The first round of incentive payments for "meaningful use" of EMRs will go out in May 2011, a top CMS official says.
Speaking at last week's meeting of the Health IT Standards Committee, Karen Trudel, deputy director of the CMS Office of E-Health Standards and Services, said that the first group of hospitals and physicians to achieve meaningful use will start seeing Medicare bonuses in mid-May. Providers must demonstrate meaningful use for a minimum of 90 consecutive days to receive a full year's credit for 2011, meaning "that no one will be able to attest [to compliance] before April," Trudel said, Government Health IT reports.
It appears that hospitals will not be able to qualify earlier, even though the hospital side of the incentive program begins Oct. 1 since Medicare Part A--inpatient care--follows the federal fiscal year, while the ambulatory Part B is tied to the calendar year. Trudel said CMS will open registration for stimulus money in January.
CMS is hard at work setting up the systems and processes to handle registration, attestation and payments for meaningful use. "We're now engineering back into the system all the changes that occurred in the final rule," Trudel told the federal advisory committee.
Eligible providers will have to have a national provider identifier and be registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS) in order to participate. Most hospitals and physicians providers also will need to have an active user account in the National Plan and Provider Enumeration System (NPPES), according to Government Health IT.
Many state Medicaid programs will be on a slightly different payment schedule than CMS. Trudel said CMS will send policy guidance to state Medicaid directors this fall.
FierceEMR
9-30-2010
Thursday, September 30, 2010
Practices Will Lose Value If They Don't Adopt EHR'S, Says HIT Coordinator
Kudos to InformationWeek's Marianne Kolbasuk McGee for scoring a comprehensive interview with Dr. David Blumenthal, who's been hard to pin down since he took the job as national health IT coordinator in April 2009. While Blumenthal is legally prohibited from discussing what's going to be in the final rules for meaningful use until HHS actually issues the standards, he is happy to discuss physician adoption of EHRs, the penalties for non-compliance with meaningful use and the legislation that created the health IT subsidy program.
While Medicare and Medicaid penalties for not using EHRs don't kick in until 2015, Blumenthal says it's important for providers to get on board with meaningful use sooner rather than later. "In future stages of meaningful use, our goal is to make sure that information follows patients. Organizations that participate in the care of patients must support the gathering of information in ways that meet the full needs of patients regardless of where they get their care," he tells McGee.
Blumenthal believes physicians will see the value of their practices plummet if they don't adopt EHRs. Older doctors may have trouble selling their practices and will struggle to recruit younger doctors. "This new generation of physicians isn't going to tolerate a paper world," Blumenthal says.
And preparing for retirement should no longer be an excuse to resist technology, according to Blumenthal. "If you're a 50- to 60-year-old physician, you're in the prime of your professional career and your patient panel is expanding. You probably want to bring on a new partner-maybe two or three-so you'll be recruiting. There's a physician shortage, so what's going to make your practice competitive?"
He also says that paper charts "are just not adequate" for reporting to Accountable Care Organizations unless practices continue to rely on claims data and incomplete documentation.
FierceEMR
9-30-2010
While Medicare and Medicaid penalties for not using EHRs don't kick in until 2015, Blumenthal says it's important for providers to get on board with meaningful use sooner rather than later. "In future stages of meaningful use, our goal is to make sure that information follows patients. Organizations that participate in the care of patients must support the gathering of information in ways that meet the full needs of patients regardless of where they get their care," he tells McGee.
Blumenthal believes physicians will see the value of their practices plummet if they don't adopt EHRs. Older doctors may have trouble selling their practices and will struggle to recruit younger doctors. "This new generation of physicians isn't going to tolerate a paper world," Blumenthal says.
And preparing for retirement should no longer be an excuse to resist technology, according to Blumenthal. "If you're a 50- to 60-year-old physician, you're in the prime of your professional career and your patient panel is expanding. You probably want to bring on a new partner-maybe two or three-so you'll be recruiting. There's a physician shortage, so what's going to make your practice competitive?"
He also says that paper charts "are just not adequate" for reporting to Accountable Care Organizations unless practices continue to rely on claims data and incomplete documentation.
FierceEMR
9-30-2010
Blumenthal Calls Meaningful Use A "One Time Offer"
If you aren't going to achieve meaningful use this time around, don't expect the federal government to give you another shot at Medicare and Medicaid subsidies for EHRs.
"[The] federal government is making a one-time offer. We'll put money on the table to help you now but we're not going to put money on the table later," national health IT coordinator Dr. David Blumenthal says in an interview with CMIO, shortly after last week's release of the final rules for Stage 1 of the bonus program.
While HHS only specified the requirements for Stage 1, Blumenthal offers some hints about what to expect in Stage 2, which begins in 2013. For example, some of the measures that are optional in 2011 and 2012 will become "core objectives" later. "We also, I suspect, will be looking at more demanding forms of health information exchange and probably more decision support, more robust use of physician order entry and also administrative simplification," Blumenthal says. "All those things are possible targets for 2013 and beyond."
He believes the federal incentive program will drive improvement in EHRs themselves, thanks to increased demand for better systems. "As physicians and other health professionals adopt EHRs, they are going to become increasingly demanding of vendors for better functionality, better usability and more comprehensive capabilities, and I think they will move the market using their professional understanding of what their patients need," Blumenthal explains. "I also think they will demand of the hospitals that the systems they use work for them and work for their patients."
FierceEMR
9-30-2010
"[The] federal government is making a one-time offer. We'll put money on the table to help you now but we're not going to put money on the table later," national health IT coordinator Dr. David Blumenthal says in an interview with CMIO, shortly after last week's release of the final rules for Stage 1 of the bonus program.
While HHS only specified the requirements for Stage 1, Blumenthal offers some hints about what to expect in Stage 2, which begins in 2013. For example, some of the measures that are optional in 2011 and 2012 will become "core objectives" later. "We also, I suspect, will be looking at more demanding forms of health information exchange and probably more decision support, more robust use of physician order entry and also administrative simplification," Blumenthal says. "All those things are possible targets for 2013 and beyond."
He believes the federal incentive program will drive improvement in EHRs themselves, thanks to increased demand for better systems. "As physicians and other health professionals adopt EHRs, they are going to become increasingly demanding of vendors for better functionality, better usability and more comprehensive capabilities, and I think they will move the market using their professional understanding of what their patients need," Blumenthal explains. "I also think they will demand of the hospitals that the systems they use work for them and work for their patients."
FierceEMR
9-30-2010
Blumenthal: Meaningful Use Is Not Asking Too Much, Too Soon
In a post on the ONC's Health IT Buzz blog, national health IT coordinator Dr. David Blumenthal seems to reject the argument from many camps that the proposed standards for meaningful use are too difficult to attain, instead siding with those who believe that EMRs are a centerpiece of true health reform. "The question healthcare providers are facing today is whether we are pushing too hard, too fast to make this important change. I respectfully submit, no. In turn, I ask, 'Can we make these changes expeditiously enough?'" Blumenthal writes.
"This is the time to realize the promise of health IT. Information technology has improved every aspect of our lives, we need to channel information technology to improve our health and care. Providing patients with improved quality and safety, more efficient care and better outcomes is paramount," Blumenthal says.
Blumenthal recalls his days of practicing internal medicine at Massachusetts General Hospital in Boston, noting that he resisted switching to an EMR himself. "Over time, however, I found that working with health IT made me a better and safer physician. Most importantly, my patients received better, safer care and improved outcomes," he says. It's time, according to Blumenthal, for all Americans to get better care delivered at a lower cost.
FierceEMR
9-30-2010
"This is the time to realize the promise of health IT. Information technology has improved every aspect of our lives, we need to channel information technology to improve our health and care. Providing patients with improved quality and safety, more efficient care and better outcomes is paramount," Blumenthal says.
Blumenthal recalls his days of practicing internal medicine at Massachusetts General Hospital in Boston, noting that he resisted switching to an EMR himself. "Over time, however, I found that working with health IT made me a better and safer physician. Most importantly, my patients received better, safer care and improved outcomes," he says. It's time, according to Blumenthal, for all Americans to get better care delivered at a lower cost.
FierceEMR
9-30-2010
Texas Hospital Patient Data For Sale
If you've been a patient in a Texas hospital over the past 10 years, chances are high that the details of your stay have wandered the U.S. and popped up in all kinds of places. The Texas Department of State Health Services (DSHS) has sold or given away hospital patient data on more than 27 million hospital stays since 1999, according to a report by the Austin Bulldog, an investigative journalism nonprofit organization.
Attorney Jim Harrington, director of the Texas Civil Rights Project, told the Bulldog, that DSHS data sales represent a "wholesale invasion of families' medical privacy" and a "shocking breach of people's constitutional rights."?DSHS makes public use data files available through its website. The data files contain more than 200 kinds of information, naming your insurance coverage, whether the stay involved placement of a heart stent, sterilization, abortion performed due to rape, and any tests or medications you may have received.
Buyers can obtain two versions of the hospital patient files, one version containing complete personal info--which includes date of birth, date of admissions and discharge, and the patient's full address--and a second, "de-identified" version with some, but not all, personal information removed by DSHS. Data security experts claim that it's easy to re-identify people in de-identified data files by comparing them with other files, the Bulldog reports.
The data files DSHS distributes often go to non-physicians who use, sell, and re-sell hospital patient data, putting personal privacy at risk. The insurance lobby group America's Health Insurance Plans, in 2009, was one of many entities approved to buy the unrestricted research version patient data files. Since January 1, 2009, 98 customers bought patient data from Texas. Several are listed in the Bulldog article.
When asked to comment on the data downloads, Deborah Peel, an Austin psychiatrist and privacy advocate told the Bulldog, "The problem is, once [hospital patient data] gets out, there's no way to know where it went forever." She heads up Patient Privacy Rights, which is a foundation that's part of a network of organizations working to restore patients' right to control access to their sensitive health records. "There is no control over any third-party use," Peel noted.
FierceHealthCare
9-30-2010
Attorney Jim Harrington, director of the Texas Civil Rights Project, told the Bulldog, that DSHS data sales represent a "wholesale invasion of families' medical privacy" and a "shocking breach of people's constitutional rights."?DSHS makes public use data files available through its website. The data files contain more than 200 kinds of information, naming your insurance coverage, whether the stay involved placement of a heart stent, sterilization, abortion performed due to rape, and any tests or medications you may have received.
Buyers can obtain two versions of the hospital patient files, one version containing complete personal info--which includes date of birth, date of admissions and discharge, and the patient's full address--and a second, "de-identified" version with some, but not all, personal information removed by DSHS. Data security experts claim that it's easy to re-identify people in de-identified data files by comparing them with other files, the Bulldog reports.
The data files DSHS distributes often go to non-physicians who use, sell, and re-sell hospital patient data, putting personal privacy at risk. The insurance lobby group America's Health Insurance Plans, in 2009, was one of many entities approved to buy the unrestricted research version patient data files. Since January 1, 2009, 98 customers bought patient data from Texas. Several are listed in the Bulldog article.
When asked to comment on the data downloads, Deborah Peel, an Austin psychiatrist and privacy advocate told the Bulldog, "The problem is, once [hospital patient data] gets out, there's no way to know where it went forever." She heads up Patient Privacy Rights, which is a foundation that's part of a network of organizations working to restore patients' right to control access to their sensitive health records. "There is no control over any third-party use," Peel noted.
FierceHealthCare
9-30-2010
Wednesday, September 29, 2010
States Clash Over AMA's Role In HealthCare Reform
The Maine Medical Association denounced Florida doctors' criticisms that the American Medical Association supported healthcare reform without representing physicians' interests. Doctors in Maine are calling for members to support AMA leaders, reports Health News Florida.
Florida's vote of "no confidence" of the AMA jeopardizes the organization's ability to "effectively advocate for physicians and the patients they serve," said the Maine chapter in a letter to the national group, reports The Hill's Healthwatch blog.
"At a time when it is critically important for physicians, as a profession, to stand together, this action threatens the very principles that our AMA was founded upon," wrote Dr. Jo Linder, president of the MMA. "Now is not the time to squander our influence in petty bickering," she said.
The FMA took offense to Maine chapter's letter. The MMA should "respect the right of other state medical associations" to express their opinions, said FMA spokeswoman Erin Van Sickle in response, reports Health News Florida.
"The FMA is simply saying what the vast majority of physicians already think and what many members of Congress have already stated publicly," she added. The FMA hopes AMA leaders will conduct an internal examination to improve the organization, she said.
FierceHealthCare
9-29-2010
Florida's vote of "no confidence" of the AMA jeopardizes the organization's ability to "effectively advocate for physicians and the patients they serve," said the Maine chapter in a letter to the national group, reports The Hill's Healthwatch blog.
"At a time when it is critically important for physicians, as a profession, to stand together, this action threatens the very principles that our AMA was founded upon," wrote Dr. Jo Linder, president of the MMA. "Now is not the time to squander our influence in petty bickering," she said.
The FMA took offense to Maine chapter's letter. The MMA should "respect the right of other state medical associations" to express their opinions, said FMA spokeswoman Erin Van Sickle in response, reports Health News Florida.
"The FMA is simply saying what the vast majority of physicians already think and what many members of Congress have already stated publicly," she added. The FMA hopes AMA leaders will conduct an internal examination to improve the organization, she said.
FierceHealthCare
9-29-2010
Tuesday, September 28, 2010
Primary Care To Get A $320 Million Booster Shot From HHS
In an attempt to bring some relief to the seemingly endless primary-care shortage situation, Department of Health and Human Services Secretary Kathleen Sebelius announced this week that $320 million in grants will go toward "strengthening the healthcare workforce." Most of the money--$253 million--will be divided up among six programs specifically designed to beef up the workforce and aiding in disease prevention, while the remaining $67 million will help educate and train low-income individuals.
The news comes a little more than a week after an announcement from Sebelius that HHS will spend more than $130 million on similar projects that include enhanced equipment training for health professionals and loan repayment.
"Investing in our primary-care workforce will strengthen the role that wellness and prevention play in our healthcare system," she said, according to a press release. "With these grants, Americans from all backgrounds will have new opportunities to enter the healthcare workforce."
Known as Prevention and Public Health Fund Workforce Grants, $253 million will be divided as follows:
$167.3 million for Primary Care Residency Expansion
$30.1 million toward the Expansion of Physician Assistant Training (EPAT)
$31 million toward Advanced Nursing Education Expansion (ANEE)
$14.8 million for Nurse Managed Health Clinics (NMHC)
$5.6 million for State Health Workforce Development
$4.2 million for Personal and Home Care Aide State Training (PHCAST)
The $67 million set aside in Health Profession Opportunity Grants will help to train low-income individuals to become home care aides, certified nursing assistants, emergency medical technicians and registered nurses, among others.
"[Temporary Assistance for Needy Families] recipients and other low-income individuals want to succeed in the workplace, but sometimes lack the skills to do so," Earl Johnson, director for the Office of Family Assistance, said. "The Health Profession Opportunity Grants will offer quality training and an opportunity to enter a dynamic job sector with real opportunities for career development."
"FierceHealthCare"
9-28-2010
The news comes a little more than a week after an announcement from Sebelius that HHS will spend more than $130 million on similar projects that include enhanced equipment training for health professionals and loan repayment.
"Investing in our primary-care workforce will strengthen the role that wellness and prevention play in our healthcare system," she said, according to a press release. "With these grants, Americans from all backgrounds will have new opportunities to enter the healthcare workforce."
Known as Prevention and Public Health Fund Workforce Grants, $253 million will be divided as follows:
$167.3 million for Primary Care Residency Expansion
$30.1 million toward the Expansion of Physician Assistant Training (EPAT)
$31 million toward Advanced Nursing Education Expansion (ANEE)
$14.8 million for Nurse Managed Health Clinics (NMHC)
$5.6 million for State Health Workforce Development
$4.2 million for Personal and Home Care Aide State Training (PHCAST)
The $67 million set aside in Health Profession Opportunity Grants will help to train low-income individuals to become home care aides, certified nursing assistants, emergency medical technicians and registered nurses, among others.
"[Temporary Assistance for Needy Families] recipients and other low-income individuals want to succeed in the workplace, but sometimes lack the skills to do so," Earl Johnson, director for the Office of Family Assistance, said. "The Health Profession Opportunity Grants will offer quality training and an opportunity to enter a dynamic job sector with real opportunities for career development."
"FierceHealthCare"
9-28-2010
Monday, September 13, 2010
Technology Buzzword, EHR
EHR – an electronic health record is the digital version of your overstuffed filing cabinets. EHRs are much more efficient because they can coordinate medical records from various sources. They allow you to streamline the data retrieval system by replacing the arduous collection of data from various sources to a single point-and-click process. Electronic medical records allow the doctor to access information as varied as patient demographics, medical history, exam reports, x-ray images, and billing records in one place.
The majority of new EHR programs are HIPAA compliant.
That is, these programs comply with the Health Insurance Portability and Accountability Act provision that “requires the establishment of national standard for electronic healthcare transactions and national identifiers for providers, health insurance plans, and employers.”
EHRs are sometimes referred to as electronic medical records (EMRs) and these phrases are often used interchangeably.
ChiroEco 9-13-10
The majority of new EHR programs are HIPAA compliant.
That is, these programs comply with the Health Insurance Portability and Accountability Act provision that “requires the establishment of national standard for electronic healthcare transactions and national identifiers for providers, health insurance plans, and employers.”
EHRs are sometimes referred to as electronic medical records (EMRs) and these phrases are often used interchangeably.
ChiroEco 9-13-10
Wednesday, September 1, 2010
EMR Meaningful Use Checklist
Everyone should keep in mind that there are no systems “Certified” at this point.
Here are some things to check as you get ready to claim your incentives for EHR Meaningful Use under the HITECH Act. This information is based on (EPs) qualifying for the Medicare incentives.
1) Start talking to your vendor about their plans to submit their EHR software for certification as “Certified EHR Technology”. The system does not have to be certified as of January 1, but it does need to be certified by the end of the 90-day period you are using to attest to your EHR Meaningful Use.
2) Keep in mind that if you are using a stand-alone EMR product with an existing legacy practice management (PM) system, the system needs to be Certified EHR Technology also. This is because some of the functions of a certified system, such as recording patient demographics electronically, are most likely functions of your PM system, not the EMR product. So talk to that vendor, too.
3) Verify that any eligible provider attesting to meeting EHR Meaningful Use objectives provides 10% or more of his/her Medicare services in an outpatient setting (not inpatient or in a hospital ED). CMS will look at the percent of services rendered in an outpatient setting for the fiscal year ending 09/30/2010 to determine the IP/OP percentages. Your EHR healthcare consultant must be qualified to do the analytical and reporting work in preparing the self-attestation report, based on the current fiscal year and the individual EHR Meaningful Use objectives in place, starting January 2011.
4) Make sure all eligible providers you are planning to certify for EHR Meaningful Use have an NPI number and are enrolled in PECOS.
5) For EPs in group practices, confirm the tax Id number – group or personal – of each provider for payment of the incentive amount. Payments can be made to either number.
6) CMS will be establishing an Internet-based enrollment process for EPs planning to apply for incentive payments. Keep checking this site for the Registration process, and enroll when it is available.
7) As soon as you start the clock on your 90-day period, make sure you are meeting all the EHR Meaningful Use objectives applicable to your practice, and, for objectives with numerical thresholds, that you are attaining the levels specified. If your EHR system is Certified EHR Technology, it should be capable of supporting all Stage 1 Meaningful Use objectives.
8) Monitor the CMS website on EHR Incentive Programs to determine the format of the attestation for 2011. And keep in mind that accuracy is paramount; attesting to EHR Meaningful Use is making a claim to a Federal program. And the penalties for false claims are significant!
Attestations can be completed as early as April, 2011, and CMS has stated payments will be made in May. For EPs seeking incentive payments under the Medicaid / Medical program, visit the CMS website for further information.
John Lynn EMR and HIPAA
August 9, 2010
Here are some things to check as you get ready to claim your incentives for EHR Meaningful Use under the HITECH Act. This information is based on (EPs) qualifying for the Medicare incentives.
1) Start talking to your vendor about their plans to submit their EHR software for certification as “Certified EHR Technology”. The system does not have to be certified as of January 1, but it does need to be certified by the end of the 90-day period you are using to attest to your EHR Meaningful Use.
2) Keep in mind that if you are using a stand-alone EMR product with an existing legacy practice management (PM) system, the system needs to be Certified EHR Technology also. This is because some of the functions of a certified system, such as recording patient demographics electronically, are most likely functions of your PM system, not the EMR product. So talk to that vendor, too.
3) Verify that any eligible provider attesting to meeting EHR Meaningful Use objectives provides 10% or more of his/her Medicare services in an outpatient setting (not inpatient or in a hospital ED). CMS will look at the percent of services rendered in an outpatient setting for the fiscal year ending 09/30/2010 to determine the IP/OP percentages. Your EHR healthcare consultant must be qualified to do the analytical and reporting work in preparing the self-attestation report, based on the current fiscal year and the individual EHR Meaningful Use objectives in place, starting January 2011.
4) Make sure all eligible providers you are planning to certify for EHR Meaningful Use have an NPI number and are enrolled in PECOS.
5) For EPs in group practices, confirm the tax Id number – group or personal – of each provider for payment of the incentive amount. Payments can be made to either number.
6) CMS will be establishing an Internet-based enrollment process for EPs planning to apply for incentive payments. Keep checking this site for the Registration process, and enroll when it is available.
7) As soon as you start the clock on your 90-day period, make sure you are meeting all the EHR Meaningful Use objectives applicable to your practice, and, for objectives with numerical thresholds, that you are attaining the levels specified. If your EHR system is Certified EHR Technology, it should be capable of supporting all Stage 1 Meaningful Use objectives.
8) Monitor the CMS website on EHR Incentive Programs to determine the format of the attestation for 2011. And keep in mind that accuracy is paramount; attesting to EHR Meaningful Use is making a claim to a Federal program. And the penalties for false claims are significant!
Attestations can be completed as early as April, 2011, and CMS has stated payments will be made in May. For EPs seeking incentive payments under the Medicaid / Medical program, visit the CMS website for further information.
John Lynn EMR and HIPAA
August 9, 2010
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