Under the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments.

For the National Ambulatory Medical Care Survey, researchers surveyed more than 10,300 physicians by mail and telephone from April through July of this year (United Press International, 12/9).

Key Results

For the survey, an EHR system was defined as being all or partially electronic (CDC report, December 2010).

The survey found that 50.7% of physicians reported using all or partial EHR systems for patient files in their practices. That figure is up from 48.3% in 2009.

This year, nearly 25% of survey respondents said their systems met criteria for a “basic” system, while 10.1% said their systems met criteria of a “fully functional” system. Both of these rates are higher than last year’s 21.8% and 6.9%, respectively, according to the survey (United Press International, 12/9).

System Features

A basic EHR system was defined as having the ability to:

• View imaging and lab results;
• View medication lists; and
• Perform other duties (McKinney, Modern Healthcare, 12/10).

A fully functional EHR system was defined as having the ability to:

• Electronically order tests;
• Provide drug interaction warnings; and
• Perform other duties (CDC report, December 2010).

Variations Across U.S.

The survey found widespread variation for EHR adoption among states. The percentage of physicians by state reporting use of a basic EHR system ranged from 12.5% to 51.5%, according to the survey (United Press International, 12/9).

Source  :  http://www.ihealthbeat.org/articles/2010/12/10/cdc-survey-finds-physician-use-of-ehrs-up-slightly-from-2009.aspx

January 5, 2011 – Integrated Systems Management Inc announced today that OmniMD™ EHR, Version 11.0 is 2011/2012 compliant and was certified as a Complete EHR on January 4, 2011 by the Certification Commission for Health Information Technology (CCHIT®), an ONC-ATCB, in accordance with the applicable (eligible provider) certification criteria adopted by the Secretary of Health and Human Services. The 2011/2012 criteria support the Stage 1 meaningful use measures required to qualify eligible providers and hospitals for funding under the American Recovery and Reinvestment Act (ARRA).

According to Divan Dave, CEO, of OmniMD™ “This certification is another step in our commitment to provide providers with intuitive, easy-to-use, affordable technologies that help them improve patient care, reduce their costs and qualify for government incentives”.

The ONC-ATCB 2011/2012 certification program tests and certifies that Complete EHRs meet all of the 2011/2012 criteria and EHR Modules meet one or more – but not all – of the criteria approved by the Secretary of Health and Human Services (HHS) for either eligible provider or hospital technology.

“CCHIT is pleased to be testing and certifying products so that companies are now able to offer these products to providers who wish to purchase and implement certified EHR technology and achieve meaningful use in time for the 2011-2012 incentives,” said Karen M. Bell, M.D., M.S.S., Chair, CCHIT.

OmniMD™ EHR, Version 11.0 certification number is CC-1112-484340-1. ONC-ATCB 2011/2012 certification conferred by CCHIT does not represent an endorsement of the certified EHR technology by the U.S. Department of Health and Human Services nor does it guarantee the receipt of incentive payments.

The clinical quality measures to which OmniMD™ has been certified include:

NQF 0421 – Adult Weight Screening & Follow-Up
NQF 0013 – Hypertension: Blood Pressure Measurement
NQF 0028 – Tobacco Use Assessment and Cessation
NQF 0041 – Influenza Immunization
NQF 0024 – Weight Assessment and Counseling
NQF 0038 – Childhood Immunization Status
NQF 0034 – Colorectal Cancer Screening
NQF 0043 – Pneumonia Vaccination Status
NQF 0067 – CAD: Oral Antiplatelet Therapy
NQF 0084 – Heart Failure: Warfarin Therapy

OmniMD™ EHR Version 11.0 is also certified in CCHIT’s separate and independently developed certification program. OmniMD™ Version 11.0 is a pre-market CCHIT Certified® 2011, Ambulatory EHR. Integrated Systems Management Inc. has certified its EHR technology in both programs to provide greater assurance to its customers.

About Integrated Systems Management, Inc

Founded in 2000, OmniMD™ integrated Electronic Health Records and Practice Management (PMS) products and services, offers unparalleled reliability, ease-of-use, efficiency and customizability. OmniMD™ Ambulatory EHR has also earned a designation as a pre-market CCHIT 2011 Certification with the highest 5 Star Usability Rating ensuring OmniMD™ commitment to have a comprehensive, secure, scalable, intuitive and interoperable EHR system. OmniMD™ Ambulatory EHR Version 11.0 is CCHIT 2011 Pre-Market Certified, web-enabled and support devices ranging from Tablet PCs to Smart phones. OmniMD™ offers a comprehensive set of services such as Health Transcriptions, Document Management, Patient Portal, Patient Reminder and Eligibility Verification as part of an integrated solution under one roof helping practices to effectively addressing their financial, administrative, clinical, and regulatory needs. OmniMD™ Ambulatory EHR Version 11.0 is built as a true Software as a Service solution.  It can be deployed as an Enterprise or a Subscription based Service as per the practice requirements.  OmniMD™ is designed to exceed the present and future needs of the healthcare industry. OmniMD™ is robust, scalable, interoperable, secure, intuitive and customizable with rapid deployment model. OmniMD™ EHR has also achieved Surescripts® Gold Solution Provider status, which allows for interoperability with the nation’s community pharmacies – improving the safety, efficiency and quality of the prescribing process. Gold Solution Provider status is granted to vendors whose software products have surpassed Surescripts’ baseline product certification, by demonstrating a higher level of commitment to e-prescribing, enhanced security, excellent customer support and service. OmniMD™ is a division of Integrated Systems Management, Inc. – ISM Inc. – (www.ismnet.com) a leader in Software Development and Information Technology Consulting since 1989.

About CCHIT

The Certification Commission for Health Information Technology (CCHIT®) is an independent, 501(c)3 nonprofit organization with the public mission of accelerating the adoption of robust, interoperable health information technology.  The Commission has been certifying electronic health record technology since 2006 and is approved by the Office of the National Coordinator for Health Information Technology (ONC) of the U.S. Department of Health and Human Services (HHS) as an Authorized Testing and Certification Body (ONC-ATCB).  More information on CCHIT, CCHIT Certified® products and ONC-ATCB certified electronic health record technology is available at http://cchit.org.

About ONC-ATCB 2011/2012 certification

The ONC-ATCB 2011/2012 certification program tests and certifies that EHR technology is capable of meeting the 2011/2012 criteria approved by the Secretary of Health and Human Services (HHS). The certifications include Complete EHRs, which meet all of the 2011/2012 criteria for either eligible provider or hospital technology and EHR Modules, which meet one or more – but not all – of the criteria. ONC-ATCB certification aligns with Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology published in the Federal Register in July 2010 and strictly adheres to the test procedures published by the National Institute of Standards and Technology (NIST) at the time of testing.   ONC-ATCB 2011/2012 certification conferred by the Certification Commission for Health Information Technology (CCHIT®) does not represent an endorsement of the certified EHR technology by the U.S. Department of Health and Human Services nor does it guarantee the receipt of incentive payments.

“CCHIT®” and “CCHIT Certified®” are registered trademarks of the Certification Commission for Health Information Technology.

North Shore Hospital System on Long Island in New York recently announced that it will pay an incentive of up to $40,000 to each physician in its network who adopts its electronic health record (EHR) — paying 50% of the cost to physicians who install an EHR that communicates with the hospital and 85% of the cost if the physician also shares de-identified data on the quality of care.1 This payment would apparently come on top of the $44,000 incentive that the American Recovery and Reinvestment Act of 2009 (ARRA) has authorized Medicare to pay each eligible health care professional who uses certified EHRs in a meaningful manner. “Meaningful use” is still being defined, but the overarching goal is to improve the population’s health through a transformed health care delivery system with the use of EHRs to improve local processes, foster quality measurement, and increase communication. North Shore’s announcement is a sign of the continuing acceleration of EHR adoption by physicians’ offices2 and hospitals.3 Support for information systems is exempted from the Stark amendment to the Omnibus Budget Reconciliation Act of 1989, which prohibits hospitals from offering physicians incentives for providing referrals or admissions. The exemption for information technology acknowledges that the likelihood of additional referrals may be part of the motivation for hospitals to form closer links with community physicians through EHRs. Another benefit to hospitals from supporting the use of EHRs by physicians who are linked to them by geography, academic appointment, or practice pattern is the enhanced ability to manage the quality and outcomes of care. For example, if financial penalties and incentives are to be imposed on the basis of rates of readmission, then the more closely aligned a hospital is with the physicians who provide its patients’ postdischarge care, the greater the benefits it will reap.

The cost–benefit calculus behind physicians’ adoption of EHRs is also changing. Financial incentives are one element. The prices of EHRs have come down as the volume of software licenses being sold has increased. A second factor is that the time investment associated with data entry, which has long represented a major obstacle to adoption, has been reduced as systems have improved in performance and become more flexible with regard to individual preferences for data entry, including free text, templated data entry, dictation, speech recognition, and freehand graphic input. System usability has also improved, thanks to competition and customers’ resistance to cumbersome products. Third, the addition to EHR systems of capabilities beyond documentation, including coding functions, the ability to create and export bills, the automated creation of consultation and patient letters, electronic prescribing, and task tracking, now translates into greater time savings for users. And a fourth factor is the increasing emphasis on quality of care, since payment for quality requires documentation of quality.

Other trends favoring EHR adoption include the emerging consensus that alignment of hospitals and physicians is necessary to provide higher-quality care and service for patients as they move among providers and traverse levels of care, as well as the recognition that information transfer is an important component of care given by multiple providers. Younger physicians — and some older ones — are more comfortable and function more efficiently and effectively in an electronic-information environment than in a world of paper records.

Some obstacles persist, of course. EHR products remain expensive to install and maintain — cost issues that should not be underestimated. The decision by North Shore to provide a financial incentive as well as the software license suggests that many physicians still do not believe that current-generation EHRs will offer a return on investment directly to physicians.

Wide dissemination of EHRs requires public trust. The sharing of patients’ information — which has been common practice for decades for the purposes of billing, treatment, and public health — has come into the public eye because of the risks associated with vastly expanded sharing and the newfound ability to easily and quickly transfer many patient records simultaneously. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) created a framework for defining privacy, breaches of privacy, and penalties. The ARRA further defined privacy breaches and increased the penalties for them. One of the challenges to setting policy in this area is that electronic privacy and its relative importance are still being defined. The capability of providing a secure electronic environment for patient data — like the capability of providing reliable data storage — is beyond the reach of most individual physician practices. Truly secure and reliable EHRs are currently feasible only for larger organizations with centrally supported technological capabilities. This may be one reason why the rate of adoption has been much higher among large practices (see graph).

Rates of Adoption of Electronic Health Records According to Practice Size.

The percentage shown above each bar is the proportion of physicians who work in a practice of the given size. The green portion of each bar represents the percentage of physicians in a practice of a given size who have adopted at least basic electronic health records (EHRs), and the yellow portion represents the percentage of physicians who have not adopted EHRs.2 For each practice size, the percentage of physicians who have not adopted EHRs relative to the total number of physicians in practice is shown at the bottom. Physicians in the smallest practices account for more than 50% of those who have not yet adopted EHRs, whereas physicians in the largest practices account for only about 3%.

Exchanging information requires that EHRs share common standards. Work is ongoing at organizations for standards development and facilitation such as Health Level Seven (HL7), which have been providing practical standards for decades. The ultimate in interoperability would be a single EHR for all health care providers, but the disadvantage of this model would be a loss of competition among vendors — a factor that has presumably contributed to increased usability and lower cost. Moreover, interoperability among disparate EHRs may actually increase competition and innovation if it makes it easier for health care providers to change vendors by populating a new system with an old system’s data. Innovation is not predicated on competition alone, however. Increasing funding for EHR research and development — as opposed to implementation and evaluation — may produce evolutionary and revolutionary improvements in EHRs.

The next major step in EHR deployment is a concrete definition of the requirements — in terms of meaningful use, information sharing, and reporting of quality measures — for physicians to receive ARRA incentives. The federal Health Information Technology Policy Committee has submitted recommendations4 to the National Coordinator of Health Information Technology; the Centers for Medicare and Medicaid Services published draft rules on December 30, 2009, and this publication will be followed by a period for public comment before a final set of rules is issued. Clarity on federal incentives for physicians to adopt EHRs will allow these incentives to be aligned with those offered by state governments, provider organizations, and commercial payers. Poorly aligned incentives may have unintended consequences, such as increases in health disparities or incentives for specialty-specific silo systems.

Electronic interaction between hospitals and physicians is just the beginning. Patients are also interacting electronically with the health care system, exchanging information with providers through secure patient portals and patient-based health records. More active transactions, such as remote case management by nurses for patients with chronic diseases,5 may occur through telemedicine. Some possibilities that will be advanced by phys   icians’ adoption of EHRs include the use of cell-phone technology for messaging, the capability of moving data from home monitoring devices to cell phones and upstream to EHRs, yet-to-be developed software capabilities that will allow EHRs to manage these uploaded data streams within clinical workflows, and the effective provision of out-of-office care.

Above article publish on http://healthcarereform.nejm.org/?p=2839&query=TOC

“The ARRA incentives have the potential to significantly accelerate adoption of EHR technology by office-based physicians, other eligible providers and hospitals,” said Alisa Ray, the Commission’s executive director.  “These first four health IT companies, demonstrating their compliance with the proposed Federal standards, are now able to offer certified products to providers who wish to purchase and implement EHR technology and achieve meaningful use in time for the 2011-2012 incentives.  We’ve had about 25 applications in our 2011 programs and inspections are continuing.  Look for additional announcements from these early applicants in the upcoming days and weeks.”

Both certification programs are represented among the four products. The CCHIT Certified 2011 Comprehensive program differs from the Preliminary ARRA certification program by providing a more rigorous inspection of integrated EHR functionality, interoperability, and security in addition to full compliance with Federal standards.  As part of the Comprehensive inspection process, key aspects of successful use are verified at live sites, and usability is rated.  The CCHIT Certified Comprehensive program is intended to serve health care providers looking for maximal assurance that a product will meet their complex needs, as well as support their achievement of meaningful use to qualify for the ARRA financial incentives.

The product certified in the CCHIT Certified 2011 Comprehensive program is ABELMed EHR-EMR/PM, Version 11, by ABEL Medical Software Inc.

The Preliminary ARRA 2011 program is a modular, limited certification and inspects technology only against the Federal standards. It offers maximal flexibility for health IT companies, developers and providers in meeting ARRA 2011-2012 certification requirements. The products certified in the Preliminary ARRA 2011 program are:

• eHealth Made EASY, Version 3, by eHealth Made EASY, LLC, supporting 2 of 27 meaningful use objectives  for eligible providers
• eHealth Made EASY – PQRI Made Easy, Version 3, by eHealth Made EASY, LLC, supporting 2 of 24 meaningful use objectives  for hospitals
• KIS Track, Version 5.1, by Kaulkin Information Systems, supporting 2 of 27 objectives for eligible providers
• Medios, Version 4.5, by IOS Health Systems, supporting 27 of 27 objectives for eligible providers

The Certification FactsTM label displayed with every product listing describes all certifications granted and lists which meaningful use objectives are supported by the technology. The ARRA certification component of both programs is considered preliminary because the definitions of meaningful use, criteria and standards have been proposed but not yet finalized by the US Department of Health and Human Services (HHS).  Health IT companies testing against the proposed standards now will be provided the opportunity to quickly close any gaps after the final rules are published in the Federal Register in spring 2010.

Above article published http://www.fiercehealthcare.com/press-releases/commission-announces-first-2011-certified-electronic-health-records#ixzz0ZGreIpcy

A panel advising the Office of the National Coordinator of Health IT (ONC) said it will heed the overwhelming consensus it has received in recent public comments to develop the simplest possible certification standards for accelerating health IT adoption.

The Health IT Standards Committee’s implementation workgroup reported today that it distilled the testimony of industry organizations within and outside healthcare, as well as contributors to its public blog. The participants provided details of their experiences with adopting standards.

On the blog, physicians and practices have reported that they have difficulty improving quality and productivity with their existing electronic health record systems. As a result, they are looking for the standards to provide a “pathway to success.” The blog will remain live until Dec. 1.

Under the health IT stimulus plan, health care providers will be entitled to receive federal incentive payments only if they purchase electronic health record certified to meet standards for interoperability and other features now being worked out by the committee.

Dr. David Blumenthal, the national health IT coordinator, emphasized that “experience in the field” embodied in the comments will inform how ONC will craft the health IT certification standards that ONC will release later this year.

ONC is expected to publish in late December an interim final rule on certification standards and a notice of proposed rulemaking for the certification process. The standards rule will detail standards for what constitutes a certified EHR.

Dr. John Halamka, vice chairman of the committee, said any  refinements to the standards would likely be applied to standards for 2013 and beyond than for 2011, the first year in which providers will be eligible to receive incentive payments under the stimulus plan. In 2011, providers must adopt standards to share medication lists, medical problems, allergies and laboratory reports.

“I think we have a basic set of requirements, and there may be some polish done to them based on the comments and principles. We’re just beginning the directional cycle for 2013 and 2015,” he said.

Physician and industry comments received by the panel overwhelmingly asked that the simplest standards be put forward to provide business value and rapid adoption.

“Our posts have led to conversations with committee members here who have taken them to their constituents,” said Aneesh Chopra, the administration’s chief technology officer and chairman of the committee’s implementation work group.

Among its guiding principles, the committee should concentrate on getting buy-in from physicians for standards required in 2011 to share medication lists, medical problems, allergies and labs before moving to more complex objectives, he said.

Halamka suggested that the committee continue to gather comments about 2011 information exchanges to determine if there are ways to improve testing platforms and implementation guidance.

Another guiding principle recommends that the committee separate content standards, such as those for continuity of care documents, from transmission standards, as well as separate the network layer standards from application layer standards.

Above article published http://www.govhealthit.com/newsitem.aspx?nid=72450

Healthcare providers will have the option to use electronic health record systems to report Medicare quality and electronic prescribing measures to CMS in some of its pay-for-performance programs next year, according to an announcement by the Centers for Medicare and Medicaid Services.

The revisions are designed “to promote adoption and use of electronic health records and to provide both eligible professionals and CMS with experience on EHR-based reporting,” CMS said in the Oct. 30 announcement.

They run parallel to efforts by the Office of the National Coordinator for Health IT to set up additional incentives for providers to measure and submit data measuring the quality of their treatments.

According to CMS, providers could use EHRs to submit information for the CMS’s Physician Quality Reporting Initiative (PQRI) program, which pays an incentive to eligible physicians and other healthcare professionals who report on specific quality measures for care for Medicare patients.

Providers also will be able to report e-prescribing usage through qualified EHR systems or registries, according to CMS. Currently, providers’ reports about e-prescribing are based on patient medical claims.

Under the fee schedule rule, providers for the first time will be able to count quality data submitted through electronic health record systems toward their eligibility for a PQRI incentive payment, CMS said.

Next year, those payments will be equal to 2 percent of their total estimated allowed charges for the reporting periods, CMS said. The final rule will appear in the Nov. 25 Federal Register.

The rule also streamlines reporting of e-prescribing and focuses on the actual use of e-prescribing by the provider. In 2010, providers will use one code for e-prescribing, but they “need to report this code at least 25 times during the reporting period to be considered a successful electronic prescriber,” CMS said.

The Medicare fee schedule puts into practice provisions of the Medicare Improvement for Patients and Providers Act of 2008, which established a program for incentive payments for e-prescribing over five years. In 2012, CMS will impose penalties on providers who are not “successful e-prescribers.”

Once CMS publishes the rule, it said it will accept comments on designated provisions of the final rule until Dec. 29. The policies become effective Jan. 1, 2010.

Above article published http://www.govhealthit.com/newsitem.aspx?nid=72313

In 2004, the trade group Healthcare Information and Management Systems Society helped found CCHIT. For several years, the commission served as the sole certifying entity for EHR systems.

CCHIT’s affiliation with HIMSS has led some observers to express concern that the commission is too closely aligned with the health IT industry.

In response to such concerns, federal committees recently approved a plan that would allow multiple entities to certify EHR systems. The plan would require all interested parties, including CCHIT, to apply for designation as an official EHR certifier.

Although the government has yet to appoint official certifying bodies, CCHIT is continuing to offer its EHR certification programs. The group also recently launched a new “Preliminary ARRA Certification” program that aims to help vendors comply with the forthcoming meaningful use rules (Blankenhorn, ZDNet Healthcare, 11/11).

Above article published http://www.ihealthbeat.org/articles/2009/11/12/cchit-continuing-role-as-major-ehr-certifier-amid-hitech-talks.aspx

Healthcare providers will have the option to use electronic health record systems to report Medicare quality and electronic prescribing measures to CMS in some of its pay-for-performance programs next year, according to an announcement by the Centers for Medicare and Medicaid Services.

The revisions are designed “to promote adoption and use of electronic health records and to provide both eligible professionals and CMS with experience on EHR-based reporting,” CMS said in the Oct. 30 announcement.

They run parallel to efforts by the Office of the National Coordinator for Health IT to set up additional incentives for providers to measure and submit data measuring the quality of their treatments.

According to CMS, providers could use EHRs to submit information for the CMS’s Physician Quality Reporting Initiative (PQRI) program, which pays an incentive to eligible physicians and other healthcare professionals who report on specific quality measures for care for Medicare patients.

Providers also will be able to report e-prescribing usage through qualified EHR systems or registries, according to CMS. Currently, providers’ reports about e-prescribing are based on patient medical claims.

Under the fee schedule rule, providers for the first time will be able to count quality data submitted through electronic health record systems toward their eligibility for a PQRI incentive payment, CMS said.

Next year, those payments will be equal to 2 percent of their total estimated allowed charges for the reporting periods, CMS said. The final rule will appear in the Nov. 25 Federal Register.

The rule also streamlines reporting of e-prescribing and focuses on the actual use of e-prescribing by the provider. In 2010, providers will use one code for e-prescribing, but they “need to report this code at least 25 times during the reporting period to be considered a successful electronic prescriber,” CMS said.

The Medicare fee schedule puts into practice provisions of the Medicare Improvement for Patients and Providers Act of 2008, which established a program for incentive payments for e-prescribing over five years. In 2012, CMS will impose penalties on providers who are not “successful e-prescribers.”

Once CMS publishes the rule, it said it will accept comments on designated provisions of the final rule until Dec. 29. The policies become effective Jan. 1, 2010.

Above article published on http://www.govhealthit.com/newsitem.aspx?nid=72313

The Certification Commission for Health Information Technology next year plans to develop a “site certification” program for hospitals and physician groups that use self-developed EHRs or a mix of commercial and proprietary applications, says Mark Leavitt, M.D., chair of the Chicago-based organization. The effort also will offer certification for those organizations that use an older, commercial clinical system that’s been heavily customized, he notes.

Although it has not yet been officially designated as an official EHR certifying body under the incentive program called for in the American Recovery and Reinvestment Act, CCHIT already is developing a new certification program designed to measure whether software is compliant with the yet-to-be-finalized federal “meaningful use” EHR standards. The site certification component will feature sliding-scale pricing to make it affordable to providers of various sizes, Leavitt says.

“Site certification is designed to help the early adopters who were EHR pioneers,” Leavitt adds.

The site certification effort won’t start until the middle of next year once the final “meaningful use” rules are enacted. CCHIT, however, will begin accepting applications Oct. 7 for its “ARRA 2011 Certification” program for vendors’ EHRs. That program is based on the proposed rules the government expects to publish in December.

Government regulators are considering a proposal to authorize multiple EHR certification programs. Leavitt says he’s confident the government will designate CCHIT as an official certifier of meaningful use for the Medicare and Medicaid EHR incentive programs. He also says it’s “not clear why others would want to launch” certification efforts. He points out that CCHIT is a not-for-profit group and contends that it would be difficult for others to start from scratch and cover their costs, much less make a profit.

CCHIT also is continuing with its longstanding effort to certify vendors’ EHRs for meeting a set of criteria much broader than the anticipated “meaningful use” standards. The criteria for the updated “CCHIT Certified 2011″ program will become “more rigorous,” Leavitt says. For example, vendors will need to prove that the application has been up and running at two sites for at least 45 days. Plus certifiers will, for the first time, assess the “usability” of EHR software for ambulatory care settings.

Above article published on

http://www.healthdatamanagement.com/news/certification-39166-1.html?ET=healthdatamanagement:e1036:156215a:&st=email