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Medicare Eligible Hospitals: Take Action by April 1 to Avoid 2015 Payment Adjustment

Payment adjustments for eligible hospitals that have not successfully participated in the Medicare EHR Incentive Program will begin on October 1, 2014. Hospitals can avoid the payment adjustment by taking action by April 1.

Hospitals that have never participated in the Medicare EHR Incentive Program can:

  • Submit a hardship exception application for experiencing circumstances that posted a significant barrier to achieving meaningful use
  • Begin 90 days of meaningful use for the 2014 reporting year by April 1 and attest by July 1

Hospitals that participated in 2011 or 2012, but did not successfully participate in 2013 due to circumstances that created barriers can also submit a hardship exception.

About Hardship Exceptions
The hardship exception application for Medicare eligible hospitals is available on the EHR Incentive Programs website and outlines the specific types of circumstances that CMS considers to be barriers to achieving meaningful use. Supporting documentation must also be provided. CMS will review applications to determine whether or not a hardship exception should be granted.

As a reminder, the application must be submitted electronically or postmarked no later than 11:59pm ET on April 1, 2014 to be considered. If approved, the exception is valid for one year.

March 10, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

2015 Edition EHR Certification Criteria NPRM Out as a #HIMSS14 Present

HHS just sent out the announcement about the 2015 Edition EHR Certification Criteria (“2015 Edition”) NPRM (Notice of Proposed Rule Making). I guess the new ONC coordinator didn’t learn from the last time an NPRM was released during HIMSS. It ruined a lot of people’s time at HIMSS as they scoured the rule. Although, I don’t think the 2015 Edition will be quite as big of a deal as the original MU NPRM. You can sure many people will enjoy the 2015 Edition NPRM as some light reading on their airplane ride to HIMSS. I’m sure HHS wanted it published before HIMSS so they could talk about it during their sessions at HIMSS as well.

Here’s the announcement and for those that don’t want to filter through the fluff of the full final rule, here’s a great 2015 Edition Fact Sheet.

The HHS Office of the National Coordinator for Health Information Technology (ONC) today issued proposals for the next edition (the “2015 Edition”) of electronic health record (EHR) technology certification criteria.

This proposed rule marks the first time ONC has proposed an edition of certification criteria separate from the Centers for Medicare & Medicaid Services’ “meaningful use” regulations. The proposals represent ONC’s new regulatory approach that includes more incremental and frequent rulemaking. This approach allows ONC to update certification criteria more often to reference improved standards, continually improve regulatory clarity, and solicit comments on potential proposals as a way to signal ONC’s interest in a particular topic area.

“The proposed 2015 Edition EHR certification criteria reflect ONC’s commitment to incrementally improving interoperability and efficiently responding to stakeholder feedback,” said Karen DeSalvo, M.D., M.P.H., national coordinator for health IT. “We will continue to focus on setting policy and adopting standards that make it possible for health care providers to safely and securely exchange electronic health information and for patients to become an integral part of their care team.”

Compliance with the 2015 Edition would be voluntary — EHR developers that have certified EHR technology to the 2014 Edition would not need to recertify to the 2015 Edition for customers to participate in the Medicare and Medicaid EHR Incentive Programs. Similarly, health care providers eligible to participate in the Medicare and Medicaid EHR Incentive Programs would not need to “upgrade” to EHR technology certified to 2015 Edition to have EHR technology that meets the Certified EHR Technology definition. “This provides the opportunity for developers and health care providers to move to the 2015 Edition on their own terms and at their own pace,” said Dr. DeSalvo.

The proposed rule will be published in the Federal Register on February 26, 2014. ONC will accept comments on the proposed rule through April 28, 2014. The final rule is expected to be issued in summer 2014.

For more information, visit Standards and Certification Regulations page on HealthIT.gov.

February 21, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

New EHR Attestation Deadline for Eligible Professionals: March 31, 2014

I just got the following update to meaningful use deadlines from CMS:

CMS is extending the deadline for eligible professionals to attest to meaningful use for the Medicare EHR Incentive Program 2013 reporting year from 11:59 pm ET on February 28, 2014 to 11:59 pm ET March 31, 2014.

In addition, CMS is offering assistance to eligible hospitals who may have experienced difficulty attesting to submit their attestation retroactively and avoid the 2015 payment adjustment.

This extension will allow more time for providers to submit their meaningful use data and receive an incentive payment for the 2013 program year, as well as avoid the 2015 payment adjustment.

This extension does not impact the deadlines for the Medicaid EHR Incentive Program or any other CMS program, including the electronic submission for the Physician Quality Reporting System EHR Incentive Program Pilot.

February 7, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Timeline and Details of Medicare EHR Penalties

Eligible professionals (EPs) participating in the Medicare EHR Incentive Program may be subject to payment adjustments beginning on January 1, 2015. CMS will determine the payment adjustment based on meaningful use data submitted prior to the 2015 calendar year. EPs must demonstrate meaningful use prior to 2015 to avoid payment adjustments.

Determine how your EHR Incentive Program participation start year will affect the 2015 payment adjustments:

If you began in 2011 or 2012…
If you first demonstrated meaningful use in 2011 or 2012, you must demonstrate meaningful use for a full year in 2013 to avoid the payment adjustment in 2015.

If you began in 2013…
If you first demonstrate meaningful use in 2013, you must demonstrate meaningful use for a 90-day reporting period in 2013 to avoid the payment adjustment in 2015.

If you plan to begin in 2014…
If you first demonstrate meaningful use in 2014, you must demonstrate meaningful use for a 90-day reporting period in 2014 to avoid the payment adjustment in 2015. This reporting period must occur in the first 9 months of calendar year 2014, and EPs must attest to meaningful use no later than October 1, 2014, to avoid the payment adjustment.

Avoiding Payment Adjustments in the Future
You must continue to demonstrate meaningful use every year to avoid payment adjustments in subsequent years.

If you are eligible to participate in both the Medicare and Medicaid EHR Incentive Programs, you MUST demonstrate meaningful use to avoid the payment adjustments. You may demonstrate meaningful use under either Medicare or Medicaid.

If you are only eligible to participate in the Medicaid EHR Incentive Program, you are not subject to these payment adjustments.

February 3, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

McKesson and Meditech Named as First “Test EHRs” by CMS and ONC

CMS and ONC just announced the first two “Test EHRs” are McKesson and Meditech. Here’s the details of their announcement:

As part of our and CMS’ ongoing effort to improve interoperability among certified Electronic Health Records Technology (CEHRT), we are pleased to announce McKesson and Meditech are the first two “Test EHRs,” selected from among certified EHRs. We strongly encourage others in the EHR technology developer community to participate in the program to become a CMS designated test EHR.

Under Stage 2 of Meaningful Use transition of care objective measure #3 [PDF - 218 KB]eligible professionals (EPs) and eligible hospitals/critical access hospitals (CAHs) must either:

- Conduct one or more successful electronic exchanges of a summary of care document, with a recipient who has EHR technology designed by a different EHR technology developer than the sender’s.

Or

- Conduct one or more successful tests with the CMS designated test EHR during the EHR reporting period

ONC and NIST conducted a pilot that ran from September through November of last year to finalize the test procedures. The pilot participants were AthenaHealthMcKesson andMeditech.

To find out more about becoming a CMS designated test EHR, read the “EHR Technology Developers” section of the FAQs on becoming a CMS designated test EHR and the “Developer Participant Information for Cross Vendor Exchange” document.

I find it interesting that AthenaHealth was a pilot participant, but isn’t one of the official “Test EHRs.” I wondered what happened there. Looks like a lot of EHR vendors will be able to at least connect to McKesson and Meditech.

January 16, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

One Physician Ready for the EMR Revolution – #EHRBacklash

In my post about the Coming Physician EHR Revolt (some are calling it the #EHRBacklash), I got the following comment from Rick Spencer, MD.

Let alone the extreme inefficiency of EMR, the generated documents are a waste of time to read. I’ve not found one EMR generated document from an ER or speciaty office that is worth any more than throwing in the trash can. An ER will send you 8 pages on your patient, and you’re lucky if you find one paragragh where a human being actually took the time to enter something useful. God forbid that doctors and nurses should actually see their patients and give good clinical descriptions of their observations and examinations. You can’t fit a round peg in a square hole, and that’s exactly what EMR is all about. What really gripes me is who is all of this for?–insurance companies?– they seem to run every thing else. And, really, what interest does the government have in mandating how helath care providers see their patients?– don’t tell me that it’s for better patient care because I’m sure they could care less. Finally, the medical school professors that taught me 25 years ago would roll over in their graves if they knew how the medical profession just rolled over and let government and insurance companies tell them how to conduct a doctor-patient relationship. I’m eager to be part of any revolution that would put health care providers back in the driver’s seat where they belong. Thanks for this opportunity to get this off my chest!!!!

Is this an isolated case or an example of a larger trend. I personally think it’s part of a larger trend. I’m not sure most doctors are ready for a revolution, but they would certainly welcome a revolution in the way EMR’s document care. I’ve heard hundreds of doctors complain about the spew of data that many EMR vendors push out to satisfy billing.

Along with this pressure, I talked to someone today who said that many doctors are looking at the meaningful use stage 2 requirements and thinking that it may not be worth the effort. The requirements are higher and the EHR incentive is lower. Don’t be surprised if many doctors revolt against MU stage 2 as well.

September 27, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

ONC Health IT Infographic

These are some really interesting numbers. The one that hit me is the percentage of doctors and hospitals which were meaningful users of an EHR. We’ll see how that percentage changes over time. No doubt EHR has made huge progress since the EHR incentive money was put in place.

ONC Health IT Infographic

September 25, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

CMS Releases MU Stage 2 Guide

CMS has released a new resource, An Eligible Professional’s Guide to Stage 2 of the EHR Incentive Programs, which provides a comprehensive overview of Stage 2 of the EHR Incentive Programs to eligible professionals. The guide outlines criteria for Stage 2 meaningful use, 2014 clinical quality measure reporting, and 2014 EHR certification.

The guide’s table of contents makes it easy for you to navigate through Stage 2 topics. Interactive tabs included at the bottom of each page allow you to transition between different chapters.

Chapters include:

  • What is Stage 2 of the EHR Incentive Programs?
  • What are the requirements under Stage 2 of Meaningful Use?
  • How will clinical quality measures (CQMs) change?
  • Resources

The guide can be found on the Educational Resources page of the EHR website.

September 17, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

New Certified Health IT Mark from ONC

One of the keys to a good certification is good branding. Think about JD Power and Associates. When you see that brand, you know what it means and what it represents. For EHR software, ONC is likely hoping that their new ONC Certified HIT mark will do something similar for EHR software.

Here’s the mark you should look for to know if an EHR meets the 2014 Edition Standards and Certification criteria:
ONC EHR Certification - Health IT Mark

What’s in a mark? I think it currently serves two purposes. First, it says if that EHR vendor can help you show meaningful use and get the EHR incentive money. This is the most important part of a good mark. The second is that EHR vendors that have this mark will have conformed to the interoperability standards that are set in the EHR certification process. I’m hopeful that this is the most valuable thing that comes out of EHR certification and meaningful use.

The following is the full press release from HHS about the new EHR certification mark.

EHR products must meet standards and certification criteria to be certified

A new mark for certified electronic health records (EHR) technology was unveiled today by the HHS Office of the National Coordinator for Health Information Technology (ONC). The mark will appear on EHR products that have been certified by an ONC-Authorized Certification Body (ONC-ACB) and will indicate that the product meets the 2014 Edition Standards and Certification Criteria.

Eligible professionals and hospitals must demonstrate meaningful use of EHR technology that has been certified under the ONC Health Information Technology (HIT) Certification Program to qualify for Medicare and Medicaid EHR incentive payments.

“We’ve reached the tipping point of doctors adopting electronic health record systems and using them to improve patient care,” said Farzad Mostashari, M.D., national coordinator for health information technology. “The use of the ONC Certified HIT mark will help to assure them that the EHR they have purchased will support them in meeting the Meaningful Use requirements.”

Electronic health records technology may be certified by one of four ONC-ACBs accredited by the American National Standards Institute (ANSI) and authorized by ONC. The mark is a visual cue that the product – whether a complete EHR, an EHR module or another type of health IT product – meets ONC’s applicable certification criteria and can achieve interoperability, functionality and security. For example, the criteria include such requirements as computerized provider order entry (CPOE), drug to drug and drug-allergy checks, and the capability to coordinate clinical information to help improve the quality of patient care, among others.

When the mark is associated with a certified “Complete EHR” it means that the EHR technology can be used without modification to achieve Meaningful Use. A certified EHR module may be combined with other modules to make a complete system. Some modules may include the ability to:

  • ·         Create a standard patient summary care record;
  • ·         Securely transmit summary care records using Direct, a tool created through an ONC-led collaboration with broad health IT industry participation, that allows for the secure exchange of health information over the Internet; and
  • ·         Provide patients with online access to view, download, and transmit their health information to destinations of their choice.

ONC-ACBs will begin to issue the mark to certified EHR products immediately. To learn more about the terms and use of the mark, click here.

July 11, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Report to Congress on Health IT Adoption and HIE

ONC recently posted the “Update on the Adoption of Health Information Technology and Related Efforts to Facilitate the Electronic Use and Exchange of Information.” The report provides updates on the adoption of health IT from January 1, 2012 to April 30, 2013. The report also describes CMS’ and ONC’s efforts to facilitate the nationwide adoption and exchange of electronic health information, identifies and discusses barriers to the adoption and exchange of electronic clinical data, and how HHS’ programs are helping to address those barriers.

Here’s the full PDF report.

These reports are always interesting, because they focus on all the very best angles for the data. Looking at the report it would seem that everything is happily moving along in the EHR adoption world and that we’re almost done with the implementation of EHR. Unfortunately, the reality is very different. We have made huge progress in adoption of EHR, but we still have a long way to go in use of EHR.

I also wish the report would have put more focus on the exchange of health information. I imagine they didn’t want to do so, because the numbers there are pretty bleak. We still have a long way to go and if they put the numbers out there for it, it would not be pretty.

I was intrigued by the final paragraph in the document. It basically suggests that healthcare IT is going to play an important role in the shift of how we pay for healthcare. This is a great question. Could the shift in healthcare payments happen without healthcare IT?

June 27, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.