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New ONC Coordinator – Dr. Karen DeSalvo

Today it was announced that Dr. Karen DeSalvo would be the replacement to the beloved Former National Coordinator for Health IT, Farzad Mostashari. It seems that Dr. DeSalvo has an interesting history currently working as Health Commissioner for the City of New Orleans and Senior Health Policy Advisor to the New Orleans Mayor. She also has served as a member of the Steering Committee for the Crescent City Beacon Community grant.

I love Jacob Reider’s note to his ONC colleagues after serving as Acting National Coordinator:

I have been honored to serve as your Acting National Coordinator. Every minute has been inspiring, educational, and energizing. Both Lisa and I appreciate all of the support each and every one of you have given us and will give to Karen. The work of “team ONC” is a product of every team member contributing as much as we can toward our shared goals. As the baseball fans among you may recall, David Murphy, an outfielder for the Texas Rangers, was called upon to pitch in a game against the Red Sox last Summer. Like Murphy’s experience, our success has been a product of the team’s hard work and support rather than my personal achievements as your leader. As my tenure as your National Coordinator is now drawing to a close, I will return to the outfield where I am proud to serve as your Chief Medical Officer, and continue to work hard with you. We have a great team, great mission-driven people, and an incredible opportunity to change our world for the better.

I think the ONC is a great team that has the right ambitions and goals. Karen certainly has a tough act to follow. Plus, health IT is entering a new era in its history. I wish her the best of luck as she takes on this challenging position.

December 19, 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.

EHR and Data Exchange Study by Farzad Mostashari and ONC Researchers

It’s always good to know who’s behind a study that you’re reading. In this case, it is a study by ONC and they are putting National Coordinator for Health Information Technology Farzad Mostashari’s name on it along with ONC researchers. In one respect, we know that ONC has a bias towards use of health IT. On the other hand they are also the organization with the most information on what’s happening with EHR and exchange of healthcare data. So, take those biases and check out some of the highlights of the study:
· 58 percent of hospitals exchanged data with providers outside their organization in 2012 and hospitals’ exchanges with other hospitals outside their organization more than doubled during the study period.

· Hospitals with basic EHR systems and participating in HIOs (health information organizations) had the highest rates of hospital exchange activity in 2012, regardless of the organizational affiliation of the provider exchanging data or the type of clinical information exchanged.

· The proportion of hospitals that adopted at least a basic EHR and participated in an HIO grew more than fivefold from 2008 to 2012.

· Between 2008 and2012, there were significant increases in the percent of hospitals exchanging radiology reports, laboratory results, clinical care summaries, and medication lists with hospitals and providers outside of their organization.

· 84 percent of hospitals that adopted an EHR and participated in a regional HIO exchanged information with providers outside their organization.

To see state-level estimates for several of the measures included in the new study, visit ONC’s Health IT Adoption and Use dashboard at http://dashboard.healthit.gov/. The abstract of the Health Affairs study can be found at http://content.healthaffairs.org/content/32/8/1346.abstract.

August 5, 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.

HHS announces 2013 Healthcare IT Agenda

Centers for Medicare & Medicaid Services (CMS) Acting Administrator Marilyn Tavenner and the National Coordinator for Health Information Technology Farzad Mostashari, M.D., today announced HHS’s plan to accelerate health information exchange (HIE) and build a seamless and secure flow of information essential to transforming the health care system.

“Thanks to the Affordable Care Act, we are improving the way care is delivered while lowering costs,” said Acting Administrator Tavenner. “We are already seeing benefits, such as a reduction in hospital readmissions due to these reforms. Health IT and the secure exchange of information across providers are crucial to reforming the system, and must be a routine part of care delivery.”

This year, HHS will:

  • Set aggressive goals for 2013: HHS is setting the goal of 50 percent of physician offices using electronic health records (EHR) and 80 percent of eligible hospitals receiving meaningful use incentive payments by the end of 2013.
  • Increase the emphasis on interoperability: HHS will increase its emphasis on ensuring electronic exchange across providers. It will start that effort by issuing a request for information (RFI) seeking public input about a variety of policies that will strengthen the business case for electronic exchange across providers to ensure patients’ health information will follow them seamlessly and securely wherever they access care.
  • Enhance the effective use of electronic health records through initiatives like the Blue Button initiative. Medicare beneficiaries can access their full Medicare records online today. HHS is working with the Veterans Administration and more than 450 different organizations to make health care information available to patients and health plan members. HHS is also encouraging Medicare Advantage plans to expand the use of Blue Button to provide beneficiaries with one-click secure access to their health information.
  • Implement Meaningful Use Stage 2: HHS is implementing rules that define what data must be able to be exchanged between Health IT systems, including how data will be structured and coded so that providers will have one uniform way to format and securely send data.
  • Underscore program integrity: HHS is taking new steps to ensure the integrity of the program is sound and technology is not being used to game the system. For example, it is conducting extensive medical reviews and issuing Comparative Billing reports that identify providers.

The goals build on the significant progress HHS and its partners have already made on expanding health information technology use. EHR adoption has tripled since 2010, increasing to 44 percent in 2012 and computerized physician order entry has more than doubled (increased 168 percent) since 2008.

“The 2014 standards for electronic health records create the technical capacity for providers to be able to share information with each and with the patient,” said Dr. Mostashari. “Through the RFI, we are interested in hearing about policies that could provide an even greater business case for such information sharing.”

In addition to seeking public input, the RFI also discusses several potential new policies and ideas to accelerate interoperability and exchange of a patient’s health information across care settings so that they can deliver better and more affordable care to their patients.

The RFI can be found at http://www.ofr.gov/OFRUpload/OFRData/2013-05266_PI.pdf. Deadline for comments is April 21, 2013.

March 8, 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.

Farzad Mostashari’s Post on Meaningful Use Stage 2 NPRM

I love that Farzad Mostashari and other people at HHS and ONC have been blogging about these exciting times in healthcare IT. Farzad recently did a post about the meaningful use stage 2 NPRM (see this Meaningful Use Monday post on Meaningful Use Stage 2). He starts off the post with some interesting numbers:

to date, more than 43,000 providers have received $3.1 billion to help make the transition to EHRs; the number of hospitals using EHRs has more than doubled in the last two years from 16 to 35 percent between 2009 and 2011; and 85 percent of hospitals now report that by 2015 they intend to take advantage of the incentive payments.

I’ve always found the ONC/CMS/HHS numbers to be a bit higher than reality. Although, I bet their hospital numbers aren’t too far off. There’s little doubt that hospitals are interested in EHR.

Farzad also offered the most succinct view of the 3 stages of meaningful use that I’ve seen. Here’s basically his vision for meaningful use:

  • Stage 1 (which began in 2011 and remains the starting point for all providers): “meaningful use” consists of transferring data to EHRs and being able to share information, including electronic copies and visit summaries for patients.
  • Stage 2 (to be implemented in 2014 under the proposed rule): “meaningful use” includes standards such as online access for patients to their health information and electronic health information exchange between providers.
  • Stage 3 (expected to be implemented in 2016): “meaningful use” includes demonstrating that the quality of health care has been improved.

I posted a comment on the blog post which is still waiting to be approved:

Some very interesting numbers and I appreciate the overall vision of what each stage will do. The first part of this post reminds me of what I heard at HIMSS, that ONC has become more of a marketing organization. I found that interesting since you could easily see why ONC is considered an EHR marketing organization.

These first year numbers are interest, but the second year numbers will matter even more. The first year numbers were likely those who already adopted EHR versus those that implemented EHR post-stimulus. Let’s hope the message that providers offer after they’ve implemented is that they love their EHR. If they start telling their colleagues that they hate the EHR that they were “forced” to implement because of the government carrots and sticks, then it will be quite disappointing.

February 27, 2012 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.

Video of Meaningful Yoose Rap at ONC Meeting

Word’s gotten out that the ONC meeting really got down to business and did a bunch of great work today. See this video of Aneesh Chopra and Farzad Mostashari getting down to what looks like maybe the ONC staff doing Ross Martin’s Meaningful Yoose rap.

Note: I tried to embed the video, but that doesn’t seem to be working. So, here’s a link to the video.

All kidding aside, I think it’s great that they did this at the ONC Meeting. Sometimes the people at ONC have to take things far too seriously. It’s like they’re not even human. Here’s a link to see the original Meaningful Yoose rap by Ross Martin.

November 17, 2011 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.

Permanent EHR Certification Program (ONC-ACB) Delayed – Is Meaningful Use Stage 2 Delay Next?

It doesn’t come as much of a surprise to me to see the news (yes it’s a couple days old now) that the permanent EHR certification program (where ONC-ATCB becomes ONC-ACB) has been delayed. It was set to sunset at the end of this year and it would essentially convert into the permanent EHR certification program.

ONC’s Farzad Mostashari put out a letter describing the delay in implementing the permanent EHR certification program in this letter. Here’s one portion of the letter:

ONC pushed the plan back after it consulted with the American National Standards Institute (ANSI), which ONC selected as its approved accreditor (ONC-AA) earlier this year, and the National Institute of Standards and Technology (NIST), which administers the National Voluntary Laboratory Accreditation Program (NVLAP). ANSI and NIST said they needed more time to complete the approval of testing labs and certification organizations and ONC to review the applications of the certifiers.

Part of the reasoning for this was for the permanent EHR certification to coincide with the final rule for meaningful use stage 2. I guess it makes sense.

The real challenge I have when thinking about the change from temporary to permanent status is, what will really change? To me this feels mostly like a bureaucratic requirement as opposed to some change that actually provides some sort of benefit.

Will an ONC-ACB provide something of more value than a ONC-ATCB does now? I think not. Will EHR vendors go through a different process with an ONC-ACB compared with what they do now with the ONC-ATCB? I can’t imagine they will. Seems the only ones that should be concerned with this are the ONC-ATCB’s.

Plus, if meaningful use stage 2 gets delayed, then will the permanent EHR certification get delayed again too? Now your ears perk up. Not because anyone cares about the permanent EHR certification, but because a delay in meaningful use stage 2 would be something of note.

November 4, 2011 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.

Mostashari Supports Meaningful Use Stage 2 Delay to 2014

Katherine wrote previously on EMR and EHR about the Meaningful Use Stage 2 delay that was agreed to by the Health IT policy committee. However, that committee is basically just a recommendation engine. They can’t make or create policies. So, it’s pretty big news (although not that unexpected) reported by Government Health IT that Mostashari is supporting the meaningful use stage 2 delay until 2014.

Here’s a short quote from that article:

By giving providers and vendors additional time, requirements for stage 2 can be more rigorous than would otherwise be possible if stage 2 were to begin in 2013 as originally planned, Mostashari said.

“In consideration of these points and the concerns expressed by multiple stakeholders, we agree with the logic of delaying the start of stage 2 of meaningful use for a period of one year for those first attesting to meaningful use in 2011. We also agree that it makes sense to maintain the current expectations for those first attesting to meaningful use in 2012 so that all providers attesting to meaningful use in 2011 or 2012 would attest to stage 2 in 2014,” he said.

Although, the article above also offers some even more interesting comments from Mostashari about those that attest to meaningful use in 2011 versus those who attest to meaningful use in 2012.

Providers who attest to meaningful use at the earliest possible time in 2011 should be rewarded, Mostashari said at the July 6 policy committee meeting. Delaying the onset of stage 2 may encourage more providers to attest in 2011.

“The last thing we want to do is provide a disincentive towards attesting for meaningful use in 2011. We recognize that not accepting your recommendation to delay the start of stage 2 could negatively impact provider participation rates in the EHR incentive program in 2011,” he added.

It’s nice to see Mostashari talking about these sorts of topics in public. They are things that we’ve discussed extensively on EMR and HIPAA and EMR and EHR. It’s a topic that is very important to clinics deciding on how to approach meaningful use.

July 7, 2011 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.

Reasons for EHR Market Failure According to ONC Director Mostashari

In the write up of the Farzad Mostashari closing keynote of the Government Health IT conference in Washington, Tom Sullivan provided the following summary and quote (emphasis mine):

Competition is a wonderful thing, said Mostashari, but “classic causes of market failure,” in this instance prohibitively high switching costs, vendor or data lock-in, among others, weaken the competitive landscape.

“We need to create a better marketplace,” he said. “We want as little government involvement as possible, but no less.”

These two items are worth considering when it comes to an EHR selection and implementation: prohibitively high switching costs and vendor or data lock-in.

I think I might have to write some future posts on these topics and possible other reasons that the EHR market has issues. For example, a clear way to differentiate EMR products seems like another EMR market failure.

June 16, 2011 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.