Federals at HIMSS12 Annual Conference & Exhibition
February 20-24, 2012 · Las Vegas, NV
Accessed and excerpted from HealthIT.gov on Feb 18, 2012

Representatives from ONC, Centers for Medicare & Medicaid Services (CMS), Office for Civil Rights (OCR), and other Federal agencies will be at HIMSS to share information about their health IT initiatives. Below are highlights from the HIMSS schedule of events. For a complete list of participating Federal agencies and their educational sessions, visit the Federal section of the HIMSS12 website.

HIMSS Schedule of Events

Theater Booth Sessions – Exhibit Hall, Booths 14624/14824

CMS and ONC will be presenting on special topics in health IT and meaningful use at the theater booth in the HIMSS exhibit hall.

ONC “Talk to the Expert” Sessions – Exhibit Booth #14824

ONC will be hosting “Talk to the Expert” sessions at its exhibit booth. Stop by to learn about:

• ONC resources
• Certification and Standards/Interoperability
• ONC’s Regional Extension Centers, Beacon, and Workforce programs.

Engage with ONC during the Conference Online

During HIMSS, ONC will be engaging people online through its social media properties by:

• Hosting discussions on LinkedIn
• Tweeting live from the event
• Loading all of their handouts from the conference on Scribd

If you are not already a member of our LinkedIn group, or following us on Twitter (@ONC_HealthIT), sign up today to join the discussion!

Don’t forget to check out Scribd to download handouts from HIMSS!

For More Information

• HIMSS12 website

David Muntz, MBA, FCHIME, CHCIO
Principal Deputy National Coordinator

David Muntz, FCHIME, CHCIO

Muntz was  Senior Vice President and Chief Information Officer for the Baylor Health Care System in Dallas and a 38-year veteran of medical information systems. According to the ONC Description of Organizational Structure and Offices, the “Principal Deputy National Coordinator works with and reports directly to the National Coordinator and is responsible for day-to-day operations, decision making, and staff management of ONC. The Principal Deputy will oversee the activities of four offices within ONC: Office of the Deputy National Coordinator for Programs and Policy; Office of the Deputy National Coordinator for Operations; Office of Economic Analysis, Evaluation and Modeling; and, Office of the Chief Scientist. One of the current ONC offices, the Office of the Chief Privacy Officer, is a position mandated by the American Recovery and Reinvestment Act of 2009, and will continue to report to the National Coordinator.”

According to a press release issued in conjunction with 2010 National Health IT Week,  “David Muntz, a 37-year veteran of Medical Information Systems, is Senior Vice President and Chief Information Officer for the Baylor Health Care System in Dallas. As CIO, Mr. Muntz is responsible for more than 650 employees who care for a delivery system with more than 140 points of entry. Mr. Muntz works closely with hospitals, leadership, boards, physicians, nurses and clinicians system-wide toward improving information technology at Baylor. Since he joined Baylor in 2006, the hospital has received notoriety in healthcare IT, most notably as the #1 innovator in the healthcare sector on the 2007 Information Week 500 list.

“Mr. Muntz is a Fellow of the College of Healthcare Information Management Executives (CHIME) and currently serves on the CHIME Board of Trustees, Advocacy Leadership Team, and Policy Steering Committee. Also an active member of the Health Information and Management Systems Society (HIMSS), he has been a speaker for  numerous local, state, and national organizations. He was recognized as CIO Innovator of the Year by CHIME in 2005 and was listed as one of the “Top 5 CIOs” in the June 1999 issue of Health Management.

“Prior to Baylor, Mr. Muntz most recently served as the Senior Vice President and CIO at Texas HealthResources, where he was responsible for all information system functions including Medical Records. While working for Texas Health Resources, Muntz’s information services organization received national recognition nine years in a row. Mr. Muntz also had a distinguished career with the Wadley Research Institute and Blood Bank, starting as a biostatistician and eventually becoming CEO of the Institute. During his tenure with Wadley, Mr. Muntz led the team that created a complete online record for the community’s blood bank. In addition, Wadley’s other divisions, the hospital, clinic,
and physician practices, shared a computer based patient record created by Mr. Muntz and his staff.

“Mr. Muntz holds an MBA from Southern Methodist University in Dallas and an AB degree in Premedicine and English from Columbia College in New York City.”

Judy Murphy, RN, FACMI, FHIMSS, FAAN
Deputy National Coordinator for Programs and Policy

Judy Murphy, RN, FACMI, FHIMSS, FAAN

According to the ONC Web site, “Judy Murphy is Deputy National Coordinator for Programs & Policy at the Office of the National Coordinator for Health IT, Department of Health and Human Services in Washington D.C.  She is a nurse, who came to the ONC in December of 2011 with more than 25 years of health informatics experience at Aurora Health Care in Wisconsin, an integrated delivery network with 15 hospitals, 120 ambulatory centers, home health agencies and over 30,000 employees.  She led the EHR program since 1995, when Aurora was one of the early adopters of health IT.  Most recently she was Vice President-EHR Applications, and managed the organization’s successful achievement of Stage 1 EHR Meaningful, with incentive payments beginning in September 2011.

ONC Organization Chart
ONC Posts New Organizational Chart Dated Nov 16, 2011.

Description of Organizational Structure and Offices

The Office of the National Coordinator for Health Information Technology (ONC) is directed by the National Coordinator and is assisted by the Chief Privacy Officer, Health Care Reform Coordinator, and Principal Deputy National Coordinator as well as the Deputy National Coordinator for Operations, Deputy National Coordinator for Programs & Policy, Chief Scientist, and the Office of Economic Analysis, Evaluation and Modeling.

The Office of the Chief Privacy Officer, a position mandated by the Recovery Act, advises on privacy, security, and data stewardship of electronic health information and coordinate ONC’s privacy and related efforts with similar privacy officers in other Federal agencies, State and regional agencies, and foreign countries.

Health Care Reform Coordinator is the principal advisor to the National Coordinator for all Health Reform issues. The coordinator ensures the programs to accelerate adoption of interoperable health IT lay the necessary foundation for health care reform including new payment policy that achieves better care, better health, and lower costs.

Principal Deputy National Coordinator works with and reports directly to the National Coordinator and is responsible for day-to-day operations, decision making, and staff management of ONC. The Principal Deputy will oversee the activities of four offices within ONC: Office of the Deputy National Coordinator for Programs and Policy; Office of the Deputy National Coordinator for Operations; Office of Economic Analysis, Evaluation and Modeling; and, Office of the Chief Scientist. One of the current ONC offices, the Office of the Chief Privacy Officer, is a position mandated by the American Recovery and Reinvestment Act of 2009, and will continue to report to the National Coordinator.

The Office of Economic Analysis and Modeling provides analyses to the National Coordinator, including advanced modeling of the U.S. health care system for simulating the micro- and macroeconomic effects of investing in health IT.

The Office of the Chief Scientist is responsible for research and for identifying innovations in information technology that can be applied in health care settings, and which will be the ONC interface for international activities.

The Office of the Deputy National Coordinator for Programs and Policy assumes functions previously performed by the Office of Health Information Technology Adoption, the Office of Interoperability and Standards, the Office of Adoption Provider Support, the Office of State and Community Programs, and the Office of Policy and Planning. The new office will lead ONC programs related to health information exchange, regional extension centers, training of the health IT workforce, and the development of technical standards for interoperability, security, and certification of health IT systems. The new office comprises:

• The Office of Standards and Interoperability, with responsibility for standards, security, certification, the Nationwide Health Information Network, Federal Health Architecture and the CONNECT program;

• The Office of Provider Adoption Support, which administers the Regional Extension Centers program and health IT workforce development;

• The Office of State and Community Programs, which administers the state-level health information exchange program and the Beacon Communities Program; and

• The Office of Policy and Planning, which is realigned to include all policy development, including privacy and security policy, and is liaison with legal affairs and legislative affairs, regulations development and externally focused strategic planning.

Deputy National Coordinator for Operations is responsible for activities that are vital to supporting ONC’s numerous programs and enhancing ONC’s ability to communication about health IT. This office comprises:

• The Office of Communications, which is responsible for stakeholder communications and constituency relations; and
• The Office of Mission Support, which supports day-to-day operations, including new grants processing, contracts management, budget execution and reporting, human resources, as well as internal strategic planning, special projects, and budget formulation; and
• The Office of Oversight, which assures oversight of grants, internal and external performance reporting, and auditing; and
• The Office of Grants Management, which is responsible for carrying out full lifecycle grants management functions and providing procedural and technical business support to ONC grant award recipients and program managers. The office is charged with awarding and managing ONC’s portfolio of grant programs. Through the execution of the grants lifecycle, the office ensures that federal grant funds are properly awarded and are managed effectively to ensure good stewardship of taxpayer dollars.

DIRECTORY as of 1/9/2012
Farzad Mostashari, MD, ScM
National Coordinator for Health Information Technology

Quick Note: This is one of many blog posts that I will be writing in September that highlights how innovation leadership within the health IT and health care communities is changing the health IT landscape. I’ll cover efforts being championed within the White House, ONC/HHS, and the broader environment, that are helping to usher in a wave of new technologies and services that will lead to better health care, health, and cost savings through continuous quality improvement.

Proof of Concept Testing – Connecting Early Stage Innovators to Stakeholders

One of the more exciting initiatives taking place is a unique effort to unite early stage innovators with the broader ecosystem to shepherd and nurture new technological development.

One of the greatest challenges facing any health care innovator is to develop ideas with the broader environment – working with a myriad of stakeholders in an appropriate manner to obtain the crucial data needed to validate the effectiveness, value, and strategy tied to the innovation. I’m referring to getting to the critical stage known as the proof-of-concept.

New White House Startup America Initiative

Realizing that getting to this stage requires substantial time and resources, I’m pleased to report that the White House Startup America Initiative, in partnership with HHS, is promoting an effort called Innovation Exchanges for Health IT – a model that promotes facilitated forums that assemble a collection of early stage, near-proof-of-concept innovators with forward looking health care organizations.  The explicit goal of this program is to identify opportunities for testbeds to support innovative development.  This is a first-of-a-kind initiative that helps to cross stakeholder lines in the interest of innovation.

The benefits of these proof-of-concept exchanges are apparent:

• Health care organizations that participate can identify potential future developers that they wish to collaborate with from a host of candidates in a single day, substantially lowering their search costs.
• Innovators can find potential partners by presenting to a dozen organizations at once – saving precious time and accelerating their development timelines.

While not meant to be a commercial opportunity, participants are free to identify scope and duration of their collaborations.

More Innovation Events Scheduled

The first Innovation Exchange for Health IT took place in Philadelphia earlier this year, under the leadership of BluePrint Health IT.   We’ll see at least three more events taking place in Indianapolis (October), San Francisco (September), and in the New England area (October) sponsored by a variety of organizations.

As I’ve noted before, community building is an essential step in the innovation process.  These exchanges are an attempt to provide the opportunity to forge the relationships needed to sustain those communities.

Feel free to contact me if you would like to participate in a future exchange.

Wil Yu, Special Assistant, Innovations (wil.yu@hhs.gov)

Accessed on June 16, 2011 and excerpted from eHealth Initiative.
The 2011 National Forum on Health Information Exchange will take place Thursday, July 14, 2011 at the Omni Shoreham Hotel in Washington DC. The HIE Forum will convene healthcare leaders from across the 50 states to discuss the challenges and best practices needed to achieve sustainable national health information exchange. It will also coincide with the release of the 2011 eHI HIE Survey. Interactive panels comprised of health information exchange experts who are in the field will be the primary focus of the event. The majority of the event will include question and answer sessions for audience members.

Transforming Healthcare Through Analytics

Analytics is one of the most exciting and promising areas for HIE innovation. HIEs can provide in-depth analytics to help providers manage patients, control costs and improve quality. Analytics can be used for predictive modeling, real-time point of care decision support, managing population health, quality reporting and comparative effectiveness research. This panel will include payers and HIEs that have experience working in this area.

How HIEs can Work with the Direct Project

This panel will explore the implementation challenges associated with the Direct Project, as well as the potential benefits that can be derived from it. The group will discuss how the Direct Project will help providers and hospitals qualify for meaningful us and encourage health information exchange. Additionally, Providers, patients, and other stakeholders in the delivery of healthcare across the country can be connected through the infrastructure of the Nationwide Health Information Network (NwHIN). While NwHIN is not a physical network, HIEs are moving towards using the standards, SSA disability determination, justifications, and other protocols set by NwHIN.

Insurance Exchanges and HIE: Coordinating Efforts for Success

Following the passage of health reform, states are now in the process of creating health insurance exchanges. Both HIE and Insurance Exchanges require significant effort, resources and focus. Coordination and competing for resources is a challenge. This panel will examine the efforts underway in several states.

Getting to Meaningful Use Through HIE

In preparation for Stage 2 of Meaningful Use, providers and hospitals must begin to prepare for increasing HIE requirements. HIEs will need to determine how they can support hospitals and providers in meeting the new requirements. Included in this topic will be immunization registries, and the stage 2 MU requirements.

Staying Alive in 2011: Different Revenue Models for Sustainability

Creating a sustainable business model remains the greatest challenge facing organizations. New models of sustainability have been suggested in the last couple of years, including utility models. Attaining sustainability is still an enormous hurdle. This panel will include speakers who use different revenue models. They will address best practices for HIE sustainability.

IT Infrastructure Required to Support ACO

With the advent of Accountable Care Organizations, health information exchange is even more critical. ACOs will need to coordinate care, manage patient health, and track administrative data. Panelists will discuss established HIEs can position themselves to support ACOs.

AGENDA for National Forum on HIE: July 14, 2011
Excerpts. For complete agenda, click here.
To register, click here.

7:00 AM Registration Exhibit Hall Open – Breakfast and Networking

8:30 – 9:00 AM Welcome, Overview and 2011 HIE Survey Key Findings  Jennifer Covich Bordenick, Chief Executive Officer, eHealth Initiative

9:00 – 9:30 AM Keynote  Todd Park, Chief Technology Officer, Department of Health and Human Services Mr. Todd Park will present the keynote address at the 2011 National Forum on Health Information Exchange. In his role as CTO, he is responsible for helping HHS leadership harness the power of data, technology, and innovation to improve the health and welfare of the nation. He will discuss CMS data and how HIEs can use that data.

9:30 – 10:30 AM Transforming Healthcare Through Analytics  Sam Ho, EVP and CMO, United Healthcare (Invited) Dick Thompson, Executive Director of the Quality Health Network Carladenise Edwards, President and CEO, Cal eConnect Ahmed Ghouri, Chief Medical Officer, Anvita Health

10:30 – 11:00 AM Break

11:00 – 12:00 PM How HIEs can Work with the Direct Project  Arien Malec, Coordinator, Direct Project, ONC (Invited) Jeff Blair, Director of Health Informatics, New Mexico Health Information Collaborative John Blair, III, MD, President and CEO, Taconic IPA

12:00 – 1:00 PM Lunch

1:00 – 2:00 PM Insurance Exchanges and HIE: Coordinating Efforts for Success  Glen Shor, Massachusetts Insurance Exchange (Invited) Kim Davis – Allen, Alabama HIT Coordinator Edward Dolly, CISSP, Deputy Commissioner, State Health Information Technology Coordinator, West Virginia Bureau for Medical Services Steve Larsen, Director, Center for Consumer Information and Insurance Oversight, CMS (Invited)

2:00 – 3:00 PM Getting to Meaningful Use Through HIE  Zachery Jiwa, Louisiana HIT Coordinator Micky Tripathi, PhD, President and CEO, Massachusetts eHealth Collaborative Scott Afzal, HIE Program Director, CRISP Stephen Palmer, Director, Office of e-Health Coordination, Texas Health and Human Services Commission

3:00 – 3:30 PM Break

3:30 – 4:30 PM Staying Alive in 2011: Different Revenue Models for Sustainability  Paul Forlenza, Vice President of Policy, VITL Christopher M. Henkenius, Program Director, NeHII, Inc. Abigail Sears, CEO, OCHIN Doug Dietzman, Executive Director, Michigan Health Connect

4:30 – 5:30 PM IT Infrastructure Required to Support ACO  Moderator: Nam Vo, Senior Director of Healthcare Strategy, Oracle Phyllis Albritton, Executive Director, CORHIO

5:30 – 7:30 PM Reception

For latest and complete information on eHI National Forum, click here.

Investing in Innovations is a two-year contract with Capital Consulting Corporation and Health 2.0 that will disburse more than $1.9 million in prize money to competition winners in up to 30 challenges. Competition proposals will derive from internal ONC staff and fellow HHS agencies.

ONC believes that competitions have a number of potential benefits. Under the right circumstances, they may allow the government to:

• Establish an important goal without having to choose the approach or the team that is most likely to succeed;
• Pay only for results;
• Increase the number and diversity of the individuals, organizations, and teams that are addressing a particular problem or challenge of national or international significance;
• Stimulate private sector investment that is many times greater than the cash value of the award; and
• Further a Federal agency’s mission by attracting more interest and attention to a defined program, activity, or issue of concern.

The competitions will focus on innovations that support (1) the goals of HITECH and clearing hurdles related to the achievement of widespread Health IT adoption and meaningful use, (2) ONC’s and HHS’ programs and programmatic goals, and (3) the achievement of a nationwide learning health system that improves quality, safety, and/or efficiency of health care.

For questions relating to the Investing in Innovations program, please email Wil Yu.

Additional Resources

• Press Release
  • June 8, 2011
    HHS and the Office of the National Coordinator for Health Information Technology Introduce New Investing in Innovations (i2) Initiative

HHS and The Office of the National Coordinator for Health Information Technology introduce new Investing in Innovations (i2) Initiative
Press Release from Department of Health and Human Services on June 8, 2011

Washington, D.C. — The Office of the National Coordinator for Health Information Technology (ONC) announced today the Investing in Innovations (i2) Initiative – a bold new program designed to spur innovations in health IT. The program centers on prizes and competitions to accelerate the development of solutions and communities around key challenges in health IT.

This landmark initiative is the first Administration-wide program using prizes and challenges to advance an agency’s mission made possible by the America COMPETES Reauthorization Act of 2010, signed into law by President Obama on Jan. 4, 2011. The Act invests in innovation through research and development and seeks to improve the competitiveness of the United States.

As part of the initiative’s rollout, ONC has awarded nearly $5 million to the Capital Consulting Corporation (CCC) and Health 2.0 LLC, to fund projects supporting innovations in research and encouraging health IT development through open-innovation mechanisms like prizes and challenges.

“The initiative demonstrates ONC’s recognition of the importance of investing in innovations and provides a platform that will attract an expanded community of innovators to the full range of the agency’s programs.  It opens the door to new opportunities for open collaboration from a wide range of diverse individuals and organizations that will increase the national rate of innovation and adoption of health IT as we improve health care of all Americans,” said Farzad Mostashari, M.D., Sc.M., national coordinator for health information technology.

The i2 Initiative will consult stakeholders across the health care sector including hospitals, doctors, consumers, payers, states, employers, advocates, and relevant federal agencies to obtain direct input on execution and to build partnerships.

The core of the i2 Initiative is an effort to use prizes and challenges to facilitate innovation and obtain solutions to identified health IT challenges.  Recognizing the promise of prizes and challenges, the President has called on agencies to promote innovation by using such innovation tools to address intractable problems. The use of prizes and competitions is widely regarded as a powerful tool to attract innovators from all walks of life to address hard problems with the added benefit of only rewarding best-in-class work. The approach makes possible rapid response to emerging issues that are difficult to address with more traditional funding approaches.

Examples of health IT competition topics developed in consultation with CCC and Health 2.0 LLC, include the following:

• Applications that allow an individual to securely and effectively share health information with members of his or her social network;
• Applications that generate results for patients, caregivers, and/or clinicians by providing them with access to rigorous and relevant information that can support real needs and immediate decisions;
• Applications that allow individuals to connect during natural disasters and other periods of emergency; and
• Tools that facilitate exchange of health information while allowing individuals to customize the privacy allowances for their personal health records.

Another component of the i2 Initiative will support analysis of the current health IT environment in an effort to track and model clusters of innovation, while simultaneously identifying connections between disparate innovator communities.  The effort will identify technology development trends in a fast-moving sector to inform future advisory and policy-making activities.

Capital Consulting Corporation, Health 2.0 LLC, along with other contributors will help provide detailed and up-to-date analysis of relevant, emerging innovations and associated trends that will help ONC and other HHS agencies better understand these developments, as well as the issues that surround them.

ONC recognizes that policies that do not appropriately anticipate technological change can jeopardize success by potentially limiting competition and setting in stone inferior technologies. Accurate and timely information from this phase of the initiative will enable the Federal government to engage in methodical and strategic health IT policies.

“Through the i2 Initiative, ONC is directly supporting innovation in health IT to accelerate the nation’s progress toward a high-performing, adaptive health care system,” said Wil Yu, the special assistant for innovations within ONC.

For more information please visit ONC’s home page at http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__onc/1200.

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HHS and The Office of the National Coordinator for Health Information Technology introduce new Investing in Innovations (i2) Initiative
Press Release from US Department of Health and Human Services on June 8, 2011

Washington, D.C. — The Office of the National Coordinator for Health Information Technology (ONC) announced today the Investing in Innovations (i2) Initiative – a bold new program designed to spur innovations in health IT. The program centers on prizes and competitions to accelerate the development of solutions and communities around key challenges in health IT.

This landmark initiative is the first Administration-wide program using prizes and challenges to advance an agency’s mission made possible by the America COMPETES Reauthorization Act of 2010, signed into law by President Obama on Jan. 4, 2011. The Act invests in innovation through research and development and seeks to improve the competitiveness of the United States.

As part of the initiative’s rollout, ONC has awarded nearly $5 million to the Capital Consulting Corporation (CCC) and Health 2.0 LLC, to fund projects supporting innovations in research and encouraging health IT development through open-innovation mechanisms like prizes and challenges.

“The initiative demonstrates ONC’s recognition of the importance of investing in innovations and provides a platform that will attract an expanded community of innovators to the full range of the agency’s programs.  It opens the door to new opportunities for open collaboration from a wide range of diverse individuals and organizations that will increase the national rate of innovation and adoption of health IT as we improve health care of all Americans,” said Farzad Mostashari, M.D., Sc.M., national coordinator for health information technology.

The i2 Initiative will consult stakeholders across the health care sector including hospitals, doctors, consumers, payers, states, employers, advocates, and relevant federal agencies to obtain direct input on execution and to build partnerships.

The core of the i2 Initiative is an effort to use prizes and challenges to facilitate innovation and obtain solutions to identified health IT challenges.  Recognizing the promise of prizes and challenges, the President has called on agencies to promote innovation by using such innovation tools to address intractable problems. The use of prizes and competitions is widely regarded as a powerful tool to attract innovators from all walks of life to address hard problems with the added benefit of only rewarding best-in-class work. The approach makes possible rapid response to emerging issues that are difficult to address with more traditional funding approaches.

Examples of health IT competition topics developed in consultation with CCC and Health 2.0 LLC, include the following:

• Applications that allow an individual to securely and effectively share health information with members of his or her social network;
• Applications that generate results for patients, caregivers, and/or clinicians by providing them with access to rigorous and relevant information that can support real needs and immediate decisions;
• Applications that allow individuals to connect during natural disasters and other periods of emergency; and
• Tools that facilitate exchange of health information while allowing individuals to customize the privacy allowances for their personal health records.

Another component of the i2 Initiative will support analysis of the current health IT environment in an effort to track and model clusters of innovation, while simultaneously identifying connections between disparate innovator communities.  The effort will identify technology development trends in a fast-moving sector to inform future advisory and policy-making activities.

Capital Consulting Corporation, Health 2.0 LLC, along with other contributors will help provide detailed and up-to-date analysis of relevant, emerging innovations and associated trends that will help ONC and other HHS agencies better understand these developments, as well as the issues that surround them.

ONC recognizes that policies that do not appropriately anticipate technological change can jeopardize success by potentially limiting competition and setting in stone inferior technologies. Accurate and timely information from this phase of the initiative will enable the Federal government to engage in methodical and strategic health IT policies.

“Through the i2 Initiative, ONC is directly supporting innovation in health IT to accelerate the nation’s progress toward a high-performing, adaptive health care system,” said Wil Yu, the special assistant for innovations within ONC.

For more information please visit ONC’s home page at http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__onc/1200.

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If enough people believe something, it has to be true, right? In my travels, I’ve found that regulatory interpretations range from being largely factual to wildly fictitious. The latter often results from misinterpretations of regulatory language, improper combinations of regulatory language from different rules, or accurate interpretations getting lost in translation as they are passed from person-to-person. These inaccurate interpretations, intentional or not, often unsurprisingly lead to confusion. Accordingly, I thought it would be helpful to clear up a few things I’ve heard related to certification.

• Statement 1: If an eligible professional or eligible hospital combines multiple certified electronic health record (EHR) Modules together (or a certified EHR Module[s] with a certified Complete EHR), that combination also needs to be separately certified in order for it to meet the definition of Certified EHR Technology – *FICTION*
  • Part 2 of the definition of Certified EHR Technology acknowledges that a combination of certified EHR Modules can be used to meet the definition of Certified EHR Technology.  At 75 FR 2023, we clarified that as long as each EHR Module which makes up the combination has been certified, the definition could be met. See also FAQ 17.
  • Combining certified EHR Modules or certified EHR Modules with a certified Complete EHR (or even two certified Complete EHRs) will not invalidate the certification assigned to the EHR technologies. Each EHR technology retains the certification assigned to it.  Our FAQs (such as #7, #14, and #21) identify cases where combining certified Complete EHRs with other certified EHR Modules could occur without any negative effects.
  • Note, generating the “CMS EHR Certification ID” on ONC’s Certified HIT Products List (CHPL) for meaningful use attestation purposes is different. Using the CHPL, an eligible professional (EP) or eligible hospital (EH) generates a CMS EHR Certification ID (a unique alpha-numeric string) to report to CMS as part of its attestation. The CMS EHR Certification ID represents the combination of certified EHR Modules or other combination of certified EHR technologies that meet the definition of Certified EHR Technology and were used during the meaningful use reporting period.
• Statement 2: The ONC-Authorized Testing and Certification Bodies (ONC-ATCBs) operate under contract with and receive funding from ONC – *FICTION*
  • ONC-ATCBs do not receive funding from ONC to perform their ONC-ATCB duties.  ONC-ATCBs support their operations through testing and certification fees charged to Complete EHR and EHR Module developers.
  • The Temporary Certification Program Final Rule established certain responsibilities and rules for ONC-ATCBs.  ONC-ATCBs must fulfill these requirements and adhere to the rules in order to maintain good standing under the program. For example, ISO/IEC Guide 65 requires ONC-ATCBs to make their services accessible to all applicants (e.g., EHR developers) whose activities fall within its declared field of operation (e.g., the temporary certification program), including not having any undue financial or other conditions.
• Statement 3: Testing and certification under the Temporary Certification Program does not examine whether two randomly combined EHR Modules will be compatible or work together – *FACT*
  • ONC-ATCBs are not required to examine the compatibility of two or more EHR Modules with each other.  EHR Module developers, however, are free, and highly encouraged, to work together to ensure that EHR Modules are compatible. 
• Statement 4: The ONC-ATCBs favor big EHR technology developers – *FICTION*
  • The ONC-ATCBs do not favor large developers, and such favoritism is precluded by the international standards to which ONC-ATCBs must adhere.
  • As of June 3, 2011, 438 EHR technology developers were represented on the CHPL.  Of those, approximately 60 percent are small companies (<51 employees) and approximately 12 percent are large companies (>200 employees).
• Statement 5: Certification doesn’t require that an EHR technology designed by one EHR developer make its data accessible or “portable” to another EHR technology designed by a different developer – *FACT*
  • We are very interested in exploring future certification requirements to improve data portability.
  • If you have any insights on how to improve data portability between EHR technologies, please feel free to leave a comment below. 
• Statement 6: As an EP or EH, you need to demonstrate meaningful use in the exact way that EHR technology was tested and certified – *FICTION* (mostly)
  • See the jointly posted ONC and CMS FAQs (#24 or 10473) 
• Statement 7: Certifications “expire” every two years – *FICTION*
  • A certification represents a “snapshot.”  It indicates that EHR technology has met specific certification criteria at a fixed point in time. In other words, an EHR technology would not “lose its certification” after a given time period.  If, however, certification requirements change (e.g., new and/or revised certification criteria are adopted), the snapshot the certification represents would no longer accurately reflect that the EHR technology meets the changed requirements.
  • In our certification program rules, we indicated that we anticipated adopting new and/or revised certification criteria every two years to coincide with changes to the meaningful use objectives and measures under the Medicare and Medicaid EHR Incentive Programs. We did not, however, set a specific expiration for certifications.  Rather, we explained that once the Secretary adopts new and/or revised certification criteria, EHR technology may need to be tested and certified again. In other words, the previously taken snapshot would no longer accurately represent what is required to meet the adopted certification criteria and, thus, would no longer be sufficient to support an EP or EH’s ability to achieve updated meaningful use requirements.
  • For more information about the validity of a certification, please refer to the Temporary Certification Program final rule (75 FR 36188) and the Permanent Certification Program final rule (76 FR 1301).

As someone who has played a roll in drafting all of ONC’s regulations, I take pride in making our rules readily understandable and as easy to read as possible. Sometimes, though, no matter how hard we try to convey a regulation’s intent, there is always another believable interpretation. Hopefully, this blog helps clear up a few points and furthers your personal understanding of our rules.
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To post comments directly on ONC’s Health IT Buzz blog post, click here.

1. Pioneer ACO Model: will tap groups experienced in coordinated care working together loking in first two years for higher level of share savings and higher level of risk. By third year, if successful, the model will move to population-based model.

2. Advanced Payment Program: proposal to provide advance on shared savings with strong oversight.

3. Advanced Development Learning Sessions: four sessions proposed, starting June 20, 2011, with intense curriculums including executive teams to dive into what’s needed. First session on June 20 will focus on preparing for coordinated care opportunities.

More info to come later from CMS Innovation Center http://innovations.cms.gov and from the major news sources covering health IT and CMS. Will catch up later on this at e-Healthcare Marketing.

CONFERENCE CALL MAY 17, 2011: 1:30PM EDT
Emailed May 17, 2011 by CMS.

The Centers for Medicare & Medicaid Services (CMS) today announced three Affordable Care Act initiatives designed to help put doctors, hospitals and other health care providers on the path to becoming Accountable Care Organizations (ACO) and improve health care for Americans with Medicare.

First, the Center for Medicare and Medicaid Innovation (Innovation Center) is requesting applications for a new Pioneer ACO Model, which provides a faster path for mature ACOs that have already begun coordinating care for patients and are ready to move forward.

Second, the Innovation Center is seeking comment on the idea of an Advance Payment Initiative that give certain ACOs participating in the Medicare Shared Savings Program access to their shared savings up front, helping them make the infrastructure and staff investments crucial to successfully coordinating and improving care for patients.

Finally, providers interested in learning more about how to coordinate patient care through ACOs can attend free new Accelerated Development Learning Sessions.  The Accelerated Development Learning Sessions will teach providers interested in becoming ACOs what steps they can take to improve care delivery and how to develop an action plan for moving toward providing better coordinated care.

Together with the Medicare Shared Savings Program, the initiatives announced today give providers a broad range of options and support that reflect the varying needs of providers in embarking on delivery system reforms.  CMS issued a proposed rule to implement the Medicare Shared Savings Program in March 2011 and is continuing to encourage and accept comments from providers and the public that will help strengthen the final rule.

These initiatives are part of a broader effort by the Obama Administration, made possible by the Affordable Care Act, to improve care and lower costs.

For more information about the announcement, click here.

For a fact sheet, click here.

For additional information about all of these initiatives, visit the Innovation Center website.

Reminder -Please join us on Tuesday, May 17, 2011 for a conference call with Centers for Medicare and Medicaid Services (CMS) Administrator Donald Berwick and Center for Medicare and Medicaid Innovation (CMMI) Acting Director Dr. Richard Gilfillan to discuss new efforts to improve care for Medicare beneficiaries through Accountable Care Organizations.

WHO: Dr. Donald Berwick, Administrator, Centers for Medicare and Medicaid Services

Dr. Richard Gilfillan, Acting Director, CMS Innovation Center

Peter Lee, Deputy Director, CMS Innovation Center

WHEN: Tuesday, May 17, 2011,  1:30 PM EDT
DIAL:              1-800-837-1935
PASSCODE:  68658167

HIT Pro Competency Exams

In April 2010, ONC awarded $6 million in a two-year cooperative agreement to Northern Virginia Community College (NOVA) to develop health information technology (health IT) competency examinations for individuals completing short-term, non-degree training programs, and members of the workforce with relevant experience or others types of training. 

These competency examinations will enable health IT professionals, employers, and other stakeholders to assess their own health IT competency levels or the competency of their health IT staff members, as appropriate. The examinations may also be used by employers to identify training gaps and personnel needs integral to achieving meaningful use of electronic health information.

• Clinician/Practitioner Consultant [PDF - 129 KB]
• Implementation Manager [PDF - 129 KB]
• Implementation Support Specialist [PDF - 138 KB]
• Practice Workflow & Information Management Redesign Specialist [PDF - 135 KB]
• Technical/Software Support Staff [PDF - 132 KB]
• Trainer [PDF - 134 KB]

The test specialist Pearson Vue will hold each exam at one of  its 230 nationwide test centers (locate the nearest center ). Individuals taking the May exam will receive their results in the mail four-to-six weeks after they take it. The September exam will provide live scoring.

Individuals can make reservations to take exams with Pearson Vue either by telephone (888-944-8776) or online . At that point, individuals may cancel or reschedule their reservations up to 48 hours before the appointment. In the absence of an emergency, individuals who fail to make their appointment will be charged a fee and will lose the free voucher.

Free exam vouchers, enabling individuals to take their first exam at no cost, will be available for students trained through the Community College Consortia program and for other individuals with relevant experience, training, or education in health care or IT. Vouchers will be available soon through Pearson Vue’s Voucher Store and may be ordered by the following institutions:

• Members of the Community College Consortia
• Other accredited academic institutions
• State and local employment agencies
• Health care providers

For eligible professionals (EPs), incentive payments for the Medicare EHR Incentive Program will be made approximately four to eight weeks after an EP successfully attests that they have demonstrated meaningful use of certified EHR technology. However, EPs will not receive incentive payments within that timeframe if they have not yet met the threshold for allowed charges for covered professional services furnished by the EP during the year. Payments will be held until the EP meets the $24,000 threshold in allowed charges for calendar year 2011 in order to maximize the amount of the EHR incentive payment they receive. If the EP has not met the $24,000 threshold in allowed charges by the end of calendar year 2011, CMS expects to issue an incentive payment for the EP in March 2012 (allowing 60 days after the end of the 2011 calendar year for all pending claims to be processed). Payments to Medicare EPs will be made to the taxpayer identification number (TIN) selected at the time of registration, through the same channels their claims payments are made. The form of payment (electronic funds transfer or check) will be the same as claims payments.

Bonus payments for EPs who practice predominantly in a geographic Health Professional Shortage Area (HPSA) will be made as separate lump-sum payments no later than 120 days after the end of the calendar year for which the EP was eligible for the bonus payment.

Please note that the 90-day reporting period an EP selects does not affect the amount of the EHR incentive payments. The Medicare EHR incentive payments to EPs are based on 75% of the estimated allowed charges for covered professional services furnished by the EP during the entire payment year. If the EP has not met the $24,000 threshold in allowed charges at the time of attestation, CMS will hold the incentive payment until the EP meets the threshold as described above.

Medicare EHR incentive payments to eligible hospitals and critical access hospitals (CAHs) will also be made approximately four to eight weeks after the eligible hospital or CAH successfully attests to having demonstrated meaningful use of certified EHR technology. Eligible hospitals and CAHs will receive an initial payment and a final payment. Eligible hospitals and CAHs that attest in April can receive their initial payment as early as May 2011. Final payment will be determined at the time of settling the hospital cost report.

Please note that the Medicaid incentives will be paid by the States, but the timing will vary according to State. Please contact your State Medicaid Agency for more details about payment.

When will CMS begin to pay incentives to EPs, eligible hospitals, and CAHs for using certified…..