Med Law Blog

The Health Information Technology for Clinical Health Act (the "HITECH" Act) provides economic incentive for the adoption and meaningful use of health information technology and qualified Electronic Health Record systems ("EHR"s). A physician, other professional, or hospital shall be deemed to be a meaningful EHR user if:

This sounds great. But, the amount of information "out there" on meaningful use is overwhelming and it seems that the medical community is struggling with what it is and how it can be implemented. To this end, a commentator on "meaningful" use wrote a succinct, yet compelling, critique of "meaningful use." John’s post on the EMR and HIPAA blog may be found here: <http://www.emrandhipaa.com/emr-and-hipaa/2010/01/19/some-pointed-thoughts-on-meaningful-use/> (last accessed January 20, 2010).

 lkim@tuckerlaw.com or 412.594.3915

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  Thanks to the commenters of the linkedIn Health Innovations Group for highlighting the Harvard study concluding that hospital computing modestly improves processes, juxtaposed with CMS announcement of intent to publish EMR incentive payment  and meaningful use regs in early January.

http://www.federalregister.gov/OFRUpload/OFRData/2009-31217_PI.pdf

http://www.amjmed.com/webfiles/images/journals/ajm/AJM10662S200.pdf

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http://online.wsj.com/article/SB125478721514066137.html?mod=djempersonal

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On Saturday, December 6, 2008, Pennsylvania Secretary of Health published the allowable medical records fees under Pennsylvania Statute 42 P.A. C.S. §§ 6152-6155. Attached below is a link to the notice published in the Pennsylvania Bulletin.

http://www.pabulletin.com/secure/data/vol38/38-51/2302.html

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One of our  Medlaw Bloggers, Software Advice, contacted us about EHR certification. We thought the information would be useful.

Here are 4 questions we answered in our analysis:

• What are the benefits of CCHIT? CCHIT has taken on the task of defining the key components of an EHR, how it should communicate with other systems and how it should protect patient information. With over 250 qualification criteria, CCHIT provides buyers with a list of EHRs that meet every one of these requirements. At the very least, CCHIT has created a functional requirements checklist for EHR buyers.

• Why does CCHIT generate controversy? As CCHIT gains momentum, many EHR buyers are using it as a filtering mechanism in their EHR selection process. The industry is also responding with payers, associations and healthcare information exchanges (HEIs) mandating CCHIT certification in various ways. This eliminates non-certified vendors from these opportunities, and at the same time, makes it more likely that certified vendors will be included in these purchase decisions.

• Will a CCHIT certified EHR improve a practice's income? CCHIT is a federally recognized certification body for EHRs. It can improve a physician's ability to participate in upcoming payment incentive programs from the Centers for Medicare & Medicaid Services (CMS). Some malpractice liability insurers even offer discounts to providers that use CCHIT Certified EHRs. However, physicians are not guaranteed eligibility for each of these incentives.

• What important criteria does CCHIT not evaluate? At this time, CCHIT does not evaluate all criteria a physician should consider in their EHR selection. This includes ease-of-use, customer support and the financial viability of the company offering the EHR software. While CCHIT plans to evaluate EHRs for cardiology and pediatrics this year, it will take some time before they are capable of evaluating all specialty-specific EHRs.

For a complete analysis, click on the link below.

http://www.softwareadvice.com/articles/medical/should-cchit-influence-your-ehr-selection/

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Pennsylvania law states that medical providers and hospitals must provide copies of patients’ medical records upon request, but may charge a fee for copying and producing the medical records. That fee is addressed annually. 

The link below is the announcement by the Pennsylvania Department of Health, entitled “Amendments to Charges for Medical Records,” which was published on the Pennsylvania Bulletin on December 1, 2007, which fees will be in effect for 2008.

www.medlawblog.com/MedicalRecordsFees.pdf

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It seems that electronic health records (EHRs) are constantly being touted as the next best way to improve both healthcare quality and medical practice profitability, but adoption of EHRs by physician practices continues to languish. The range for provider adoptions in small and solo practitioners’ offices, as determined by the Robert Wood Johnson Foundation, is somewhere between 13% and 19%. The impediments to adoption of EHR appear to be cost, doubt as to the benefits, and uncertainty regarding new technology, despite some of the following claims:

§      The Alliance for Health Reform recently reported that “research has shown that computerized physician order entry (CPOE) systems for prescriptions can reduce preventable medication errors by as much as 55%,”

§      Early Family Practice Management reports indicated that physicians are undercoding E&M Codes by as much as 33%, while overcoding by only 16%, leading to estimates that physicians are losing as much as $60,000 annually through coding inefficiencies and mistakes, and

§      The Institute of Medicine Report first indicated that as many as 100,000 Americans die each year due to preventable medical mistakes.

In the next month or so, Tucker Arensberg is planning to arrange a program that will assist you in evaluating EHR adoption. The purpose of the program is to explain the practical and contracting steps you must take to adopt an EHR program, educate you regarding the new federal Safe Harbors allowing hospitals to provide EHR hardware and software, and provide an opportunity for a hands-on demonstration of an actual EHR application as it would operate in your practice.

Since we are just planning this program, would do not have dates or times to announce yet, but I would be most interested in knowing if you would be interested in attending, assuming the times and locations work with your schedule. Please respond via email to mcassidy@tuckerlaw.com.

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CCHIT was awarded a contract  in September of 2005 by the Department of Health and Human Services (HHS) to develop and evaluate criteria and to establish an inspection process to provide certification for electronic health records. CCHIT has been endorsed by the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), and the American College of Physicians (ACP). You can access the list of certified EHR products at the CCHIT website: www.cchit.org.

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Electronic Health Records (EHR) are touted by proponents within the healthcare industry as a means to both improve quality and reduce cost through a combination of reduced errors and improved communication. The drive to standardize the process for the utilization of electronic healthcare records gained its greatest impetus from the electronic transaction standards of HIPAA, first enacted a decade ago with the Health Insurance Portability and Accountability Act of 1996. Since that time, healthcare reform advocate from both industry and government have pushed for the transition to HER. More recently, a provision of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) required the federal government to develop Stark exceptions and Safe Harbors to facilitate the implementation of EHR systems.

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HHS/CMS announce ePrescribing regulations. The Department of Health and Human Services and CMS issued a final rule for ePrescribing standards. The final rules were published in the Federal Register under November 7, 2005 at 70 FR 67568.

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Highmark announces the Highmark E Health Collaborative. The Highmark E Health Collaborative is a joint project between Highmark and the Pittsburgh Foundation to foster the adoption and utilization of electronic prescription systems. The Collaborative will provide funding to eligible physicians who wish to acquire and use electronic technology. Highmark will contribute $26.5 million , $18.5 million of which will go to physician funding and $8 million of which will go to support eHealth technology at UPMC. The maximum grant per physician is $7,000. In order to determine if you are eligible for this program, visit the Highmark E Health Collaborative Web site at www.highmarkehealth.org.

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While CMS was announcing its EHR beta test, the Secretary of Health and Human Services, Michael Leavitt, announced the composition of the American Health Information Community. Access the HHS Press Release here. The purpose of the Community is to advance President Bush's HER project. Modern Healthcare reported in its September 19, 2005 edition that many healthcare information specialists see the panel as too politicized with insufficient real-world experience.

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