EHR Incentive | EMR Thoughts

EHR Certification Revoked for EHRMagic

Yesterday HHS released news that they’d revoked the EHR certification of the EHRMagic-Ambulatory and EHRMagic-Inpatient EHR software. Looks like InoGard originally certified the EHR and they and ONC received information that had them retest the EHR software and it failed the certification re-test.

I think we all want government to hold bad actors accountable. So, it’s good to weed out EHR companies that aren’t doing what they should. However, they better also be careful. Imagine being a doctor of an EHR vendor whose EHR certification gets revoked. Does that mean that they have to give back the EHR incentive money the received? Those doctors trusted in InfoGard’s ability to certify an EHR vendor and InfoGard failed at that job. Should a doctor be punished for InfoGard’s failing? Now apply this to a hospital that uses a certified EHR and loses that EHR certification. That’s a multi-million dollar impact.

I guess EHRMagic better take down the info on their website that says they can get physicians $44,000 in EHR incentive money. Looking at their website, it makes me wonder who chose to use their EHR in the first place. That would be interesting to know.

Here’s the full press release from HHS on the EHR revocation:

Two electronic health records, previously certified as products to be used as part of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, have had their certifications revoked. Farzad Mostashari, M.D., the national coordinator for health information technology, announced today that the products do not meet standards and providers cannot use these products to meet the requirements of the Medicare and Medicaid EHR Incentive programs.

EHRMagic-Ambulatory and EHRMagic-Inpatient, both developed by EHRMagic Inc. of Santa Fe Springs, Calif., no longer meet the EHR certification requirements. The EHRs must be certified by a certification body (ACB) authorized by the Office of the National Coordinator for Health IT (ONC) before regaining certification.

Both ONC and an ONC ACB, InfoGard Laboratories Inc. (InfoGard), received notifications that the EHRMagic products did not meet the required functionality and the products should not have passed certification. InfoGard analyzed the additional information from the notification and contacted EHRMagic, launching the ONC authorized certification body required surveillance activities. InfoGard concluded that it was necessary for the EHR products to be retested for select requirements. EHRMagic, Inc. participated in retesting and failed.

“We and our certification bodies take complaints and our follow-up seriously. By revoking the certification of these EHR products, we are making sure that certified electronic health record products meet the requirements to protect patients and providers,” said Dr. Mostashari. “Because EHRMagic was unable to show that their EHR products met ONC’s certification requirements, their EHRs will no longer be certified under the ONC HIT Certification Program.”

Information about ONC’s certification process for EHR technologies is available at http://www.healthit.gov/providers-professionals/certification-process-ehr-technologies.

EHR Incentive Sequestration and Guidance on Meaningful Use Attestation

The CMS website has a great resource with answers to a number of FAQs. For example, here’s two questions that related to sequestration’s impact on EHR incentive and meaningful use attestation.

Question: Will incentive payments earned in the Medicare and Medicaid Electronic Health Records Incentive programs be affected by sequestration?

Answer: Incentive payments made through the Medicare EHR Incentive Program are subject to the mandatory reductions in federal spending known as sequestration, required by the Budget Control Act of 2011. The American Taxpayer Relief Act of 2012 postponed sequestration for 2 months. As required by law, President Obama issued a sequestration order on March 1, 2013. Under these mandatory reductions, Medicare EHR incentive payments made to eligible professionals and eligible hospitals will be reduced by 2%. This 2% reduction will be applied to any Medicare EHR incentive payment for a reporting period that ends on or after April 1, 2013. If the final day of the reporting period occurs before April 1, 2013, those incentive payments will not be subject to the reduction.

Please note that this reduction does not apply to Medicaid EHR incentive payments, which are exempt from the mandatory reductions.

Question: For the Medicare and Medicaid EHR Incentive Programs, how should an EP, eligible hospital, or critical access hospital (CAH) attest if the certified EHR vendor being used is switched to another certified EHR vendor in the middle of the program year?

Answer: If an EP, eligible hospital or CAH switches from one certified EHR vendor to another during the program year, the data collected for the selected menu objectives and quality measures should be combined from both of the EHR systems for attestation. The count of unique patients does not need to be reconciled when combining from the two EHR systems.

If the menu objectives and/or clinical quality measures used are also being changed when switching vendors, the menu objectives and/or quality measures collected from the EHR system that was used for the majority of the program year should be reported.

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April 25, 2013 I Written By John

Filed Under: EHR EHR Incentive Electronic Health Record Electronic Medical Record EMR Healthcare IT Meaningful Use

Tags:CMS CMS FAQ EHR Incentives EHR Stimulus HITECH Sequestration

EHR Incentive Money and Sequestration Update

At HIMSS, the news was tweeted out about the impact of Sequestration on Meaningful Use and EHR incentive money. I’d seen little other details about the impact of sequestration on the EHR incentive money until now. CMS just sent out the following update on the mandated sequestration.

Mandated Sequestration Payment Reductions Beginning for Medicare EHR Incentive Program

Incentive payments made through the Medicare Electronic Health Record (EHR) Incentive Program are subject to the mandatory reductions in federal spending known as sequestration, required by the Budget Control Act of 2011.

Incentive Payment Reduction
The American Taxpayer Relief Act of 2012 postponed sequestration for two months. As required by law, President Obama issued a sequestration order on March 1, 2013. Under these mandatory reductions, Medicare EHR incentive payments made to eligible professionals and eligible hospitals will be reduced by 2%.

Reduction Timing
This 2% reduction will be applied to any Medicare EHR incentive payment for a reporting period that ends on or after April 1, 2013. If the final day of the reporting period occurs before April 1, 2013, those incentive payments will not be subject to the reduction.

Please note: This reduction does not apply to Medicaid EHR incentive payments, which are exempt from the mandatory reductions.

The 2% will be a little annoying for a doctor’s office, but the 2% off the multi-million dollar EHR incentive a hospital receives is going to add up to a pretty penny. At least the information is out there so that hospitals can plan. Although, it’s not like you can stop the EHR implementation at this point in the cycle.

MU Stage 3 Comment Period and Hospital EHR Attestation Deadline Approaching

HIT Policy Committee sent out an email with a request for comments on meaningful use stage 3. Here’s the email that was sent out:

Speak up now to help ONC’s Health Information Technology Policy Committee (HITPC) develop Stage 3 meaningful use recommendations that will target a collaborative model of care with shared responsibility and accountability, building upon previous meaningful use objectives through the Request for Comment.

The comment period is now open. Each item that the HITPC is requesting comment on has been given an identification number in order to streamline the accumulation of comments. Please use this ID number when submitting comments. Submit a comment online.

The deadline for comments is 11:59p.m. ET on January 14, 2013.

Following the analysis of the comments received throughout the comment period, the HITPC intends to revisit these recommendations in its public meetings in the first quarter of 2013.

Also, for those Eligible Hospitals and Critical Access Hospitals (CAHs), the last day for you to register and submit attestation in fiscal year 2012 for the Medicare EHR program is November 30, 2012. For eligible hospitals and CAHs, this means that they must successfully attest to meeting meaningful use to be eligible to receive an incentive payment for FY 2012.

CMS has also put together this PDF of the meaningful use and EHR incentive timeline. Be careful so you don’t miss any deadlines.

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November 27, 2012 I Written By John

Filed Under: EHR EHR Incentive Electronic Health Record Electronic Medical Record EMR Healthcare IT HITECH Meaningful Use

Tags:CAHs CMS Eligible Hospitals HIT Policy Committee Meaningful Use Deadlines Meaningful Use Stage 3 Meaningful Use Timelines ONC

The Impact of EHR Certification

In the comments of my post on EMR and EHR titled EHR Vendors Using EHR Certification Excuse, Jeff offered a frank comment about the realities EHR vendors face in this current climate:

I went through EHR certification for a EHR product – for the sake of this discussion it can remain nameless as you can insert any EHR name and it will share the same issues. The process was cumbersome and I agree is not worthwhile for our clients. However at least 90% of our clients were requesting it and all of our sales pipelines say they required it. The interaction you describe I have had. I don’t think it’s the fault of us as a vendor as much as the short sightedness of the committee that created the certification rules. We had to implement fields/screens/buttons that served no purpose in the type of practice we supplied our software to. That did not matter to the certification proctor, we had to show it or we failed and lost a lot of money. Getting certified threw off our development cycle at least 6 months. During that time we had to push off many good customer requested enhancements. In hindsight would our customers prefer we did not get certified – probably, but could our company take a chance at not being able to renew contracts or get new sales. No way, not for a government mandated push.

This reminds me of a video I recently saw that asked the question, “What do we want EHR certification to do?” The problem here is that I think everyone has a different answer to that question. Until we define what EHR certification should really accomplish, it’s hard to make criteria that are beneficial and easy to understand. In the rush to meet the regulatory requirements I think we missed creating the bigger vision of why we’re doing EHR certification at all. That’s why we’re where we’re at today.

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October 24, 2012 I Written By John

Filed Under: EHR EHR Incentive Electronic Health Record Electronic Medical Record EMR Healthcare IT HITECH Meaningful Use

Tags:EHR Certification EHR Software EHR Vendors HITECH Meaningful Use

October 3 is the Last Day for EPs to Begin the Medicare EHR Incentive Program in 2012

Wednesday, October 3rd marks two important deadlines for the Medicare EHR Incentive Program:

The last day for eligible professionals (EPs) to begin their 90-day reporting period for calendar year (CY) 2012 for the Medicare EHR Incentive Program. For EPs, this means that they must begin their consecutive 90-day reporting period by October 3rd in order to attest to meeting meaningful use and be eligible to receive an incentive payment for CY 2012.
The last day Medicare EPs can start participating and receive their maximum possible Medicare incentive payment. This is the last year that EPs can begin participation in the EHR Incentive Program and get the full Medicare incentives of $44,000 per EP. If first-year Medicare EPs have not started their 90-day reporting period by October 3rd, they will not be eligible for a CY 2012 payment, and can only receive $39,000 in Medicare incentives if they successfully participate in 2013.

For more information on how incentive payments are distributed, take a look at the EHR Basics page of the newly updated EHR website. For EPs who have already completed their reporting period, CMS has a number of tools available to help prepare for attestation, including the Meaningful Use Attestation Calculatorand Attestation User Guide for Eligible Professionals.

Looking Ahead
Take a look at all of the other EHR Incentive Program important dates that are coming up by going to our Health Information Technology Timeline.

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September 25, 2012 I Written By John

Filed Under: EHR EHR Incentive Electronic Health Record Electronic Medical Record EMR Healthcare IT HITECH Meaningful Use

Tags:CMS EHR Incentive Timeline EHR Stimulus Eligible Providers Medicare EHR Incentive Program

Meaningful Use Stage 2 Final Rule Published

UPDATE: For those not wanting to go through all 672 pages of the meaningful use stage 2 final rule, ONC has put out this summary PDF.

Today, CMS publishes the meaningful use Stage 2 Final rule in the Federal Register. The MU stage 2 final rule is 672 pages long.

The HHS press release announcing the EHR incentive money stage 2 final rule also offered these important points to note:

Make clear that stage two of the program will begin as early as 2014. No providers will be required to follow the Stage 2 requirements outlined today before 2014.
Outline the certification criteria for the certification of EHR technology, so eligible professionals and hospitals may be assured that the systems they use will work, help them meaningfully use health information technology, and qualify for incentive payments.
Modify the certification program to cut red tape and make the certification process more efficient.
Allow current “2011 Edition Certified EHR Technology” to be used until 2014.

The second point annoys me a little after hearing about some of the EHR certification fraud and issues it could cause providers that attest to meaningful use.

The press release also offered the following EHR incentive participation numbers:
-120,000 Eligible Health Professionals have participated
-3,300 Hospitals have participated
-More than half of all eligible hospitals and critical access hospitals and 1 out of every 5 eligible health care professionals

Watch for more detailed coverage of the meaningful use stage 2 final rule in our ongoing Meaningful Use Monday series.

Guest Post: How One of the Nation’s Top Hospitals Made the Switch to EMR Easier

In 2010, the Obama administration rolled out an ambitious five-year plan, moving doctors and hospitals to electronic medical records (EMR), with the goal of reducing costs and providing greater safety for patients. When the plan was announced, the federal government promised funding to hospitals and other health systems to help defray the astronomical costs of the conversion. Healthcare providers were warned that failure to comply by 2015 would result in cuts to Medicare, which could lead to financial losses for both doctors and hospitals.

This plan is currently underway, and both medical professionals and IT experts are scrambling to find ways to adhere to the timeline and ensure federal incentives. Prudent healthcare IT leaders realize that proactive planning is necessary to ensure seamless, cost-effective transitions that both improve efficiency and maintain customer satisfaction. To successfully transfer to EMR by the 2015 deadline, hospitals must prepare now.

When Obama’s plan was announced, Paul Moriarty, the Manager of IT Support Services for Rochester General Hospital (RGH) and his IT support team were supporting 7,500 employees. RGH is the flagship of Rochester General Health System, and the fourth largest cardiac center in the state of New York. Recognized as one of the nation’s 100 Top Cardiovascular Hospitals, RGH ranks first in New York for overall medical care.

Getting ahead of the looming mandate, Moriarty decided to evaluate and streamline his existing help desk processes so when the new computerization of health records were finally implemented, the spike in new tickets could be managed seamlessly.

Before the EMR transition process began, Moriarty’s team was utilizing HelpSTAR, a help desk solution that hospital employees used to submit issues with portals, emails and phone calls. With his team handling 5,000 IT service tickets per month prior to the EMR transition, Moriarty knew that his help desk technology would need to be able to handle a huge influx of additional requests when the transition got underway. To ensure high levels of service and satisfaction were maintained throughout the EMR move, Moriarty had to move quickly.

An existing HelpSTAR customer, Moriarty looked to HelpSTAR to identify and leverage additional features he knew his hospital would need, such as intelligent queuing, self-help tools and prompts (including alarms, follow-up reminders and automatic priority escalation). Along with these features, HelpSTAR’s built-in rapid problem resolution and extensive reporting capabilities provided just the combination Moriarty’s team needed. Moriarty designed customized ticket rules that directed requests to available team members, providing a faster and more seamless workflow. This fix brought their number of electronic tickets versus help desk calls to a manageable 3:1 ratio. With Moriarty’s proactive planning, the IT help desk has improved the efficiency and customer satisfaction needed to help facilitate a smooth EMR transition for RGH.

To learn more about Rochester General Hospital (RGH), visit the http://www.rochestergeneral.org/rochester-general-hospital/

To see if HelpSTAR can help you, visit http://www.helpstar.com/

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July 2, 2012 I Written By John

Filed Under: EHR EHR Incentive Electronic Health Record Electronic Medical Record EMR Healthcare IT HITECH

Tags:EHR Mandate EMR Switch HelpSTAR Medicare Obama Paul Moriarty RGH Rochester General Hospital

EMR Market Numbers and Number of EHR Vendors with 0 Meaningful Use Attestations

Since I’ve kind of turned EMR Thoughts into an EMR and healthcare IT market website, I feel I should definitely point out this post I did on EMR and HIPAA about the Meaningful Use EHR Vendor Breakout by Percentage. It’s a really interesting post looking at which EHR vendors are doing well with meaningful use attestation and a look at what that means in the broader EHR market.

In the comments, Dr. Rowley (who first posted some of the meaningful use numbers) offered this added insight that I think is worth highlighting:

Here’s another observation on the ambulatory EHR market. If you look at all the Certified complete EHRs on the CMS CHPL list, and compare that to the HHS Meaningful Use list from data.gov, you will see that 284 vendors had products that were used (at least once) for MU attestion; however 295 additional vendors had NO usage of their products for MU attestation in 2011. More argument to a very crowded field, and lots of products in the market with perhaps no usage (or, at least, no Meaningful Usage).

Nearly 300 EHR vendors are listed on the list of Complete Certified EHR and had 0 meaningful use attestations! Wow! I guess I shouldn’t be that surprised since I even know a number of EHR vendors that still aren’t complete EHR certified. The volume of EHR companies is just astounding to me though.

These will be important numbers to look at near the end of 2012. We’ll see how many of those nearly 300 EHR companies still don’t have any meaningful use attestations.

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June 21, 2012 I Written By John

Filed Under: EHR EHR Companies EHR Incentive EHR Market Electronic Health Record Electronic Medical Record EMR Healthcare IT HITECH Meaningful Use

Tags:Complete Certified EHR EHR Companies EHR Market EMR Market HHS Meaningful Use Meaningful Use Attestation Robert Rowley

Meaningful Use Stage 2 Comment Period Ends May 7th

ONC and CMS sent out the following email about the meaningful use stage 2 comment period. It closes very soon and so I encourage everyone to submit their comments on meaningful use stage 2. I’m a real proponent of the benefits of crowd sourcing and if enough people comment on meaningful use stage 2, I think we’ll receive the benefits of the crowd participating in the discussion and improving MU stage 2. I encourage doctors in particular to share their comments on the meaningful use stage 2 NPRM.

Please note that the comment period closes on Monday, May 7 for the notices of proposed rule-making (NPRMs) for Stage 2 of meaningful use and updated certification criteria.

The Office of the National Coordinator for Health IT (ONC) rule proposes the capabilities and related standards and implementation specifications that Certified EHR Technology will need to include to, at a minimum, support the achievement of “meaningful use” by eligible health care professionals beginning with the EHR reporting periods in FY/CY 2014. The rule also proposes revisions to the permanent certification program for health information technology, which include changing the name of the program to the “ONC HIT Certification Program.”

ONC’s rule complements the newly released Centers for Medicare & Medicaid Services (CMS) proposed rule for Stage 2 of the EHR Incentive Programs, clarifying the specifications necessary to meet the criteria for these programs.

Comments Can Be Submitted in 4 Ways

Both ONC and CMS rules identify that comments can be officially submitted in 4 ways:

Electronically through www.regulations.gov – this is the preferred method

Regular mail

Express mail or overnight mail

Hand-delivered/courier

Faxes are not accepted.

To enhance the public comment experience, ONC and CMS have made a copy of the rule available in Microsoft Word to make it easier those who comment to access and copy portions of their proposed rule for use in their individual comments. Visit http://www.healthit.gov/providers-professionals/meaningful-use-stage-2 for more information.

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May 4, 2012 I Written By John

Filed Under: EHR EHR Incentive Electronic Health Record Electronic Medical Record EMR Healthcare IT HITECH Meaningful Use

Tags:CMS EHR Certification EHR Stimulus Meaningful Use Stage 2 Meaningful Use Stage 2 NPRM MU Stage 2 ONC ONC HIT Certification Program

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