The first proposal would create a temporary certification program that would be issue temporary certifications through the authorized testing and certification bodies (ONC-ATCB) to test and certify complete EHRs/or EHR Modules. During this first proposal the ONC would assume most of the responsibilities during the temporary certification program. This means that no other organization (private ones) would serve as an accreditation body.

The second proposal would create a permanent certification program that would replace the first temporary proposal. This would also mean that the ONC is intended in allowing approved private sector accreditor to fulfill the responsibility of the accreditation body.

The National Institute of Standards and Technology has been working with the ONC to develop the test method and infrastructure that will be used by many of the testing laboratories in the testing stage for both proposed certification programs. This entity (NVLAP) would include specific calibration and or test standards related methods and protocols that would satisfy the needs and requirements of an “Certified EHR”.

The details of what would be the methodology used in the certification test is defined as “The same basic methodology used in third-party conformance assessment”.

More details to come once I can get through the 184 pages of the proposal.Article source: http://thehealthcareitgroup.blogspot.com/2010/03/much-anticipated-proposal-for.html

This makes the state of North Carolina one of the 41 states to get $12.9 million dollars in funding to facilitate HIE for the state. While there are several other already established health record exchange initiatives established, the NC HWTF (North Carolina Health and Wellness Trust Fund) has greater potential to get a strong NC HIE started.

In addition, with the establishment of the regional extension centers and their awarded 13.6 Million dollars available through North Carolina Area Health Education Centers Program (AHEC) North Carolina care providers will have better access to onsite technical assistance to help with the adoption of electronic health records.

For a full list of grants awarded visit:
http://www.whitehouse.gov/the-press-office/sebelius-solis-announce-nearly-1-billion-recovery-act-investment-advancing-use-heal

Travelling to conferences recently showed me an interesting trend, and that is of software vendors providing along with their package a “Guaranteed Certifiable Product” or “Guaranteed Stimulus Money”. While some of the requirements have been described, it is alarming to see that this trend is spreading like wild fire and gaining momentum. Much of the concerns should be around how practices will gather the resources and the right stakeholders to apply meaningful use and implement policies and procedures as part exchange of electronic health records.

So, while we are coming to a better understanding of the ARRA HITECH, we are now facing a new round of recommendations and new potential incentives. On October 29th, 2009 House Speaker Nancy Pelosi announced a new Bill by the 111th Congress titled: Affordable Health Care for America Act.

After reviewing some of the sections that are relating to health care technology or HITECH, I discovered some very encouraging items in the bill. I will just list the very basic AHCAA HITECH summary of the areas I got through reading:

• The bill recommends that a study be conducted to see if providing higher rates of reimbursements or other incentives would increase the adoption of certified EHR.
• The secretary will have until January 1st, 2012 to develop a plan to integrate clinical reporting on quality measures which would include the following items:
  • The development of measures that can demonstrate meaningful use of HER, and clinical quality of care furnished to an individual.
  • The collection of health data to identify deficiencies in the quality and coordination of care for individuals eligible for benefits.

• Extension of Incentive payments from Act 42 USC 1395w -4(m) (1) where 2010 payments would be replaced by 2010, then instead of 2009 inserting 2010.

• Promoting low-cost electronic health records software packages that are available for use. Examples (can anyone say Medsphere is loving the AHCAA) which is based on the package of the Veterans Administration.

This was an abvious expectation from any bill that was upcoming. Making the push for electronic health records part of a public option, the motives are to encourage the adoption of EHR after many healthcare providers showed some resistance ARRA plans.

Between requiring electronic clinical data reporting, to adopting meaningful use, it to note that adopting some Electronic Health Record system will improve coordination of care, reduce medical error, and provide faster access to data when it is most needed. At this stage the only debatable factor of any EHR package is whether it offers a true Positive ROI.

This is the challenge that much of the current vendor must prove to the rest, otherwise everyone will look to OpenSource and vendors will lose a substantial market share.

As part of this stimulus plan, there are four requirements that medical offices need to be aware of if they want to receive any funds for their EHR: Certified EHR, Information Exchange, Meaningful Use, and Reporting on Clinical Quality Measures.

Certified EHR: It is believed that the CCHIT will be the certification method of choice. In a recent announcement made by CCHIT Chair, Mark Leavitt, there will be three paths to certification for vendors and health organizations. Applications will adhere to one of the following: EHR Comprehensive EHR-C, Certified EHR Module EHR-M, or Certified Site EHR-S. These certifications vary in requirements. For example, to become EHR-M or EHR-S certified, your system will be required to have patient-physician PHR communication capabilities as well as an ability to exchange data with a certified HIE (Health Information Exchange).

Information Exchange: It is important to note that there has been a significant emphasis on data exchange in the certification process. The purpose is to reduce healthcare costs and medical errors by promoting care coordination. This means that if a patient has had services provided for them and would like this data shared across a community based HIE or National HIE, this information would be available to other participating health organizations with the appropriate access. This includes SSA, CMS and other federal or state entities.

Meaningful Use: Recently a document has been released regarding some outlines of the “Meaningful Use Matrix” from the HIT Policy Committee.  Everyone is still waiting for the final definition of “Meaningful Use”. One thing to keep in mind regardless of the details of this requirement is that physicians may need to make adjustments on how data is reported as well as recorded.

Reporting on Clinical Quality Measures: It is stated that the eligible professional must be able to submit clinical data in a form and manner specified by the Secretary, on such clinical quality measures and such other measures as selected by the secretary.

Physicians and other health organizations must thoroughly examine the ARRA in great detail, and the changing environments surrounding them.  Many have successfully adopted electronic prescription, computerized physician order entry CPOE, patients using online PHR and all the possible potential adjustments surrounding the insurance reform. Taking the right steps forward will require careful planning and assessment. Creating the right strategy for your healthcare information technology will position your organization to receive funds for your EHR. However, one has to be aware of the fact that getting any money from the government may prove to be a considerable effort!