e-CareManagement blog

Just the Facts 

Certification Programs NPRM (Notice of Proposed Rulemaking)

Health IT, U. S. Department of Health and Human Services; March 2, 2010

Certification NPRM

Facts-At-A-Glance

FAQ

Bookmarked version of Certification NPRM (much easier to navigate)

U. S. Department of Health and Human Services; March 2, 2010

Via OCCAM Practice Management blog, March 3, 2010

Commentary and Analysis

Proposed EHR Certification Rule Changes Game

HDM Breaking News; March 2, 2010

“The rule mentions the Certification Commission for Health Information Technology, but does not grant it any grandfather status…. So, while CCHIT appears to be able to continue its operations under the proposed temporary certification program, its future isn’t clear in the proposed permanent program.”

Certification NPRM: A Statement from Alisa Ray, Executive Director, Certification Commission for Health Information Technology (CCHIT)

EHR Decisions; March 3, 2010

“…we feel confident about our prospects of becoming accredited…. We feel confident about the future, and we look forward to the opportunity to continue playing a role in accelerating the adoption of health IT.

 Why Rush Vendor Certification of EHR Technologies?

The Health Care Blog; March 08, 2010

“David Blumenthal and his staff have unveiled two separate plans to test and certify EHR technology products and services. We don’t think this is a good idea…this recently-announced two-stage EHR technology certification plan bears all the marks of a hastily drawn up blueprint that, if rushed into production, could easily collapse of its own bureaucratic weight.”

HIT Leaders React to Proposed EHR Testing and Compliance Rule

HealthLeaders Media; March 4, 2010

• “They got it exactly right.” Simeon Schwartz, MD, president and CEO of WestMed Medical Group.
• “It’s going to be interesting to see how much the vendors got out ahead of this and how much they’ve hedged their bets” Eric Saff, CIO of John Muir Health
• “…no matter where you are in the chain of this market, you can in fact certify those modules as opposed to waiting until you meet complete meaningful use to be certified. So I think that’s great. I think that’s really considerate of the ONC.” Luigi Leblanc of Solink

Continue reading “A Compendium of Perspectives on the HITECH Certification NPRM”

There’s a great discussion going on on The Healthcare IT Guy’s blog:  Innovation in healthcare IT is dead (hopefully only temporarily). Read BOTH the essay by Shahid Shah and the comments.

John Moore of Chilmark Research and I agree on things 90+ percent of the time. He even thanked me personally for our collegial relationship in a Thanksgiving Day essay on his blog.

However…I can’t help but comment on John’s misleading story “CCD Standard Gaining Traction, CCR Fading” in The Health Care Blog. He writes:

In a number of interviews with leading HIE [Health Information Exchange] vendors, it is becoming clear that the clinical standard, Continuity of Care Document (CCD) will be the dominant standard in the future.  The leading competing standard, Continuity of Care Record (CCR) appears to be fading with one vendor stating that virtually no client is asking for CCR today.

I have four beefs with John’s essay:

1. It’s no news that HIEs prefer CCD.
2. HIEs are not representative of the broader health IT market.
3. The narrow findings don’t justify the broad conclusion.
4. The CCD and CCR standards are more complementary than competitive

Let’s look at these one at a time.

Continue reading “Chilmark Needs to Chill Out on CCR/CCD Findings”

Hospitals charge on a cost basis, which places no penalty on inefficient operations. Moreover, present systems of hospital management make it very difficult to maintain effective control over hospital costs. The Commission concluded:

“If the needs for health care are to be met, the health care system must be organized to employ its resources with more wisdom and effectiveness. The two areas which appear to offer the greatest potential for improvement are (1) reducing unnecessary (or unnecessarily expensive) medical care and (2) increasing efficiency in the provision of hospital care.”

It will not be easy to carry out this recommendation.

Who said this? …and when? Continue reading “How Long Have We Known This?”

My wife Jill loves her  iPhone…she raves about it. Last night she showed me an application she had recently acquired for her iPhone. She was able to explain and demonstrate the app and its functionality to me (yes, to ME!) in about 30 seconds. 

I’d describe the app as Garmin-like but running on the iPhone. You type in the address at which you’re going to start your drive and then you type in the address of the location where you want to drive to. The iPhone displays a map and step-by-step directions. Want to zoom in on a section of the map? …just put your fingers on the screen, spread them, and instantly you see the map in greater detail. The app uses the GPS built into the iPhone to display your current location and progress on the map.

A few years ago you would have had to purchase a separate Garmin or Garmin-like appliance to get this type of functionality. Is this iPhone app as good as the Garmin? For many people, the answer might well be “No”, but that’s not the point.  For many people the iPhone app WILL be good enough — and having that choice is what creates a vibrant marketplace.

So what does this have to do with health care? A lot.

To date, health care has not had an iPhone like platform on which to run multiple high value applications. If you wanted specific functionality, you had to buy an independent appliance. For more on the appliance vs. platform distinction, start reading at Chapter 2 of Harvard Law Prof. Jonathan Zittrain’s excellent (and freely available) book, The Future of the Internet and How to Avoid It.

If you rethink health care, just about ANY technology or service can be reconceptualized as an app that COULD run on a common platform. Mull this over for a while…

Continue reading “Appliance or Application? The Choice Finally is Coming to Health Care.”

I received this email in my inbox this morning:

Thank you for being a loyal user of the Revolution Health Personal Health Record. Unfortunately we will be discontinuing this service as of the end of February 2010 and removing all records, information, and data from the Revolution Health Web site.

So that you don’t lose the information you’ve entered into the system, we strongly suggest that you download your personal records as a PDF to print and save for future reference. To do this, simply follow these instructions:

1. Log in to your Personal Health Record.
2. From any page of your record, click on the “printable version” link on the top right corner of any page. When you see a pop-up box asking you to “Select the following sections to include in your print out,” simply make sure that the sections you want to print and save are checked and then click the “Submit” button.
3. Once the PDF is created (this only takes a moment), you can print directly from it and/or save it to your computer. To print the PDF, click on the printer icon at the top left of the page. To save it, click on the disk icon to the right of the printer icon.

If you encounter a problem printing or saving your records, please e-mail our customer service department at CustomerCare@revolutionhealth.com for assistance. Even after the Personal Health Record is no longer available, Revolution Health and our partner sites will continue to offer you the same great health information and community pages as always. We hope you continue to visit Revolution Health often to take advantage of our offerings.

Thank you,
The Revolution Health Team

What happened here????  what’s the lesson?

I just got off the phone with my mom.  She’s a young 85. Mom told me about the cataract surgery she had this morning and the patch over one eye that she came home wearing.

“So Mom, are you learning to talk like a pirate? …like ‘aye, matey’”?

“I baby?” she asked.

“No, aye matey’”

“I-80?”

“…er, never mind Mom…how’s Benji?”

Vince’s mom (sans eyepatch) and Benji

Check out the latest Health Wonk Review penned by Dr. Jaan Sidorov over at the Disease Management Care blog. I commend Dr. Sidorov for his selection of a new personal photo on his blog — very handsome, and certainly a better presentation than this earlier photo from his youth.

* = highly recommended

Descriptive Summaries and Documents

 *Dissecting the Meaningful Use Proposed Rule PowerPoint

eHealth Initiative Policy Webinar; January 8, 2010

*What You Need to Know About the Meaningful Use Proposed Rule, Standards and Implementation Specification, and Interim Final Rule Certification Criteria PowerPoint

HIMSS Webinar; January 6, 2010

*Meaningful Use, Certification Criteria and Standards, and HHS Certification Process

HIMSS, frequently updated material, some members-only

Source Documents (Bookmarked)

Notice of Proposed Rulemaking (NPRM), Medicare and Medicaid Programs; Electronic Health Record Incentive Program; December 30, 2009

Warning: 536 pages of barely intelligible gobbledygook; stay away from this unless you are a lawyer, accountant, actuary, consultant, geek or wanna-be thereof 

Interim Federal Rule (IFR), HIT: Initial Set of Standards, Implementation Specifications, and Certification Criteria For EHR Technology; December 30, 2009

NPRM and IFR Tables in Spreadsheet Format

Healthcare Standards; January 9, 2009

Centers for Medicare & Medicaid Services (CMS) Website, Fact Sheets, Links

Updates on Meaningful Use, Certified EHR Technology and the Stimulus Bill

Software Advice; January 10, 2010

Analyses

*Urgently Needed: Useful Meaning of Meaningful Use

The Health Care Blog; January 9, 2009

*Now Reading: Proposed CMS Rule for EHR Incentives (from a patient access perspective)

Ted Eytan MD; January 10, 2010

Continue reading “A Compendium of Resources on the Federal HIT Meaningful Use NPRM and Standards IFR”