Innovation Center Report Released

A national center set up a year ago to test and implement new ways to improve patient care while cutting costs has delivered its first report. The Center for Medicare and Medicaid Innovation was created by the health care reform act.

It has funded 16 initiatives since it began operations, primarily focused on incentives for delivering care to Medicare, Medicaid, and the Chilren's Health Insurance Program (CHIP).

Source: The Washington Post Article

ONC Launches Health IT Challenge to Improve Hospital Discharge Care

The National Coordinator for Health Information Technology announced a Discharge Follow-Up Appointment care transitions challenge – the second as part of the Office of the National Coordinator for Health Information Technology (ONC) Investing in Innovation (i2) Initiative. With the support of Health 2.0 and Partnership for Patients, ONC launched the Discharge Follow-Up Appointment challenge in support of ONC’s Investing in Innovation (i2) program.

The i2 Initiative is a bold new effort to spur innovations in health IT. The program utilizes prizes and challenges to facilitate innovation and obtain solutions to intractable health IT problems. Aligned with the Obama administration’s innovation agenda, i2 is the first federal program to operate under the authority of the America COMPETES Reauthorization Act of 2010.

The challenge aims to stimulate the use of simple, information technology-enabled processes and tools to make transitions easier and safer for patients, caregivers and providers, particularly when a patient is discharged from a hospital. The first health IT challenge, Ensuring Safe Transitions from Hospital to Home , called upon developers to create a web-based application that could empower patients and caregivers to better navigate and manage a transition from a hospital.

The scheduling of follow-up appointments and post-discharge testing before leaving the hospital helps ensure safer and more effective transitions. Unfortunately, most patients across the country continue to leave the hospital without confirmed appointments and many providers remain frustrated by a highly manual and unreliable system. The Discharge Follow-Up Appointment challenge will focus on promoting effective care transitions.

“This challenge is an enormous opportunity for software developers to develop solutions, and pursue models that can be adopted across a community,” said Farzad Mostashari, M.D., Sc.M., national coordinator for health information technology. “Scheduling post-discharge follow-up appointments is critical, but not easy for patients or providers and we’re excited by the possibilities that will stem from this challenge.”

For additional information about ONC or on the i2 program, visit http://HealthIT.HHS.gov.

For more information about Health 2.0, which helps support the i2 challenge program, visit www.Health2Con.com .

For more information about Partnership for Patients, which also supports the i2 challenge program, visit http://www.healthcare.gov/compare/partnership-for-patients/index.html .
F
or more information about U. S. Department of Health and Human Services’ Recovery Act programs, see www.hhs.gov/recovery.

Source: HHS News Release

Privacy and Security Mobile Device Good Practices Project Launched

The Office of the National Coordinator for Health Information Technology's (ONC) Office of the Chief Privacy Officer (OCPO), in working with the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR), recently launched a Privacy & Security Mobile Device project.

The project goal is to develop an effective and practical way to bring awareness and understanding to those in the clinical sector to help them better secure and protect health information while using mobile devices (e.g., laptops, tablets, and smartphones). Building on the existing HHS HIPAA Security Rule - Remote Use Guidance, the project is designed to identify privacy and security good practices for mobile devices. Identified good practices and use cases will be communicated in plain, practical, and easy to understand language for health care providers, professionals, and other entities.

HHS will be looking for public input. Stay tuned for a public roundtable this Spring.

For information about other HHS mHealth activities, please visit the mHealth Initiative website: http://www.hhs.gov/open/initiatives/mhealth/index.html.

Source: ONC News Release

Weigh In: WSJ Discussion on Patient Unique IDs

A robust debate has begun in the Wall Street Journal regarding Should Every Patient Have a Unique ID Number for All Medical Records?

NAHAM members are encouraged to weigh in.

Source: WSJ Article

HHS OIG: Most Hospital Errors Unreported

A report by the U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) says that only 1 out of seven hospital errors are reported. The report, Hospital Incident Reporting Systems Do Not Capture Most Patient Harm, also indicates that even after hospital errors are reported, rarely are corrective actions taken to ensure these adverse events do not occur again.

Source: New York Times article

AHRQ Seeks Input from Health IT Community

The Agency for Healthcare Research and Quality (AHRQ) is seeking input from health IT researchers and implementers who have experience using the Health IT Survey Compendium.

The Health IT Survey Compendium is a tool for health IT researchers and implementers who are looking for Health IT related surveys to help support their implementation and evaluation needs.

If you are a health IT researcher or implementer with prior experience using the AHRQ Health IT Survey Compendium, and you are interested in participating in this AHRQ research effort, please email Westat at AHRQ_HIT_Tool_Eval@westat.com. If you prefer, you can also call Westat toll-free at 888-789-8869. Westat will then contact you for some additional information. If you are selected to participate, Westat will schedule a time with you and send you a confirmation in advance. Your participation would include participating in an online interview and will take approximately 60-90 minutes of your time and does not require any travel. No advance preparation is required and you will receive a payment of $75 to thank you for your time.

Please contact Westat by February 2, 2012 to schedule a call.

Source: AHRQ News Release

EHNAC Announces 2012 Criteria for All Accreditation Programs

The Electronic Healthcare Network Accreditation Commission (EHNAC), a non-profit standards development organization and accrediting body, announced the adoption of new program criteria for 2012.

Following the standard, 60-day public comment period, EHNAC has incorporated feedback to finalize and adopt the enhanced criteria versions for the following programs:
ePAP – e-Prescribing Accreditation Program (Version 6.3)
FSAP EHN – Financial Services Accreditation Program for Electronic Health Networks (Version 2.3)
FSAP Lockbox – Financial Services Accreditation Program for Lockbox Services (Version 2.3)
HIEAP – Health Information Exchange Accreditation Program (Version 1.1)
HNAP-70 – Healthcare Network Accreditation Plus Select SAS 70©1 Criteria Program (Version 1.3)
HNAP EHN – Healthcare Network Accreditation Program for Electronic Health Networks (Version 10.3) 2
HNAP Medical Biller – Healthcare Network Accreditation Program for Medical Billers (Version 1.2)
HNAP TPA – Healthcare Network Accreditation Program for Third Party Administrators (Version 1.2)
MSOAP – Management Service Organization Accreditation Program (Version 1.1)
OSAP – Outsourced Services Accreditation Program2 (Version 1.2)
OSAP HIE – Outsourced Services Accreditation Program for Health Information Exchange Services (Version 1.1)

“The continued evolution and improvement of our accreditation programs is vital to support the dynamic climate of healthcare reform and industry standards,” says Mark Gingrich, EHNAC Commissioner and Criteria Committee Chair. “EHNAC is fully committed to regularly adjusting our program criteria for accreditation in all areas that affect health data processing to set the bar for the industry standards of today.”

EHNAC accreditation recognizes excellence in health data processing and transactions, and confirms compliance with industry-established standards and HIPAA regulations. Organizations that apply for accreditation or re-accreditation after Jan. 1, 2012 will now need to adhere to the enhanced criteria standards. Criteria for all EHNAC programs are posted online.

Source: EHNAC News Release

New National Biodefense Science Board to Advise HHS

Seven experts from outside the federal government will join the National Biodefense Science Board (NBSB), a federal advisory committee which provides expert advice and guidance on preventing, preparing for, and responding to adverse health effects of public health emergencies to the HHS Secretary and the HHS Assistant Secretary for Preparedness and Response (ASPR). The new members replace members whose 4-year terms expire Jan. 31.

The ASPR serves as the Secretary’s principal advisor on bioterrorism and other public health emergencies and coordinates the federal public health and medical response to disasters.

“NBSB members bring a broad range of perspectives and experiences, and over the past four years, the board has helped us improve federal policies and practices in disaster preparedness and response,” said Assistant Secretary Nicole Lurie. “I look forward to working with the new members as we forge ahead in helping communities across the country become more resilient to all hazards.”

The board was created under the Pandemic and All-Hazards Preparedness Act of 2006 and chartered in May 2007. Since then, the board has provided recommendations on a variety of federal disaster preparedness and response issues. The issues include, the effectiveness of the National Disaster Medical System and federal management of the research and development medical countermeasures – the medicines, vaccines and equipment needed to protect health from bioterrorism and pandemic disease.

In addition, the board assessed the department’s progress in integrating behavioral health into emergency preparedness and response activities. HHS incorporated the NBSB recommendations in the first federal disaster behavioral health concept of operations which ASPR recently released. The board also has recommended ways to improve the nation’s ability to mobilize scientific resources quickly and comprehensively in support of public health emergency response.

By statute, the board has 13 voting members with a broad range of expertise in science, medicine, and public health. Additionally, there are non-voting members from federal and state government agencies as deemed appropriate by the Secretary.

The next meeting of the board and the first for new members will take place Feb. 2. Information about the meeting and the National Biodefense Science Board is available at http://www.phe.gov/Preparedness/legal/boards/nbsb/Pages/default.aspx.

Incoming members are as follows:
John S. Parker, M.D., major general (retired) U.S. Army, senior vice president, Science Applications International Corporation, re-nominated to serve as NBSB chair
John S. Bradley, M.D., director, Division of Infectious Diseases, Rady Children’s Hospital
Nelson J. Chao, M.D., M.B.A., chief, Division of Cellular Therapy/Bone Marrow Transplantation, Duke University
Emilio A. Emini, Ph.D., chief scientific officer, Vaccine Research, Pfizer, Inc.
Manohar R. Furtado, Ph.D., vice president, Research and Development, Life Technologies/Applied Biosystems
Steven E. Krug, M.D., head, Division of Emergency Medicine at Children’s Memorial Hospital
Sarah Y. Park, M.D., state epidemiologist and chief, Disease Outbreak Control Division, Hawaii Department of Health
The following members’ terms are expiring:
NBSB Chair Patricia Quinlisk, M.D., M.P.H., state epidemiologist and medical director, Iowa Department of Public Health
Ruth L. Berkelman, M.D., Rollins professor and director, Center for Public Health Preparedness and Research, Rollins School of Public Health, Emory University
Stephen V. Cantrill, M.D., BNICE Training Center, Department of Emergency Medicine, Denver Health Medical Center
John D. Grabenstein, R.Ph., Ph.D., senior medical director, Adult Vaccines, Merck Vaccine Division
Thomas J. MacVittie, Ph.D., professor, Departments of Radiation Oncology and Pathology, University of Maryland School of Medicine
John S. Parker, M.D., major general (retired), senior vice president, Scientific Applications International Corporation – re-nominated to serve as NBSB chair
Patrick J. Scannon, M.D., Ph.D., executive vice president and chief, Biotechnology, Officer XOMA, Ltd.
The following members are continuing with the NBSB:
Georges Benjamin, M.D., executive director, American Public Health Association
Jane Delgado, Ph.D., M.S., president and chief executive officer, National Alliance for Hispanic Health
David Ecker, Ph.D., divisional vice president and site general manager, Ibis Biosciences
Daniel Fagbuyi, M.D., medical director, Disaster Preparedness and Emergency Management, Children’s National Medical Center
Kevin Jarrell, Ph.D., chief executive officer, Modular Genetics, Inc.
Betty Pfefferbaum, J.D., M.D., professor and chair, Department of Psychiatry and Behavioral Sciences, University of Oklahoma Sciences Center

Source: HHS News Release

Doctors Are Cautious, Patients Enthusiastic About Sharing Medical Notes

Patients are overwhelmingly interested in exploring the notes doctors write about them after an office visit, but doctors worry about the impact of such transparency on their patients and on their own workflow, a Beth Israel Deaconess Medical Center (BIDMC) study suggests.

In a study published in the Dec. 20 issue of the Annals of Internal Medicine, patient and doctor attitudes were surveyed extensively prior to the launch of the OpenNotes trial in which patients at BIDMC, Geisinger Health System of Danville, PA, and Harborview Medical Center in Seattle were offered online access to their doctors’ notes written after office visits. Such notes have long been primarily within the doctors’ domain, even though patients have the legal right to obtain them.

"Doctors were divided in many of their expectations, and the issues we highlight have important consequences for both their work life and quality of care," writes lead author Jan Walker, RN, MBA, of BIDMC’s Division of General Medicine and Primary Care.

While many of the more than 100 primary care doctors who volunteered to participate in this experiment predicted possible health benefits from allowing patients to read their notes, the majority of those who declined participation were doubtful about positive impacts. And among the 173 doctors completing surveys, the majority expressed concerns about confusing or worrying patients with the content. Doctors also anticipated that they would write their notes less candidly and that responding to patient questions might be exceedingly time-consuming.
In contrast to the doctors surveyed, the nearly 38,000 patients who completed the baseline survey were almost uniformly optimistic about OpenNotes, and few anticipated being confused or worried

"The enthusiasm of patients exceeded our expectations," wrote Walker. "Most of them were overwhelmingly positive about the prospect of reading visit notes, regardless of demographic or health characteristics."

More than 90 percent favored making the notes available. Well over half anticipated improved adherence to their medications, 90 percent expected to feel more in control of their care, and four out of five predicted they would take better care of themselves.

"We know a lot more about our cars than our own bodies," responded one patient. "We leave all of that to the clinicians. I think by having access to our notes, we can take control, and that’s important."

In addition, half of patients surveyed reported that they would consider sharing their notes with other people, including other doctors.

"As I help my aging mother with her medical needs, I wish I could see the notes her doctors have made," wrote one patient. "I think it would help me in caring for her."

In an accompanying editorial, Thomas W. Feeley, MD, of the MD Anderson Cancer, and Kenneth I. Shine, MD, of the University of Texas, urged that electronic health records be used to engage participants in all parts of the health care delivery system.

"Expanding who uses the records and how they use them promises to facilitate communication, decrease redundant testing, and enhance our care delivery in ways we have yet to imagine."

The year-long OpenNotes study period has now ended, and Walker and her colleagues in the three diverse sites are eager to learn how the baseline expectations will play out. They are currently evaluating reports from follow-up surveys completed by participating doctors and patients and analyzing other metrics, such as how often patients reviewed their notes, shared them with others, or corrected errors their doctors may have made.

"They said they wanted the notes. They said they’d use them, but we have no idea if they actually went online and read them," said Walker. "And if they did read them, we don’t know yet what impact that had on the patients or the doctors."

"Patients want to look into the doctor’s black box, and many doctors are a bit nervous about what they’ll find," said Tom Delbanco, MD, senior author and co-principal investigator of OpenNotes. "But I expect that over time everyone will benefit enormously from such transparency."

"While OpenNotes represents a simple change of practice, the effect on the patient-doctor relationship could be profound. The fact that there’s such a gap between how most patients and many doctors expect that patients will handle the information contained in these notes hints at just how profound that effect might be," added Steve Downs, Robert Wood Johnson Foundation’s Chief Technology and Information Officer. In addition to Walker and Delbanco, the study’s co-authors include: Henry Feldman, MD and Long Ngo, PhD, BIDMC; Suzanne G. Leveille, PhD, RN, University of Massachusetts Boston; Jonathan D. Darer, MD, MPH, Marc J. Lichtenfeld, PhD, Geisinger Health System, Pennsylvania; Shireesha Dhanireddy, MD, Joann G. Elmore, MD, MPH, Natalia Oster, MPH, Elisabeth Vodicka, BA; Harborview Medical Center, Seattle; James D. Ralston, MD, MPH, Group Health Research Institute, Seattle; and Stephen E. Ross, MD, University of Colorado Health Sciences Center.

Source: OpenNotes Press Release

Health Care Reform Law's Rate Review Provision Holding Insurance Rates Down

Health insurance premium increases in five states have been deemed “unreasonable” by the U.S. Department of Health and Human Services, HHS Secretary Kathleen Sebelius announced .

After independent expert review, HHS determined that Trustmark Life Insurance Company has proposed unreasonable health insurance premium increases in five states—Alabama, Arizona, Pennsylvania, Virginia, and Wyoming. The excessive rate hikes would affect nearly 10,000 residents across these five states.

To make these determinations, HHS used its “rate review” authority from the Affordable Care Act (the health care reform law of 2010) to determine whether premium increases of over 10 percent are reasonable.

"Before the Affordable Care Act, consumers were in the dark about their health insurance premiums because there was no nationwide transparency or accountability," said Secretary Kathleen Sebelius. "Now, insurance companies are required to disclose rate increases over 10 percent and justify these increases. It’s time for Trustmark to immediately rescind the rates, issue refunds to consumers or publicly explain their refusal to do so."

In these five states, Trustmark has raised rates by 13 percent. For small businesses in Alabama and Arizona, when combined with other rate hikes made over the last 12 months, rates have increased by 27.2 percent and 18.1 percent, respectively. These increases were reviewed by independent experts to determine whether they are reasonable. In this case, HHS determined that the rate increases were unreasonable because the insurer would be spending a low percent of premium dollars on actual medical care and quality improvements, and because the justifications were based on unreasonable assumptions.

In addition to the review of rate increases, many states have the authority to reject unreasonable premium increases. Since the passage of the health care reform law, the number of states with this authority increased from 30 to 37, with several states extending existing “prior authority” to new markets.

Examples of how states have used this authority include:
- In New Mexico, the state insurance division denied a request from Presbyterian Healthcare for a 9.7 percent rate hike, lowering it to 4.7 percent;
- In Connecticut, the state stopped Anthem Blue Cross Blue Shield, the state’s largest insurer, from hiking rates by a proposed 12.9 percent, instead limiting it to a 3.9 percent increase;
In Oregon, the state denied a proposed 22.1 percent rate hike by Regence, limiting it to 12.8 percent.
- In New York, the state denied rate increases from Emblem, Oxford, and Aetna that averaged 12.7 percent, instead holding them to an 8.2 percent increase.
- In Rhode Island, the state denied rate hikes from United Healthcare of New England ranging from 18 to 20.1 percent, instead seeing them cut to 9.6 to 10.6 percent.
- In Pennsylvania, the state held Highmark to rate hikes ranging from 4.9 to 8.3 percent, down from 9.9 percent.

HHS' announcement comes the same week that a report showed that health care spending has grown at remarkably low rates. According to an analysis done each year by the Centers for Medicare & Medicaid Services (CMS), U.S. health care spending experienced historically low rates of growth in 2009 and 2010. A recent study released by Mercer Consulting also showed a slow-down in the average employee health benefit cost to businesses.

The Affordable Care Act includes several policies, including rate review, to continue this slow growth. By fighting fraud, better coordinating care, preventing disease and illness before they happen and creating a new state-based insurance marketplace, it helps keep health care cost growth low.

For more information on the specific determinations made today, please visit http://companyprofiles.healthcare.gov/

For general information about rate review, visit: http://www.healthcare.gov/law/features/costs/rate-review/

Source: HHS News Release

CMS Selects Innovation Advisors

The Centers for Medicare and Medicaid Services (CMS) announced that it has selected 73 individuals from 27 States and the District of Columbia for its Innovation Advisors program.

A list of Innovation Advisors can be found at http://www.cms.gov/apps/media/press/factsheet.asp?Counter=4240.

The initiative, launched by the CMS Innovation Center in October 2011, will help health professionals deepen skills that will drive improvements to patient care and reduce costs. After an initial orientation phase, Innovation Advisors will work with the CMS Innovation Center to test new models of care delivery in their own organizations and communities. They will also create partnerships to find new ideas that work and share them regionally and across the United States.

Funding for this initiative was made possible by the Affordable Care Act.

“There has been an incredible groundswell of interest in becoming an Innovation Advisor. It’s clear that doctors, hospitals and health care providers are enthusiastic about implementing the Affordable Care Act and strengthening our health care system,” said CMS Acting Administrator Marilyn Tavenner.

The 73 individuals were selected from 920 applications through a competitive process, and include clinicians, allied health professionals, health administrators and others. By attending in-person meetings as well as remote sessions to expand their skills and applying what they learn, the Advisors will be able to deepen their knowledge in health care economics and finance, population health, systems analysis, and operations research.

“We’re looking to these Innovation Advisors to be our partners—we want them to discover and generate new ideas that will work and help us bring them to every corner of the United States,” said CMS Innovation Center Director Rick Gilfillan, M.D.

Among other duties, the Advisors will be expected to support the Innovation Center in testing new models of care delivery, to form partnerships with local organizations to drive delivery system reform, and to improve their own health systems so their communities will have better health and better care at a lower cost.

Each Innovation Advisor’s home organization will receive a stipend of up to $20,000. The stipend will support an individual’s activities while serving as an Innovation Advisor.

More information about the Innovation Advisors Program, including a fact sheet and list of participants and their home organization, can be found at: http://innovations.cms.gov/initiatives/innovation-advisors/index.html.

Report on Identifying Health Care Quality Measures in Medicaid-Eligible Adults Released

The Agency for Healthcare Research and Quality (AHRQ) released a background report documenting the process, deliberations, and results of AHRQ's National Advisory Council Subcommittee for Identifying Health Care Quality Measures for Medicaid-Eligible Adults.
The Affordable Care Act requires the Secretary of the Department of Health and Human Services to identify and publish a core set of health quality measures for Medicaid-eligible adults.

Source: AHRQ Release

AHRQ Releases Podcast on e-Rx

The Agency for Healthcare Research and Quality (AHRQ) has released a new podcast that highlights findings of a recent AHRQ-funded study on e-prescribing as part of the Agency’s Healthcare 411 podcast series.

The study found electronic prescribing is safe and efficient but barriers to its use remain. In the segment, AHRQ Health IT expert, Teresa Zayas-Caban, Ph.D shares some highlights of the study, which overall found that while physician practices and pharmacies generally view electronic prescribing as an important tool to improve patient safety and save time, there are still barriers to realizing the technology's full benefit.

To listen to the podcast and access other related resources, visit: http://www.healthcare411.ahrq.gov/radiocast.aspx?id=887.

Source: AHRQ News Release

HHS Launches Consumer HIT Video Challenge of 2012

The National Coordinator for Health Information Technology (ONC) announced a nationwide, open call for entries in the Healthy New Year Video Challenge, highlighting personal stories of patients and families using health technology to improve health. The video challenge, launched by the Office of the National Coordinator for Health Information Technology (ONC), kicks off the first in a series of consumer video contests in 2012 as a way to engage consumers to integrate technology into their health care.

"In order to empower individuals to be more active partners in their health, they need access to their information and tools they can use,” said Farzad Mostashari, M.D., Sc.M., national coordinator for health information technology. “We are excited to harness the creativity of ordinary Americans to help promote the positive impact of the myriad health information technology tools and services on health and health care.”

Submissions for the Healthy New Year Video Challenge will be accepted through February 16 and can range from creative and innovative ways of e-mailing your doctor, using an online patient-portal to manage your health information, or downloading a mobile application that sends medication reminders. All videos must meet certain eligibility criteria.

The winning entries will be determined from public votes and a panel of judges will ultimately select the top winners in each category. ONC will award winners a portion of $5,000 in prize money and feature the videos on its consumer-facing website, www.HealthIT.gov, as a way to motivate and inspire everyone to use health information technology to be more engaged partners in improving health and health care.

For more details, including contest rules on the Health New Year Video Challenge, visit http://healthynewyear.challenge.gov.

For more information about ONC, visit http://HealthIT.gov.

Source: HHS News Release

TJC 2012 Health Care Staffing Review Process Guide Available

The Joint Commission (TJC) has released its updated 2012 Health Care Staffing Certification Review Process Guide. The guide is designed to provide guidance for onsite certification review.

Source: TJC Release

Hospitals Slow to Embrace Tablet Computers

According to a recent article from Kaiser Health News, hospitals have been slow to adopt tablet computer technologies and other mobile devices in providing every day care to patients.

Jonathan Mack of the West Wireless Health Institute says that less than 1 percent of hospitals are using tablet computers, such as iPads, and very few of these devices have apps that allow doctors to record their notes as they can on a desktop or laptop computer.

For Hospitals, There's No App for Adopting Tablet Computers by Jenny Gold, may be viewed here.

Source: Kaiser Health News

Study: U.S. Needs to Strengthen Privacy Safeguards for EHRs

Electronic health records can potentially save billions of dollars in health care costs and increase patient safety, but have considerable risks to individual privacy in the United States, more so than the European Union, says a new study co-authored by Pamplin College of Business professor Janine Hiller.

“EU countries have adopted electronic health records and systems, or EHRs, and legally protected privacy at the same time,” Hiller says. EHRs include a wide range of patient medical information collected in digital format and accessible via computer, most often over a network.

Strengthening the legal and technical safeguards, she says, would significantly minimize the privacy and security risks and address public concerns in the U.S. about EHRs. Her study examines their benefits and drawbacks, the adequacy of U.S. laws to meet the challenges posed by the privacy risks and concerns, and compares the EU’s legal approach to EHRs.

The U.S. legal framework for health care privacy, she says, is “a hodgepodge of constitutional, statutory, and regulatory law at the federal and state levels.” Hiller and her co-authors believe that though federal efforts to protect privacy seem to be a step up from inconsistent state laws, Americans currently still “have no real control over the collection of sensitive medical information if they want to be treated,” in contrast to the choice accorded to EU residents.

Their study, Hiller says, makes it clear that the privacy issue should be central to any discussion of EHR implementation in the U.S. and the technical and policy framework that guides it. Her recent research in Sweden, she says, showed her “that the legal and technical frameworks cannot stand alone; that they should be developed hand in hand in order to design systems that will effectively protect patient privacy.”

Until then, she says, “public confidence and trust in EHRs is unlikely.”

The study, titled Privacy and Security in the Implementation of Health Information Technology (Electronic Health Records): U.S. and E.U. Compared, appears in the winter 2011 issue of the Journal of and may be viewed here. An article about the study, Privacy or Savings? published in the Virginia Tech Pamplin College of Business Magazine, may be viewed here.

Source: VA Tech News Release

New HHS Regs Streamline Health Electronic Funds Transfer; Cut Red Tape

New standards for electronic funds transfers in health care, required by the Affordable Care Act, will reduce up to $4.5 billion off administrative costs for doctors and hospitals, private health plans, states, and other government health plans, over the next ten years, according to estimates included in new rules published by the U.S. Department of Health and Human Services (HHS).

The standards build upon regulations published in 2011 that set industry-wide standards for how health providers use electronic systems to quickly and easily determine a patient’s eligibility for health coverage and check on the status of a health claim.

Together, the two regulations implementing the Administrative Simplification provisions of the Affordable Care Act and the Health Insurance Portability and Accountability Act (HIPAA) are projected to save the health care industry more than $16 billion over the next 10 years. These savings come from the adoption of electronic standards that will help eliminate inefficient manual processes and reduce costs.

“Thanks to the Affordable Care Act, health care professionals will spend less time filling out paperwork and more time focusing on delivering the best care for patients,” said HHS Secretary Kathleen Sebelius.

A May 2010 study in the journal Health Affairs found that physicians spend nearly 12 percent of every dollar they receive from patients to cover the costs of filling out forms and performing other excessively complex administrative tasks. The study found that simplifying these systems could save four hours per week of professional time per physician and five hours of support staff time every week – time that could be better spent on patient care.

“As a nurse, I know the importance of giving health care professionals time to focus on patient care,” said CMS Acting Administrator Marilyn Tavenner. “The less time a physician has to spend on paperwork is that much more time that can be devoted to patient care. Having standardized procedures across the health care industry can only lead to lower costs and greater efficiencies all around.”

The rule—the Adoption of Standards for Health Care Electronic Funds Transfers and Remittance Advice — adopts streamlined standards for the format and data content of the transmission a health plan sends to its bank when it wants to pay a claim to a provider electronically (through an electronic funds transfer) and to issue a Remittance Advice notice. Remittance Advice is a notice of payment sent to providers that may or may not accompany the payment the provider receives.

For example, currently when a provider submits a claim electronically for payment, a health plan often sends a Remittance Advice separately from the Electronic Funds Transfers payment. The disconnect between the two makes it difficult or sometimes impossible for the provider to match up the bill and the corresponding payment. The rule addresses this by requiring the use of a trace number that automatically matches the two. The new tracking system will allow health care providers to eliminate costly manual reconciliation that must currently be done.

Future administrative simplification rules will address adoption of:
- A standard unique identifier for health plans;
- A standard for claims attachments; and
- Requirements that health plans certify compliance with all HIPAA standards and operating rules.

The regulation is effective January 1, 2012. All health plans covered under HIPAA must comply by January 1, 2014.

To view the Interim Final Regulation with comment period, go to: http://www.regulations.gov

For more information on the June 2011 HIPAA Administrative regulation: Adoption of Operating Rules for Eligibility for a Health Plan and Health Care Claim Status, visit: http://www.hhs.gov/news/press/2011pres/06/20110630a.html

Source: HHS News Release

Final Health IT Innovators Win Funding for Cancer Treatment Apps

Innovative winners of a U.S. Department of Health and Human Services (HHS) public data and cancer challenge have created health IT applications that use public data and existing technology to help patients and health care professionals prevent, detect, diagnose and treat cancer. The two winners presented their submissions during a special symposium at the Hawaii International Conference on Systems Sciences and were each awarded $20,000 by the Office for the National Coordinator for Health Information Technology (ONC).

The two winning applications include:
- Ask Dory! – submitted by Chintan Patel, Ph.D.; Sharib Khan, M.D., M.A., M.P.H.; and Aamir Hussain of Applied Informatics LLC – helps patients find information about clinical trials for cancer and other diseases, integrating data from www.ClinicalTrials.gov and making use of an entropy-based, decision-tree algorithm. A functional demonstration of the application is available at http://Dory.trialx.com .

- My Cancer Genome – submitted by Mia Levy, Ph.D., M.D., of the Vanderbilt University Medical Center – provides therapeutic options based on the individual patient’s tumor gene mutations, making use of the NCI’s physician data query clinical trial registry data set and information on genes being evaluated in therapeutic clinical trials. The app is in operation at www.MyCancerGenome.org .

Information on the four semifinalist teams can be found at http://go.USA.gov/5DA.

With the support of the National Cancer Institute, part of the National Institutes of Health, ONC launched the “Using Public Data for Cancer Prevention and Control: From Innovation to Impact” challenge during the summer of 2011 in support of ONC’s Investing in Innovation (i2) program. The i2 program utilizes prizes and challenges to facilitate innovation and obtain solutions to intractable health IT problems. Aligned with the Obama administration’s innovation agenda, i2 is the first federal program to operate under the authority of the America COMPETES Reauthorization Act.

“What makes these health IT challenges so powerful is their ability to catalyze the expertise and creativity of innovators both in and out of health care,” said Wil Yu, ONC’s special assistant for innovations. “We seek breakthrough solutions to nuanced issues; some are ready for the marketplace and some are prototypes, but all will have a great potential to benefit Americans. Ask Dory and My Cancer Genome are examples of results that innovation challenges can incentivize and deliver – we’re really excited to see their impact.”

For additional details on the “Using Public Data for Cancer Prevention and Control” challenge, visit www.Health2Challenge.org/using-public-data-for-cancer-prevention-and-control-from-innovation-to-impact-2.

For additional information about ONC or on the Investing in Innovation (i2) program, visit http://HealthIT.HHS.gov.

Source: HHS News Release

Choosing Wisely Campaign Launches to Help Physicians Better Manage Health Care

Recognizing that patients often ask for tests and treatments that are not necessarily in their best
interest, and physicians often struggle with decisions about prescribing tests and procedures as a way of covering all possible bases, the ABIM Foundation has joined with nine leading medical specialty societies to develop evidence-based lists of tests and procedures for patients and physicians to question as part of Choosing Wisely TM.

The goal of the campaign is to help physicians, patients and other health care stakeholders think and talk about overuse or misuse of health care resources in the United States.

Consumer Reports, the nation’s leading expert, independent, nonprofit consumer organization, has also joined the campaign to provide resources for consumers and physicians to engage in these important conversations. The campaign is part of the ABIM Foundation’s goal of promoting wise choices by clinicians in order to improve health care outcomes, provide patient-centered care that avoids unnecessary and even harmful interventions and reduce the rapidly-expanding costs of the health care system. The lists of Five Things Physicians and Patients
Should Question is modeled after the successful National Physicians Alliance (NPA) project titled “Five Things You Can Do in Your Practice,” which was funded by the ABIM Foundation in 2009.
As part of Choosing Wisely, each participating specialty society will identify its own list of five common tests or procedures whose use in their profession should be discussed or questioned. The lists will be unveiled in April 2012. The societies were given the following parameters to develop the lists:
- Each item should be within the specialty’s purview and control;
- Procedures should be used frequently and/or carry a significant cost; and
- There needs to be evidence to support each recommendation.

“Physicians play a leading role in addressing problems with our nation’s health care system. That is why the ABIM Foundation is proud to be working with specialty societies that have proactively decided to address some of the most important issues in health care head on,” said Christine K. Cassel, MD, president and CEO of the ABIM Foundation. “By identifying specific procedures or tests that may commonly be ordered, but not always necessary to improving patient care, we’re kicking off an important and overdue conversation about making wise choices in health care. Everyone – providers, patients and others – plays a part in being better stewards of the system’s finite resources.”

The Congressional Budget Office estimates that up to 30 percent of care delivered in America goes toward unnecessary tests, procedures, medical appointments, hospital stays and other services that may not improve people’s health – and in fact may actually cause harm. If current trends remain unchanged, the Centers for Medicare & Medicaid Services project U.S. health care spending will reach $4.3 trillion and account for 19.3 percent of the nation’s gross domestic product by 2019.

First announced in March 2011, Choosing Wisely is part of a multi-year effort led by the ABIM Foundation to support and engage physicians in being better stewards of finite health care resources. It is part of the ABIM Foundation’s long history of advancing medical professionalism and supporting similar initiatives. In 2002 the Foundation, along with the American College of Physicians Foundation and European Federation of Internal Medicine, authored Medical Professionalism in the New Millennium: A Physician Charter. The Physician Charter has as its fundamental principles the primacy of patient welfare, patient autonomy and social justice and articulates professional responsibilities of physicians, including a commitment to improving quality and access to care, advocating for a just and cost-effective distribution of finite resources and maintaining trust by managing conflicts of interest.

To learn more about Choosing Wisely visit www.ChoosingWisely.org.

Source: Choosing Wisely News Release

TJC Seeks Organizations for New Intracycle Monitoring Pilot

The Joint Commission (TJC) is seeking accredited organizations to begin pilot testing
a new Intracycle Monitoring process from February through May of 2012.

The Intracycle Monitoring process is planned for implementation in January 2013. For more information about the process, send an e-mail to intracycle@jointcommission.org.

For more information, please click here.

Source: TJC News Release

TJC Releases 2012 Survey Activity Guide

The Joint Commission (TJC) recently released its 2012 Survey Activity Guide for use in preparing for an accreditation on-site survey.

For more information, please click here.

Source: TJC News Release

HHS Announces New National Health Promotion & Disease Prevention Agenda

The U.S. Department of Health and Human Services unveiled Healthy People 2020, the nation‟s new 10-year goals and objectives for health promotion and disease prevention, and "myHealthyPeople," a new challenge for technology application developers.

For the past 30 years, Healthy People has been committed to improving the quality of our Nation‟s health by producing a framework for public health prevention priorities and actions.

"The launch of Healthy People 2020 comes at a critical time," said HHS Secretary Kathleen Sebelius. "Our challenge and opportunity is to avoid preventable diseases from occurring in the first place."

Chronic diseases, such as heart disease, cancer and diabetes, are responsible for seven out of every 10 deaths among Americans each year and account for 75 percent of the nation‟s health spending. Many of the risk factors that contribute to the development of these diseases are preventable.

"Too many people are not reaching their full potential for health because of preventable conditions," said Assistant Secretary for Health Howard K. Koh, M.D., M.P.H. "Healthy People is the nation‟s roadmap and compass for better health, providing our society a vision for improving both the quantity and quality of life for all Americans."

The Healthy People initiative is grounded in the principle that setting national objectives and monitoring progress can motivate action, and indeed, in just the last decade, preliminary analyses indicate that the country has either progressed toward or met 71 percent of its Healthy People targets. Healthy People 2020 is the product of an extensive stakeholder feedback process that is unparalleled in government and health. It integrates input from public health and prevention experts, a wide range of federal, state and local government officials, a consortium of more than 2,000 organizations, and perhaps most importantly, the public. More than 8,000 comments were considered in drafting a comprehensive set of Healthy People 2020 objectives.

Healthy People is also issuing a special challenge to encourage developers to create easy-to-use applications for professionals who are working with the new national health objectives and state- and community-level health data.

"This milestone in disease prevention and health promotion creates an opportunity to leverage information technology to make Healthy People come alive for all Americans in their communities and workplaces," said Chief Technology Officer Todd Park. "The 'myHealthyPeople' apps challenge will help spur innovative approaches to helping communities track their progress using Healthy People objectives and targets as well as develop an agenda for health improvement."

HHS is also launching a newly redesigned Healthy People Web site that allows users to tailor information to their needs and explore evidence-based resources for implementation.
The Web site is located at: www.healthypeople.gov.

For more information about myHealthyPeople, go to www.challenge.gov/.

Source: HHS News Release

Affordable Care Act “Sunshine” Rule Released

The Centers for Medicare & Medicaid Services (CMS) announced a proposed rule that will increase public awareness of financial relationships between drug and device manufacturers and certain health care providers. This is one of many steps under the Affordable Care Act designed to increase transparency in the health care system, which can lead to better care at lower costs.

“When people are faced with the difficult task of choosing the right doctor, they need all the information they can gather. If your doctor is taking money from manufacturers of prescription drugs, suppliers of wheelchairs or other devices, you deserve to know about it,” said Peter Budetti, M.D. CMS deputy administrator for Program Integrity. “Disclosure of these relationships will discourage the inappropriate influence on clinical decision-making that sometimes occurs while still allowing legitimate partnerships.”

The proposed rule would require manufacturers of drugs, devices, biologicals, and medical supplies covered by Medicare, Medicaid, or the Children’s Health Insurance Program to report to CMS payments or other transfers of value they make to physicians and teaching hospitals. The proposed rule would also require manufacturers and group purchasing organizations (GPOs) to disclose to CMS physician ownership or investment interests.

This increased transparency is intended to help reduce the potential for conflicts of interest that physicians or teaching hospitals might face as a result of their relationships with manufacturers.

Drug and biologic manufacturers, medical device or supply manufacturers, and GPOs would be affected by the new reporting requirements. These organizations, as well as the physicians and teaching hospitals, would be allowed an opportunity to review and correct information prior to its publication.

The Affordable Care Act provides that violators of the reporting requirements will be subject to civil monetary penalties (CMPs), capped at $150,000 annually for failing to report, and $1,000,000 for knowingly failing to report.

CMS is proposing that data collection will not begin on Jan. 1, 2012 and that manufacturers and GPOs do not need to begin data collection until final regulations are issued. Depending on the timing of the final rule, CMS is proposing that manufacturers and GPOs will be required to submit a partial year on Mar. 31, 2013. Once the data has been submitted, CMS will aggregate manufacturer submissions at the individual physician and teaching hospital level, provide them with a 45-day period to confidentially review and, if necessary, correct the data, and make the data publicly available by Sep. 30, 2013.

CMS will accept comments on the proposed rule until Feb. 17, 2012, and will respond to them in a final rule to be published in 2012.

The proposed rule can be downloaded at:
https://s3.amazonaws.com/public-inspection.federalregister.gov/2011-32244.pdf

Source: CMS News Release