$2 Billion in Federal Economic Stimulus Funding Being Used for Electronic Health Records
HHS Grants $83.9M to Boost EHRs in Health Care Networks
June 3, 2010iHealthBeat - On Thursday, HHS Secretary Kathleen Sebelius announced $83.9 million in grants to 45 organizations to help Health Center Controlled Networks implement electronic health records and other health IT projects, Federal Computer Week reports (Lipowicz, Federal Computer Week, 6/3).
HCCNs are community-based coalitions of health care organizations that provide management, financial, technology and clinical support services to health centers that receive funding from HHS' Health Resources and Services Administration.
The new grants come from the $2 billion in federal economic stimulus funding allocated to HRSA to help it expand health services for low-income and uninsured U.S. residents through its health center program (Monegain, Healthcare IT News, 6/3).
Health care providers at the centers who demonstrate "meaningful use" of EHRs also could be eligible for federal incentive payments under the stimulus package, officials said (Lubell, Modern Healthcare, 6/3).
A complete list of the organizations receiving grants is available online.
CMS Awards $9M to Four States for Medicaid EHR Incentives
Biden, Sebelius Award $220M for EHR Incentives
University of Louisville Patient Data Mistakenly Posted Publicly Online
June 4, 2010iHealthBeat - A University of Louisville in Kentucky database containing names, Social Security numbers and medical information on 708 dialysis patients was unintentionally accessible to the public for about 19 months, university officials announced recently, Health Data Management reports.
Background
In October 2008, a university physician posted the patient data to a website that was assumed to have password protection. According to the university, the site did not include a log-in requirement because of a programming error.
The site was accessible only by directly entering its URL, not through search engine navigation, according to a university spokesperson (Health Data Management, 6/3).
The university disabled the site on May 17 after discovering the error. It is unknown how many people accessed the information while it was posted (Louisville Courier-Journal, 6/2).
Follow-Up Action
The university has notified affected patients, or their next-of-kin, about the data breach (Adams, Business First of Louisville, 6/2). The school also is offering no-cost credit monitoring services to affected individuals (AP/Lexington Herald-Leader, 6/2).
In addition, university officials have reviewed safeguards on other online databases (Business First of Louisville, 6/2). The university also has reviewed its privacy and security training records to ensure that its employees meet certain requirements (Health Data Management, 6/3).
Laptop Thefts Prompt New Security Measures for Hospital, Hospice
VA Takes Heat for Data Security Protocol Following Laptop Theft
Study: Health Data Leaks Still an Issue After New HITECH Rules
Laptop Thefts Expose Personal Health Data on Vets, Reservists
Could Small Practices Be Left Behind in the Push for EHR Adoption?
June 03, 2010iHealthBeat - The federal government is banking that the billions of dollars allocated for health IT in the 2009 federal economic stimulus package will lead to widespread electronic health record adoption. But some stakeholders think it might be more of a gamble than a sure thing, noting that for many small physician practices, the Medicare and Medicaid incentive payments -- and later penalties -- might not be enough to overcome the barriers to EHR adoption.
Dozens of medical societies have urged CMS to make changes to the Notice of Proposed Rulemaking describing how health care providers can demonstrate "meaningful use" of certified EHRs to qualify for incentive payments under the federal stimulus package. The groups want federal officials to make the requirements more attainable for smaller physician practices.
The final rule could be released any day now, but how many of the medical groups' suggestions are incorporated remains to be seen.
Because most primary care is delivered through small physician practices, such offices are a key group in the government's quest for widespread EHR adoption.
President Obama has set a goal of providing all U.S. residents with an EHR by 2014. According to 2009 preliminary results from CDC's National Ambulatory Medical Care Survey, about 20.5% of U.S. physicians reported having basic EHR systems, and 6.3% reported having a fully functional system.
In a March 15 comment letter to CMS, more than 95 state and specialty medical societies wrote:
"The vast majority of physicians' practices are comprised of five or fewer physicians. Encouraging physician of health IT, especially small physician practices, is critical to ensuring widespread EHR use."Furthermore, Vince Kuraitis -- founder and principal of Better Health Technologies -- and David Kibbe -- a senior adviser to the American Academy of Family Physicians -- note in a blog post that small physician practices with EHRs are influential in encouraging specialists to whom they refer patients to adopt the technology.
All health care providers will face hurdles when it comes to shifting to computerized health records, but experts say those challenges likely will be more severe for small practice physicians.
Steven Waldren, director of AAFP's Center for Health Information Technology, said that up until now, health IT systems have been focused primarily on documentation and billing, rather than managing populations and driving quality care. Because of this shift, it will be a challenge for physician practices of all sizes "to find product[s] to meet the intent of meaningful use," Waldren said.
He noted that because small physician practices lack capital, it will be even more difficult for those who already have invested in some form of health IT to make another investment, pay for an upgrade or replace their system altogether.
Waldren also noted that small physician practices "don't have the economy of scale like the large practices do where they could pull that $44,000 a doc and create some central services." He added that a lot of small practices are located in "rural areas where they don't have access to IT professionals to help them" in their EHR adoption.
The coalition of medical groups and state medical societies states in its comment letter:
"Studies of EHR adoption clearly show that it takes more time for smaller practices to adopt and implement EHRs because they have fewer resources and support." It adds, "Aggressive timelines and criteria during the initial stage of the incentive program will only serve to undermine this effort."Steven Stack -- an emergency physician and American Medical Association board member -- said:
"AMA is supportive of the widespread adoption and meaningful use of EHRs by physicians, but the Stage 1 criteria proposed by CMS are too aggressive," adding, "It could unreasonably punish physicians who undertake great efforts to achieve meaningful use of EHRs -- only to be denied incentive payments due to overly complex and unattainable criteria."Many medical groups have urged the federal government to add greater flexibility to the meaningful use criteria to make participation in the incentive program more appealing for smaller physician practices.
Some of the medical groups' suggestions include:
- Offering partial incentives for partial meaningful use, rather than the current "all or nothing" approach;
- Eliminating meaningful use objectives and measures that do not directly relate to EHR adoption; and
- Reducing the number of clinical quality reporting measures.
Waldren said that AAFP has "some very serious reservations as the proposed rule is today that practices will even attempt to make the commitment" to adopting EHRs. He noted that to qualify for the Medicare and Medicaid incentive payments, physicians will have to make the upfront investment, implement the EHR system, begin using the system, do the required reporting, "and then if you miss one thing and you miss it just barely, you get $0." He added, "So I think that's a large potential risk."
He added that given the track record of the federal government's Physician Quality Reporting Initiative, some physicians are skeptical that they will be able to successfully receive the health IT incentive payments.
Experts have also noted that doctors risk little by not participating in the health IT incentive program in the first couple of years. Furthermore, some doctors and policy insiders have questioned whether the federal government will actually go through with the scheduled reimbursement penalties beginning in 2015.
Waldren said that he's heard discussions in policy circles that medical societies could block the penalties from kicking in. He said that he believes the penalties will be somewhat dependent on how successful HITECH is at increasing the rate of adoption. He said:
"We're underneath the assumption that the penalties are on the books, they are law, and we need to make physicians aware and prepared for such." However, he added that if EHR adoption "doesn't get a lot of uptake, I think it may be challenging to keep those penalties where they're at."Waldren said he has been telling physician practices that their reason for making an investment in EHRs should be to increase the efficiency of their practices, increase care quality, improve patient safety, and provide new features and services for patients, not to qualify for the $44,000 in incentive payments. However, he noted that those who are committed to EHR adoption might want to try to speed up their timetables to qualify for the meaningful use incentives.
Waldren said that physicians who adopt EHR software solely to meet the Stage 1 meaningful use criteria likely will "spend a lot more money over the long run than the $44,000 they would get from the federal government."
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