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EHR and Health IT Consulting
Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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NIH Clinics Receive Stage 7 HIMSS Award for EHR Adoption

NIH Clinics Receive Stage 7 HIMSS Award for EHR Adoption | EHR and Health IT Consulting | Scoop.it

The National Institutes of Health (NIH) Clinical Centers has become the first federal healthcare clinic to receive a HIMSS Stage 7 Award, according to a public announcement Friday. The NIH clinics join a select group of healthcare facilities who have received this award for excellence in EHR adoption. Healthcare facilities qualify as HIMSS Stage 7 by transitioning completely from paper health records to EHRs.


The HIMSS Stage 7 Award signifies that the NIH clinics have reached the highest level of the Electronic Medical Record Adoption Model (EMRAM), a decade-old system for monitoring the effectiveness of EHRs for all HIMSS hospitals. The EMRAM operates on a scale of 0-7, 7 being the highest level. This year, only 3.7 percent of hospitals attained this ranking, proving just how prestigious this award is for NIH.


In order to receive this award, NIH had to go through rigorous examination. “The validation process to confirm a hospital has reached Stage 7 includes a site visit by an executive from HIMSS Analytics and former or current chief information officers to ensure an unbiased evaluation of the State 7 environments,” the organization stated.


According to an NIH press release, the clinic has been using electronic health records since the 1970s, but are being awarded for their most recent accomplishments in electronic health record use. These accomplishments include eradicating the use of all paper healthcare records, using electronic records for research to improve quality of care, and improving interoperability amongst their electronic medical record systems and those at other authorized healthcare centers.

HIMSS evaluated the NIH’s Clinical Research Information System (CRIS), the clinic’s fundamental software used for electronic medical records. Used by over 2,750 clinic staff members, CRIS is used in a variety of settings.


“NIH experts rely on CRIS to manage patient protocol information, write medical orders, retrieve laboratory results, documents progress notes and other aspects of medical care,” NIH says.

HIMSS says it was a clear choice awarding NIH with Stage 7.


“The NIH Clinical Center is a remarkable place doing remarkable things with its EHR for the patients they serve,” said John H. Daniels, CNM, FACHE, FHIMSS, CPHIMS, Global Vice President, Healthcare Advisory Services Group, HIMSS Analytics. “From automatically capturing discrete data on anomalies found in digital imaging to providing pharmacogenomics clinical decisions support to physicians, they are clearly a Stage 7 organization.”


The NIH Clinical Center is the research hospital for the National Institutes for Health. Using clinical research, the NIH clinics aim to improve treatments, which in turn should improve the national health. A branch of the Department of Health & Human Services (HHS), NIH is the nation’s primary source for clinical research.

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EHR Interoperability Stressed in DeSalvo’s Keynote Address

EHR Interoperability Stressed in DeSalvo’s Keynote Address | EHR and Health IT Consulting | Scoop.it

To conclude the 2015 HIMSS Annual Conference and Exhibition in Chicago that brought in 35,000 healthcare IT professionals, providers, and other key stakeholders, Dr. Karen B. DeSalvo, National Coordinator for Health IT, delivered a keynote address. EHR interoperability was a major topic of DeSalvo’s speech.

“It has been a great week here at HIMSS,” DeSalvo starts. “I’m so optimistic about the bright future that we have ahead to leverage health information technology and enable better health for everyone in this country.”


“Last year, I stood before you as a brand new National Coordinator and shared what I saw as the need to move our focus beyond adoption and focus on interoperability,” she said. “Unlocking the data can [put it] to many important uses demanded by consumers, hospitals, doctors, and others who are part of our learning health system. We’ve had a very busy year. We took the time to listen, to understand, and to shift our strategic focus to see that we can built upon the strong foundation that we all have built.”


“I personally had the chance to participate in or host two dozen listening sessions across the country. In those sessions, I was able to hear from people on the front lines about what matters most to them,” DeSalvo stated. “I became more and more optimistic as I heard how people are committed to see that we would leverage health IT to the advancement of everyone’s health.”


“In Alabama, adoption can still be a debate in some circles. They have challenges like lack of broadband access in rural communities. In New Jersey, the close proximity to other states and differing state privacy laws when crossing state lines has become an increasing challenge,” DeSalvo continued.


“In the Silicon Valley, the entrepreneurial community is moving past the notion of an electronic health record and is thinking about the next phase – the person-centered health records and the Internet. In places like Chicago and Minnesota, a history of collaboration showed me that when we let go of our own interests, communities move further when they work together instead of against each other and we can put priorities like the public’s health at the top of the agenda.”

DeSalvo also acknowledged her team who have attended HIMSS and spent time listening and discussing the challenges of EHR interoperability as well as the solutions that can improve nationwide data exchange.


“We [need to] continue the great progress and get to a place where every American has access to their electronic health information,” DeSalvo continued. “They, like me, remain steady and unwavering in that vision. Indeed, that was the vision more than a decade ago when President Bush signed an executive order and asked David Brailer to stand in the Office for the National Coordinator for Health Information Technology. In 2009, Congress codified the role and we carry out those responsibilities every day on behalf of the people in this country.”

“The flurry of work in the five years since the HITECH Act, through a set of grant programs, certification programs, the EHR Incentive Programs, has brought us all to a tipping point. Today we know that adoption is strong.”


“We have much work to do to digitize the care experience across the entire care continuum. We also have to see that we achieve true interoperability – not only exchange,” DeSalvo said. “What became clear quickly is that we need to develop a strategic approach that would leverage health IT beyond electronic health records using levers beyond meaningful use to bring not only better healthcare but better health.”


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Do Meaningful Use Requirements Need the 5% Objective Back?

Do Meaningful Use Requirements Need the 5% Objective Back? | EHR and Health IT Consulting | Scoop.it

Ever since the proposed modifications to Stage 2 Meaningful Use requirements were announced, a wide variety of opinions and objections surfaced throughout the healthcare industry. For instance, patient engagement advocates are calling for a Data Independence Day. Other medical societies are sending forward their comments about both the proposed Stage 3 Meaningful Use requirements as well as the potential modifications to Stage 2.


HIMSS is one organization that supports some aspects that the Centers for Medicare & Medicaid Services (CMS) is pushing forward in the latest proposals for Stage 3 Meaningful Use requirements. For instance, reducing redundant reporting is very beneficial for the healthcare industry, according to a letter HIMSS representatives sent forward to CMS.


For example, HIMSS is supportive of the new 2015 Stage 2 Meaningful Use change to a 90-day reporting period. However, HIMSS is also looking to encourage CMS to develop a phased-in approach to meeting the Patient Electronic Access objectives under meaningful use requirements.


“HIMSS recommends a balanced approach for meeting this objective that recognizes the challenges that some providers are encountering as they try to get their patient population more engaged on viewing, downloading, or transmitting their information to a third party,” the letter stated. “As a part of this approach, given the tight timeline between the publication of this Final Rule and the end of calendar year 2015, CMS could leave the proposed measures in place for 2015, and then phase-in increased threshold requirements for 2016 and 2017, increasing each 1%, 2% to 3% per year to propel the field forward... Overall, HIMSS believes a phased-in approach for the patient electronic access objective to be an appropriate and balanced step forward.”


The Consumer Partnership for eHealth (CPeH), the Consumer-Purchaser Alliance (C-P Alliance), and other organizations sent a letter to CMS expressing their concern over a specific modification on patient engagement objectives under Stage 2 Meaningful Use requirements. Now that CMS intends to only have one patient view, download, and transmit their information under Stage 2 Meaningful Use, many organizations are pushing for bringing back the prior 5 percent requirement.


“CPeH, C-P Alliance, and the undersigned organizations and individuals are dismayed that CMS intends no longer to require that five percent of patients1 view, download or transmit their health information or send a secure message to their providers,” The letter from the Consumer Partnership for eHealth states. “Instead, CMS proposes that doctors and hospitals merely show that just one patient used online access to their health information, and that secure messaging was merely turned on, not whether any patient has actually used it. We are deeply disappointed in CMS’s reversal of these essential commitments to patient and family engagement.”


Healthcare providers should be able to meet the 5 percent requirement and better engage patients with their medical information, according to the letter. Additionally, prior analysis shows that this should be achievable, which is why the new CMS modification is causing such an uproar in the medical community. Research shows that more than half of patients want to be able to email their healthcare provider, which is why the secure messaging aspect of a patient portal should increase patient engagement if properly leveraged. CMS would be wise to take these comments under advisement as they continue to develop meaningful use requirements.

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