• On May 10th InformationWeek detailed a new report by the Commission on U.S. Federal Leadership in Health and Medicine (http://www.cspresidency.org/Programs/health_and_medicine.php) entitled: “A 21st Century Roadmap for Advancing America’s Health: the Path from Peril to Progress.” The May 5th report highlights the role HIT will play in re-engineering healthcare through the adoption of electronic health records, providing better analytics, and driving greater efficiency as the country builds a more comprehensive framework that strengthens the public health infrastructure. Additionally, new systems can create cost savings. “If used in innovative ways, the estimated savings from HIT expansion could reach $261 billion over 10 years,” the report said.  However, the goal of widespread implementation of EHRs is still in the nascent stages of development, with only 20.5% of physicians and 8-10% of hospitals using basic EHRs. Fewer still are meaningfully applying HIT to advance care coordination, aide clinical decision-making, or report health outcomes, among other practice. To gain appreciable benefits from HIT, a comprehensive approach must be adopted.
  • On May 4th, Vice President Biden together with DHHS Secretary Kathleen Sebelius announced that 15 communities will serve as health IT models under the $220 million Beacon Community program. Sebelius said the selected communities will offer insight into how health IT can improve health care delivery. The Office of the National Coordinator for Health IT received 130 applications for the grants. Some additional Beacon Community awards may be announced shortly. http://healthit.hhs.gov/portal/server.pt?open=512&objID=1422&mode=2
  • Mary Mosquera writes in the April 16th issue of Government Health IT that: President Obama signed into law legislation that allows physicians who treat patients in hospital-based outpatient clinics to be eligible for incentive payments under the HITECH Act. By modifying the definition of hospital-based physician, the administration will enable many more physicians to become meaningful users of electronic health records. http://govhealthit.com/newsitem.aspx?nid=7353
  • On April 15th, Representatives Patrick Kennedy (D-R.I.) and Tim Murphy (R-PA), Co-Chairs of the House 21st Century Healthcare Caucus, introduced the Health Information Technology Extension for Behavioral Health Services Act of 2010. This legislation would extend the incentives for the “meaningful use” of electronic health records established through the American Recovery and Reinvestment Act by ensuring the eligibility of many behavioral and mental health professionals, psychiatric hospitals, behavioral and mental health treatment facilities, and substance abuse treatment facilities.
  • Computer Sciences Corporation, one of the contractors that HHS used to develop the National Health Information Network, has issued a report on the top 10 challenges facing healthcare providers qualifying for meaningful use incentives. These challenges include: establishing effective workflows, using computer-based order entry systems, configuring EHRs to do ePrescribing and implementing health information exchange capabilities. The Foundation believes that meeting the consumer-based criteria will also be challenging. The report can be found at: http://www.csc.com/health_services/insights/44165-meaningful_use_for_eligible_professionals_the_top_ten_challenges
  • On April 6th U.S. Department of Health and Human Services Secretary Kathleen Sebelius announced that more than $267 million has been awarded to 28 additional non-profit organizations to establish Health Information Technology Regional Extension Centers (RECs). This investment, funded by the American Recovery and Reinvestment Act of 2009, will help grow the emerging health information technology (health IT) industry which is expected to support tens of thousands of jobs ranging from nurses and pharmacy techs to IT technicians and trainers.  RECs enable health care practitioners to reach out to a local resource for technical assistance, guidance, and information on best practices. RECs are designed to address unique community requirements and to support and accelerate provider efforts to become meaningful users of electronic health records.
  • The HIT Policy Committee of the Office of the National Coordinator has recently made a series of recommendations regarding meaningful use qualification, certification of EHRs and privacy and security. The primary recommendations include relaxing the ‘all-or-none’ requirement for qualification so that there would be some mandatory criteria & some flexibility in meeting many of the others. Both the Certification and the Privacy/Security Workgroups made recommendations regarding EHR modules. These are important primarily because HHS is taking seriously the idea that meaningful use qualification could be done without using a single EHR application that covered all of the potential required function. Qualification can also be done using a series of EHR modules, software that provides only one or a few of the required functions. This combined with any relaxing of the ‘all-or-none’ rule could be very significant for health centers. The foundation will provide more commentary on this in the coming months. The Policy Committee’s recommendations can be found by clicking here.
  • Early in April (2010), the Food and Drug Association’s Center for Devices and Radiological Health (http://www.fda.gov/AboutFDA/CentersOffices/CDRH/default.htm) established a working group to determine if and how the FDA should regulate EHRs. There have been several recent reports and published papers indicating that EHRs, and particularly computer-based provider order entry (CPOE) may have negatively affected both operational effectiveness and clinical outcomes. For recent articles, see Metzger et al. in Health Affairs 29(4) 655-663. http://content.healthaffairs.org/cgi/content/abstract/29/4/655) and a piece by Fred Schulte and Emma Schwartz featured in the Huffington Post Investigative Fund.
  • The FDA could regulate EHRs in a number of ways; the most onerous would be as a medical device, in which case they would have to undergo clinical trials. The ONC’s HIT Policy Committee recently recommended that the ONC work with the FDA and other stakeholders to determine what role the FDA should play in EHR certification and regulation. More information can be found at: http://govhealthit.com/newsitem.aspx?nid=73573