Great strides are being made in furthering the use of health information technology both locally and nationally.

On February 17, 2012 U.S. Department of Health and Human Services announced the number of hospitals using health information technology (IT) has more than doubled in the last two years from 16 to 35 percent and 85 percent of hospitals now report that by 2015 they intend to take advantage of the incentive payments made available through the Medicare and Medicaid EHR Incentive Programs.HHS also announced new data showing nearly 2,000 hospitals and more than 41,000 doctors have received $3.1 billion in incentive payments for ensuring meaningful use of health IT, particularly certified Electronic Health Records (EHR).

HHS’ announcement details information from a new survey conducted by the American Hospital Association and reported by the HHS Office of the National Coordinator for Health IT.The announcement also highlights new data from the Centers for Medicare & Medicaid Services (CMS) detailing $3.12 billion in incentive payments the agency has made to physicians, hospitals, and other health care providers who have started to meaningfully use EHRs to improve the quality of patient care. In January alone, CMS provided $519 million to eligible providers. EHR incentive payments can total as much as $44,000 under the Medicare EHR Incentive Program and $63,750 under the Medicaid EHR Incentive Program.

IHIT has expended more than $2.05M to date to further Indiana’s efforts towards enabling connectivity of hospitals, labs and physicians for meaningful use of health IT. The numbers below show the progress being made in Indiana:

 
For more information on how health IT can lead to safer, better,  and more efficient care, click here.

For more information about the Medicare and Medicaid EHR Incentive Programs, click here.

For more information about the HHS Recovery Act Health IT programs, click here.

The Bipartisan Policy Center’s (BPC) Task Force on Delivery System Reform and Health IT recently released a set of recommendations for the most effective use of health IT dollars to support delivery system and payment reforms to achieve improved health, better health care, and reductions in the cost of care.  The Health Project is co-led by former Senate majority leaders Tom Daschle and Bill Frist and includes a broad range of nationally respected experts and leaders from many sectors of health care. The Task Force on Delivery System Reform was created to focus on two primary goals: 

•      Identify real-world examples and best practices that facilitate coordinated, accountable, patient-centered care; and

•      Make recommendations for ensuring that current health information technology (IT) efforts support delivery system and payment models shown to improve quality and reduce costs in health care, in ways that best utilize scarce public and private resources.

The report’s findings that health information technology (health IT) “plays a critical role in supporting new models of care and payment designed to achieve health care’s triple aim: improve health, improve the experience of care for patients and families and reduce the cost of care.”  ONC agrees that continued rapid progress on ensuring the adoption and meaningful use of health IT will be aided by, among other things: ongoing progress in the secure exchange of health information, even greater availability of consumer-oriented health IT tools, and building on the already rapid progress on adoption of electronic health records.

These recommendations are supportive of ONC’s vision and efforts to encourage and coordinate adoption of health IT and are consistent with State HIE program activities.

To read the full report, click on the link to take you directly to BPC’s website.

Transforming Health Care: The Role of Health IT

The numbers are in and IHIT, with the help of Indiana’s five regionally-based Health Information Organizations (HIO’s), is making steady progress towards advancing sustainable, secure, standards-based health information exchange throughout Indiana’s rural communities and underserved populations.

Some highlights as of December 31, 2011:

• 101 of 123 acute hospitals have signed contracts with a HIO
• 2532 active participants  for directed exchange (Push)[includes unique ambulatory providers and individual labs]
• 5511 active participants for query exchange (Pull) )[includes unique ambulatory providers and individual labs]
• 13,365,891 transactions sent (Directed/Push) [includes lab results, discharge summaries, public health results, visit summaries]
• 1,205,317 transactions for patient record inquiries

As the numbers show, Indiana is well on its way towards securely moving electronic health data in a meaningful way to improve coordination among health providers to help them achieve improved health outcomes for their patients.

Late last year, IHIT launched the Indiana eHealth pledge. Twenty-five (25) organizations have joined the pledge to date. From the payer/governmental side, the organizations represent the largest commercial payer, Medicaid, the State Public Health Entity. From the healthcare side, the organizations represent 49 hospitals (41% of Indiana hospitals), large specialty physician groups, a regional reference laboratory, and the largest student health clinic. All five of the sub-state health information organizations have signed the pledge.

The pledge was launched in conjunction with the Office of the National Coordinators eHealth pledge. These organizations are pledging to providing education and greater access to health information for the patients and consumers they serve. Providing patients and their care givers with timely, accurate health information will lead to improved engagement and quality outcomes. IHIT, in its role as the State HIE, is proud to push such an initiative and collaborate with the organizations working to improve health care.

Next steps for the pledge include development of marketing materials for the program and those that join. IHIT will be developing a voluntary recognition/rating program to identify organizations that excel in providing consumers with education and health information. If you are an organization interested in engagement of the health care consumer, join the Indiana Health pledge today.

More information on the ONC efforts can be found at: http://www.healthit.gov/

To join the Indiana pledge, download the pledge form at: Indinana eHealth Pledge

The proof of the benefits of e-prescribing is undeniable and growing daily. When a basic CPOE (computerized physician order entry) is used, it reduces the odds of medication errors by 70%. ⁽¹⁾ To date, the estimated savings from preventing adverse drug events alone totaled $4.64 billion. ⁽²⁾

The following data was acquired by ONC from Surescripts, the nation's leading e-prescription network.

• There are currently 8,271 total e-prescribers in the State of Indiana which is an increase of 480 in just 3 months.
• 47.1% of office-based Indiana physicians sent an electronic prescription via Surescripts while the national average is 43%.
• There are currently 74% of e-prescribers in Indiana that send more than 20 e-prescriptions monthly while nationally, the number is 71%. We hope to see this number grow both nationally and statewide in the near future.
• Tracking the distribution of new prescriptions and renewal requests on the Surescripts network is a useful way to assess the robustness of HIE. Renewal requests are more complicated than new because it is a two-way transaction (pharmacist must identify and locate the original prescriber) whereas a new prescription is a one-way process. 84% of prescriptions in the State are new while 16% are renewal.

For more information click on the link to take you directly to their website.

Surescripts

Agency for Healthcare Research and Quality (AHRQ)

ONC

(1) Devine et. al (2010)

(2) Center for IT Leadership (2010)

In the ONC's December 21st announcement, this new system of records will be used by the ONC and its partners to assess, evaluate, improve and publicize the effectiveness of ONC health IT grants to States and State-designated entities.

The datasets will enable the ONC to assess how well the grantees are doing compared to each other. The 62 regional health IT extension centers can also validate their progress reports and track performance improvements so they can receive payments.

ONC intends to collect data about physicians' health IT implementation, demographics and contact information from their National Provider Identifier (NPI).

“ONC partners and ONC grantees will only have access to data specifically pertaining to the achievement of that entity’s grant or contract purpose,” ONC said in its notice.

The system will not contain information about patients, ONC assured.

To read the ONC Action in its entirety, click here.

EHR enabled medical practices report that they are experiencing improved medical practice management through integrated scheduling systems that link appointments directly to progress notes, automate coding and managed claims.

They are saving time (which equals money) because of easier centralized chart management, condition-specific queries and many other shortcuts.

They have better communication with other clinicians, labs and health plans because there is

• easy access to patient information from anywhere
• tracking electronic messages to staff, other clinicians, hospitals, labs and more
• automated formulary checks by health plans
• order and retrieve lab results easily as well as diagnostic images
• links to public health systems such as registries and communicable disease database

Because there is an increase of accuracy in coding, this leads to an average of $26 per patient visit of billable gains! There increased patient flow and staff productivity which results in increased revenue.

Electronic health records reduce paperwork overall. Administrative tasks, such as filling out forms and processing billing requests, represent a significant percentage of health care costs. EHR's increase practice efficiencies by streamlining these tasks which significantly decrease costs.

In addition, EHR's can deliver more information in additional directions. They can be programmed for easy or even automatic delivery of information that needs to be shared with public health agencies or for the purpose of quality measurement.

Because EHR's contain all of the patient's health information in one place, it is less likely that providers will have to spend time ordering, and reviewing the results of unnecessary or duplicate tests and medical procedures. Bottom line, less utilization means fewer costs.

Few doubt the benefits of implementing an EHR, but can confused on where to turn for help.

After speaking with several providers over recent weeks, it is obvious there is still much confusion about the basics of EHRs, where to turn to for incentive funds and the complexities of meaningful use.

Even though Indiana is at the forefront of the Health Information Technology, there is a severe shortage of skilled healthcare and IT professionals able to understand, apply and manage these emerging technologies.

As we blogged earlier, Ivy Tech has recently begun to offer classes in EMR implementation and optimization. These classes will help bridge the gap between healthcare and information technology.

The Indiana Health Information Technology Training Collaborative (I-HITTC) is a collaboration between IUPUI School of Informatics, IU School of Medicine, and the Regenstrief Institute. This program is funded through the Office of National Coordinator for health information technologies program of assistance for university-based training.

I-HITTC has developed and deployed the following IT training programs:

• Certificate in Clinical Informatics
• Certificate in Informatics for Public Health Professionals
• Certificate in Informatics in Health Management and Exchange
• Certificate in Informatics in Health Information Security
• Certificate in Informatics in Health Information Systems Architecture
• Master of Science in Clinical Research

Students also have the choice to work in the field for hands-on experience such as St. Francis Hospital, IU Health North, IU Health Methodist, or in an operational HIE.

For more information on the following, click on their name;

Office of National Coordinator

Ivy Tech

IU Certificate and Degree Programs in HIT

Electronically prescribing controlled substances has been a long awaited function because it should actually cut prescription forgery levels by helping pharmacists and DEA officials to more easly trace controlled substance scripts to legitimate prescribers. They can also make sure that the meds get dispensed by the intended pharmacist and received by the intended patient. Of course, e-prescribing these scripts would also have the benefit of avoiding illegibly-written orders, as it does for non-controlled drugs.

Surescripts announced recently that it has upgraded its nationwide network to support electronic prescribing of controlled substances (EPCS). For this initial operation, Surescripts is actively monitoring the end-to-end characteristics of EPCS usage, such as physician credentialing, workflows, processing times and quality. When they complete this preliminary monitoring, which is planned to end later this year, Surescripts will make EPCS support available to all certified participants.

In order to electronically prescribe controlled substances, some of the major DEA requirements prescribers must adhere to include:

• Use of an e-prescribing application that is certified for this purpose.
• Completion of a compliant identity-proof process.
• Use of a secure, two-factor authentication process to sign prescriptions for controlled substances.

This is a great step in the right direction for eHealth. For more information, visit Surescripts website.

Indiana has launched a pledge campaign geared at providing education and greater consumer (patient) access to their health information.

Indiana FSSA announced last week that a St. Joseph County hospital has received a substantial incentive payment for meeting federal requirements for electronic recordkeeping.

IRHA (Indiana Rural Health Association) announced earlier this week they have been awarded federal funding to create the Upper Midwest Telehealth Resource Center.

This is great news for patients who wish to be more involved in their own healthcare. Up until now, patients had to receive their test results through the ordering provider.

MHIN (Michiana Health Information Network) Located in South Bend Indiana has achieved accreditation this week by EHNAC (Electronic Healthcare Network Accreditation Commission). EHNAC evaluates Health Information Exchanges in the areas of privacy and security, technical performance, business practices and organizational resources as it relates to HIE policies and procedures.

MHIN either meets or exceeds all EHNAC criteria and industry standards. This does not come as a big surprise as MHIN is one of the most mature and robust HIEs in the country.

"With so much developing and changing still in the HIE industry, it is important for our regional providers and communities to recognize and understand that MHIN is taking every necessary measure to ensure that we are handling their secure medical information with the most advanced technology and service available," stated Tom Liddell, Executive Director of MHIN. "EHNAC HIEAP accreditation reinforces our dedication to serve our region and continue to be a leader in the industry."

For more information about MHIN, their history, services provided, mission and solutions offered, click here or call (574) 968-1004.

Meet e-Patient Dave, a man full of energy and with a new found calling for helping other patients.

“I think our work with asthma is just the beginning of managing all the practice patients with complex medical problems. As each patient sees a specialist or has contact with another health care provider, regardless of the location or institution, that information could then be sent to the medical home and have the key drivers captured for surveillance, management, pay for performance, and quality improvement efforts. This can be done with minimal staff requirements and a high level of sustainability in an electronic environment.

- Dr. Scott Callahan, pediatrician and medical director with Children’s Health Care in Batesville, IN

It is very exciting in the IT world when someone comes up with a great idea. BluePrint Health IT has done just that with their Innovation Summit Series coming to Indianapolis in September of this year.

The vision of the BluePrint Health IT Innovation Summit Series is to accelerate and optimize patient care capabilities for providers, users and consumers of health information technology by showcasing and fostering innovation through a national platform for education and collaboration which matches Providers with Health IT Innovators.

What better way to do this than to replicate the methodology used in the speed dating arena? This is how it works, 10 healthcare technology companies and 10 healthcare providers will come together and meet for about 10 minutes each in order for the technology companies to present their innovative ideas to the providers and allow the providers to ask questions.

Applications are being accepted now for Health IT Innovators, Hospitals and Sponsors. The deadline is August 19, 2011. Click here to register.

John Kansky VP of product management of IHIE has just joined the BluePrint advisory board.