lohnes presentation himss meaningful use
Post on 08-Apr-2018
227 Views
Preview:
TRANSCRIPT
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
1/42
ea g u se - us y e spec ve
Maggie Lohnes, RN, FHIMSS
Western States Health-e Connection SummitApril 12, 2010
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
2/42
Topics
What is HIMSS Who is the HIMSS Public Policy Committee
MU Impact to Healthcare Providers
MU Impact to Vendors
HIMSS Public Comments for Meaningful Use
Additional Resources
2
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
3/42
Resources
Meaningful Use HIMSS Recommendations on Meaningful Use
Standards and Certification Criteria
HIMSS Recommendations
Health Insurance Reform
Health IT Provisions
Other Items
FDA and EHRs as Medical De ices
3
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
4/42
HIMSS
e ea care n orma on an anagemen ys ems oc e y
(HIMSS) is a comprehensive healthcare-stakeholdermembership organization exclusively focused on providing
(IT) and management systems for the betterment of healthcare.
, . .,Brussels, Singapore, and other locations across the UnitedStates, HIMSS represents more than 23,000 individualmembers of which 73% work in atient care deliversettings.
4
30 not-for-profit organizations.
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
5/42
The HIMSS Public Policy Team
Public Policy Steering Committee (PPSC)Make recommendations
vot ng mem ers year terms
4 non-voting members (CHIME, ME/PI Community,
NACHC, and Federal Health Community) 3 Board Liaisons (Burde, Keeler, and Paramore)
HIMSS Government Relations Roundtable (HGRR)
Cha ter Advocac Roundtable CAR
HIMSS Business Diversity Roundtable
HIMSS Affiliate Roundtable
Individual members and staff
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
6/42
HIMSS Public Policy Committee , , , ,
Vice-Chair: Fred Hannett, MPA, Managing Partner, The Capital Alliance Neal Ganguly, FHIMSS, MBA, VP and CIO CentraState Healthcare System Bruce Gordon, BA, Program Manager Mitre Corporation
, , , , Kathleen Fortney, Director, Business Development Northrop Grumman Susan Schade, FHIMSS, CIO Partners Healthcare System
Carladenise Edwards MS, Ed, PhD, Chief of Staff, Georgia Dept of Community Health,
Ruth Perot, MAT, Executive Director Summit Health Herb Smaltz PhD, FHIMSS, CIO Ohio State Medical Center Benjamin McLarin, Management Engineering Consultant, Sacramento, California
Dave Roberts, VP Government Relations Tom Leary, Senior Director, Federal Affairs K. Meredith Taylor, MPH, HIMSS Director, Congressional Affairs
6
, ,
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
7/42
HIMSS Public Policy Activities
Annual Public Policy Summit 3 Asks to Congress
December 2008 - A Call to Action: Supporting Healthcare Reform through Health
(update for delivery June 2010)
Strong Chapter Advocacy Liaison program
7
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
8/42
MU Impact to Providers
Perfect Storm of HITECH, State Medicaid Initiatives,
Tight implementation lead time for those without
automation Capital funding obstacles
System selection support
Quality reporting validation
8
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
9/42
MU Impact to Vendors
HIMSS Electronic Health Record Vendor Association (EHRVA) supportedby HIMSS but operates independently - developed comments (available at
himssehrva.org) with concerns regarding:
Timelines for implementation, particularly to generate and report quality data
Finalizing certification process and authorized certificating entities
Earlier timing for Stage 2 NPRMs -- i.e., by end of 2010
Refine all or nothing approach ; scale back on MU criteria
Reduce number of quality measures; focus on measures with EMR specs
Refine certification criteria
Provide more robust approaches to HIE Refine/strengthen standards proposals
Narrow definition of "hospital-based professionals"
About the EHR Association: Contact Elizabeth (Liddy) West for more
information ewest123@msn.com 520-730-8212 9
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
10/42
Meaningful Use
HIMSS Public Comments
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
11/42
Five Broad Healthcare Goals for
. , , ,health disparities
2. En a e Patients and Families3. Improve Care Coordination
4. Ensure adequate privacy and security protections
for Personal Health Info5. Improve Population and Public Health
11
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
12/42
HIMSS Recommendations on MU
Incentive Program Eligibility and CCN: Correctsthe unintended impact of using CMS Certification
um ers to ent y osp ta s or ncent ve
payments.
ncen ve rogram g y an : orrec s
the NPRM on Hospital-based professionals (HBPs)
EHR that the provider is using as well as Place of
Service (POS) settings, reducing substantially the
number of professionals who are excluded from
incentives as HBPs. 12
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
13/42
HIMSS Recommendations on MU
Incentive Program Eligibility Need Legislative Fix
Additional eligible professional categories over the course ofthe timeline for the edicare and Medicaid Pro ramsElectronic Health Record Incentive Programs on such actionitems as:
Expanding the care delivery setting to encompass more parts of thecontinuum of care
Collectin standardized clinical erformance measures as a b roduct
of care delivery and clinician documentation that support workflowand improve care delivery
Enhancing programs and funding availability for patient educationofferings and the advancement of personal health records and how toleverage patients personal health information to improve clinicaloutcomes. 13
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
14/42
HIMSS Recommendations on MU
Criteria for Meaningful Use: Streamlines Criteriafor Meanin ful Use that reco nizes the im act on
workflow; places an emphasis on realistic
percentages for metrics; and allows for partial credit Quality Metrics for Meaningful Use: Streamlines
the Quality Metrics and ensures the measures can be
ea t -ena e as part o t e care process
14
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
15/42
HIMSS Recommendations on MU
Privacy and Security: Supports the adherence toexisting privacy and security law and regulation
without creating duplicate or redundant regulatory
requirements. Health Information Exchange: Supports the
governments intent to accelerate the use of HIE as
capabilities increase after Stage 1 and suggests thegovernment place more emphasis on standards-based
HIE in the Stage 2 and 3 MU requirements15
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
16/42
HIMSS Recommendations on MU
-
certified technology to be employed to supportcertified EHR technology to help providers achieve
meaningful use, so long as the provider has certified
EHR technology. Health IT Implementation Timelines: Recognizes
the impending strain on healthcare community from
e po en a er ec orm o ea pro ectimelines required for Meaningful Use and the
,
with the conversion to ICD-10 and X-12 5010standard.16
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
17/42
Quality Metrics Recommendations
. m na e ore easure e or g e
Professionals
.
adequately vetted to ensure they can be captured and
3. Implement an aggressive Quality Measures Testing
Pro ram
4. Align current Quality Measure Reporting with new
re uirements to avoid du lication
5. Limit reporting on quality measures in 201117
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
18/42
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
19/42
Standards and Certification Criteria IFR
Relevant Themes Creates a floor for standards, implementation
spec ca ons, an cer ca on cr er a ormeaningful use.
1. Vocabulary
2. Content exchange3. Transporting of information
. r vacy an secur ty
19
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
20/42
Standards & Certification Criteria
Definitions: Seeks clarification on several definitions,
functionality of CPOE (data capture and order creation);
definition
Venue of Care su orts Con ressional intent of hos ital-
based professional
Intero erabilit in Sta e I: Re uests clarification on im actof interoperability requirements and testing and certificationrequirements on complete and modular EHRs for Stage I.
20
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
21/42
Standards & Certification Criteria
Supports the Adoption of one patient record summary to supportMU Stage II and beyond
Supports the use of CCD or CCR in Stage I
Supports a push toward administrative simplification using theCORE rocess
Supports maturation of the eligibility verification processbased on CORE Phase II by 2014
ecommen s rev s ng e conom c mpac ssessmen Small Business criteria assessment not consistent with
CCHIT data
Supports ONC efforts to monitor industry developments on
health data security 21
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
22/42
Certification Process
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
23/42
Formulation Of Certification Proposal
1. HIT Policy Committee recommendations2 oordination ith the HIT tandards and
Certification Criteria Interim Final Rule and theMedicare and Medicaid Incentive Programs
3. Consultations with NIST
4. Timeliness related to the beginning of the
Medicare and Medicaid EHR IncentivePrograms
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
24/42
Coordination with HIT Standards and Certification
IFR and Medicare/Medicaid EHR Incentive
Proposed Rule Third and final element of Department of Health and Human
Services (HHS) coordinated rule makings to define themeaningful use of Certified EHR Technology and support the
achievement of meaningful use. As required by the HITECH Act, eligible professionals and
eligible hospitals must demonstrate meaningful use of certifiedEHR technology in order to receive incentive payments under
t e e care an e ca ncent ve programs. This proposed rule creates the certification programs under
which Complete EHRs and EHR Modules could be tested andcert e an su sequent y use as ert e tec no ogy.
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
25/42
HIT Certification Programs Proposed Rule
Propose both temporary and permanent certification
Currently test and certify Complete EHRs and EHR Modules
In the future, permanent certification program could alsoinclude testing and certification of other types and aspects ofHIT.
This proposed rule marks the beginning of the formal notice andcomment rulemaking described in CGD.
,
certification will supersede the CGD. Authorization process will constitute the new method for
recognizing certification bodies.
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
26/42
Temporary Certification Program
National
CoordinatorNIST
uthorize
Develo
ps
ONC-Authorized
Testin & Certification Bodies
Test
Methods
Tests and CertifiesCom lete EHRs/EHR Modules
26
Vendors/
Self-DevelopersSource: ONC - HIT Policy Committee Presentation
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
27/42
Overview of Temporary Certification Program
ONC-Authorized Testing and Certification Body (ONC-
ATCB) An or anization or or anizations
Submit an application to National Coordinator to demonstrate
competency to test and certify Complete EHRs and/or EHR
Under temporary certification program, an applicant for ONC-
ATCB must be able to test and certify Complete EHRs and/or
EHR Modules Anticipated that only a few organizations would qualify
and at least one certification body has been authorized by the
National Coordinator
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
28/42
Overview of Permanent Certification Program
Permanent Pro ram
ONC-Approved Accreditor (ONC-AA)
- -
ACB)
a ona o un ary a ora oryAccreditation Program (NVLAP)
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
29/42
Overview of Permanent Certification Program
Introduces ONC-Approved Accreditor (ONC-AA) u respons t es assume y t e at ona
Coordinator under the temporary certification program
National Coordinator where a ro riate will seek tomove as many of the temporary certifications
programs processes as possible to organizations in the
.
Only one at a time
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
30/42
Overview of Permanent Certification Program
ONC Authorized Certification Body (ONC-ACB) ONC-ACB in the permanent certification program is different than an
- n t e temporary cert cat on program.
Under permanent certification program, National Coordinators
authorization would be valid only for certification. National Coordinators authorization would no longer be valid for the
purposes of testing Complete EHRs and EHR Modules.
Proposed that NIST through the National Voluntary Laboratory
Accreditation Program (NVLAP) would be responsible for accreditingtesting laboratories and determining their competency
NIST would be solely responsible for overseeing activities related to
testing laboratories
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
31/42
Permanent Certification Program[Testing] [Certification]
NISTNational
CoordinatorNVLAP
uthorizes
ONC-AA
Accre
dit
ONC-AuthorizedNVLAP-Accredited
ccre s
Tests Certifies
31
Vendors/
Self-Developers
EHR Modules
EHR Modules
Source: ONC - HIT Policy CommitteePresentation
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
32/42
Health IT Provisions
in Healthcare Insurance Reform Law
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
33/42
Health IT Provisions in Healthcare
1. On May 23, 2010, President Obama signed into law HR,
Act.
2. The U.S. Senate passed H.R. 3590 on December 24,, . .
March 21, 2010.
3. Also on the March 21, 2010, the House passed theReconciliation Act of 2010 HR 4872 which makes
changes to HR 3590. The Senate is expected to considerHR 4872 during the week of March 22, 2010.
33
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
34/42
Health IT Provisions in Healthcare
In ur n R f rm L i l i n
HR 3590 aims to increase healthcare coverage among
Americans and implement broad reforms within the
Insurance industry
ms to expan ea t nsurance coverage to
million currently uninsured Americans
Prohibits insurance com anies from den in covera e
to individuals with preexisting conditions (effectiveimmediately for children and applies to all individuals
34
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
35/42
Health IT Provisions in Healthcare
.
xpan s e ca o cover n v ua s w ncome
less than 133 percent of the federal poverty level, or
$29,327 for a family of four Closes the gap in prescription drug coverage
Prohibits insurance companies from placing lifetime
caps on coverage Requires health plans to allow young adults, up to age
26 to remain on their arents insurance olic
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
36/42
Health IT Provisions in Healthcare
R f rm L i l i n
Leverages health IT to improve the quality, cost, and
Supports programs to foster the reporting of quality measures
through the use of health IT rects t e esta s ment o stan ar s to ac tate t eenrollment of individuals in health plans, as well as standardsto enable the determination of an individuals eligibility and
nanc a respons ty or spec c serv ces pr or to or at t epoint of care
health IT to test new, more effective healthcare delivery
models 36
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
37/42
Health IT Provisions in Healthcare
In ur n R f rm L i l i n
Leverages health IT to improve the quality, cost,.
Aims to increase the use of health IT in long-term care
settings through financial assistance Directs the use of health IT in health risk assessments for
Medicare beneficiaries
Esta is es incentive payments for ea t p ans an provi ersthat apply health IT in improving healthcare outcomes
students37
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
38/42
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
39/42
FDA and EHRs as Medical Devices
Per FDA, health IT has advanced so far that the professional
intermediary is no longer required or used Under the Federal Food Dru and Cosmetic Act health IT
software is a medical device.
Per voluntary reports from patients, clinicians, and user
facilities, the FDA cites data indicating 260 reports of HIT-related adverse events, including 44 reported injuries and 6reported deaths
Because these reports were purely voluntary, they may
represent only the tip of the iceberg in terms of HITproblems that may exist
FDA UNDECIDED AT THIS TIME!
- Testimony of Dr. Jeffery Shuren, Director for FDA Center for Devices and Radiological Health to the HIT Policy Committee 2/25/10
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
40/42
3 FDA Options for Engagement
Postmarket Safety
Option 3: Traditional FDA Regulatory Framework
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
41/42
Additional Information
For additional information related to ARRA, please access the
http://www.himss.org/EconomicStimulus/
Comments on Meaningful Usehttp://www.himss.org/content/files/HIMSSResponseCMS_
Standards and Certification Criteria
http://www.himss.org/content/files/HIMSSresponseONC_IF.p
41
-
8/7/2019 Lohnes presentation HIMSS Meaningful use
42/42
Health IT Provisions in Healthcare
In ur n R f rm L i l i n
Additional information concerning health IT provisions
included in healthcare reform legislation can be accessed
through the HIMSS website:
http://www.himss.org/ASP/topics_healthcarereform.asp
42
top related