Meaningful Use | 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

Meaningful Use Attestation Deadline for 2012 and MU Stage 2 Testing Ready

Eligible professionals (EPs) who participated in the Medicare Electronic Health Record (EHR) Incentive Program in 2012 must complete attestation for the 2012 program year by February 28, 2013. In order to be eligible to attest you must have completed your 2012 reporting period by December 31, 2012.

CMS encourages Medicare EPs to register and attest as soon as possible to resolve any potential issues that may delay their payment.

Medicaid EPs should check with their State for their attestation deadline.

Resources from CMS
CMS has several resources located on the EHR Incentive Programs website to help EPs properly meet meaningful use and attest, including:

A Registration & Attestation page that includes information on registration and attestation, and links to additional resources.
The Meaningful Use Attestation Calculator, which allows EPs and eligible hospitals to determine if they have met the Stage 1 meaningful use guidelines before they attest in the system.
The Attestation User Guide for Medicare Eligible Professionals, providing step-by-step guidance for EPs participating in the Medicare EHR Incentive Program on navigating the attestation system.
The Attestation Worksheet for Eligible Professionals, allowing users to enter their meaningful use measure values, creating a quick reference tool to use while attesting.

Also, for EHR vendors, ICSA just announced that they are now set to begin testing EHR software for meaningful use stage 2. That’s right. Meaningful Use stage 2 is just around the corner.

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January 16, 2013 I Written By John

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

Tags:CMS EHR Certification ICSA Meaningful Use Deadlines Meaningful Use Stage 2 Meaningful Use Timeline

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.

Disturbing: Empty EHR Meaningful Use Reports

Melissa Joubert offered this comment on a LinkedIn thread I was following that I found incredibly disturbing:

This and many other barriers currently exist. For example, some systems that claim to be certified for meaningful use simply don’t offer a fully integrated report module. I have seen cases where either the numbers are skewed, or there are no numbers showing at all even when a practice swears they are entering all necessary data.

Have you seen this happening as well? Have you seen certified EHR software that can’t report the proper meaningful use numbers? If this was widespread I’d think that we’d have heard more people complaining about it. What’s been your experience?

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

EHR Adoption to Potentially Reach 80 Percent by 2016

Meaningful Use incentives and cloud computing are two factors that are helping EHR become more widespread across the country. According to a new IDC MarketScape report, EHR will be adopted in more than 80 percent of health care organizations by 2016. In 2009, only 25% of health organizations had implemented EHR into their practices.

Because smart phones and tablets are becoming more and more prevalent in the health care scene, this is thought to be a driving force in the increase in EHR throughout the country.

The IDC report examined 11 EMR/EHR products in the United States. Athenahealth and eClinical works were recognized for their pricing modles, while Optum was found to have excellent collaboration with a health insurer.

However, even though this growth is predicted, adoption in small practices isn’t growing very fast. Of the companies examined, the companies that was most popular among small practices were AllScripts and eClinicalWorks, though Cerner, GE Healthcare and NextGen Healthcare Information Systems also appeal to these small practices. Although the incentive program is supposed to aid in adoption EHR, Judy Hanover, the research director at IDC Health Insights, believes that small practices will not benefit long term if only the meaningful use guidelines are being met.

This seems like a relatively small EHR market study with plenty of EHR vendor bias. However, it’s one more data point to consider when you look at the future of the EHR market. I personally don’t believe we’ll be anywhere near 80% EHR adoption by 2016, but I’d love to be proved wrong.

EHR Certification Revoked for EHRMagic

EHR Incentive Sequestration and Guidance on Meaningful Use Attestation

Meaningful Use Attestation Deadline for 2012 and MU Stage 2 Testing Ready

MU Stage 3 Comment Period and Hospital EHR Attestation Deadline Approaching

The Impact of EHR Certification

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

Meaningful Use Stage 2 Final Rule Published

Disturbing: Empty EHR Meaningful Use Reports

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

EHR Adoption to Potentially Reach 80 Percent by 2016

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