HHS has allocated an initial $50 million to be invested in establishing the national Health IT Research Center (HITRC). The HITRC will gather relevant information on effective practices from a wide variety of sources across the country and help the Regional Extension Centers (RECs) collaborate with one another and with relevant stakeholders to identify and share best practices in EHR adoption, effective use, and provider support. The HITRC will build a virtual community of shared learning to advance best practices that support providers’ adoption and meaningful use of EHRs. I imagine this is going to use kind kind of social media component that will allow real time collaboration.
The legislation states the HITRC will assemble and disseminate materials to support and address the needs of all prioritized providers, including but not limited to materials addressing the unique needs of providers serving Native Americans, persons with limited proficiency in the English language, persons with disabilities, and other historically underserved populations, as well as those that serve patients with maternal, child, and behavioral health needs. But interpretation of exactly what defines "historically underserved populations" is vague. I hope that rural communities are prioritized because that seems to me to be an area of great need.
The first awards for the RECs have been announced and they are beginning to ramp up. The RECs will become members of a consortium that will be coordinated and facilitated by the HITRC. Research and analysis of best practices regarding health IT utilization rests primarily with the HITRC, dissemination and implementation of those best practices learned from the HITRC will rest with the regional centers.
Federal CTO Aneesh Chopra announced on the FACA Blog that on March 8, 2010 the Implementation Workgroup of the Health IT Standards Committee will hold a public hearing on “Implementation Starter Kit: Lessons and Resources to Accelerate Adoption” to help providers achieve meaningful use by, in part, surfacing examples of effective meaningful use implementation preparation. He is asking us to post questions and comments about implementation opportunities and challenges we are facing today and for which we would either like to share or would welcome support. Unfortunately the response so far has been underwhelming. I would encourage everyone to consider posting some real life examples so we are not operating in a theoretical world but with actual experiences to develop best practices.
Considering the timing of the needs for the HITRC to develop best practices and this upcoming Implementation Workgroup meeting, I imagine that these stories could become templates that would be used to create effective adoption and implementation strategies. Every EHR implementation has a story to tell - it may be a wonderful example, or it could be a terrible warning. But now is the time to make your voice heard.
Saturday, February 20, 2010
Thursday, February 18, 2010
Physician Office Usage of Electronic Healthcare Records Software
EHR adoption rate in U.S. physician practices is 36.1 percent, a 3.2 percent increase over one year ago, according to a report from health IT company SK&A, a Cegedim company.
From their press release:
As healthcare providers make preparations to implement EHR solutions and qualify for federal incentives outlined in the American Recovery and Reinvestment Act of 2009, SK&A, A Cegedim Company, today released its updated "Physician Office Usage of Electronic Healthcare Records Software" report, which shows a 36.1% EHR adoption rate in U.S. medical offices -- a 3.2% increase since the February 2009 version of the study.
Like its predecessor study, the latest report identifies physician adoption rates by office size, practice size, practice specialties, patient volume, ownership, geography and other variables. This updated study also measures the level of software functionality available to and being utilized by physicians in medical offices to support the government's newly defined "meaningful use" criteria.
SK&A's study, which was based on completed telephone surveys with 180,000 U.S. physician offices, shows that 36.1% of physician offices are using EHR systems -- a 3.2% increase in usage since the 2009 report's adoption rate of 32.9%. Trends from the study show:
-- Physicians primarily use EHR systems for electronic notes (28.3%), as opposed to electronic labs/x-rays and electronic prescribing.
-- EHR adoption rates increase as the number of physicians, number of exam rooms and daily patient volume rise.
-- EHR adoption is more prevalent in hospital- or health system-owned sites. Hospital-owned and health-system-owned sites have adoption rates of 44.1% and 50.2%, respectively. On the contrary, non-hospital-owned and non-health-system-owned sites have adoption rates of 34.4% and 34.2%, respectively.
-- The specialty areas with the highest adoption rates include dialysis, critical care medicine and radiology. Those specialties with the lowest adoption rates include allergy/immunology, general surgery and general practice.
Editor's Note: For a copy of the summary findings for publication, please contact Jack Schember, SK&A Vice President of Marketing, at 800-752-5478, ext. 1259.
via skainfo.com
From their press release:
As healthcare providers make preparations to implement EHR solutions and qualify for federal incentives outlined in the American Recovery and Reinvestment Act of 2009, SK&A, A Cegedim Company, today released its updated "Physician Office Usage of Electronic Healthcare Records Software" report, which shows a 36.1% EHR adoption rate in U.S. medical offices -- a 3.2% increase since the February 2009 version of the study.
Like its predecessor study, the latest report identifies physician adoption rates by office size, practice size, practice specialties, patient volume, ownership, geography and other variables. This updated study also measures the level of software functionality available to and being utilized by physicians in medical offices to support the government's newly defined "meaningful use" criteria.
SK&A's study, which was based on completed telephone surveys with 180,000 U.S. physician offices, shows that 36.1% of physician offices are using EHR systems -- a 3.2% increase in usage since the 2009 report's adoption rate of 32.9%. Trends from the study show:
-- Physicians primarily use EHR systems for electronic notes (28.3%), as opposed to electronic labs/x-rays and electronic prescribing.
-- EHR adoption rates increase as the number of physicians, number of exam rooms and daily patient volume rise.
-- EHR adoption is more prevalent in hospital- or health system-owned sites. Hospital-owned and health-system-owned sites have adoption rates of 44.1% and 50.2%, respectively. On the contrary, non-hospital-owned and non-health-system-owned sites have adoption rates of 34.4% and 34.2%, respectively.
-- The specialty areas with the highest adoption rates include dialysis, critical care medicine and radiology. Those specialties with the lowest adoption rates include allergy/immunology, general surgery and general practice.
Editor's Note: For a copy of the summary findings for publication, please contact Jack Schember, SK&A Vice President of Marketing, at 800-752-5478, ext. 1259.
via skainfo.com
2-17 HIT Policy Committee
The HIT Policy Committee gathered for its second meeting of the year on February 17th in Washington, DC. The majority of the meeting time was dedicated to discussing recommendations of the Meaningful Use Notice of Proposed Rulemaking (NPRM) and Standards and Certification Interim Final Rule (IFR). Four Committee workgroups presented recommendations for the existing criteria, to better enable the electronic health records (EHR) incentive program to achieve its objectives and facilitate progress toward the ultimate goal of improving health and health care of all Americans.
The Meaningful Use Workgroup began by laying out a series of 12 recommendations, including proposals to make progress note documentation a part of the Stage 1 meaningful use definition and to allow eligible providers a certain degree of flexibility in meeting the meaningful use criteria. Next, the Adoption/Certification Workgroup presented comments on eligible provider reporting metrics and interoperability standards. Both the Adoption/Certification and the Health Information Exchange workgroups put forward recommendations regarding the laboratory portions of the NPRM and IFR. Finally, the Privacy and Security Policy Workgroup proposed ways to strengthen existing meaningful use and certification criteria relevant to privacy and security, as well as concerns and future policy and standards priorities.
Following dialogue about the NPRM and IFR, the HIT Policy Committee shifted attention to its effort in creating a set of recommendations for the Nationwide Health Information Network (NHIN). The NHIN Workgroup focused the meeting’s discussion on the role of enabling organizations and associated functions and services, encompassing a minimal core set of services and functions needed to support standards-based interoperability along with further services to support additional interoperability at scale.
The last segment of the meeting was devoted to reviewing the framework for the Federal Health IT Strategic Plan. The Strategic Planning Workgroup outlined the framework’s vision and four key themes, which center around meaningful use, development and support of a policy and technical infrastructure, incorporation of privacy and security solutions into every phase of health IT adoption and use, and transformation of the current healthcare delivery system into a learning health system.
The meeting materials from the meeting are below. Here is the audio:
Download
via healthit.hhs.gov
The Meaningful Use Workgroup began by laying out a series of 12 recommendations, including proposals to make progress note documentation a part of the Stage 1 meaningful use definition and to allow eligible providers a certain degree of flexibility in meeting the meaningful use criteria. Next, the Adoption/Certification Workgroup presented comments on eligible provider reporting metrics and interoperability standards. Both the Adoption/Certification and the Health Information Exchange workgroups put forward recommendations regarding the laboratory portions of the NPRM and IFR. Finally, the Privacy and Security Policy Workgroup proposed ways to strengthen existing meaningful use and certification criteria relevant to privacy and security, as well as concerns and future policy and standards priorities.
Following dialogue about the NPRM and IFR, the HIT Policy Committee shifted attention to its effort in creating a set of recommendations for the Nationwide Health Information Network (NHIN). The NHIN Workgroup focused the meeting’s discussion on the role of enabling organizations and associated functions and services, encompassing a minimal core set of services and functions needed to support standards-based interoperability along with further services to support additional interoperability at scale.
The last segment of the meeting was devoted to reviewing the framework for the Federal Health IT Strategic Plan. The Strategic Planning Workgroup outlined the framework’s vision and four key themes, which center around meaningful use, development and support of a policy and technical infrastructure, incorporation of privacy and security solutions into every phase of health IT adoption and use, and transformation of the current healthcare delivery system into a learning health system.
The meeting materials from the meeting are below. Here is the audio:
Download
- Agenda
- Meaningful Use Workgroup: Comments & Discussion on the NPRM
- Adoption/Certification Workgroup: Comments & Discussion on the NPRM and IFR on Certification Criteria
- Information Exchange Workgroup: Comments & Discussion on Health Information Exchange in the NPRM
- Privacy & Security Policy Workgroup: Comments & Discussion on the Privacy & Security Objective in the NPRM
- NHIN Workgroup Recommendations
- Update: Strategic Plan Workgroup
via healthit.hhs.gov
Who's Who at the ONC
I have been generally very impressed with the efforts at implementation of government 2.0 principles, but here is one area where there needs much greater transparency at the Office of the National Coordinator and this in listing their staff and contractors. To avoid the impression that identities of personnel and contractors are being withheld from the public to prevent the public from knowing who they are and what their past and present affiliations might be, the ONC should immediately release contact information and titles for all the staff. (Update 5/28/10 - much of this information has now been released).
HHS does have a listing of public employees. Unfortunately the ONC is not in this list. However, doing some creative searching I was able to create the following list with active links to their contact information pages. But, alas many of the titles are blank, much of the data are outdated, and there seems to still be some missing data.
I am very pleased with the additional information that is being provided on the ONC web site ~ Things are continuing to improve and I have updated the contact information below (updated 10/1/2010)
Federal Register Notice: December 1, 2009
Organization, Functions, and Delegations of Authority; Office of the National Coordinator for Health Information Technology
Below are listed responsibilities for each office:
The Office of the Deputy National Coordinator for Programs and Policy assumes functions previously performed by the Office of Health Information Technology Adoption, the Office of Interoperability and Standards, the Office of Adoption Provider Support, the Office of State and Community Programs, and the Office of Policy and Planning. The new office will lead ONC programs related to health information exchange, regional extension centers, training of the health IT workforce, and the development of technical standards for interoperability, security, and certification of health IT systems. The new office comprises:
HHS does have a listing of public employees. Unfortunately the ONC is not in this list. However, doing some creative searching I was able to create the following list with active links to their contact information pages. But, alas many of the titles are blank, much of the data are outdated, and there seems to still be some missing data.
| Last name | First name | Job title |
| Alvarez | Juan | |
| Andriesen | Brett | |
| Anozie | Emily | Administrative Assistant |
| Anthony | Elise | Policy Advisor |
| Arbogast | Carol | Director Human Resources |
| Ashkenaz | Peter | |
| Baker | Alexander | Project Officer |
| Barnes | Michelle | Administrative Assistant |
| Becker | Targi | Management Analyst |
| Black | Erin | |
| Bonner | Tiffany | Intern |
| Boone | Edna | Contractor |
| Borja | Tom | |
| Brooks | Aja | Policy Analyst |
| Brown | Jennifer | |
| Buchele | Libbie | |
| Bundy | Yvette | Management Analyst |
| Butler | Tiffany | |
| Cao | Yolanda | |
| Caton-Peters | Helen | Information Technology Specialist |
| Celentano | Kristina | |
| Chambers | Cortney | Program Analyst |
| Chaput | Daniel | Public Health Analyst |
| Charles | Dustin | |
| Chikatla | Ruhana | Executive Assistant |
| Choi | Christy | |
| Choi | Mera | Program Analyst |
| Chrapaty | Kevin | Contractor |
| Clark | Asara | Program Analyst |
| Colby-Elborn | Sharon | |
| Consolazio | Michelle | Program Analyst |
| Constant | Monifa | |
| Costa | Bianca | |
| Costa | Catherine | Innovator In Resisdence |
| Coughlin | Brett | Communications Specialist |
| Coy | Caroline | Presidential Management Fellow |
| Cramer | Jennifer | |
| Cronin | Kelly | Director Office of Programs and Coordination |
| Dandashi | Fatma | Contractor |
| Daniel | James | |
| Daniel | Jodi | Director of Policy and Research |
| Darbouze | Farrah | |
| Davis | Seon | Program Analyst |
| Day | Chartese | Supervisory Communication Manager |
| Day | Wes | |
| Dean | Kevin | |
| DeSalvo | Karen | National Coordinator |
| Digiacomo | Nicholas | Project Coordinator |
| Eckerman | Ivy | |
| Erickson | Christina | |
| Fowler | Crystal | Program Coordinator |
| Frazier | Jennifer | |
| Frazier | Pavla | Nurse consultant |
| Gabriel | Meghan | |
| Galvez | Erica | |
| Gettinger | Andrew | IPA |
| Ghebresillassie | Lisa | |
| Govan-Jenkins | Wanda | |
| Gray | Aaron | |
| Halloun | Carmel | |
| Hammond-Hatcher | Deone | |
| Haque | Ahmed | Director Office of Programs and Engagement |
| Haynes (Harris) | Yvette | |
| Hedgepeth | Blair | Legislative Liason |
| Heintzman | Elizabeth | Intern |
| Heisey-Grove | Dawn | |
| Himelright | Michele | Supervisory CAM (Acting) |
| Hogan | Michelle | Financial Analyst |
| Hollin | Ilene | Student Trainee |
| Holloway | Jason | |
| Hopewell | D'Lisa | |
| Hua | Jiuyi | IT Specialist |
| Hughes | Penelope | Intern |
| Hunt | David | Medical Officer |
| Ihlenfeld | Matthew | |
| Jain | Trishla | Intern |
| Jessup | Larry | |
| Johnson | Janelle | Intern |
| Johnson | Patricia | Executive Assistant |
| Jones | Jerome | Financial Analyst |
| Jones | Michael | Contractor |
| Justus | Ralph | |
| Kalbfleisch | Gail | Director FHA |
| Keesey | Peter | |
| Kendrick | David | Principal Investigator |
| Kenyon | Kathy | |
| Khan | Kashif | Project Manager |
| Khetan | Vanitha | Contractor |
| Kilgore | Wendy | |
| Klintworth | Paul | |
| Krishnamoorthy | Sathiyanarayanan | |
| Lamadine | Beh | Administrative Assistant |
| Larsen | Kevin | |
| Larson | Eric | |
| Lazzaro | Victor | |
| Leavelle | Cannon | Program Analyst |
| Lehrer | Evan | Intern |
| Lewis | Lisa | |
| Lipinski | Michael | Policy Analyst |
| Livingston | Ebony | Financial Analyst |
| Lueck | Greg | |
| Mactaggart | Patricia | IPA |
| Madlansacay | Cheryl | |
| Makar | Ellen | Program Analyst |
| Marchesini | Kathryn | |
| Marks | LaShawn | Management Analyst |
| Marshall | Carmelita | Summer Intern |
| Meklir | Samantha | Senior Policy Advisor |
| Mertz | Kory | Program Manager |
| Metcalf | John | Contractor |
| Meter | Erin | |
| Mock | Tracey | Program Manager |
| Mohla | Chitra | Management & Program Analyst |
| Monterastelli | Mark | External Entrepreneur |
| Moore | Mary | Executive Assistant |
| Moriarty | Lana | Director |
| Morrison | Michael | |
| Morton | Alicia | Director Health IT Certification Program |
| Muir | Christopher | Senior Program Analyst |
| Murphy | Judy | |
| Murray | Michelle | Program Analyst |
| Nelson | Rachel | Special Assistant to Deputy Nat'l Coordinator for HIT |
| Nguyen | Ngoc | Senior Developer |
| Norman | John | Program Officer |
| O'rourke | Lena | Contractor |
| Palena Hall | Elizabeth | |
| Patel | Vaishali | |
| Pazinski | Seth | Division Director Planning and Operations |
| Perlie | Laverne | Nurse Consultant |
| Perry | Cynthia | |
| Pinkney | Rudette | |
| Porotesano | Charity | Truman-Albright Fellow |
| Posnack | Steven | Policy Analyst |
| Prendergast | Erin | Intern |
| Pretto | Marissa | |
| Purnell-Saunders | Scott | Program Analyst |
| Rahn | Matthew | Program Analyst |
| Ramsey | Arlene | |
| Ramsey | Jamil | Contractor |
| Rancourt | John | Program Analyst |
| Reed | Cinyon | |
| Rego | Susette | Project Manager |
| Reider | Jacob | Director Chief Medical Officer |
| Reyes | Natalie | |
| Richie | Lauren | Public Health Analyst |
| Roberts | Vernette | |
| Ryan | Caitlin | Business Administrator |
| Samy | Leila | |
| Sarnowski | Lisa-Nicole | |
| Savage | Lucia | Chief Privacy Officer |
| Savoy | Kimberly | |
| Searcy | Talisha | Supervisory Social Scientist |
| Shanbhag | Krishnakant | |
| Shelton | Leo | Program Analyst |
| Shevlin | David | Junior Analyst |
| Shimabukuro | John | |
| Shkarovsky | Gerald | Program Management Office Functional Analyst |
| Showen | Kristin | Intern |
| Siminerio | Erin | Policy Analyst |
| Skipper | Jamie | |
| Stevens | Lee | Senior Program Analyst |
| Styma | Amy | Program Analyst |
| Swain | Matthew | |
| Szemraj | Nancy | Program Analyst OPC |
| Tate | Algeria | |
| Tavernia | Kimberly | |
| Taylor | Tevon | |
| Thomas | Alice | Contractor |
| Thomas | Vincent | IT Desktop Support Analyst |
| Thompson | Lauren | FHA Program Lead |
| Thompson-Teagle | Yolonda | Grants Management Specialist |
| Todd | Nickol | |
| Tomlinson | Andrew | Grants Management Specialist |
| Toro | Cameline | Policy Analyst |
| Townsend | Sonya | Administrative Assistant |
| Tumati | Bheeshma | Contractor |
| Tuten | Paul | |
| Wagner | Steven | |
| Walters | Acheeria | Briefings and Logistics Analyst |
| Wanis | Maggie | Program Analyst |
| Warner | Keviar | Contract Specialist |
| Wesley | Ellen | |
| White | Jon | Acting Director OCQS |
| Wiggins | Davina | Contactor |
| Wilburg | Seon | Management Analyst |
| Wilkins | Tricia | Project Officer |
| Williams | Claudia | |
| Wilson | Douglas | Contractor |
| Wilson | Ryan | Contractor |
| Wittie | Michael | Program Analyst |
| Wong | Adam | |
| Woodhead | Amanda | Sr. Stakeholder Outreach Coordinator |
| Wu | Lauren | Policy Analyst |
| Wyatt | Gretchen | Policy Analyst |
| Yuan Yuan | Zhang | Web Producer |
Federal Register Notice: December 1, 2009
Organization, Functions, and Delegations of Authority; Office of the National Coordinator for Health Information Technology
Below are listed responsibilities for each office:
Office of the National Coordinator: Organization
Description of Organizational Structure and Offices
The Office of the National Coordinator for Health Information Technology (ONC) is directed by the National Coordinator and is assisted by the Deputy National Coordinator for Operations, the Deputy National Coordinator for Programs & Policy, the Chief Scientist, the Chief Privacy Officer, and the Office of Economic Modeling and Analysis.
Within the Deputy National Coordinator for Operations are: the Office of Communications; the Office of Oversight; the Office of Mission Support; and, the Office of Strategic Initiatives.
Within the Deputy National Coordinator for Programs & Policy are: the Office of Policy and Planning; the Office of Standards and Interoperability; the Office of Provider Adoption Support; and, the Office of State and Community Programs.
The Office of the Deputy National Coordinator for Programs and Policy assumes functions previously performed by the Office of Health Information Technology Adoption, the Office of Interoperability and Standards, the Office of Adoption Provider Support, the Office of State and Community Programs, and the Office of Policy and Planning. The new office will lead ONC programs related to health information exchange, regional extension centers, training of the health IT workforce, and the development of technical standards for interoperability, security, and certification of health IT systems. The new office comprises:
- The Office of Standards and Interoperability, with responsibility for standards, security, certification, the Nationwide Health Information Network, Federal Health Architecture and the CONNECT program;
- The Office of Provider Adoption Support, which administers the Regional Extension Centers program and health IT workforce development;
- The Office of State and Community Programs, which administers the state-level health information exchange program and the Beacon Communities Program; and
- The Office of Policy and Planning, which is realigned to include all policy development, including privacy and security policy, and is liaison with legal affairs and legislative affairs, regulations development and externally focused strategic planning.
- The Office of Communications, which is responsible for stakeholder communications and constituency relations;
- The Office of Mission Support, which supports day-to-day operations, including new grants processing, contracts management, budget execution and reporting, and human resources;
- The Office of Oversight, which assures oversight of grants, internal and external performance reporting, and auditing; and
- The Office of Strategic Initiatives to oversee internal strategic planning, special projects, and budget formulation.
The Office of the Chief Scientist is responsible for research and for identifying innovations in information technology that can be applied in health care settings, and which will be the ONC interface for international activities.
The Office of the Chief Privacy Officer, a position mandated by the Recovery Act, advises on privacy, security, and data stewardship of electronic health information and coordinate ONC’s privacy and related efforts with similar privacy officers in other Federal agencies, State and regional agencies, and foreign countries.
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