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Great Response to Blumenthal Interview

Posted on February 1, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The other day I came across an interview with David Blumenthal. I didn’t find anything all that meaningful in the interview itself. However, in the comments, someone provided some really interesting commentary on what Blumenthal said in the interview.

Dr. Blumenthal says we need operability before we move to interoperability. Yet if you don’t design your systems from the start to interoperate, you’ll inevitably wind up with operable systems that do not interoperate – at all. Having accomplished this, we’ll then have to develop and impose an after-the-fact standard to which all systems must comply. This will mean redesign, retrofit, and plastering all kinds of middleware layers between disparate systems. It may even result in retraining tomorrow all those providers you hope will learn new ways of working today.

Dr. Blumenthal also says that new and better technology is coming out every day. Yet the current incentive and certification programs heavily favor the older technology which he himself says frightens many providers away from this migration. Many of the older vendors have huge installed bases and old technology. They no doubt influence advisory boards much to lean towards what is versus what might be, all assurances to the contrary.

The cost of fixing practically anything is much higher than doing it correctly the first time. I realize you can’t design perfection, and anything we build will need adaptation and improvement. But we’re following a path that ensures that we will have to do much more fixing than we would if we’d just stop and think a bit more.

The inevitability of this evolution is not a justifcation for doing it carelessly.

Talk about bringing up some valid issues. The second one really hits me that the incentive money favors older technology. I’m afraid this is very much the case and that 5 years from now the major topic we’re covering on EMR and HIPAA is switching EMRs.

Meaningful Use Exceptions for Specialists

Posted on November 19, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Neil Versel at Fierce EMR recently did a post talking about the meaningful use exceptions that are available for specialists. In it he quotes David Blumenthal, national health IT coordinator, and Dr. Derek Robinson, medical director for HHS Region V. They provide an example of an exception to the meaningful use criteria that a specialist might be able to use:

For example, three of the “core” measures of meaningful use that all providers must be able report on are blood pressure levels, whether patients over 13 use tobacco products and adult weight screening. “You may say that one of these or all three of these may not be part of your scope of practice,” Robinson said, amednews reports. It is possible to report zero as both the denominator and numerator for the quality measure if that specific item is outside a physician’s scope of practice.

This is what I was talking about in my last post about the EHR Stimulus money for dentists. No doubt there are a whole lot of specialties that will want to be granted these types of exceptions. It will be interesting to see what the exact process is for being granted the exception. I also won’t be surprised if we see some EMR vendors (specialty specific EMR vendors in particular) helping their doctors apply for these exceptions.

The only problem with the exception is for those specialists where the denominator is not 0, but it’s a very small number. I seem to remember a pediatric orthopedic surgeon saying that he only wrote prescriptions a few times a week. Learning and implementing an ePrescribing system for a couple scripts a week isn’t going to be very fun.

Commercial Insurance Implementing Meaningful Use

Posted on August 17, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The HITECH Law Blog had a post recently titled “Commercial Payors Implementing EHR Meaningful Use Criteria in P4P Programs.” Here’s a short excerpt:

On August 5, 2010, four major commercial health insurance payors participated in the Health Industry Forum in Washington, D.C., to discuss private industry collaboration with the United States Health & Human Services Department (HHS) to support providers in the adoption of certified electronic health records (EHRs). Leading the Forum’s panel discussion was David Blumenthal, M.D., Chief of the Office of National Coordinator of HIT. All four payors will include the Meaningful Use criteria in their pay for performance (P4P) programs.

The 4 insurance groups identified are Aetna, Inc and its subsidiary, ActiveHealth Managent, United Health Group (UHG), Wellpoint, Inc, and Highmark, Inc. (Blue Cross Blue Shield).

The author of the blog also asserts that now that the government has created the final meaningful use rule, it will clear the way for the commercial payors to implement it as well. The press releases from the 4 companies about this change are really vague and so it’s hard to say exactly how these companies will implement the meaningful use criteria.

In fact, this almost feels like it’s a little warning shot from the commercial payors. It seems like they’re testing the waters to see how doctors and practices will react to this type of announcement. Plus, I’ll be surprised if we see any major implementation of meaningful use by commercial payors until we see the first physicians showing meaningful use to the government. That way the commercial payors can sit back and watch the impact on physicians of having to show meaningful use to the government. If it goes poorly (like the bad PQRI incentives), then I can see commercial payors backing off the meaningful use bandwagon.

The theme I did read in all the press releases is that it’s valuable for commercial payors to have information from an EHR. Now I think the payors are just trying to figure out the best way to achieve that outcome. Will it be meaningful use? Will it be some other method? They don’t really care. They’re just concerned with their outcomes.

If commercial payors do require meaningful use, I think it’s going to be a really ugly outcome.

Official ONC and CMS Conference Call on EHR Stimulus Programs

Posted on July 19, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The “Official” ONC/CMS Audio conference call on the EHR stimulus programs. Don’t want to miss this one!

ONC Certification and Medicare and Medicaid EHR Incentive Programs:
Final Rules
How will they impact you?

The Centers for Medicare & Medicaid Services (CMS) together with The Office of the National Coordinator for Health Information Technology (ONC) invite you to join us for an Audio Training on the Final Rules for ONC Certification and Medicare and Medicaid EHR Incentive Programs.

Learn about:

• The Benefit of HIT
• Summary of the final rules
o ONC temporary certification process
o ONC initial set of standards and implementation specifications
o Medicare and Medicaid EHR Incentives Programs including the initial definition of meaningful Use
• Where to find additional resources

Hear first hand from ONC and CMS Experts!

Date: Thursday, July 22, 2010
Time: 2:00-3:30 pm EST

Call in information
Dial:
1-877-251-0301

Conference ID pass code:
87841621

Materials will be made available prior to the training at the following web address: http://www.cms.gov/EHRIncentivePrograms/05_Spotlight_and_Upcoming_Events.asp
Be sure to visit CMS’ web section on the Medicare & Medicaid EHR Incentive Programs at: http://www.cms.gov/EHRIncentivePrograms/

Thanks to Charles Phelps from MedXSolutions for the tip.

Meaningful Use Final Rule Thoughts

Posted on July 14, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As you can imagine my inbox has been kind of blown up with all the people talking about the final meaningful use rule. It’s going to take a bit to really digest what the final rule will mean for healthcare and EMR in general. I’m still trying to digest everything that’s been said and the 864 pages of the meaningful use rule (seriously, that’s longer than most books I read). Later today I’ll be posting a list of links to the various meaningful use articles and summaries I find on EMR and EHR. I think that will become a really valuable resource since a lot of people have done a lot of digging into the rule already.

While I still have some concerns about how doctors will or will not take to the meaningful use rule and the EMR stimulus money, I have to admit that HHS did scale back some of the requirements rather significantly. I’ve always found David Blumenthal and the other people at ONC to be sincere people that were trying to make a sincere effort to make this work. I think the changes to the meaningful use rule reflect this sincerity also.

Of course, the million dollar question is what will doctors think? There going to be inundated with information. I’m pretty sure a lot of doctors aren’t going to know which way is up and will be sitting out at list the first round of fun to see how their colleagues who take the meaningful use plunge fair first.

Also, here’s the 864 pages of the meaningful use final rule for those who want to go to the source:

If you want to see the HHS dog and pony show that you missed yesterday, I’ve embedded the video of the press conference for meaningful use below:

Meaningful Use Final Rule Published

Posted on July 13, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This morning HHS held a live webcast (I guess it’s a news conference?) announcing the final meaningful use rule. Unfortunately, it was a little early for me on the west coast (the life of a blogger), but I caught the second half of the webcast.

Seems like they have made some changes to the meaningful use program. The most notable I think are the drop in percentage of ePrescriptions that are required (now at 40% I believe) and the mandatory and ala carte meaningful use requirements.

I’m really interested to look into how they’ve implemented the second option. I believe this is how they’re trying to deal with the problems of meaningful use and specialties. So, hopefully the mandatory meaningful use requirements will be those that apply to ALL specialties and then the ala carte items can be customized to each specialties needs.

I’m sure I’m missing some other notable details. I’ll do what I can over the next week to look over the documents and the other meaningful use coverage on the web to bring you more analysis on the announcement.

In the mean time, it looks like CMS has published a website on the EHR incentive programs. They even have this page on Meaningful Use which includes the download of the Meaningful Use final rule.

HIMSS 2010 Day 4

Posted on March 3, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Once again, you can go and check out many of the tweets I did during my various activities at HIMSS on my two twitter accounts: @techguy and @ehrandhit.

The day started with the Blumenthal keynote. I can’t say that he really said anything earth shattering. It was a bit interesting to hear an overview of his perspectives. However, my favorite part of his speech was his opening story about how he got involved in healthcare IT and the time when he was a doctor and his EMR saved him from making a major medical mistake. It was really smart of him to tell a story like this. He also had some really good one liners (see my twitter accounts) that indicate his goals. So, I guess the David Blumenthal HIMSS keynote wasn’t completely meaningless.

Then, the rest of the afternoon was fantastic since I was able to spend almost the entire rest of the day roaming the floor. I had a number of interviews with vendors on the floor, but it was nice to just be able to be on the floor and learning in the booths. I think that some people don’t like it, but I really like browsing through the mayhem. I love seeing the message people are trying to send. I won’t go into all the details of people I talked to, but will be posting about them over the next couple weeks. I did get a number of videos that I think people will really enjoy.

I will just quickly mention the coolest swag I got. One place was handing out candy bars. I love chocolate so that was a big deal. Practice Fusion was fantastic since they treated me like a rock star for some reason and they gave me a cool jersey shirt. Very nicely done. I also got a $25 amazon gift certificate from Nuance thanks to seeing a tweet to go to their booth. Twitter definitely pays off.

However, the best giveaway I got was the Econo-keys completely waterproof keyboards. Yes, that’s right. You can actually clean these keyboards. The best news about this free swag is that I got a few of these keyboards to give away to readers of this site. So, watch for the video of these keyboards and an opportunity to get your own washable, flexible keyboard. They’re super cool.

Ok, enough about the swag. Sorry if you don’t like these summary posts. I’ll plan on posting more substantive posts tomorrow. For now, I’m going to bed. 15 hour days wear you out.

My Major HIMSS 10 Event Plans

Posted on February 23, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ll admit that I’m having an interesting challenge figuring out how to manage all of the various things I can do at HIMSS. I’m sure that many others have the same problem. Not to mention managing the mix of all the content that’s coming out and planning my own visit to HIMSS. A great problem to have I think.

For those who are interested in meeting me, here’s a couple places where you will be sure to find me at HIMSS 10:
HIMSS Meet the Blogger Panel – I’ll be on the panel on Monday, March 1st from 3-4:30. This is an incredible panel of people that I highly respect. This should be a really lively discussion.

New Media Meetups at HIMSS 10 – These events are shaping up to be really incredible events. Looking through the list of people who have RSVP’d for the kick off event, it’s going to be a really interesting mix of people. Not to mention Colbie Caillat singing, free food and some great free giveaways. Make sure you Register for the Kick Off Event on Monday, March 1st at the MEDecision party. Thanks to MxSecure and Pervasive for also sponsoring the other meetups.

I’d love to meetup with other people or if you’re an EMR vendor that’s doing something innovative let me know in the comments or drop me a note on my Contact Us page.

There are so many events I’m interested in attending. However, no doubt I’ll have some fun at the CCHIT Town Hall Meeting and I’ll be hoping that the David Blumenthal’s HIMSS Keynote is meaningful.

Are there any must see sessions or events? Let me know of any events you think I should attend and cover on this blog.

Also, if you’re interested in following my HIMSS 10 coverage, you can sign up for my EMR and HIPAA email list, check out my posts on EMR and EHR, and follow my tweets on my @ehrandhit and @techguy twitter accounts. It will basically be like you’re there with me.

MGMA Letter to David Blumenthal About HITECH Act’s EMR Stimulus Money

Posted on December 5, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The MGMA sent a letter to David Blumenthal warning that if done poorly the ARRA’s EMR stimulus money could result in “the needless squandering of resources and significant disruption to the nation’s healthcare system.”

The bNet Healthcare blog gives a summary of MGMA’s recommendations to avoid this situation:

  • The meaningful use criteria should be easily adoptable in a wide range of practice settings, including small practices and rural practices.
  • Between the date of the final rule and the 2011 start date of the incentive program, the government should conduct a pilot to ensure that “the process of demonstrating meaningful use is achievable and practical.”
  • Instead of using a “pass/fail” structure, the government should inform physicians of whether they meet the criteria and give them an opportunity to modify their systems and submit corrected data.
  • There should be a simplified process for physician attestation of their use of EHRs, to be verified through random audits.
  • If vendors cannot provide “appropriate and cost-efficient products” that enable physicians to show meaningful use, the government should use its statutory authority to provide a low-cost EHR that meets those criteria.
  • Doctors should be able to use a range of methods of reporting quality data, including claims-based information, and they should be able to test their reporting systems before the incentive start date.
  • The government should create a website and toll-free telephone numbers so that physicians can report problems with vendors.

I especially like the pilot program idea since one of my biggest complaints about previous government healthcare IT incentives was that many people planned and hoped for the government money and some catch left them empty handed.

Health Information Technology Regional Extension Centers

Posted on August 26, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

David Blumenthal, National Coordinator for Health Information Technology, has been putting out some letters about HIT and EHR in particular. In his latest letter he talks about the recent announcement of the HIT Regional Extension Centers designed to assist and help with the implementation, selection and use of EHR software. Here’s a portion of his letter:

Key to the successful adoption and meaningful use of EHRs is the assurance that providers have the help and guidance they need to select, implement and maintain a certified EHR system. In addition, we need the various and often disparate local, statewide and regional systems to work together, regardless of location and differing state and federal standards or policies, to enhance patient care.

Toward that end, the first grant program, the Health Information Technology Extension Program, will fund dozens of Health Information Technology Regional Extension Centers across the country. The regional extension centers will offer hospitals and clinicians hands-on technical assistance to support meaningful use of certified EHR systems. These modern health IT centers could be considered as somewhat akin to the agricultural extension centers Congress set up early in the 20th century, which helped to support vast improvements in the efficiency, quality and productivity of the agricultural sector.

We hope this 21st century health IT extension program will have a similarly profound effect in helping health care providers through a major transition in our nation’s health system, ultimately improving the quality, efficiency, reliability, availability and equity of care for every American.

A national Health Information Technology Research Center (HITRC) will also be created. The HITRC will help the regional centers collaborate with each other, and it will serve as a national clearinghouse to identify and share best practices and experiences so that providers can learn from what others have gone through as they’ve put such systems in place.

You can read more about the details of the grant program on Chilmark’s post about the grant money.

Honestly, I look at all the millions of dollars that they’re going to pour into these programs and I wonder if any of them will have any real impact. They have to all be non profit organizations which is probably a good thing. However, I won’t be surprised if smart people find ways to siphon off the money given to these organizations for themselves. Maybe that’s the cynic in me. Maybe it’s just the reality of grant money.

I do like that they’re having a national organization that will hopefully aggregate data from the various regional extension centers. I think the problem will be that the national organizations won’t have any teeth to be able to ensure that the regional extension centers to do their job and share the information.

I’m hopeful that I’m wrong. I’m really interested to see the types of resources that come out of these centers. They should be creating a lot of really great stuff and helping lots of people. I’ll be interested to see which organizations get the grants. Will they be new or existing ones?