Learn about regulatory requirements to qualify for HITECH incentives

On Thursday, July 29, 2010, physicians, physician practice managers, and others interested in learning more about the regulations governing incentives under the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act) are invited to a free education session (by Kathie McDonald-McClure) and networking event hosted by MedX12.

Date: July 29, 2010.  Time: 6:00 pm (EST).

Place: Suburban Plaza 3, 4121 Dutchman’s Lane, Louisville, KY.

Call for a reservation due to limited seating:  502-339-7175 ext 225

For more information, click here: MedX12 EHR Brochure.

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CMS Holds Training Teleconference on EHR Final Rules

On Thursday, July 22, 2010, the Centers for Medicare and Medicaid Services (CMS) held a publicly available teleconference to give an overview of the 800+ page Final Rule on Meaningful Use (MU) under the HITECH Act, as well as an overview of the Final and Proposed Rules on Temporary & Permanent Certification Program and the Final Rule on the Standards and Certification Criteria for electronic health records (EHRs).  CMS is making an “encore recording” of the 90-minute teleconference available until 11:00 pm, Saturday, July 24, 2010.  Call toll-free, 1-800-642-1689 and enter the conference ID 87841621 to hear the encore recording.  CMS will post an audio recording link to the teleconference on its EHR Incentive Programs website sometime in August 2010.  The slides accompanying the audio are available on that same website, here (scroll to Downloads and click on the links for the July 22, 2010 Training materials). 

FCC’s Investment in Broadband Health Care Technology

On July 15, 2010, the Federal Communications Commission announced that it would expand investment in broadband for medically underserved communities. This $400 million annual investment is expected to help improve medical care and reduce health care costs by enabling the development of improved health IT infrastructures and solutions in rural areas. To read the FCC’s press release, click here.

HHS Releases Final Rule on “Meaningful Use” of Electronic Health Records

HHS Secretary Kathleen Sebelius wasted no time in putting the brand new CMS Director to work on July 13, 2010, in announcing the release of two rules under the Health Information Technology for Clinical and Economic Health Act (HITECH), including the Final Rule on Meaningful Use and the Final Rule for “certified EHR” technology. Donald M. Berwick, MD, MPP, FRCP, was sworn in as Director of the Centers for Medicare and Medicaid Services on Monday afternoon, July 12, 2010, and by the next morning was primed to discuss the important role of health information technology (HIT) in America. In addition to Dr. Berwick’s participation at the press briefing, other participants included David Blumenthal, MD, the Chief Coordinator for the HHS Office of National Coordinator of HIT (ONC), Regina Benjamin, MD, U.S. Surgeon General, and Regina Holiday, an individual who shared a personal experience involving access to health information and how such access impacts the care of patients. 

Quick Reference: The CMS Fact Sheet on both Final Rules is available here. 

Conversion to electronic health record and retention of paper records

Many hospitals have electronic health records (EHRs) that are hybrid digital records. While the hospital may be using electronic data entry in the ER, inpatient nursing care, pharmacy, lab, and pre-op anesthesia, oftentimes, these EHRs are not integrated and, thus, are not merged into a single EHR. The short-term solution may have been to scan printed records from some department, like lab or pharmacy, into the patient’s on-line digital record. As a result, the hospital’s “electronic health record” contains information that is not captured in a “coded format.”  For one, this will not meet the Stage One “meaningful use” criteria under the HITECH Act.

But let’s assume that the hospital can overcome this hurdle by working with vendors to integrate these records in a way that will meet HITECH EHR certification standards.  If the hospital has been maintaining certain portions of patient records in a paper format, what does it do with those paper records after converting to an EHR?   If the hospital scans all the paper patient records into its EHR, how long should the hospital retain the paper record after it is scanned into their EHR? 

Use of electronic communications with patients

The Office of National Coordinator for Health Information Technology (ONC) and its HIT Policy Committee worked hard throughout the summer to develop a framework for the “meaningful use” standards required to qualify for electronic health record (EHR) adoption stimulus funds available under the Health Information Technology for Economic and Clinical Health Act (HITECH Act).  When I saw the survey that HIMSS released today regarding the use of social networking tools to communicate with patients, it reminded me of the “meaningful use” standard that centers on “engaging patients and families.”  The stated goal of this standard is to “Provide patients and families with timely access to data, knowledge, and tools to make informed decisions and to manage their health.” Although it’s doubtful today that social networking tools would be accepted as meeting this goal for purposes of the EHR stimulus funds, it did get me to thinking about the use of technology to literally communicate with patients and, in particular, the studies that have been done in regard to using technology, such as e-mail and texting, to communicate with patients.  

ONC Issues Proposed Rule for Two EHR Certification Programs

On March 2, 2010, the Office of National Coordinator (ONC) issued its proposed rulemaking respecting the certification standards that an eligible health care provider’s electronic health record must satisfy in order to qualify for incentives under the Health Information Technology for Clinical and Economic Health Act (HITECH Act), which was part of the American Recovery and Reinvestment Act of 2009 (ARRA). The ONC proposes establishing two certification programs:

1) A temporary certification program whereby the ONC would authorize organizations to test and certify Complete EHRs and/or EHR Modules, thereby assuring the availability of Certified EHR Technology prior to the date on which health care providers seeking the incentive payments may begin demonstrating meaningful use of Certified EHR Technology; and

2) A permanent certification program that would replace the temporary certification program. The permanent certification program would separate the responsibilities for performing testing and certification, introduce accreditation requirements, establish requirements for certification bodies authorized by the ONC related to the surveillance of Certified EHR Technology, and would include the potential for certification bodies authorized by the ONC to certify other types of health information technology besides Complete EHRs and EHR Modules.

The comment period for the proposed rule will be established once it is published in the Federal Register. In the meantime, you can read the proposed rule on the ONC’s webpage.

DEA’s Interim Final Rule Allows Electronic Prescriptions for Controlled Substances

Post-script: The Office of National Coordinator posted helpful FAQs about the DEA’s Interim Final Rule for E-prescribing of controlled substances on the HHS Healthit website here.  The Interim Final Rule was effective June 1, 2010.

On March 31, 2010, the Drug Enforcement Agency (DEA) published its Interim Final Rule (IFR) addressing electronic prescriptions (e-prescribing) for controlled substances, 75 Federal Register 16236.  Up until now, the DEA has been concerned that the lack of security controls for e-prescribing of controlled substances would lead to higher levels of illegal use. That concern, along with the rigid requirements of the Controlled Substances Act of 1970 (CSA), have been a barrier for DEA in moving forward with its e-prescribing rule, which was originally proposed in June 2008. The DEA’s IFR cites the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act, which was part of the American Recovery and Reinvestment Act of 2009 (ARRA), and HITECH’s encouragement of e-prescribing, as one impetus for propelling this issue forward. DEA also indicated that the lack of a mature standard that allows for electronic interoperability (i.e. formatting of prescription data) among e-prescribing applications (e.g., from physician to pharmacy) was another reason to forge ahead and fill the gap.  

Federal court dismisses lawsuit alleging HITECH violates privacy rights

On May 13, 2010, the United States District Court for the Southern District of New York rejected the privacy challenge to the Health Information Technology for Economic and Clinical Health Act (HITECH Act) asserted by Beatrice M. Heghmann, a registered nurse, and Robert A. Heghmann, her husband and attorney, against Kathleen Sebelius, Secretary of the Health & Human Services (HHS), Nancy-Ann DeParle, Director, White House Office of Health Reform, and Charlene Frizzera, Administrator, Centers For Medicare and Medicaid Services (CMS).  The Plaintiffs alleged that HITECH violates the HIPAA Privacy Rule, the Privacy Act, and Federal Common Law.

ONC Releases Final Rule on EHR Temporary Certification Program

From the Office of National Coordinator of Health Information Technology (ONC HIT):

“On June 18, the Office of the National Coordinator for Health Information Technology issued its temporary certification program final rule, which establishes a way for organizations to become authorized by the National Coordinator to test and certify electronic health record technology.”

To read more information and to read the rule, click here.

HHS announces proposed rulemaking to “significantly” modify HIPAA

On Thursday, July 8, 2010, the United States Department of Health & Human Services (HHS) held a press briefing to announce “significant modifications” through proposed rulemaking to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) pursuant to the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH). The proposed modifications also seek to strengthen the privacy of health information and help Americans understand their rights and resources available to safeguard their personal health information. As part of the latter effort, Sebelius announced the launch of another new website “where Americans can read about all HHS’ efforts to protect privacy in the exchange of electronic health information and that will give Americans the tools needed to embrace technology to take control over their health information.” The website will be available at www.hhs.gov/healthprivacy.

HHS Office of Civil Rights updates HIPAA Breach Website

As indicated in a July 8, 2010 press briefing, the Office of Civil Rights (OCR) of the United States Department of Health & Human Services (HHS) has updated its HIPAA breach notification webpage.  This is the webpage where OCR is posting breaches of unsecured Protected Health Information (PHI) affecting 500 or more individuals.  The format includes brief summaries of the incidents reported to the HHS Secretary that OCR has investigated and closed.  The format also allows users to search and sort the posted breaches by entity, state, date, number of individuals affected, type of breach, and location of breached information.  There are currently 107 breach notifications posted, all occurring since September 9, 2009.  The breaches reported thus far indicate that theft ranks #1 as the type of activity leading to a breach. A quick run-down of the stats reflect the following:

HHS and ONC Announce Briefing on Meaningful Use Rule

UPDATE: Watch the LIVE webcast here.

According to HealthcareIT News, federal officials have announced that, on Tuesday morning, July 13, 2010, at 10:00 am EST, the Centers for Medicare and Medicaid (CMS) and the Office of National Coordinator (ONC) will release the final rule on making a “meaningful use” of electronic health records under the HITECH Act.