Archived HIT News

October 6, 2008

Accelerating Progress: Using Health Information Technology and Electronic Health Information Exchange to Improve Care
In this inaugural report, the State Alliance examines the challenges states face in implementing HIT and HIE, including provider concerns about implementation costs, variations in technical standards for interoperability and consumer concerns about data privacy and security. The report is meant to spur continued innovation in states to make the vision of an interconnected, efficient, quality-based health care system – and ultimately a healthier American public – a reality.

To help states navigate the complexities of developing and using HIT and electronic HIE, the National Governors Association Center for Best Practices created the State Alliance for e-Health in 2006. The State Alliance – supported by funding from the U.S. Department of Health and Human Services – provides a nationwide forum through which governors, state policymakers and other stakeholders can work together to identify effective HIT policies and best practices and explore solutions to challenges related to the exchange of health information. For more information on the State Alliance and to view the report, please visit  www.nga.org/center/ehealth

October 1, 2008

CCHIT certifies outpatient EHR systems

The Certification Commission for Healthcare Information Technology this week listed the first vendors certified under the organization’s 2008 criteria for ambulatory electronic health record products.

Eight vendors are fully certified under the 2008 criteria, and they are: Community Computer Service, for MEDENT, version 18; eClinicalWorks, for eClinicalWorks, version 8; Epic Systems, for EpicCare Ambulatory EMR, version Spring 2008; Greenway Medical Technologies, for PrimeSuite, version 2008; McKesson Provider Technologies, for Practice Partner, version 9.3; MedLink International, for MedLink TotalOffice, version 3.1; MedPlexus, for MedPlexus EHR, version 9.2, and NextGen Healthcare Information Systems, for NextGen EMR, version 5.5.27.

Community Computer Service, eClinicalWorks, Epic Systems, McKesson Provider Technologies, and MedPlexus have also been certified for child health. Greenway Medical Technologies and NextGen Healthcare Information Systems are certified for child health and cardiovascular medicine.

Two vendors with pre-market products are conditionally certified under the 2008 criteria. They are Pulse Systems, for Pulse Patient Relationship Management, version 4.1; and VIP Medicine, for SmartClinic, version 16.

Conditionally certified EHR products may be fully certified once their operational use at a physician’s office has been verified, according to CCHIT.

http://www.govhealthit.com/online/news/350598-1.html?GHITNLnetworks=yes

Commission Certifies 10 EHR Products Based on New 2008 Criteria

This week, the Certification Commission for Health IT certified ambulatory care electronic health records based on its new 2008 criteria. Eight EHR products received full certification, while two EHR products received pre-market conditional certification. Health Data Management et al.

Source:  http://lyris.ihealthbeat.org/t/3119/359440/4370/0/ and http://www.healthdatamanagement.com/news/electronic_health_record_EHR_EMR27018-1.html?CMP=OTC-RSS

Research Firm Makes Personal Health Record Recommendations

A report by Chilmark Research urges vendors to create personal health record systems that meet the information needs of consumers. The report also stresses the importance of incorporating a high level of security in PHR systems. Health Data Management.

Source:  http://www.ihealthbeat.org/Articles/2008/10/1/Research-Firm-Makes-Personal-Health-Record-Recommendations.aspx and http://www.healthdatamanagement.com/news/PHR27053-1.html

Wal-Mart Offers Employees Personal Health Records

Wal-Mart is first member of the Dossia employer coalition to offer its employees personal health records. The PHRs initially will be populated with claims data from health plans and pharmacies and later could include clinical information from health care providers' electronic health record systems. The seven other companies participating in Dossia soon will follow suit and roll out their own PHR initiatives. Health Data Management.

September 30, 2008

Rhode Island Law To Create Health Information Exchange

On Monday, Rhode Island Gov. Don Carcieri (R) signed into law the Rhode Island Health Information Act of 2008 to create a statewide health information exchange, the Providence Journal reports.

The state has tasked the Rhode Island Quality Institute, a private agency, to run the voluntary health data exchange. The Rhode Island Quality Institute has received a $5 million federal grant to build the network but will seek additional funding from the state and health insurers.

Laura Adams, president and CEO of the Rhode Island Quality Institute, estimates that it will cost $3 million to $4 million annually for five years to build the health data exchange and then about $1.5 million to $2 million annually to sustain the exchange.

When the health data exchange launches in March, it will include laboratory information from Lifespan, East Side Clinical and the Department of Health laboratories, as well as medication history information from retail pharmacies. Gradually, other groups will join the health information exchange, with Adams setting a goal of connecting the entire state within five years.

Patient Privacy

The new law gives Rhode Island residents the option of participating in the health information exchange, as well as control over who can access their health records.

Residents who choose to enroll in the health information exchange can choose from three levels of privacy:

• Making their health records available only in an emergency;
• Specifying certain health care providers who can access their records; or
• Giving anyone involved in their health care access to their health records.

Patients participating in the health data exchange will be notified every time someone looks at their medical records. They also will have the ability to change their privacy level or withdraw from the system at any time.

According to the Journal, the law provides stronger patient privacy protections than the HIPAA medical privacy rule. Adams added that the law's $10,000 fine for each privacy violation is greater than federal privacy penalties.

Still, Steven Brown, executive director of the Rhode Island Affiliate of the American Civil Liberties Union, raised concerns that patients will not have the ability to control what information is included in their health records.

Adams said that physicians would not participate in the health data exchange program if they did not have the assurance that patients' medical records are complete.

Brown also noted that the law does not prevent physicians from refusing to treat patients who decide not to participate in the exchange, arguing that voluntary participation may prove "illusory" (Freyer, Providence Journal, 9/30).

Source:  http://www.ihealthbeat.org/Articles/2008/9/30/Rhode-Island-Law-To-Create-Health-Information-Exchange.aspx#

Texas Program Uses EHRs To Boost Care of Foster Children

An electronic health record system, called the Health Passport, is credited with helping to overhaul the Texas foster child health care system, Government Technology reports.

The Texas Health and Human Services Commission launched the online Health Passport in April, and now more than 30,000 foster children have EHRs that follow them when they move. The EHR system is making it easier to keep track of a child's medical history and insurance claims, Government Technology reports.

A child's guardian, doctor and "medical consenter" can review the child's medical history and make any updates through a Web-based interface. Insurance claims, lab results and other medical data are updated automatically.

Texas received a $4 million HHS grant to build the EHR system.

The Texas Health Passport program is the first of its kind in the country, but project developers say other states could launch similar programs (Michels, Government Technology, 9/29).

Source:  http://www.ihealthbeat.org/Articles/2008/9/30/Texas-Program-Uses-EHRs-To-Boost-Care-of-Foster-Children.aspx#

September 26, 2008

CCHIT catalogs HIT adoption incentives

The Certification Commission for Healthcare Information Technology has published its first catalog of programs that subsidize physician adoption of health IT.

The CCHIT Incentive Index now covers 90 public and private sector initiatives.

The Incentive Index represents at least $700 million in potential funding for EHR software and implementation expenses, according to CCHIT. The commission reports that 50 programs stem from hospital organizations responding to federal “safe harbor” regulations. Those regulations, announced in 2006, let hospitals subsidize a portion of the costs for physicians to adopt CCHIT-certified EHRs.

Meanwhile, government agencies, insurance plans, employer coalitions and public-private partnerships offer 40 incentive programs, half of which specifically call for CCHIT-certified technology.

http://www.govhealthit.com/online/news/350594-1.html?GHITNLnetworks=yes

Guidelines for National Disaster Response EHR Win Endorsement

The National Biodefense Science Board has approved recommendations for an electronic health record system for federal disaster response efforts, Government Health IT reports.

Besides using the EHR system to help with patients involved in disasters, the National Disaster Medical System, which is a part of HHS and aims to supplement state and local responses to disasters, uses the system to monitor changes in public health.

According to the recommendations, the system should be linked with patient-tracking and medical resource availability programs and should be interoperable. Further, the National Disaster Medical System should be in charge of defining the minimum required patient dataset for the EHR.

The board's draft materials read: "Along with the EHR, there is a critical need to integrate the various patient-tracking and medical resources availability systems in use during a response to ensure that medical needs of patients are captured and that (patients) are transported to facilities that are ready to receive them and have the medical resources to treat them."

Much work remains on the EHR system, the recommendations indicate. In addition, the National Disaster Medical System "does not represent an overall system to provide for medical needs of patients at a time of national needs," the recommendations say.

The board will send its final recommendations to HHS (Foxhall, Government Health IT, 9/25).

Source:  iHealthBeat - http://www.ihealthbeat.org/Articles/2008/9/26/Guidelines-for-National-Disaster-Response-EHR-Win-Endorsement.aspx

September 25, 2008

Many Programs Offer Doctors Financial Help To Adopt EHRs

There are about 90 initiatives offering a total of at least $700 million to help physicians adopt electronic health records, according to a new Certification Commission for Healthcare IT study, Health Data Management reports.

The study found that at least 50 hospital organizations have launched programs to partially subsidize the cost of EHRs for doctors, as allowed under relaxed federal regulations adopted in 2006. The study also found that 40 EHR incentive programs have been launched by:

• Government agencies;
• Insurance companies;
• Employer coalitions; and
• Public-private partnerships (Health Data Management, 9/25).

John Morrissey, CCHIT's communication manager and author of the study, said at least 43,000 physicians already are being offered subsidies in state and local initiatives (Manos, Healthcare IT News, 9/25).

Source:  iHealthBeat - http://www.ihealthbeat.org/Articles/2008/9/25/Many-Programs-Offer-Doctors-Financial-Help-To-Adopt-EHRs.aspx

August 18, 2008

Staffing shortages, EHRs keep hospital execs awake at night

Electronic health records and staffing shortages are on the minds of hospital executives, physicians and nurses, according to a recent poll conducted by healthcare technology company Picis.

The rollout of electronic health records ranks as the second biggest concern, raising additional questions about how the role of government-funded EHR initiatives and joint ventures from companies such as Google and Microsoft will affect the future of hospital technology systems.

Nearly 90 percent of poll respondents believe EHRs are going to revolutionize the healthcare system, but the majority predicts it will be at least 10 years before EHRs are used in a majority of U.S. hospitals.

Additionally, 55 percent said patients would be more likely to visit a hospital using an EHR system, versus one that uses paper systems.

Close to 90 percent said government-run EHRs are the answer, but many expressed interest in joint funding from the private and public sectors.

The live poll was conducted June 15-18 at the annual Picis Exchange customer conference in Palm Beach, Fla. , among 325 attendees who are employed as physicians, nurses, IT technicians or hospital administrators in hospitals and health centers across North America.

Source:  http://www.healthcareitnews.com/story.cms?id=9793
Survey Results:  http://www.picis.com/healthcare-buzz/Poll-results-EHR.pdf 

August 13, 2008

Foundation donates open-source HIE code
California HealthCare Foundation officials hope the donation of open-source tools will help health information exchanges sustain their businesses.

The California HealthCare Foundation donated software for an open-source health information exchange project designed to help sustain regional health information organizations.

The code donation includes two key HIE components: a master patient index and a record locator service, according to Jonah Frohlich, the foundation’s senior program officer.

“The donated software would serve as a foundation for customers and developers to use and enhance to help sustain Regional Health Information Organizations,” Frohlich said. “We are not currently working with any specific HIEs or RHIOs but hope that through this effort we can support existing and developing” RHIO clients looking for open-source solutions, he added.

Source:  http://www.govhealthit.com/online/news/350514-1.html?GHITNL=yes

August 11, 2008

Massachusetts requires EHRs in hospitals by 2015

Massachusetts Gov. Deval Patrick has signed into law a health care bill that will require hospitals and community health centers to use interoperable electronic health records (EHR) systems if they seek to obtain or renew licenses to operate in 2015 or afterward.

The law outlines a goal of “full implementation of electronic health records systems and the statewide interoperable electronic health records network by January 1, 2015.” It sets up a mechanism for creating a statewide health information network.

However, it stops short of requiring doctors in private practice to use health IT. Instead, it requires doctors to demonstrate competence in the use of computerized physician order entry (CPOE), e-prescribing, EHRs and other forms of health IT by the beginning of 2015, as part of their licensure requirements.

The new law also requires hospitals and community health centers to implement CPOE as a licensing requirement, beginning in 2012.

The health IT provisions are only one aspect of the new law, which aims to contain health care costs in Massachusetts while boosting quality, transparency and access to health care.

Under the law, the state will create the Massachusetts eHealth Initiative, which “shall advance the dissemination of health information technology across the commonwealth, including the deployment of electronic health records systems in all health care provider settings that are networked through a statewide health information exchange.” A council including high-ranking state officials will advise the institute and act as a board of directors.

The institute is required to develop a statewide plan for EHR implementation and update it annually. The plan’s implementation will be funded by an e-Health Institute fund that could have a variety of sources for its money, including state bonds, appropriations, federal grants or loans or private donations.

The institute’s implementation plan will include grants for providers. Also, it may contract with other organizations that will provide implementation services to providers.

The law calls for providing patients with the ability to opt into the health information network and then to opt out at any time. It also calls for encryption and other measures to keep personal health information private. In the event of security breaches in which patients’ personal information is disclosed, the patients must be notified within 10 days.

“I applaud the many important initiatives that this legislation enacts to enhance the quality and cost-effectiveness of health care in the commonwealth,” Gov. Patrick said in a statement.

State Senate President Therese Murray was the bill’s primary sponsor.

Source:  Government HealthIT - http://www.govhealthit.com/online/news/350511-1.html?topic=state

August 1, 2008

Governor plans to give Minnesotans access to PHRs by 2011

Minnesota Gov. Tim Pawlenty has proposed to give all Minnesotans access to an online personal health portfolio by 2011.

As the first step in this effort, the governor has directed the Department of Finance and Employee Relations to seek proposals for a secure and portable online personal health portfolio for each of the state's approximately 50,000 employees in 2009...

"Minnesota's healthcare system must be market-driven, patient-centered and quality-focused," Pawlenty said. "Minnesota took a giant step forward to transform our healthcare system this year. Now Minnesota will lead the nation in the development of portable personal health records and expanded consumer-directed healthcare spending accounts for state employees."

The portfolio will offer:

• Electronic access to test results;
• Access to one's own medical records electronically;
• Instant access to immunization records; and
• Prescription history and detection of interactions.

"In healthcare, information is power. Right now the consumer is the only person in the system without access to their healthcare information," Pawlenty said. "We need to turn that around and allow the consumer to build their own healthcare portfolio, control who has access to it and take it with them wherever they go for the rest of their lives."...

To read the entire article go to:  http://www.healthcareitnews.com/story.cms?id=9691

Providers cite decreased Medicare payments as greatest challenge, EMRs as potential solution

Dealing with decreased payments from Medicare and insurers was cited as the biggest concern of healthcare providers in a recent survey by data and network service provider IVANS, Inc.

To help close the "payment gap," many of these providers say they are turning to information technology...

More than 60 percent of survey respondents believe the use of electronic health records can have a significant impact on improving their businesses, and greater than 65 percent have already implemented or plan to implement EHR systems. Eight-five percent believe that Health Information Exchanges can facilitate information sharing for improving patient care.

Eighty-five percent of providers surveyed cited lack of budget as the biggest challenge to technology adoption, followed by lack of expertise and getting staff to use technology. Healthcare providers surveyed seem to view technology as a viable method for doing more with less, but they are not sure they have the internal resources to leverage it. ..

To read the entire article go to:  http://www.healthcareitnews.com/story.cms?id=9688

July 31, 2008

Telemedicine in California: Progress, Challenges, and Opportunities

Telemedicine — the use of telecommunications and information technologies to provide health care remotely — has the potential to improve health care by bridging time and distance barriers, reducing delivery costs, and altering referral patterns among physicians. Yet although telemedicine has been around for a number of years, and despite the success of telemedicine programs in rural pockets of California, its use in the state is not widespread.

This report examines the evolution of telemedicine in California and identifies the technological, financial, regulatory, and user-related hurdles that may be stifling further progress. It finds that while some patients have benefited from early innovators who transformed inventive technology projects into statewide telemedicine programs and e-health networks, the impediments to broader adoption remain daunting.

Although the authors acknowledge the persistence of such barriers, they also suggest that given the explosive growth in Internet use, the expansion of remote communication models, and the relentless pressure to cut the cost of care delivery, the time may finally be ripe for telemedicine. The report concludes by exploring questions about the key factors that could affect the proliferation of telemedicine technology in California...

To read the entire article go to :  http://www.chcf.org/topics/view.cfm?itemid=133682

July 27, 2008

Privacy should be #1 PHR priority, CCHIT committee says

While other issues matter, privacy should be the top priority in setting certification criteria for PHRs, according to a task force run by the Certification Commission for Healthcare Information Technology. The CCHIT's Personal Health Records Advisory Task Force recommended not only that PHRs protect private patient information, but also that they be able to send and receive data from varied data sources including ambulatory and hospital EMRs, labs and pharmacies.

The committee's work builds on prior research done by the National Alliance for Health Information Technology, which developed standardized definitions for six key health IT terms. These include that PHRs would conform to nationally recognized interoperability standards, and also, that individuals would manage PHR data.

To learn more about the PHR task force's recommendations:
- read this Modern Healthcare piece (reg. req.)

Source: http://www.fiercehealthit.com/story/privacy-should-be-1-phr-priority-cchit-committee-says/2008-07-27?utm_medium=nl&utm_source=internal&cmp-id=EMC-NL-FHI&dest=FHI

July 24, 2008

HITSP Program Director Testifies to House of Representatives on Health Information Technology

LeRoy Jones, program director for the Healthcare Information Technology Standards Panel (HITSP) and principal and chief executive of GSI Health, testified today before the U.S. House of Representatives Committee on Ways and Means, Subcommittee on Health.

The hearing was focused on options to encourage the adoption and use of a secure, clinically comprehensive, and fully interoperable health information technology system in the United States.

Mr. Jones' testimony detailed several initiatives funded by the U.S. Department of Health and Human Services (HHS) to accelerate electronic medical record interoperability efforts, including: harmonizing standards for healthcare information technology (undertaken by HITSP), ensuring that electronic medical records provide the basic functions needed for a doctor to record and transmit patient medical information (undertaken by the Certification Commission for Healthcare Information Technology), cataloguing privacy and security policies across the nation and reconciling their variances to insure interoperability across state borders (undertaken by the Health Information Security and Privacy Collaboration), and establishing a real health information exchange network which demonstrates the feasibility of implementing interoperability standards in an effective way and propagates their widespread use (undertaken by the Nationwide Health Information Network)...

Read the Full Article at ThomasNet - http://news.thomasnet.com/companystory/547471

July 17, 2008

Why Not the Best? Results from the National Scorecard on U.S. Health System Performance, 2008
Authors:   The Commonwealth Fund Commission on a High Performance Health System

Overview

National Scorecard on Health System Performance 2008 http://www.commonwealthfund.org/usr_doc/site_docs/slideshows/NatlScorecard/NatlScorecard.html
download individual report charts in ChartCart.

Prepared for the Commonwealth Fund Commission on a High Performance Health System, the National Scorecard on U.S. Health System Performance, 2008, updates the 2006 Scorecard, the first comprehensive means of measuring and monitoring health care outcomes, quality, access, efficiency, and equity in the United States. The 2008 Scorecard, which presents trends for each dimension of health system performance and for individual indicators, confirms that the U.S. health system continues to fall far short of what is attainable, especially given the resources invested. Across 37 core indicators of performance, the U.S. achieves an overall score of 65 out of a possible 100 when comparing national averages with U.S. and international performance benchmarks. Overall, performance did not improve from 2006 to 2008. Access to health care significantly declined, while health system efficiency remained low. Quality metrics that have been the focus of national campaigns or public reporting efforts did show gains.

Executive Summary

Every family wants the best care for an ill or injured family member. Most are grateful for the care and attention received. Yet, evidence in the National Scorecard on U.S. Health System Performance, 2008, shows that care typically falls far short of what is achievable. Quality of care is highly variable, and opportunities are routinely missed to prevent disease, disability, hospitalization, and mortality. Across 37 indicators of performance, the U.S. achieves an overall score of 65 out of a possible 100 when comparing national averages with benchmarks of best performance achieved internationally and within the United States...

To read the entire article go to: http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=692682

July 14, 2008

Business Case Needed To Argue for EHR Adoption, Experts Say

In most cases, the U.S. health care system does not provide incentives for physicians or hospitals to share clinical data with other health care providers, raising barriers to widespread adoption of the technology, Computerworld reports.

Charles Jaffe -- CEO of Health Level 7, which develops data standards for health care organizations -- said, "The problem we have in this country is a lack of business reasons for integrating." He added, "What is the business case for two competing hospitals to share data? None."

For example, five major hospitals in San Diego held a series of meetings about three years ago to consider sharing information stored in their respective EHR systems.

However, the hospitals decided not to pursue the plan because economic benefits were inadequate.

Joshua Lee, medical director of information services at the University of California-San Diego Medical Center, said, "The financial and oversight responsibility would fall on the medical centers, even though it's a very intangible benefit to the medical centers."

Although studies show that EHRs, computer physician order entry and other technology applications can improve the quality of health care, health care providers generally are not compensated for improvements to care, according to John Quinn, chief technology officer for HL7.

John Halamka, CIO at Harvard Medical School and Beth Israel Deaconess Medical Center, said, "The provider bears the cost, but most of the benefits accrue to other parties," particularly insurers and other health care payers.

Shaun Grannis, a medical informatics researcher at the Regenstrief Institute in Indianapolis, said that Regenstrief is working to develop an economic model for health information exchanges that would be sustainable over the long term, but he said that such projects continue to rely on "a patchwork of funding" (Mitchell, Computerworld, 7/14).

Source:  http://www.ihealthbeat.org/articles/2008/7/14/Business-Case-Needed-To-Argue-for-EHR-Adoption-Experts-Say.aspx?topicID=54#

June 26, 2008

Broad Coalition Releases First Privacy Guidelines for PHRs

On Wednesday, Microsoft, Google and dozens of other health care organizations approved the first-ever privacy framework for personal health records, the AP/Washington Post reports.

The Connecting for Health guidelines were created to address consumer advocates' concerns that HIPAA medical privacy rules do not apply to PHR companies. Privacy advocates worried that patients' data could be obtained by the government, insurers or marketers without necessary protections (Liedtke, AP/Washington Post, 6/25).

Over 18 months, the Markle Foundation and 46 other electronic service providers, consumer advocates, medical associations and other stakeholders created the guidelines (Vanac, Cleveland Plain Dealer, 6/26).

Scope of Guidelines

The PHR guidelines address:

• Authentication of consumers;
• Audit trails;
• Restrictions on identifying information;
• Portability of patient data;
• Security and systems requirements;
• Provisions for consumer consent; and
• Policies for notifying patients when their information is breached (Health Data Management, 6/25).

PHR Survey

On Wednesday, the Markle Foundation also released a survey, conducted by Columbia University professor emeritus Allan Westin, on consumer attitudes toward PHRs. The survey of 1,580 individuals found that:

• 2.7% of respondents, or about 6.1 million U.S. residents, have a PHR;
• 57% of those without PHRs cited privacy concerns for not having a PHR (Health Data Management, 6/25);
• Eight in 10 respondents said PHRs could improve their health; and
• Nearly nine in 10 respondents said online privacy practices played a significant role in their signing up to use PHRs (Cleveland Plain Dealer, 6/26).

June 20, 2008

CCHIT sets tests for inpatient, ER e-health records

The Certification Commission for Healthcare Information Technology (CCHIT) approved final criteria today for certifying inpatient and emergency department electronic health records.

It also published standards for a new category of certification — enterprise EHRs — to cover vendors that provide interoperable outpatient, inpatient and emergency room records.

Dr. Mark Leavitt, CCHIT chairman, said the approvals mean outpatient and inpatient EHRs must now be able to exchange clinical in the Continuity of Care Document format, “making basic elements of health records, such as medications and allergies, interoperable and portable for the first time.”

The first applications for products to be certified against the new criteria will be accepted Aug. 1-14.

This concludes CCHIT’s work on its 2008 agenda for establishing health IT certification criteria. It published final outpatient, child health and cardiovascular medicine criteria May 20 and will take certification applications for those products July 1 - 14.

CCHIT said it would set up a July 10 teleconference for vendors interested in the new certifications.
Source:  Government HealthIT - http://www.govhealthit.com/online/news/350436-1.html

June 19, 2008

Only 4 percent of U.S. physicians have a fully functional electronic health records system and 13 percent have a basic one, says a study in the June 19 online edition of the New England Journal of Medicine.

The survey of 2,758 physicians - which claims to be the most up-to-date and comprehensive picture of EHR adoption trends - shows that 16 percent of physicians said their practice had purchased an EHR but had not yet employed it.

Another 26 percent said their practice was planning on purchasing a digital record-keeping system within the next two years.

The RWJF also provided a $600,000 grant for the first two years of work on a forthcoming nine-chapter report on healthcare IT titled "Health Information Technology in the United States: Where We Stand, 2008," co-authored by the Institute for Health Policy at Massachusetts General and George Washington University.

The authors define a fully functional EHR as one that has a broad range of capabilities including order entry and clinical decision support. A basic EHR is one with a minimum set of functionalities such as recording laboratory data and clinical notes and electronic prescribing.

Physicians who serve a higher proportion of minority, uninsured or Medicaid patients were equally likely to have an EHR as others.

Physicians who practiced in groups of at least 50 were three times more likely as those in very small practices (three doctors or less) to have a basic EHR. Yet only a minority of physicians in these larger groups (17 percent) had a fully functional EHR and 49 percent did not have an EHR at all.

"The cost of an EHR system is the most commonly cited barrier to adoption," said DesRoches. She noted that two-thirds of physicians without EHRs cite affordability as the reason they don't have an EHR.  Other reasons include finding the right EHR, concern about return on investment, and fears that the system will become obsolete quickly.

The study's authors said EHR adoption could be enhanced by helping doctors buy the technology through loans, incentive programs or direct payments.  DesRoches noted that physicians are especially interested in legal protection from personal liability for record tampering by external parties.

http://www.healthcareitnews.com/story.cms?id=9438

Electronic Health Records in Ambulatory Care — A National Survey of Physicians:  http://content.nejm.org/cgi/content/full/NEJMsa0802005

June 18, 2008

4 percent of U.S. doctors use EHRs, new study finds

A milestone study of the adoption of health information technology has produced findings that one of the study’s authors calls troubling and the other calls very sobering.

The survey of 2,758 U.S. doctors, sponsored by the Office of the National Coordinator for Health IT (ONC), found that only 4 percent had a fully functional electronic health record system. Another 13 percent had a basic or partially functional EHR system.

A 2006 study, also sponsored by ONC, found that as many as 9 percent of doctors had fully functional EHR systems. However, Dr. Karen Bell, director of ONC’s Office of Health IT Adoption, said the survey parameters were different.

“There is an increase,” Bell said at a press conference to discuss the results, which were reported today in an online edition of the New England Journal of Medicine.

The earlier survey, undertaken by the same team, found that 24 percent of doctors had some sort of computerized record system, but the question allowed them to count billing systems and other kinds of systems not directly related to health care.

Dr. David Blumenthal, director of the Institute of Health Policy at Massachusetts General Hospital and a co-author of the study, said, “We need to get moving a lot faster than we have been if we are going to take full advantage of this technology and realize its promise for medicine."

His colleague, Massachusetts General researcher Catherine DesRoches, said she found reason for hope in the findings. Forty-two percent of the doctors surveyed said their practice had bought an EHR system but had not yet implemented it or they were planning to buy one in the next two years.

“Physicians who use these systems like them,” she said, and they reported that the technology supported better patient care.

But, DesRoches said, doctors are uncertain whether they will get a financial return on their investment in EHRs, and they are fearful of new legal liabilities that could arise. Cost, she said, is the No. 1 barrier to doctors’ adoption of the technology.

Although ONC had touted the previous survey as a benchmark from which to measure future EHR adoption, Bell said the more recent one is “a true benchmark.” She said an agency of the Centers for Disease Control and Prevention will repeat the survey using the same survey instrument in the future.

The Robert Wood Johnson Foundation funded a nine-chapter report on health IT adoption, including the survey results, that will be available on its Web site July 2.
Source:  Government HealthIT - http://www.govhealthit.com/online/news/350433-1.html

June 10, 2008

CCHIT adds personal health records to 2009 agenda

June 3, 2008

Coodinated Federal Health IT Strategic Plan Released

The Office of the National Coordinator for Health Information Technology has just released a four-year plan for advancing HIT. The plan identifies two areas of emphasis: patient-focused healthcare and population health.

A copy of the complete plan as well as a plan synopsis can be found at www.hhs.gov/healthit or click on
HHS HIT Strategic Plan (.pdf  679KB)
HHS HIT Strategic Plan Summary (.pdf  501KB)
Source: ONC - National Coordinator for Health IT News

May 28, 2008

House proposes bill to help small physician practices pay for health IT

Members of the House Committee on Energy and Commerce proposed a bill to help doctors pay for healthcare IT and improve patient privacy protection.
Source: Healthcare IT News