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Adoption and Meaningful Use of EHRs – The Journey Begins ... Health Affairs Blog by David Blumenthal and Donald Berwick

Colleagues,

The two individuals most responsible for EHR (Electronic Health Record) adoption in the United States , Dr David Blumenthal, National Coordinator for Health Information Technology, and Dr Donald Berwick, Administrator of the Centers for Medicare and Medicaid Services, have decided to express their opinions on the subject in the form of a blog post in today's Health Affairs...

... Please see excepts blow ...

Remember ....“The secret of life…is to fall seven times and to get up eight times.” -Paulo Coelho, The Alchemist

ENJOY!

CC

 
David Blumenthal


Don Berwick

On July 13, with the issuance of two regulations defining and supporting “meaningful use” of electronic health records (EHRs), our
nation began in earnest its journey toward ubiquitous and effective useof health information technology....

... The proximate event leading us to the July 13 announcement was the enactment of the Health Information Technology for Economic and Clinical Health (HITECH) Act, in February 2009. This act makes available unprecedented resources to support the nation’s transition to EHRs...

... These constitute the operational supports for a multiyear, multiphase campaign of EHR adoption and use. But behind these preparations lies a longer and deeper history that has prepared us to seize this moment...

... it was a decade ago that the Institute of Medicine (IOM) published findings regarding safety and quality of health care in America in a pair of groundbreaking studies: To Err Is Human and The Quality Chasm... The IOM reports played an important part in illustrating both the need for improved information systems in health care and the potential for electronic data to help fill that
need...

... A review of the pages of Health Affairs itself would reveal a layered progression of discovery and understanding. For some years, we have reviewed the evidence and considered the questions: “Is the technology ready for significant national investment?” and “How is such investment to be made?”...

...
Congress answered those questions in HITECH, not only by providing significant new resources, but equally importantly by creating a multifaceted structure of standards, supports, and protections that reflect the learning of many years...
 

... First, Congress found that universal adoption and meaningful use of EHRs can indeed yield unique and substantial benefits that are urgently needed in our health care system—to improve individual and public health, support providers in the delivery of care, empower patients, and improve cost-effectiveness...


... To help achieve those benefits, HITECH authorized significant federal expenditure over a ten-year period: up to an estimated $27 billion in incentive payments through Medicare and Medicaid to support clinicians and hospitals in the adoption and use of EHRs...

... Second, Congress made clear that HITECH’s incentive payments are not intended merely to support acquisition of EHR technology for its own sake ... Instead, as outlined by the law, it is the “meaningful use” of EHR systems that creates new value—including the capacity to make a patient’s information available when and where it is needed, and the capacity to improve patient safety and quality of care. To achieve those goals for the meaningful use of EHRs, the Department of Health and Human Services (HHS) developed three companion regulations: 

... Third, HHS continues to build the protections necessary for an EHR-based health care system. Privacy and security are the bedrock of building trust, a “must-have” component for the success of health IT. On July 8, the HHS Office for Civil Rights announced a proposed rule strengthening protections under the Health Insurance Portability and Accountability Act of 1996 (HIPAA)...



... Finally, Congress provided a variety of supports to assist providers in adopting and using EHRs, and to help enable EHR technology to keep moving forward: 
  • The Health Information Technology Extension Program ($643 million). A nationwide network of Regional Extension Centers (RECs) will provide technical assistance to clinicians, especially those who provide primary care services in smaller practices. Clinicians in such practices deliver the majority of primary care services but have the lowest rates of EHR adoption and the least access to resources to help them implement
    and use EHRs. The RECs’ goal is to provide outreach and support services to at least 100,000 high-priority primary care providers within two years. A Health IT Research Center will also provide support materials, especially to clinicians serving patient populations with special needs. 
  • The State Health Information Exchange Cooperative Agreement Program ($564 million). This grant program is helping states to rapidly build capacity for exchanging health information. The ability to exchange information is vital to realizing the benefits of EHRs, and state leadership is essential to achieving this. 
  • The Health IT Workforce Training Program ($118 million). There is a national shortage of health IT professionals who can help clinicians and hospitals achieve meaningful use. The workforce training program will support education of health IT personnel, including
    curriculum development, funds for community college programs, and competency examinations. 
  • The Beacon Community Program ($235 million). This grant program has identified leading communities where health and IT goals are being combined to demonstrate improved health and care results. They will focus on achieving measurable health and efficiency improvements over a compressed time frame, and they will provide lessons
    that can be transferred to other communities in the United States. 
  • The Strategic Health IT Advanced Research Projects (SHARP) Program ($60 million). This grant program will fund research to address key issues for health IT use that could impede progress in adoption and meaningful use. 

In addition, the ONC continues to develop a National Health Information Network, a secure means for exchanging health information to ensure that the information follows the patient...


... July 13: Beginning The Journey In Earnest 

... July 13 marked the beginning of a national EHR initiative...


... It is our privilege to be able to help our health care colleagues bring about these improvements...


... It is our pledge to work closely and productively with them to achieve these goals...

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