AHRQ Presents: Sustainable HIEs, Patient Empowerment, Transitions in Care

Posted on July 5, 2010 by Mike Squires

PDFs of Three Webinars Produced by AHRQ
and Released on Web June 18, 2010
These are all large files and take time to open.

Building and Maintaining a Sustainable Health Information Exchange: Experience from Diverse Care Settings: [PDF-1.49MB]
May 14, 2010

The Vanderbilt HIE Experience in Memphis
Mark Frisse, Vanderbilt University Medical Center

Health Information Exchange in Small Primary Care Practices: Someone Needs Needs to Say “Do It”
Patricia Fontaine, University of Minnesota

Delaware Health Information Network: Better Communicaation for Better Healthcare
Gina Perez, Advances in Management

A National Web Conference on Patient Empowerment: Leveraging Health IT for Patient Empowerment [PDF-3.73MB]
April 8, 2010

Leveraging Health Information Technology for Patient Empowerment
Christine A. Sinsky, Medical Associates Clinic and Health Plans

A Personalized Portal to Promote Patient-Centered Prevntive Care
Alex Krist, Virginia Commonwealth University

e-Coaching: Interactive Voice Response (IVR)-Enhanced Care Transition Support for Complex Patients
Christine S. Ritchie, University of Alabama at Birmington

A National Web Conference on Transitions in Care [PDF-1.07MB]
February 24, 2010

Transitional Care and Rehospitalization: Information Technology
Stephen Jencks, Independent Consultant In Health Care Safety

Project RED: The ReEngineed Discharge
Brian Jack, Boston University School of Medicine

Transitions in Care
Terry Field, University of Massachusetts Medical School

‘National Progress Report on eHealth’ Shows Significant Progress in Last 3 Years

Posted on July 4, 2010 by Mike Squires

eHealth Initiative Survey Identifies Challenges with Consumer Outreach and Understanding of Value
eHealth Initiative (eHI) issued the following press release on July 1, 2010.
WASHINGTON, DC – July 1, 2010 -Today, the eHealth Initiative (eHI) released the “National Progress Report on eHealth,” which tracks the progress of eHealth in the wake of the American Recovery and Reinvestment Act of 2009.

National Progress Report on eHealth 2010

The National Progress Report on eHealth includes a review of progress made over the last three years relative to strategies and actions proposed in a 2007 eHI report. Over one hundred individuals participated on committees charged with assessing progress in five focus areas: Aligning Incentives; Engaging Consumers; Improving Population Health; Managing Privacy, Security & Confidentiality; and, Transforming Care Delivery. The report highlights key trends, actions, and strategies that still need to be addressed.

The report reveals a number of high-level findings including:

Significant progress has been made over the last three years as a result of public and private sector initiatives. The American Recovery and Reinvestment Act (ARRA) was the key driver of progress.
Many providers are concerned about the lack of coordination across the government health and health information technology (HIT) initiatives.
More education and outreach to consumers about HIT and health information exchange (HIE) is required.
Knowledge and transparency of privacy and security policies will be the key to building consumer trust of HIT and HIE.

As part of the assessment process, eHI conducted an informal online survey to gauge perceptions of progress. The survey responses offer a snapshot about the eHealth landscape. Some findings include:

The majority of respondents believe significant progress has been made: 61 percent of respondents agree or strongly agree with the statement that significant progress has been made in the successful adoption and use of HIT since 2007.
The value of HIE is not clearly understood by the majority of respondents: 54.9 percent disagree or strongly disagree with the statement that the value of HIE is clearly understood.
The majority of respondents believe outreach to consumers about the value of EHRs and HIE is not effective: 66.6 percent disagree or strongly disagree with the statement that current outreach to consumers about the value of EHRs and HIE is effective.
The majority believe Regional Extension Centers and the National Health Information Technology Research Center (HITRC) will be vital to educating providers: 66.1 percent of respondents agree or strongly agree with the view that Regional Extension Centers and the HITRC will be vital to educating providers about adoption and meaningful use of HIT.

“Contributors to the report found that, while considerable progress has been made over the past three years, challenges remain,” noted Jennifer Covich Bordenick, eHealth Initiative’s Chief Executive Officer. “Coordinating public and private sector efforts, and communicating the true value of HIT and HIE to consumers will be critical as we move forward.”

As part of its work, the eHealth Initiative collected information on dozens of existing and new HIT initiatives occurring across the country. An online version of the current activities is available in the report and online.

The National Progress Report on eHealth was supported by the Commonwealth Fund, a private foundation supporting independent research on health policy reform and a high performance health system.

The report is available on the eHI website at: http://www.ehealthinitiative.org/

###

About eHealth Initiative
The eHealth Initiative (eHI) is an independent, non-profit, multi-stakeholder organization whose mission is to drive improvements in the quality, safety, and efficiency of healthcare through information and information technology (IT). eHI is the only organization that represents all of the stakeholders in the healthcare industry. eHI advocates for the use of HIT that is practical, sustainable and addresses stakeholder needs, particularly those of patients. For more information, visit http://www.ehealthinitiative.org/
# # #

Jennifer Lubell, HITS staff writer, reported July 2, 2010 in ModernHealthcare.com on National Progress Report,
“Electronic healthcare initiatives have made headway over the last several years, but health information technology remains an undervalued tool, a new report concludes.”

PwC CIO Survey: ‘Ready or not: On the road to meaningful use of EHRs and health IT’

Posted on July 3, 2010 by Mike Squires

Survey: eight in ten hospital CIO members of CHIME concerned they won’t meet standards in time
Pricewaterhouse Press Release of June 29, 2010 in full below.
NEW YORK, June 29, 2010 – A year and a half after the American Recovery and Reinvestment Act allocated billions of dollars to help hospitals and doctors purchase equipment to computerize patient medical records, even the most sophisticated hospitals in the country are struggling to qualify for the payments. Eight in 10 hospital chief information officers (CIOs) surveyed by PricewaterhouseCoopers LLP said they are concerned or very concerned they will not be able to demonstrate “meaningful use” of electronic health records (EHR) within the federally established deadline of 2015, according to a report entitled Ready or not: On the road to the meaningful use of EHRs and health IT, published today by PricewaterhouseCoopers’ Health Research Institute (HRI).

PricewaterhouseCoopers’ survey of 120 hospital CIOs who are members of the College of Healthcare Information Management Executives (CHIME) found:

Only half of the hospitals and health system CIOs surveyed say they will be prepared to meet the first set of meaningful use requirements and apply for incentive bonuses in 2011, the first year they are available.
CIOs interviewed for the report said they also were concerned about meeting later-stage requirements within the specified time frames. These requirements include (1) advancing care processes through decision support; (2) providing and populating patients’ personal health records; and (3) improving health outcomes through data-sharing outside their own organizations, such as with insurers, patients and other providers.

The promise of stimulus funding has accelerated EHR adoption and the collection of massive amounts of electronic health data as hospitals and physicians across the country race to meet eligibility requirements. But the existing infrastructure to support meaningful use of EHRs on a national health information superhighway is insufficient, according to the CIOs interviewed by PricewaterhouseCoopers.

“Healthcare organizations are building high-performance race cars to travel back country roads,” said Daniel Garrett, leader of the health information technology practice, PricewaterhouseCoopers. “Furthermore, we found many healthcare providers are mired in the complexity of incentive-rule criteria and may not be working toward longer-term goals for meaningful EHR usage. The bottom line is improved quality of care and patient safety, delivered more efficiently. Government leaders and health organizations need to give consideration to the ultimate goal as they work to finalize and meet guidelines for meaningful use.”

According to PricewaterhouseCoopers’ report, many hospitals are behind the curve on the path to meaningful use. The biggest barriers include:

Lack of clarity and a final ruling hinder meaningful use implementation. Guidelines for system certification were issued by the US Department of Health and Human Services on June 7, but final guidelines for meaningful use criteria are not expected until fall of 2010, leaving many CIOs and their vendors at an impasse. CIOs surveyed by PricewaterhouseCoopers are most concerned about reporting requirements. Ninety-four percent of CIOs said they are concerned they can’t meet government requirements about how to report meaningful use, and 92% are concerned about remaining lack of clarity in meaningful use criteria.
Shortage of skilled staff. There is a shortage of professionals in the labor market with the appropriate mix of skills to help integrate information technology usage into clinical, operational and administrative practices. The government predicts a shortfall of about 50,000 qualified health IT workers over the next five years. According to the report, hospitals are scrambling to hire additional staff, including clinicians with IT expertise and business skills.
Vendor readiness and fallout from consolidation are unclear. More than one-third of CIOs surveyed by PricewaterhouseCoopers said they are concerned or very concerned about vendor readiness overall. In particular, 44% of CIOs said they are concerned that the external vendors they rely on in health information exchanges (HIEs) are not prepared for meaningful use implementation. Recent merger and acquisition activity among EHR and IT vendors reflects serious efforts by technology suppliers to better position themselves for rapid deployment of systems and integration support.
Existing infrastructure capabilities are being questioned. Complex networking capabilities and increased bandwidth are needed to reliably handle the massive influx of data that needs to flow 24X7, and hospital CIOs are concerned about the unknown cost of maintaining back-up plans should the system go down and they have to revert to paper records.

Collaboration characterizes early adopters

According to PricewaterhouseCoopers, one of the keys to successful meaningful use of EHRs is getting buy-in early on from physicians and increasing the involvement of physicians and other clinicians in quality initiatives.

“Nowhere would the meaningful use of EHRs be more valuable than in a hospital emergency department, where it could mean life or death for a patient,” added Garrett. “Emergency department physicians aren’t eligible for stimulus incentives but their meaningful use of EHRs is crucial to the hospital and its patients. Hospitals that do not see the path to meaningful use of EHRs as part of a bigger transformational opportunity to improve healthcare quality could be on a long path toward meaningless use.”

PricewaterhouseCoopers’ CIO survey found distinct patterns of collaboration among hospitals and health systems furthest ahead in achieving meaningful use. The survey found:

Health systems that have connected with physicians, patients and health insurers around meaningful use are more likely to be ready to apply in 2011 for incentives. They are three times more likely to incorporate patient input, 87% more likely to work with health insurers and 63% more likely to assist physicians with regard to meaningful use than are those planning to apply for the first time after 2011.
Health systems that include patients in the planning for EHRs are more confident about meeting meaningful use requirements. Seventy-four percent of CIOs who had involved patients responded that they would be among those applying for stimulus incentives in 2011, compared with 50% of all hospitals and health systems surveyed. Yet, fewer than 20% of CIOs surveyed said their organizations are incorporating patient input into meaningful use initiatives.
Sixty-three percent of CIOs said their organizations are either already working with physicians around meaningful use issues or plan to do so within the next six months. Moreover, an overwhelming 88% responded that meaningful use is somewhat or very likely to increase the involvement of non-administrative physicians in quality initiatives.
Most health systems are missing out on opportunities to connect with health insurers around meaningful use. Only 6% of CIOs said meaningful use would improve alignment with health insurers over the next two years, and only 24% said it would improve alignment long-term. Academic medical centers appear most unclear about how they will work with health insurers around meaningful use; 81% of their CIOs said their organizations either do not plan to work with health insurers at all or do not know whether they will do so, compared with 47% among all hospitals.

“Success in achieving meaningful use standards hinges on closer integration with key constituents – physicians, health insurers and patients,” said Kelly Barnes, US leader, health industries, PricewaterhouseCoopers. “Meaningful use of EHRs is an ambitious goal that requires significant clinical, operational and cultural changes, and patients need to be at the center of all planning. Healthcare organizations have an opportunity to be listening much more closely to what patients are telling them they want and need, and through meaningful use of EHRs, they can deliver care in a more personalized, coordinated way.”

The PricewaterhouseCoopers report outlines five milestones that hospitals will have to meet to achieve meaningful use. These include: Governance and tone set by the top of the organization; a balance among competing priorities; forging new public-private and community partnerships; a decision to make patients the purpose; and collaborating with physicians and payers.

A full copy of the report Ready or not: On the road to meaningful use of EHRs and health IT is available at http://www.pwc.com/us/meaningfuluse.

Methodology

PricewaterhouseCoopers’ Health Research Institute surveyed 120 CIOs and health IT executives, who are members of the College of Healthcare Information Management Executives (CHIME) during the second quarter of 2010. In addition, HRI conducted in-depth interviews with 14 CIOs and health leaders from health systems, health information exchanges, health insurers and regional extension centers.

About PricewaterhouseCoopers’ Health Research Institute (HRI)

PricewaterhouseCoopers’ Health Research Institute (http://www.pwc.com/hri) is an leading resource for health industry expertise. By providing cutting-edge intelligence, perspective and analysis on issues impacting the health industry, HRI assists executive decision-makers and stakeholders worldwide in navigating their most pressing business challenges. PricewaterhouseCoopers is one of the only firms with a dedicated global healthcare research unit, capitalizing on fact-based research and collaborative exchange among our network of professionals with day-to-day experience in the health industries.

About PricewaterhouseCoopers’ Health Industries Group

PricewaterhouseCoopers’ Health Industries Group (http://www.pwc.com/healthindustries) is a leading advisor to public and private organizations across the health industry, including payers, providers, academic institutions, health sciences, biotech/medical devices, pharmaceutical companies, employers and new non-traditional market participants in the dynamic healthcare space. PricewaterhouseCoopers has a network of more than 4,000 professionals worldwide and 1,200 professionals in the US dedicated to the health industries.

PricewaterhouseCoopers’ Health Industries’ clients include 40 of the top 100 hospitals in the US and 16 of the 18 best hospitals as ranked by US News & World Report; all 20 of the world’s major pharmaceutical companies; all of the top 20 commercial payers in the US; municipal, state and federal government agencies and many of the world’s preeminent medical foundations and associations. Follow PwC Health Industries at http://twitter.com/PwCHealth.

About PricewaterhouseCoopers
PricewaterhouseCoopers (www.pwc.com) provides industry-focused assurance, tax and advisory services to build public trust and enhance value for its clients and their stakeholders. More than 163,000 people in 151 countries across our network share their thinking, experience and solutions to develop fresh perspectives and practical advice.

“PricewaterhouseCoopers” refers to PricewaterhouseCoopers LLP or, as the context requires, the PricewaterhouseCoopers global network or other member firms of the network, each of which is a separate and independent legal entity. © 2010 PricewaterhouseCoopers LLP. All rights reserved.

CHIME Comments on Final Rule of Temporary EHR Certification

Posted on July 1, 2010 by Mike Squires

CHIME/College of Healthcare Information Management Executives issues Comments
Excerpted from CHIME Press Release July 1, 2010.
ANN ARBOR, MI, July 1, 2010 – The government’s certification program for health information technology will continue to evolve over time, according to a review of the recently released final rule for the temporary certification program, released last week.

The temporary program to certify electronic health record technology went into effect on June 24, and it will be replaced by the permanent certification program as soon as Dec. 31, 2011. However, the analysis by the College of Health Information Management Executives (CHIME) indicates that certification criteria will change, necessitating the ongoing need to certify HIT products for the foreseeable future.

CHIME found that the recently released final rule suggests that electronic health records (EHR) will need to be certified on an ongoing basis, and that meaningful use criteria are likely to evolve over time.

To receive stimulus funds, eligible hospitals and providers that implement electronic health records must demonstrate that they are using them to improve care delivery and clinical results. The plan originally proposed by the Centers for Medicare & Medicaid Services (CMS) would require providers to give evidence that their systems are achieving certain standards to show they’re using EHRs in meaningful ways. The original plan anticipated that the measures for demonstrating meaningful use would get tougher every two years over the three stages of the program. Providers can enter the program at any time over the next four years by meeting Stage 1 meaningful use criteria.

While the industry is uncertain about the final shape of the meaningful use objectives that CMS will choose, the temporary certification final rule suggests that Stage 1 criteria could become tougher over time.

“Regardless of the year and meaningful use stage at which an eligible professional or eligible hospital enters the Medicare or Medicaid EHR Incentive Program, the certified EHR technology that they would need to use would have to include the capabilities necessary to meet the most current certification criteria,” the temporary certification rule notes.

CHIME’s reading of the rule suggests that, although Stage 1 criteria will be finalized soon, it is possible future rule-making could include updates to the Stage 1 criteria, said Pamela McNutt, FCHIME, senior vice president and CIO at Dallas-based Methodist Health System and chair of CHIME’s Policy Steering Committee.

However, the final rules for temporary certification do provide some relief because they don’t require recertification for HIT product updates and “fixes” that don’t adversely affect meaningful use criteria. However, a product may be certified if there are any concerns about changes in an application that could affect its ability to achieve meaningful use objectives.

Additionally, the authorized testing and certification bodies recognized by the Office of the National Coordinator for Healthcare IT (ONC-ATCBs) can not require that integrated bundled EHRs or EHR modules be certified to a higher set of standards than the certification criteria set by the ONC. CHIME views this clarification as a positive result of the commenting process that caused ONC to re-evaluate the proposed rule.

CHIME also positively views provisions in the final regulation that call for ONC-ATCBs to provide remote testing of applications.

Additionally, the regulations don’t require that an application must be live at a customer’s site before it is tested, opening the way for testing of applications at vendors’ facilities.

While the final regulations reflected resolutions of many of CHIME’s concerns and clarifies certain issues, the organization still is concerned that a product’s certification can be revoked for some “Type 1” violations by an ONC-ATCB that would prompt questions about the integrity of the certification of those products. If a product loses certification, a healthcare organization would have 120 days to secure a certified product, either by the vendor having its product re-certified by a different ATCB or installing another certified product.

While the loss of a product’s certification is unlikely, any such occurrence will probably affect hundreds of provider organizations and could place them under extreme stress to resolve the issue quickly, CHIME said.

About CHIME
The College of Healthcare Information Management Executives (CHIME) is an executive organization dedicated to serving chief information officers and other senior healthcare IT leaders. With more than 1,400 CIO members and over 70 healthcare IT vendors and professional services firms, CHIME provides a highly interactive, trusted environment enabling senior professional and industry leaders to collaborate; exchange best practices; address professional development needs; and advocate the effective use of information management to improve the health and healthcare in the communities they serve. For more information, please visit http://www.cio-chime.org/

ONC Health IT Stories from the EHR Road: Update

Posted on June 30, 2010 by Mike Squires

New “Journey Stories” on Implementing EHRs
Excerpts from stories collected by Office of National Coordinator (ONC) for Health IT based on physician practices around the country. Earlier stories repeated from a previous post on e-Healthcare Marketing.com . All carry a map and a quote from the practice.

Dr. Lisa Moreno
Queens pediatric allergist and immunology specialist starts her practice from the cutting edge of HIT.
Queens, New York
Posted June 28, 2010

Cooley Dickinson Hospital
EHR adoption marks a time of rebirth for Massachusetts hospital. Northampton, Massachussetts
Posted June 28, 2010

Heart of Texas Community Health Center
McLennan County, Texas
Posted June 28, 2010

White River Rural Health Center
High standards for care and safety are met with the implementation of EHRs.
Augusta, Arkansas
Posted June 10, 2010

Thayer County Health Services
Five rural health centers and a 19 bed critical access hospital implement EHRs and HIE to benefit county residents.
Hebron, Nebraska
Posted June 10, 2010

Dr. Russell Kohl, Green Country Family Medicine
A two-doctor practice in rural Oklahoma creatively funds the practice’s journey to health IT implementation.
Vinita, Oklahoma
May 27, 2010

Urban Health Plan
The implementation of EHRs improves access to care and reduces health disparities for the urban underserved in the South Bronx.
South Bronx, NY
May 27, 2010

ONC: Informational Calls on Temporary Certification Program + FAQs, Fact Sheet

Posted on June 28, 2010 by Mike Squires

June 30-July 2: Overview of Temporary Certification for Electronic Health Records
for Potential Applicants (ONC-ATCB), Health IT Developers/Vendors, Provider/Developers and Interested Provider
Notice emailed June 26, 2010, and excerpted below.
The Office of the National Coordinator for Health Information Technology (ONC) within the Department of Health and Human Services is hosting a series of informational calls the purpose of which is to provide an overview of the recently released final rule to establish a temporary certification program for electronic health record (EHR) technology. The temporary rule establishes processes that organizations will need to follow in order to be authorized by the National Coordinator to test and certify EHR technology.

Participants will hear an overview of the final rule, and be able to ask questions.

Four informational calls are planned, targeting the information needs of specific audiences who may be impacted by the final rule:

1. For Potential Applicants Who Wish to Pursue Becoming an ONC-Authorized Testing and Certification Body (ONC-ATCB)

Date and Time: Wednesday, June 30, 2010, 4:00 p.m. – 5:00 p.m. EDT

Call-in Information:

Phone Number: 800-857-9600

Participant Passcode: 3533556

2. For Health IT Developers/Vendors

Date and Time: Thursday, July 1, 2010, 4:00 p.m. – 5:00 p.m. EDT

Call-in Information:

Phone Number: 800-619-0361

Participant Passcode: 3533556

3. For Providers Who are Also Health IT Developers (who may seek certification of systems developed in-house)

Date and Time: Friday, July 2, 2010, 10:00 a.m. – 11:00 a.m. EDT

Call-in Information:

Phone Number: 800-857-9600

Participant Passcode: 4129010

4. For Providers, Including Clinicians, Hospitals and Other Provider Organizations Interested in the Details of the Temporary Certification Program

Date and Time: Friday, July 2, 2010, 11:00 a.m. – 12:00 p.m. EDT

Call-in Information:

Phone Number: 800-769-9420

Participant Passcode: 3533556

Transcripts of each phone call will be made available on the ONC web site, within 48 hours of each call.

For more information about the temporary certification program and the final rule, please visit http://healthit.hhs.gov/certification.
# # #

ONC Fact Sheet: HITECH Temporary Certification Program for EHR Technology
Excerpted from ONC site on 6/28/2010.
The Health Information Technology for Economic and Clinical Health (HITECH) Act provides HHS with the authority to establish programs to improve health care quality, safety, and efficiency through the promotion of health information technology (HIT), including electronic health records (EHRs) and private and secure electronic health information exchange.

The HITECH legislation directs the Office of the National Coordinator for Health Information Technology (ONC) to support and promote meaningful use of certified electronic health record (EHR) technology nationwide through the adoption of standards, implementation specifications, and certification criteria as well as the establishment of certification programs for HIT, such as EHR technology.

About the Temporary Certification Program and ONC-ATCBs
To provide assurance to eligible professionals, eligible hospitals and critical access hospitals (CAHs) that the EHR technology they adopt will assist their achievement of meaningful use, the Department of Health and Human Services (HHS) issued a final rule to establish a temporary certification program for EHR technology on June 18, 2010. The rule outlines how organizations can become ONC-Authorized Testing and Certification Bodies (ONC-ATCBs). Authorized by the National Coordinator, ONC-ATCBs are required to test and certify that certain types of EHR technology (Complete EHRs and EHR Modules) are compliant with the standards, implementation specifications, and certification criteria adopted by the HHS Secretary and meet the definition of “certified EHR technology”.

About the Standards, Implementation Specifications, and Certification Criteria
On January 13, 2010, the Secretary published in the Federal Register an interim final rule that adopted standards, implementation specifications, and certification criteria for HIT. A final rule, which will realign with the Medicare and Medicaid EHR Incentive Programs final rule, is expected to be released in the near future.

What Certification Means for Health Care Providers
EHR technology, certified by an ONC-ATCB must be used in order to qualify for incentive payments. The temporary certification program provides assurance that the EHR technology health care providers adopt is technically capable of supporting their efforts to achieve meaningful use.

What Certification Means for Developers of EHR Technology
The temporary certification program provides a way for developers of EHR technology to have their HIT tested and certified so that it can be subsequently adopted by eligible professionals, eligible hospitals and CAHs who seek to achieve meaningful use.

For other questions related to the Temporary Certification program, please email ONC.Certification@hhs.gov.

•   Temporary Certification Program, visit http://healthit.hhs.gov/tempcert
•   Medicare and Medicaid EHR incentive programs, visit http://www.cms.gov/EHRIncentivePrograms/
#                    #            #

Frequently Asked Questions:
Temporary Certification Program Final Rule

Excerpted from ONC site 6/28/2010.
A. Background/General

Key Messages

Health Care Providers: Key Points
In order to qualify for Medicare and Medicaid EHR incentive payments, providers must use EHR technology that has been certified by an Office of the National Coordinator for Health Information Technology-Authorized Testing and Certification Body (ONC-ATCB, or ATCB). The temporary certification program provides assurances that the EHR technology adopted by health care providers is technically capable of supporting their efforts to achieve meaningful use.

Developers of EHR Technology: Key Points
The temporary certification program provides a way for developers of EHR Technology to have their EHR technology tested and certified so that it can be subsequently adopted by health care providers who seek to achieve meaningful use.

A1. What is the temporary certification program final rule?
The Secretary of Health and Human Services (the Secretary) issued the temporary certification program final rule to establish a process through which organizations may become ONC-ATCBs. An ONC-ATCB is authorized by the National Coordinator to test and certify EHR technology (Complete EHRs and/or EHR Modules).

A2. What is the purpose of the temporary certification program?
The temporary certification program is the first part of ONC’s two-part approach to establish a transparent and objective certification process. The temporary certification program was established to ensure that “Certified EHR Technology” will be available for adoption by health care providers who seek to qualify for the Medicare and Medicaid EHR incentive payments beginning in 2011. ONC-ATCBs will be required to test and certify EHR technology (Complete EHRs and/or EHR Modules) as being in compliance with the standards, implementation specifications, and certification criteria to be adopted by the Secretary in a forthcoming final rule.

A3. When will the temporary certification program end?
The temporary certification program will be in effect until the permanent certification program is in place. We anticipate that certifications issued under the permanent certification program will occur no earlier than January 1, 2012.

A4. How will ONC work with the National Institute of Standards and Technology (NIST) in regard to certification and standards?
ONC will work with NIST to ensure the availability of relevant test methods and other resources for the temporary certification program. ONC will continue to work with NIST in developing the permanent certification program.

B. Application Process
B1. How does an organization become an ONC-ATCB?
An organization must submit an application to the National Coordinator to demonstrate its competency and ability to test and certify EHR technology (Complete EHRs and/or EHR Modules). Once authorized, ONC-ATCBs are required to comply with the principles and conditions applicable to the testing and certification of EHR technology as specified in the temporary certification program final rule.

B2. Can you provide an overview of the application process?
Applicants are required to request, in writing, an application for ONC-ATCB status from the National Coordinator at ATCBapplication@hhs.gov. The application has two parts:

Part I: Provide general identifying and contact information; complete and submit the results of self-audits to all sections of ISO/IEC Guide 65:1996 (Guide 65) and ISO/IEC 17025:2005 (ISO 17025); submit additional documentation related to Guide 65 and ISO 17025; and agree to adhere to the Principles of Proper Conduct for ONC-ATCBs.

Part II: Successfully complete a proficiency examination.

Applicants are required to complete and submit both parts of the application to the National Coordinator for the application to be considered complete. Please review Section III of the final rule for more details about the application and application review processes.

B3. When will ONC begin accepting applications, and when will applicants be informed if they have received ONC-ATCB status?
The National Coordinator will begin accepting applications on July 1st and any time thereafter while the temporary certification program is operating. Because the final rule is effective immediately, the National Coordinator will review, process, and make determinations regarding submitted applications as soon as possible.

B4. Will ONC limit the number applicants who apply for ONC-ATCB status?
ONC will not restrict the number of applicants who may apply for ONC-ATCB status. Having available more organizations with ONC-ATCB status will give developers of EHR technology more options for testing and certification.

C. Certification Process

C1. I have an EHR technology ready for market. Is there anything I can do to get the technology certified now so that I can start marketing to hospitals and physicians?
Until organizations are authorized by the National Coordinator to perform testing and certification, EHR technology cannot be tested and certified in accordance with the temporary certification program final rule. At this time, no organizations are currently authorized to test and certify EHR technology under the temporary certification program established by HHS, but when organizations attain ONC-ATCB status ONC will make it publicly known and post their names on our website. ONC will work with ATCBs to encourage them to begin certifying EHR technology as soon as possible after they are authorized to do so.

C2. When will ONC-ATCBs be up and running?
ONC-ATCBs are permitted to start testing and certifying EHR technology consistent with the scope of their authorization as soon as it is received. Some ONC-ATCBs may need more time to establish their processes than others; however, we anticipate that ONC-ATCBs would be ready to test and certify EHR technology within a few weeks of attaining their authorization.

C3. How long will it take for an EHR technology to be certified?
This will vary according to the process used by the ONC-ATCB.

C4. What does a developer of EHR technology need to do to get its EHR technology tested and certified?
A developer of EHR technology will need to (1) select an ONC-ATCB that is authorized to test and certify its EHR technology (Complete EHR or EHR Module), and (2) demonstrate in accordance with the ONC-ATCB’s processes that the EHR technology provides the capabilities required by all applicable certification criteria adopted by the Secretary.

C5. Where can I find out information about EHR technology that has been certified?
ONC will maintain on its website a Certified HIT Products List (CHPL) as a single, aggregate source of all certified Complete EHRs and EHR Modules reported by ONC-ATCBs to the National Coordinator. The CHPL will comprise all of the certified Complete EHRs and EHR Modules that could be used to meet the definition of Certified EHR Technology. It will also include the other pertinent information we require ONC-ATCBs to report to the National Coordinator, such as a certified Complete EHR’s version number. Eligible professionals and eligible hospitals that elect to use a combination of certified EHR Modules may also use the CHPL webpage to validate whether the EHR Modules they have selected satisfy all of the applicable certification criteria that are necessary to meet the definition of Certified EHR Technology.

C6. Will EHR technology previously certified under any other programs or organizations automatically be certified by this new process?
No. In order to meet regulatory requirements implementing the HITECH Act, including the definition of “Certified EHR Technology,” EHR technology (Complete EHRs and/or EHR Modules) must be tested and certified by an ONC-ATCB. Any other certifications issued by an organization that is not an ONC-ATCB at the time of issuance will be invalid for purposes of meeting the definition of Certified EHR Technology and cannot be used to qualify for incentive payments under the Medicare and Medicaid EHR Incentive Programs. Unless reissued in accordance with the requirements of the temporary certification program, certifications previously issued by an organization that has subsequently become an ONC-ATCB will also be invalid for purposes of satisfying the definition of “Certified EHR Technology,” because such certifications were issued prior to the organization achieving ONC-ATCB status.

Certification by an ONC-ATCB means that EHR technology meets the specific standards, implementation specifications, and certification criteria established for the temporary certification program. (HHS issued an interim final rule outlining specific standards and certification criteria on December 30, 2009, and a final rule is expected to be issued in the near future.)

EHR technology must be tested and certified by an organization authorized by ONC as an ONC-ATCB, using currently adopted standards and certification criteria. Once ONC has authorized testing and certification organizations as ONC-ATCBs, the follow actions are appropriate:

Developers of EHR technology who wish to have their EHR technology tested and certified should contact an ONC-ATCB
Health care providers who are eligible under the Medicare and Medicaid EHR Incentive Programs should contact their vendors to ensure their EHR technology is tested and certified by an ONC-ATCB under the temporary certification program requirements

C7. Will EHR technology certified under the temporary certification program be automatically certified under the permanent certification program?
EHR technology tested and certified by an ONC-ATCB under the temporary certification program will remain certified once the permanent certification program replaces the temporary certification program. The change in certification programs will not affect the certified status of EHR technology at the time of change. However, we anticipate that new or modified certification criteria will be adopted by the Secretary to support future stages of meaningful use, and as a result, certifications issued by ONC-ATCBs will presumably no longer indicate or represent that a Complete EHR or EHR Module can provide all of the capabilities necessary for an eligible professional or eligible hospital to achieve a future stage of meaningful use.

C8. Whose responsibility is it to make sure that EHR technology gets tested and certified as required to meet the certification criteria adopted to support meaningful use?
In most cases it will be the responsibility of developers of EHR technology that sell EHR technology. However, a health care provider that has developed its own EHR technology and is eligible under Medicare and Medicaid EHR Incentive Programs likely will be responsible for getting it tested and certified.

C9. If I buy an EHR technology that is tested and certified, does that qualify me for the Medicare or Medicaid EHR incentive payments?
Having EHR technology that is certified by an ONC-ATCB is an essential part of qualifying for the EHR incentive payments. For details on the Medicare and Medicaid EHR Incentive Programs, please visit http://www.cms.gov/Recovery/11_HealthIT.asp.

C10. I already use EHR technology. If it gets certified, will I qualify for the Medicare or Medicaid EHR incentive payments?
If the EHR technology you currently use is certified in the HHS temporary certification program, you may be eligible for incentive payments. For details on the Medicare and Medicaid EHR Incentive Programs, please visit http://www.cms.gov/Recovery/11_HealthIT.asp.

D. Comments on Proposed Rule

D1. Where can I learn about how my comments on the proposed rule on the Establishment of Certification Programs for Health Information Technology issued in March were addressed in the temporary certification program final rule?
ONC staff carefully reviewed and considered each comment received on the proposed rule. Section III of the temporary certification program final rule includes a discussion of how the comments were incorporated into the temporary certification program final rule.

E. Related Rules

E1. How does this final rule relate to the Medicare and Medicaid EHR Incentive Programs Proposed Rule?
The National Coordinator will use the temporary certification program to authorize organizations to test and certify EHR technology (Complete EHRs and/or EHR Modules). Once tested and certified, these types of HIT may be used to meet the regulatory definition of “Certified EHR Technology.” Health care providers who are eligible to qualify for incentive payments under the Medicare and Medicaid EHR Incentive Programs are required to use Certified EHR Technology, as promulgated in the CMS final rule.
HHS expects to issue final rules related to the initial set of standards, implementation specifications, and certification criteria and to the Medicare and Medicaid EHR Incentive Programs in the near future.

E2. When will the permanent certification program final rule be published?
We anticipate that a final rule for the permanent certification program will be issued by fall 2010 and that the permanent program will be in place in 2012.

For other questions related to the Temporary Certification program, please email ONC.Certification@hhs.gov.

###

George Washington Awarded $1 Mil to Study Health IT Quality Care Improvement

Posted on June 28, 2010 by Mike Squires

Study and Report to: Identify Methods to Create Efficient Reimbursement Incentives to Improve Health Care Quality and Understand the Impact of Health IT in Underserved Communities and those with Health Disparities
George Washington University was awarded $1 million to cover two research projects which will examine efficient reimbursement incentives and the impact of Health IT on delivering health care in underserved areas. Awards were made on July 17, and published July 21, 2010. They will be overseen by the Office of the National Coordinator (ONC) for Health IT.

“The purpose of this contract is to conduct two projects required under the American Reinvestment and Recovery Act of 2009. This statute includes The Health Information Technology for Economic and Clinical Health Act of 2009 (the HITECH Act) that sets forth a plan for advancing the appropriate use of health information technology to improve quality of care and establish a foundation for health care reform.

“The first project (Project A) will examine methods to create efficient reimbursement incentives for improving health care quality in federally qualified health centers (FQHCs), rural health clinics (RHCs), and free clinics. Project A requires a Report to Congress by February, 2011.

“The second project (Project B) will investigate the impact of Health Information Technology (HIT), including electronic health records (EHR), in communities with health disparities and in areas with a high proportion of individuals who are uninsured, underinsured, and medically underserved (including urban and rural areas). This project will also identify practices to increase adoption of HIT by health care providers in such communities and the use of HIT to reduce and better manage chronic diseases.

“The purpose of Project A under this contract is to examine methods to create efficient reimbursement incentives for improving health care quality in federally qualified health centers (FQHCs), rural health clinics (RHCs), and free clinics. This project was mandated in the American Recovery and Reinvestment Act (ARRA) of 2009 (P.L. 111-5, section 13113(b)), and requires, not later than 2 years after the date of the enactment of the Act, the submission of a Report to the appropriate committees of jurisdiction of the House of Representatives and the Senate. Project A will review and assess different reimbursement incentives that have been utilized in Medicare, Medicaid and by private payers and States. The study should then address whether or not these incentives can be duplicated among safety-net providers. Since the study was authorized in The Health Information Technology for Economic and Clinical Health (HITECH) Act (P.L. 111-5, Sec. 13113(b)), it should include a focus on the role of payment incentives for health information technology (HIT), including payment for telehealth services, and how these incentives can lead to improved health care.

“This study will investigate the impact of Health Information Technology (HIT) including electronic health records (EHR) in communities with health disparities and in areas with a high proportion of individuals who are uninsured, underinsured, and medically underserved (including urban and rural areas). The study will also identify practices to increase adoption of HIT by health care providers in such communities and the use of HIT to reduce and better manage chronic diseases. Legislative authority for this activity is found in the American Recovery and Reinvestment Act (ARRA) of 2009 (P.L. 111-5, Sec. 13101, Subtitle A, Sec. 3001).”

Project A:

“The need to reform current health care payment methods that promote inappropriate or inefficient behaviors and that impede progress toward better quality care has been established. The current basic payment systems reward overuse of services and use of high-cost complex procedures; it is understood that there is a wide variation in practice patterns and that these variations do not necessarily correlate with improved quality. Payment reforms are recognized as a key ingredient to promote high quality clinical, patient-centered, and efficient care. The concept of payment that rewards higher quality has begun to be accepted by payers and to take shape in ways such as through CMS demonstration programs, performance measures, and other private payer incentive programs. The evidence in support of various public- and private-sector programs designed to align payment incentives to promote better-quality care by rewarding providers who perform well has been reported. Current efforts to link health care payment to the quality and efficiency of care provided are shifting the reimbursement structure away from paying providers based solely on their volume of services.

“The current structure of reimbursement programs designed to promote quality often limit FQHC, RHC, and free clinic participation because of their unique payment methodologies. These types of providers generally bill Medicare on an institutional claim form which does not include certain critical data elements necessary for implementing quality incentive types of programs established by CMS and other payers. FQHC and RHC participation in previous quality incentive programs has been contingent on whether or not they elect to bill on a physician claim form and be paid according to the physician fee schedule. Changing to this billing approach would result in eligibility to participate in the demonstration programs.

“The Office of the National Coordinator for Health IT (ONC), in coordination with other offices in the Department, seeks to describe and assess methods to create efficient reimbursement incentives for improving health care quality in FQHCs, RHCs and free clinics, under the guidance provided in ARRA section 13113(b).”

Project B:

“The U.S. health care system faces multiple challenges that require new approaches to protecting the health of the American people and to providing essential health care services. These challenges include rising health care costs, ongoing evidence of poor quality and outcomes, an aging population with multiple chronic conditions, an ethnic and racial diversity in health care access and outcomes, and an increasingly complex health care system.

“Interoperable health information technology (HIT) includes a promising set of tools that can help address these issues by improving quality, safety and efficiency of health care. These technologies include telehealth, EHRs, and personal health records (PHRs), to enhance communication and access between patients and providers, as well as health information exchange (HIE) to facilitate appropriate sharing of health care data and coordination among health care practitioners.

Project A Goals:

“The goals for the project are to:

1. Provide a baseline understanding and assessment of reimbursement incentive programs in place or in the process of being implemented. This assessment shall include different categories of quality incentive programs, targeted goals and outcomes, methodologies for payment, and the types of providers participating in the programs. It should discuss provider reimbursement incentive initiatives in the planning stages or under discussion and how FQHCs, RHCs, and free clinics might participate in those quality-related incentive programs. Future reimbursement initiatives might include, for example, those under consideration in Congressional health reform legislation, initiatives under development at the Centers for Medicare and Medicaid Services, or state-specific reimbursement initiatives that could be generalized across FQHCs, RHCs and free clinics.

2. Provide options for potential approaches to increase the participation of FQHCs, RHCs, and free clinics in initiatives involving efficient reimbursement for improving health care quality.

3. Define the conditions, catalysts and barriers that facilitate and hinder FQHCs, RHCs, and free clinics programs’ participation in quality-related reimbursement initiatives.

4. Using an expert panel and regional meetings, identify the most promising methods and successful approaches to establish quality-related reimbursement programs that include FQHCs, RHCs, and free clinics. The methods and topics reviewed by the expert panel should take into account time-sensitive issues such as health care reform, accountable care organizations, episodes of care, medical home, and “meaningful use” HIT incentive payments. Topics should focus on pay for performance approaches that result in both cost reduction and quality improvement.

5. Create a set of options demonstrating what is needed to include and sustain participation of FQHCs, RHCs, and free clinics in quality-related incentive programs including barriers, gaps and successful strategies and suggestions for future opportunities. ”

“To accomplish these goals, the Contractor will conduct an assessment of current quality incentive reimbursement programs. The assessment will examine how these programs have been structured in the past and how they have evolved over time and the extent that these incentive programs are effective at achieving the intended outcomes (e.g. improved quality, efficiency). The Contractor will conduct an environmental scan that will provide an analytic framework for the project that can be used to clarify the types and characteristics of various public- and private-sector programs designed to align payment incentives to promote better quality of care. The environmental scan will include information from published as well as unpublished resources, open-ended discussions with payer organizations such as the Centers for Medicare and Medicaid Services as well as discussions with organizations representing FQHCs, RHCs and free clinics, and other resources, academia, and experts in health care financing. An important aspect of the environmental scan will be the identification of gaps, as well as recommendations for studies and approaches to fill those gaps. These identified gaps can be used to generate topics for additional research.

“The environmental scan will provide information to assist in the development of a slate of topics to be further evaluated in white papers to be developed. An expert panel will be convened to help guide the study content. The expert panel will work on identifying topics for a series of white papers based on a set of focused questions on key topic areas

“A meeting of internal and external stakeholders will be held to provide input in establishing methods to create efficient reimbursement incentives for improving health care quality in FQHCs, RHCs, and free clinics. The Contractor will follow the definitions for FQHCs, RHCs, and free clinics found in current federal guidelines. External stakeholders should include organizations such as the National Association of State Medicaid Directors, the National Association of Community Health Centers (NACHC), the National Association of Rural Health Clinics (NARHC), and the National Association of Free Clinics (NAFC). In addition, foundations and other organizations that have offered or studied quality incentive programs will be included in these meetings.

“The study will provide an assessment of whether and how FQHCs, RHCs, and free clinics can more effectively participate in quality incentive programs and will identify methods to create new appropriate reimbursement incentives for improving health care quality for these provider types. The final product will include a synthesis report with specific and practical methods regarding ways these programs can achieve quality improvement through payment incentives. The study will provide the Congress with information regarding innovative quality reimbursement incentives.”

Project B Goals:

“The goals for the project are to:

1. Assess the impact of HIT and EHR in communities with health disparities and in areas with a high proportion of individuals who are uninsured, underinsured, and medically underserved (including urban and rural areas);

2. Identify practices to increase the adoption of HIT by health care providers in such communities; and

3. Identify practices to increase the use of HIT to reduce and better manage chronic diseases.”

“In order to accomplish these goals, the contractor shall work closely with the ONC project officer to:
“• Assist in the formation and convening of an interdisciplinary panel of experts in HIT, frontline healthcare delivery, health disparities and quality measurement, quality improvement and other disciplines as necessary. The expert panel shall assist with all phases of the contract, as described in the following sections. The composition of the interdisciplinary panel shall be developed in consultation with the project officer and shall be approved by the project officer before appointments are made. The interdisciplinary panel of experts shall be no larger than 10 non-federal individuals.

“• Conduct an environmental scan and literature review using published and gray literature as well as interviews. The environmental scan should provide an analytic framework for the project that can be used to clarify the types and characteristics of model HIT adopters in the context of this study. As part of the environmental scan, the contractor will identify potential sources of data supported by rigorous research and robust studies that can be used for the analysis. Specific health information technologies and tools (including, but not limited to, electronic health records, electronic registries, public health information systems, telehealth, personal health records and health information exchanges) should be included in the environmental scan to evaluate whether and how these technologies might impact health disparities. The contractor will be required to select a reference point from which disparities can be measured; whether disparities should be measured in relative or absolute terms; the precision of the statistics used to measure disparities; the use and interpretation of summary measures of disparities; etc.

“• Develop and implement a study framework to examine the impact of HIT on communities with health disparities and in areas with a high proportion of individuals who are uninsured, underinsured, and medically underserved (including urban and rural areas). This assessment should provide information and recommendations regarding practices to increase the use of HIT by both patients and providers to reduce and better manage chronic diseases. “

New Mexico Health Information Collaborative Leads the Way

Posted on June 28, 2010 by Mike Squires

Leading the Way in State Health Information Exchange: A Presentation on the New Mexico Health Information Collaborative
Slides and Transcript
As the first state to have its strategic and opeational Health Information Exchange plans approved by the Office of the National Coordinator for Health IT in 2010, New Mexico serves as a model for other state HIEs. The presentations and transcript from a Webinar held by a division of the National Governors Association on May 21, 2010, and posted on the NGA Center for Best Practices site, features the people responsible for leading New Mexico’s Health IT initiatives.

According to the NGA News Summary, “Representatives from LCF Research, which supports both the New Mexico Health Information Collaborative (NMHIC) and the New Mexico Health Information Technology Regional Extension Center (NM HITREC), held an informational presentation about multiple initiatives in place to develop, implement and maintain health information exchange in New Mexico. Participants joined to learn more about the innovative and collaborative efforts that are laying the groundwork for statewide HIE. The meeting was sponsored by the NGA Center State Alliance for eHealth.

“In February 2010, New Mexico’s state-designated entity for health information exchange (HIE) – the New Mexico Health Information Collaborative (NMHIC) –established itself as a leader in the health IT/health information arena. As the first state to meet all Office of the National Coordinator for Health Information Technology requirements for HIE strategic and operational planning, NMHIC is able to go directly to the implementation phase in expanding its health information exchange network using the funds allocated for state HIE through ARRA.”

Presenters
Maggie Gunter:president of LCF Research
Bob Mayer: New Mexico State Health IT Coordinator
Dave Perry: CIO of LCF Research
Lindy Dittmer-Perry: project manager, New Mexico Regional Extension Center
Jeff Blair: director of Health Informatics for LCF Research.

ONC-ATCB? ONC-Authorized Testing and Certification Body

Posted on June 27, 2010 by Mike Squires

FINAL RULE Issued: Temporary Certification Program for Health IT
Published in Federal Register on June 24, 2010
AGENCY: Office of the National Coordinator for Health Information
Technology, Department of Health and Human Services.
45 CFR Part 170
“Establishment of the Temporary Certification Program for Health
Information Technology; Final Rule” was published in the Federal Register on June 24, 2010, with excerpts below and links to html and PDF versions. ONC now estimates there may be as many as five ONC-ATCBs, up from the three estimated in the interim rule and that they will certify ”at most, approximately 205 Complete EHRs and/or EHR Modules under the temporary certification program.” Organizations for ATCB status may start applying July 1, 2010.

FORMATS: HTML , PDF , SUMMARY

“SUMMARY: This final rule establishes a temporary certification program
for the purposes of testing and certifying health information technology. This final rule is established under the authority granted to the National Coordinator for Health Information Technology (the National Coordinator) by section 3001(c)(5) of the Public Health Service Act (PHSA), as added by the Health Information Technology for Economic and Clinical Health (HITECH) Act. The National Coordinator will utilize the temporary certification program to authorize organizations to test and certify Complete Electronic Health Records (EHRs) and/or EHR Modules, thereby making Certified EHR Technology available prior to the date on which health care providers seeking incentive payments available under the Medicare and Medicaid EHR Incentive Programs may begin demonstrating meaningful use of Certified EHR Technology.”

II. Overview of the Temporary Certification Program

“The temporary certification program provides a process by which an organization or organizations may become an ONC-Authorized Testing and Certification Body (ONC-ATCB) and be authorized by the National Coordinator to perform the testing and certification of Complete EHRs and/or EHR Modules.

“Under the temporary certification program, the National Coordinator will accept applications for ONC-ATCB status at any time. In order to become an ONC-ATCB, an organization or organizations must submit an application to the National Coordinator to demonstrate its competency and ability to test and certify Complete EHRs and/or EHR Modules. An
applicant will need to be able to both test and certify Complete EHRs and/or EHR Modules. We anticipate that only a few organizations will qualify and become ONC-ATCBs under the temporary certification program. These organizations will be required to remain in good standing by adhering to the Principles of Proper Conduct for ONC-ATCBs. ONC-ATCBs will also be required to follow the conditions and requirements applicable to the testing and certification of Complete EHRs and/or EHR Modules as specified in this final rule. The temporary certification program will sunset on December 31, 2011, or if the permanent certification program is not fully constituted at that time, then upon a subsequent date that is determined to be appropriate by the National Coordinator.”

Analysis and Response to Public Comments: Overview
”This section discusses the 84 timely received comments on the Proposed Rule’s proposed temporary certification program and our responses. We have structured this section of the final rule based on the proposed regulatory sections of the temporary certification program and discuss each regulatory section sequentially. For each discussion of the regulatory provision, we first restate or paraphrase the provision as proposed in the Proposed Rule as well as identify any
correlated issues for which we sought public comment. Second, we summarize the comments received. Lastly, we provide our response to the comments, including stating whether we will finalize the provision as proposed in the Proposed Rule or modify the proposed provision in
response to public comment. Comments on the incorporation of the “recognized certification body” process, “grandfathering” of certifications, the concept of “self-developed,” validity and expiration of certifications, general comments, and comments beyond the scope of this final rule are discussed towards the end of the preamble.”

Several Excerpts About Increase Estimate to Five ONC-ATCBs
Different Levels of Preparedness
“As stated in the collection of information section, we estimate that each ONC-ATCB will incur the same burden and, assuming that there are 5 ONC-ATCBs, will test and certify, at most, approximately 205 Complete EHRs and/or EHR Modules under the temporary certification program.”

“In the Proposed Rule, we stated that we anticipated that there would be no more than 3 applicants for ONC-ATCB status. Based on the comments received, we now believe that there may be up to 5 applicants for ONC-ATCB status. In addition, we believe that up to 2 of these applicants will not have the level of preparedness that we originally estimated for all potential applicants for ONC-ATCB status.”

“As part of the temporary certification program, an applicant will be required to submit an application and complete a proficiency exam. We do not believe that there will be an appreciable difference in the time commitment an applicant for ONC-ATCB status will have to make based on the type of authorization it seeks (i.e., we believe the application process and time commitment will be the same for applicants seeking authorization to conduct the testing and certification of
either Complete EHRs or EHR Modules). We do, however, believe that there will be a distinction between applicants based on their level of preparedness. For the purposes of estimating applicant costs, we have divided applicants into two categories, “conformant applicants” and
“partially conformant applicants.” We still believe, after reviewing comments, that there will be three “conformant applicants” and that these applicants will have reviewed the relevant requirements found in the ISO/IEC standards and will have a majority, if not all, of the documentation requested in the application already developed and available before applying for ONC-ATCB status. Therefore, with the exception of completing a proficiency examination, we believe “conformant applicants” will only spend time collecting and assembling already developed information to submit with their application. Conversely, we believe that there will be up to two “partially conformant applicants” and that these applicants will spend significantly more time establishing their compliance with Guide 65 and ISO 17025.”
# # #

For several interesting points in the rule, see John Halamka’s June 25, 2010 post in his Life as a CIO blog. He credits Robin Raiford for bookmarking the site, to whom–in serial form–this blog give credit as well.

e-Healthcare Marketing published a post on June 19, 2010 on Final Rule with HSS press release, FAQs, overview, and ONC’s blog post from David Blumenthal.

NHIN 105: The Future Landscape: Understanding the Value Proposition of Today as Context for Tomorrow

Posted on June 26, 2010 by Mike Squires

JUNE 28 NHIN 105: The Future Landscape: Understanding the Value Proposition of Today as Context for Tomorrow
The description and related information was excerpted from National eHealth Collaborative on 6/26/10.

COURSE DESCRIPTION: As healthcare entities across the country consider their options for meeting the exchange-related criteria of Meaningful Use, NHIN 105 will offer up examples of the diverse value propositions that current participants of the NHIN Exchange garner from their involvement in the program today and discuss how federal agencies see participation in the NHIN Exchange as a critical element of their long term health information exchange strategies.

COURSE OBJECTIVES: By participating in this NHIN University class, students will:

Understand multiple perspectives on the value of participation in the NHIN Exchange
Learn how participation in the NHIN Exchange is an integral part of the long-term health information exchange plans of multiple federal agencies
Begin to consider how these value propositions may be relevant to their own short- and long-term exchange needs

DATE: Monday, June 28, 2010

TIME: 3:00 – 4:30 pm ET

FACULTY:

Michael Matthews – Chair, Nationwide Health Information Network (NHIN) Exchange Coordinating Committee; CEO, MedVirginia
Colonel Ron Moody, MD – Chief Medical Information Officer, Military Health System, U.S. Department of Defense
Linda Fischetti, RN – Chief Health Informatics Officer, Veterans Health Administration, U.S. Department of Veterans Affairs

MODERATOR:

Aaron Seib - Interim CEO and NHIN Program Director, National eHealth Collaborative

WEBINAR: https://nationalehealthevents.webex.com/nationalehealthevents/onstage/g.php?t=a&d=666129690

AUDIOCONFERENCE: (866) 699-3239 or (408) 792-6300
(Please join the event with a computer system first and follow the audio instructions on the screen.)

ACCESS/EVENT CODE: 666 129 690

ATTENDEE ID: You will receive this number when you join the event first with a computer connection.

For additional courses www.NationaleHealth.org/NHIN-U .