsFrom electronic health records (EHRs), health information exchange, ICD-10 conversion, meaningful use mandates to data privacy and security regulations, healthcare organizations are slowly, but surely, making headway in implementing many different initiatives.

The opening months of 2013 saw the federal government offer providers a number of resources to ease the strain of new technology and workflow adoption, as well as implementing legislative measures to keep IT leaders accountable to policy.

This infographic summarizes what resources are available--from tools to improve HIE and meaningful use audits, to the final installment of the HIPAA omnibus rule and updated certification standards for EHRs. 

Federal Health IT initiatives 2013

Topics: EHR, EMR, Meaningful Use, CMS, HIT, HealthIT, ONC, HITECH, Eligible Providers

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