EHR developed for long-term care holds promise

By Molly Merrill

COLUMBIA, MO – Researchers from the University of Missouri are developing an electronic health record system aimed at meeting the needs of a population of older adults that’s expected to almost double in the next 20 years.

According to the U.S. Administration on Aging, there will be about 72 million older adults living in the U.S. who will require care from a workforce that is already projected to be lacking.

Researchers from MU are currently working on a solution they say may help alleviate some of the burden. They’re developing an EHR system that encompasses standard health assessments and those obtained through new technologies. The goal, they say, is to increase efficiency and accuracy, improve patient outcomes and reduce costs for long-term care.

“As the use of emerging technologies increases along with the older population, maintaining complete and accurate patient information can be overwhelming,” said Marilyn Rantz, professor in the MU Sinclair School of Nursing. “A comprehensive system that encompasses all measures, old and new, is the key to enhance and efficient clinical decision making.”

The EHR is being tested at TigerPlace, an independent senior-living facility in Columbia, Mo. According to the researchers’ initial findings, use of the EHR system can enhance nursing care coordination and advance technology use and clinical research.

“New technologies to passively monitor older adults’ health are being developed and are increasingly commercially available,” Rantz said. “The challenge remains to integrate clinical information systems with passive monitoring data, especially in long-term care and home health settings, in order to improve clinical decision making and ensure patient records are complete.”

Effective EHR systems display data in ways that are meaningful and quickly assessable for clinicians, Rantz said. With access to comprehensive data, clinicians can make more informed clinical decisions, better perform risk assessments and provide risk-reducing interventions.

Source :- http://www.ehrexperts.us/ehr-developed-for-long-term-care-holds-promise/

CMS announces $9 million in funding for Medicaid IT

By Joseph Conn

The CMS has announced the awarding of a total of just over $9 million in matching funds to be used by four states to plan for their Medicaid programs to subsidize provider purchases and the use of electronic health-record systems under the American Recovery and Reinvestment Act of 2009, also known as the stimulus law.

The states and their grant amounts are: New Jersey, $4.93 million; Louisiana, $1.85 million; Maryland, $1.37 million; and Minnesota, $1.04 million.

Since November 2009, 39 states, Puerto Rico and the U.S. Virgin Islands have shared nearly $67.6 million in planning grants, according to news release information on the CMS website.

The stimulus law provides a 90% federal match to cover the cost of state planning efforts for the Medicaid EHR subsidy programs. According to federal estimates, the government estimates it could spend as much as $27.3 billion on the EHR subsidies under Medicaid, Medicare and Medicare Advantage programs.

Above article publish on http://www.myemrstimulus.com/cms-announces-9-million-funding-medicaid/

Obama launches national campaign to sell health reform, health IT

By Chelsey Ledue

WASHINGTON – After signing the healthcare reform bill into law on March 23, President Barack Obama traveled to Iowa and Maine to promote his vision, which includes the role of healthcare IT in saving lives and cutting cost.

Obama visited Iowa City, Iowa on March 25 and Portland, Maine on April 1.

At the Maine rally, Obama said passage of the healthcare reform law is a reminder that the country has the power to shape its own destiny.

“It has reminded us that we, as a people, do not shrink from a challenge,” he said. “We overcome it.”

Obama has had a history of supporting healthcare IT advancement, which includes a call for every American to have an electronic health record by 2014. The president requested $110 million in his budget this year, to strengthen healthcare IT policy coordination and research activities.

Last year, the administration backed more than $20 billion over 10 years to advance healthcare IT adoption in the American Recovery and Reinvestment Act (ARRA).

At the president’s rally in Portland, Maine Gov. John Baldacci touted healthcare IT as the means for improving quality of care, noting that Maine has been an early leader in the adoption of medical technology.

Information technology “plays a huge role” in medical reform, Baldacci told Healthcare IT News. “A huge role. It’s going to be through medical information technology that you’re going to enhance the ability of the providers to give quality care but also do it in a way that will reduce costs. It’s a critical element that needs to be part of this.”

David Howes, a physician and CEO of Portland, Maine-based Martin’s Point Health Care, said the reform law is “an enormous step forward.”

“The bill builds support for primary care and EHRs,” Howes said. “It contains flexibility and support for new models of care and Medicare quality and effectiveness measures. It is an enormous step forward for the American people and businesses.”

“I think it’s an opportunity for the president to help market the good parts of the bill,” said Gordon H. Smith, executive vice president of the Maine Medical Association, prior to the president’s visit. “I think it’s a battle for the hearts and minds of the public.”

Above article publish on http://www.ehrexperts.us/obama-launches-national-campaign-to-sell-health-reform-health-it/

Covering Electronic Health Records

By Neil Versel

Electronic health records (EHRs) have been around in one form or another since the 1960s, but the notion of patient records being stored on computers is only beginning to seep into the public’s consciousness. While pretty much every other industry computerized years ago, the vast majority of Americans’ medical records remain on paper.

The goal of electronic health records (and health information technology in general) is to make health care safer and more efficient by providing health professionals and patients alike with information to inform decision-making, promote preventive care and reduce duplication.

It sounds simple enough, but health IT is a complex, frequently misunderstood topic. In this essay, I’ll provide some background on electronic health records and health information technology, a glossary of terms, and some story ideas, with the goal of helping you better cover this important health and business topic.

Ditching paper charts is not easy, nor is writing about the conversion. The central story is not the technology itself, but rather how health information technology will transform care. “It’s really a matter of change management rather than technology,” Dr. David Blumenthal, the Obama administration’s national coordinator for health IT, explained in November 2009.

Online health records for all – “in 10 years”

First, some background: in 2004, President George W. Bush called for “most Americans” to have electronic health records within 10 years and created the Office of the National Coordinator for Health Information Technology within the Department of Health and Human Services to help make it happen. One early project of the office was the attempted conversion of VistA, the EHR long in place at the Department of Veterans Affairs, for use in small medical practices. The EHR, which was difficult to install in most doctors’ offices, never made it past a beta version before federal officials dropped the project.

Health IT subsequently drifted in and out of the national spotlight over the next several years, but didn’t garner much coverage in the mainstream press unless there was a local angle, such as a hospital installing a system. As a longtime reporter on this beat, it has been a challenge to “sell” this story outside the trade press. But now that health information technology is a major story, with plenty of interesting national and local angles, I’ve noticed more reporters scrambling to grasp this difficult subject.

So what’s finally turning arcane health information technology into a mainstream news story? Two things: National health reform and the federal stimulus bill.

Health Reform: Can Better Health IT Lower Costs and Improve Care?

Now that health insurance reform legislation[NV1] has passed, I hope mainstream media will turn their attention to a major health information technology story: greater access to health care does not guarantee good care, so it won’t matter much whether government or private companies administer health plans for millions of new enrollees as long as fee-for-service remains the dominant payment model.

The perverse reality is that mistakes can be good for business. Medical errors and other complications lead to more hospitalizations and longer stays. Both the fear of being sued and the inability to access previous results cause doctors to order extra tests, without regard to medical prudence.

Health IT can help prevent errors by offering what’s known as clinical decision support — computerized alerts recommending best practices and warning against harmful actions, such as prescribing a medication to which a patient is allergic. EHRs, if properly connected to laboratory systems, make test results more readily available so there is less need to re-order procedures. A good EHR should keep a record of every instruction a doctor gives to a patient so there is no question what was or was not communicated, in case of a malpractice claim.

From the perspective of a health IT reporter, health reform started not with the bills President Obama signed in March 2010, but more than a year earlier with the passage of the $787 billion stimulus bill, also known as the American Recovery and Reinvestment Act. The 2009 legislation contains an estimated $25.8 billion for health IT, mostly in the form of incentives [NV2] for doctors and hospitals to adopt electronic health records. Those that have not ditched their paper charts by 2015 face lower Medicare and Medicaid reimbursements.

Insurers and employers that provide health benefits tend to reap the greatest financial rewards from EHRs, so there has been little incentive for the actual providers of health care – physicians and hospitals – to invest in technology. The stimulus is supposed to change the paradigm by rewarding providers that demonstrate “meaningful use” of EHRs beginning in October 2010 for hospitals and January 2011 for physician practices.

According to rules proposed at the end of 2009, EHRs should provide clinical decision support, doctors and nurses should enter orders electronically, patients should be able to get a copy of their medical records on demand and users should be able to share data between facilities and organizations. The requirements will get tougher in 2013 and again in 2015; providers eventually will have to prove that they follow nationally recognized standards of practice.

As electronic health records – and subsets of them like personal health records – become more of a hot topic for mainstream media, it’s important to learn the lingo and get your facts straight.

Know your acronyms: a cautionary tale

Here’s what can happen if you don’t: On Dec. 2, 2009, a website called eSecurity Planet published a story about a privacy watchdog organization publishing a pre-emptive strike against personal health records, a subset of EHRs that has virtually zero market traction to date.

The eSecurity Planet story confused consumer-oriented personal health records for “electronic medical records” and wrongly reported that the stimulus is paying for billions in “electronic personal health records (PHRs).” The stimulus is supporting EHRs, a much broader category. Additionally, the story, like far too many others I’ve read, referred to the much-hyped Google Health and Microsoft HealthVault platforms as market leaders. They are nothing more than early-stage products from big names in the consumer arena, not established health IT powerhouses.

Look past the hype, learn the terminology and talk to people on the front lines. Go to the chief information officer and nursing shift managers of a local hospital. Physicians in private practice should have plenty to say as well.

This subject is often tough to grasp, so don’t be afraid to ask seemingly simple questions. I’ve been covering health IT since 2001, and I still frequently need detailed explanations.

Story ideas for your community

As implementation of national health insurance reform begins and EHR money starts flowing from the stimulus bill, I hope you’ll consider these story ideas for your community.

1. Who owns your EHR[NV3] ? Should you be concerned about it being used as a source of information for pharmaceutical researchers or medical marketers?

2. What is your local hospital or large medical group doing to get stimulus money for EHR development? What differences might patients see as a result?

3. How will the physician office visit change as a result of computerization? Will patients be asked to complete medical history forms online rather than filling out the ubiquitous clipboard each time they go to the doctor? Will nurses and physician assistants be able to provide services once the exclusive domain of physicians because if they have access to more complete patient information?

4. How might patients get better preventive care if medical practices are able to generate, with the help of EHRs, automatic reminders for recommended screening based on age, gender and health risk factors?

Above article publish on http://www.ehrexperts.us/covering-electronic-health-records/

Case Western Reserve to help providers adopt EHRs in Ohio

By Mike Miliard

CLEVELAND – Case Western Reserve University (CWRU) School of Medicine has received nearly $8 million in federal stimulus money from the Ohio Health Information Partnership (OHIP), the state designated entity for health information exchange development. That funding will position the school as a regional extension center (REC), allowing it to help 1,765 healthcare providers in Lorain, Cuyahoga, Lake, Geauga and Ashtabula counties advance the use of health IT in their practices.

The CWRU School of Medicine is one of seven RECs in Ohio established by OHIP and made possible by funding from the American Recovery and Reinvestment Act (ARRA). An eighth REC was awarded directly by the federal government to HealthBridge, a not-for-profit health information exchange serving Greater Cincinnati and surrounding areas.

The federal and state initiative is providing smaller primary care practices with an incentive to early adoption of health information technology.

“Electronic health records tend to be financially out of reach for private practitioners and small practices,” said Julie Rehm, senior associate dean of the CWRU School of Medicine and associate vice president of strategic initiatives for CWRU. “If healthcare providers adopt early they are eligible for additional reimbursement from the Centers of Medicare and Medicaid Services until 2011. After that, the reimbursement declines and penalties kick in starting in 2015.”

The REC endeavor, as directed by the federal government, is targeted towards primary care providers, specifically, physicians—MDs or DOs who are family physicians, general internal, pediatric or OB/GYN, and other primary care providers such as nurse practitioners, nurse midwives, or physician assistants with prescriptive privileges and practicing in one of the previously mentioned areas.

The CWRU School of Medicine will provide administration and management to multiple contractors whose roles will vary by expertise but overall will help providers select products and provide training on how to use the technology to its fullest potential in order to improve patient care. This includes providing workforce support, implementation and project management, practice and workflow design, vendor selection, privacy and security best practices, progress towards meaningful use, functional interoperability and health information exchange.

The CWRU REC has a number of stakeholders, including University Hospitals, the Cleveland Clinic and Massachusetts eHealth Collaborative. In addition, the entities likely to participate in the CWRU REC include Kaiser Permanente, Medical Mutual of Ohio and CareSource.

“The School of Medicine is committed to improving the health of our community,” said Pamela B. Davis, MD, dean of the School of Medicine and vice president for medical affairs, CWRU. “We believe that HIT is a key tool in healthcare reform and we look forward to partnering with independent healthcare providers to encourage quick adoption of HIT. Once enabled, HIT provides a two-fold benefit: 1) improving patient care, for example, through electronic alerts that notify healthcare providers of a patient’s need for annual testing e.g., mammograms, and 2) by lowering healthcare costs by reducing redundant testing.”

The Case Western Reserve REC is expected to begin work sometime this month.

“Success for the CWRU REC will be measured in three ways,” said Rehm. “First, we must meet the milestones and metrics that are being asked of us by the federal government. Second, we must enable the earliest adoption possible which will allow primary care providers to pull in the maximum amount of federal dollars from reimbursements. And third, we must improve the quality of care through the utilization of this technology which will ultimately improve the health of Clevelanders.”

http://www.myemrstimulus.com/case-western-reserve-providers-adopt-ehrs-ohio/