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Mass Senate Seat and EMR Reform

Posted on January 28, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

SRSsoft, an EMR vendor, put out an interesting press release putting the lost democratic senate seat in Massachusetts with healthcare reform and EHR adoption. Here’s a quote from the press release:

“The question is not whether we need healthcare reform,” says Evan Steele, CEO, SRSsoft. “Rather, the voters voiced their concern that reform must benefit consumers and physicians, not just government, insurance companies, and vendors. This election must open the government to input from all stakeholders, and that is a good sign for the constituents of SRS—the physicians—who feel that their voice is not being heard on healthcare reform and on EHR adoption.”

Honestly, I don’t see the change in the Senate seat affecting EMR adoption at all. However, I think it will have a big impact on healthcare reform. I’ve said before that the healthcare reform has opened our eyes to the government processes in ways we’d never seen before. I think that the HITECH act has done much of the same for those of us interested in EMR legislation and rule making.

David Blumenthal on Meaningful Use, Nationwide Health Information Network and CCHIT

Posted on January 27, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I just found this really nice interview by InformationWeek with David Blumenthal, Health IT Czar. Here are a few snippets of what David Blumenthal said with my own commentary in italics.

Congress set very ambitious goals for the HITECH legislation. The concept of meaningful use is novel, and a very powerful and important concept. The process of defining meaningful use has gone through many months, through many public hearings.

I think David Blumenthal realizes that meaningful use is going to be a major problem for many doctors offices. I think we’re going to hear him blaming Congress for the “ambitious” HITECH legislation which has his hands tied. It probably does, but it’s too bad he can’t just say it that way if it is the case.

The Office of National Coordinator is still committed to developing the Nationwide Health Information Network. Many of our federal colleagues and quite a number of larger healthcare organizations are on the verge of using NHIN as it was originally conceived and configured for their own purposes, and we’re continuing to invest in it.

At its last meeting the HIT Policy Committee adopted recommendations that they have not yet formally transmitted to me to encourage the development of a more flexible, adaptable, less complicated method of health information exchange than the Nationwide Health Information Network. And that’s something that we’ll be studying.

I think this is a good move. This national network in its current state just doesn’t seem like it’s going to have much affect on small doctors offices, which last I checked make up a large part of our healthcare system. I think in politics they call this move taking it to the people.

InformationWeek: Once you get clinicians using e-medical records, who pays to maintain the exchange infrastructure?

Blumenthal: It’s a short-term issue. Long term it’s going to become an expectation on the part of the clinician and patient that information is going to be exchanged. And I think it will become a cost of doing business in the healthcare sector just as physicians and nurses consider it a cost of doing business to buy stethoscopes and run an office.

Doctors will hate to hear this quote. Although, they shouldn’t be too upset. In reality, they’ll be passing this cost on to the consumers. Now how we get to the point Blumenthal talks about is beyond me. That’s a huge gap to cross.

InformationWeek: Will the Certification Commission for Heath IT–CCHIT– remain the organization doing these certifications, or will there be others?

Blumenthal: We’ll have to see what the regulation actually is and see where CCHIT fits in. CCHIT is clearly going to have the option to participate in certification going forward, but I can’t tell you what role exactly it will play.

Translation: I don’t care about CCHIT. If they want to participate great, but I’m playing no favorites here.

Another Meaningful Use Webcast

Posted on January 25, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

These webcasts have been popping up all over the place. It’s really quite amazing. You could make it a full time career just attending various webcasts on the EMR stimulus and meaningful use. Well, I’ve seen a ton of them, but this one by Modern Healthcare looked pretty interesting with a variety of people including the Director of CMS Office of E-Health Standards and Services. You can read more about it here and I’ll put some of the details of the meaningful use regulations webcast below:

Wednesday, Jan. 27, 2010
10 a.m. Central Time
FREE REGISTRATION*

About this Webcast

The federal government is offering as much as $34 billion in financial assistance to healthcare providers that buy, implement and use information technology in a manner consistent with the way the government wants it to be used. The government explained what it wants in nearly 700 pages of proposed regulations issued earlier this month.

In this webcast moderated by Modern Healthcare Information Technology Reporter Joseph Conn, four healthcare IT experts will break down those regulations and help attendees:
Identify the key sections of the regulations
Understand the impact of the regulations on hospitals, health systems and physician practices
Teach providers strategies to qualify for federal funding
Featured Speakers

J. Michael Kramer, M.D.
Chief Medical Information Officer
Trinity Health
Novi, Mich.

David Seaman
CEO
Pronger Smith Medical Care
Blue Island, Ill.

Tony Trenkle
Director
CMS Office of E-Health Standards and Services
Washington

Paul Tang, M.D.
Chief Medical Information Officer
Palo Alto Medical Foundation
Palo Alto, CA

P.S. If you’re able to attend this or any other webcast and want to do a guest post on what was said at the webcast, feel free to contact me on the EMR and EHR contact us page.

CCHIT Responds to Booz Allen Hamilton EHR Certification Contract with NIST

Posted on January 23, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

CCHIT’s Mark Leavitt has published his analysis of the $400,000 contract that NIST awared to Booz Allen Hamilton to develop a framework for electronic health record certification (see certified EHR).

Honestly, it seems that Mark’s as confused as everyone about this whole process. This is an interesting development since I would have thought that CCHIT would have had a close relationship with HHS, ONC, NIST, CMS, etc. The fact that CCHIT and Mark Leavitt are kind of left in the dark and full of lots of questions is not a good sign for CCHIT and fans of CCHIT. It is a good sign for those who don’t care for CCHIT.

Allscripts EMR Profits

Posted on January 20, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I found this about a week ago and found it really really interesting. Here’s the numbers for the EMR behemoth Allscripts per HIT News:

The company [Allscripts] made $15.8 million in net income for the quarter, turning around a $6 million loss for the same period last year. Non-GAAP net income increased 45 percent, from $16.6 million a year ago to $24 million this year.

The sad part is that Allscripts went through a nice round of layoffs last year. I can’t find the number right now, but I remember it was pretty significant. Too bad they had to fire so many people while turning such a large profit. Seems like an opportunistic cut to me. I wonder how well Allscripts support was with all the cuts.

Another quote from the same article:

“We believe that 2010 will be the ‘Year of the EHR’ in which we expect to see significant acceleration in the adoption and utilization of healthcare information technology to improve quality and reduce cost,” said Glen Tullman, Allscripts CEO. “This is a once-in-a-lifetime market opportunity, driven by the American Recovery and Reinvestment Act.”

There’s no doubt that Glen Tullman is salivating over the $18 billion of EMR stimulus money that’s on the table. He probably should be since Allscripts is likely to make a killing off of the stimulus money.

I think all of this is also a very good sign for smaller EMR vendors as well. I expect a number of EMR vendors to scale to 500 or so installs and sell off for a very nice return in the next few years. I guess we’ll see if Glen’s right about this being the “Year of the EHR.”

Growth of HIT Spurred By EMR

Posted on January 19, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As if this was a major announcement, but EMR is leading the growth in the healthcare IT market according to a report by Scientia Advisors:

A new report from Scientia Advisors says health IT is the fastest-growing segment of what the Cambridge, Mass., management advisory company calls a $1 trillion global healthcare products marketplace. Health IT currently is growing at an 11 percent annual rate, and solid growth should continue at least through 2013, which would be the third year of the federal EMR stimulus program here in the States, the Scientia report forecasts. In that time frame, health IT will increase its market share by a quarter, to 5 percent of global healthcare products sales from the current 4 percent.

They also predicted that established EMR vendors should benefit the most from increased spending. “Leading players with large installed bases, proven products, and streamlined routes to meaningful use of EHRs are likely to gain share,” Scientia says.

There’s no doubt they’re going to gain major market share. Add in major mergers and acquisitions by the major players and these companies are going to become huge. Can you imagine the support doctors are going to get from these major EMR vendors?

EMR Research Isn’t Respected

Posted on I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

At the same meeting where Google’s CEO, Eric Schmidt, commented about healthcare IT, there was another interesting comment by Eric Lander about the state of researching EMR and healthcare IT. Here’s his comment:

“My sense is that we don’t respect this stuff,” said PCAST co-chair Eric Lander. “We respect the cancer genome, but not checklists. What do we need to do to send a signal to the next generation of researchers that this is a high-class, worthy thing to do? What would it take to move the needle?”

I agree. I’ve done the searching through the journals for well done EMR research and found very little. Not that research is the end all be all, but it can provide insight that can’t be found other ways.

Easy 12 Page Matrix for Meaningful Use

Posted on January 15, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Lots of people have been putting out lots of simplified versions of Meaningful Use. The latest I found is a “simple” 12 page PDF file (see embedded document below) that has a matrix of the various stage 1 meaningful use objectives and the criteria for Eligible Professionals and the criteria for Hospitals. I’ll keep searching the net to compile the various resources out there. Then, I’ll decide if it’s worth making my own or if I’ll just continue to compile others and provide commentary on the criteria themselves. What do you think?

Google’s Eric Schmidt Talks Health IT

Posted on January 14, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I always find it interesting when someone who knows very little about healthcare IT starts joining into the discussion. Part of me wants to scream that they are making assertions about something they know little about. How often in my life have I done the same and it came back to bite me? Too often. However, the other part of me loves the idea of fresh eyes taking a look at a problem. Sometimes it stimulates a new way of thinking that promote effective change.

So, of course, I find Google CEO, Eric Schmidt’s, comments on healthcare IT interesting. Here they are according to the Science Insider:

“My question has to do with the model of health care that we’ll be facing in 5 or 10 years,” Schmidt began. “It’s pretty clear that we’ll have personalized health records, and we’ll have the equivalent of a UPC sticker with your medical history. So when you show up at the doctor with some set of symptoms, in my ideal world what would happen is that the doctor would type in the symptoms he or she also observes, and it would be matched against the data in this repository. Then this knowledge engine would use best practices, and all the knowledge in the world to give physicians some sort of standardized guidance. This is a generalized form of the checklists that you’re talking about.”

Then Schmidt made clear what was troubling him. “As computer scientists, this is a platform database problem, and we do these very, very well, as a general rule. And it befuddles me why medicine hasn’t organized itself around these platform opportunities.”

I bet Eric Schmidt wants that UPC sticker to be doing lookup on Google Health.

HIT News’ List of 25 Meaningful Use Objectives

Posted on January 13, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Healthcare IT News has an article that did a good job listing the 25 meaningful use objectives in a simple to read format. Much better than the 692 pages of Meaningful Use and Certified EHR information HHS put out. Here’s the 25 Meaningful Use Objectives you’ll need to meet to get the EMR stimulus money:

[1] Objective: Use CPOE
Measure: CPOE is used for at least 80 percent of all orders

[2] Objective: Implement drug-drug, drug-allergy, drug- formulary checks
Measure: The EP has enabled this functionality

[3] Objective: Maintain an up-to-date problem list of current and active diagnoses based on ICD-9-CM or SNOMED CT®
Measure: At least 80 percent of all unique patients seen by the EP have at least one entry or an indication of none recorded as structured data.

[4] Objective: Generate and transmit permissible prescriptions electronically (eRx).
Measure: At least 75 percent of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology.

[5] Objective: Maintain active medication list.
Measure: At least 80 percent of all unique patients seen by the EP have at least one entry (or an indication of “none” if the patient is not currently prescribed any medication) recorded as structured data.

[6] Objective: Maintain active medication allergy list.
Measure: At least 80 percent of all unique patients seen by the EP have at least one entry (or an indication of “none” if the patient has no medication allergies) recorded as structured data.

[7] Objective: Record demographics.
Measure: At least 80 percent of all unique patients seen by the EP or admitted to the eligible hospital have demographics recorded as structured data

[8] Objective: Record and chart changes in vital signs.
Measure: For at least 80 percent of all unique patients age 2 and over seen by the EP, record blood pressure and BMI; additionally, plot growth chart for children age 2 to 20.

[9] Objective: Record smoking status for patients 13 years old or older
Measure: At least 80 percent of all unique patients 13 years old or older seen by the EP “smoking status” recorded

[10] Objective: Incorporate clinical lab-test results into EHR as structured data.
Measure: At least 50 percent of all clinical lab tests results ordered by the EP or by an authorized provider of the eligible hospital during the EHR reporting period whose results are in either in a positive/negative or numerical format are incorporated in certified EHR technology as structured data.

[11] Objective: Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, and outreach.
Measure: Generate at least one report listing patients of the EP with a specific condition.

[12] Objective: Report ambulatory quality measures to CMS or the States.
Measure: For 2011, an EP would provide the aggregate numerator and denominator through attestation as discussed in section II.A.3 of this proposed rule. For 2012, an EP would electronically submit the measures are discussed in section II.A.3. of this proposed rule.

[13] Objective: Send reminders to patients per patient preference for preventive/ follow-up care
Measure: Reminder sent to at least 50 percent of all unique patients seen by the EP that are 50 and over

[14] Objective: Implement five clinical decision support rules relevant to specialty or high clinical priority, including for diagnostic test ordering, along with the ability to track compliance with those rules
Measure: Implement five clinical decision support rules relevant to the clinical quality metrics the EP is responsible for as described further in section II.A.3.

[15] Objective: Check insurance eligibility electronically from public and private payers
Measure: Insurance eligibility checked electronically for at least 80 percent of all unique patients seen by the EP

[16] Objective: Submit claims electronically to public and private payers.
Measure: At least 80 percent of all claims filed electronically by the EP.

[17] Objective: Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, and allergies) upon request
Measure: At least 80 percent of all patients who request an electronic copy of their health information are provided it within 48 hours.

[18] Objective: Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, allergies)
Measure: At least 10 percent of all unique patients seen by the EP are provided timely electronic access to their health information

[19] Objective: Provide clinical summaries to patients for each office visit.
Measure: Clinical summaries provided to patients for at least 80 percent of all office visits.

[20] Objective: Capability to exchange key clinical information (for example, problem list, medication list, allergies, and diagnostic test results), among providers of care and patient authorized entities electronically.
Measure: Performed at least one test of certified EHR technology’s capacity to electronically exchange key clinical information.

[21] Objective: Perform medication reconciliation at relevant encounters and each transition of care.
Measure: Perform medication reconciliation for at least 80 percent of relevant encounters and transitions of care.

[22] Objective: Provide summary care record for each transition of care and referral.
Measure: Provide summary of care record for at least 80 percent of transitions of care and referrals.

[23] Objective: Capability to submit electronic data to immunization registries and actual submission where required and accepted.
Measure: Performed at least one test of certified EHR technology’s capacity to submit electronic data to immunization registries.

[24] Objective: Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice.
Measure: Performed at least one test of certified EHR technology’s capacity to provide electronic syndromic surveillance data to public health agencies (unless none of the public health agencies to which an EP or eligible hospital submits such information have the capacity to receive the information electronically).

[25] Objective: Protect electronic health information maintained using certified EHR technology through the implementation of appropriate technical capabilities.
Measure: Conduct or review a security risk analysis in accordance with the requirements under 45 CFR 164.308 (a)(1) and implement security updates as necessary.