Docs to Feds: Go Slow on Meaningful Use

HDM Reports on “Go Slow” Comments to ONC
Joseph Goedert of HealthData Management reported on June 29, 2009, that while 80 physician organizations, including the AMA, support the federal EHR initiative, they submitted comments on “Meaningful Use” that “We are concerned, however, that the committee’s timeline to meet the proposed measures is too aggressive given that we continue to lack the necessary infrastructure, standards and systems.”  The recommendations point out specialties for which no certified EHR products are on market: “e.g., oncologists, dermatologists, opthalmologists, obstetricians.” Recommendations also note major transitions to HIPPA Version 5010 by January 1, 2012, and  ICD-10 codes by Otober 1, 2013.
Here are the recommendations these organizations submitted(pdf).

HIMSS Comments on Meaningful Use: Need to Differentiate Hospital and Physician Practices
HIMSS Board of Directors approved comments on June 26, 2009 which “coalesced around three categories: Implementation Timeline & Structure, Adoption Sequence, and Workforce.” Summary Comments start by saying ”Overarching all of HIMSS’s comments, we express out strong concern that the Committee does not distinguish clearly enough between hospital and physician practices.”
Here are the actual comments (pdf).

Association of Medical Directors of Information Systems submits comments
Here are the comments (pdf).

UPDATE: HIT Policy Committee June 16, 2009 Meeting 
OFFICIAL  Documents/Audio & Slides Added

CCHIT explores ‘meaningful use’ in certification process

Certification: CCHIT process evolves
Thoughtful wrapup by Joseph Conn of  Modern Healthcare’s HITS on June 26, 2009, of evolving Certification process with comments by Mark Leavitt, MD, chair of CCHIT, and Steve Waldren, a physician and director of the AAFP’s Center for Health Information Technology. More review of CCHIT processes by this blog next week.
http://www.modernhealthcare.com/article/20090626/REG/306269994/1153

A Lifeline for Primary Care

NEJM Perspective Calls for More Technical Assistance to Reorganize Primary Care Practices
NEJM notes that HIT Regional Extension Centers called for in ARRA to assist practices and hospitals in implementing HIT are based on Department of Agriculture’s Cooperative Extension Service which combines federal, state, state university experts, and farmers. In June 25, 2009 issue of New England Journal of Medicine, Thomas Bodenheimer, MD, and Kevin Grumbach, MD, from University of California, San Francisco, School of Medicine; and Robert A. Berenson, MD, Urban Institute; present three areas of focus needed to revitalize primary care with the goal of transforming primary care practices into “modernized medical homes.” Authors state that national policies are required to rescue primary care from its inability to attract enough primary care practitioners due to lower pay, stress of “more work at less pay,” and “medical education favors training in non-primary care fields.”
http://content.nejm.org/cgi/content/full/360/26/2693

Primary-Care Doctor Shortage May Undermine Reform Efforts
Washington Post’s Ashley Halsey III reported on June 20, 2009, that “Fixing the problem (of a shortage of primary care physicians) will require fundamental changes in medical education and compensation to lure more doctors into primary-care offices, which already receive 215 million visits each year.”

Blumenthal Pledges EHR Support for Small Physician Practices
“National Coordinator for Health IT David Blumenthal said the federal government would pay special attention to individual physicians and small group practices as it works to implement the health IT provisions of the federal economic stimulus package,” based on reporting from CongressDaily that iHealthBeat summarized on June 25, 2009. Blumenthal also discussed regional extension programs to support implementation of EHRs and said he would set up listening sessions nationwide.
Here’s the the orginal reporting from Andrew Noyes, CongressDaily on nextgov.com, a National Journal Group site.  Hearing by “the House Small Business Regulations and Healthcare Subcommittee, which heard from pediatricians, optometrists and others who fear they could be disadvantaged when the government doles out about $17 billion in Medicare and Medicaid bonuses, grants and technical assistance.”

Do Small Practices Lack Resources for Quality Upgrades?
iHealthBeat
also pointed out reporting from John Commins for HealthLeaders Media on June 24, 2009: “Small medical practices provide nearly 75% all ambulatory care in the United States, yet many lack the resources to improve the quality of care delivered or install electronic health records to serve an increasingly diverse patient mix, according to a report released today by the National Committee for Quality Assurance.”

National Committee for Quality Assurance (NCQA) Report on Small Physician Practices
Recommends HITECH Act Regional Centers should give priority to “certain types of providers including individual or small group practices focused on primary care and providers that serve uninsured, undreinsured and medically underserved individuals.”
Supporting Small Practices: Lessons for Health Reform Topic Page
Press Release
Report
Presentation Slides pdf

Physicians: Prepare to meet “meaningful use”

Advice to Physicians: Prepare to meet “meaningful use” EMR requirement
Pamela Lewis Dolan, of
American Medical News, reporting June 15, 2009 on the experts’ answer to whether physicians should wait until all the rules have been clarified. The experts told her “Don’t wait to buy or upgrade just for want of a definition. There are enough clues in the legislation to estimate the definition of ‘meaningful use.’”  http://www.ama-assn.org/amednews/2009/06/15/bica0615.htm

Scenario: How do you keep the patient at the center of the medical interview?
On the American Medical News site on June 8, 2009, Frederic W. Platt, MD, answered the question: “Given the high-tech trend in patient encounters, how do you conduct the medical interview in a way that does not interfere with the patient relationship?” Dr. Platt is clinical professor of medicine, University of Colorado, Denver, School of Medicine, and regional consultant for the Institute for Healthcare Communication. The post is part of AMedNews.com’s Ethics Forum.
http://www.ama-assn.org/amednews/2009/06/08/prca0608.htm
Dr. Platt’s quide to the essence of physician-patient communications:
Field Guide to the Difficult Patient Interview, 2nd Edition. Co-authored with Geoffrey H. Gordon.

AMedNews.com’s Current and Archived Articles on EMRs
Ready source of articles written for physicians about Electronic Medical Records
http://www.ama-assn.org/amednews/site/topic.htm#emrs

More from 6/16/09 HIT Policy Meeting

Blumenthal Asks Work Group to revise Meaningful Draft plans
Fred Pannic, of Healthcare IT Consultant Blog, summarizes key issues related to June 16, 2009 HIT Policy committee meeting as reported by online pubs.
http://hitconsultant.blogspot.com/2009/06/blumenthal-asks-work-group-to-revise.html

FierceEMR runs Neil Fersel’s reporting summary with links to related stories.

OFFICIAL MEETING TRANSCRIPT FROM ONC (pdf)
Meeting transcript (rough version) from Brian Ahier.

OFFICIAL MEETING SUMMARY (pdf)

AUDIO AND SLIDES from ONC/HIT Policy Committee
https://admin.na3.acrobat.com/_a758956138/p28111342/
To view the webconference, an up-to-date version of Adobe Flash Player is required.

Press release from ONC Office on Progress on “Meaningful Use”

Healthcare Apps on iPhone: Glimpse outside EHRs

15 Free Healthcare Apps for the iPhone
This is a diversion from the usual content about EHRs and Health IT, but perhaps it will get creative juices flowing. FierceHealthCare ran a June 9, 2009 feature showing 15 free healthcare apps for iPhone or iPod Touch that starts with this page: http://www.fiercehealthcare.com/slideshows/15-free-healthcare-apps-iphone You click on the first icon on upper right of text, and it starts the review.

Disclosure: The author of e-Healthcare Marketing blog owns shares of Apple.

HIT Policy Committee Slides, Docs: June 16, 2009

HIT Policy Committee Slides, Documents, Agenda
Tuesday, June 16, 2009; 10 am to 1 pm
See previous post “Meaningful Use has arrived plus Interoperability” for link to excellent summary.
Agenda
Meaningful Use Workgroup update (ppt version) (html version)
          Meaningful Use Preamble (pdf)
          Meaningful Use Matrix (pdf)
         
Certification/Adoption Workgroup update(ppt) (html version)
Information Exchange Workgroup update(ppt) (html version)
Minutes from previous meeting (5/11/09) (pdf)

Link to HIT Policy site meetings area: http://tinyurl.com/l63do7

Related Interoperability Issues
HITSP Interoperability Capabilities document from HITSP Tiger Teams
Access to this document is thanks to John Halamka’s article in Healthcare IT News. “Tiger Teams” are working to simplify HITSP Interoperability Specifications.

HITSP Tiger Teams
Five ”Tiger Teams” were formed by HITSP in 2009 ”to bring high-level technical focus on ARRA (the American Recovery and Reinvestment Act).” Click for breakout of teams.

Meaningful Use has arrived + Interoperability

Interoperability included in June 16, 2009 HIT Policy meeting
Reporting for Healthcare IT News, John Halamka, MD, of Harvard Medical School, provides excellent overview of June 16, 2009 HIT Policy meeting including interoperability.  Be sure to read his article and see the full documentation from the meeting. Dr. Halamka serves as CEO of HITSP (Health Information Technology Standards Panel), and co-chair of ONC’s new HIT Standards Committee.
http://www.healthcareitnews.com/blog/meaningful-use-has-arrived

“Meaningful Use” Comments Due June 26, 2009

ONC requests comments by June 26 on Meaningful Use Documents
“The Office of the National Coordinator for Health Information Technology (ONC) is seeking comments on the preliminary definition of “Meaningful Use,” as presented to the HIT Policy Committee on June 16, 2009.  Comments on the draft description of Meaningful Use are due by June 26, 2009, and should be no more than 1,000 words in length.”
See additional context in previous posting below.
http://healthit.hhs.gov/portal/server.pt?open=512&objID=1269&parentname=CommunityPage&parentid=1&mode=2&in_hi_userid=10741&cached=true#MeaningfulUse

Comment: Very long urls above, but wanted to show complete url for now. ms

Sharpening Focus on “Meaningful Use”

First Look at ‘Meaningful Use”
Joseph Goedert of Health Data Management reported today
 on releases from a work group of the federal HIT Policy committee. While not offering a specific definition, the work group issued a “framework for definition” and a matrix of Health Outcomes Policy Priorities, Care Goals, Objectives, and Measures they hope to achieve from 2011 through 2015.

Links to reporting, HIT Policy Committee site, and the two key documents
HDM Reporting: First Look at Meaningful Use
http://www.healthdatamanagement.com/news/meaningful_use-38487-1.html

iHealthBeat reporting: Panel Offers Initial Criteria for Defining “Meaningful Use”
http://www.ihealthbeat.org/Articles/2009/6/16/Panel-Offers-Initial-Criteria-for-Defining-Meaningful-Use.aspx#

HIMSS brief reporting: HIT Policy Committee Reveals the ‘First Draft’ of Meaningful Use and Requests Public Comment
http://himss.org/ASP/ContentRedirector.asp?ContentID=69358&type=HIMSSNewsItem

HIMSS Summary of Recommendations: Written by Jonathan French, HIMSS Manager of Federal Affairs
http://www.himss.org/advocacy/d/MeaningfulUseSummaryPublicComment.pdf?src=winews20090617 (pdf)

OFFICIAL DOCUMENTS
Health IT Policy Committee site:
http://healthit.hhs.gov/portal/server.pt?open=512&objID=1269&parentname=CommunityPage&parentid=1&mode=2&in_hi_userid=10741&cached=true

“Meaningful Use: A Definition”  Recommendations from HIT Policy ‘Meaningful Use’ Workgroup
http://healthit.hhs.gov/portal/server.pt/gateway/PTARGS_0_11113_872720_0_0_18/Meaningful%20Use%20Preamble.pdfeaningful Use: A Definition”

Meaningful Use Matrix proposed by Meaningful Use Workgroup
Summarizes Health Outcomes Policy Priorities, Care Goals, Annual Objectives and Measures 2011 through 2015
http://healthit.hhs.gov/portal/server.pt/gateway/PTARGS_0_11113_872719_0_0_18/Meaningful%20Use%20Matrix.pdf (pdf)

Comment: Very long urls above, but wanted to show complete urls for now. ms