Sens. Mark Pryor (D-Ark) and Jay Rockefeller (D-W.Va.) Introduce Legislation to Protect Personal Health Information:
- On August 5th, Senators Mark Pryor of Arkansas and Jay Rockefeller of West Virginia introduced legislation that would add additional requirements to HIPAA and HITECH privacy and security provisions by creating standards to restrict and safeguard personal health information. Under the proposed Data Security and Breach Notification Act of 2010, business and non- profit healthcare organizations that handle sensitive information would be required, under the watchful eye of the Federal Trade Commission, to establish comprehensive data compliance plans and following strict breach-notification requirements. Affected consumers would be entitled to receive consumer credit reports or monitoring services for two years under the legislation.
FCC Seeks Public Comment on Rural Health Care Infrastructure Program:
- The FCC’s Notice of Proposed Rulemaking (NPRM) to expand the Rural Health Care (RHC) Program was published in the Federal Register on August 9th. Program stakeholders are encouraged to review the NPRM and submit their comments to the FCC. Public comments are due September 8, 2010 and “Reply Comments” due September 23, 2010.
- The NPRM would establish a permanent telehealth infrastructure fund, cover more of the recurring cost for broadband connectivity, and expand the types of services and health care providers that are eligible to receive funding. The reforms are consistent with the recommendations set forth in the National Broadband Plan.
- Among other things, the Rural Health NPRM proposes:
– Support of up to 85% of new broadband infrastructure costs;
– Reimbursement for 50% of recurring monthly broadband costs (currently 25% for Internet Access only);
– Funding for eligible skilled nursing facilities, dialysis centers, and off-site administrative offices and data centers ;
– Clarification of the FCC’s existing recordkeeping requirements to enhance its ability to protect against waste, fraud and abuse ;
– Elimination of the current rule that requires that funding offset universal service contributions owed by participating service providers, direct distribution by Universal Service Administrative Company (USAC) of funds to service providers participating in the health broadband services program, telecommunications program, and health infrastructure program.
- In related rulemaking, the FCC sought public comment on a petition to permanently grandfather rural health care providers that would otherwise not be eligible for universal service support after June 30, 2011, absent Commission action. Comments were due August 30 and reply comments are due September 13.
CMS Helps State Medicaid Directors Further Understand HITECH Requirements:
- The Centers for Medicare and Medicaid Services (CMS) recently distributed a detailed letter to State Medicaid Directors providing guidance for implementing the ARRA provisions to promote the adoption and meaningful use of certified electronic health (EHR) technology and qualifying for incentives under the HITECH Act. ARRA provides 100 percent Federal financial participation (FFP) to States for incentive payments to eligible Medicaid providers to adopt, implement, upgrade, and meaningfully use certified EHR technology, and 90 percent FFP for State administrative expenses related to the program. The August 17 CMS letter discusses qualifying administrative expenses, requirements for matching funds, and appropriate use of the funds.
Agriculture and Commerce Departments Announce $1.8 Billion in Broadband Projects:
- On August 18th, Vice President Biden announced 94 Recovery Act projects across 37 states totaling $1.8 billion as part of a $7 billion effort to invest in broadband high-speed Internet in rural and urban areas. A joint effort of the US Departments of Agriculture’ Rural Utilities Service (RUS) and Department of Commerce’s National Telecommunications and Information Administration (NTIA), it includes projects geared toward education, public safety/ emergency response, social services and healthcare. A recent analysis by the National Economic Council had concluded that Recovery Act investments in broadband are expected to create tens of thousands of jobs in the near term, and expand economic development and jobs. Telehealth and HIT advocates have stressed the importance of coordinating Recovery Act broadband programs with the Medicare and Medicaid IT incentive funding initiatives toward a more complete solution to achieving an e-enabled healthcare environment. Click here for a list of the projects.
DHHS Announces $32 Million to Support Rural Health / Telehealth
- On August 23rd, Secretary Sebelius announced $32 million in FY 2010 funding to increase access to healthcare in rural areas. Among other elements, the initiative includes the Medicare Rural Hospital Flexibility Program, and Rural Health Workforce Development Program, as well as $2 million for Telehealth Network grants to build capacity to develop sustainable telehealth programs and networks, and $1 million for a Telehealth Resource Centers grant program to support technical assistance to help health care organizations, networks and providers implement cost-effective telehealth programs serving rural and medically underserved areas and populations.
White House Report Highlights Recovery Act Provisions on Health IT:
- On August 24th, Vice President Biden released a new White House Report entitled: “The Recovery Act: Transforming the American Economy Through Innovation” which discusses, among other initiatives, provisions related to incentives for health IT and broadband. Summarizing the effort related to building HIT capacity, the report states that: “The Recovery Act is investing approximately $20 billion in health information technology to boost significantly advancements in electronic health records, e-prescribing, e-care, and community health initiatives. Through the $250 million Beacon Communities program, communities will demonstrate the use of new technologies aimed at sustainable improvements in health outcomes, health care quality, safety, and efficiency. These efforts will not only cut certain medical costs, but also improve care. Finally, the rise in e-care technologies or telemedicine will allow medical personnel to treat patients remotely, while being able to monitor conditions and prescribe or administer medications from miles away.”
Secretary Sebelius Outlines Collaborative Efforts Behind the Nationwide Push to Electronic Health Records:
- In a Kaiser Health News guest column, DHHS Secretary Kathleen Sebelius discusses collaborative industry efforts toward eHealth Care, citing public/private sector leveraging efforts. Secretary Sebelius comments on the Brandeis University/Health Affairs Industry Forum at the National Press Club (see what’s happening August 16, 2010) noting that: “Health care providers may agree with the benefits of electronic health records. But they’ve also believed that adopting them was too difficult and expensive. As the event earlier this month demonstrated, that’s changing – in large part due to an ambitious investment we made in the Recovery Act to reduce many of the obstacles that limited the spread of electronic health records in the past”.
EHR Adoption and Meaningful Use:
- A recent article in Health Affairs by Ashish K. Jha, Catherine M. DesRoches and colleagues titled, “A Progress Report On Electronic Health Records In U.S. Hospitals” reports on a survey of E H R adoption in hospitals in the U.S. The survey found that although adoption increased from 8.7% in 2008 to 11.9% in 2009, only 2% of hospitals reported that their EHRs would allow them to meet Stage 1 meaningful use requirements. The two largest impediments to adoption were cost, often much more than the projected increase in CMS reimbursement, and the changes to clinical workflows that require modifications to existing procedures. The survey found that these impediments were stronger in small, public and rural hospitals which were less likely to qualify for meaningful use. The survey findings suggest important considerations for CHCs.
Shortage of Healthcare Workers to Install and Operate EHRs:
- The Office of the National Coordinator (ONC) estimates that an additional 50,000 workers will be needed to install and operate the EHRs required for meaningful use qualification. A new report by Walt Zywiak explores the implications of this new demand. Aside from the staffing and training considerations, Zywiak recommends exploring new ways to leverage IT resources such as remote hosting or vendor outsourcing of both deployment and operation/maintenance, shared HIT teams (as, for example, through Health Center Controlled Networks or ,Primary Care Associations) and use of pre-packaged or preconfigured systems to help minimize complexity of deployment and maintenance. Meaningful use will make HIT staff and HIT resources a more important focus for CHCs.
ONC Announces the First Two ATCBs:
- The Office of the National Coordinator today announced the first two organizations, CCHIT and the Drummond Group, to be approved as ONC Approved Testing and Certification Bodies, or ATCBs, under the temporary EHR certification program. Since 2006, CCHIT has held responsibility for certifying EHR technology. The Drummond Group is a testing and certification company in Austin, TX that has concentrated on software interoperability, compliance and standards testing. It has been in business since 1999.
ONC Announces New HIT Policy Committee Workgroup Stage 2 Meaningful Use Quality Measures:
- Quality measures and the quality measure convergence process will be an important part of the Stage 2 Meaningful Use criteria. ONC has convened a Quality Measures Workgroup of the HIT Policy Committee to produce initial recommendations on prioritizing quality measures. The Committee must prepare a set of recommendations for quality measures for inclusion in the Stage 2 Proposed Rule, to be issues some time in 2012.
- Measures were also discussed at the June 30 HIT Standards committee.