• Blumenthal Discusses Barriers to HIT Adoption
National Coordinator for HIT David Blumenthal, spoke at an October 30th briefing in Washington on efforts by the U.S. and other countries to support HIT adoption. He outlined four barriers to EHR adoption in the U.S. as follows: 1) the lack of adequate funds to acquire, adopt and maintain HIT; 2) the lack of an infrastructure to support health information exchange; 3) concerns among providers and provider organizations about EHR certification, what EHR to purchase and whether their selected EHR would become outdated (or decertified) quickly; and 4) consumer and patient opinion that exchange of healthcare information will not be sufficiently private. Blumenthal remarked that he felt the HITECH Act addressed these concerns. In response to a question about the use of social networking in HIT, he  replied that social networking tools might be useful in the future, but that healthcare information had to first be available in an electronic form. For more, see MODERN HEALTHCARE.

• 64 EHR Products Currently Certified
The Office of the National Coordinator (ONC)  list of certified HIT products list has 64 EHR or EHR Module products as of November 1, 2010. The list consists of 42 complete EHRs and 22 EHR modules. The modules range from simple components such as patient registries to more complex software providing ePrescribing and medication history function. Complete EHRs are certified to provide all aspects of Stage 1 meaningful use capability. Review the Certified Product List.


• Morehouse to Create Minority Health Disparities Database
The Morehouse School of Medicine (Atlanta, GA) has received a 3-year, $13.3 million grant from the National Institutes of Health to create a repository of clinical and genetic data from minority patients, known as the  “Minority Health Genomics and Translational Research Bio-Repository Database (MH-GRID) Network: A Genomics Resource for Health Disparity Research”.  The data will be aggregated from EHRs at hospitals, community health centers and other healthcare organizations primarily treating minority populations and will be used to study disparities affecting the minority population. The first effort will be to study disparities in treatment and outcome of hypertension and its complication, including stroke. Ultimately, the study investigators hope to use the database to help develop approaches to personalized medicine that could be applied across diverse patient populations. Read the Morehouse Press Release.

• New DHHS Grant Opportunity for “Early Innovators” Announced
DHHS announced competitive funding opportunities on October 29th for states to design and implement the Information Technology (IT) infrastructure needed to operate Health Insurance Exchanges.  The Exchanges represent new competitive insurance marketplaces that will help Americans and small businesses purchase affordable private health insurance starting in 2014 and a strong IT infrastructure will be critical to their success.  For the first time, funding will be directed to states that are willing and able to lead the race to develop IT systems.  These systems can then be used as models by all states in their efforts to establish Exchanges.  The new competitive “Early Innovators” grants will reward States that demonstrate leadership in developing cutting-edge and cost effective consumer-based technologies and models for insurance eligibility and enrollment for Exchanges. Two year grants will be awarded by February 15th, 2011 to up to five states. For more, see the HHS Press release.


• New York State Plans Extensive  Health Information Exchange (HIE)
The New York State Department of Health (NYDOH) and the New York eHealth Collaborative (NYeC) have submitted a plan to the ONC for a state-wide HIE that would serve up to 20 million patients. The plan will use $129 million in State and Federal funding to create the Statewide Health Information Network for New York (SHIN-NY). The proposed HIE will integrate several regional exchanges with new infrastructure and programming. In addition, state agencies will set policies for governance and maintenance of the exchange. The first deployment is expected in mid-2011 with new services and organizations being added through 2014. Read more in the NY eHealth Collaborative Press Release.

• Dr. Wakefield Announces “Find A Health Center” Mobile App
On October 29th, HRSA Administrator Mary Wakefield, Ph.D.blogged about a new, free, mobile iPhone “Find a Health Center” application.   Dr. Wakefield says that already, an average of 3,200 people use “Find a Health Center” to locate high quality, affordable care at HRSA-supported community health centers. Now, users can go mobile by downloading the new application directly to their phones.

• States Working to Improve Their Medicaid Management Information Systems
A November 3rd report in Federal Telemedicine News, reports that several states are planning to replace their Medicaid Management Information Systems (R-MMIS).   According to Carolyn Bloch’s article, States working to upgrade their systems include New Jersey, Louisiana, South Carolina, New York Missouri, and Utah.


• ONC Opens Public Comment Period on PHRs
The ONC has announced a public comment period on issues related to personal health records (PHR) in conjunction with its PHR Roundtable to be held this December. The specific issues for comment are: privacy and security risks for all parties including non-covered entities; emerging technologies and business models related to PHR; consumer expectation about collection and use of health data and  any other PHR related issues or concerns. The comment period is open until December 10, 2010. For specific details on submitting comments, see the ONC PUBLIC COMMENT NOTICE.

• DHHS Blog Opens Door for Increased Consumer Involvement 
A November 1st blog by Jodi Daniel, JD, MPH of the ONC Office of Policy and Planning further helps set the stage for empowering consumers to better manage their health through information technology (IT). As part of its five-year Federal Health IT Strategic Plan, ONC is seeking input during public forums and on the web regarding: how best to engage consumers in HIT policy and programs; accelerate consumer access to electronic health information; foster innovation in consumer health IT; and, drive consumer-provider electronic communications.


• New Report Summarizes HIT Effect on Clinical Workflow
A new report, “Incorporating Health Information Technology into Workflow ReDesign” by the University of Wisconsin-Madison Center for Quality and Productivity Improvement summarizes previous work on the effect of HIT adoption and use on clinical workflow. Beginning with a data base in excess of $700 articles, the study examines HIT and workflow in 192 previously published articles on HIT and workflow. The care settings included primary care settings (54 %) and as well as specialty and other settings (46%).  The most commonly used HER application in the study settings was  some form of clinical decision support (40%),  followed by EHRs (23%) , telemedicine applications (19%) and separate ePrescribing applications (4%).  Others reported use of various applications such as registries and public health reporting applications. The analysis showed mixed results with respect to workflow, safety and outcome improvement. The investigators conclude: “The main reasons seems to be a lack of integration of health IT into clinical workflow in a way that supports the cognitive work of the clinician and the workflows among organizations (e.g., between a clinic and community pharmacy), within a clinic and within a visit. It is clear that if health IT is to provide optimum performance, it must be designed to fit the specific context in which it will be used, specifically practice and patient types.” The purpose of the study was to provide a toolkit to allow the assessment of workflow in order to successfully implement HIT. This toolkit is described in the report. To download the report, copy and paste this link into your browser:

• Industry Survey: Half of  All Healthcare Providers Using Some Form of EHR  
A survey by the CompTIA of 370 IT firms in the United States , 40% of which are in healthcare, claims that 34 % of healthcare providers report using a comprehensive EHR system, while an additional 16% say they are using a partial system.  More than half of the adopting healthcare providers report that they are completely or mostly satisfied with their systems.  As reported in the Comp TIA Press Release about half of all healthcare practices are expecting to  increase their IT expenditures over the next 12 months.