Perot to launch new EHR service March 30, 2009
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March 30, 2009 | Healthcare IT News Staff and Bernie Monegain, Editor
PLANO, TX – Perot Systems will launch a new service to help hospitals achieve guidelines for “meaningful use” of electronic health records, as called for in the American Recovery and Reinvestment ACT.
The HITECH Act within ARRA requires that healthcare providers become meaningful users by 2016. It sets aside about $23 billion in incentives through Medicare and Medicaid reimbursements to encourage the adoption of EHR systems as soon as 2014.
The law requires that the user must “demonstrate it is using certified EHR technology, that the technology is connected in a manner that allows for the exchange of healthcare information that the EHR user can effectively demonstrate the technology’s meaningful use.”
Harry Greenspun, MD “While many hospitals have some form of an electronic medical records system in place, the lack of standardization and interoperability surrounding EHRs beyond an individual hospital’s walls has led to a fragmented approach to adoption,” said Harry Greespun, MD, executive vice president and chief medical officer of Perot Systems’ healthcare group. “As a result many hospitals may not be able to meet the new standard of meaningful use as defined by ARRA. Our service offering is designed to help them take that next critical step.”
Perot executives will detail the new service in Web presentation 10:30 a.m. Central Time on Wednesday. The session is part of a series on topics related to the ARRA. It can be accessed at www.perotsystems.com/insights.
SOURCE: HealthCare IT News
Brailer: ‘The bright spot is health IT’ March 25, 2009
Posted by gonzalezloumiet in Data Exchange, EMR, Health Care, HHS, nationwide health information exchange, Obama, ONC.add a comment
March 25, 2009 | Patty Enrado, Contributing EditorRelated Links
David Brailer, MDSAN FRANCISCO – Amid the “most perilous time we’ve ever seen,” healthcare IT and innovation can drive fundamental changes in the U.S. healthcare system, David Brailer, MD, former federal healthcare IT czar, told attendees at the Health Tech Investment Forum here on Tuesday.
While the nation hasn’t made meaningful progress in driving systemic changes in the way healthcare is delivered, entrepreneurs, investments in disruptive technology and support from state leaders will get America to the other end of healthcare reform, said Brailer, founder and chairman of Health Evolution Partners.
Proposals for new taxes and cutting Medicare benefits should be scrapped in favor of focusing on innovative solutions that bring long-term efficiencies that embrace quality and the right treatment at the right time, he said.
Despite the economic downturn and the “tremendous nervousness” among investors, “capital will find a way” to fund innovation, he said, adding, “The bright spot is health IT.”
The $37 billion allotted for the Office of the National Coordinator for Health Information Technology in February was a “tremendous commitment” that has made ONC the fastest growing federal program in history. The biggest beneficiaries of the federal stimulus funds for healthcare IT adoption are the electronic health record companies, he said.
While Brailer applauded the $500 million set aside for health information exchange, or HIE, he noted that changes in privacy policy, while socially appropriate, would make HIE more difficult. He also decried the notable absence of funding for personal health records.
With 75 percent of hospitals already committed to healthcare IT implementations, the federal stimulus funding is basically a subsidy – and not a stimulus – to these hospitals, he said. The real test will be whether small hospitals, with less staff, dollars and resources, can find products that fit into their environments. If they do, “the impact could be quite powerful,” he said.
“Health IT probably is and rightfully should be center stage,” Brailer said. “This is a promising scenario. We’re in for a long course, but there is tremendous opportunity on the entrepreneurial side.”
SOURCE: http://www.healthcareitnews.com/news/brailer-bright-spot-health-it
Montana uses data sharing program to increase biosurveillance March 25, 2009
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March 24, 2009 | Molly Merrill, Associate EditorSuggested Content
San Diego-based Crossflo Systems, Inc., will provide the state with its DataExchange Server software, which runs on HP Integrity NonStop systems.
http://www.crossflo.com/index.php
Crossflo worked with HP to implement an initial data sharing environment among the National Center for Health Care Informatics (NCHCI) and four Montana hospitals. Using a data sharing model based on the National Information Exchange Model, anonymous data was mapped from the four hospitals to a target system to enable data exchange between the systems.
“Healthcare organizations want to improve the quality of care by reducing response times to public health emergencies at the same time they lower cost,” said Winston Prather, vice president of HP’s NonStop Enterprise Division. “The Health Information Exchange solution, created from the combination of HP Integrity NonStop systems and Crossflo DataExchange Server software, enables secure, real-time sharing of patient health records and disease monitoring data between health facilities.”
The project demonstrated the ability to rapidly develop and deploy health information for the purpose of detecting naturally occurring or bioterrorists’ pathogens in their pre-epidemic phases (syndromic surveillance).
The data sharing program provides a platform from which to build future capabilities, including the ability to securely move patients’ medical records to the point of care.
“The success of this pilot provides the foundation for future expansion that may include additional hospital and public health facilities as well as further functionality,” said Raymond F. Rogers, NCHCI’s chief executive officer. “We are proud to have been the catalyst to combine the expertise and the robust solutions of Crossflo and HP to meet these information sharing challenges.”
SOURCE: http://www.healthcareitnews.com/news/montana-uses-data-sharing-program-increase-biosurveillance
KLAS offers free EMR assessment tool for providers March 25, 2009
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March 24, 2009 | Bernie Monegain, EditorRelated Links
OREM, UT – Healthcare research firm KLAS has released the KLAS EMR Toolkit to help providers make informed choices regarding stimulus-related technology decisions.
The new stimulus package and its provisions for the “meaningful use” of EMRs have created a number of questions, and many healthcare providers are examining what the package might mean to their facilities, KLAS executives said. Despite the potential of increased funding for healthcare IT, some in the industry are warning CIOs against moving too quickly, without careful consideration to the long-term impact of those purchases.
“Providers have to be careful that they are not so focused on the money that they make poor vendor choices and slam in systems in a way that fails to make necessary process changes and meaningfully engage clinicians,” John Glaser, CIO at Partners Healthcare System in Boston, wrote recently.
To assist providers, KLAS has created the KLAS EMR Toolkit, which offers performance ratings and analyses of leading EMR vendors for inpatient and outpatient markets, as well as professional services firms that offer implementation expertise. The toolkit is available as a complimentary resource to all healthcare providers.
“We hope the KLAS EMR Toolkit will be a useful resource for providers as they consider the increased use, replacement or adoption of EMR systems,” said KLAS founder and Chairman Kent Gale. “While increased funding for healthcare IT holds the potential of improving hospital operations, the realization of those benefits is all about finding the right long-term technology investment.”
The KLAS EMR Toolkit can be downloaded by healthcare providers at www.KLASresearch.com/klasemrtoolkit. Healthcare IT vendors, consultants and investment bankers can purchase the toolkit from the KLAS Web site.
SOURCE: http://www.healthcareitnews.com/news/klas-offers-free-emr-assessment-tool-providers
Certification Commission accelerates certification development March 23, 2009
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March 23, 2009 | Diana Manos, Senior EditorSuggested Content
Critics charge HIMSS-CCHIT connection ‘too cozy’
CCHIT Chair Mark LeavittCHICAGO – The Certification Commission for Healthcare Information Technology will accelerate its development of advanced technology certification programs to include clinical decision support, interoperability, quality and security in the upcoming 2009-2010 development cycle. Clinical decision support and security were not scheduled to be completed until 2011.
“We see evidence that the health IT programs under the Recovery Act will be implemented according to the ambitious schedules in the legislation,” said Mark Leavitt, MD, Commission chair. “For CCHIT to ensure that a robust selection of certification options will be available when the HIT Policy and Standards Committees make their decisions later this year, our own schedule must be equally ambitious. That’s why we have decided to develop all four of these advanced certification options at once.”
According to Leavitt, advanced technology certification in the four new areas complements the Commission’s core certification programs in multiple domains, giving policymakers as well as healthcare IT buyers more options.
In an earlier announcement of its expansion roadmap, the Commission emphasized the need for flexibility and responsiveness, adapting the certification cycle as needed to support the implementation of the American Recovery and Reinvestment Act (ARRA).
Because of the certification expansion, CCHIT announced a brief delay in the opening of the Commission’s annual volunteer recruitment period so the application data collection system can be updated, adding four additional work group choices for participants, a CCHIT statement said.
CCHIT will begin accepting volunteer applications March 26, instead of the originally scheduled March 23. The application window will close on April 20. The new advanced technology work groups are open to all applicants.
SOURCE: http://www.healthcareitnews.com/news/certification-commission-accelerates-certification-development
Questions surround health IT money March 23, 2009
Posted by gonzalezloumiet in FBI, HHS, HIT, IBM, Obama, Standards, Stimulus Plan.add a comment
By ERICA WERNER – 10 hours ago
WASHINGTON (AP) — Here’s the best-case scenario for the government’s plans to spend $19 billion on computerized medical records: seamless communication among doctors and patients, and far fewer mistakes.
And the worst-case: $19 billion goes down the drain.
The medical industry is hoping for the first outcome, even while some fear the second, as the Health and Human Services Department tries to get hundreds of thousands of doctors to quit using paper files and join the digital age.
The money for the massive undertaking is in the economic stimulus bill that President Barack Obama signed into law last month.
“We need to get this right,” said Dr. David Kibbe, a senior adviser at the American Academy of Family Physicians. “Adoption of information technology for its own sake really is not the end game.”
The end game, Kibbe and others say, is for doctors’ offices and hospitals to be able to easily share patient information, something the vast majority can’t do today. That would cut down on mistaken and unnecessary procedures and give doctors faster access to more accurate information about patients’ medical histories and drug regimens.
The government’s history of undertaking major technological upgrades isn’t entirely encouraging.
The FBI spent four years and $170 million trying to modernize its paper-based case system, only to kill the project in 2005. Before that, the Federal Aviation Administration wasted more than $1 billion trying to overhaul the air traffic control system.
For advocates of the health technology transformation, the biggest fear is that the money could pay just for making paper records electronic, without giving doctors and hospitals much greater ability to connect.
“It’s not going to improve the decisions that either providers of care or patients make unless we get that information to move from the existing stovepipes,” said Zoe Baird, president of the Markle Foundation, which works to improve health care and national security.
The U.S. lags behind many other countries in adoption of electronic health records. A report in the New England Journal of Medicine, based on surveys from 2007 and 2008, found that 4 percent of physicians had extensive, fully functional electronic records systems, while 13 percent had more basic systems.
Typically, many systems aren’t connected to other physicians or hospitals. Dozens of vendors compete to sell proprietary systems that often cannot communicate with each other. Installation costs are prohibitively expensive for some doctors, particularly those in small practices.
Lawmakers and the Obama administration say they are aware of those problems and tried to write the stimulus legislation to address them. The bill envisions new standards to drive development of systems that are better able to communicate, and requires doctors and hospitals to show they’re going to be able to put those systems to “meaningful use.”
Computerizing records will “save money, improve the quality of care for patients and make our health care system more efficient,” HHS spokesman Nick Papas said. “We will move quickly and carefully to help implement this technology.”
But important details are missing from the legislation. A health secretary is not yet on the job, and other important officials are not in place. Just on Friday, the administration named the official who will serve as national coordinator for health information technology — Dr. David Blumenthal, a former Harvard Medical School professor who advised Obama during the presidential campaign and once worked for Sen. Ted Kennedy, D-Mass. Kennedy is chairman of the Senate Health, Education, Labor and Pensions Committee.
The stimulus bill specifies that $17 billion is to be spent in incentives through Medicare and Medicaid to nudge doctors and hospitals toward electronic record-keeping beginning in 2011. In 2015, financial penalties will start for doctors and hospitals if they haven’t done so.
What systems will be deemed acceptable? How will doctors and hospitals be able to show they will put such systems to meaningful use? Those questions remain largely unanswered.
Preliminary technological standards are due at the end of this year. That doesn’t give doctors, hospitals or technology companies much time to get systems up and running by 2011.
The bill also contains $2 billion for items such as health technology grants, training initiatives and state programs. The uncertainty surrounding this money has touched off heavy lobbying from interest groups hoping for a piece.
“The devils are in the details and we don’t know the details,” said Janet Marchibroda, head of the eHealth Initiative, a nonprofit that advocates for health improvements through technology.
Still, many health care professionals are optimistic about the prospects for a more connected health care system ahead.
“It will take time to get there,” said Tom Romeo, IBM’s vice president for government health care. “But everything’s in place to really make a huge jump forward now like it never has been before.”
Copyright © 2009 The Associated Press. All rights reserved.
A Healthcare IT Primer March 23, 2009
Posted by gonzalezloumiet in EHR, EMR, John D. Halamka, MD, MS, open source, PHR.add a comment
From our friend, John D. Halamka, MD, MS
Now that Healthcare IT is part of the stimulus and newsworthy, I receive many questions from reporters about the fundamentals of healthcare IT. Here’s a primer with the Top 10 questions and answers:
1. Can you define EHR, EMR, PHR and PM in simple terms?
Electronic Medical Record – An electronic record of health-related information on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within one health care organization.
Electronic Health Record – An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff, across more than one health care organization.
Personal Health Record – An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual.
Practice Management – An application used to manage the physician business operations including scheduling, registration, and billing
2. How large is the unserved market for HIT?
There are 800,000 clinicians in the US. 17% have EHRs today. This leaves 664,000 who need EHRs. Over the next 5 years the early to mid-adopters will work hard to gain the full stimulus incentive amounts available in 2011-2012. Late adopters will gain the reduced stimulus available in 2013-2014. Resistors will begin receiving penalties in 2015.
3. How many companies are currently competing in the small practice/ ambulatory EHR market? Are there any clear leaders in terms of client base or innovation?
There are over 100 companies providing EHRs for small practices. In my experience the ambulatory market leaders are eClinicalWorks, Allscripts, NextGen, GE Centricity, and Meditech/LSS (for small practices tightly affiliated to a hospital using Meditech). Epic is a market leader but not for small practices.
4. What does “meaningful use” really mean? Do you think physicians currently feel compelled to wait for clearer language from the government on the interoperability standards before investing?
“Meaningful use” is demonstrating to the satisfaction of the Secretary that the professional is using a certified EHR in a meaningful manner, which includes the use of e-prescribing, electronic HIE, and submission of information on clinical quality measures. Additional clarity on interoperability will be complete by the end of 2009. I do not believe clinicians should wait for all the details before investing. They should begin EHR implementation now.
5. What other details about meaningful use are listed in the bill?
-The Secretary may develop more stringent measures of meaningful use over time.
-For eligible professionals that are not meaningful users of EHRs, Medicare reimbursements will be cut 1% in 2015, 2% in 2016, and 3% in 2017.
-If less than 75% of professionals are meaningful users in 2018, Secretary can cut reimbursements another 1 percentage point, to maximum of 5%.
-Exceptions to the reimbursement reductions may be made on a case-by-case basis for hardships.
-The CMS Website will list eligible professionals who are meaningful EHR users.
6. Will Healthcare Smart Cards replace PHRs?
Smart cards have not received wide acceptance in any US industry, although they are very popular in other parts of the world. Reading and writing to smart cards would require a substantial investment in hardware throughout the healthcare industry. There are likely to be privacy concerns associated with lost or stolen smart cards. For all these reasons, I believe it is much more likely that web-based Personal Health Records, such as those provided by Google, Microsoft, and Dossia, will be more popular than smart cards. These PHRs are secure, protect confidentiality, and are automatically updated by labs, pharmacies, hospitals, and clinician offices.
7. Will clinicians be able to migrate easily from one EHR to another?
Interoperability in 2009 includes e-Prescribing, laboratories and clinical summaries needed for continuity of care. It does not include every field in the EHR. Conversion for one to EHR to another requires a combination of automated and manual data transfer. For the next few years, replacing one EHR product with another will still be a data conversion challenge.
8. What is the roadmap for interoperability?
See my blog on this topic. Over the past 3 years, HITSP has focused on Labs, Medications, Clinical Summaries, Public/Population Health, and Devices. In 2009 and beyond we’ll add clinical research, newborn screening and close numerous gaps. In general, I believe meaningful use will include exchange of
Problems lists/Diagnoses
Medications including e-prescribing
Allergies
Text-based summaries
Quality data sets
Population health data sets submitted to CDC, public health departments, and other government agencies.
9. “After standards are adopted in 2009, the National Coordinator shall make available at a nominal fee an electronic health record, unless the Secretary determines that the needs and demands of providers are being substantially and adequately met by the marketplace. Nothing in the legislation requires that entities adopt or use the technology made available through this provision.” -from HITECH Act. Do you see this as a viable solution for small practices who want to wait it out and go with a cheaper software product?
See my blog on this topic. Open Source may provide reduced licensing cost, but other costs beyond license fees are the majority of implementation expenditures including practice workflow redesign, interfaces, and training. Open Source is an important part of the nationwide acceleration of EHR implementation, but it is not a panacea.
10. Do you see PHR’s and EHR’s as separate markets currently and what about in the future?
PHRs and EHRs are different products and I do not believe that PHRs will replace EHRs. EHRs are workflow tools for clinicians. PHRs are lifetime clinical summary and workflow tools for the consumer. They are complementary not competitive technologies.
SOURCE: http://geekdoctor.blogspot.com/2009/03/healthcare-it-primer.html
Electronic Medical Records: Nebraska envisions statewide network March 23, 2009
Posted by gonzalezloumiet in EMR, HUB, Nebraska.add a comment
March 22, 2009
(Omaha World-Herald (NE) Via Acquire Media NewsEdge) Mar. 22–The Nebraska Health Information Initiative plans to seek federal stimulus funds to establish a statewide network for electronic medical records.
Participating parties will explain the system, called the Nebraska Statewide Health Information Exchange, at a ceremony with Gov. Dave Heineman in Lincoln on April 2.
The Internet-based exchange would allow health care professionals, hospitals and other medical organizations to get access to a central database of patient medical records.
President Barack Obama has said computerization of Americans’ medical information is a priority of his administration, in order to save money and improve medical care.
His $787 billion economic stimulus legislation included about $20 billion to modernize health care technology systems, with a goal of computerizing all records by 2014.
Dr. Harris Frankel, an Omaha neurologist and president of the Nebraska Health Information Initiative, said statewide implementation of the system would begin this spring or summer.
Receiving stimulus funds would provide a “huge shot in the arm,” Frankel said, accelerating the process that eventually will bring information technology and connectivity to rural areas of the state, where Frankel said it is most needed.
Deb Bass, interim executive director of the Nebraska Health Information Initiative, said the group hasn’t determined the exact amount of stimulus funds it will request. The federal government still is working out details of the stimulus program, she said.
The organization hopes to be designated the official recipient of federal funds to implement a health information exchange in Nebraska, which would come with funds attached. It also might seek additional funds from the general pool of money directed to the state.
The total requested will be several million dollars, Bass said. The pilot project, which has an implementation phase that begins Monday, will cost $3.5 million, Bass said.
Allana Cummings, vice president and chief information officer at Children’s Hospital & Medical Center, said rural residents now must obtain and bring with them their medical records when visiting specialists outside their communities.
The information initiative group — which is a public-private collaboration — has been working on creating the system for more than three years and it’s ready to go, Frankel said.
He said the new exchange would create an undetermined number of new positions for information technology employees as well as some in administration.
Steve Martin, chief executive of Blue Cross Blue Shield of Nebraska and treasurer of the Nebraska Health Information Initiative, said major hospitals and health systems invest significant amounts of money to build and maintain in-house electronic medical records systems. Yet those records can be accessed only by those hospitals or health system members, he said.
The goal of the Nebraska Health Information Initiative is to create one uniform, cost-effective system to store and share patient information, Martin said.
Consumers also would benefit, he said.
Providers would be able to access information more quickly, and a central information system would slow the rate of increase in health care costs by reducing redundant testing.
Consumers also would know where their medical records were housed, Martin said. Patients treated in multiple health systems may have records stored in several places.
Frankel said paper-based medical records are inefficient. Providers aren’t always able to get access to complete patient records at the “point of care,” which could hurt the quality of care that is provided, he said.
Lianne Stevens, vice president of information technology and chief information officer at the Nebraska Medical Center, said that issue is particularly important in emergencies.
Information about medications, chronic conditions, allergies and lab results could be crucial to determining a course of treatment, she said. But that information can be difficult to obtain now, Stevens said, because hospital systems aren’t connected.
There also is no standard procedure or format to obtain medical records from other health systems, said Ken Lawonn, senior vice president and chief information officer at Alegent Health.
Lawonn said the new system would reduce costs by eliminating redundant paperwork as well as unnecessary tests.
The information exchange will provide a higher level of security and privacy for records, Frankel said, by authenticating and tracking users to a greater degree than is possible with paper records.
A patient who wanted to opt out of the information exchange could do so, Frankel said.
Full implementation of the system across the state will take several years, said Martin of Blue Cross Blue Shield of Nebraska. “It won’t happen tomorrow.” But even reduced use of a central information network is expected to help control rising health care costs, he said.
Frankel said Nebraska is positioned to be one of the first states to implement a statewide health information exchange. Groups in Idaho and Utah are working on similar projects, he said.
Frankel said he already has received inquiries from neighboring states about Nebraska’s system, which could result in the state becoming a hub for a regional health information exchange.
“It’s really exciting for the state,” he said. “It reflects the vision and innovation here.” –Contact the writer: 444-1085, stefanie.monge@owh.com To see more of the Omaha World-Herald, or to subscribe to the newspaper, go to http://www.omaha.com.
Copyright (c) 2009, Omaha World-Herald, Neb.
Distributed by McClatchy-Tribune Information Services.
Tampa Bay launches e-health ‘revolution’ March 23, 2009
Posted by gonzalezloumiet in eprescribing, ONC, Tampa Bay.add a comment
March 15, 2009 | Bernie Monegain, EditorStephen Klasko,
MDTAMPA, FL – The people behind Paperfree Tampa Bay foresee the $18 million initiative as President Barack Obama’s vision made good. They have set their sights for the 10-county, 8,000-physician e-prescribing pilot launched Monday on no less than 100 percent adoption. They’ll achieve it, they say, by going to physicians door-to-door and providing the help they need to get on board.
The backers of the project – USF Health and Allscripts – are angling for $16 million of the $2 billion in federal economic stimulus money the Office of the National Coordinator will distribute to help speed up the adoption of healthcare information technology.
They figure they have a good chance of landing the money they need. The project has the right stuff, says Stephen Klasko, MD, an CEO of USF Health and dean of the USF College of Medicine.
Paperfree Tampa takes bold, yet achievable steps toward the adoption of healthcare IT, he says. It creates jobs – more than 200 to help physicians and their staffs with implementation. It has the backing of the area’s Congressional delegation, it’s ready to go, and it holds the promise of a replicable model for other parts of the country.
Discussions are already under way in Hartford, Conn., Pittsburgh and Iowa.
“The revolution is going to start in Tampa Bay,” Klasko said.
U.S. Rep. Kathy Castor (D-Tampa) says it’s fitting that the revolution would start in Tampa Bay.
“We are a healthcare innovation center,” she said, noting that Tampa is home to the University of South Florida’s colleges of medicine, nursing and public health, as well as BayCare Health System and the James A. Haley Veterans Hospital.
“It makes it a natural location to kick off a project like this,” she said. Castor said the initiative combines the important elements of healthcare reform and the reduction of medical errors.
An Institute of Medicine report estimates 1.5 million Americans are injured each year and 7,000 die from preventable medication errors. Yet, today, less than 10 percent of U.S. physicians write prescriptions electronically.
In addition, Castor noted, Paperfree Tampa Bay creates a new occupation and new jobs.
“I think these jobs will multiply,” she said.
U.S. Rep. C. W. Bill Young (R-Indian Shores) also champions the project.
“This is an innovative private-public partnership that will help physicians across our region take a first step toward embracing electronic health records,” Young said.
SOURCE: http://www.healthcareitnews.com/news/tampa-bay-launches-e-health-revolution
