CCHIT indentifies $700 million in EHR funding

The links include a breakdown of 90 programs and 21 states activities. SV


CCHIT

CCHIT Incentive Index

CCHIT will certify free standing e-Prescribing software

The CCHIT Incentive Index does not yet include what may become one of the largest new incentive programs offered. Under recent legislation (Medicare Improvements for Patients and Providers Act, or MIPPA), Medicare payment bonuses will become available for any physician who uses qualified electronic prescribing technology beginning in 2009. Although the Commission requires e-prescribing in certified EHR systems, it has not been certifying stand-alone e-prescribing products. But that situation will soon change: At its Sept. 23 meeting, the CCHIT Board of Commissioners officially gave the go-ahead to develop certification for stand-alone e-prescribing systems. After public comments and a pilot test, the Commission expects to launch this new program by July 2009.

CCHIT

AmeriHealth New Jersey launches statewide program to give physicians shared, web access to patient imaging records

Done right, this will save lives and reduce costs. Presumaby this will be using Xebra. More details to follow. SV

The exchange, now in the pilot program stage, is being built by Philadelphia-based HxTechnologies (HxTI), a health care IT and services company specializing in health information exchange. HxTI will also operate the system, and continually audit system use to enforce compliance.

Philadelphia – November 6, 2007 – Today HxTechnologies, Inc. (HxTI) announced the public availability and free open source licensing of the Xebra™ platform for web-based distribution and clinical review of medical imaging.

The software provides healthcare organizations and software developers with all the necessary components to securely transmit and review medical images over a network such as the Internet. Unlike its closed and proprietary predecessors locked to a single vendor, Xebra is intended to work alongside any picture archiving and communication system (PACS) and to provide advanced imaging capabilities to a wide range of healthcare IT applications. Written in Java, the software is designed to run on any operating system with an ultra-thin client that can be launched over the Web without any installation required by the end user.

In addition to image navigation and manipulation tools, the initial release of Xebra introduces features not generally available in web viewers offered with current PACS solutions. Xebra provides interoperability based on the latest industry standards such as JPEG2000 and WADO and contains advanced encryption and network security features especially well suited for health information exchanges (HIEs), regional health information organizations (RHIOs), longitudinal electronic health records (EHRs) and personal health records (PHRs) accessed over the Web.

HxTI

Columbia Center for Advanced Information Management December 2008 Event

Please save the date for the:

2008 New York City Medical Informatics Update

December 10, 2008

More information to follow shortly.

Center for Advanced Information Management
Columbia University
630 West 168th Street, PH1501
New York, NY 10032
212-305-2944

www.cat.columbia.edu

Availity and Prematics Launch First Comprehensive E-Prescribing Service For Florida Physicians

This a wonderful use of the Availity Health Information Network.
Transaction fees to be paid by the MCOs will finance the system.
The only thing missing is the additional reimbursement to providers for using the system to help compensate the initial slowdown with any new office workflow and to reward them with some of the savings to be accrued. The reimbursement needs to be in addition to the temporary bonus from CMS. SV


Prematics

HIMSS Event Information: Webinar - Post-Election Highlights and Implications for Health Information Technology Policy Changes in 2009

I encourage everyone to "attend" this free Webinar. SV

Date and time: Wednesday, November 12, 2008 11:00 am
Central Standard Time (GMT -06:00, Chicago)
Change time zone
Wednesday, November 12, 2008 10:00 am
Mountain Standard Time (GMT -07:00, Denver)
Wednesday, November 12, 2008 9:00 am
Pacific Standard Time (GMT -08:00, San Francisco)
Wednesday, November 12, 2008 12:00 pm
Eastern Standard Time (GMT -05:00, New York)

Duration: 1 hour

Description: Post-Election Highlights and Implications for Health Information Technology Policy Changes in 2009

The November 4, 2008, elections are predicted to have a tremendous impact on anyone connected with the health information technology industry...and most importantly - you! Learn from national experts and a former Congressman how to prepare for the new Presidential Administration and 111th Congress about the big changes ahead affecting your community...your state and the whole country.


HIMSS

Eclipsys to Acquire MediNotes (EHR/PMS)

Eclipsys, well-known among hospital staff, will be purchasing MediNotes.
MediNotes is a very popular solution for small practices and has dozens of interfaces with practice management systems such as Per-se Medisoft.
In interesting means of connecting small practices with an enterprise system.SV


Eclipsys

Highmark Blue Cross Blue Shield to contribute $29 million to promote ePrescribing

Highmark Inc. announced that it is contributing $29 million to help physicians acquire ePrescribing/eHealth Record technology for their practices.

Highmark will pay up to 75 percent of the cost for a physician's office to acquire, install and implement an electronic technology system, up to a maximum of $7,000 per physician, with the physician's practice to pay the remaining balance.

ZixCorp Pocketscript will be participating.

Highmark

ZixCorp

NY County Medical Society Presidental Campaign Forum

Admission free


Health advisors to the candidates present their health policies on:


Monday, October 6, 2008, from 6:00 to 8:00 p.m.,

in the Second Floor Conference Room, Hospital for Special Surgery

535 East 70th Street, New York, New York 10021.


Sponsored by
The New York County Medical Society

and the
Health Policy Journal Club of the Hospital for Special Surgery


With

Irwin Redlener, MD, Advisor to Senator Barack Obama

Gail Wilensky, PhD, Advisor to Senator John McCain



Both Presidential candidates have ambitious plans for reforming the U.S. healthcare system: Reforming the health insurance market, expanding coverage, boosting HIT, modifying Medicare to reward physicians and hospitals for higher quality care.


Hear how the two candidates would tackle these and other challenges from two different philosophies, and how they would handle the details.


There will be ample time for debate and audience questions.


Admission free


RSVP required. Call Lisa Joseph at 212-684-4670, ext. 222, or e-mail ljoseph@nycms.org.

MRI TEPR Award 2008 Winners

The 2008 TEPR Awards honorees are:

Personal Health Record Systems
Recognizing superior providers of PHR systems based on criteria such as data, data integrity, security, and consumer control.

1st Honors: CapMed
2nd Honors (tie): Doctations and Passport MD

Hot Products
Recognizing the most innovative IT products bringing the most positive benefits to healthcare.

1st Honors: MediNotes' Clinician Supply Chain Manager
2nd Honors: XLEMR's SOX - The Physician's Quickbooks Accounting Robot
3rd Honors: CapMed's icePHR Mobile

EMR Systems Best Meeting Medicolegal Requirements
A new TEPR Awards category recognizing EMRs best meeting medicolegal requirements based on criteria such as identity/authentication, documentation version management, signature events, data integrity, and document event auditing functions.

1st Honors (tie): Doctations and eMedicalFiles

Prior to TEPR, industry experts, who served as independent judges, reviewed Award applications, assessed them and selected finalists in each category. Then at TEPR, on Sunday, May 18, finalists presented their solutions before judges and TEPR registrants. Judges determined Honors in each category, and the honorees were officially recognized at the TEPR Opening Session.

Medical Records Institute

Smartphone PDA descriptions Podcast


Short piece discusses the different types of phones , PDAs and operating systems.

This was recorded before Apple released the SDK for the iPhone. SV



Smartphone Podcast

Canadian electronic health record projects quadruple in four years

We should be mindful of the work being down North of the Border to see what can be applied in the USA.

Does anyone know of any "Cross-Border" activity to facilitate care for commuters and others? SV


August 11, 2008 (Toronto) - Canada's electronic health record (EHR) projects increased by 12 per cent last year and have quadrupled since 2004 announced Richard Alvarez, President and CEO of Canada Health Infoway (Infoway).

"Canadians want their medical information available electronically to the clinicians who care for them," said Alvarez. "And that's starting to happen in communities across Canada. Collaboration among governments is at an all-time high and with continued federal funding, we are well on our way to providing every Canadian with an electronic health record by 2016."

Canada Health Infoway

Retail medical clinic "gold rush" slowing down

Apparently the phrase, "if you build it, they will come", is not always true. At least in the short-term. Investors and clinics are finding that patience and greater evaluation of local market needs are required to establish a profitable clinic. SV


Star Tribune

ePocrates Online, new free version!

The medical reference material is a great addition to thus formerly medication only tool. The diseases can be searched by category and by a search box which automatically begins the search as the first character is entered. While not exhaustive, the topics include a good number of pediatric as adult entries. Photos add additional value. Medications mentioned in the disease module are linked to the complete discription in the medication reference module.

The premium version of the product adds

alternative medications
the Pill Identifier
the Medical Calculators
the Clinical Tables and Guidelines. SV

Epocrates partnered with BMJ Group, publisher of the British Medical Journal, to create this new web-based reference which delivers practical and up-to-date disease diagnosis and treatment guidelines at the immediate point of care. The product features peer-reviewed content that is authored by physician experts with guidance by BMJ Group. With the new disease database, you’ll get condition overview and risk factors, treatment approach, tests to order, national medical society guidelines, and more.

Epocrates online

H.R.6331 Medicare Improvements for Patients and Providers Act of 2008


Here is an excerpt from the recently passed legislation: carrots, sticks and all.
I am surprised at small size of the initial bonus and the quickness with which it will be decreased.

Let's get some opinions. SV

The bonuses would seem to decrease over the years:

`(C) APPLICABLE ELECTRONIC PRESCRIBING PERCENT- For purposes of subparagraph (A), the term `applicable electronic prescribing percent' means--

`(i) for 2009 and 2010, 2.0 percent;

`(ii) for 2011 and 2012, 1.0 percent; and

`(iii) for 2013, 0.5 percent.';

While the penalalties would increase over the years (percent of fee schedule after penalty is applied):

ii) APPLICABLE PERCENT- For purposes of clause (i), the term `applicable percent' means--

`(I) for 2012, 99 percent;

`(II) for 2013, 98.5 percent; and

`(III) for 2014 and each subsequent year, 98 percent.

The Government will revisit the incentives/disincentives base upon several variables including:

(c) GAO Report on Electronic Prescribing- Not later than September 1, 2012, the Comptroller General of the United States shall submit to Congress a report on the implementation of the incentives for electronic prescribing established under the provisions of, and amendments made by, this section. Such report shall include information regarding the following:

(1) The percentage of eligible professionals (as defined in section 1848(k)(3) of the Social Security Act (42 U.S.C. 1395w-4(k)(3)) that are using electronic prescribing systems, including a determination of whether less than 50 percent of eligible professionals are using electronic prescribing systems.

(2) If less than 50 percent of eligible professionals are using electronic prescribing systems, recommendations for increasing the use of electronic prescribing systems by eligible professionals, such as changes to the incentive payment adjustments established under section 1848(a)(5) of such Act, as added by subsection (b).

(3) The estimated savings to the Medicare program under title XVIII of such Act resulting from the use of electronic prescribing systems.

(4) Reductions in avoidable medical errors resulting from the use of electronic prescribing systems.

H.R. 6331

DEA e-prescription regulations released June 27 2008

The highlights:

1) Prescriber in-person identity proofing (fortunately this can be done at a DEA-registered hospital)

2)Authentication protocol would have to be two-factor

3)Pharmacies would have to regularly check on the prescriber's status

4)Both the electronic prescription service provider and the pharmacy system provider would need to obtain annual third-party audits for security and processing integrity. 3rd party audits


Here is an abridged version of the 62 page document.

Public comment is strongly recommended. SV

DEA considered and is proposing two options:

Electronically signed prescriptions with security controls. Under this alternative, practitioners would be required to undergo in-person identity proofing and submit documentation of that to a service provider. The identity proofing would be conducted by a DEA-registered hospital, a State licensing board, or State or local law enforcement agency. The service provider would be required to check the validity of the DEA registration and State license before issuing an authentication protocol to be used to sign controlled substance prescriptions. The authentication protocol would have to be two-factor, with one factor stored on a hard token (e.g., a PDA, a multifactor one-time-use password token, a thumb drive, a smart card). DEA would also impose certain system requirements related to the prescription elements and their presentation; most existing systems may already meet these requirements. The prescription would have to be transmitted immediately upon being signed and the service provider would have to digitally sign and archive the record before transmitting the plain text prescription to the intermediaries. The pharmacy would have to digitally sign and archive the prescription as received. The pharmacy system would need an internal audit trail to record any attempts to alter a record and conduct internal checks for such attempts. Both the electronic prescription service provider and the pharmacy system provider would need to obtain annual third-party audits for security and processing integrity. The service provider would have to generate a monthly log, which practitioners would be required to check for obvious anomalies. The rationale for each of the requirements is presented under the discussion of the proposed rule below.
Modified digitally signed prescriptions. Due to the current use of
digital signatures by Federal health care systems, and the added security afforded by such signatures, DEA is proposing to allow practitioners that prescribe controlled substances at Federal health care facilities (e.g., Department of Veterans Affairs, Department of Defense) the additional option of using digital certificates, issued by such Federal agencies, to sign controlled substance prescriptions issued in the course of their official duties within those facilities. These Federal agencies would need to determine that the practitioner is authorized and registered, or exempted from the requirement of registration, to prescribe controlled substances. The private key would be required to be stored on a hard token. Federal agencies will already be meeting this requirement in issuing Personal Identification Verification (PIV) cards under Federal Information Processing Standard 201. Most of the system requirements would be the same as in the previous option except that the Federal agency could elect to allow the practitioner to digitally sign and archive the prescription once the DEA-required elements are complete and transmit later when other information has been added (e.g., retail pharmacy URL). The Federal agency would not have to digitally sign the record as transmitted. The pharmacy requirements would be the same. The digital signature would not be transmitted to the pharmacy; the pharmacy would not have to validate the record. However, if a Federal agency wished to include the digital signature as part of the transmission, DEA is permitting this alternative. In that case, the pharmacy would be required to validate the digital signature, but would not be required to digitally sign the prescription as received. Because a Certification Authority would issue the digital certificate and because record integrity is more assured with a digital signature, DEA would not require a check of a monthly log or third-party audits for security. The rationale for each of the requirements is presented under the discussion of the proposed rule below.

National Register

Horizon BCBSNJ Sponsors Hospitals adoption of E-Medication Technology

This is a wonderful application of existing technology that will yield immediate benefits. Concurrent with this press release was news of the SureScripts-RxHub merger. As we await the "construction" of RHIOs, the Horizon sponsorship and hopefully others like it will permit patients to reap the benefits of what is readily available. SV

Horizon BCBSNJ First Insurer in the Nation to Provide Financial Support to Select Network Hospitals for the Adoption of E- Medication History Technology

The program will be administered through RcopiaAC MedHx by DrFirst which connects to the largest and most comprehensive medication history data sources available in the market. RcopiaAC collects, displays, and documents patient medication history information at the time of admission and connects directly to hospitals taking part in the program. When a patient is admitted into the hospital, RcopiaAC will send an electronic medical history request to multiple sources including RxHub, Surescripts, DrFirst’s nationwide network of Rcopia e-prescribing users, and DrFirst’s EMR Open Borders partners. When medication history information is found, it will be submitted back to the hospital. The system will be completely automated and the information will be relayed in real time.

Horizon BCBSNJ

Federal budget:your opportunity to act

Here is the link for the ACPONLINE CAPWIZ site. SV


ACPONLINE CAPWIZ

Here is the link for a sample letter for patients.

Letter

DEA Issues Proposed Regulations to Allow Electronic Prescriptions for Controlled Substances

ePrescribing of controlled substances will further improve operations in doctors' offices. SV



JUN 27 -- DEA today published proposed regulations that would provide physicians and other authorized prescribers with the option of issuing electronic prescriptions for controlled substances. These regulations would also permit pharmacies to receive, dispense, and archive these electronic prescriptions. The agency is seeking public comment on the proposed regulations. Any member of the public wishing to submit comments may do so by mail or electronically on or before September 25, 2008.

These regulations provide pharmacies, hospitals, and practitioners with the ability to use modern technology for controlled substance prescriptions while maintaining the closed system of controls on controlled substances dispensing; additionally, the proposed regulations would reduce paperwork for DEA registrants who prescribe or dispense controlled substances and have the potential to reduce prescription forgery.

US DOJ

Personal Health Records (PHR) privacy protections codified: Common Framework for Networked Personal Health Information

The Markle Foundation has published the suggested rules of operation that should give greater protection to users of PHR type products. Google, Microsoft, among others, are on-board. SV

Connectingforhealth.org