Accelerating e-Prescribing

CCHIT to Offer Limited Certificate

According to Government Health IT, the Certification Commission for Health IT (CCHIT) recently indicated that it would move ahead with its plans to offer “more limited, modular” certification of electronic health records so providers could get a jump start on health IT purchases under the economic stimulus plan. CCHIT said it would hold a “Town Call” Web conference Sept. 3 to go over its “new paths to certification,” which involve offering preliminary certification for individual EHR components, such as electronic prescribing or computerized physician order entry software that meet the “meaningful use” conditions of the stimulus law.

“We are concerned that providers could not achieve meaningful EHR use in 2011 if they wait until spring 2010 – the expected date of HHS final approval of requirements – to begin adopting this technology,” said Mark Leavitt, CCHIT’s chairman. The American Recovery and Reinvestment Act (ARRA) required that providers be meaningful users of EHRs to be eligible for Medicare and Medicaid incentives beginning in 2011.

In addition to limited certification, CCHIT said it would continue to offer comprehensive certification of EHRs for different clinical settings that meet the terms of meaningful use.  The Department of Health and Human Service’s Health IT Policy Committee, chaired by national health IT coordinator Dr. David Blumenthal, has recommended that providers be required to purchase EHRs, or components of those systems, that are certified for a minimum set of measures of meaningful use.

The committee would not require CCHIT’s more comprehensive certification, but CCHIT said it would continue to offer it. The Health IT Committee also recommended that more organizations be able to certify systems in the future once a method was developed to approve them. 

The stimulus package required that providers be meaningful users of their electronic health records systems to be eligible for Medicare and Medicaid incentives beginning in 2011. HHS, which expects to publish an interim final rule in December, will not finalize details for meaningful use until early 2010.

CCHIT’s Sept. 3 Webcast will provide developers and vendors a chance to discuss details of the commission’s certification programs and the differences between the certification paths. CCHIT will also hold sessions Sept. 29 and Oct. 1 in Chicago to educate vendors and developers on new application processes, certification and system test scripts. 

Grants Available for HIT Infrastructure

According to Reuters, the U.S. government announced grants of almost $1.2 billion to help hospitals and healthcare providers implement and use electronic health records. The Obama administration has made the overhaul of the $2.5 trillion U.S. healthcare system the centerpiece of its domestic agenda, including the use of technology to improve efficiency and cut costs.

The grants include $598 million to set up some 70 health information technology centers to help healthcare institutions acquire electronic health record systems and $564 million to develop a nationwide system of health information networks. "Expanding the use of electronic health records is fundamental to reforming our healthcare system," said Health and Human Services Secretary Kathleen Sebelius, unveiling the grants with VP Joe Biden in Chicago.

The grants will be funded by the American Recovery and Reinvestment Act of 2009 and be made available in 2010, the statement said.

States at "Ground Zero" for Exchange of Health Information

National coordinator for health IT Dr. David Blumenthal told state Medicaid IT directors that they stood at "ground zero" in the health information exchange policy and technology hierarchy.  “This is in many ways ground zero for much of what my office and the Medicaid program and the federal health agenda have to accomplish,” Blumenthal told an audience of over 400 government IT officials attending the Medicaid Management Information Systems Conference in Chicago this week.  Dr. Blumenthal said states and local jurisdictions will be responsible for building the infrastructure on which health information exchange will operate. That means states also bear the burden of solving policy conflicts that will arise when health exchange transactions cross state lines.

States' success managing this jurisdictional “thicket” is essential to federal plans to finance a nationwide system of health information sharing.  “We won’t be successful unless you all take the initiative to find ways of allowing information to move across the jurisdictional boundaries that patients do not recognize when it comes to getting the care that they need,” Dr. Blumenthal said in recent remarks.

Dr. Blumenthal stressed that increasing social mobility required cross-jurisdictional care coordination. Citing a personal example, he said he routinely saw patients from other New England states when practicing medicine in eastern Massachusetts earlier in his career.

“Many of your states have medical markets that cross jurisdictions; so it’s going to be very important that you coordinate not only with the providers in your own communities but that you coordinate across state lines, difficult as that may be,” he said.

A good part of the difficulty stems from health information privacy protections that differ from state to state. Although the HITECH health IT funding law strengthened federal privacy regs, several states have imposed additional health information privacy requirements of their own, Blumenthal noted.

To assist in these efforts, Blumenthal said he hoped “in the very near future” to be able announce a “program or programs” involving $300 million Congress set aside in the HITECH legislation to provide states support in expanding heath information exchange.

Surescripts to Offer "The Nuts and Bolts of e-Prescribing" Webinar

Webinar To Be Presented on Tuesday, August 18th from 5:30 pm to 6:30 EST.

The eHealth Initiative, in partnership with Surescripts®, is presenting a series of webinars, entitled the “Nuts and Bolts of e-Prescribing”.

Our August 18th Webinar is designed to provide a general overview of e-Prescribing including:

• What is it?
• How does it work?
• How is it growing?
• How does it benefit clinicians, payers, pharmacies and patients?
• What type of systems can get practices connected.
• What questions should you ask potential vendors before you buy?
• How best to implement and use e-prescribing. 

In addition to a Surescripts representative, doctors that have successfully adopted and implemented e-prescribing in their practices will be on hand to speak to their experience.

Presenters include:

• Michael Hughes, Sr. Manager, Marketing Communications, Surescripts
• Dr. Steven Green, Garrard Clinic, Lancaster KY.
• Dr. Mark Earhart, Windridge Family Medicine, Watkinsville GA
  

The “Nuts and Bolts series of Webinars are designed to cover a broad range of topics related to adoption and implementation of e-Prescribing such as:

• How to Get Started
• Implementation Best Practices
• Physician Case Studies
• Health System/Large Clinic Case Studies
• Multi-Stakeholder Initiative Case Studies
  

These webinars are free for eHI members.  We always welcome the participation of non-members and all of eHI’s e-Prescribing webinars are open to outside participants for a cost of $50.00 per session. 

Click here to register for any e-prescribing webinar.

Governors Encourage Accelerated Adoption of e-Prescribing

According to a new Issue Brief from the National Governors Association Center for Best Practices, states are using innovative strategies to address the issue of integrated electronic health records and the electronic exchange of health information.

Accelerating the adoption of e-prescribing was the main focus of the report.  According to NGA, e-prescribing "improves patient safety and quality of care, increases prescribing accuracy and efficiency and reduces health care costs by making critical information available to health care providers. The use of e-prescribing will grow as states and others provide support for e-prescribing."

In recent years, e-prescribing has grown significantly.  At the current rate of adoption, e-prescribing will reach at least 50 percent of all prescriptions by 2012, according to State Alliance for e-Health Call to Action for NGA.

Stimulus Funds Help Train HIT Workers

Labor Secretary Hilda Solis (recently announced that $220 million in federal stimulus funds will be disbursed to programs that train workers in health care and other high-growth industries. Sec. Solis unveiled the plan Tuesday in Topeka, where she toured the Shawnee County Community Health Care Clinic.

Solis said in a news release that $25 million of the funds would be reserved for training in communities hurt by the recent restructuring of the auto industry.  The stimulus money will go to public entities and private non-profit groups that train workers in health information technology, nursing, long-term care and allied health careers.

Electronic Medical Records Work Well for Physicians

Doctors increasingly use e-mail and electronic medical records to improve health care. In an essay in the Los Angeles Times, Dr. Rahul Parikh, who is a pediatrician, writes about his own experience at a Kaiser Permanente facility in Northern California where they recently implemented an electronic medical record system:  "...notes, orders and prescriptions are clear and contiguous. There's no waiting for paperwork. And if a patient of mine shows up in another office across town (Kaiser is an integrated system -- we all share the same computer network), a doctor whom I have never met can see what I've written, my patient's list of problems and what I've done for the patient in the past before he or she even sets foot in the room to talk to the patient. Such record systems can alert us to possible medication errors or dangerous drug interactions. They can continuously be updated to identify best practices. And they talk to patients as well, allowing them to access past-visit information and immunization records and to make appointments and send e-mails to their doctor."

The piece explores criticism of electronic medical records including that data is rarely rechecked for accuracy, concern about the security of computerized health information, and what happens to health care should a system crash. Parikh ends the piece: "Ultimately, getting away from a pen and paper is better for my patients. So though electronic medical records are far from perfect, you'd have to tear my cold, dead hand from the mouse to make me go back to relying solely on pen and paper."

Surescripts and eHI Offer Webinar on e-Prescribing

CHT Member Surescripts in partnership with the eHealth Initiative (eHI) are hosting a new series of webinars, entitled “Nuts and Bolts of e-Prescribing.” The first webinar in the series,

"Case Studies of Large Physician Practices"will take place on July 15, 2009, from 2:00 - 3:00 p.m. ET.

 

This series of webinars will build off previous electronic prescribing webinars and cover a broad range of topics related to adoption and implementation of e-prescribing, such as:

• How to Get Started
• Implementation Best Practices
• Physician Case Studies
• Health System/Large Clinic Case Studies
• Multi-Stakeholder Initiative Case Studies

Join eHI and Surescripts for "Case Studies of Large Physician Practices"on July 15, 2009, from 2:00 - 3:00 p.m. ET. The webinar will feature experts discussing their experiences implementing e-prescribing, including: sharing of best practices, steps to overcoming obstacles, implementation advice, and more!

 

Presenters include: Tammy Anderer, Ph.D., CRNP, Department of Best Practices, Geisinger Health System and Maggie Felger, Information Technology Manager; Austin Regional Clinic.

 

Click hereto register today.

e-Health Savannah Project: Records upgrade tests docs

The following article recently appeared in the Savannah Morning News regarding electronic medical records systems recently installed in a free health clinic:

Volunteer Dr. Robert Proctor calls it the "kennel" where old dogs prove they can learn new tricks. Dr. Miriam Rittmeyer, executive director of the Community Health Mission, calls it the face of the future where electronic medical records replace paper for improved medical care for low-income and uninsured adults.

The computer-based system promises to streamline record keeping, reduce errors and enhance treatment of patients at the Eisenhower Drive site and at St. Mary's Community Center in Cuyler-Brownville. "The system is really beautiful," Rittmeyer said. "We are excited about it. It's going to make a difference."

The system went online June 9 - two weeks after St. Mary's went active - as staff and volunteer docs began the learning process.  It all began in July 2007 when Anita Nivens, associate professor of nursing and graduate nursing coordinator at Armstrong Atlantic State University, obtained a $1.4 million grant over five years to use the two clinics as partners.

A family nursing practitioner since 1980, Nivens said she saw first-hand the great needs of the uninsured and set out to help find solutions.  "What we do doesn't begin to scratch the surface," she said. But it is a great help, Rittmeyer said.

Because the clinics rely on Memorial University Medical Center and the St. Joseph's/Candler system respectively, the new program provides collaboration with the hospitals, Rittmeyer said. It will eventually link the two clinics with federally qualified centers at Curtis V. Cooper Primary Health Care and Union Mission's J.C. Lewis Health Center through the Chatham County's Safety Net Planning Council, Rittmeyer said.

By year's end, they will be connected to pharmacies.  And down the road, to emergency departments at the three local hospitals, Rittmeyer said.

The Community Health Mission is the combination of the Savannah Health Mission and the Community HealthCare Center providing primary health care for low-income and uninsured folk.  It found a kindred spirit in the Alliance for Chicago Community Health Services, a group of four inner-city sites serving the same basic groups.

And with it, the group's cutting-edge use of electronic medical records. With the program used by the Chicago group, doctors are able to view patient histories, medications, schedules, instructions and allergies on a screen with the click of the mouse.

For Proctor and many of a group of almost 100 doctors - including 18 retired physicians - who volunteer at the mission, the new system is a challenge.  Most are products of the hand-written charts and records being replaced by the new system.  Once they overcome the newness, they can see the benefit.

"I'm the old dog and this is the new trick," Proctor, 75, said as he fired up his computer program. "I'm seeing patients in two-thirds the time as I did last week."  An internal medicine specialist, Proctor practiced medicine for 50 years, most recently in emergency rooms across Georgia.  He has been at the mission since September and retired from paid medicine in November.  He volunteers on Tuesdays, and on Thursday's he works with another clinic on Gamble Road with a largely Hispanic population.

Ailments range from diabetes and hypertension to obesity and occasionally mental health issues.  Here, financial problems mix with medical issues.  "These people are under a lot of stress," he said. 

Massachusetts Bill Extends Tax Breaks for Companies Encouraging e-Prescribing

Companies that make it easier for doctors to write prescriptions electronically would be eligible for a tax break under a bill being considered on Beacon Hill.

Massachusetts lawmakers have been pushing hospitals, doctors and insurers to make the switch to electronic medical records-keeping saying. They say it could save millions in paperwork at a time when the state is trying to reign in runaway health care costs.

The bill, sponsored by state Rep. Peter Koutoujian, would give companies a tax break on the cost of purchasing and installing the technology.

The Waltham Democrat is also backing a bill giving companies tax breaks for sponsoring employee wellness programs.