CMS Awards WV Medicaid $945K Federal Matching Funds for EHR Incentive Programs

iHealthBeat reports that West Virginia Medicaid along with five other states will receive federal matching funds from the Centers for Medicare and Medicaid (CMS)to help implement electronic health record (EHR) incentive programs.

West Virginia Medicaid will receive $945,000 in federal matching funds. The CMS press release indicates that West Virginia will use the funds for planning activities that include conducting a comprehensive analysis to determine the current status of HIT activities in the state. The funds will be used to gather information on issues such as existing barriers to its use of EHRs, provider eligibility for EHR incentive payments, and the creation of a State Medicaid HIT Plan.

The CMS press release states:

WEST VIRGINIA TO RECEIVE FEDERAL MATCHING FUNDS FOR ELECTRONIC HEALTH RECORD INCENTIVES PROGRAM

In another key step to further states’ role in developing a robust U.S. health information technology (HIT) infrastructure, the Centers for Medicare & Medicaid Services (CMS) announced today that West Virginia’s Medicaid program will receive federal matching funds for state planning activities necessary to implement the electronic health record (EHR) incentive program established by the American Recovery and Reinvestment Act of 2009 (Recovery Act). West Virginia will receive approximately $945,000 in federal matching funds.

EHRs will improve the quality of health care for the citizens of West Virginia and make their care more efficient. The records make it easier for the many providers who may be treating a Medicaid patient to coordinate care. Additionally, EHRs make it easier for patients to access the information they need to make decisions about their health care.

The Recovery Act provides a 90 percent federal match for state planning activities to administer the incentive payments to Medicaid providers, to ensure their proper payments through audits and to participate in statewide efforts to promote interoperability and meaningful use of EHR technology statewide and, eventually, across the nation.

“We congratulate West Virginia for qualifying for these federal matching funds to assist its plan for implementing the Recovery Act’s EHR incentive program,” said Cindy Mann, director of the Center for Medicaid and State Operations at CMS. “Meaningful and interoperable use of EHRs in Medicaid will increase health care efficiency, reduce medical errors and improve quality-outcomes and patient satisfaction within and across the states.”

West Virginia will use its federal matching funds for planning activities that include conducting a comprehensive analysis to determine the current status of HIT activities in the state. As part of that process, West Virginia will gather information on issues such as existing barriers to its use of EHRs, provider eligibility for EHR incentive payments, and the creation of a State Medicaid HIT Plan, which will define the state’s vision for its long-term HIT use.

ONC Issues Final Rule for EHR Temporary Certification Program

Last Friday the Office of National Coordinator for Health Information Technology (ONC) issued a final rule providing the details on how organizations can be authorized by ONC to test and certify EHR technology. ONC discusses the details the Temporary Certification Program.

Certification is important because the Medicare and Medicaid EHR incentives under HITECH require the use of certificate EHR technology for eligible hospital and providers to recieve payments under the incentive program.

For more information check out the Temporary Certification Program information on the ONC Health IT website, including a link to a complete copy of the Temporary Certification Program Final Rule.

More information from Government Health IT, ONC launches health IT certification program and iHealthBeat, ONC To Start Accepting Bids for Entities to Certify EHR Products.

UPDATE (6/24/2010): The official Federal Register version of the Final Rule is now available: 45 CFR Part 170, Establishment of the Temporary Certification Program for Health Information Technology; Final Rule (75 Fed. Reg. 36158, June 24, 2010). The Final Rule is effective on June 24, 2010.

WV Senator Rockefeller: The Health Information Technology Public Utility Act of 2009

Yesterday West Virginia Senator Jay Rockefeller introduced "The Health Information Technology Public Utility Act of 2009"(Senate Bill 890) to facilitate the nationwide adoption of electronic health records (EHRs) though an "open source" public utility model.

A copy of Senate Bill 890 is available on Thomas (GPO PDF version).  According to the press release the Act would:

• Create a new federal Public Utility Board within the Office of the National Coordinator for Health IT to direct and oversee formation of this HIT Public Utility Model, its implementation, and its ongoing operation.
• Implement and administer a new 21st Century Health IT Grant program for safety-net providers to cover the full cost of open source software implementation and maintenance for up to five years, with the possibility of renewal for up to five years if required benchmarks are met.
• Facilitate ongoing communication with open source user groups to incorporate improvements and innovations from them into the core programs.
• Ensure interoperability between these programs, including as innovations are incorporated, and develop mechanisms to integrate open source software with Medicaid and CHIP billing.
• Create a child-specific Electronic Health Record (EHR) to be used in Medicaid, CHIP, and other federal children’s health programs.
• Develop and integrate quality and performance measurement into open source software modules.

The Health Cloud

Tim Sturgill, MD JD at symtym provides an explanation and insight into the potential shift from silo'ed EHRs controlled by multiple providers to a Health Cloud centralized around a single PHR.

The result of such a shift lessens the need for complex health information exchanges to process and communicate information among a variety of health information silos, matching patient records and trying to match multiple sources of health information that may or may not be identical.

This approach is similar to the discussion and perspective I outlined in a recent article on PHRs for Health Lawyer News.

Graphic image courtesy of Tim's post.

Purkinje: Another SaaS EHR

Justen Deal in his post, Purkinje: stealth fighter, introduced me to another SasS focused Electronic Health Record (EHR) and practice management service provider called Purkinje. Interesting read on the company and its history.

The principle owner of Purkinje is John Doerr, a partner in Kleiner, Perkins, Caufield and Byers, who provides venture capital funding for some of the largest technology companies in the world.

Like Athena Health, who I do know about, Purkinje appears headed in the same direction. I think this business model has a bright future in helping quickly ramp up the adoption of electronic health information systems in medium to small physicians practices. Justen's post provides his prospective on the cost/benefit analysis as compared to traditional EMR software vendors. Also, John Halamka, CIO of the CareGroup Health System and blogger at Life as a Healthcare CIO, lists these types of SaaS EMR providers as part of his Winners in 2009 list.

Sounds convincing from a $$$ standpoint and could be one of the solutions for West Virginia to expedite its efforts to bring low cost, flexible, electronic solutions to the provider community.

Thanks for the tip Justen.

HR 6898: The Health-e Information Technology Act of 2008

Jen McCabe Gorman at Health Management RX brought attention to a new House of Representative Bill (HR 6898) focused on electronic health information introduced in the 110th Congress by Congressman Pete Stark. The bill was introduced on September 15, 2008, and is currently referred out to committee.

Jen provides some great analysis and brainstorming on the impact of the draft bill in her post, "Breaking News: Congress Wants to Create National eHealthNetwork, Legislate Who Owns Health Data." Well worth a read for anyone interested in health information technology, electronic health information, personal health records, health 2.0 or the future of our health care system.

Jen highlights those sections dealing with who owns the electronic health information. Should it be the government? the provider? the consumer? This key legal concept - ownership of health information -- is a key question to discuss and debate. As I have mentioned in the past (here and here) the consumer health movement may force a change in the traditional legal notion of health information ownership rights.

The draft bill also addresses a variety of other areas - including the regulation of non-covered entities under HIPAA (many of which weren't even contemplated when HIPAA was enacted) who create or handle health information, codification of ONCHIT under HHS and empowering them with various tasks, creating Medicare related incentives for adoption and modifying other sections of the current HIPAA privacy standards. I haven't had a chance to read through the full bill and spend time reading the related materials but look forward to further analyzing.

For more information about HR 6898 (The Health-e Information Technology Act of 2008) check out Congressman Stark's website information about the legislation:

• Summary
• Introduction Statement
• Press Release
• Section by Section Analysis
• Privacy and Security Provisions
• Incentives

To locate the current status of the bill check out Thomas. I suspect that there will be little movement on the bill this Congressional session - but it does give insight into what might be coming down the road.

eHealthWV: West Virginia EHR Public Service Announcement

As a part of West Virginia's participation in the Health Information Security and Privacy Collaborative (HISPC), West Virginia Medical Institute and its partners launch the eHealthWV website focused on educating consumers about electronic health records and health information exchange.

West Virginia was one of a number of states awarded a grant by RTI International to participate in the HISPC, a national collaborative effort to study health information security and privacy. To learn more about EHRs and HIEs check out the website. They also have a toolkit of brochures for physician practices to use.

Project Director, Patty Ruddick, notified me last week that they had filmed a new EHR/HIT public service announcement that will start airing across West Virginia over the next few months. I thought I would upload the PSA to YouTube and share a copy (click below to watch).

ADVANCE Magazine - Article on EHRs and PHRs

Recently I was interviewed for an article looking at the legal issues involved in the developing world of EHRs and PHRs written by Beth Walsh for ADVANCE Magazine. The article, Looking at Legality: Medical Records - New questions and concerns are popping up around the legalities of EHRs and PHRs, appears in the August 11, 2008 edition of the magazine.

Those interested in reading the article can register for the free online digital edition of ADVANCE Magazine (left side bar). The article appears on page 24.

Does Your Doctor Use An EHR?

The latest statistics are out regarding the adoption and use of electronic health records (EHRs). The New England Journal of Medicine published the government sponsored survey report. Check out the article in the NY Times, "Most Doctors Aren't Using Electronic Health Records." (full report - Electronic Health Records in Ambulatory Care -- A National Survey of Physicians).

The article indicates that only 9% of medical practices with less than 3 physicians have adopted an EHR -- while the percentage increases to 50% for those practices with 50 or more physicians. The comments in the article by one physician seem to confirm a recent conversation with Jack Shaffer, health IT specialist, that EHRs don't necessarily improve physician efficiency.

West Virginia native, Dr. Brailer, is quoted in the article:

But the new study is based on a large sampling — more than 2,600 doctors across the country — and a detailed survey, making it more definitive than past research, experts say. The results, they say, also show a strong endorsement of electronic health records by doctors who have them, especially for what the report termed “fully functional” records, which include reminders of care guidelines, based on a patient’s age, gender or medical history.

For example, 82 percent of those using such electronic records said they improved the quality of clinical decisions, 86 percent said they helped in avoiding medication errors and 85 percent said they improved the delivery of preventative care.

“Those numbers are huge and very encouraging,” said Dr. David J. Brailer, the former health information technology coordinator in the Bush administration.

Dr. Brailer also pointed to the 54 percent of doctors without electronic health records who said that not finding an electronic health record that met their needs was a “major barrier” to adoption. In short, they are not satisfied with the existing products, which tend to be designed for hospitals — big customers — instead of small practices.

“What we see is a deficit in innovation, and that is something innovators and the capital markets can address,” said Dr. Brailer, who leads a firm that invests in medical ventures, Health Evolution Partners.

AthenaHealth is also mentioned in the article. Over the last several months I have been thinking about whether a web based service as software approach, like AthenaHealth, might be an method to grow the adoption of EHR usage in West Virginia as a part of the West Virginia Health Information Network.

The report finding that that most doctors are not satisfied with existing technology should give Dr. Parkinson via Hello Health and other health 2.0 innovators a positive sense of opportunity.

Better Understanding of Key Health Information Technology Terms

On April 28, 2008, the National Alliance for Health Information Technology released its Report, "Defining Key Health Information Technology Terms," to the Office of the National Coordinator for Health Information Technology.

The report is an effort to get everyone working in health information technology to have a common understanding of and differences between EMRs, EHRs, PHRs, HIEs, HIOs and RHIOs. If you don't know what each of these are or are interested in better understanding these key health tech terms check out the report.

An article by Health Data Management indicates that the Report will be "presented on June 3 to the American Health Information Community, a Department of Health and Human Services advisory body, for final approval."

HHS Announces Physician EHR Demo Project

Yesterday HHS announced that CMS will involve physicians in a five year demonstration project encouraging small and medium physician practices to adopt electronic health records.

Excerpt from Secretary Leavitt's announcement:

“This demonstration is designed to show that streamlining health care management with electronic health records will reduce medical errors and improve quality of care for 3.6 million Americans. By linking higher payment to use of EHRs to meet quality measures, we will encourage adoption of health information technology at the community level, where 60 percent of patients receive care,” Secretary Leavitt said. “We also anticipate that EHRs will produce significant savings for Medicare over time by improving quality of care. This is another step in our ongoing effort to become a smart purchaser of health care -- paying for better, rather than simply paying for more.”

Conducted by the Centers for Medicare & Medicaid Services (CMS), the demonstration would be open to participation by up to 1,200 physician practices beginning in the spring. Over a five-year period, the program will provide financial incentives to physician groups using certified EHRs to meet certain clinical quality measures. A bonus will be provided each year based on a physician group’s score on a standardized survey that assesses the specific EHR functions a group employs to support the delivery of care.

The CMS demonstration also will help advance Secretary Leavitt’s efforts to shift health care in the U.S. toward a system based on value. The Department is working to effect change through its Value-Driven Health Care initiative, which is based on Four Cornerstones: interoperable electronic health records, public reporting of provider quality information, public reporting of cost information, and incentives for value comparison.

For more info check out the HHS Press Release.

Thanks to the Medicare Update blog for a tip on this new project.