Meaningful Use Final, Certification, EHR: 3 concepts spilled about these past 18 months like over-buttered popcorn across a theatre’s gooey floor. Slippery. Sticky. Messy. Repulsively Intriguing.

Somewhat ignored in this regulatory skein has been Health Information Exchanges, HIE’s. Critical to healthcare data transfer between disparate applications, locations, and practices, HIE’s have been expanding functionality and gaining ever more traction across the healthcare industry even as the sky “falls” following ARRA.

So what’s the latest on HIE? The following links give a rather auspicious glimpse of this part of the MU “cataclysm.”

Washington-based eHealthCare Initiatives’ 2010 HIE survey was released this week and can be found here.

CMIO has done a fine job of parsing the survey numbers. The article can be found here.

Take 2 parts I.T., 1 part improved public health, 3 parts research database, a pinch of certification and 19 billion parts federal incentive and what do you get? Healthcare executive consensus on prioritizing Meaningful Use.

InfoWeek breaks down the numbers in CSC’s survey of healthcare IT and non-IT executives’ intended compliance with MU. Not surprising, the “suits” parade in unison.

Get the whole story to feel “with it” or “left behind”:

CSC Survey parsed by InfoWeek

We are a culture of of contradictory preferences.

July’s International Journal of Internet and Enterprise Management publishes a report by Ajit Appari, PhD, research fellow at the Glassmeyer/McNamee Center for Digital Strategies at Dartmouth College’s Tuck School of Business, and M. Eric Johnson, director of the center, that the growth of electronic healthcare suffers from a judged lack of security.

As media reports of data breaches permeate the ether, health consumers’ fears over privacy and security multiply. Yet, the federal mandate in ARRA to effect digitized health records, can seem to run counter to securing such records, Appari and Johnson discovered.

So, like many things human – except for FaceBook, we prefer the benefits but loathe any consequent exposure.

More about this conundrum and fuller details of the report can be found here: CMIO.net report on Appari/Johnson Security Survey

In a related privacy issue, the government has arrived and is here to help. An April 1, 2010, initiative to assess risks and provide tools to combat threats against the health IT community, educate health IT users about security awareness, provide proper IT management guidance and create support functions has been followed by the ONC rolling out an 18-month effort to strengthen electronic healthcare cybersecurtiy. The ONC is requesting the public share its experiences with electronic health records (EHR). More on this effort can be found here: ONC Healthcare Initiative Privacy Anecdote Gathering

At this link, prove to yourself that while Security HIT Breaches happen, they aren’t apocalyptic by clicking on Health IT Mag’s link below the article.

The attached link was a curious find. Access the just-released pdf results of Embarcadero Technologies' online survey conducted last spring. In a nutshell, results show improving EHR is being embraced positively, propelled by federal incentives attached to ARRA/Meaningful Use.

Remember, however, while these results indicate trends that should bode well for healthcare providers, vendors, consultants, and (most importantly) patients, this is NOT a scientific sample. Still, the visuals on pages 4 and 5 are compelling for the HIT industry. And the chart colors used? Well, let’s just say they are vivid!

Healthcare Data Management Survey Report

Amid the sweltering summer blizzard of last week’s MU finalization, the VCS BlogMasters lost sight of the earlier, July 7, announcement by CMS and ONC that “current health information privacy and security rules will now include broader individual rights and stronger protections when third parties handle individually identifiable health information.”

So, here’s the delayed scoop (if that’s even possible!):

These measures expand and strengthen privacy, security, and enforcement rules of HIPAA ’96.

“Giving more Americans the ability to access their health information wherever, whenever and in whatever form is a critical first step toward improving our health care system,” said David Blumenthal, M.D., M.P.P., HHS’ national coordinator for health information technology,

HHS Secretary Kathleen Sebelius added, “While health information technology will help America move its health care system forward, the privacy and security of personal health data is at the core of all our work.”

The full press release can be found here: http://www.hhs.gov/news/press/2010pres/07/20100708c.html

In a related matter, the National Institute of Standards and Technology has developed and sold a role-based-workflow (RBW) security application that restricts access to patient information based on a situational need. NIST sold the patent.

NIST’s press release can be found here: http://www.nist.gov/itl/csd/health_070610.cfm

Both developments bode well for VCS clients. Ensuring privacy while improving workflow has posed a challenging solution for most HIT vendors even as medical record privacy has been a salient concern for most patients.

VCS humbly extends congratulations to Johns Hopkins Hospital and the Cleveland Clinic – two of the top four institutions on US News and World Report’s 2010 Best Hospitals Honor Roll – that were cited for “tak(ing) on and meet(ing) the most difficult challenges” in patient healthcare.

Because each ranked in the top 25 of sixteen respective care specialties, we also acknowledge the following VCS clients for their dedication and expertise: Stanford Hospitals and Clinics, University of Iowa Medical Center, NYU Langone Medical Center, Fox Chase Cancer Center, Clarian Health Partners, Hospital for Special Surgery, Massachusetts Eye and Ear Infirmary, McLean Hospital, Shands at the University of Florida.

VCS extends kudos to its pediatrics clients that garnered honor roll laurels: Children's Hospital Boston, Children's Hospital of Pittsburgh, and Cincinnati Children's Hospital Medical Center. Each scored high on all ten pediatric specialties assessed In addition, Children's National Medical Center, and Nationwide Children's Hospital were cited for expertise in neonatology, cancer, and heart and heart surgery and gastroenterology, pulmonology, and heart and heart surgery, respectively.

We are privileged to be serving these pillars of medical expertise.

Below are two links to substantive accounts of the latest MU evolution. The first, released yesterday, is an explication by HHS National HIT Coordinator Dr. D. Blumenthal & CMS deputy administrator M. Tavenner. Given tables summarize new Core and Menu Set objectives.

The second link takes you to HISTalk’s Inga, who had by early morning today, compiled a straight-forward contrast, sort of a “then-and-now,” as regards MU after yesterday’s announcement by HHS.

You’ve probably spent the last 24 hours squinting at as many websites & sources as we have. Trying to keep you up-to-date while avoiding information overload & repetition, the blogmasters extend what we’d like to call a representative sample of our latest research done for you by our agents in the field.

Meaningful Use Regulation for EHR

Inga's Comparison

Today’s big story is that the CMS and ONC offices relented to the onslaught of protests from healthcare groups and have announced clarifications to the MU incentive eligibility criteria. The Feds have backed off of the initial “all-or-nothing, pass/fail” approach to the 20+ requirements of MU compliance and eligibility to incentives.

Now, a core set of objectives with associated measures and a menu set of objectives with associated measures has been established.

“In order to qualify as a meaningful EHR user, an EP, eligible hospital, or CAH must successfully meet the measure for each objective in the core set and all but five of the objectives in the menu set. With one limitation, an EP, eligible hospital, or CAH may select any five objectives from the menu set to be removed from consideration for the determination of qualifying as a meaningful EHR user,” quoth the rule.

CPOE criteria – originally set at hospitals running 10% of all orders through CPOE in first 90 days to qualify for incentive – have been modified to an incremental approach that will start with achieving 30% of medication orders only to qualify.

Plenty of links, below, provide greater detail. But this information should permit VCS clients to exhale a bit, and VCS consultants to plan how best to help clients achieve the new eligibility requirements.

http://www.modernhealthcare.com/article/20100713/NEWS/307139973

http://articles.icmcc.org/2010/07/13/a-meaningful-definition/

http://www.scribd.com/doc/34265058/Meaningful-Use-final

video of announcement: http://www.youtube.com/watch?v=0jPSa-tfyKs

With CPOE compliance looming for 2011/2012, Kathy Donlin-Shore, RN, Project Manager with our PMO Services, offers some valuable project management and organizational techniques to facilitate a smoother adoption of this Meaningful Use plank. Read her nine recommendations on how to best implement CPOE.  Her best practice suggestions include:

• Instilling Physician Leadership
• Establishing Governance and Clinical Advisory Committees
• Developing Integrated Physician and Multi-Disciplinary Workflows
• Understanding the Culture of the Organization
• Coordinating Project Managers, Team Leads, and Clinical Rapport
• Training for Go Live
• Keeping support nearby at Go Live

Check out the full article here: Successful Keys to CPOE Adoption

The recently published PriceWaterhouseCoopers Health Research Institute report, Ready or Not: On the Road to the meaningful use of EHRs and health IT, has circulated through the blogmasters desk, and in our continuing effort to keep you informed, we’ve produced the following abstract…

After surveying 120 CIO’s and another handful of healthcare executives, the PwC report adds heft to the impact of the ARRA’s Meaningful Use (MU).

The report makes many keen assertions including:

• “Health systems will need to transform the way they deliver care, so they can sustain performance and grow revenue in the future.”
• Successfully achieving meaningful use “hinges on closer integration with key constituents” (physicians, health insurers, patients).
• Health systems that already have connected with physicians, patients, and health insurers around MU are “more likely to be applying for government incentives” than those that haven’t. But only half of respondents expected to apply for incentives in 2011. (By 2014, 90% expect to be applying).
• Health systems that have included patients in the planning are “more confident about meeting MU standards.”
• “Implementing MU can enhance hospital-physician alignment.”
• Most health systems are failing to connect with health insurers around MU.
• 80% of CIO’s are more than concerned about meeting MU requirements by deadlines. (An American Hospital Association survey reports that 55% of hospitals expect to incur penalties.)
• “The benefits of achieving MU outweigh the challenges.” Those benefits include improve healthcare quality, disease management, coordination of care, improved alignment with physicians, increased productivity, market advantage, and improved alignment with payers.

But PwC identified four barriers to attaining MU: Lack of MU standards clarity, shortage of skilled IT staff, vendor readiness, limited capacity of existing infrastructure . . .

and proffered five benchmarks to achieve compliance: Establish governance, balance compliance against competing priorities, forge new public-private ventures, make the patient the purpose, collaborate with physicians and health insurers.