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Meaningful Use at HIMSS 2012 – Meaningful Use Monday

Posted on February 13, 2012 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.

Since I have HIMSS on the mind (as has probably been seen from my previous posts), I figured I’d talk about what we can expect from meaningful use at HIMSS 2012 in Las Vegas.

Meaningful Use Conversations Dominate
I think with all certainty all of us will be tired of hearing the word meaningful use after HIMSS. I might have to try and keep track of how many conversations I have where the words meaningful use aren’t used. Notice I’m counting the ones where it’s not used since I know that almost every conversation will include meaningful use.

I’m not sure that’s very healthy for the industry, but I think that’s the reality of where we’re at. While I’m sure I’ll ask plenty of questions about meaningful use as well, my favorite EHR vendors are probably going to be those that say: we meet meaningful use, we’ve abstracted meaningful use so its not an annoyance to doctors, and here’s what we’ve done to innovate our product outside of MU.

Meaningful Use Stage 2
Any day now I think that ONC/CMS is going to announce the final details for meaningful use stage 2. I imagine the regulatory process could push this so that ONC/CMS announce meaningful use stage 2 at HIMSS, but from what I’ve read I think they want to get it out before HIMSS. I hope they’re successful in making this happen.

Either way, I’ll be surprised if we don’t know about meaningful use stage 2 before/during HIMSS. So, if you want to be in the know, be prepared to talk about the final details of meaningful use stage 2. In the mean time, check out Lynn’s previous MU Monday post about meaningful use stage 2.

Federal IT Participation at HIMSS 12
Every healthcare related part of the federal government is going to be represented at HIMSS 12. HIMSS has been nice enough to provide a page listing all of HHS, CMS, ONC, AHRQ, CDC, HRSA, NIST, OCR, SSA, and VA sessions at HIMSS 2012. My only complaint with that page is that there are still a bunch of details missing on a number of the sessions. I imagine this is the government dragging their feet, but it sure makes it hard to plan.

While many of the government sessions can be dry and boring (partially attributed to what I call the government muzzle), it can be a really good place to hear the direction of the federal government when it comes to healthcare IT directly from their own mouth.

I also suggest that Farzad Mostashari’s keynote address won’t be nearly as interesting to someone familiar with healthcare IT as his ONC Townhall: Advancing Health IT into the Future session on Wed, 2/22 at 2:15 in San Polo 3503. I know I also want to work in a session on MU stage 2 and the future of EHR certification from the federal perspective as well.

“Meaningful” References
Is it just me, or do other people have a problem using the word meaningful now. At least it’s a challenge with many of my healthcare friends. Although, sometimes I throw it in there just for irony’s sake. Hopefully this post was meaningful to you.

Also, a big thanks to all those that filled out the EMR and HIPAA reader survey. I’ve loved all the feedback. Interestingly enough, one of the more common feedback items was that you liked the Meaningful Use Monday series. We’ll do what we can to keep it going.

HIE, ACOs Are the ‘Fast-Moving Train’ of Health Reform

Posted on May 12, 2011 I Written By

Healthcare and health IT are plagued by conundrums. Providers long have been the ones asked to make hefty investments in EMRs and other IT systems to help remove costs from the healthcare system, but payers and plan sponsors tend to enjoy most of the financial benefits. Clinicians wish their organizations would share data with others, but those in the executive suite have been reluctant to cooperate with competitors for fear of losing revenue. And, let’s face it, medical errors can be profitable if a routine procedure turns into an expensive inpatient admission.

Portions of the American Recovery and Reinvestment Act and the Patient Protection and Affordable Care Act are intended to address these problems by providing financial incentives for “meaningful use” of EMRs (including health information exchange) and by encouraging the creation of Accountable Care Organizations

I’m just back from the Institute for Health Technology Transformation health IT summit in Fort Lauderdale, Fla., where I moderated panels on how health IT underpins ACOs and how business intelligence can create a framework for health information exchange.

The panelists did great job of articulating some of these conundrums and strategies to overcome them, but none better than Kevin Maher, director of clinical innovations for Horizon Healthcare Innovations, a new affiliate of Horizon Blue Cross Blue Shield of New Jersey tasked with testing new care models, and Victor Freeman, M.D., quality director in the Health Resources and Services Administration‘s Office of Health IT and Quality.

The patient-centered medical home is a great idea for managing care, promoting prevention and, ultimately reducing costs. “We view the base of the ACO as the patient-centered medical home,” Maher said. But what exactly does an ACO look like? “An ACO is like a unicorn,” Maher said. “We can all describe it, but we’ve never seen one.”

He noted that Horizon has started paying some physicians a care coordination fee to manage populations that potentially could add $60,000 or more to a doctor’s annual income. But there are plenty of factors outside a physicians’ control.

“Potentially the No. 1 focal point of a patient-centered medical home or an ACO is patient behavior,” Maher said. A doctor can’t force a patient to exercise more, quit smoking or get a mammogram or PSA test. There’s pay-for-performance for doctors, but what about paying for patient performance?

In January 2012, Horizon will launch a pilot to offer incentives to members who get recommended tests and choose providers that meet the health plan’s quality standards. That’s right, the Blues plan in New Jersey will pay people to go to the doctor and to make informed choices about which doctors they see. (“Everyone says she’s a great doctor” won’t cut it as an informed choice anymore.)

Freeman called the Horizon experiment “P4P that makes sense.”

Let’s just hope the technology can support making the right choices. “People in government get more involved in quality measurement, not necessarily quality,” Freeman said. Incentive programs these days still tend to be more pay-for-reporting than pay-for-quality, and the technology hasn’t fully matured in that area.

“EMRs were designed for billing, not quality reporting,” noted Freeman, who has a background in public and population health. Information often isn’t stored in discrete form, such as with images generated by specialists flagged as being abnormal, so even with HIE, it’s hard for primary care physicians to identify patients who might be candidates for early interventions before they actually exhibit symptoms of a disease.

“My biggest interest in HIE is how clinicians communicate with each other,” Freeman said.

But is the technology ready to help them do so? “HIE now reminds me of what EMRs were five years ago,” said another panelist, Bruce Metz, Ph.D., newly hired senior VP and CIO at the Lahey Clinic in Massachusetts. It’s viewed as an IT project that’s not necessarily linked to a business or clinical strategy. “You can’t force the technology to mature that fast,” he added.

And so the ride continues on what Metz called “a fast-moving train.” Have we even had time to see if the right people are on board?

HITECH Act Gives HHS $2 Billion of Discretionary Funds

Posted on February 20, 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 HITECH Act gives Health and Human Services (HHS) 90 days to develop a plan to allocate $2 Billion of discretionary funds. Talk about a nice infusion of funding for HHS. HHS does have a set of core areas of focus for the money (per an Allscripts presentation on HITECH).

The area of focus that interests me most is the “Regional Health IT Resource Centers.” Seriously, what is a regional health IT resource center? Can any of you imagine a doctor visiting a health IT resource center? I don’t understand how this will work at all.

I have a better idea. Why not take a cool million and give it to me? I’ll create a killer online platform for sharing of health care IT resources where people can share information nationally or within their region. Could be a killer application for sharing information quickly and could be available to every state in the country (and for that matter the world). Unless you think that training health care IT staff is better done without using IT.

Here’s a look at the full list of core areas of focus:

  • Standards requirements due before the end of this year
  • HIE Infastructure, National Health Information Network (NHIN)
  • Regional Health IT Resource Centers
  • Federal grants through AHRQ, HRSA, CMS
  • Grants to the states in 2010
  • Promote advanced EHR