SMARTDC Monthly Newsletter- A Timely Summary of Your IT News

Farzad Mostashari, MD, the ONC Director, stated during his address to this week's MGMA Conference in Las Vegas that “it's never going to be an easier time than now to adopt an electronic health record, meet meaningful use guidelines and move toward an ACO”. He also shared how much the EHR has changed in a positive way since its infancy many years ago, from “just little notes to a tool for care coordination”. He said he predicts to see the rate of adoption among physician practices to top 40 percent this year and 50 percent next year. Adopting EHRs, he said, will enable physician practices to develop the “information foundation” to coordinated care and demonstrate meaningful use.

CMS Issues Final Rule for ACOs, Relaxes Health IT Requirements

On Thursday, CMS released its final rule on Medicare accountable care organizations and removed a requirement that at least 50% of ACO physicians achieve meaningful use of electronic health records.

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments. Under the federal health reform law, the ACO program offers incentives for groups of medical professionals who provide every aspect of patients' care. If ACOs are able to reduce costs, CMS will reward the providers with a portion of the savings. The agency expects the program to help Medicare reduce costs by as much as $940 million over four years.

The final rule does not include the requirement that 50% of participating physicians achieve meaningful use. The rule does retain EHR use as a quality measure and weights it higher than any other measure for quality reporting purposes. In addition, the rule states that ACO participants can use survey, claims and administrative information to report quality measures instead of EHRs. Participants also can use a Web-based group practice reporting option for submission of quality measures. The final rule also reduced from 65 to 33 the number of quality measures CMS will use to gauge performance.

HHS also launched a complementary program called the Advance Payment Model that will experiment with whether prepaying a portion of potential future savings will encourage ACO participation and whether advance payments will help providers improve care and reduce costs more quickly.

The final rule also:

Eliminates the practice of barring ACOs with net losses from continued participation in the program, if the ACOs meet all other requirements; assigns patients to ACOs up front rather than retrospectively; and allows ACOs to share on all savings earned after qualifying by earning a minimum savings rate, rather than allowing them to share in all savings after reducing costs by 2%.

RelayHealth's PHR wins Blue Button contest

By Molly Merrill, Associate Editor , Created 10/25/2011

WASHINGTON – RelayHealth, McKesson's connectivity business, has been awarded a $50,000 prize as the winner of the VA's "Blue Button for All Americans" personal health record contest. RelayHealth, an Atlanta-based provider of information exchange services, said that in order to win the prize, the company had to show that it had upgraded its PHR to use Blue Button technology, and at least 25,000 of its physicians offered the new Blue Button functions to their patients.

"RelayHealth has always offered one-click download of the continuity of care document (CCD) and is proud to support the Blue Button initiative," said Jim Bodenbender, president, RelayHealth Connectivity Solutions. "By allowing patients – including veterans and active-duty service members – to easily access their healthcare information, the initiative will increase patients' ability to actively engage in managing their own healthcare."

Blue Button personal health records allow patients to see, download and keep their health data by clicking the "Blue Button" on a secure Internet site. Patients can then choose to share their data with their physicians or family members or make it available if emergency treatment is needed. Blue Button downloads are delivered in text files that can be downloaded, read, stored and printed on any computer without special software. Patients can also authorize use of a Blue Button transfer of their medical data from a treating physician to another medical provider.

A recent study by New York-based Manhattan Research found that 56 million Americans have accessed their health information on electronic systems maintained by their physicians – and 41 million more are interested in doing so.

"This contest proves that patient-controlled PHRs using the Blue Button can be simple, secure and inexpensive," said Peter L. Levin, VA's chief technology officer. "It also proves that through collaborations like this, the government and private-sector organizations like RelayHealth can make healthcare information exchanges part of the mainstream of American medicine."

EHR Market To Reach $6.5 Billion By 2012

Hospital EHR adoption is expected to expand significantly as advanced systems are implemented to meet Meaningful Use criteria, a Frost & Sullivan study says.

By Nicole Lewis,  InformationWeek 
October 21, 2011
URL: http://www.informationweek.com/news/healthcare/EMR/231901445

Total market revenue for electronic health records (EHRs) is expected to hit $6.5 billion in 2012, which is more than a sixfold increase from the $973.2 million posted in 2009, a study from Frost & Sullivan predicts. The rise in EHR revenues is primarily due to new licensing and upgrades as hospitals get their EHR systems ready to meet Meaningful Use requirements.

The new report, U.S. Hospital EHR Market, 2009-2016: Charting the Course for Dramatic Change , found that today's IT infrastructure at many hospitals is very different from 2009 when approximately 12% of hospitals were using what could be considered either a basic or advanced EHR, and only 2% of those hospitals were using EHRs in a way that would qualify for Meaningful Use.

"Sales of EHR systems doubled from 2009 to 2010 so you can really say that that was a direct impact of the HITECH Act ," Nancy Fabozzi, industry analyst at Frost & Sullivan, told InformationWeek Healthcare. "There was such a low baseline to move up from and everyone I talked to said there is an almost singular focus in hospitals today in terms of purchasing EHRs and getting that functionality to be able to meet Meaningful Use."

Fabozzi, who is also the report's author, said she relied on existing research and spoke with key market participants such as technology vendors, healthcare CIOs, and payers to develop its findings. She said key executives stressed the importance of the Medicare and Medicaid EHR Incentive Programs , saying that for many hospitals EHR incentive payments are worth millions of dollars, which is money that these organizations can't afford to leave on the table. Hospitals are also very aware of the penalties they will face if they don't implement EHRs after 2015.

Fabozzi also pointed to other factors that are encouraging EHR adoption, including the role that computerized patient information plays in advancing the practice of evidence-based medicine and comparative effectiveness research. And then there are Accountable Care Organizations (ACOs), which require data analytics to verify quality and cost performance, and health insurers who want to collect more data about the process of care and care outcomes.

In recent years, clinicians have also embraced mobile devices that connect with EHRs, providing a new method of entering and accessing patient data from their iPads or smartphones.

"Hospitals absolutely understand that they have to have a new business model and EHRs are at the heart of that change," according to Fabozzi. "It's about collecting, analyzing and exchanging data--they can't do that without an EHR, which is why for hospitals the adoption of an EHR is inevitable."

The report also predicts that as health IT executives implement new clinical systems and practice management software, they are looking at reducing the number of vendors and reorganizing the way they do business with technology providers. While many hospitals have already picked their key clinical systems vendors, they might still change vendors further down the road.

According to Fabozzi, this shift is being prodded along by the fact that larger hospitals are purchasing smaller ones and larger physician groups are buying smaller physician practices. These mergers and acquisitions in the hospital sector present hospital executives with an opportunity to reduce number of technology vendors they use.

"We are going to see a natural consolidation and vendor rationalization is happening across the board, as the Cerners and the Epics move in and take larger and larger market share," Fabozzi said. "Hospital CIOs don't want to deal with so many vendors; they want to replace some of their systems and, as much as possible, have one single vendor to keep track of more easily."