Monthly Archives: January 2011

Blumenthal Letter #24: Our Journey Continues: $80 Million in Add’l Funds to RECs, 8 HIEs, and Community Colleges

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Our Journey Continues…
January 27, 2011 (accessed 1/27/2011 from ONC site)

With the new year, we are turning the page to a next chapter in our journey to adoption and meaningful use of health information technology (HIT). As we begin this chapter, ONC is accelerating progress with new funding for programs vital to our goals.

No doubt the “star player” in 2011 is the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs. As of this year, providers can begin qualifying for significant payments through Medicare and Medicaid, as they achieve meaningful use objectives.

But equally important are the “supporting players.” These are the programs created under the HITECH Act to help providers adopt and achieve meaningful use of EHRs through technical assistance, through information exchange, and through development of a new workforce of HIT specialists.

These supporting programs all started last year, and they’ve had a successful launch:

  • We funded 62 Regional Extension Centers (RECs) across the nation to provide technical assistance, especially for smaller practice primary care providers, rural hospitals and other settings which serve the underserved. We want the RECs to assist at least 100,000 primary care providers. And already, some 38,000 primary care providers have enrolled for REC assistance.
  • We created a state grant program to support health information exchange (HIE) and facilitate all the potential uses and benefits of secure information sharing. Already, approved HIE implementation plans are in place in 25 states.
  • We funded 84 community colleges to train HIT specialists that will help to meet the anticipated national shortage of 50,000. The first 3,400 students will graduate by May, 2011 – and with excellent job prospects.

This month we are adding new funding for these important initiatives:

For the RECs, we are providing additional funding of $32 million. This especially reflects our plan to accelerate outreach to health care providers to encourage registration for the CMS Incentive Programs and to provide more support in the field as providers adopt health information technology in their practices. We recognize that the early transition to HIT can be challenging and we want to make sure that our RECs are fully operational to help make this transition as smooth as possible. We are committed to offer substantial ongoing support to achieve meaningful use through the RECs.

For HIE, we are providing $16 million in new Challenge Grants to encourage breakthrough innovations for health information exchange that can be leveraged widely to support nationwide health information exchange and interoperability. The HIE Challenge Grant Program is providing 10 awards of between $1 and $2 million to State HIE Cooperative Agreement Program grantees, to develop innovative and scalable solutions in five key areas: achieving specific health goals, improving care transitions, consumer-mediated information exchange, enhanced querying for patient care, and fostering distributed population-level analytics.

For community colleges, $32 million in second year funding is being provided to continue academic HIT programs training the specialists needed to make rapid adoption and meaningful use possible. We remain on track to ramp up and graduate an estimated 10,500 students a year through our community college programs.

In playing their part for HIT adoption and meaningful use, every awardee in our supporting programs is a star! Awardees and funding amounts for these programs can be found at http://healthit.hhs.gov.

Warmest Regards,
David Blumenthal, MD, MPP
National Coordinator for Health Information Technology

The Office of the National Coordinator for Health Information Technology (ONC) encourages you to share this information as we work together to enhance the quality, safety and value of care and the health of all Americans through the use of electronic health records and health information technology.

For more information and to receive regular updates from the Office of the National Coordinator for Health Information Technology, please subscribe to our Health IT News list.
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See list of newly awarded challenge grants to state HIEs on e-Healthcare Marketing.

ONC Awards 10 Challenge Grants to 8 State HIEs: Totals $16 Million

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Health Information Exchange Challenge Grant Program
Excerpted from ONC site on 1/27/2011.
The Office of the National Coordinator for Health Information Technology (ONC) has awarded $16 million in new Challenge Grants to encourage breakthrough innovations for health information exchange that can be leveraged widely to support nationwide health information exchange and interoperability.
The Health Information Exchange (HIE) Challenge Grant Program is providing 10 awards between $1 and $2 million to State HIE Cooperative Agreement Program grantees to develop innovative and scalable solutions in five key areas:

  1. Achieving health goals through health information exchange
  2. Improving long-term and post-acute care transitions
  3. Consumer-mediated information exchange
  4. Enabling enhanced query for patient care
  5. Fostering distributed population-level analytics
The ONC-funded State HIE Cooperative Agreement Program promotes secure exchange of health information to enable patient-centered care and providers’ achievement of meaningful use requirements.
State/SDE Previous Award Amount Amount Awarded
January 2011		 Challenge
Theme
Colorado Regional Health Information Organization $9,175,777 $1,718,783

2
Georgia Department of Community Health $13,003,003 $1,686,989

3
Indiana Health Information Technology, Inc. $10,300,000 $1,718,439

4
Indiana Health Information Technology, Inc. $1,267,970

3
Massachusetts Technology Park Corporation $10,599,719 $1,717,610

2
Massachusetts Technology Park Corporation $1,675,019

5
Maryland Department of Health & Mental Hygiene $9,313,924 $1,683,171

2
HealthShare Montana $5,767,926 $1,400,802

5
NC Dept of State Treasurer $12,950,860 $1,708,693

1
Oklahoma Health Care Authrity $8,883,741 $1,719,086

2
TOTAL $79,994,950 $16,296,562

Learn more about the funding opportunity for this important initiative.

CMS Produces EHR Registration Video for Eligible Professionals

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CMS Video Provides Step-by-Step Registration Guidance for Eligible Professionals for the EHR Incentives Program

CMS Video for EP Registration
Centers for Medicare and Medicaid Services (CMS) has produced an 11-minute step-by-step video tutorial for registration for the EHR Incentive Payments Programs for Eligible Professionals.

Medicare and Medicaid EHR Incentive Program Webinar Video for Eligible Professionals [44.2MB - WMV] -
Per CMS “This tutorial video will provide Eligible Professionals with a step-by-step guide to help ensure the registration process is a success.” This may take several minutes to download. Clicking on the title immediately above or the photo will start downloading the video.

A transcript of this webinar is available [PDF] .

Register for the Medicare and/or Medicaid EHR Incentive Programs

Below are step-by-step PDF guides to help you register for EHR Incentive Programs. Choose the guide that fits your needs:

Medicaid EHR Incentives Registration for Eligible Professionals opened in the following states on January 3, 2011:

eHI Finalizes Jan 19-20 Annual Conference Agenda, Washington, DC.

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eHealth Initiative Annual Conference,
Turning Policy into Action
Washington, DC  

Featuring David Blumenthal and Joy Pritts from ONC, Keynote from Cokie Roberts.

Panels on CMS Innovation, Looking Ahead to Stage 2 Meaningful Use, Outlook for Health Care Policy with New Congress, eHI Awards, Privacy and Health IT, Care Coordination in Real Word, Creating Accountable Care Organizations, Data for Quality Improvement, and Progress and Barriers at State Level: HIT Coordination Panel.

For more information and registration, click here.

AGENDA
DAY ONE: Wednesday, January 19, 2011
9:30 a.m. – 1:30 p.m.
eHI Members Only

1:30 p.m. – 2:00 p.m.
Conference Registration 

2:00 p.m. – 2:15 p.m.
Welcome and Overview of the Day
–Jennifer Covich Bordenick, Chief Executive Officer, eHealth Initiative
–William F. Jessee, MD, FACMPE, FACPM, President and Chief Executive Officer, Medical Group Management Association, 2011 eHealth Initiative Board Chair

2:15 p.m. – 3:00 p.m.
A Discussion with the Center for Medicare and Medicaid Innovation
Guest Speakers:
–Moderator: Steve Stack, MD, Member, Secretary, American Medical Association
– Mandy Krauthamer Cohen, MD, MPH, Senior Advisor, Center for Medicare and Medicaid Innovation

3:00 p.m. – 4:00 p.m.
Meaningful Use: A Look Ahead to Stage 2
–Moderator: Larry Yuhasz, Director, Strategy and Business Development, Thomson Reuters
–Mark Bell, Chief Information Officer, North Carolina Hospital Association
–Hank Fanberg, Technology Advocacy, Christus Health
–Charles Jarvis, Vice President of Healthcare Services and Government Relations, NextGen Healthcare
–Harry F. Laws, MD, FAAP, Chief Medical Information Officer, Community Health Network, Clinical Professor of Pediatrics, Indiana School of Medicine

4:00 p.m. – 4:45 p.m.
The New Congress in 2011: Outlook for Health Care Policy
–Introduction: Leigh Burchell, Allscripts, and 2011 eHI Policy Steering Committee Vice Chair
–Democrat Perspective: David Thomas, Principal, Mehlman Vogel Castagnetti Inc.
–Republican Perspective: Alex Vogel, Partner, Mehlman Vogel Castagnetti Inc.

4:45 p.m. – 7:00 p.m.
Awards Ceremony & Welcome
–Presented by: William F. Jessee, MD, FACMPE, FACPM, President and Chief Executive Officer, Medical Group Management Association, 2011 eHealth Initiative Board Chair

DAY TWO: Thursday, January 20, 2011

7:30 a.m. – 8:30 a.m.
Registration & Breakfast

8:30 a.m. – 9:00 a.m.
Conference Overview Welcome Back

9:00 a.m. – 9:30 a.m.
Privacy and Health IT: A Conversation with the Chief Privacy Officer
–Introduction: Gerry Hinkley, Co-Chair, Health Care Industry Team, Pillsbury Winthrop Shaw Pittman LLP
–Joy Pritts, Chief Privacy Officer, Office of the National Coordinator for Health Information Technology, US Department of Health and Human Services

9:30 a.m.- 10:30 a.m.
Care Coordination in the Real World
–Moderated by: Bruce Henderson, National Leader, EHR/HIE Practice, PricewaterhouseCoopers
Guest Speakers:
–Robert Fortini, Chief Clinical Officer, Bon Secours Medical Group from Bon Secours Health System
–Dr. Bruce Hamory, MD, Executive Vice President, Managing Partner, Geisinger Consulting Services, Geisinger Health System
–Charles Kennedy, MD, Vice President for Health Information Technology, WellPoint

10:30 a.m – 10:45 a.m.|
Networking Break

10:45 a.m.- 11:45 a.m.
Creating Accountable Care Organizations (ACOs)
–Moderated by: John Edelblut, Senior Executive, Accenture
–Andrew Ziskind, Partner and Senior Executive, Accenture
–Dick Salmon, MD, PhD, National Medical Director for Quality, CIGNA HealthCare
–Mike Flammini, Head of Strategy, Aetna
–James Walton, DO, MBA, Vice President of Health Equity and Chief Equity Officer, Baylor Health Care System

11:45 a.m.- 12:45 p.m.
Lunch and Networking

12:45 p.m. – 2:00 p.m.|
Data for Quality Improvement
–Moderator: Daniel Carmody, CPA, ChFC, Operations Director, Information Strategy and Solutions, CIGNA HealthCare
–Janet Corrigan, President and CEO, National Quality Forum
–Scott Cullen, MD, Lead for Clinical Analytics, Accenture
–Tracey Moorhead, President & CEO, Care Continuum Alliance
–Gurvaneet Randhawa, MD, MPH, Senior Advisor on Clinical Genomics & Personalized Medicine, Agency for Healthcare Research and Quality

 2:00 p.m. – 2:15 p.m.
Networking Break

2:15 p.m. – 3:30 p.m.
HIT Coordination Panel: Progress and Barriers at State Level
–Moderator: Rebecca Little, Senior Vice President, Medicity
–Doug Dietzman, Executive Director, Michigan Health Connect
–Gina Bianco Perez, Executive Director, Delaware Health Information Network
–John K. Evans, MHA, FACHE, President, S2A Consulting
–Liza Fox-Wylie, Policy Director, Colorado Regional Health Information Organization 
–Tom Liddell, Executive Director, Michiana Health Information Network
–Vikas Khosla, President and CEO, BluePrint Healthcare IT, NJ HIN Privacy and Security Committee Subject Matter Expert

3:30 p.m. – 4:15 p.m.
Keynote Address:
–Introduction by Diane Jones, Vice President of Policy and Government Affairs, eHealth Initiative
–David Blumenthal, MD, MPH, National Coordinator for Health Information Technology, US Department of Health and Human Services

4:15 p.m. – 5:00 p.m
Keynote Address:
–Introduction by Jennifer Covich, Chief Executive Officer, eHealth Initiative
–Cokie Roberts Cokie Roberts, ABC Congressional Correspondent and Senior News Analyst for National Public Radio

5:00 p.m. – 5:15 p.m
Closing Remarks
Jennifer Covich Bordenick, Chief Executive Officer, eHealth Initiative

For more information and registration, click here.

New Jersey: 20th State to Receive ONC Approval for HIE Operational Plan

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ONC Approves 20th Strategic and Operational State HIE Plan: New Jersey
On January 13, 2011, the Office of the National Coordinator for Health IT approved the operational portion of the State of New Jersey’s Strategic and Operational Plan for Health Information Exchange. This should lead soon to a release of funding for the first of four years of the plan. Previously only planning funds were released. Total Award Amount for New Jersey is $11,408,594. NJ-HITEC, New Jersey’s Regional Extension Center (REC), has already been awarded $23,048,351. Funds for HIE and REC programs are released based on reaching specific milestones.

List of Approved Plans on ONC’s State HIE Program site
New Jersey Strategic and Operational Plan–ONC Summary [PDF]

Following are excerpts from the first five of six pages ONC released summarizing the NJ program. The sixth page is an HIE Inventory, enabling easier comparisons with other state programs.

Health Information Exchange
Strategic and Operational Plan Profile

Overview
The State of New Jersey is committed to building on existing health information technology and exchange investments in developing a strategy for providers in the state to meet the EHR Incentive Program meaningful use requirements. It has developed a strategy for health information exchange that includes first strengthening exchange in local nodes and then creating a “network-of-networks” linking four regional health information exchange organizations (RHIOs) to create statewide coverage.

Model and Services
The New Jersey plan builds the capacity of local/regional exchange efforts. The state will use a large portion of the funds to support four local RHIOs in increasing data liquidity and supporting providers in achieving meaningful use. The work to strengthen the capacity of local exchange will be paired with strategic policy and operational interventions to increase lab data liquidity and e-prescribing participation statewide:
• Enable lab results delivery from Quest Diagnostics using the NHIN Direct specifications.
• Implement regulations that will require commercial and private laboratories to make electronically interfaced laboratory result transactions available to physician EHRs and regional HIEs at no extra cost to physicians.
• Implement a statewide education program on e-prescribing that targets the 15% of pharmacies not currently enabled for this functionality. This includes identification and monitoring of the targeted pharmacies.
In a later phase, that state will support node to node exchange and other services. The planned statewide services will include:
• Statewide broker/backbone that will connect HIEs
o Record locator services to find location of patient records across the state
o Patient health record services
• State-provided data from key registries (Immunization, Lead, Public Health, etc.)
• State-provided data on Medicaid Medication History
• State-provided Master Patient Index/Master Client Index (MPI/MCI)
• NJHIN stored “master” Record Locator Service for Standalone
EHRs and out-of-state provider access

Highlights
• Supporting Innovation: New Jersey has a special focus on incentivizing creative innovation within the state. They have established the HIT Innovation Center which is a partnership between the St. Barnabus healthcare system and the New Jersey Institute of Technology. There is a program under development to use NJIT students to create and develop HIT applications as well. The HIT Coordinator Office, the NJ-HITEC and the Innovation Center will be sponsoring an Innovation Summit in early 2011 to feature pilot projects already in place as well as special projects for future consideration. They also continue to emphasize and support a number of innovative projects currently in place across the state including:
o Meridian Home Health Pilot
o Bergen Regional Center Behavioral Health Pilot
o Virtua – Personal Health Records
o St Joe’s – Telemedicine

• Advancing Multi-State Collaboration: New Jersey has expressed an interest in leading new multi-state coordination activities for the mid-Atlantic region. All multi-state HIE coordination initiatives New Jersey is exploring will be in accordance with NHIN standards for communication and interaction. These include:
o Hosting a multi-state collaboration event – New Jersey plans to host its own multi-state collaboration event with surrounding states, to focus on sharing of plans and establishing an interstate approach for secure HIE.
o Project Management focus on multi-state pilots – New Jersey plans to assign full-time project management support to oversee and coordinate several interstate secure HIE pilot initiatives.
o Regional HIE data exchange – Three regional HIEs (South Jersey HIE, the Virtua HIE, and the South Jersey Health System HIE) have plans to exchange data in late 2010/early 2011 with Fox Chase Cancer Center’s HIE, located in Philadelphia, Pennsylvania.

MEANINGFUL USE
[ONC issued new guidance to State HIE Programs on July 6, 2010, in the form of a Program Information Notice, which established "The immediate priority of the State HIE Program is to ensure that all eligible providers within every state have at least one option available to them to meet the HIE requirements of meaningful use in 2011... (and therefore) states and SDEs shall outline in their State Strategic and Operational Plans (state plans) a concrete and operationally feasible plan to address and enable these three HIE capabilities in the next year:
1. E-prescribing
2. Receipt of structured lab results
3. Sharing patient care summaries across unaffiliated organizations]

NJ E-Prescribing Landscape
As of the end of 2009, there are 1,609 community active pharmacies capable of filling e-prescriptions. This figure excludes hospital pharmacies, but includes both chain and independent facilities (both retail and closed) and represents an 85% adoption rate across pharmacies in New Jersey. A total of 2,696 physicians routed prescriptions electronically in New Jersey, representing a 15% e-prescribing adoption rate for physicians in New Jersey.
NJ E-Prescribing Strategy
The State HIT Coordinator’s office, working NJ-HITEC, the NJ Dept of Health and Senior Services, and state associations, will develop a new program tentatively titled “ePrescribing New Jersey” to target pharmacists, clinicians, and consumers. In January, the state will develop the list of pharmacies who do not offer ePrescribing by matching Surescripts’ list of ePrescribing pharmacies against the NJ Board of Pharmacy’s list of all licensed pharmacies in the state. In February, the Coordinator’s office, working with the Department of Health and Board of Pharmacy will develop information on ePrescribing in the form of a course, handouts, and Web pages (part of the state HIT Coordinator’s Web site). In March, the state and REC will coordinate the start of a series of educational sessions with the HIEs to target non-eRx pharmacies, consumers, and clinicians.

NJ Structured Lab Results Landscape
New Jersey has 5,703 Clinical Laboratory Improvement Amendments (CLIA)-recognized laboratories with various certifications. Of these, there are 85 CLIA-accredited independent clinical laboratories, 4,079 recognized physician office laboratories, and 134 CLIA-accredited hospital-based clinical laboratories in the State.

Electronic sharing of laboratory orders and results within hospitals is already a generally accepted practice for all hospitals in New Jersey.

National laboratories have a large presence in New Jersey. These laboratory companies provide connectivity solutions to many state hospitals and healthcare providers for the exchange of electronic lab orders and results. Three of the largest independent clinical laboratories in New Jersey (Quest Diagnostics Inc., Laboratory Corporation of America, and Bio-Reference Laboratories) are able to directly interface with numerous electronic health record (EHR) systems. These interfaces allow for EHR systems to send lab orders electronically and receive results that can be downloaded directly into the EHR. Other connectivity solutions offered by laboratory companies in the State include proprietary portals for requesting lab orders and receiving results.

While the capability to exchange lab orders and results exists within the State, healthcare providers and regional health information exchange organizations have had varying levels of success incorporating laboratory data from commercial laboratory companies into their electronic health information exchange environments. Hospitals and health information exchange organizations that want to exchange lab data with independent laboratories are required to build custom interfaces to support these integration points and to incur ongoing transaction costs. The resulting drain on monetary and human resources for these point-to-point interfaces for electronic laboratory data exchange continues to be an adoption-limiting factor in the State.
NJ Structured Lab Results Strategy
New Jersey will approach the adoption of electronic transmission of lab results by leveraging the NJHINT law S323 and the regulations already in place for the electronic reporting of medical data to the NJ Department of Health and Senior Services. The Office of Statewide HIT Coordinator will pursue statutory and regulatory avenues in 2010/2011 that will require commercial and private laboratories to make electronically interfaced laboratory result transactions available to physician EHRs and regional HIEs at no extra cost to physicians (replacing traditional means such as faxing of results).

NJ Patient Care Summary Landscape
There is minimal current activity in the state related to the sharing of patient care summaries.
NJ Patient Care Summary Strategy
New Jersey is taking several approaches to enable this requirement. The primary mechanism is to pursue certification processes and participation agreements with the HIEs that will require them to support the exchange of Patient Care Summaries (PCS) with Physician EHRs and other HIEs in order to be eligible for state-sponsored funding and related state benefits.

ONC and CMS: Blog Post on Resources to Become ‘Meaningful User’

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Becoming a Meaningful User of EHRs: Resources from ONC and CMS
Wednesday, January 12th, 2011 | Posted by: Julie Franklin CMS and Peter Garrett ONC on ONC’s Health IT Buzz blog and republished here by e-Healthcare Marketing.

The Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare & Medicaid Services (CMS) want to help you on your journey to becoming a meaningful user of certified electronic health record (EHR) technology.  Here are resources about meaningful use, Medicare and Medicaid EHR Incentive Programs, and the EHR certification process to help guide you:

Meaningful Use and Medicare and Medicaid EHR Incentive Programs

1) Meaningful Use Overview
https://www.cms.gov/EHRIncentivePrograms/01_Overview.asp

2) Path to Payment
https://www.cms.gov/EHRIncentivePrograms/10_PathtoPayment.asp

3) PowerPoint Presentation: Medicare and Medicaid EHR Incentive Programs Final Rule
https://www.cms.gov/EHRIncentivePrograms/Downloads/EHR_Incentive_Program_Agency_Training_v8-20.pdf

4) Timeline: Medicare and Medicaid EHR Incentive Programs
https://www.cms.gov/EHRIncentivePrograms/Downloads/EHRIncentProgtimeline508.pdf

5) Being a Meaningful User of Electronic Health Records
http://healthit.hhs.gov/meaningfuluse/provider

6) Meaningful Use Specification Sheets
https://www.cms.gov/EHRIncentivePrograms/Downloads/EP-MU-TOC-Core-and-MenuSet-Objectives.pdf

7) Flow Chart – Determine Eligibility for Medicare and Medicaid EHR Incentive Programs
https://www.cms.gov/EHRIncentivePrograms/downloads/eligibility_flow_chart.pdf

Certification

1) Certification Programs Overview
http://healthit.hhs.gov/certification

2) Standards and Certification Criteria Final Rule Fact Sheet
http://healthit.hhs.gov/standardsandcertification/factsheet

3) HITECH Temporary Certification Program for EHR Technology Fact Sheet
http://healthit.hhs.gov/tempcert/factsheet

4) Temporary Certification Program Final Rule Frequently Asked Questions
http://healthit.hhs.gov/tempcert/faqs

5) Permanent Certification Program
http://healthit.hhs.gov/permcert/factsheet

6) Certified Health IT Product List
http://healthit.hhs.gov/chpl

Privacy and Security

1) Building Trust in Health Information Exchange
http://healthit.hhs.gov/buildingtrust

2) Health Information Privacy and Information on HIPAA
http://www.hhs.gov/ocr/privacy/

For additional resources on certification and meaningful use check out ONC’s Meaningful Use resources:
http://healthit.hhs.gov/meaningfuluse/resources.

ONC has also funded 62 Regional Extension Centers, located across the country, to offer customized, on-the-ground assistance for providers who need help adopting and meaningfully using certified EHR technology.

You can also stay up to date on ONC and CMS activities by:

What resources or tools from ONC, CMS, or other organizations have you or your practice used to help you become a meaningful user? What challenges have you faced on your road to meaningful use? We encourage you to start a dialogue and share your comments [on the ONC site].
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Please share your comments directly on the ONC Health IT Buzz blog post.

Blumenthal Letter #23: EHR Adoption Set to Soar

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EHR Adoption Set to Soar
January 13, 2010 (accessed from ONC site on 1/13/2010)

Portrait of Dr. Blumenthal

The tide is turning.

An increasing number of office-based physician practices report having an electronic health record, according to a recent survey.  Survey respondents also reported high levels of interest in adopting electronic health records and health information technology.

The survey [PDF - 220 KB] was conducted by the National Center for Health Statistics (NCHS), an agency of the HHS’ Centers for Disease Control and Prevention.

More and more physicians are putting a private and secure electronic framework in place to realize long-term improvements in quality of care, efficiency, and health costs. But the presence of an EHR does not make a physician a meaningful user.

An electronic health record, as defined in the survey, could have been just a “basic” EHR—one that stores patient demographic information, patient problem lists, clinical notes, laboratory and imaging results, and orders for prescriptions. Basic EHRs are not capable of being used to meet the requirements of meaningful use.

Fortunately, additional data commissioned by the Office of the National Coordinator for Health Information Technology (ONC) and carried out in the course of regular annual surveillance by the NCHS and by the American Hospital Association (AHA) provide further encouragement that EHR adoption is about to pick up speed.

The NCHS survey found that 41 percent of office-based physicians are currently planning to achieve meaningful use of EHRs and apply for incentive payments. Four-fifths of these, or about a third of all office-based physicians (32.4 percent), plan to apply this year.

The AHA survey found that 81 percent of acute care non-federal hospitals plan to achieve meaningful use of EHRs and apply for incentive payments. About two-thirds of hospitals (65 percent) plan to enroll during Stage 1 of the Incentive Programs, in 2011-2012.

At ONC we are gratified that such sizeable percentages of physicians and hospitals intend to take the plunge—and to take the plunge sooner rather than later.

Acting early (in Stage 1) means obtaining maximum funding through the Medicare and Medicaid EHR Incentive Programs. Physicians and other eligible professionals can qualify for incentive payments totaling as much as $44,000 through Medicare or $63,750 through Medicaid. Hospitals can qualify for millions of dollars of incentive payments for implementing and becoming meaningful users of EHR technology.

The registration process is now open for health care providers to obtain significant incentive payments for the adoption and meaningful use of certified EHRs.

We recognize that EHR adoption and meaningful use are hard work and a big investment, especially for small primary care practices, where the vast majority of physicians work and where most of patient care is coordinated and documented. Many of these providers still need to learn about the opportunity they have.

Now is the time. Unprecedented resources, including the EHR incentive and technical assistance programs created under HITECH, are available. Sixty-two Regional Extension Centers (RECs) across the nation are prepared to offer customized, on-the-ground assistance. And the Health IT Workforce Development Program is training talented professionals to help providers implement and manage their health IT systems. Moreover, medical and hospital professional organizations are lighting the way.

Rest assured there are also regulations in place to make sure that information stored in an EHR is protected. The same Health Insurance Portability and Accountability Act (HIPAA) privacy and security protections that apply to paper records also apply to EHRs.

Never again will the same level of resources and talent be devoted to helping providers make the switch to health IT.

The incipient surge in EHR adoption is galvanizing, especially for those of us who are committed to making the transition from paper-based medical records to EHRs as seamless and as successful as possible for every provider. ONC will continue to offer encouragement and support.

For more information on the Medicare and Medicaid EHR Incentive Programs, visit http://www.cms.gov/EHRIncentivePrograms. Providers can also find REC contact information at http://healthit.hhs.gov/rec. Learn about the HIPAA Privacy and Security Rules by visiting http://www.hhs.gov/ocr/privacy/.

Warmest Regards,

David Blumenthal, MD, MPP
National Coordinator for Health Information Technology

The Office of the National Coordinator for Health Information Technology (ONC) encourages you to share this information as we work together to enhance the quality, safety and value of care and the health of all Americans through the use of electronic health records and health information technology.

For more information and to receive regular updates from the Office of the National Coordinator for Health Information Technology, please subscribe to our Health IT News list.

8 of 10 Hospitals, 4 of 10 Physicians Plan to Adopt Electronic Health Records; Reversal of Trends

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Surveys show significant proportions of hospitals and doctors already plan to adopt electronic health records and qualify for federal incentive payments
2/3 of Hospitals Plan to Enroll During Stage 1, 2011-2012
HHS Press Release
Thursday, January 13, 2010

Four-fifths of the nation’s hospitals, and 41 percent of office-based physicians, currently intend to take advantage of federal incentive payments for adoption and meaningful use of certified electronic health records (EHR) technology, according to survey data released today by the Office of the National Coordinator for Health Information Technology (ONC).  The survey information was released as the registration period opened for the Medicare and Medicaid EHR Incentive Programs.

David Blumenthal, M.D., M.P.P., the National Coordinator for Health Information Technology, said the survey numbers represent a reversal of the low interest in EHR adoption in previous years.  He credited leadership from the medical community and the federal government for the improved prospects for adoption and use of health information technology (health IT).

“For years we have known that electronic health records would improve care for patients and bring about greater cost effectiveness in our health sector, yet adoption rates by health care providers remained low,” Dr. Blumenthal said.  “In 2009, Congress and the President authorized major new federal support for EHR adoption and use, and in combination with medical professional and hospital leadership. I believe we are seeing the tide turn toward widespread and accelerating adoption and use of health IT.”

The data released today comes from surveys commissioned by ONC and carried out in the course of regular annual surveillance by the American Hospital Association (AHA) and the National Center for Health Statistics (NCHS), an agency of HHS’ Centers for Disease Control and Prevention (CDC).

The AHA survey found that 81 percent of hospitals plan to achieve meaningful use of EHRs and take advantage of incentive payments.  About two-thirds of hospitals (65 percent) responded that they will enroll during Stage 1 of the Incentive Programs, in 2011-2012.

The NCHS survey found that 41 percent of office-based physicians are currently planning to achieve meaningful use of certified EHR technology and take advantage of the incentive payments.  Four-fifths of these, or about a third of all office-based physicians (32.4 percent), responded that they will enroll during Stage 1 of the programs.  Only 14 percent of respondents said they were not planning to apply for meaningful use incentives.

Additional survey data from NCHS show that significantly increasing numbers of primary care physicians have already adopted a basic EHR, rising by 50 percent from 19.8 percent of primary care physicians in 2008 to 29.6 percent in 2010.  Basic EHRs provide a beginning point for use of electronic health records in physician offices, but most physicians would need to further upgrade their EHR systems or their use of the systems in order to qualify for meaningful use incentive payments.

Incentive payments for the adoption and meaningful use of certified EHR technology were authorized in the Health Information Technology Economic and Clinical Health Act (HITECH) in 2009.   Incentive payments will be made through the Medicare and Medicaid programs.  High rates of adoption and meaningful use could result in as much as $27 billion in incentive payments over 10 years.

Non-hospital-based physicians and other eligible professionals can obtain incentive payments of as much as $44,000 under Medicare or $63,750 under Medicaid.  Under both Medicare and Medicaid, eligible hospitals may receive millions of dollars for implementing and meaningfully using certified EHR technology.

Provider registration for the Medicare EHR Incentive Program and some Medicaid EHR Incentive Programs opened Jan. 3, 2011.  Most states will allow provider registration to begin for their Medicaid EHR Incentive Programs during the spring and summer of 2010.

“We are pleased to see this evidence of an enthusiastic early response, and we believe participation will continue to grow, especially as the Nation’s physicians become more familiar with this one-time opportunity to improve care while helping to offset the costs of adopting EHR systems,” said Donald Berwick, M.D., Administrator of the Centers for Medicare & Medicaid Services (CMS).

To qualify for incentive payments, under the Medicare EHR Incentive Program, providers must achieve meaningful use of certified EHR technology, under regulations issued by CMS and ONC.  Medicaid providers can receive their first year’s incentive payment for adopting, implementing, and upgrading certified EHR technology but must demonstrate meaningful use in subsequent years in order to qualify for additional payments.

Dr. Blumenthal said the meaningful use process has contributed to the increased willingness of providers to adopt EHR systems, especially because it guides providers through staged objectives for the productive use of EHRs, and because providers can now be assured that Complete EHRs and EHR Modules certified under ONC criteria by ONC-authorized testing and certification bodies can be relied upon to support the meaningful use objectives.

He also pointed to the technical support programs created under the HITECH Act and now operating under ONC, which offer support to providers as they switch from paper records to EHRs.  In particular, 62 Regional Extension Centers (RECs) across the nation will offer customized, on-the-ground assistance, especially for smaller-practice primary care providers and for small hospitals and clinics.

“We know that adoption of EHRs and conversion to EHR-based care is expensive and challenging, especially for smaller providers,” Dr. Blumenthal said.  “With HITECH, we are able to provide unprecedented funding and technical support programs to help providers make the transition and to help our nation achieve the improvements in health care quality, safety and cost effectiveness EHRs will bring about.”

Dr. Blumenthal also praised medical professional organizations and hospital leaders, who have encouraged members to act soon in taking advantage of HITECH support programs and adopting EHR systems.

Survey results from NCHS  and AHA can be obtained at :

http://www.cdc.gov/nchs/data/hestat/emr_ehr_09/emr_ehr_09.htm

http://www.ahadata.com/ahadata/html/AHASurvey.html

Information about the incentive payments program is available on the CMS website at http://www.cms.gov/ehrincentiveprograms.

Information about Regional Extension Centers (RECs) and technical assistance is available on the ONC website at http://healthit.hhs.gov/REC.

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State Medicaid EHR Programs’ Expected Rollout Dates Released by CMS

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Going Beyond the January and February 2011 State Medicaid EHR Incentive Program Rollout Dates and Web sites
Beyond the rollout dates of January and February 2011 for 14 state Medicaid EHR Incentive Programs, Centers for Medicare and Medicaid Services (CMS) released the anticipated dates for the program to go live in the balance of the states and territories as of December 15, 2010. State and territory Medicaid information sites are also shown.

The CMS EHR Incentive Programs Spotlight Page listed the states that will have their State EHR Medicaid programs ready in the first two months of 2011.

Registration opens in the following states on January 3, 2011:

  • Alaska
  • Iowa
  • Kentucky
  • Louisiana
  • Oklahoma
  • Michigan
  • Mississippi
  • North Carolina
  • South Carolina
  • Tennessee
  • Texas

Registration opens in the following states in February 2011:

  • California
  • Missouri
  • North Dakota

List of all states and territories with expected dates they reported to CMS when they anticipate their state/territory Medicaid EHR programs to be ready. [The list in PDF form was dated December 15, 2010, and was included in 1/3/2011 update of a CMS FAQ on how dual eligible (Medicare and Medicaid) hospitals should register.]

“The Medicaid EHR Incentive Program is a voluntary program established by Congress, but administered individually by each State and territory. While we currently estimate that every State will have an Incentive Program in the future, the preparation for the program varies from State to State. Below is the estimated date each State [and territory] intends to begin accepting registrations for their Medicaid EHR Incentive Program. These dates are provided to CMS by the States, and this list is updated monthly. Even States that are listed as “Unknown” are progressing toward program launch; however, they have not provided CMS with an estimated launch date [as of December 15, 2010].”

State EHR Medicaid Registration Dates and Web sites

State Expected Launch Date Program URL
AK January 2011 http://hss.state.ak.us/hit/
AL March 2011 http://www.onehealthrecord.alabama.gov/
AR Spring 2011 https://www.medicaid.state.ar.us/provider/arra.aspx
AS Unknown No State URL Known
AZ Unknown http://www.azahcccs.gov/HIT/about/Incentives.aspx
CA February 2011 http://medi-cal.ehr.ca.gov/
CO Unknown http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1251581838726
CT Unknown http://www.ct.gov/dph/cwp/view.asp?a=3936&q=462912&dphNav_GID=1993
DC Unknown No State URL Known
DE Spring 2011 http://dhss.delaware.gov/dhss/dmma/ehr_summary.html
FL Unknown http://fhin.net/FHIN/MedicaidElectronicHealthRecordIncentiveProgram.shtml
GA Unknown http://dch.georgia.gov/00/article/0,2086,31446711_154959664_156789923,00.html
GU Unknown http://dphss.guam.gov
HI Unknown http://www.med-quest.us/providers/ElectronicHealthRecordIncentiveProgram.html
IA January 2011 http://www.ime.state.ia.us/Providers/EHRIncentives.html
ID Fall 2011 http://www.MedicaidEHR.dhw.idaho.gov
IL late Spring 2011 http://www.hie.illinois.gov/ehrincentives/
IN Mid-2011 http://provider.indianamedicaid.com/general-provider-services/ehr-incentive-program.aspx
KS June 2011 http://www.khpa.ks.gov/hite/default.htm
KY January 2011 http://chfs.ky.gov/dms/EHR.htm
LA January 2011 http://www.lamedicaid.com/provweb1/EHR/EHRIndex.htm
MA Unknown No State URL Known
MD Unknown http://mhcc.maryland.gov/electronichealth/electronichealth.html
ME August 2011 http://www.maine.gov/dhhs/oms/HIT/index.html
MI January 2011 http://michiganhealthit.org/
MN Fall 2011 http://www.health.state.mn.us/e-health/hitech.html
MO February 2011 http://www.dss.mo.gov/mhd/ehr/
MP Unknown No State URL Known
MS January 2011 http://ms.arraincentive.com/
MT Spring 2011 http://medicaidprovider.hhs.mt.gov/providerpages/ehrincentives.shtml
NC January 2011 http://www.ncdhhs.gov/dma/provider/ehr.htm
ND February 2011 http://www.healthit.nd.gov/medicaid
NE Fall 2011 http://www.dhhs.ne.gov/med/EHR.htm
NH Winter 2011/2012 http://www.NHMedicaidHIT.org
NJ Unknown No State URL Known
NM Unknown http://www.hsd.state.nm.us/mad/MeiPP.html
NV Summer 2011 https://dhcfp.nv.gov/EHRIncentives.htm
NY September 2011 http://www.health.ny.gov/regulations/arra/department_of_health_programs.htm#health_it
OH Unknown http://grc.osu.edu/MPIP
OK January 2011 http://www.okhca.org/EHR-incentive
OR Summer 2011 http://www.oregon.gov/DHS/mhit/incentive.shtml
PA Unknown http://www.dpw.state.pa.us/provider/healthcaremedicalassistance/medicalassistancehealthinformationtechnologyinitiative/index.html
PR Unknown
RI June 2011 http://www.dhs.ri.gov/Portals/0/Uploads/Documents/Public/MA_Providers/ehr_incentive_prg.pdf
SC January 2011 http://hit.scdhhs.gov/hit/
SD Fall 2011 http://www.dss.sd.gov/medicalservices/incentiveprogram/
TN January 2011 http://www.tn.gov/tenncare/hitech.html
TX January 2011 http://www.tmhp.com/Pages/HealthIT/HIT_Home.aspx
UT September 2011 http://health.utah.gov/medicaid/provhtml/HIT.htm
VA Fall 2011 http://dmasva.dmas.virginia.gov/Content_pgs/pr-arra.aspx
VI Unknown No State URL Known
VT Unknown http://hcr.vermont.gov/cms_meaningful_use
WA April 2011 http://hrsa.dshs.wa.gov/MedicaidHealthCareReform/IT.shtml
WI Unknown http://www.dhs.wisconsin.gov/ehrincentive/
WV Unknown No State URL Known
WY Summer 2011 http://www.wyominghit.com/

As of December 15, 2010.

Blumenthal Blogs on HIT Taskforce Guidance on Federal Health IT

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HIT Taskforce Guidance on Health IT
Friday, January 7th, 2011 | Posted by: Dr. David Blumenthal, National Coordinator for Health IT on ONC’s Health IT Buzz blog and reposted here by e-Healthcare Marketing.

In September 2010, Vivek Kundra, the Federal Chief Information Officer, and I issued guidance articulating five key health IT policy and technology principles for Federal health IT projects. The goal of these principles is to encourage better strategic alignment of health IT investments by guiding modernization strategies for existing systems, as well as new investment decisions. Agencies were asked to demonstrate how they plan to incorporate the following policy and technology principles into future health IT investments and to provide specific examples from their fiscal year (FY) 2012 budget submissions:

  • Improving health and health care: Agencies should design their health IT systems to support clinical decision-making and to measurably improve long term outcomes. For FY 2012, agencies will be asked to demonstrate their support for the universal attainment of Meaningful Use either by, if eligible, becoming Meaningful Users themselves or by assisting and encouraging others that are eligible, to become Meaningful Users.
  • Promoting open government: Agencies should share information with their clients/patients, when possible and practicable. An FY 2012 priority is providing clients/patients a secure, timely, electronic copy of their own information in a format they can use and reuse.
  • Securely sharing health information between providers for treatment purposes to enable better care: Agencies should ensure Federal HIT systems are interoperable.  In FY 2012, agencies should use standards and specifications adopted under the HITECH Act in communicating between applications and organizations.
  • Being a trusted steward of taxpayer dollars: Agencies should incorporate interoperable voluntary consensus standards and terminologies where available, and contribute to their ongoing development, as their missions provide for and their resources permit. To this end, FY 2012 investments should use and re-use common, interoperable voluntary consensus standards and terminology, as well as employ modular, flexible solutions to ensure health IT systems are built for re-use and evolution.
  • Protecting privacy and security: Agencies should align their health IT investments with the Fair Information Practice Principles and demonstrate this alignment in FY 2012.

Following submission, agency plans underwent a rigorous peer review process, and representatives from HHS, Department of Agriculture, Department of Commerce, Department of Defense, Department of Veterans Affairs, Social Security Administration, and Office of Personnel Management took an active role in evaluating the investments of the various Federal counterparts.

The development of principles and the use of peer review to review Federal health IT expenditures constitute a novel basis for coordinating these expenditures and providing the best possible advice to sister agencies.  In the future, we hope that this process will result in valuable learning for managers of health IT in the Federal Government, and lead to better value for patients and taxpayers.
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