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Friday, March 26, 2010
HHS Adds to List of Data Breaches
Feds Award More MU Planning Grants
Six more states will receive matching federal planning funds to implement programs to administer Medicaid incentive payments for meaningful use of electronic health records, bringing the total to at least 16 states and the U.S. Virgin Islands.
The Centers for Medicare and Medicaid Services is awarding the funds, authorized under the American Recovery and Reinvestment Act. States with new grants include Colorado ($798,000), Mississippi ($1.47 million), Nevada ($1.05 million), North Carolina ($2.29 million), Utah ($396,000) and Wyoming ($596,000).
States and territories must submit plans for CMS approval before receiving matching funds. They will use the funds for such activities as analyzing the current status of health information technology, examining barriers to EHR adoption, establishing eligibility for incentives and creating a long-term state Medicaid HIT plan.
States that previously received funds include Alaska, California, Georgia, Iowa, Kentucky, Montana, New York, South Carolina, Texas and Wisconsin. More information is available at cms.hhs.gov/Recovery/11_HealthIT.asp#TopOfPage.
-- Joseph Goedert
HHS Adds to List of Data Breaches
The posting is mandated under the HHS breach notification rule that was authorized under the HITECH Act. Under the rule, notification within 60 days to HHS and the media is required when a breach affects more than 500 individuals. Smaller breaches must be annually reported to HHS. Business associates of HIPAA-covered entities must notify the affected covered entity of breaches.
The five new listings are:
* Montefiore Medical Center, New York, 625 affected individuals, theft of a laptop;
* Private Practice, San Antonio, 21,000 affected individuals, theft of a portable device;
* Thrivent Financial for Lutherans, Wisconsin, 9,500 affected individuals, theft of a laptop;
* Wyoming Department of Health, 9,023 affected individuals, unauthorized access of a network server; and
* Aspen Dental Care P.C., Colorado, 2,500 affected individuals, theft of an undisclosed nature.
Private practices are not individually identified in the listing, in compliance with the federal Privacy Act. HHS is working to permit the naming of private practices. The full list of large breaches, which the OCR will regularly update, is available at hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/postedbreaches.html.
--Joseph Goedert
NIST Readies EHR Testing
The National Institute of Standards and Technology has released the first of four installments, called Waves, of new test methods and related software for ensuring electronic health records systems comply with meaningful use requirements.
NIST, part of the Department of Commerce, is partnering with the Healthcare Information Technology Standards Panel and the Office of the National Coordinator for Health Information Technology on the initiative.
The test methods are procedures, data and tools to ensure compliance with the meaningful use technical requirements and standards as proposed in the interim final rule published on Jan. 13, 2010. These methods are subject to revision if changes are made to the interim final rule following the public comment period that ended on March 15.
The Waves are four sets of meaningful use criteria from the proposed rule published on Jan. 13, which is subject to change in a final rule expected in late spring.
The first Wave and its associated tools, now available, cover the following meaningful use criteria: Maintain up-to-date problem list, maintain active medication list, record and chart vital signs, smoking status, and computerized provider order entry. Draft test procedures on these criteria are available at http://healthcare.nist.gov/use_testing/under_development.html.
More information is available at http://healthcare.nist.gov. An overview of the test methods and the four Waves is available at http://healthcare.nist.gov/use_testing/index.html. The implementation support and testing Web site is at http://xreg2.nist.gov/hit-testing/.
Insurer Adds Breach Protection
The new service covers regulatory and liability claims arising from the theft, loss or accidental transmission of confidential patient or financial information, as well as the cost of data recovery. Members can add the coverage, called CyberGuard at no additional cost upon renewal of their policies.
CyberGuard covers costs associated with HIPAA or government investigations, fines, patient notification, and credit monitoring services for affected individuals, as well as Red Flag rule violations. Coverage includes online and offline information, virus attacks, identity theft and the costs of data recovery. The coverage pays up to $5,000 for data recovery costs, and up to $50,000 for patient notification and credit monitoring, network security and privacy, and regulatory costs. All coverage is subject to a maximum aggregate limit of liability of $50,000.
The Doctors Company instituted the coverage in response to customers' requests for assistance in handling information breaches, says Brendan Doherty, manager of marketing and public relations. More information is available at thedoctors.com/cyberguard.
-- Joseph Goedert
Thursday, March 25, 2010
Paper Studies Patient Consent for HIEs
A new white paper from George Washington University's Department of Health Policy examines whether, to what extent, and how patients should have the option to control the sharing of their health information in a health information exchange.
The paper, "Consumer Consent Options for Electronic Health Information Exchange: Policy Considerations and Analysis," is the first of a serious of privacy and security reports the university is doing under contract with the Office of the National Coordinator for Health Information Technology.
The paper examines five core options for consent: no consent, opt-out, opt-out with exceptions, opt-in and opt-in with restrictions.
"The consent model selected for electronic exchange, as well as the determination of which types of health information to exchange, affects many stakeholders (e.g., patients, providers and payers)," according to the paper. "These decisions also have consequences for national policy goals, such as improving the quality of healthcare, promoting public health, engaging patients in their health care, and ensuring the privacy and security of personal health information.
This discussion requires not only an appreciation of the sometimes competing interests of various stakeholders, but also consideration of the interests of the individual relative to those of society as a whole."
To access the white paper, click here.
Athenahealth Boosts Web Content
Watertown, Mass. based athenahealth Inc. has introduced new Web services integrated with its practice management and electronic health records software, which the vendor offers with its outsourced billing services to physician practices.
The athenaCommunicator platform includes automated phone calls and e-mails about appointment reminders, past due balance alerts, disease management programs, test results and other types of messages to patients.
The platform also includes a patient portal to schedule appointments, retrieve test results, view personal health information, update insurance and demographic information, view educational content, review financial statements, and make online payments.
More information is available at athenahealth.com.
--Joseph Goedert
Feds Want Input on HIT Strategic Plan
The HIT Policy Committee's Strategic Plan workgroup will hold a three-hour "listening session" to April 6 to get feedback on a draft update to the Federal Health IT Strategic Plan.
The update to a plan issued in 2008 is mandated under the HITECH Act. The new plan will focus on 2011 through 2015, but also lay the groundwork beyond 2015 to create a "learning health system" through effective use of health information technology.
The draft framework, session registration and agenda are available at http://healthit.hhs.gov/portal/server.pt?open=512&objID=1477&mode=2.
-- Joseph Goedert
Interface Engine Links Holland Apps
Holland Hospital, serving southwest Michigan, is implementing an interface engine enterprise-wide and also will use the technology link to electronic records systems at affiliated physician group practices.
The 209-bed facility is using the Ensemble platform of InterSystems Corp., Cambridge, Mass. The hospital so far has converted all legacy interfaces to the Ensemble platform, and has integrated the lab, radiology and other applications to the core hospital information system and billing systems.
There has been no unscheduled downtime as more projects are added to the platform, says Randy Paruch, director of information systems. More information is available at hollandhospital.org and intersystems.com.
--Joseph Goedert
Rule OKs E-Scripts for Controlled Rx
The Drug Enforcement Administration in the Department of Justice has published a long-delayed interim final rule, with a comment period, to permit electronic prescriptions for controlled substances.
The rule is available at the Federal Register's public inspection site at federalregister.gov/inspection.aspx, and will be officially published on March 31, effective 60 days later. The DEA will accept public comments during the 60-day interval.
Controlled substances are drugs that have the potential for abuse or dependence, including opiates, stimulants, depressants, hallucinogens and anabolic steroids. These drugs account for up to 20 percent of all prescriptions, according to various studies, which has forced providers that have adopted electronic prescribing to still maintain paper processes.
The rule will permit pharmacies to receive, dispense and archive electronic prescriptions for controlled substances. The regulations, according to DEA, are an addition to, not a replacement of, existing rules governing controlled substances.
"The regulations provide pharmacies, hospitals and practitioners with the ability to use modern technology for controlled substance prescriptions while maintaining the closed system of controls on controlled substances dispensing; additionally, the regulations will reduce paperwork for DEA registrants who dispense controlled substances and have the potential to reduce prescription forgery," according to the interim final rule. "The regulations will also have the potential to reduce the number of prescription errors caused by illegible handwriting and misunderstood oral prescriptions. Moreover, they will help both pharmacies and hospitals to integrate prescription records into other medical records more directly, which may increase efficiency, and potentially reduce the amount of time patients spend waiting to have their prescriptions filled."
It's these expected benefits that industry stakeholders, and a growing number of members of Congress, have been trying to convince DEA to appreciate for nearly a decade. The agency has considered such a rule since at least May 2001 when it issued an advanced notice of proposed rulemaking on the topic. But it wasn't until four years later than the DEA began to examine how to revise its rules to permit electronic prescriptions.
In December 2007, a 50-member coalition of stakeholders sent President Bush a letter asking for movement on the issue. "The country can no longer afford to have a two-tiered prescribing system," the letter stated. Nineteen U.S. Senators soon followed with their own letter. The agency finally published a proposed rule in June 2008, and 11 senators sent another letter in May 2009 asking for the final rule.
--Joseph Goedert
Wednesday, March 24, 2010
Report: hospitals and vendors, not government, will drive EHR usage
The federal government can encourage physicians to buy electronic health record (EHR) systems, but it is the vendors and hospitals that affiliate with doctors that ultimately will determine whether they adopt them, according to a new report from healthcare market research publisher Kalorama Information.
Vendor actions such as “stimulus guarantees,” in which a vendor assures a customer that the system will earn stimulus incentives from the Centers for Medicare and Medicaid Services, enhance the effects of government incentives, according to the report. Kalorama Information expects vendors to go further, offering aggressive financing and/or installment of the capital outlay, especially to attract small group practices.
Do Consumers Like HIEs?
The Office of the National Coordinator for Health Information Technology plans to survey more than 2,500 households across the nation to assess consumer attitudes toward health information exchanges.
ONC will conduct the survey using computer-assisted telephone interviews over an eight-week period. The office will prepare a draft report and conduct a Web seminar to discuss findings prior to publishing a final report at http://healthit.hhs.gov.
The survey "will permit us to better understand individuals' attitudes toward electronic health exchange and its associated privacy and security aspects as well as inform policy and programmatic objectives," according to an ONC notice published in the Federal Register.
--Joseph Goedert
Commentary: Your Plate Just Spilled Over
In public comments to federal officials about the proposed meaningful use criteria, one message came through loud and clear: "We already have a lot of regulatory deadlines on our plate and the meaningful use criteria are too much, too soon."
Well, your plate just got fuller. Assuming the Senate holds its end of the bargain, President Obama within days will sign health reform legislation into law. And that law will have a lot of new electronic data interchange/transactions processing mandates imposed on the health care industry with the first deadlines only three years away (see story).
On the surface, the EDI mandates are good for the industry, and especially good for providers who should see improvements in their revenue cycle management processes. Providers will have a much better idea at the point of service of how much insurance will pay and how much the patient will owe. Providers, ideally, will experience fewer denied or pended claims because they thoughtlessly forgot how each of the dozens or hundreds of payers they deal with like their transactions to be sent to them.
The EDI mandates in the reform bill are designed to, finally, make the HIPAA transaction standards far more standardized. They also will add new transactions, such as electronic funds transfer and claims attachments, as well as a unique health plan identifier. The mandates require consensus-based "operating rules" be adopted for each HIPAA transaction to make the movement of electronic claims and related transactions as easy as ATM transactions. Payer advocacy organization CAQH has championed these operating rules and has prodded industry stakeholders to negotiate and develop them to make transactions more uniform.
In theory, that means you'll fill out and send your claims, eligibility and claims status inquiries, authorizations and other transactions to Aetna the same way you send them to Cigna, UnitedHealthcare, the Blues and everyone else. And the payers will send their responses back in a uniform manner. And who owes what and when it will be paid will be far more clearer than today. And you'll save money by having fewer employees spend large parts of their day on the phone, on hold, waiting to talk to insurers. And more claims will get adjudicated on the first pass through payer systems, improving your cash flow. And auto-posting of payments to patient accounts will be a breeze.
But many providers may view the deadlines for all this nifty administrative simplification stuff to be as unrealistic as they viewed the meaningful use deadlines.
The reform bill calls for a unique health plan identifier by October 2012; and operating rules in place for eligibility and claim status transactions by January 2013; EFT and payment/remittance advice transactions by January 2014; and claims/encounters, enrollment/disenrollment, premium payment, referral certification/authorization and attachments transactions by January 2016.
That means that by the time HIPAA 5010 transactions go into effect in January 2012, work will be well underway to significantly change those transactions--and add new transactions--within just a few years.
And that also means all this transactions/operating rules developing, building, testing and implementation will come during the same time providers are handling ICD-10, Red Flag, and meaningful use requirements.
If that doesn't seem realistic, then the transactions timetables must be extended and that means getting amendments approved to a health care reform bill that just passed after decades of trying. That won't be easy. Still, maybe the 5010 transactions shouldn't go into effect in January 2012 as scheduled. But that argument can't be made to policymakers until it is clear how a delay in 5010 would affect ICD-10's deadline of October 2013--and the degree to which a 5010 delay would impact the industry migration to ICD-10.
Regardless, it won't take long for the ink to dry once President Obama signs the reform legislation, and that's when a new round of questions will arise.
--Joseph Goedert
KLAS Grades Consultants
The Orem, Utah-based company surveyed 350 providers for the report, "Getting to Stimulus Funding: Which Consultants Can Help?" Larger, full-service firms often act as the lead for major implementations, including CPOE, while smaller firms play supporting roles for smaller projects.
Three full-service firms, Affiliated Computer Services, CTG and Deloitte, virtually tied for the lead in client satisfaction, "scoring a full 10 points above the next closest firm, Accenture, which is a significant performance gap," according to KLAS.
Two firms that scored high in past surveys, Computer Sciences Corp. and IBM Corp., have fallen significantly, the report notes. "Neither firm has been able to maintain the high customer ratings once enjoyed by the healthcare focused consultancies Healthlink (acquired by IBM in 2005) and First Consulting Group (acquired by CSC in 2007)."
Several smaller firms have shown solid performance working in supportive roles or focusing on a particular vendor or product, according to the report. These include maxIT Healthcare, Vitalize Consulting Solutions, Costal Healthcare Consulting, Ingenix, Innovative Healthcare Solutions and Peer Consulting.
The report is available for purchase at klasresearch.com.
--Joseph Goedert
Unibased Teams with U.S. Bank
Healthcare Payment Management is a Web-based application enabling a provider to process payments and enroll patients in a financing program. The product also enables patients to pay online via Unibased Systems' consumer portal.
More information is available at unibased.com and usbank.com.
--Joseph Goedert
ISO Reports Cover Patient Archives
The International Organization for Standardization has published two documents that provide internationally harmonized guidelines for archiving patient information.
The technical specification document, ISO/TS 21547:2010, Health informatics-Security requirements for archiving of electronic health records-Principles, addresses a process covering records maintenance, retention, disclosure and eventual destruction.
Guidelines for implementing these principles are included in a technical report, ISO/TR21548:2010, Health informatics-Security requirements for archiving of electronic health records-Guidelines. In addition to guidelines, the report offers a practical method and tools for the development and management of eArchives.
The documents address electronic health integrity, ethical and legal concerns, privacy protection, and regulations covering access and disclosure of records. They also cover emerging trends, such as patients actively participating in their health care and the data that must be available to them.
More information is available at iso.org/iso/catalogue_detail?csnumber=44479 and iso.org/iso/iso_catalogue/catalogue_tc/catalogue_detail.htm?csnumber=44480.
--Joseph Goedert
Weight Scale Links to HealthVault
France-based Withings, which sells a body scale with built-in Wi-Fi connectivity, has integrated the product with Microsoft Corp.'s HealthVault consumer portal.
The integration enables consumers using the scale to upload weight, lean and fat mass, and body mass index data to their HealthVault personal health record. The scale can track up to eight users. Its cost is $159.
More information is available at withings.com and healthvault.com.
--Joseph Goederta
Study: e-Commerce Full Value Elusive
A new study from the HIMSS Analytics research unit of the Healthcare Information and Management Systems Society shows many hospitals use electronic commerce in their purchasing process but have a ways to go before getting full value from e-commerce.
The Chicago-based firm surveyed 199 hospital purchasing officers for the study, which Louisville, Colo.-based e-commerce vendor GHX sponsored. Results show that 95 percent of acute care facilities with more than 150 beds electronically order at least some medical-surgical supplies.
About one-third of responding hospitals use an exchange service as their sole method for ordering medical-surgical supplies electronically, with 15 percent using direct electronic data interchange connections. Thirteen percent use both ways.
Sixty two percent of respondents receive updated pricing catalogs for products under contract electronically, but only about half of those receive the catalogs via EDI.
Respondents identify a number of issues related to e-commerce that need improvements. These include processing invoices, real-time discrepancy reporting and exception management. They also report considerable supplier reluctance or incapability to conduct business via EDI.
To access the study, click here.
--Joseph Goedert
Seminar to Detail CONNECT HIE App
The Office of the National Coordinator for Health Information Technology will host a Web seminar on March 25 to explain new features in version 2.4 of the CONNECT integration software.
The software was developed by several organizations under a federal contract, and is designed to ease connecting to the emerging national health information network. New features include the ability to "push" data for a given patient from one health information exchange to another; and support for service registries, certificate revocation lists and certificate authorities, among other features.
The two-hour Web seminar on March 25 is scheduled for 2 p.m. Eastern Time. For more information, click here.
--Joseph Goedert
Ingenix Enhances Outcomes Services
Eden Prairie, Minn.-based Ingenix, the health information technology unit of UnitedHealth Group, has acquired QualityMetric Inc., a health outcomes measurement vendor. Terms of the acquisition were not disclosed.
Lincoln, R.I.-based QualityMetric develops patient-reported outcomes surveys to measure the effectiveness of multiple programs, and software to analyze and score results. These programs include clinical trials, disease management, clinical improvement, pharmaceutical marketing, risk prediction, population monitoring and patient satisfaction, among others.
QualityMetric's surveys have been used in thousands of clinical trials and cited in more than 14,000 peer-reviewed articles, according to the companies. The acquisition will complement the work of Ingenix's Lewin Group Center for Comparative Effectiveness Research. The buy also will expand Ingenix's services to the life sciences, government, health system, insurer and consumer markets.
The American Recovery and Reinvestment Act appropriated $1.1 billion for comparative effectiveness research to assess the strengths and weaknesses of various medical treatments. More information on QualityMetric is available at qualitymetric.com.
--Joseph Goedert
GE Buy Targets Small Practices
GE Healthcare has acquired MedPlexus Inc., a vendor of software for small, independent physician practices, for an undisclosed sum.
The acquisition expands GE's initiative to target independent practices, which are a primary focus of the economic stimulus package's incentive payments for meaningful use of electronic health records.
Sunnyvale, Calif.-based MedPlexus generally targets practices with 10 or fewer physicians. It offers integrated practice management, electronic records and patient portal software. The applications can be sold as a package or individually, and hosted by the vendor or the client. The acquisition gives GE remote hosting capability for smaller practices.
GE declined to disclose the number of customers MedPlexus serves but acknowledges the installed base is small. "We've acquired them because of their targeted services in a strategic market we were already working in and believe their portfolio will only serve to accelerate our growth in that area," according to a spokesperson.
MedPlexus has about 100 employees in its Sunnyvale office and a development facility in Hyderabad, India.
--Joseph Goedert
Monday, March 22, 2010
Financing News Pulse: National Edition
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