$220 Million Granted to Pilot Programs

HS Funds 'Beacon' Communities

HDM Breaking News, May 4, 2010

The Department of Health and Human Services has awarded grants totaling $220 million to organizations in 15 communities to serve as pilot sites for comprehensive use of health information technology.

The grants, funded under the HITECH Act, are for the Beacon Communities program to build and strengthen health I.T. infrastructure and health information exchange capabilities in the selected localities. Another $15 million will be provided for technical assistance.



The goal of the program is to accelerate and demonstrate the benefits of health information technology, while laying the groundwork for establishment of tens of thousands of health I.T. jobs. Federal officials expect the 15 Beacon Communities to create up to 1,100 jobs paying an average of $70,000 a year.

Beacon Communities will tackle specific goals of improving health care and population health status through advanced use of I.T. These include obesity and diabetes management, preventable emergency department visits and re-hospitalizations, increased immunizations, better adherence to smoking cessation, and appropriate cancer screening guidelines, among others.

The communities will work closely with regional technology extension centers created and funded under HITECH, as well as state health information exchange initiatives and the National Health Information Technology Research Center to ensure the dissemination of lessons learned. The 15 Beacon Communities grant awardees are:

* Community Services Council of Tulsa, Okla., $12,043,948;

* Delta Health Alliance Inc., Stoneville, Miss., $14,666,156;

* Eastern Maine Healthcare Systems, Brewer, $12,749,740;

* Geisinger Clinic, Danville, Pa., $16,069,110;

* HealthInsight, Salt Lake City, $15,790,181;

* Indiana Health Information Exchange, Indianapolis, $16,008,431;

* Inland Northwest Health Services, Spokane, Wash., $15,702,479;

* Louisiana Public Health Institute, New Orleans, $13,525,434;

* Mayo Clinic, Rochester, Minn., $12,284,770;

* Rhode Island Quality Institute, Providence, $15,914,787;

* Rocky Mountain Health Maintenance Organization, Grand Junction, Colo., $11,878,279;

* Southern Piedmont Community Care Plan, Concord, N.C., $15,907,622;

* The Regents of the University of California at San Diego, $15,275,115;

* University of Hawaii at Hilo, $16,091,390; and

* Western New York Clinical Information Exchange, Buffalo, $16, 092,485.

EHR Challenges ?

EHR Challenges?

HIM Professionals Are Poised

To Ease The Pain

(ARRA) The American Recovery and Reinvestment Act gave adoption of electronic health records (EHRs) momentum. It also gave many healthcare providers an array of new regulations to navigate. HIM professionals have the skill set and expertise to aid their organizations with some of these new changes.

AHIMA wants to give you the information you need so you can:

• Feel empowered that your HIM skills are urgently needed in this new electronic world.

• Speak up when you see factors that could compromise data integrity.

• Improve your understanding of the implications of the proposed ARRA "meaningful use" rules that were recently issued by the federal government.

• Seize opportunities to take on new roles in your organization and profession.

Positive Attitude

While you may feel overwhelmed keeping up with your workload and all the new changes, stay focused on the positive outcomes of the EHR and all the opportunities it offers. And frequently remind yourself that you have the knowledge and skills to aid this transition.

Whether your facility or office is still working on paper, balancing a hybrid record, or in a full-out sprint to EHR implementation, you have an important role to play, said Diane Larson, RHIA, CHPS, director of HIM at St. Luke's Hospital in Duluth, MN. Their EHR system is well developed; at least 90 percent of all hospital and clinic records reside electronically."Having been in healthcare for 35 years, I can see that the EHR is a wonderful new technology" Larson said. "However, it has to be implemented correctly. In some organizations the IT department is taking so much responsibility that some HIM people stand back and let them go for it. But, HIM needs to be a part of the transition. If we see that something is not going to work right or negatively impact data integrity, we need to identify those problems as technology implementation showstoppers"

When patient health records can be shared with the click of the mouse, HIM expertise is acutely needed. The EHR will change the way HIM professionals execute core processes (such as privacy, security, coding processes, and record retention) and staff competencies (like abstracting and release of information), but it will not erase their importance.

Protect Data Integrity

The EHR has exacerbated some old problems, such as ensuring data integrity. This is an area where HIM professionals can exert their expertise and leadership.

"Data integrity needs more attention now than ever before;' Larson said. ''An electronic system is less forgiving than paper. If data integrity is not paid attention to, it can create nightmares. People don't think it's important, but data integrity is the foundation of the EHR:' We've all heard examples of EHRs gone wrong: Otherwise healthy patients are arriving at their provider's offices to hear that they have diabetes, sleep apnea, or high blood pressure. When in actuality, doctors are reading the wrong records because master patient indexes were compromised.

HIM has an important role in ensuring data integrity. Unfortunately, HIM processes are not always addressed very well by EHR vendors. This is all the more reason to be involved when your organization is purchasing or modifying EHR systems.

Getting Ahead of The Curve with ARRA

ARRA contains new regulations and incentives for supporting providers who serve Medicare and Medicaid patients in their transition to the EHR. HIM professionals may be affected by ARRA unlike anything we've ever seen before.

In particular, the "meaningful use" financial incentive program is having a huge impact, both in the changes it requires today, and in the uncertainties of what the final rules will eventually look like. Here are a few meaningful use basics:

1. To qualify for incentives, providers must meet certain criteria to show that they are using their EHR systems to achieve certain goals for increasing patient care, quality, and safety, and for increasing the efficiency of the healthcare delivery system.

   The first stage of the meaningful use program was announced in a notice of proposed rule making (NPRM) on January 13,2010.

   The Centers for Medicare and Medicaid (CMS) is still determining more rigorous criteria for two additional stages.

   After 2015, providers may be financially

   penalized if they don't meet requirements.
   "There's no question about it: The meaningful use rule has changed the strategic direction of our organization;' said Elaine O'Bleness, MBA, RHlA, CHP, CPHQ, director of health information services/ HIPAA contact for Banner Health Western Region in Greeley, CO. With 22 facilities in seven states, Banner Health is the fourth largest secular, not-for-profit healthcare system in the US. "We have full project plans with an eye towards all the requirements of meaningful use, and have changed our time line to accommodate the new deadlines;' O'Bleness said.
   Meaningful use ties into two other regulations.
   1. The "Health Information Technology:
   Initial Set of Standards, Implementation Specifications, and Certification Criteria for EHR Technology" interim final rule details the standards and criteria that must be used in reporting functional measures to demonstrate meaningful use of an EHR system.
   2. Another NPRM, "Establishment of Certification Programs for Health Information Technology;' which defines the certification process for EHR vendors, was posted on March 2.
   A big challenge is charting a strategic implementation schedule without having all necessary information from the federal government. Providers must also keep track of which rules are proposed, interim and final, and monitor all the implemen-
   tation deadlines, such as for providing electronic access to medical records and updating business associate agreements.
   By keeping current on ongoing ARRA rules and regulations, you can assist your organization as it moves to meet the objectives and measures. To help you, AHIMA has created a central resource center on leading edge information, opportunities, and requirements related to ARRA at www.ahima.org/arra. There, you'll find:

   A series of nine ARRA white papers that summarize the meaningful use rule

   Breaking industry news related to ARRA

   An overview of Title XIII of ARRA, called "Health Information Technology for Economic and Clinical Health Act" (HITECH)

   A calendar of ARRA-HITECH due dates

Public Comment Period for Interoperability

The Healthcare Information Technology Standards Panel (HITSP) announces the opening of the public comment period for the following Interoperability Specifications (IS), Capabilities (CAP), Technical Note (TN) and other construct documents:

• IS07 - Medication Management Interoperability Specification
• IS09 - Consultations and Transfers of Care Interoperability Specification
• IS11 - Public Health Case Reporting Interoperability Specification
• IS91 - Maternal and Child Health Interoperability Specification
• IS98 - Medical Home Interoperability Specification
• CAP93 – Scheduling Capability
• CAP119 - Communicate Structured Document Capability
• CAP135 – Retrieve and Populate Form Capability
• CAP136 - Communicate Emergency Alert Capability
• TN907 - Common Data Transport Technical Note
• TP13 - Manage Sharing of Documents Transaction Package
• C28 - Emergency Care Summary Document Using IHE Emergency Department Encounter Summary (EDES) Component
• C80 - Clinical Document and Message Terminology Component
• C83 - CDA Content Modules Component
• C148 - EMS Transfer of Care Component
• C154 - Data Dictionary Component
• C162 - Plan of Care Component
• C165 - Anonymize Long Term and Post Acute Care Assessment Data Component
• C166 - Operative Note Document Component
• C168 - Long Term and Post Acute Care Assessments Component
• C170 - Vital Records Component
The public comment period on these documents will be open from Monday, February 1st until Close of Business, Friday, February 26th. HITSP members and public stakeholders are encouraged to review these documents and provide comments through the HITSP comment tracking system. The documents and the HITSP comment tracking system are located on www.hitsp.org.
As stated at the HITSP Panel meeting and in document HITSP 10 N 459 – No-cost extension to the HITSP contract, there is currently no plan for formal disposition of the comments gathered, and such work will be deferred until the resumption of normal HITSP activity. ANSI will export all comments gathered during the comment period, and publish them on the HITSP public website for broader access by members and industry.

Questions about the documents, or the process for review should be addressed to me, the HITSP Secretariat at mmaasdeane@ansi.org.

AHIMA Goes To Washington

AHIMA Launches White Paper Series on Meaningful Use

This week AHIMA launches a series of short white papers analyzing the recently released notice of proposed rulemaking on “meaningful use,” the federal incentive program to encourage EHR adoption and use. Each week the series will review the notice and discuss the issues for hospitals and physician practices that decide to apply for these payments. In later weeks the papers will cover AHIMA’s comments on the proposed regulations. The series is available on the AHIMA ARRA Web page and the Journal of AHIMA Web site, where readers can discuss the issues, opportunities, and challenges with each other. The tentative schedule:

• Week 1—Overview of the NPRM and the Meaningful Use Definition
• Week 2—Continuation of the Overview and Meaningful Use Mechanisms
• Week 3—Meaningful Use and Certification
• Week 4—HIT Functionality Measures for Eligible Providers/Hospitals
• Week 5—Clinical Quality Measures for Eligible Providers/Hospitals
• Week 6—Process for Demonstrating Meaningful Use
• Week 7-8—AHIMA Comments on Meaningful Use

Watch for announcements of new papers each week in e-alert. AHIMA has already provided an overview of the notice of proposed rulemaking based on the draft issued on December 30, 2009. This can be found at the AHIMA ARRA Web page.


AHIMA Advantage Goes Digital in 2010

Look for your first digital edition of AHIMA Advantage beginning with the February issue. In 2010, AHIMA Advantage will be offering three digital issues in the months of February, June, and October and three print issues in April, August, and December. The digital editions will come to you much faster via e-mail and offer additional features such as searchability and portability. No software will be needed to access the digital versions and they will be available at your convenience. You will be receiving your first digital edition of AHIM Advantage in February. Please let us know what you think! E-mail us at advantage@ahima.org.

Advocates Sought For 2010 AHIMA Capitol Hill Day

AHIMA’s Capitol Hill Day is an opportunity for members of the 111th Congress to hear directly from HIM professionals who are working to ensure quality healthcare through quality information. This second session of Congress must address HIM issues beyond the coverage of the ARRA stimulus package or healthcare reform. Issues remain to be addressed including HIM and allied health education, privacy and security, red flags rules, and record audits. Who better to inform Congress than HIM professionals working on the front line of change and facing many practical questions that can be resolved in part by members of Congress?

AHIMA members will visit Capitol Hill on March 23, a day after AHIMA holds its Winter Team Talks in Washington, DC. Imagine the impact if every member of Congress received a visit from one or more constituents carrying a message of interest to the HIM profession. Join us and plans to participate early by going to the Hill Day Web site for more information.

Reservations with AHIMA must be made by February 26 to accommodate the Congressional visit appointment process. Hotel reservations should also be made no later than February 19, to obtain a room at the Hilton Washington Hotel. Learn more here. Let’s send a professional message to Congress and move our HIM agenda forward.