By Hootsbuddy
Most people have no idea but experts are already toiling away working out the details of health care reform. The administration was really slick getting significant portions of the program included in the ARRA package already approved and in the pipeline. Lots of money on the table to be awarded to medical providers by way of incentives to expedite the changes required to get a handle on costs.
John D. Halamka, MD, MS, is Chief Information Officer of the CareGroup Health System, Chief Information Officer and Dean for Technology at Harvard Medical School, Chairman of the New England Health Electronic Data Interchange Network (NEHEN), CEO of MA-SHARE (the Regional Health Information Organization), Chair of the US Healthcare Information Technology Standards Panel (HITSP), and a practicing Emergency Physician.
I have been following Dr.Halamka's blog for some time and find him to be a wellspring of rich and timely information. Today's post is particularly informative, although the appeal may be mostly to a nerdy minority outside the profession. By way of background, ARRA has a pile of money waiting to reward medical providers for getting into compliance with electronic health records as soon as possible. (That is measured in years, not months.)
Among the many challenges is that (even now) there is no universal platform by which that data can be managed and exchanged. Definitions and database content must be agreed upon, then the technology must be available and agreed upon by which the data can be put to use. As a layman I have only the vaguest shape of the problem, but from what I can tell when the dust settles something better than what we now have will be standing in studio.
For the newcomer, a few acronyms and sources to find more are in order.
CPOE -- Computerized Physician Order Entry
CMS -- Center for Medicare and Medicaid Seervices
EHR -- Electronic Health Record
PHR -- Personal Health Record
HIT -- Health Information Technology
OP -- Outpatient
IP -- Inpatient
SNOMED -- Systematized Nomenclature of Medicine
ICD9 -- International Statistical Classification of Diseases (I don't know what the 9 means)
Healthcare Acronyms List -- Links to a ten page list of medical acronyms
There won't be a test. This is just to let the reader get a chance to peek behind the curtain.
On June 16, I wrote about the release of the draft definition of meaningful use.
Today, at the HIT Policy Committee meeting, the final definition of meaningful use was released and adopted. What was changed?
1. For inpatient CPOE, only 10% of orders must be entered electronically
2. For problem lists, ICD9 or SNOMED must be used
3. Advanced directives must be recorded
4. Smoking status must be recorded
5. Quality measures must be reported to CMS
6. Clinicians and Hospitals must implement at least one clinical decision rule relevant to a high clinical priority
7. Administrative transactions, including eligibility and claims, must be completed electronically
Also, the timing of meaningful use was clarified in this presentation on Slide 12 and 13
The Meaningful Use Workgroup recommended use of an 'adoption year' timeframe (i.e., '2011 measures' applies to first adoption year even if HIT adopted in 2013; '2013 measures' applies to 3rd adoption year.
Thus, clinicians can still receive partial stimulus funds if they implement 2013-2015 instead of 2011-2013, and they can follow the same path as early adopters instead of an increasingly difficult set of criteria.
The Committee also discussed options for certification which I encourage you to read.
A very important meeting today. Now that meaningful use has been defined and approved, the HIT Standards Committee can complete its initial standards and certification criteria recommendations, which will be delivered next Tuesday.
The links include multi-page PDF data charts that go into tedious detail. As I said, this post is not intended to be a layman's guide to medicine. That would be like a do-it-yourself appendectomy.
The point is that health care reform has already begun.
When the president says the impact will not be seen for several years, this is what he is talking about. He's not just making stuff up. ARRA is already under way and the wrinkles are being ironed out.
My earlier post about professional resistance as the worst obstacle applies here. But the time is coming when health care reform will come to pass. It's already started.
as much as we need reform, why do i feel no matter what they do it will be worse......
ReplyDeletemaybe because of people like Mitch Mcconnell