Posts Tagged ‘HITECH’
There has been considerable activity at the Federal level over the past week regarding new technology in general as well as EHRs and eRx in particular. It seems that not a month goes by where we are reminded of the press of innovative technology and how we must “catch up” with other countries that have invested in these technologies proportionally more than us over the past decade.
An illustrative example was chronicled early last week when President Obama visited Holland, Michigan to help celebrate the opening of a plant that will employ a few hundred people and will manufacture the sophisticated batteries needed to power the upcoming Electric Vehicles (EV) made in America such as the Chevy Volt, the electric Ford Focus and the Tesla cars among others. A $2.4 billion federal stimulus helped to jump start this journey to the future where the government and industry are betting serious money and strategic initiatives that the demand will be large and the industry will be sustainable and produce good jobs for at least the rest of this century.
So it is with the federal stimulus for EHRs, eRx and Clinical IT in general, though our stimulus amounts to at least 10 times more than the battery money. In a parallel fashion, both the federal government and industry and making some big monetary bets that this “HITECH” journey will produce good jobs in America and see enduring demand for the products and services long after this generation is gone.
The need to teach and train a new generation of professionals to support the networking and other technologies that require more security than commercial IT as well as wider understanding of the complexity of various clinical workflows are major examples of the job skills that are in demand and will increase dramatically once clinicians start adopting these tools in greater numbers. In addition to the professional caregivers, both patients and their families will need to learn more about the IT options to communicate with their doctors and with the complex health system we have created in this country.
Several examples were published last week on July 13th by CMS and the Office of the National Coordinator (ONC). “Final Rules” were released on that day that address both how Meaningful Use (MU) and the IT Standards will play out over 2011 and 2012 (Stage I) which are the first two years where the $44 – 64k reimbursement will start to be distributed to clinicians.
In general, the final rules were made much easier for the major stakeholders and their efforts to qualify for the reimbursements; this was the direct results of considerable feedback during the comment period as well as numerous instances of outreach to clinicians and to industry on the part of David Blumenthal, MD and his staff from ONC.
eRx continues to be the clearest use case for clinical IT that gives the most rapid and reliable “Return on Investment” (ROI) for most physicians and prescribers. However, the day in nearing where many practitioners, especially in large groups, will find it compelling to add functions to the eRx application or to make the jump to the full suite of functions in a robust EHR. DrFirst has been planning for this migration for several years and offers products and services to cover the spectrum of health care providers.
References to the details of the publication of the Final Rules for both Standards and Meaningful use are linked below:
From The New England Journal of Medicine (Always the best!!):
http://healthcarereform.nejm.org/?p=3732&query=home
From John Halamka, MD’s blog (always informative) – The Geek Doctor – This past week he has summarized the Standards as well as the MU rule and offered his comments and links to the pdfs of the Federal Register official publication:
U.S. Health and Human Services Department (HHS) released it’s final rules for “meaningful use” of Electronic Health Records (EHR) this week. Health care providers that meet these meaningful use guidelines will be eligible for Medicare and Medicaid incentive payments under The Health Information Technology for Economic and Clinical Health Act of 2009.
Included in the final rules for meaningful use is the adoption of secure, electronic transmission of prescriptions and prescription-related information. DrFirst is currently reading up on the 864 pages of the newly final ARRA/HITECH Meaningful Use rules- and will update our blog soon on the changes!!
If you are a physician or clinician involved with patient care in America today, you have been thinking and reading about – or perhaps even using – Electronic Health Records (EHR). In fact, if you are even remotely connected to the healthcare delivery system, e.g. as a very occasional patient or perhaps a rare caregiver, you have been hearing about the issue whether you like it or not.
In addition, administrative office managers, billing clerks and hundreds of other stakeholders who traditionally did not interact with personal health information, aka Protected Health Information – PHI – are becoming more engaged since the advent of the privacy and security components of HIPAA and more recently the HITECH act.
Within a few short years, the socioeconomic impact of EHRs has had a pervasive and profound influence on healthcare that will grow and continue for many years to come. As a practicing physician with more than 35 years of direct patient care, I have been an unrelenting champion of this trend for at least the past 25 years, despite the considerable pitfalls and many twists and turns that have led to disappointments, mistakes and failures along the journey.
I have some well formed opinions and lessons learned to share, but I also recognize I still have much to learn from this complex and ever changing environment that is shaping the future of one of the most sacred endeavors in human history – relieving pain and suffering, caring for the sick and infirm and promoting wellness as much as possible.
The recent rapid acceleration of clinical Information technology – significantly different than the innovations in diagnostic and therapeutic technology – has allowed us to collect, organize and share vital information much more readily and efficiently than was thought possible only 5-10 years ago.
In its essence it’s all about COMMUNICATION…“Anywhere, anytime on any device”…To quote one of the early visionaries of the digital age.
A well designed, robust and sophisticated EHR has well over a hundred functions, but in my opinion the ability to capture essential information from multiple sources, organize and store the data and share it securely, easily and rapidly with those who have “ a need to know”…far outweighs all the other functions combined.
Finally, the ability to incorporate “clinical decision support” at the point of care has grown from just “icing on the cake” a few years ago, to the “sine qua non” for “meaningful use” that marries quality improvement to cost reduction. Its best and clearest manifestation is two way Electronic Prescribing (between prescriber and pharmacist/PBM), coupled with a continuously updated and innovative knowledge base to help with Drug- Allergy, Drug-Drug, Drug -Formulary and other interactions such as Drug- Diagnosis, Drug- Lab, and soon Drug- Genome.
The eRx function represents the most rapid ROI, and easiest module to implement in terms of prospective changes to clinical workflow for most physicians, though this varies considerably by specialty.
Since this is a blog and by definition brief, I have touched just superficially on some of my ideas and long experience with clinical information technology, EHRs and eRx and their impact on my practice and my staff. More to follow over the next few weeks.
Well, all the states are covered. On Monday, March 15, 2010, HHS Secretary Sebelius announced that an additional $162 million in grant money was being awarded to 16 states and “qualified state entities” for the state
Health Information Exchange (HIE) Cooperative Agreement Program. Although this is only a small chunk of the $2 billion allocated to drive HIT adoption under the ARRA incentives, this round accomplishes the goal of providing some HIT funding to each of the 50 states.
The HIEs funded include several states where DrFirst is very active (even my home state of Maryland), and we hope to participate with data to be exchanged in these programs. These grants are in addition to the $385 million released to 40 states back in February of this year, and hopefully these grants will be used to jump-start ARRA-related programs that will result in physician HIT incentives in 2011.
To see which states were awarded this round of grants visit Healthcare IT News at http://www.healthcareitnews.com/news/hhs-announces-162-million-16-state-hie-grants
Surescripts released the highly anticipated 2009 National Progress Report on E-Prescribing last week at HIMSS10, and the results are spectacular. Here are some of the key findings:
- About 25% of office-based providers are e-prescribing! The number grew from 74,000 at the end of 2008 to 156,000 by the end of 2009.
- Surescripts can now provide access to prescription benefit and history information for more than 65% of patients in the U.S.
- About 85% of community pharmacies in the U.S. are connected for e-prescribing; 6 of the largest mail order pharmacies are online.
- Nearly 81 million prescription histories were delivered to prescribers.
- 191 million prescriptions were routed electronically.
- You’re twice as likely to find the full set of electronic services in a standalone system like Rcopia from DrFirst than in an EMR (unless the EMR is a DrFirst partner!).
Surescripts noted that e-prescribing is being driven by a broad set factors including government incentive programs (MIPPA and HITECH), broader CCHIT certification criteria, increased interest from large clinics and health systems, and regional initiatives.
2009 was a year of strong growth for both Surescripts and DrFirst; the tipping point is here!
To read the summaries, or download the full report, visit: http://www.surescripts.com/national-progress-report.aspx
Survey Shows Increased Confidence in Meeting Meaningful Use for Healthland Users
Healthland, a DrFirst Certified Partner, has just released the results collected from a February, 2010 survey on the ARRA incentives and Meaningful Use criteria at the HIMSS10 Conference.
The study surveyed over 100 critical access and small community hospitals from across the country, asking respondents to share how they feel their knowledge of the ARRA incentives and Meaningful Use guidelines has changed compared to just 1 year ago.
