I imagine most of my readers know that I’ve launched the Healthcare Scene blog network. EMR and EHR is one member of the blog network along with 7 other blogs that have been announced with 6 more blogs that will be announced shortly (Have you found them already?). We’re growing rapidly and expanding the number of people that are sharing great content with the world of healthcare IT and in particular EMR and EHR. The goal of providing a platform for the independent Healthcare IT voice is becoming a reality.

It’s a really exciting thing to be a part of. The most exciting part of it all is the amazing people that I get to work with and the content they create. Here’s a quick glimpse at some of their content with my thoughts on their posts.

EMR and HIPAA
Neil Versel recently started posting a regular weekly column on EMR and HIPAA. Check out his latest post on clinical decision support and an update on Dr. Larry Weed. Reading articles like that from Neil help me to appreciate more fully the history of healthcare IT. I’ve admittedly showed up late to the party, but Neil provides some interesting perspectives based on his knowledge and experience in healthcare IT. Here’s my favorite quote from his article:

“Patients may surmise that a physician who uses a [decision support system] is not as capable as a physician who makes the diagnosis with no assistance from a DSS.” I then noted that Weed has been saying for more than 50 years that physicians shouldn’t have to rely on their memory to make clinical decisions when computers can help them process an increasingly voluminous knowledge base.

Meaningful HIT News
Neil’s blog Meaningful Healthcare IT News is also a member of the Healthcare Scene blog network. How can you not enjoy a post entitled Skype for “Redneck Telehealth”? Sometimes, you’ve got to do what you’ve got to do.

Happy EMR Doctor
What doctor isn’t interested in reading another doctor’s perspective on “Getting a Life with Electronic Medical Records,” “Gag Orders and Bad EMR Systems,” and a Doctor’s issues with PQRI Incentive Money? Those are the latest topics from Dr. West over on Happy EMR Doctor. Of course, now that Dr. West has gotten the blogging bug, his EMR gave him a life and his new blog has taken it back. I always appreciate a practicing doctor’s perspective.

Smart Phone Health Care
I’d been covering a number of mobile health care and mHealth related topics on this and my EMR and HIPAA blog, but the topic has become so popular that I knew it was time to start a mobile health care related site of its very own. I’m now doing it in partnership with David. He’s been churning out some interesting posts about Cell Phones Saving Lives in Africa and a Mobile App that Could Detect an Acute Stroke. I’ve always seen one of the major developments of mobile health happening in the developing world where the IT networks aren’t yet in place. Mobile phones can have such a tremendous impact for good. It’s beautiful to learn about. Although, mobile health is still in its infancy in the developed world as well. Personally, I’ve been trying to kick around some mobile gaming app that would encourage activity (ie. movement). Far too many of us sit in front of our computers all day. Healthcare would be so much better if more people just moved (written as I sit in front of my computer).

EMR, EHR and Healthcare IT News
This site is still very young, but just hit it’s 100,000 pageview mark. That’s a result that I would have never been able to predict. Although, news like the one posted today about the First Medicare EHR Stimulus Checks is something that many find interesting. If you know of other news we should be posting, let us know.

EMR and EHR Screenshots
The most recently announced member of the Healthcare Scene blog network is a website called EMR and EHR Screenshots. There’s still a lot I want to do to improve the interface for viewing the various EMR and EHR screenshots, but I think the concept is really interesting. My goal is to aggregate as many of the EMR and EHR screenshots as I can get. Hopefully that will mean even screenshots from the same EMR and EHR software as it releases new versions of the software. I’d love to have screenshots of CPOE, ePrescribing, scheduling, charting, diagnosing, etc. Basically if you’re interested in knowing what an EMR looks like or what it looked like previously, we’re hoping to provide you that view into an EMR’s development. A lofty vision. We’ll see how many EMR and EHR vendors, doctors, and other users will support it.

See what I mean when I talk about the amazing content that’s being generated. This doesn’t even include the great posts that Katherine Rourke is doing on this blog and my own posts (which could be classified as good or bad).

As I mentioned, I have 6 more blogs to be announced shortly. So, keep an eye on Healthcare Scene to see what will be announced next.

I recently quietly launched a new blog designed to just post the various EMR, EHR and health care IT news announcements. It’s been seeing some good traffic, but I think I’m ready to start getting more EMR related news that I can post to the site.

Of course, the more interesting the EMR related news, the more likely I am to post it. However, we’ll be pretty flexible at first and see how it goes. If you have any EMR news, just drop us a note on our Contact Us page. Plus, then you can get my direct email for future EMR news that you might want shared.

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?

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.

Check out this quote from an article at health care IT news that talks about the challenges the HIT Standards Committee has had understanding the committee’s recommendations:

However, some standards for 2011 – particularly those governing security and privacy – have been difficult to grasp, even for committee members. “They don’t understand what we’re recommending and how the pieces fit together,” said Dixie Baker, chairman of the committee’s privacy and security workgroup.

The security standards the committee has recommended are based on the HIPAA security and privacy rule, she said. Those include requirements to authenticate identity, control access to health information by authorized users, encrypt and decrypt information, and create an audit trail to track who has accessed data.

In explaining the security standards for 2011, Baker said they “are used on a daily basis when we use the Web even if you don’t realize it.” For instance, the standard that the committee used for identity authentication is the same standard used to conduct commercial transactions securely over shopping Web sites, such as Amazon.

“When you’re about to present a credit card (online) a picture of a lock appears in the lower corner (of the Website),” said Baker. “What locks that is an approach that’s called the Transport Layer Security,” which authenticates one or both ends of the exchange, she said.

Does this scare anyone else? First, you have to wonder what those people are doing on the committee. Second, you have to ask if the committee (who should be well educated on these subjects) has a challenge understanding their recommendations how are busy doctors going to do with the regulations? Doctors must be so excited to go through the 692 pages of Meaningful Use regulations.