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Health IT Pulse

January 29, 2015  2:34 PM

Responding to industry pressure, CMS plans to shorten meaningful use reporting to 90 days

Posted by: Scott Wallask
CHIME, CMS, EHR, electronic health record, meaningful use attestation, meaningful use stage 3, stage 2

Relief is coming for thousands of providers who worried about gathering and reporting EHR data for 365 days as part of stage 2 of the government’s meaningful use program.

CMS announced on its blog this morning that it intends to relax its meaningful use reporting period to 90 days for stage 2 in 2015, a move that industry groups such as the College of Healthcare Information Management Executives (CHIME) and the American Medical Association pushed hard for.

“The agencies have listened,” said Russell Branzell, FCHIME, CHCIO, president and CEO of CHIME. “CMS and the ONC have been nothing but supportive.”

The time and money required to attest for a 365-day reporting period gave heartburn to many hospitals and physicians.

Specifically, CMS proposed today to update its Medicare and Medicaid EHR Incentive Programs to accomplish the following goals:

  • Adjust hospital EHR reporting periods to the calendar year to allow eligible hospitals more time to install and implement 2014 edition software
  • Modify other aspects of the program to match long-term goals, reduce complexity, and lessen provider reporting burdens
  • Shorten the EHR reporting period in 2015 to 90 days to accommodate these changes

These actions will be part of a proposed rule from the agency, and as such, related public comment and deliberation will take time, Branzell said.

However, CMS’ announcement allow providers who had become pessimistic about the 365-day reporting period — and dropped out of the incentive program — to reconsider with the 90-day timeline, he added.

“For many that were giving up … now they can go back and say, ‘Let’s start collecting data,’ because now they can collect data without incurring penalties and participate,” he said.

The stage 2 announcement is separate from CMS’ upcoming stage 3 rule, which it expects to publish in March, Patrick Conway, M.D., wrote in the agency’s blog post.

“CMS intends to limit the scope of the Stage 3 proposed rule to the requirements and criteria for meaningful use in 2017 and subsequent years,” wrote Conway, who is deputy administrator for innovation and quality and CMS’ chief medical officer.

At the end of 2014, a coalition of healthcare industry groups attempted unsuccessfully to insert a 90-day clause into a federal government spending package.

The point of the government’s reporting mandates is to increase the adoption and meaningful use of EHRs.

Scott Wallask is news director at SearchHealthIT. Follow him on Twitter @Scott_HighTech.

January 28, 2015  2:47 PM

HL7 International starts user group for payers

Posted by: ShaunSutner
FHIR, HL7, payers

Unlike in European countries with single-payer or similar health insurance systems, the U.S. healthcare market is fragmented among a large number of individual private payer companies and groups.

That setup brings technological problems when it comes to exchanging information between payers and providers, and between payers and members, or customers.

Enter HL7 International.

The influential non-profit standards and interoperability organization — the steward of HL7 health data exchange standards and the popular emerging new health IT standard, (FHIR) Fast Healthcare Interoperability Resources) – has decided to try to bring more order to the payer world.

In furtherance of that goal, HL7 has launched a payer user group to support insurers that use HL7 standards and protocols to better manage member care, promote better medical outcomes and work toward the long-term objective of more affordable healthcare, according to a release.

The main areas of focus for the HL7 Payer User Group are to:

  • Educate and train the payer community on how to put into action HL7 standards
  • Share lessons learned during implementations
  • Provide feedback to HL7 work groups that are responsible for creation of the standards that affect the payer community
  • Be a collaborative resource for other stakeholders at HL7 from the payer perspective

“Over the past year, HL7 has become increasingly active within the payer community. These efforts have provided critical support through the introduction of the payer summit program, and now enabled the launch of the HL7 Payer User Group,” Dr. Charles Jaffe, M.D., CEO of HL7, said in the release.

The payer user group is the second user group HL7 has started recently.

Last year, HL7 created an immunization user group in collaboration with the American Immunization Registry Association.

Similarly, HL7 is working on the payer group initiative with insurers such as BlueCross BlueShield, Cambia Health Solutions, Inc., Cigna Health and Life Insurance Company, Humana Inc., and other payers, according to HL7 spokeswoman Andrea Ribick.







January 27, 2015  1:46 PM

In Massachusetts, medical marijuana alerts get a second look

Posted by: Scott Wallask
healthcare, patient privacy, PHI, prescriptions

Imagine checking a personal email at work or at the public library and seeing this subject line show up in the alert box: “Confirmation of Patient Certification in the Medical Use of Marijuana Online System.”

That’s what happened to more than 6,800 patients in Massachusetts who have been approved for marijuana use as part of medical treatment, although after questioning by The Boston Globe, the state’s Department of Health has changed its ways. New emails will feature a softened subject line and no longer include the patients’ full names in the body of the message, The Globe reported earlier this month.


subject line

Patient privacy experts expressed surprise at the state’s original email wording, saying it failed to safeguard protected health information.

“They are supposed to protect the privacy of medical information,” David Szabo, a healthcare lawyer with Locke Lord Edwards LLP in Boston, told The Globe.

Massachusetts requires patients who can use marijuana, along with their prescribing physicians, to register with a state database.

In comparison, IT officials at a pair of Boston hospitals contacted by The Globe outlined more conservative approaches to emailing medical marijuana patients:

  • Beth Israel Deaconess Medical Center’s emails to patients include a subject line that simply says “Important Information from Your Doctor.”
  • Electronic messages from Partners HealthCare don’t include a patient’s personal information, instead prompting patients to log in to a Partners’ hospital’s website to view sensitive material.

Regardless of whether you agree with the medical marijuana movement, mentioning that information in an email subject line is a poor practice. It’s no different than getting an email from your provider saying a Rogaine prescription or birth control pills are ready. It’s protected health information, and mentioning it in the subject line of an email that a passerby could see raises questions about protection efforts.

 Scott Wallask is news director at SearchHealthIT. Follow him on Twitter @Scott_HighTech.

January 27, 2015  1:29 PM

State Innovation Models Initiative to fund telehealth, EHRs

Posted by: adelvecchio
CMS, EHR, State Innovation Models Initiative, telehealth

A portion of an investment approaching $1 billion, made by the Centers for Medicare and Medicaid Services, will go toward stimulating the practice of telehealth and increasing patient access to EHRs.

An Accenture report analyzes how states that created State Health Innovation Plans as part of CMS’ State Innovation Models Initiative are planning to assign the funds supplied to them and where they stand in the development process. CMS doled out money in two stages. First, in 2013, they awarded nearly $300 million to 25 states for plotting and developing an innovation plan. In 2014, 28 states, three territories and Washington D.C. received a sum of $660 million to design and test their plans.

The Accenture report examined the 25 states that were part of the first round of the State Innovation Models Initiative and found that 19 intend to increase use of virtual care technology, including remote patient monitoring and telehealth. Nearly two-thirds of the states will attempt to involve a larger number of patients in their care by offering them patient portals and increasing their ability to view their EHRs. For example, patients in Delaware will be able to use mobile applications to view their EHRs and assess care options.

More than half (14) of the participating states are going to deploy analytics to increase their knowledge of population health, reduce care redundancy and combine analysis of health data and human services data. Analyzing both of those data sets will help create more opportunities for preventive care, such as wellness programs, and may reduce the long-term cost of patient treatment.

Each of the 25 states will invest in patient-centered medical homes, with a focus on improving primary care integration with specialists. All 25 will also devote some of their funds to hire lower-cost community health workers in an effort to place more of the cost of care on more specialized caregivers.

January 21, 2015  12:55 PM

CHIME and AHA launch Most Wired 2015 survey

Posted by: ShaunSutner
AHA, CHIME, Meaningful use

CMS may be the source of the definitive numbers about which hospitals, healthcare systems and physicians are attesting to meaningful use, but the College of Health Information Management Executives (CHIME) knows which providers are “most wired.”

CHIME, in conjunction with the American Hospital Association’s (AHA) Health Forum, has opened the two groups’ “2015 Most Wired” survey and benchmarking study.

Last year, 1,901 hospitals were represented among 680 people who responded to the survey – roughly 33% of U.S. hospitals.

This industry barometer looks at how well hospitals use IT to improve performance for value-based healthcare and helps survey participants map strategic IT plans.

Participating providers answer questions about their progress in adoption, rollout and use in four key areas: infrastructure; business and administrative management; clinical quality and safety in inpatient and outpatient settings; and clinical integration.

In October, CHIME and the AHA announced that they would work together to further develop the survey, begin recognizing IT use in hospitals, and encourage IT use and performance improvements with results from the survey.

As a result, the groups say they have made changes, including:

  • Stricter verification and checks of whether organizations have successfully met meaningful use criteria
  • New questions about security measures
  • Additions to the survey involving patient engagement, telemedicine and integrated networks

Hospitals and healthcare systems taking part in the survey can be named among the Most Wired, Most Improved, or Most Wired among small or rural hospitals. Hospitals with unusual IT projects can compete for the Innovator Award.

A panel of hospital and IT Ieaders will evaluate the submissions, which are due March 15.

The annual survey link and Innovator award application can be found here.


January 20, 2015  2:02 PM

Health Information Trust Alliance creates health IT security group

Posted by: adelvecchio
athenahealth, Epic, health IT security, HITRUST

The success of health IT rests on users and beneficiaries learning to trust healthcare technology. A move made by The Health Information Trust Alliance put more stock in that statement. The alliance announced the formation of another group — the Health Information Technology and Medical Device Integrity and Security Program — that intends to work on improving the general security of health IT, with a focus on systems and devices.

The Health Information Trust Alliance (HITRUST) outlined the group’s mission to “avoid, report, and mitigate vulnerabilities.” It plans to accomplish this by stimulating awareness of individuals’ roles in the operation of healthcare systems and by creating a framework to aid providers in avoiding, reporting and documenting security vulnerabilities. The group will assemble subgroups to produce specific security recommendations and best practices.

In addition to observing the mechanics of health IT systems, the HITRUST security program will monitor people’s level of trust in the health IT sector. Keeping tabs on the public’s attitude toward health IT is one of the ways HITRUST will measure the success of its program — which it hopes will boost the public’s faith in the reliability, privacy and security of the health IT sector.

HITRUST also announced the creation of a committee to oversee the newly-formed health IT security program. Committee members include: Karl Stubelis, CFO and VP of athenahealth, Pamela Arora, senior VP and CIO of Dallas-based Children’s Health System, Carl Dvorak, president of Epic Systems Corp. and David Muntz, senior VP and CIO at GetWellNetwork, Inc. Muntz previously served as principal deputy national coordinator for health IT at ONC.

In a release announcing the group’s formation, Muntz said: “Given the pace and complexities associated with protecting these [health IT] systems, the private sector, not the government, should step up to manage this process. There is too much riding on the effectiveness and acceptance of these systems and we must ensure we maintain consumers’ confidence.”

January 15, 2015  12:01 PM

Patient care metrics available from CMS

Posted by: ShaunSutner
CMS, medicare

Patients looking for more help in choosing providers that best fit their needs can now turn to new data on healthcare quality from CMS.

The care quality data provided by physician group practices, hospitals and accountable care organizations (ACOs) is available on the Medicare Web sites Physician Compare, Hospital Compare, and

The information falls into these categories:

  • Hospital Value-based Purchasing Program 2015 payment adjustments. The program, created under the Affordable Care Act (ACA), shows how hospitals perform on key indicators of patient care, quality, efficiency and well-being, according to CMS. The program ties a portion of Medicare reimbursements to hospitals’ performance on certain quality of care measures, such as deaths within 30 days of heart attacks and patients’ care experience.
  • Updated performance results on diabetes and cardiovascular care by some physician group practices and ACOs. Performance data on the Physician Quality Reporting System (PQRS) measures come from 139 group practices, 214 Shared Savings Program ACOs, and 23 Pioneer ACOs.
  • Hospital performance results on hospital-acquired conditions (HAC)such as central line-associated bloodstream infections, catheter-associated urinary tract infections, pressure ulcers and accidental punctures or lacerations. CMS has more information on HACs and its HAC Reduction Program here.

Beyond the benefits to consumers, the healthcare quality data motivates providers to work toward higher quality levels and drives overall improvement in healthcare systems, according to CMS.

January 13, 2015  2:25 PM

A majority of patients would share their data for healthcare research

Posted by: adelvecchio
patient data, patient data privacy, sharing patient data

Healthcare organizations searching for ways to improve the business aspect of their daily operations would be wise to keep an eye on future studies from healthcare researchers. Slightly more than half (53%) of patients said they would be willing to anonymously share their health data with researchers. Of those 53%, 96% would approve of their data being used to reduce healthcare costs.

The costs of treating diseases, identifying safety issues and how to spend national dollars were other prime reasons that respondents approved of sharing their data. The figures derive from the responses of 3,010 survey participants who took party in a Truven Health Analytics — NPR health poll on data privacy.

More than 60% of those younger than age 35 responded positively to sharing their health data, compared to 43.1% of subjects 65 or older. Of those that fell in between those two age groups, 52.6% said they’d be comfortable with their anonymized data being used for research purposes.

The Truven Health – NPR poll asked positive respondents to share which research groups they would likely share information with. Government researchers topped the list at 92%, while consultants, university professors and drug researchers all came in at just below 90%.

In the first half of their data privacy poll released last November, the two groups asked patients a similar question about anonymously sharing their data — and received a markedly different result. More than two-thirds (67.6%) of all respondents said they would be willing to share their health data, with more than 60% of people in all three age groups sharing that sentiment. Enthusiasm for researchers having access to their anonymous health data was highest among those under age 35, with 74.7% of that group giving their approval. The November survey was given to approximately the same number of people as the more recent edition and it’s not immediately apparent why there’s a sizable gap between the two polls.

January 9, 2015  10:53 AM

With the new year in mind, a look back at hot health IT trends 20 years ago

Posted by: Scott Wallask
EHR adoption, healthcare, HIPAA audits, Interoperability, LOINC, Meaningful use, patient data, PDA, smartphones

As we jump into 2015, health IT professionals are familiar with the road ahead: Meaningful use debates, HIPAA audits, and EHR advances will all make headlines this year. And new technologies like wearable devices will push the boundaries of patient-centered care.

With that in mind, I thought it would be fun to briefly look back instead of forward — way back 20 years ago — to remember the IT-themed tech and trends that once grabbed attention in the medical field.



Back then, when the Internet was a tool only the cool kids used (Internet service providers had just started getting competitive), healthcare IT started a shift that can still be felt today. Previously, IT acted as an automated way to control healthcare costs. However, in 1994 and 1995, people began to instead consider IT as part of an approach to improve patient outcomes through technology.

Nowadays, that notion is leaping from providers to patients, thanks to wearable gadgets that measure vital signs and other health-related data.

Meanwhile, a system still in use debuted two decades ago: LOINC, or the Logical Observation Identifiers Names and Codes system, which standardizes electronic information going between laboratories and clinicians. LOINC developers clearly appreciated interoperability long before many of us did.

The system is hosted by the Regenstrief Institute, an informatics research organization in Indianapolis that recently released study results about patients who chose to withhold information in their medical records from some or all of their healthcare providers.

Finally, in 1995 some caregivers began to tote around personal digital assistants — PDAs, as we called them back then — to capture point-of-care data from patients. I remember writing about the potential hassles that wireless devices like PDAs and radio-frequency barcode readers might bring to telemetry systems in hospitals.

In the case of PDAs, although their technology was important, the devices hopped onto a more significant trend of testing at the patient bedside, rather than dragging a patient to the lab or other location. Smartphones and tablets eventually overtook PDAs, although they all share the common idea of a handheld, wireless device designed to give clinicians more options in the care units.

Speaking of smartphones, I sometimes wonder if the PDA’s history will repeat itself over the next 20 years. Will the features we all enjoy in modern phones transition to wearable devices or even implanted technology?

See you in 2035 to find out.

If you have any memories of other healthcare IT trends from 20 years ago, let me know in the comments box.

FYI, I culled much of my historical references in this blog from the websites of the Regenstrief Institute, Informatics and Nursing: Opportunities and Challenges (Fourth Edition), and

Scott Wallask is news director at SearchHealthIT. Follow him on Twitter @Scott_HighTech.

January 7, 2015  10:49 AM

Jonathan Bush of athenahealth in media spotlight

Posted by: ShaunSutner

Jonathan Bush, CEO of athenahealth, Inc., is the pre-eminent personality in the EHR vendor universe.

A new Fortune profile of the mercurial businessman, cousin to a former president and nephew to another, paints his company’s recent More Disruption Please startup conference in Maine as a frathhouse-like corporate gathering complete with Bush hijinks such as wild ATV driving and drinking games.

And while the piece quotes admirers of athenahealth’s cloud-based, open architecture approach to health IT and of Bush’s entrepreneurial spirit, writer Jen Wieczner also gives plenty of attention to critics, such as hedge fund manager David Einhorn, who openly short-sold athenahealth stock and drove down its price.

Meanwhile, Bush’s memoir, Where Does it Hurt? An Entrepreneur’s Guide to Fixing Health Care, came out last spring and is an entertaining window into the sometimes wacky workings of the 45-year-old’s brain.

The book chronicles Bush’s journey from diffident college student to New Orleans ambulance driver to improbable founder of a failed chain of women’s health and birthing centers. Eventually he started an electronic medical billing company, which is how Watertown, Mass.-based athenahealth began in 1997.

Indeed, Wieczner depicts athenahealth as still largely a medical billing operation, even though the $5 billion company has positioned itself as the leading cloud EHR vendor. Bush and other athenahealth execs have pointedly and as being closed, un-interoperable systems that ultimately don’t serve patients well.

Wieczner notes that athenahealth’s billing system has only 5% to 7% of the ambulatory market and its EHR less than 3% of the ambulatory clinical market. However, she also points out the company’s remarkable growth, with an average annual revenue gain of 32% (even though that performance has tailed off lately and the company has said it expects to lose money in 2015).

For Bush, however, it is actually athenahealth’s More Disruption Please online marketplace — on which other companies sell health IT products and services and give athenahealth a hefty cut of every sale — that is a key part of the company eventually becoming a kind of national standard or “backbone” of the health IT industry.

I interviewed Bush and watched him give a dynamic speaking performance at a connected health conference in Boston in October.

He strode the stage like a rock star, drawing repeated laughs and energetic applause from the audience with often humorous and sometimes risqué calls for more iconoclasm and risk-taking in health IT.

In my brief chat with Bush, he furiously munched on fruit while criticizing both Democrats and Republicans for being too big government-oriented, but declined to directly take on ONC, which his cousin, former President George W. Bush, established by executive order.

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