Posts Tagged ‘EHR system’

Federal EHR Incentives – Required Certification

Wednesday, February 25th, 2009

January 5 UPDATE – Definition of “Meaningful Use”

ONCHIT has released “Meaningful Use” regulations that will impact EMR certification and providers’ qualification for ARRA EMR incentives. Learn more here.

July 17 UPDATE – Multiple EHR Certification Groups

The Health IT Policy Committee has suggested that multiple groups engage in the certification of EHR systems. Previously, the Certification Commission for Healthcare Information Technology (CCHIT), a private organization, had a monoploy on EHR system certification. The Health IT Policy Committee also recommended that officials examine gaps between existing CCHIT certification criteria and the emerging definition of “meaningful use”.

July 16 UPDATE – Definition of “Meaningful Use”

The Health IT Policy Committee approved a work group’s revised recommendations for defining “meaningful use” of electronic health records. Current elements of the definition of “meaningful use” include:

    Allow patients to access their health records in a timely manner;

    Develop capabilities to exchange health information where possible;

    Implement at least one clinical decision support rule for a specialty or clinical priority;

    Provide patients with electronic copies of discharge instructions and procedures;

    Submit insurance claims electronically; and

    Verify insurance eligibility electronically when possible.

Read more here.

July 13 UPDATE – Definition of “Meaningful Use”

The comments period for the first release of a working definition of “meaningful use” ended on June 26. Following are links to comments submitted by a number of organizations.

    CCHIT comments
    The Markle Foundation comments
    The American Hospital Association (AHA) letter
    College of Health Information Management Executives letter
    The American Medical Association (AMA) letter and comments
    Healthcare Information Mangement Systems Society (HIMSS) comments
    eHealth Initiative comments

June 23 UPDATE – Definition of “Meaningful Use” – Standards and Certification Criteria

The HIT Standards Committee is meeting today to discuss the application of standards and certification criteria to the definition of “meaningful use” of health IT (EHR). No additional information is available at this time.

June 16 UPDATE – Definition of “Meaningful Use”

The HIT Policy Committee today offered some criteria that it feels should be part of the definition of “meaningful use”. You can view the Meaningful Use Workgroup’s June 16, 2009 update here.

April 16 UPDATE – Definition of “Meaningful Use”

A workgroup of the HIT Policy Committee has until June 16 to deliver its recommendations for a working definition of “meaningful use” of electronic health records. If the Committee approves the definition, it will be forwarded to ONCHIT for approval and adoption.

April 8 UPDATE – HIT Standards Committee and HIT Policy Committee

The HIT Standards Committee has received over 1,000 nominations, but as of today, no appointments have been made.

The HIT Policy Committee has made 13 of 20 appointments.

March 19 UPDATE – HIT Standards Committee and HIT Policy Committee

By law, the Office of the National Coordinator for Health Information Technology (ONCHIT) must announce appointments to the HIT Standards Committee and HIT Policy Committee on or before March 31, 2009. ONCHIT has not been forthcoming with news about its progress toward filling these committee posts.

March 12 UPDATE – Continuing Role for CCHIT?

During a webinar today, CCHIT Chair Mark Leavitt said he is confident that HHS will select CCHIT as the certification body identified in the stimulus law because HHS has recognized CCHIT since 2006. He thinks there is not enough time to develop a new certification group because IT systems need to be certified within the next year to qualify for stimulus package bonuses.

March 11 UPDATE – Serve on Standards or Policy Committee

The Office of the National Coordinator for Health Information Technology is seeking nominations to the HIT Standards Committee and HIT Policy Committee, both created under the American Recovery and Reinvestment Act.

The deadline for letters of nomination for both committees is March 16.  The e-mail address is  The postal address is Office of the National Coordinator, Department of Health and Human Services, 200 Independence Avenue NW, Washington, DC 20201, Attention:  Judith Sparrow, Room 729D.

March 8 UPDATE – National Institute of Standards and Technology (NIST) – Role in Developing HIT and EHR Standards

As part of the Economic Stimulus Package, the NIST will receive approximately $20 Billion to fund its development of HIT infrastructure structure and related standards, including those impacting Electronic Health Records (EHR).  You can access the NIST’s Project Statement here.

Feb. 26 UPDATE – “Billions for health records rest on NIST standards”

Great article from NextGov here.

Feb. 25 Original Post: Federal EHR Incentives – Required Certification

The American Recovery and Reinvestment Act of 2009 (Economic Stimulus Bill) provides financial incentives for physicians and other healthcare providers to adopt electronic health records (EHRs). Physicians, hospitals and health systems will be eligible for the incentives through implementation of their first EHR system or completion of an ongoing EHR project. However, in order to qualify for the incentive payments, a deployed EHR system must be “certified”.

The Certification Dilemma – The certification requirements necessary to qualify for the federal EHR incentives are not known yet and may not be defined until late 2009 (or later). As of today, the EHR certification provided by a nonprofit think tank, the Certification Commission for Healthcare Information Technology (CCHIT), is the closest relevant certification standard in effect. But don’t necessarily rely on that certification to be the one adopted by the federal government when it decides what EHR systems will qualify for the financial incentives.

Stay Informed – On a weekly basis I will be tracking certification standards as they are promulgated by the Office of the National Coordinator for Health Information Technology (ONCHIT), including notice of “comments periods” during which members of the public are invited to comment upon proposed regulations.

If you want to stay abreast of these certification developments, check back often for additional details, or subscribe to the RSS feed below to automatically receive updates.

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Economic Stimulus Package – Finalized Bill – EHR Incentives

Friday, February 20th, 2009

medical-records1Finalized Bill – President Obama has signed into law the American Recovery and Reinvestment Act of 2009. You can view the text of the signed bill here.

Authorized Incentives for Use of EHR Systems – The incentives total over $17 Billion and will be adminstered through Medicare and Medicaid as reimbursements over a 5-year period as follows.

    Hospitals – Hospital incentives start at $2 Million annually, with an additional reimbursement amount tied to annual Medicare discharge volume, and decrease for each subsequent year during the 5-year incentive period.

    Physicians – Non-hospital-based physicians and physician groups can expect to receive up to $60,000 during the 5-year incentive period, including $18,000 the first year, if they have qualifying EHR systems in place by 2011.

EHR Systems That Qualify for the Incentives – Qualifying EHR systems (tied to “meaningful EHR users”) must meet the following criteria.

    Clinical Decision Support – As yet undefined, but presumably includes, for example, drug allergy and drug interaction tracking capability

    Physician Order Entry (CPOE) – As yet undefined, but presumably includes the ability to order lab tests, prescriptions, etc., electronically.

    Ability to Capture Health Care Quality Data – “To capture and query information relevant
    to health care quality.” As yet undefined, but the legislative history suggests concerns over those “underserved” within the U.S. healthcare system.

    Ability to Support the Exchange of Clinical Data with Other Organizations – As yet undefined, but will presumably include elements of system interoperability.

The definition of a “qualifying EHR system” is relatively soft right now (meets the above criteria and is CCHIT-certified), but the definiton will become more onerous as we move further into the 5-year incentive period. The Office of the National Coordinator for Health Information Technology (ONCHIT) will be issuing regulations over time that will define additional qualifying criteria and certification standards.

Other Sources of Funding – ONCHIT will have approximately $2 Billion to make low-interest loans and grants available with respect to EHR. Eligibility standards have not been established, but the legisative history suggests the these dollars will go to the states and perhaps private sector participants for the development of EHR system and interoperability standards.

Buy Now, Upgrade Now, Or Wait? – Excellent question.

Reasons to Wait

    State of Flux – Just like you, EHR system vendors are anxiously awaiting the new EHR system qualification criteria, including any new certification standards. They cannot develop to compliance until the new compliance requirements are known. So, you might decide to wait for the regulatory dust to settle before you buy your first EHR system or upgrade to a new system.

    Buy Now, Get Reimbursed Later – With the after-the-fact reimbursement structure of the EHR incentive program, you may find that you do not have sufficient money of your own right now to invest in an EHR system. And even if you do, you certainly don’t want to waste money on a system that might not qualify for incentive reimbursements down the road (as ONCHIT changes the rules of the game over time).

Reasons NOT to Wait

    Planning and Sourcing Take Time – Think of it this way. There are over 300 EHR system vendors out there, and your attempt to understand the functional and technology-environmental variations among the current vendor offerings could make your head spin. Add your attempt to factor in an uncertain future with respect to qualification and certification standards, and you’ll quickly find yourself overwhelmed.

    My point is this. If you want to take advantage of the EHR incentives, you better get started NOW. You don’t necessarily have to commit to a buying decision now, but you should start your planning process now. Get informed, stay informed. Don’t procrastinate.

    Reimbursement Penalties – Remember that the stimulus bill includes not just incentives for EHR system adoption. It also includes penalties. Starting in 2015, healthcare providers that have not adopted a qualifying EHR system will face cuts in their normal Medicare reimbursements.

    EHR System Vendor Terms and Conditions – You can address the uncertainty within the EHR system market place by demanding tough terms and conditions from your EHR system vendor. You want your EHR system to be a qualifying system when you buy it, and it’s fair to expect that your vendor will warrant its qualifying status over time. Under the present circumstances, EHR vendors realize they will have to be extending some very buyer-favorable terms and conditions in order to sell their systems. Take full advantage of this situation, but remember one thing. Good terms and conditions, including system warranties, are only as good as your vendor’s ability to back them up. Larger, more-established vendors may have more financial wherewithal to support the buyer-favorable T&C they extend over time. Smaller shops may not.