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ACR staff answers your Meaningful Use questions.

  Overview of the Program

  Available Incentives

  How it Works

  Meaningful Use Criteria

  Next Steps

  Registration and Payment Information

  Resources/Calendar of Events

Meaningful Use Overview

The 2009 American Recovery and Reinvestment Act(ARRA) authorizes the Centers for Medicare & Medicaid Services (CMS) to provide a reimbursement incentive for providers who are "meaningful users" of an electronic health record (EHR). CMS estimates that between $14.1 and $27.5 billion in funding will be distributed through the EHR Meaningful Use incentive program.

Like their colleagues throughout medicine, many rheumatology providers practice in settings that use paper medical records. Through the EHR Meaningful Use program, the government is incentivizing providers and hospitals to:

• adopt EHRs
• implement the systems locally in ways that fully realize the potential of electronic systems
• use the EHRs to exchange data
  • among non-affiliated providers
  • for secondary analyses

The requirements for the program encourage providers to use their electronic systems fully (e.g., as more than simply an electronic medical chart) opening the potential for greater efficiency, improved quality, and effectively coordinated care. Meaningful users have the potential to earn as much as $44,000 over 5 years in the Medicare program, or $63,750 over 6 years in the Medicaid program. Starting in 2015, Medicare will implement payment reductions for eligible providers who are not meaningful EHR users.

The Meaningful Use Incentive Program will be defined through three stages of rulemaking. Stage 1 will begin in 2011, Stage 2 in 2013, and Stage 3 in 2015. New requirements will be added at each stage, as noted below.

The Stage 1 Meaningful Use standards , implementation specifications, and certification criteria for EHR technology were announced by CMS on July 13, 2010.

The EHR Meaningful Use program will likely have significant implications for rheumatology providers. It is only one component of the broader Health Information Technology for Economic and Clinical Health (HITECH ) Act , introduced as part of ARRA. HITECH’s reach includes the development of a framework and infrastructure to support health information technology adoption and implementation, health information exchange infrastructure, HIT workforce training, and health information and communication systems research and development.

Available Incentives

Eligible providers can participate in the EHR Incentive Program through one of two programs. One incentive program targets providers who see large volumes of Medicaid patients and another focuses on physicians seeing Medicare patients.

Medicare

Physicians who accept Medicare patients can receive up to $44,000 over the five years. These incentive payments begin in 2011 and gradually phase down. Starting in 2015, providers are expected to have adopted and be actively utilizing an EHR in compliance with the "meaningful use" definition or they will be subject to financial penalties under Medicare.

Medicare incentive payments are capped at 75% of allowable Medicare charges, up to $18,000 for the first payment year. Maximum incentive payments are reduced in subsequent years: $15,000, $12,000, $8,000, $4,000, and $2000.

For eligible professionals in a rural health professional shortage area, the incentive payment amounts are increased by 10 percent.

Medicaid

Eligible providers for Medicaid incentives include:

• Non-hospital based professionals with at least 30% patient volume from Medicaid
• Non-hospital based pediatricians who have at least 20% of patient volume from Medicaid

Eligible providers can receive incentive payments of up to $63,750 over 6 years.

No reductions in Medicaid payments will be made if a provider does not adopt certified EHR technology, although incentives are available only through 2021, and providers must start receiving payments by 2016.

It is important to note that the Secretary may exempt hospitals and providers from penalties on a case-by-case basis for hardship situations. Providers may not receive multiple incentives. Those who qualify for both Medicare and Medicaid incentives must choose to pursue benefits through only one program

Participating in the EHR Incentive Program and other CMS Incentive Programs

How it Works

In order to qualify for the EHR Incentive payments, the program requires that three criteria are met and states the program will provide incentive payments to:

• eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs)
• that are meaningful users
• of certified EHR technology.

Eligible Providers

In order to participate in the Medicare and Medicaid EHR incentive programs, rheumatologists must meet the eligibility criteria defined in the EHR Incentive Program Final Rule. The incentive payments are based on individual providers and each eligible professional your practice may qualify for an incentive payment provided they successfully demonstrate meaningful use.

+ More information on Provider Eligibility for the EHR Incentive Program

- More information on Provider Eligibility for the EHR Incentive Program

Meaningful Use Requirements/Measures

To qualify for Medicare or Medicaid incentive payments, eligible professionals must successfully demonstrate meaningful use for each year of participation in the program.

+ More information on Meaningful Use requirements and measures

- More information on Meaningful Use requirements and measures

Certified EHRs

The EHR Incentive Programs require the use of certified EHR technology in order to qualify for the incentive payments.

+ More information on Meaningful Use requirements and measures

- More information on Meaningful Use requirements and measures

In order to be considered a ‘Meaningful User’, the EHR Incentive Program requires that the eligible provider use a certified EHR system. Certification ensures that the EHR adheres to specified standards and is technically able to provide a secure environment for sharing information with other health care providers, patients, and public health entities. To demonstrate this, the EHR system must be tested and certified to support:

• use in a "meaningful" manner
• use for electronic exchange of health information
• use to submit clinical quality and other measures to the government

On June 18, 2010, the Office of the National Coordinator for Health Information Technology (ONC) issued a final rule establishing a temporary certification program and process for selecting organizations to test and certify Complete EHRs and EHR Modules as Certified EHR Technology. This temporary certification program will be used to ensure that "Certified EHR Technology" is available for adoption by eligible professionals, eligible hospitals and critical access hospitals for purposes of qualifying for meaningful use incentives in the first demonstration year, 2011.

ONC has stated that it expects authorized organizations will be testing and certifying EHRs by the end of summer 2010, which will allow for certified EHR products to be on the market in the fall of 2010. As more EHR technology products and systems become widely available, adoption of HIT will ideally accelerate as providers and hospitals are able to qualify for federal incentives.

+ How does testing and certification work?

- How does testing and certification work?

There are several federal agencies working together to develop the criteria for testing and certification of EHR systems according to the requirements of Meaningful use. These groups include:

• The Policy and Standards Committees will create and define the meaningful use criteria
• ONCHIT is responsible for selecting independent third party certification bodies
• NIST is responsible for coming up with the test materials (assertions, procedures, methods, tools, data, etc).
• Third-party testing bodies are responsible for actually performing the tests and validating and verifying conformance to NIST's test plans. There will be more than one body approved for EHR testing.
• Third-party certification bodies are responsible for reviewing output from testing bodies and recommending certification to ONCHIT. Once a certification body recommends approval, the product is "certified" (and not before that time).

Upon the "opening" of the certifying bodies, vendors can submit their EHR products to be tested and certified. Hospitals and practices who have developed their own EHR systems can also seek to have their existing systems tested and certified. Complete EHRs may be certified as well as EHR modules that meet at least one of the certification criterions. Once a product is certified, it will be published on the ONC web site. It is expected that the first EHRs will be certified and listed on the ONC web site in fall 2010.

+ How do I find a certified EHR system or verify that my current system is certified?

- How do I find a certified EHR system or verify that my current system is certified?

To support providers in identifying certified products, the ONC will post a list of certified products on their website (link to be added as soon as the site goes live) and will continually update the listing of EHR systems and EHR modules upon receipt of 'certified status' from authorized certification bodies.

It is important to remember to remember that these certification requirements only test to support the objectives (and measures) for meaningful use. The ONC and NIST focus on standards to support the use of the EHR system according to the development of the national data exchange infrastructure. Meaningful use certification serves an important purpose in the adoption and utilization of clinical information technology, but it serves a very narrow scope.

Rheumatologists seeking to implement a new EHR system or module should still carefully review to ensure that the system meets all those usability and functionality needs of the practice. Also keep in mind that meaningful use certification does not replace CCHIT certification which is a much more robust review of EHR system security and functionality.

For more information on EHR adoption, please visit our partner site, AmericanEHR Partners.

Meaningful Use Criteria

The definition of meaningful use is one of the most critical pieces in the implementation of the HITECH Act. This definition will have a huge impact on the types of HIT systems implemented in physician practices and hospitals across the United States, the technical standards that EHR systems use (and the standards which other systems must align to), and the clinical and data exchange processes which take the highest priority. The definition could impact the efficiency of rheumatology practices and the quality and safety of care provided.

The definition of meaningful use will be expanded in three stages, setting the bar higher and requiring more features and more data exchange and sharing in each stage. Stage 2 (est. 2013) and Stage 3 (est. 2015) will continue to expand on the Stage 1 baseline and be developed through future rule making.

Meaningful Use Stage 1 (2011/ 2012)

Reporting on Stage 1 Functional and Interoperability Measures

To successfully achieve meaningful use, eligible providers will have to report on a series of EHR functionality and interoperability objectives and a set of Clinical Quality Measures as defined by CMS in the final rule .

Meaningful use criteria for Medicare eligible providers are divided into a set of 15 core EHR functionality and interoperability objectives and a separate menu of 10 additional advanced objectives from which providers will choose 5 to implement during stage 1. Although the core objectives are all required to be a meaningful user, the menu provides some room for rheumatologists to pick their own path toward full EHR implementation and meaningful use.

A full listing of Stage 1 Meaningful Use Core Objectives

A full listing of Menu Set of Objectives and Measures

Providers will be required to demonstrate their compliance with the functionality/interoperability objectives by reporting functionality/interoperability measures. These measures will be calculated by 1 of 3 methods:

• Through the EHR only. The count for these measures is limited to information for patients whose records are maintained in the certified EHR.
• Attestation. This is a simple yes or no statement such as, "yes, the drug interaction alerting system is switched on".
• EHR and Paper records. EHR must have ability to tabulate patient’s records stored in the EHR, however, if thresholds are not met through those patient records stored in the EHR, there are some situations where manual counting is needed to meet a measure. For example: A physician has seen 100 patients during the EHR reporting period. To meet a measure, the physician is required to report that 80% of his/her patients have an up-to-date problem list. However, only 60 of the 100 patient records have been recorded in the EHR with an up-to-date problem list. In this scenario, the physician would need to ensure that he/she has prepared an up-to-date problem list for an additional 20 patients whose electronic records are not yet in the EHR, thus, requiring a manual counting process to meet the 80% threshold requirement.

It is important for rheumatologists to note that these objectives and associated measures are based on individual unique patients (not patient visits). The unique patient is defined as a patient who is seen more than 1 time during the EHR reporting period and they are only counted once for the measure reporting. This should make meeting measure thresholds easier for those who have many patients they see only once during the reporting period (e.g. for a consult).

Reporting on Stage 1 Clinical Quality Metrics

The Stage 1 core objectives include the reporting of clinical quality measures to CMS for the Medicare program or to states for the Medicaid program. For Stage 1, CMS requires reporting of clinical quality measures based on data in the EHR system:

1. Core Clinical quality measures
2. Alternate core clinical quality measures (these measures are reported in place of a core measure which may not apply to the provider)
3. A menu set from which providers must choose 3 quality measures to report

A full listing of Core Clinical Quality Measures

A full listing of Alternate Core Clinical Quality Measures

A full listing of Menu Set Clinical Quality Measures

Clinical Quality Measures will be reported by attestation methodology and the submission of summary information to CMS. If the capability exists by CY 2012, HHS may require electronic submission of the data directly from the EHR system.

What if the clinical quality measures aren’t applicable to my practice? Although CMS requires all EPs to report core quality measures to achieve meaningful use, there is no requirement to satisfy a minimum value for any of the denominator, numerator or exclusion fields for clinical quality measures and EPs are not penalized as long as they:

• have adopted a certified EHR
• the EHR calculates the required measure
• the EP submits the required clinical quality information to CMS or the state.

The value for any or all of those fields, as reported to CMS or the States, may be zero. If the denominator for one or more of the Core Measures is zero (meaning that the measure is not applicable to the EP's patient population), EPs will be required to report results for up to three Alternate Core Measures.

Similarly, the EP may report 2 values for the 3 measures selected from the menu set. If so, the EP will have to attest that all of the other clinical quality measures from the menu set calculated by the certified EHR technology have a value of zero in the denominator. If this is done, the EP is exempt from reporting any of the additional clinical quality measures.

CMS limits the clinical quality measures to those for which electronic specifications are available as of the date of publishing of the final rule. EHR specifications for meaningful use are obtained from the specification documents for the CMS EHR incentive program and in order for an EHR to be certified, it must be able to calculate measure numerators, denominators and exclusions for each of the clinical quality measures listed in the Final Rule .

More information on Registration and Reporting

Next Steps

1) REVIEW THE MEANINGFUL USE REQUIREMENTS, MEASURES, AND TIMELINES

• Are you eligible for the incentive program?
• Where do you stand in regards to current technology and EHR utilization?
• How might the meaningful use requirements impact your workflow?
• Are you ready to pursue meaningful use incentives?
• How does EHR meaningful use fit into the long term HIT goals for your practice? MU will be achieved most successfully if coordinated with your broader HIT plan supporting the clinical, administrative and business functions of your practice

2) IDENTIFY YOUR CURRENT READINESS STATE: DO YOU ALREADY HAVE AN EHR SYSTEM?

3) GET YOUR TEAM ONBOARD AND DEVELOP A PLAN

• Bringing your practice staff on board with meaningful use is a key step to success. Achieving meaningful use will involve your whole team. Clinical and administrative staff should be involved from the beginning.

• Meet with your team to assess what's happening in your practice and identify internal barriers to EHR utilization and meaningful use.

  Review your practice's current workflow and utilization of the EHR system. Is everyone consistently and fully using the EHR system? What data is collected and where?

  Perform a gap analysis. Assess your current infrastructure against meaningful use requirements to determine your compliance with functionality and interoperability criteria. What systems or modules will need to be newly adopted? Is new data collection required? Is your system set up to collect it?

  Develop an approach and prioritized roadmap, along with estimated costs, to achieve the meaningful use requirements. What resources do you have available to you?

• Develop a strategic plan for integrating IT.

  Redesign workflow: craft a plan/workflow for each of the meaningful use requirements, including identifying which data points are needed in the EHR system, such as demographic info and vital signs. All team members (clinical, administrative, and support staff) should understand their roles in inputting these data.

  Participate in EHR implementation planning. Work with your vendors on implementing the meaningful use measures and standards. Conduct internal pilot tests to evaluate the effectiveness of your plan, and make changes as needed. Is the workflow feasible? Are expectations realistic? After rollout, put into place measurement tools to assess meaningful use compliance and use them!

• Develop an oversight structure.

4) MEANINGFUL USE

5) REGISTER, REPORT AND IMPROVE

6) INFLUENCE RULEMAKING AND GUIDANCE

Registration and Payment Information

Registration

All eligible providers must register via the CMS EHR Incentive Program Website.

In order to participate, all Medicare providers must:

• Be enrolled in Medicare FFS, MA, or Medicaid (FFS or managed care)
• Be enrolled in PECOS
• Use certified EHR technology
• Have a National Provider Identifier (NPI)
• Register provider Name, NPI, business address, phone, Tax payer ID Number (TIN) via the CMS EHR Incentive Program Registration Portal

For Medicaid providers:

• States that are participating will interface with to the EHR Incentive Program registration website
• States will ask providers to provide and/or attest to additional information in order to make accurate and timely payments, such as:
  • Patient Volume,
  • Licensure,
  • Adoption/Implementation/Utilization or Meaningful Use,
  • Certified EHR Technology

Medicare Incentive Payment Timeframe

EPs can begin receiving incentive payments in any CY from 2011 to 2014 and may receive incentive payments for up to five years, depending on the year in which the EP first becomes a meaningful user of certified EHR technology. For example, if an EP successfully demonstrates meaningful use and receives a Medicare EHR incentive payment in the first or second year of the incentive program (2011 or 2012); the EP may qualify to receive payments for the full five years.

Medicare EPs that first successfully demonstrate meaningful use for 2013 can only receive incentive payments for four years and will receive less than the maximum possible incentive payment. Accordingly EPs who start participating in 2014 can only receive incentive payments for three years and will also receive less than the maximum incentive payment possible. An EP who first successfully demonstrates meaningful use of certified EHR technology for 2015 will not qualify for any Medicare EHR incentive payments. In addition, starting in 2015, an EP who does not successfully demonstrate meaningful use of certified EHR technology will be subject to reduced physician fee schedule payments.

The rule also requires that each payment year "immediately follow" the prior year, meaning that every year subsequent to the first payment year is a payment year regardless of whether an incentive payment is received by the EP. For example, if a Medicare EP receives an incentive in CY 2011, but does not successfully demonstrate meaningful use or otherwise fails to qualify for the incentive in CY 2012, CY 2012 still counts as one of the EP's five payment years. In this example, the maximum incentive payment that would apply for this Medicare EP not practicing predominately in a health professional shortage area (HPSA) would be $18,000 in 2011, $8,000 in 2013, $4,000 in 2014, and $2,000 in 2015 . The EP would have qualified for a maximum incentive payment of $12,000 in 2012, but did not qualify as a meaningful user for this year.

No incentives may be made under the Medicare EHR incentive program after 2016.

Incentive Payment Calculation

Payment Accounting under Medicare

Resources/Calendar of Events

OVERVIEW OF THE EHR INCENTIVE PROGRAM (MEANINGFUL USE)

EHR STANDARDS AND CERTIFICATION

REGULATIONS

EHR RESOURCES

ARRA funding seeks to lower the technical, organizational and legal costs associated with health information exchange through a certification framework, grants to states to facilitate infrastructure, grants to develop HIT regional extension centers that will encourage effective and efficient use of technology, and support through a nationwide health information network governance authority. It is expected that these resources, combined with the approximately $48B incentive payments (and penalties) tied to “meaningful use” of EHR systems (including clinical data exchange) can create a business imperative for more information exchange.

More information on Health Information Exchange

ARRA includes more than $7 billion to expand broadband internet access and use and promote adoption of telehealth and distance learning.

Affordable, secure and reliable broadband connections are a foundational element to effective and efficient eHealth are crucial to making telehealth and health information exchange possible.

These efforts to extend telehealth applications to underserved communities afford new opportunities to not only improve patient care but also to facilitate research that will lead to better health outcomes in those communities. Improvements in the availability of broadband and health-related hardware and software make it possible to create new models of remote consultation among providers, assess medical images, and establish new ways for clinicians to interact with patients. Resources available through various ARRA programs give crucial support necessary to realize the vision of technology-enabled health care reform.

More information on the Broadband Initiatives Program

The value of eHealth is greatest when it is supported by clinical and administrative information technology, such as interoperable EHRs, that enable providers in different care settings to readily exchange, integrate, and act on patient information.

In order to support the adoption of EHR systems that facilitate appropriate data utilization and exchange, the HITECH Act establishes a certification program to review core EHR functionalities and provides financial incentives to providers for using certified electronic health records that have the capability to support the exchange of health information according to defined standards.

More information on the Meaningful Use Incentive Program and EHR Certification.

The HITECH Act provides for additional funds to States for low-interest loans to help providers finance the adoption and implementation of qualified electronic health record systems. Loans under this section may be used by a healthcare provider to carry out such activities as:

1. Facilitate the purchase of certified EHR technology;
2. Enhance the utilization of certified EHR technology;
3. Train personnel in the use of such technology; or,
4. Improve the secure electronic exchange of health information

For more information on loans available in your state, contact your Regional HIT Extension Center.

ARRA allocates $1.5 billion to HRSA to fund capital needs at federally qualified health centers, primarily construction, renovation and equipment, and the acquisition of health information technology, including telehealth equipment.

ARRA appropriates $85 million for HIS’s health IT activities. These funds will be used to support HIT related activities that fit the HIS mission to improve access to and the quality and safety of health care, and to improve the overall health of Native American and Alaska Native patients and populations. Funded Health IT activities will include those related to:

• The Resource and Patient Management System: EHR modernization, personal health record, enhancement of the population health application, acquisition of a practice management system, and architecture enhancements
• Telehealth infrastructure and development: security enhancements and network upgrades.

  Strategic Framework

  Leadership

  Workforce

Strategic Framework

ONC is mandated under the HITECH Act to consult with federal agencies, to update the Federal Health IT Strategic Plan published in June 2008. The 2008 Strategic Plan focused on the 2008 to 2012 timeframe and was intended "to guide the nationwide implementation of interoperable health information technology in both the public and private health care sectors that will reduce medical errors, improve quality, and produce greater value for health care expenditures."

The strategic framework covers the strategic themes, principles, objectives, and strategies ONC plans to address in its 2010 strategic plan. The Plan will focus on the 2011-2015 time period, "as well as lay the groundwork for the period beyond 2015 to create a learning health system through the effective use of HIT."

The scope of the framework is defined as:

• encompassing three levels:
  • The full array of entities in the public and private sectors who have a role in affecting and implementing the use of HIT to improve health and health care;
  • The broad array of Federal HIT policies, regulations, systems, and activities; and
  • The specific mandate, authorities, and role of the ONC.
• Emphasizing the implementation of legislative imperatives to achieve widespread adoption and meaningful use of HIT.
• Focusing on features that would be essential to continue the adoption and value of HIT beyond ARRA funding.
• The Framework focuses on 2011 through 2015 time period and on laying the ground work for the period beyond 2015 to create a learning health system through the effective use of HIT.

The current draft can be found, on the ONC website.

Leadership

The Office of the National Coordinator for Health Information Technology (ONC)

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administration’s health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care. ONC is organizationally located within the Office of the Secretary for the U.S. Department of Health and Human Services (HHS).

ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information. The position of National Coordinator was created in 2004, through an Executive Order, and legislatively mandated in the Health Information Technology for Economic and Clinical Health Act (HITECH Act) of 2009.

ONC is responsible for the coordination of efforts to implement and use HIT to promote the nationwide exchange of health information to improve health care. ONC’s mission includes:

• promoting the development of a nationwide IT infrastructure that allows for electronic use and exchange of health information that, among other functions, ensures data security, advances health care quality, reduces health care costs, provides for clinical decision support, improves public health, promotes early detection, prevention, and management of chronic diseases, and improves efforts to reduce heal disparities;
• HIT policy coordination; providing leadership in the development, recognition, and implementation of standards and the certification of HIT products;
• strategic planning for HIT adoption and health information exchange; and
• establishing governance for the Nationwide Health Information Network (NHIN).

Organizational Structure and Offices

The Office of the Chief Scientist is responsible for research and for identifying innovations in information technology that can be applied in health care settings, and which will be the ONC interface for international activities.

The Office of Economic Analysis and Modeling provides analyses to the National Coordinator, including advanced modeling of the U.S. health care system for simulating the micro- and macroeconomic effects of investing in health IT.

The Office of the Chief Privacy Officer, a position mandated by the Recovery Act, advises on privacy, security, and data stewardship of electronic health information and coordinate ONC’s privacy and related efforts with similar privacy officers in other Federal agencies, State and regional agencies, and foreign countries.

The Office of the Deputy National Coordinator for Operations is responsible for activities that are vital to supporting ONC’s numerous programs and enhancing ONC’s ability to communication about health IT.

This office comprises:

• The Office of Communications, which is responsible for stakeholder communications and constituency relations
• The Office of Mission Support, which supports day-to-day operations, including new grants processing, contracts management, budget execution and reporting, and human resources
• The Office of Oversight, which assures oversight of grants, internal and external performance reporting, and auditing
• The Office of Strategic Initiatives to oversee internal strategic planning, special projects, and budget formulation

The Office of the Deputy National Coordinator for Programs and Policy assumes functions previously performed by the Office of Health Information Technology Adoption, the Office of Interoperability and Standards, the Office of Adoption Provider Support, the Office of State and Community Programs, and the Office of Policy and Planning. The new office will lead ONC programs related to health information exchange, regional extension centers, training of the health IT workforce, and the development of technical standards for interoperability, security, and certification of health IT systems

The new office comprises:

• The Office of Standards and Interoperability, with responsibility for standards, security, certification, the Nationwide Health Information Network, Federal Health Architecture and the CONNECT program
• The Office of Provider Adoption Support, which administers the Regional Extension Centers program and health IT workforce development
• The Office of State and Community Programs, which administers the state-level health information exchange program and the Beacon Communities Program
• The Office of Policy and Planning, which is realigned to include all policy development, including privacy and security policy, and is liaison with legal affairs and legislative affairs, regulations development and externally focused strategic planning

Federal Advisory Committees

+ Health IT Policy Committee (a Federal Advisory Committee)

- Health IT Policy Committee (a Federal Advisory Committee)

+ Health IT Standards Committee (a Federal Advisory Committee)

- Health IT Standards Committee (a Federal Advisory Committee)

Current Other Committees

+ National Committee on Vital and Health Statistics (NCVHS) (1949 – present)

- National Committee on Vital and Health Statistics (NCVHS) (1949 – present)

Past Committees

+ American Health Information Community (AHIC) and AHIC Workgroups (2005 – 2008)

- American Health Information Community (AHIC) and AHIC Workgroups (2005 – 2008)

National Governor's Association: State Alliance for e-Health

To work to improve the nation's health care system and enable states to increase the efficiency and effectiveness of health information technology (HIT), the NGA Center formed a collaborative body known as the State Alliance for e-Health(State Alliance).

The State Alliance provides a nationwide forum through which stakeholders can work together to identify inter- and intrastate-based health information technology policies and best practices and explore solutions to programmatic and legal issues related to the exchange of health information.

The State Alliance is co-chaired by Vermont Gov. Jim Douglas and Tennessee Gov. Phil Bredesen who guide the efforts of governors, state legislators, attorneys general, insurance commissioners and others to help them develop real-world solutions and model practices for improving the quality and efficiency of health care.

Workforce

The provisions of the HITECH Act are specifically designed to work together to provide the necessary assistance and technical support to providers, enable coordination and alignment within and among states, establish connectivity to the public health community in case of emergencies, and assure the workforce is properly trained and equipped to be meaningful users of EHRs. Combined these programs build the foundation for every American to benefit from an electronic health record, as part of a modernized, interconnected, and vastly improved system of care delivery.

Regional Extension Centers

The HITECH Act authorizes a Health Information Technology Extension Program. The extension program consists of Regional Extension Centers and a national Health Information Technology Research Center (HITRC). The regional centers will offer technical assistance, guidance, and information on best practices to support and accelerate health care providers’ efforts to implement and become meaningful users of Electronic Health Records (EHRs) to improve the quality and value of health care. The extension program will establish an estimated 70 (or more) regional centers, each serving a defined geographic area.

Services are open to specialists, however in the initial two year budget period, HITECH directs the regional centers to give priority support to primary care providers in small practices, public and critical access hospitals, community health centers and rural health clinics, and other settings that predominantly serve uninsured and medically underserved populations. During this time, the regional extension centers collectively must serve at least 100,000 primary care providers, through participating non-profit organizations, in achieving meaningful use of EHRs and enabling nationwide health information exchange.

The regional centers will offer services in the following areas:

• Education and Outreach
  Disseminate knowledge about the effective strategies and practices to select, implement, and meaningfully use certified EHR technology to improve quality and value of healthcare
• National Learning Consortium
  Participate in the National Learning Consortium facilitated by the HITRC and share tools and materials developed through the cooperative agreement with other Regional Centers, interested stakeholders, and the public.
• Local Workforce Support
  Partner with local resources, such as community colleges, to promote integration of health IT into the initial and ongoing training of health professionals and supporting staff.
• Practice and Workflow Redesign
  Support for practice and workflow redesign necessary to achieve meaningful use of EHRs
• Functional Interoperability and Health Information Exchange
  Assist priority primary-care providers in connecting to available health information exchange infrastructure(s).
• Vendor Selection & Group Purchasing
  Help providers select the highest-value option -- the option that offers the greatest opportunity to achieve and maintain meaningful use of EHRs and improved quality of care at the most favorable cost of ownership and operation, including both the initial acquisition of the technology, cost of implementation, and ongoing maintenance and predictable needed upgrades over time.
  • Each Regional Center will offer unbiased advice on the systems and services best suited to enable the priority primary-care providers to become meaningful users of EHRs. Regional Centers will avoid entering into business arrangements creating an actual or apparent conflict of interest with the Regional Center’s obligation to act solely in the best interests of advancing meaningful use of certified health IT by providers it serves.
  • Applicants are required to submit a Conflict of Interest Certification with the vendors that that they’ve identified. If vendors have not yet been identified applicant can leave the vendor portion of the certification blank for the moment.
• Privacy and Security Best Practices
  Support providers in implementing best practices in the privacy and security of personal health information.
• Implementation and Project Management
  Support end-to-end project management over the entire EHR implementation process, including individualized and on-site coaching, consultation, troubleshooting.
• Progress Towards Meaningful Use
  Participate in program training and be able to provide their clients effective assistance in attaining meaningful use.

The Extension Program will also establish a HIT Research Center, funded separately, to gather relevant information on effective practices and help the regional centers collaborate with one another and with relevant stakeholders to identify and share best practices in EHR adoption, effective use, and provider support.

Academic Curricula and Medical Health Informatics Education Programs

These programs provide for grant funds for demonstration projects to develop academic curricula integrating certified EHR technology in the clinical education of health professionals, and to provide for assistance to institutions of higher education to establish or expand medical health informatics education programs, including certification, undergraduate, and masters degree programs for both healthcare and IT students to ensure the rapid and effective development and utilization of HIT.

• Community College Consortia to Educate Health Information Technology Professionals Program
  A grant program that seeks to rapidly create health IT education and training programs at Community Colleges or expand existing programs. Community Colleges funded under this initiative will establish intensive, non-degree training programs that can be completed in six months or less. This is one component of the Health IT Workforce Program.
  » Read more
• Curriculum Development Centers Program
  A grant program to provide $10 million in grants to institutions of higher education (or consortia thereof) to support health information technology (health IT) curriculum development. This is one component of the Health IT Workforce Program.
  » Read more
• Program of Assistance for University-Based Training
  A grant program to rapidly increase the availability of individuals qualified to serve in specific health information technology professional roles requiring university-level training. This is one component of the Health IT Workforce Program.
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• Competency Examination for Individuals Completing Non-Degree Training Program
  A grant program to provide $6 million in grants to an institution of higher education (or consortia thereof) to support the development and initial administration of a set of health IT competency examinations. This is one component of the Health IT Workforce Program.
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Research Programs:

HITECH authorized funds for HIT related research focused on achieving breakthrough advances to address well-documented problems that have impeded adoption of health IT and accelerating progress towards achieving nationwide meaningful use of health IT in support of a high-performing, continuously-learning health care system.

• Strategic Health IT Advanced Research Projects (SHARP) Program
  A grant program to fund research focused on achieving breakthrough advances to address well-documented problems that have impeded adoption: 1) Security of Health Information Technology; 2) Patient-Centered Cognitive Support; 3) Healthcare Application and Network Platform Architectures; and, 4) Secondary Use of EHR Data.
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• Beacon Community Program
  A grant program for communities to build and strengthen their health information technology (health IT) infrastructure and exchange capabilities. These communities will demonstrate the vision of a future where hospitals, clinicians, and patients are meaningful users of health IT, and together the community achieves measurable improvements in health care quality, safety, efficiency, and population health.
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