Meaningful Use

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The CMS and ONC Final Rules Arrive

Steve Posnack from ONC declared today IT Bonanza Day. The Interoperability Roadmap, CMS Meaningful Use Final Rules with a Comment Period (Stage 2 and 3) as well as the ONC 2015 Certification Rule were published today...Here’s my first impression: It remains to be seen how the comment period on the EHR Incentive Programs final rule will be used to align the Meaningful Use program  with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) effort. It would not surprise me that the CMS final rules are not really final...

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The Experience of Interoperability Thus Far

As I travel across the country and listen to CIOs struggling with mandates from Meaningful Use to ICD-10 to the HIPAA Omnibus rule to the Affordable Care Act, I'm always looking for ways to reduce the burden on IT leaders. All have expressed frustration with the health information exchange (HIE) policies and technologies for care coordination. quality measurement, and patient engagement. As a country, what can we do to reduce this anxiety? Read More »

The Fax of Life

Sarah Kliff | Vox | October 30, 2017

When you walk into the Arlington Women’s Center, you see a spacious waiting room with artwork on the wall, maroon chairs, and a friendly receptionist sitting at the front desk. The obstetrics and gynecology practice serves a high-income suburb of Washington, DC. Framed photographs on the wall advertise the center’s physicians who’ve made lists of the city’s best doctors. It’s a modern, upscale doctor office. But when it needs to share patient records, it turns to an outdated technology: the fax machine...

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The HITECH Era in Retrospect

John D. Halamka, M.D. and Micky Tripathi, Ph.D. | The New England Journal of Medicine | September 7, 2017

At a high level, the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 accomplished something miraculous: the vast majority of U.S. hospitals and physicians are now active users of electronic health record (EHR) systems. No other sector of the U.S. economy of similar size (one sixth of the gross domestic product) and complexity (more than 5000 hospitals and more than 500,000 physicians) has undergone such rapid computerization...

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The Next Generation of EHRs Will Be Fundamentally Different

Robert Rowley | CIO | March 29, 2017

Electronic Health Records (EHRs) have come a long way. Over 80 percent of physicians use them in their offices, and nearly all hospitals have implemented EHRs as well. Spurred by the HITECH portion of the 2009 Recovery act, Meaningful Use has put money on the table for physicians and hospitals to adopt and use EHRs. It also defined what kinds of features an EHR must have in order to be Certified. Legacy systems took on these new requirements by adding to their offerings (sometimes referred to as “bolt-on solutions”)...

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The Pathway to Patient Data Ownership and Better Health

Katherine A. Mikk, Harry A. Sleeper, and Eric J. Topol | JAMA | September 25, 2017

Digital health data are rapidly expanding to include patient-reported outcomes, patient-generated health data, and social determinants of health. Measurements collected in clinical settings are being supplemented by data collected in daily life, such as data derived from wearable sensors and smartphone apps, and access to other data, such as genomic data, is rapidly increasing. One projection suggests that a billion individuals will have their whole genome sequenced in the next several years. These additional sources of data, whether patient-generated, genomic, or other, are critical for a comprehensive picture of an individual’s health...

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The Patient Is Mentally Ill. Why Are We Only Treating His Broken Hand?

Nationwide, the patchwork nature of mental health care—most mental health hospitals lack electronic health records (EHRs)—drives up overall health care costs primarily through expensive emergency department (ED) visits by people who present with apparent mental health challenges. Of course, the disparity between mental and acute health care in the United States is caused by far more than a lack of EHRs in behavioral health settings. But more information enables better care and helps control costs, making it a necessary component in reforming the health care system.

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The Quality Payment Program Final Rule

Many people have asked me to review the Quality Payment Program final rule, released on October 14, 2016. Several summaries have already been written but your best bet is to rely on the CMS Quality Payment Program website at https://qpp.cms.gov. Yes, the rule is still complex - over 2400 pages, of which more than 50% is the mandated response to comments made on the proposed rule.  The good news is that CMS has been very responsive to feedback, creating a transition plan for adoption, reducing the number of criteria and extending the timeline which enables iterative learning before large scale implementation. Under the Quality Payment Program, clinicians have two approaches to choose from for reimbursement:  the Merit-based Incentive program (MIPS) and Advanced Alternative Payment Models (APMs)...

The State of Health IT according to the American Hospital Association

Andy Oram | O'Reilly Radar | May 6, 2012

Last week, the American Hospital Association released a major document. Framed as comments on a major federal initiative, the proposed Stage 2 Meaningful Use criteria by the Centers for Medicare & Medicaid Services (CMS) , the letter also conveys a rather sorrowful message about the state of health IT in the United States...

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Three Words That Health Care Should Stop Using: Insurance, Market, and Quality (Part 2 of 2)

Andy Oram | EMH & HIPAA | August 23, 2016

Andy Oram

Endless organizations such as the National Association for Healthcare Quality (NAHQ) and the Agency for Healthcare Research and Quality (AHRQ) collect quality measures, and CMS has tried strenuously to include quality measures in Meaningful Use and the new MACRA program. We actually have not a dearth of quality measures, but a surfeit. Doctors feel overwhelmed with these measures. They are difficult to collect, and we don’t know how to combine them to create easy reports that patients can act on. There is a difference between completing a successful surgery, caring for things such as pain and infection prevention after surgery, and creating a follow-up plan that minimizes the chance of readmission. All those things (and many more) are elements of quality.

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Time For Hard HITECH Reboot

John W. Loonsk | Healthcare IT News | May 29, 2014

...The Government Accountability Office reports that there is a lack of strategy, prioritized actions, and milestones in HITECH. HIT interoperability is recognized as being limited at multiple levels. And resultantly, the benefits of HIT that depend on a combination of adoption, interoperability, and health information exchange as table stakes are elusive...

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Too Soon to Tell If EHRs Provide Good ROI

Marla Durben Hirsch | Fierce Healthcare | July 20, 2016

There’s been a lot of hoopla about the role of electronic health records in patient safety, Meaningful Use, data sharing and security. But the elephant in the room is always "do EHRs provide a good return on investment? Will EHR users make more money?" It seems, based on recent research, that the answer might be yes. First, there’s the study that EHRs are adept at increasing a provider’s charge capture. By using their EHR’s automation and enhanced coding capability, pediatric primary care physicians saw an $11.49 increase on average, per-patient collections and an $11.09 increase on average, per-patient charges, as well as an improvement in collection ratios...

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UMD Researchers Develop Tool to Counter Public Health IT Challenges

Press Release | University of Maryland | August 9, 2016

Front-line protection of U.S. communities against disease epidemics relies on seamless information sharing between public health officials and doctors, plus the wherewithal to act on that data. But health departments have faltered in this mission by lacking guidance to effectively strategize about appropriate “IT investments. And incidents like the current Zika crisis bring the issue to the forefront,” says Ritu Agarwal, Robert H. Smith Dean's Chair of Information Systems and Senior Associate Dean for Faculty and Research at the University of Maryland’s Robert H. Smith School of Business...

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Understanding Effect of EHR Usability on Clinical Workflows

Sara Heath | EHR Intelligence | August 26, 2016

As EHR use becomes ubiquitous in the healthcare industry, questions about EHR usability come into play. Read More »

Update: CMS, ONC Ease EHR Certification Requirements For MU

Tom Sullivan, | Government Health IT | May 30, 2014

Healthcare providers and the IT vendors who serve them just got a dose of welcome relief from the increasingly controversial certification pieces of meaningful use.

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