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‘Bitter Pill’ only tells half the story

I finally got around to finishing “Bitter Pill: Why Medical Bills Are Killing Us,” the 24,000-word special report about healthcare costs that took up the entire feature section of the Feb. 20 edition of Time magazine. I was expecting to agree with most if not all of Steven Brill’s supposedly epic investigative piece. Instead, I was underwhelmed and quite disappointed that Brill, the founder of CourtTV (R.I.P., reincarnated as TruTV in Turner Broadcasting’s quest for more “reality” programming) and of American Lawyer magazine,  only told half the story about all that ails the U.S. healthcare industry. Brill also editorializes far more than he should.

Granted, the story is about the high cost of care, but you can’t discuss cutting costs without also delving into the subject of improving outcomes. As has been stated in many other places, we have more of a sick-care system than a healthcare system. The incentives favor treating illness, not preventing it.

I have to say I learned a lot about how the racket known as the chargemaster works to keep the true costs of care opaque to patients. I suspect that, with the exception of uninsured people who are the only ones expected to pay full price, the public was unaware of the chargemaster system that hospitals guard like a state secret. Brill is right when he says, “Unless you have Medicare, the health care market is not a market at all. It’s a crapshoot.” But he’s not telling the full story. Medicare’s payment list is public, sure, but do Medicare beneficiaries really care what the federal government pays their hospitals and doctors? No, they, like everyone else with insurance coverage, only pay attention to their out-of-pocket cost.

Sure, Brill spends a lot of time discussing the perverse incentives in healthcare, particularly those that encourage expensive testing, and even touches on some of the reforms in the Patient Protection and Affordable Care Act that seem to have been left out of the debate over insurance coverage. Think the Medicare policy of not reimbursing hospitals for certain preventable readmissions.

But he completely neglects accountable care. Nor is there a mention of electronic health records and how interoperability can help reduce duplicate testing and unnecessary care. And he never addresses the elephant in the room, the shamefully high rate of medical errors that makes American healthcare far from the best in the world.

July 23, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

More on Blue Button Plus and MU2

My last post, based on comments from Frost & Sullivan health IT analyst Nancy Fabozzi at last week’s Healthcare Unbound conference, has generated a bit of controversy. Fabozzi said that “Blue Button Plus is totally disruptive,” possibly eliminating the need for some providers to get full-fledged patient portals in order to meet Meaningful Use Stage 2 standards.

In the comments under that post, David Smith of HealthInsight.org, a health improvement consortium in three Western states, correctly pointed out that MU2 requires not just that providers give 50 percent of patients electronic access to their records, but also that 5 percent of patients actually view, download and/or transmit information back to their doctors or hospitals. I also got an e-mail from a GE Healthcare executive reminding me that of the view/download requirement as well as the fact that EHR technology had to be certified by an ONC-approved certification and testing body.

The viewing and downloading certainly can be accomplished with Blue Button Plus apps or widgets. In fact, ONC’s Lygeia Ricciardi has said Blue Button Plus could be part of the Stage 3 rules.

Transmitting would seem to necessitate a portal since HIPAA demands — and patients should expect — security when sending protected health information over the Internet. Standard e-mail doesn’t cut it, but e-mail following Direct Project protocols does. MU2 already sanctions Direct Project for health information exchange between healthcare entities. There is no reason why it can’t work for individuals as well, as Dr. Deborah Peel’s Patient Privacy Rights Foundation is trying to facilitate.

This might be a bit unwieldy, asking each patient to set up a Direct e-mail address, but remember, providers only need 5 percent to do so in Stage 2. I see it as perfectly feasible that some small physician practices could bypass the portal and just make do with freely available resources like Blue Button Plus — though Blue Button Plus app developers likely will charge fees — and open-source Direct standards.

UPDATE, July 18, 12:40 a.m. CDT:

HHS itself says Blue Button Plus meets MU2 standards.

From http://www.hhs.gov/digitalstrategy/open-data/introducing-blue-button-plus.html:

Blue Button Plus is a blueprint for the structured and secure transmission of personal health data. It meets and builds on the view, download, and transmit requirements in Meaningful Use Stage 2 for certified EHR technology in the following ways —

Structure: The recommended standard for clinical health data is the HL7 Consolidated Clinical Document Architecture or Consolidated CDA. The C-CDA is a XML-based standard that specifies the encoding, structure, and semantics of a clinical document. Blue Button Plus adopts the requirements for sections and fields from Meaningful Use Stage 2.

Transmit: In alignment with Meaningful Use Stage 2 standards, Blue Button Plus uses Direct protocols to securely transport health information from providers to third party applications. Direct uses SMTP, S/MIME, and X.509 certificates to achieve security, privacy, data integrity, and authentication of sender and receiver.

It sounds to me like compliance is just a matter of making sure that a Blue Button Plus app is certified as an EHR module.

July 17, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

‘Blue Button Plus is totally disruptive’

AURORA, Colo.—”Blue Button Plus is totally disruptive,” Frost & Sullivan health IT analyst Nancy Fabozzi just told me at the Healthcare Unbound conference. Why? Because the enhanced Blue Button Plus format can eliminate the need for healthcare providers to invest in patient portals in order to meet Meaningful Use Stage 2.

I tend to agree. The Stage 2 rules don’t require a portal, just the ability to transmit records securely from provider to patient. Providers, whether they be hospitals, clinics or even small physician practices, can just put a Blue Button widget on their Web site and give patients easy access to their medical records, transferred securely by the Direct protocol, itself a disruptive force for health information exchange.

Longtime readers might recall that I had dissed Blue Button in the past. More than once, in fact. That’s because the original Blue Button format was plain, unstructured text when it was an experiment at the VA. My opinion changed this week, when I realized that Blue Button Plus adds structure such as the Continuity of Care Document, and third-party vendors like Humetrix, make of the iBlueButton mobile app, provide additional context.

I don’t think this will kill the portal business because portals provide additional services such as secure messaging, appointment scheduling, refill requests and online bill payment. But it will make a lot of providers think twice about springing for an advanced portal when Blue Button Plus will fill the Meaningful Use need so easily.

July 12, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Comprehensive coverage of WTN Media’s Digital Health Conference

As you may know from at least one of my earlier posts, I was in Madison, Wis., last month for a great little health IT event called the Digital Health Conference, a production of the Wisconsin Technology Network and the affiliated WTN Media. In fact, WTN Media hired me to cover the conference for them, so I did, pretty comprehensively. In fact, I wrote eight stories over the last couple of weeks, seven of which have been published:

I still have an overview story that should go up this week.

Why do I say it’s a great little conference? The list of speakers was impressive for a meeting of its size, with about 200 attendees for the two-day main conference and 150 for a pre-conference day about startups and entrepreneurship.

Since it is practically in the backyard of Epic Systems, CEO Judy Faulkner is a fixture at this annual event, and this time she also sent the company’s vendor liaison. Informatics and process improvement guru Dr. Barry Chaiken came in from Boston to chair the conference and native Wisconsinite Judy Murphy, now deputy national coordinator for programs and policy at ONC, returned from Washington. Kaiser Permanente was represented, as was Gulfport (Miss.) Memorial Hospital. IBM’s chief medical scientist for care delivery systems, Dr. Marty Kohn, flew in from the West Coast, while Patient Privacy Rights Foundation founder Dr. Deborah Peel, made the trip from another great college town, Austin, Texas. (Too bad Peel and Faulkner weren’t part of the same session to discuss data control. That alone would be worth the price of admission.)

July 2, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Is this Cisco commercial reflective of the real world?

Cisco Systems is running this commercial about the “Internet of everything,” with a focus on connected healthcare.

 

It all sounds great, but how much of this is grounded in the real world today and how much is wishful thinking? I mean, connected medical records? It sounds so idealistic.

May 19, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

DoD-VA integration failure is no laughing matter, even to Stewart

Last week, I had a clip from “The Colbert Report” because Dr. Eric Topol appeared on the show to discuss digital health in a lively segment with Stephen Colbert. (I reported on it for InformationWeek Healthcare. The editors told me to have fun, so I did.) This time around, I’m going to give Jon Stewart equal time, not because I feel like having more fun with “fake news,” but because the host of “The Daily Show” had some insightful comments about the failure of the Military Health System and the Veterans Health Administration to get their EHRs to interoperate.

Though his job is to make people laugh—and ostensibly to upset conservatives—Stewart has been an outspoken advocate for America’s veterans, and when he heard the Obama administration has created a massive backlog for disabled veterans to receive VA health benefits, he went off. As far as I can tell, he got everything right, too.

April 1, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Podcast: HIMSS CEO Steve Lieber: 2013 edition

Once again, as has become custom, I sat down with HIMSS CEO Steve Lieber at the organization’s Chicago headquarters the week before the annual HIMSS conference to discuss the conference as well as important trends and issues in the health IT industry. I did the interview Monday.

Here it is late Friday and I’m finally getting around to posting the interview, but it’s still in plenty of time for you to listen before you get on your flight to New Orleans for HIMSS13, which starts Monday but which really gets going with pre-conference activities on Sunday. At the very least, you have time to download the podcast and listen on the plane or even in the car on the way to the airport. As a bonus, the audio quality is better than usual.

Podcast details: Interview with HIMSS CEO Steve Lieber about HIMSS13 and the state of health IT. Recorded Feb. 25, 2013, at HIMSS HQ in Chicago. MP3, stereo, 128 kbps, 46.0 MB. Running time: 50:17.

1:00        Industry growth and industry consolidation
2:50        mHIMSS
3:45        Why Dr. Eric Topol is keynoting
6:00        New Orleans as a HIMSS venue
6:50        Changes at HIMSS13, including integration of HIT X.0 into the main conference
8:55        Focus on the patient experience
9:35        Global Health Forum and other “conferences within a conference”
13:00     Criticisms of meaningful use, EHRs and health IT in general
17:00     Progress in the last five years
20:45     Healthcare reform, including payment reform
22:30     Why private payers haven’t demanded EHR usage since meaningful use came along
23:50     Payers and data
26:28     Potential for delay of 2015 penalties for not meeting meaningful use
29:15     Benefits of EHRs
30:40     Progress on interoperability between EHRs and medical devices
32:52     Efficiency gains from health IT
35:27     Home-based monitoring in the framework of accountable care
36:55     Consumerism in healthcare
39:40     Accelerating pace of change
41:10     Entrepreneurs, free markets and the economics of healthcare
43:25     Informed, empowered patients and consumer outreach
46:30     Fundamental change in care delivery

March 1, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

My HIMSS will be all about quality and patient safety

As regular readers might already know, 2012 was a transformative year in my life, and mostly not in a good way. I ended the year on a high note, taking a character-building six-day, 400-mile bike tour through the mountains, desert and coastline of Southern California that brought rain, mud, cold, more climbing than my poor legs could ever hope to endure in the Midwest, some harrowing descents and even a hail storm. But the final leg from Oceanside to San Diego felt triumphant, like I was cruising down the Champs-Élysées during the last stage of the Tour de France, save the stop at the original Rubio’s fish taco stand about five miles from the finish.

But the months before that were difficult. My grandmother passed away at the end of November at the ripe old age of 93, but at least she lived a long, full life and got to see all of her grandchildren grow up. The worst part of 2012 was in April and May, when my father endured needless suffering in a poorly run hospital during his last month of life as he lost his courageous but futile battle with an insidious neurodegenerative disorder called multiple system atrophy, or MSA. (On a personal note, March is MSA Awareness Month, and I am raising funds for the newly renamed Multiple System Atrophy Coalition.)

That ordeal changed my whole perspective, as you may have noticed in my writing since then. No longer do I care about the financial machinations of healthcare such as electronic transactions, revenue-cycle management, the new HIPAA omnibus rule or reasons why healthcare facilities aren’t ready to switch to ICD-10 coding. Nor am I much interested in those who believe it’s more worthwhile to take the Medicare penalties starting in 2015 for not achieving “meaningful use” than to put the time and money into adopting electronic health records. I’m not interested in lists of “best hospitals” or “best doctors” based solely on reputation. I am sick of the excuses for why healthcare can’t fix its broken processes.

And don’t get me started on those opposed to reform because they somehow believe that the U.S. has the “best healthcare in the world.” We don’t. We simply have the most expensive, least efficient healthcare in the world, and it’s really dangerous in many cases.

No, I am dedicated to bringing news about efforts to improve patient safety and reduce medical errors. Yes, we need to bring costs down and increase access to care, too, but we can make a big dent on those fronts by creating incentives to do the right thing instead of doing the easy thing. Accountable care and bundled payments seem like they’re steps in the right direction, though the jury remains out. All the recent questioning about whether meaningful use has had its intended effect and even whether current EHR systems are safe also makes me optimistic that people are starting to care about quality.

Keep that in mind as you pitch me for the upcoming HIMSS conference. Also keep in mind that I have two distinct audiences: CIOs read InformationWeek Healthcare, while a broad mix of innovators, consultants and healthcare and IT professionals keep up with my work at MobiHealthNews. For the latter, I’m interested in mobile tools for doctors and on the consumerization of health IT.

I’m not doing a whole lot of feature writing at the moment, so I’d like to see and hear things I can relate in a 500-word story. Contract wins don’t really interest me since there are far too many of them to report on. Mergers and acquisitions as well as venture investments matter to MobiHealthNews but not so much to InformationWeek. And remember, I see through the hype. I want substance. Policy insights are good. Case studies are better, as long as we’re talking about quality and safety. Think care coordination and health information exchange for example, but not necessarily the technical workings behind the scenes.

And, as always, I tend to find a lot more interesting things happening in the educational sessions than in that zoo known as the exhibit hall. I’m there for the conference, not the “show.”

Many of you already have sent your pitches. I expect to get to them no later than this weekend, and I’ll respond in the order I’ve received them. Thank you kindly for your patience.

February 13, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Podcast: This time, I’m the interviewee

In a rare turn of events, I’m the one being asked the questions on a podcast by Sivad Business Solutions, which hosts regular audio discussions on a variety of business topics. I give kind of a high-level view of health IT and offer my very strong opinions on patient safety and healthcare reform. There’s an interesting discussion about EHRs being designed to maximize reimbursements rather than assure safety.

Interestingly, we recorded this via Skype. I like the audio quality, if not the nasal quality of my own voice, more than usual that day.

Hopefully the embedded audio works. If not, click here.

September 18, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Sampling of opinions on meaningful use Stage 2

I’ve been an absentee blogger yet again the last few weeks. Here’s something to chew on while I get caught up, a sampling of all the statements I received regarding the Stage 2 final rules for meaningful use, in the order I received them. Most interesting are what the consumer groups had to say because CMS lowered the threshold for sharing records through a patient portal to a laughable 5 percent of patients, down from the proposed (and almost equally laughable) level of 10 percent. Patients need to speak up and demand access to their own records. Providers need to stop fighting the inevitable.

National Partnership for Women & Families

Leading Consumer Advocate Lauds Stage 2 Meaningful Use Final Rule for Promoting Better Communication Among Doctors, Fewer Medical Errors and Lower Health Costs

Statement of Christine Bechtel, Vice President, National Partnership for Women & Families

“The Stage 2 Final Rule released by the Centers for Medicare & Medicaid Services (CMS) this afternoon is a huge step forward.  It brings us closer to the days when fewer overwhelmed patients and their family caregivers struggle to keep track of tests, diagnoses and medications; beg their doctors to talk to one another; suffer avoidable medical errors; and pay for duplicative and unnecessary care.  The rule issued today offers the promise of better, more efficient care, improved safety and fewer hospital readmissions.

We are pleased that the new rule gives patients the ability to go online and view, download and transmit their health information from the Electronic Health Record (EHR) to secure places of their choosing.  A recent public opinion survey commissioned by the National Partnership for Women & Families found that this kind of feature helps consumers see great value in physicians’ use of EHRs, and helps them have more trust in electronic systems.  The fact that this is now a core requirement, and will apply to the hospital setting as well as to physicians, is key to finally recognizing the critical role patients play as partners in their own care. This is a huge advance that will allow patients to be more actively engaged in their care.  It helps realize the potential of health IT in ways the nation needs.

It is good that the new rule also recognizes the essential role that providers and their staff play in encouraging patients to use this online access.  It does that by holding physicians and hospitals accountable for ensuring that 5 percent of their patient population logs in once during the year.

In addition, enabling patients to download and transmit their health information electronically will help foster more of the kind of information sharing that is desperately needed to facilitate care coordination, improve safety and reduce costs.  Patients play a key role in information sharing, and this rule gives patients the tools they need to do just that.

The rule’s requirements that a summary of care document be sent from one provider to the next for at least one of every two transitions of care or referrals is a good step.  CMS is also requiring 10 percent of those transmissions to be electronic.  And providers will have to show they are capable of sending these documents to providers who have different EHRs.

Improving care coordination and patient engagement through these criteria (information sharing requirements and online access for patients) are cornerstones of building the foundation of interoperability that will support health system reform.  So many new models of care like Accountable Care Organizations and medical homes will crumble without this bedrock foundation.  This is a good day for consumers who urgently need a more efficient, safer, better coordinated health care system.”

Click the links below for:

  1. Interviews with physician leaders who have implemented patient portals (or online access for patients)
  2. A snapshot of the national HIT opinion survey results
  3. A full executive summary of the national HIT opinion survey results

 

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American Health Information Management Association

Meaningful Use Stage 2 Final Rule:

AHIMA Provides Initial Comments on CMS Ruling

 

CHICAGO – Aug. 23, 2012 Today the final rule on the Electronic Health Record Incentive Program Stage 2 Meaningful Use (MU2) was announced by the Centers for Medicare and Medicaid Services (CMS). This act focuses on incentive payments to eligible professionals, hospitals and critical access hospitals participating in this program that successfully demonstrate meaningful use of certified electronic health record (EHR) technology.

A full analysis of this complex ruling announced as part of the American Recovery and Reinvestment Act – Health Information Technology for Economic and Clinical Health (ARRA-HITECH) will be forthcoming from the American Health Information Management Association (AHIMA). AHIMA is the preeminent nonprofit association representing Health Information Management (HIM) professionals on the front lines for implementing the rule.

While AHIMA studies the complete text of the rule and its scope, the following points have been included:

  • Consistent with the proposed regulation, health information technology (HIT) measures will allow for patients to have the ability to view online, download, and transmit their health information within four business days of the information being available.
  • CMS continues to acknowledge and align Clinical Quality Measures with other reporting programs to reduce burden and duplication of efforts.
  • All HIT Menu Set measures have been transitioned to the Core Set of measures with the exception of electronic syndromic surveillance data and advance directives.

 “We are encouraged to see CMS’ continued push toward actively exchanging health information to improve coordination of care thus improving patient safety,” said AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, CAE, FACHE.  “We are also pleased to learn of CMS’ continued commitment toward engaging patients and families in their healthcare through the ability to view online, download and transmit their health information.  We believe patients must be partners and work side-by-side with their providers to achieve the best possible healthcare outcomes.”

According to Thomas Gordon, the 2014 compliance date CMS provided will enable the industry – providers, hospitals and vendors – the appropriate time to plan and implement the necessary changes.

“As HIM professionals, we are a critical component to the reporting of clinical and HIT quality measures in achieving meaningful use,” said Allison Viola, MBA, RHIA, senior director of federal relations at AHIMA. “We are pleased to see that CMS has heard our calls for increased alignment of quality reporting programs and acknowledgement of making an effort to reduce the reporting burden and duplication of reporting.  We also stand ready to support patients and their ability to have online access to their health information to ensure its privacy, integrity, and timeliness for their continued care.”

Live webinars to discuss the rule’s provisions will be available free for AHIMA members and for $59 for non-members. Visit ahima.org for the schedule and registration information.

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Society for Participatory Medicine

Statement of Sarah Krug, president of the Society for Participatory Medicine:

“Although we’re disappointed this final rule does not give patients next-day access to their electronic medical record after they leave the hospital, we believe that on balance the Stage 2 Meaningful Use requirements go a long ways towards patient empowerment and feature a number of important patient-centered innovations. Patients must be full partners in access to their health information so they can be full partners in their care. For that reason, the Society for Participatory Medicine intends to keep a sharp eye on how the new Meaningful Use rules are actually implemented.”

 

Healthcare Information and Management Systems Society

HIMSS Statement on Release of Meaningful Use Stage 2 and Standards & Certification Criteria Final Rules

August 24, 2012 – (Washington, DC) – HIMSS appreciates the release of the Meaningful Use Stage 2 and Standards & Certification Criteria final rules by the U.S. Department of Health and Human Services. The Stage 2 regulations allow the healthcare community to continue the necessary steps to ensure health information technology will support the transformation of healthcare delivery in the United States.

In our initial review of the Medicare and Medicaid Programs; Electronic Health Record Incentive Program–Stage 2 Final Rule from the Centers for Medicare and Medicaid, HIMSS has identified several significant policy decisions, including:

  • Setting the Meaningful Use Stage 2 start date as 2014, which will maximize the number of eligible professionals (EPs), eligible hospitals (EHs), and critical access hospitals (CAHs) prepared to meet Stage 2 requirements
  • Allowing a 90-day reporting period in Year 1 of Stage 2, which is consistent with HIMSS’ recommendations on the proposed rule
  • Accepting 2013 as the attestation deadline for EPs, EHs, and CAHs to avoid a Medicare payment adjustment, and allowing for exceptions, including limited availability of information technology
  • Finalizing Clinical Quality Measure submission specifications for EPs, EHs, and CAHs

ONC’s efforts in the Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition  appear to streamline the administrative process of certifying EHR products.  We note that the Final Rule both adopts and concurs with a number of HIMSS recommendations. The HIMSS response to the proposed rule had requested several points of clarity and additional specification around certain criterion, and we commend the government’s thorough review and inclusion of additional information to clarify many topics.

We are assessing impacts of each Final Rule regarding Clinical Quality Measurement, reporting options, standards specifications, and alignment with other federal quality reporting and performance improvement programs.

We look forward to continuing to work with the federal government and our members to ensure that the EHR Incentive Program makes impactful improvements to the quality of healthcare delivery in the United States.

Stay tuned for in-depth analysis on HIMSS’ Meaningful Use OneSource; a webinar series in September; and a full slate of Meaningful Use education and exhibition activities at HIMSS13, including a new Meaningful Use Experience.

MGMA-ACMPE

Statement from Susan Turney, MD, MS, president and CEO of MGMA-ACMPE

“MGMA is pleased that the Centers for Medicare & Medicaid Services (CMS) responded to our concerns regarding several of the proposed Stage 2 meaningful use requirements. Extending the start for stage 2 until 2014 was a necessary step to permit medical groups sufficient time to implement new software. Permitting group reporting will reduce administrative burden, as will lowering the thresholds for achieving certain measures such as mandatory online access and electronic exchange of summary of care documents. MGMA supports the rule’s expanded list of exclusions and believes it will allow physicians to achieve meaningful use with fewer hurdles.”

 

Health IT Now Coalition

Health IT Now Coalition Expresses Concern over Meaningful Use Stage 2 Final Rule
Stresses clinical exchange measures are insufficient

WASHINGTON – The Centers for Medicare and Medicaid Services (CMS) today issued its final rule detailing criteria for Stage 2 of the federal electronic health-record system incentive program. The following should be attributed to Joel White, executive director of the Health IT Now Coalition<http://www.healthitnow.org>:

“While we are encouraged that ONC and CMS have recognized that care coordination cannot be achieved exclusively through directed exchange, the rule still fails to adequately address the core issue of interoperability.  Providers, developers, and state health information exchanges have already adopted and implemented more mature and scalable standards that are functioning well in the market today.

“More could and should have been done to support the interoperability requirements necessary for advanced payment and delivery reforms to operate optimally.  The measures for clinical exchange laid out in the Stage 2 final rule will likely not be sufficient.”

Health IT Now is a coalition to promote the rapid deployment of heath information technology (health IT). Health IT will benefit patients and health care consumers while supporting health practitioners to make smart decisions about patient care and save money. For more information, visit www.healthitnow.org<http://www.healthitnow.org>.

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College of Healthcare Information Management Executives

The College of Healthcare Information Management Executives (CHIME) today issued a statement in response to final rules on Stage 2 of the EHR Incentive Payments program, also known as Meaningful Use:

“CHIME applauds efforts made by officials at the Department of Health and Human Services in working diligently to prepare final rules on Stage 2 of the EHR Incentive Payments program,” said CHIME President and CEO Richard A. Correll.

“We commend the Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health IT for seeing the wisdom and practicality of heeding many of CHIME’s recommendations, filed during the spring public comment period. By allowing providers to demonstrate Meaningful Use through a 90-day EHR reporting period for 2014, government rule-makers have ensured greater levels of program success. And by including additional measures to the menu set, providers have a better chance of receiving funds for meeting Stage 2.

“However, we also recognize that these points are conciliatory and that many details may need further clarification. The final rule still puts providers at risk of not demonstrating meaningful use based on measures that are outside their control, such as requiring 5 percent of patients to view, download or transmit their health information during a 3-month period. Some areas of clarification include some of the exclusionary language as well as nuances around health information exchange provisions, clinical quality measures and accessing images through a certified EHR.

“CHIME will continue to delve into this sizable and weighty effort, including the technical specifications and certification criteria,” Correll added.

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September 5, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.