MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'hit policy'. Sat, 03 Sep 2011 02:27:37 +0100 http://www.medworm.com/index.php?rid=5159280&cid=t_99948_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FTRWtDdOJM_4%2F Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts. In addition to the Meaningful Use Stage 2 recommendations discussed in last week’s Meaningful Use Monday, the HIT Policy Committee proposed a new framework for the reporting of clinical quality measures that was designed by its specifically-tasked Quality Measure Workgroup. The recommended concept is depicted in the graphic below—the intention is to broaden the scope of reporting to address a wid... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5159280 Mon, 22 Aug 2011 15:19:08 +0100 5159280 http://www.medworm.com/index.php?rid=5130856&cid=t_99948_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F7izZd7JZcgo%2F Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts. A few weeks ago, the HIT Policy Committee forwarded its Stage 2 meaningful use recommendations to CMS. CMS is expected to issue a Proposed Rule in early 2012 and the Final Rule in mid-2012.  The first recommendation—intensely debated, but overwhelmingly supported in the end—is to delay the start of Stage 2 until 2014, recognizing the unrealistic time pressure that vendors and providers would fac... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5130856 Mon, 15 Aug 2011 16:43:35 +0100 5130856 http://www.medworm.com/index.php?rid=5107647&cid=t_99948_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2011%2F08%2F05%2Fpreliminary-meaningful-use-details-out%2F Brian Ahier has a great post up that had the presentation and report (embedded below) that CMS provided to the HIT Policy Committee. It has a lot of great information worth talking about. I’m going to embed the presentation and report below and pull out some of the key points in a post later. Let me know what catches your eye. The CMS Meaningful Use Presentation The CMS Meaningful Use Report Related posts:Meaningful Use Mondays – More 90 Day Reporting Period Details As a follow-up to last week’s Meaningful Use Monday, the... Meaningful Use Measures: Electronic Copy of Health Information – Meaningful Use Monday Meaningful Use Core Measure: More than 50% of all patients... Helpful Meaningful Use Resources – Meaningful Use Monday I spend a lot of my day answering questio... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5107647 Fri, 05 Aug 2011 21:38:20 +0100 5107647 http://www.medworm.com/index.php?rid=5028543&cid=t_99948_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FHhgUwFu7e1U%2F Meaningful Use Core Measure: More than 50% of all patients who request an electronic copy of their health information are provided it within 3 business days. Exclusion: Any EP who receives no requests for this information in electronic format.  This measure is distinguished from  the clinical summary measure, (discussed in the previous Meaningful Use Monday post), in two major ways: 1)      “Electronic copy of health information” covers all health information that the provider has regarding the patient, whereas the “clinical summary” is a snapshot of a particular visit. 2)      This measure is driven by requests made by patients or their agents—electronic access must be provided in response to at least 50% of the specific requests received by a provider. By contrast, ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5028543 Mon, 11 Jul 2011 14:18:26 +0100 5028543 http://www.medworm.com/index.php?rid=2954609&cid=t_99948_114_f&fid=34646&url=http%3A%2F%2Fhealthit.hhs.gov%2Fportal%2Fserver.pt%2Fgateway%2FPTARGS_0_11113_890784_0_0_18%2FHIT%2520Standards%2520Cmte_Transmittal_8-20-09.pdf The Office of the National Coordinator for Health Information Technology (ONCHIT) has launched a new blog called the Federal Advisory Committee Blog (FACA Blog).The initial post by Judy Sparrow discusses that the FACA Blog will be uses in a spirit of transparency and collaboration to help open a broader dialogue on the issues before the Health IT Standards Committee and the Health IT Policy Committee. The post also provides some background on the role that Federal Advisory Groups play under the Federal Advisory Committee Act.The second post by Aneesh Chopra, Federal Chief Technology Officer, spells out the planned process for an open conversation that will take place over the next couple of weeks with various committee members blogging about a variety of topics (Proposed Standards, Interop... Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=2954609 Tue, 03 Nov 2009 14:08:31 +0100 2954609 http://www.medworm.com/index.php?rid=2950810&cid=t_99948_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FtE2kF5Y_eLo%2F All I can say is that it’s very cool that ONC now has a blog. This is probably right up there with when I found past HHS secretary Mike Leavitt’s blog. Ok, yes I am a complete blog nerd. At least I’m able to admit it up front. Basically, Judy Sparrow has just done an introduction post where she talks about the Federal Advisory Committees and their role at ONC. She’s the ONC liason for these committees and so hopefully she’ll keep us updated on progress with these two very important committees. She also provides this explanation about the committees in her first ONC blog post: “FACAs” get their name from the Federal Advisory Committee Act, which lays out the guidelines for such committees. FACAs are advisory and intended to provide external guidance to the ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2950810 Thu, 29 Oct 2009 16:00:13 +0100 2950810 http://www.medworm.com/index.php?rid=2793253&cid=t_99948_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F09%2F11%2Fhit-policy-committee-meeting-on-certified-ehr%2F I’ve been meaning to post about the HIT Policy Committee meeting for a month or so now. The reason I didn’t is that when I post about things like this, I like to make sure that I’ve had a chance to digest the information and provide some thoughtful analysis and commentary on what’s happening. Of course, thoughtful analysis and commentary takes a lot more work and time and so thus the delay. Enough about me… Yes, on August 14th the HIT Policy Committee met to mostly talk about what certified EHR will mean under ARRA. You can see the full powerpoint from the presentation here. Luckily, CCHIT (I guess they have an interest in the topic) wrote a pretty good summary of what was said about EHR certification at the meeting (with a few of my own modifications): There... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2793253 Fri, 11 Sep 2009 20:15:14 +0100 2793253 http://www.medworm.com/index.php?rid=2662558&cid=t_99948_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FgemlcZp0t6s%2F A relatively new reader of EMR and HIPAA, Michael Archuleta, sent me his notes from the Utah Medical Group Managers Association 6/25/09 where the keynote speaker was Marc Probst. For those that don’t know, Marc Probst is the CIO of Intermountain Healthcare (IHC). IHC is huge in Utah and I think it does pretty well in a number of surrounding states as well. Plus, Marc Probst is also a member of the HIT Policy Committee. You may remember that I’ve talked about Marc Probst on EMR and HIPAA a few times before. Anyway, I found some of the points that Michael captured interesting. I guess in the end I was interested to hear what Marc Probst was telling people. Michael Archuleta’s notes are as follows (published with permission and the emphasis added was mine to highlight some i... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2662558 Sat, 01 Aug 2009 15:45:55 +0100 2662558 http://www.medworm.com/index.php?rid=2637881&cid=t_99948_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FMOdN01pvbl8%2F Yes, I’m still on my kick of asking the question of why we’re making the definition of meaningful use so complicated. Certainly I could make an ambitious goal of every doctor having to document everything granularly and electronically and share everything with everyone so we give the best care possible to patients. The reality is that if you do that, then no one will care about meaningful use and the EHR stimulus money will go unspent. Certainly the above is a bit of an exaggeration, but I can’t help but ask myself if the definition of “meaningful use” isn’t so ambitious that the above will be the net result (at least for small practices) of the current definition of meaningful use. It’s a little bit wrong for me to say it’s too complex, but ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2637881 Fri, 24 Jul 2009 17:12:26 +0100 2637881 http://www.medworm.com/index.php?rid=2630206&cid=t_99948_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FWqNz6OcJbAw%2F Now that the HIT Policy committee has marginalized CCHIT EHR certification and proposed that HHS define the EHR certification criteria, it only seems reasonable to ask whether HHS will do a much better job than CCHIT did at defining “certified EHR.” What has me a little concerned is the process the work they’ve done in creating the meaningful use guidelines. They are too complicated and I believe will leave us with a lot of unhappy doctors. It makes me wonder if the same will happen with defining the EHR certification criteria. A few things do give me hope. First, the HIT policy committee’s suggestion is for the EHR certification to remain focused on just those things which are applicable to the EHR stimulus money. This should provide HHS with an advantage over CCHI... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2630206 Wed, 22 Jul 2009 21:48:10 +0100 2630206 http://www.medworm.com/index.php?rid=2621884&cid=t_99948_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FGsC5Ed1Fxbg%2F I posted previously a short summary of the changes to meaningful use in the final meaningful use matrix presented at the HIT policy committee meeting. As I’ve thought about these changes this weekend, I couldn’t help but remember the major problem I (and many others) had with the original meaningful use criteria being too complex. My argument then was that the 22 meaningful use criteria as a collective whole were too much for a doctor’s office to complete in the current time frame. Unfortunately, it seems that the HIT policy committee has chosen to only make slight simplifications of the meaningful use matrix for hospitals (For inpatient CPOE, only 10% of orders must be entered electronically) and has actually added to the EMR requirements for ambulatory clinics. I do thi... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2621884 Mon, 20 Jul 2009 16:10:14 +0100 2621884 http://www.medworm.com/index.php?rid=2615394&cid=t_99948_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FnQZKzRDsdnY%2F I read that the HIT Policy Committee meeting that happened on July 16, 2009 was a “big one” according to Chilmark Research. He said that “the committee went from hearing revised recommendations for Meaningful Use, to recommendations from the HIE workgroup and lastly recommendations regarding certification processes for EHRs.” I was unfortunately tied up doing a presentation on ARRA EHR Stimulus money and so I wasn’t able to follow the event live (or on one of my twitter accounts). I know that Chilmark is planning to do some posts and I’m looking forward to those. I also found this short summary from John Halamka about the changes to meaningful use in the final definition: 1. For inpatient CPOE, only 10% of orders must be entered electronically 2. For pro... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2615394 Sat, 18 Jul 2009 17:37:16 +0100 2615394 http://www.medworm.com/index.php?rid=2553115&cid=t_99948_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F06%2F25%2Fproviding-feedback-on-meaningful-use-matrix%2F I’d been meaning to post this when the meaningful use document came out, but didn’t get around to it until now. ONC has asked for public comment on the preliminary definition of “meaningful use” as presented by the HIT policy Committee (see the Meaningful Use Matrix). Submissions are due by 5 pm est June 26, 2009, and should be no more than 2,000 words in length (per the HHS HIT website). I encourage everyone involved in Helathcare IT to submit their thoughts on meaningful use. I’m a big believer in leveraging the knowledge of crowds to make something better. I believe that if you amass enough smart people on something, you usually get a pretty good result. Assuming that they listen. I’d also certainly welcome people to post their submissions in the comm... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2553115 Thu, 25 Jun 2009 17:52:45 +0100 2553115 http://www.medworm.com/index.php?rid=2553116&cid=t_99948_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F06%2F24%2Fmeaningful-use-matrix-from-hit-policy-committee%2F As I first looked over the meaningful use matrix (PDF) that was created by the HIT policy committee I thought that the requirements listed were reasonable and doable. Then, I realized that I was only looking at the first page of a seven page document. For now, I’ve focused on looking at the 2011 objectives. I wanted to really focus on it since that’s the bar with the most stringent timeline for those wanting to get the EHR stimulus money from ARRA. I’ll talk in more detail about the various items in a future post. However, as I look through the list of objectives to show meaningful use for 2011, I don’t think any of them sound unreasonable. On their own, each objective listed seems to be something that is completely doable. I might question why some are on the list,... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2553116 Wed, 24 Jun 2009 17:07:10 +0100 2553116 http://www.medworm.com/index.php?rid=2523212&cid=t_99948_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FSaiG6cX0Wv8%2F I participated in both of the CCHIT “town calls” that happened this morning and yesterday. I did miss the beginning of today’s call, but looking through the slides it looks like the presentation was more or less the same for both town calls. You can see the slides from both CCHIT presentations here. Between this and the HIT Policy Committee meeting yesterday there’s almost too much to digest. So, in my regular fashion I’m going to break down my analysis into lots of bite sized chunks. The biggest change that was proposed/announced during the CCHIT meeting was three EHR certification pathways: EHR-C: Certified EHR Comprehensive EHR-M: Certified EHR Module EHR-S: Certified EHR Site Basically, the EHR-C is the same certification that CCHIT has been doing since th... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2523212 Wed, 17 Jun 2009 18:26:45 +0100 2523212 http://www.medworm.com/index.php?rid=2473623&cid=t_99948_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2Ffedg2KK4tNM%2F The healthcare IT airwaves are abuzz with the date of June 16th.  That’s the date that they say we should get more indications on how the government is going to define the all important term “meaningful use.”  Here’s a short quote from John Halamka about the meaningful use dates: On June 16th, the Quality workgroup will receive meaningful use guidance from the HIT Policy Committee. We’ll work hard over the following week and will present our strawman standards, implementation guidance, and certification criteria at the June 23rd public meeting of the HIT Standards Workgroup. We’ll continue to refine the matrix in July and complete our work in August. John Halamka also described the format for the HIT Standards Committee’s meaningful use document:... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2473623 Fri, 12 Jun 2009 16:07:15 +0100 2473623 http://www.medworm.com/index.php?rid=2408548&cid=t_99948_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FWk2JkDjgXuA%2F As I’ve been writing and reading about ARRA and the HITECH Act, I’ve had a few moments to consider the impact that things like the HIT Policy Committee will have on the future of EMR adoption in the US. Between that committee, ONCHIT and HHS the decisions they make will have far reaching impact on EHR adoption. I’ll leave the question of whether they’ll have a good or bad impact to another post. Instead, I couldn’t help but wonder what impact bloggers and various EMR related websites and forums can have on EMR adoption. More specifically, I’ve been asking myself what kind of impact does this blog have on overall EMR adoption including both selection and implementation. Maybe I should be asking myself the question of how much impact could EMR bloggers hav... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2408548 Thu, 14 May 2009 23:20:34 +0100 2408548 http://www.medworm.com/index.php?rid=2382593&cid=t_99948_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FX2ItRyp8LkA%2F Marc Probst, CIO at Intermountain Healthcare and member of the new Health Information Technology Policy Committee, gave a really interesting interview to Healthcare Informatics. I really don’t know Marc Probst other than what I read in this interview, but I do know something about Intermountain Healthcare (or IHC as it’s known in Utah). When I was in high school I actually worked for IHC spending one hour a day cleaning a local doctors office. I’m glad those days are over and I don’t think I did a very good job at it either. However, from that experience and also my high school friend’s dad being the CEO of IHC I got to know the company pretty well. I was really impressed with how the company was run. From the above interview I think that Marc Probst probably ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2382593 Sat, 02 May 2009 23:11:05 +0100 2382593 http://www.medworm.com/index.php?rid=2314671&cid=t_99948_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FPZgGIfDuOyc%2F One of my loyal readers and colleagues in the EHR field recently sent me a link (pdf) to the list of members that were announced on the Health Information Technology (HIT) Committee. Take a look at the list of members on the HIT Policy Committee: Christine Bechtel, vice president, National Partnership for Woman and Families Arthur Davidson, director, Public Health Informatics, Denver Public Health Department; director, Denver Center for Public Health Preparedness; medical epidemiologist; director, HIV/AIDS Surveillance, City and County of Denver Adam Clark, research and policy director, Lance Armstrong Foundation Marc Probst, chief information officer, Intermountain Healthcare Paul Tang, vice president and chief medical information officer, Palo Alto Medical Foundation Scott White, assist... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2314671 Sun, 05 Apr 2009 07:30:55 +0100 2314671 http://www.medworm.com/index.php?rid=2314692&cid=t_99948_113_f&fid=34625&url=http%3A%2F%2Fclinicalit.blogspot.com%2F2009%2F04%2Fgao-picks-first-13-members-of-hit.html The Government Accountability Office today named the first 13 members of the Health Information Technology Policy Committee, one of the new advisory boards called for in the stimulus legislation. The appointments fall under 10 categories: Advocates for Patients or Consumers1. Christine Bechtel, Washington, D.C. (3-year term) Vice President, National Partnership for Women & Families 2. Arthur Davidson, M.D., Denver (2-year term) Denver Public Health Department; Director, Public Health Informatics; Director, Denver Center for Public Health Preparedness; Medical epidemiologist; Director, HIV/AIDS Surveillance, City and County of Denver 3. Adam Clark, Ph.D., Austin, Texas (1-year term) Director of Research and Policy, Lance Armstrong Foundation Representatives of Health Care Providers, includi... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=2314692 Fri, 03 Apr 2009 16:21:00 +0100 2314692 http://www.medworm.com/index.php?rid=1720286&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2008%2F08%2Fgrant-roundup-f.html Health IT funding news and links to resources. (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1720286 Wed, 20 Aug 2008 16:13:48 +0100 1720286 http://www.medworm.com/index.php?rid=1622073&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2008%2F07%2Fnew-hipaa-stand.html Tired of the ambiguities and outdated constraints of the electronic claim, remittance advice, eligibility and other X12 transactions? Help is on the way.  Or at least it's coming into view. The enabling regulation to adopt a new version of those standards has cleared the Department of Health and Human Services and has been passed on to Office of Management and Budget for final review. OMB has 30 days to approve it (with or without revisions negotiated with HHS) or reject it. I was fortunate to have the opportunity to participate in some of the X12 workgroups that built the new standards, and am certain that the new standards will improve efficiency and reduce the number of customizations and workarounds.   We won't be able to say goodbye to those nasty Companion Guides, bu... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1622073 Mon, 14 Jul 2008 21:13:45 +0100 1622073 http://www.medworm.com/index.php?rid=1399117&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2008%2F04%2Fprepping-for-cc.html Last fall, I reported about how much fun I had at the Collaborative Communications Summit. Not "fun" as in golf outings and spa appointments, but "fun" as in meeting some really interesting and influential people, and being surprised at just how much some executives at the top tiers of the healthcare industry actually know about health IT. But CCS is not just about IT, it's about IT-enabled healthcare, which is a different spin from the typically techy-wonky conferences I traditionally attend. And I didn't just like it enough to go back; I liked it enough to help make the next one happen. [Disclosure: HITTG is a media sponsor for this event. But we don't sell blog endorsements to anybody.] Multisyllabic Session Title #1On Tuesday, I'll be moderating a session called, ... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1399117 Fri, 25 Apr 2008 18:32:47 +0100 1399117 http://www.medworm.com/index.php?rid=1362380&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2008%2F03%2Fbest-care-lowes.html The Wall Street Journal offers a doomy, gloomy perspective on the state of primary care in the US: Primary Health Care Needs Fixing Before Universal Care Can Work We don't train enough, we don't pay enough, and adding more patients to the load is not going to work, either at the state level or the national level. I agree with the author, Dr. Benjamin Brewer, but I'm afraid he doesn't know the half of it. High deductible health plans are eating PCPs for lunch, and they don't even realize it yet. Right about now, the final adjudications for January's billing will be coming in. That means the millions of new HDHP enrollments that shifted over on the calendar year are starting to move from claim-to-payer to patient-responsibility. And patients, as we know, are deadbeats. At least collectiv... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1362380 Wed, 26 Mar 2008 23:34:07 +0100 1362380 http://www.medworm.com/index.php?rid=1307657&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2008%2F03%2Fuhc-ingenix-and.html It's not like UnitedHealthcare needed any more bad news. First they and their Ingenix software division get the business-headline perp walk in New York Attorney General's investigation of the intentional skewing of "usual and customary" fee calculations that govern millions of Americans' out-of-network payments.  Then some uppity blogger points out that Cuomo planted his flag a the top of a very hefty deductible-sinking iceberg. Then, adding insult to inquiry, they flat out lose a national popularity contest among hospital administrators. And they didn't lose by a little -- they doubled the score of their nearest competitor, Wellpoint. Orangemen Take Football, Go HomeYou'd think today's story would just be a minor piling-on thing, to look at it. Everybody wants to smack th... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1307657 Mon, 17 Mar 2008 19:33:17 +0100 1307657 http://www.medworm.com/index.php?rid=1279412&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2008%2F03%2Fare-cuomos-esti.html When we read the coverage of NY Attorney General Andrew Cuomo's accusation that Ingenix, United Healthcare and a host of other payers had systematically underestimated the "Reasonable and Customary" fees used to calculate reimbursements for out-of-network services, one frequently-repeated statement caught our eye: Lacewell said, in one example, the office's investigation showed that when $200 was a fair market rate for a 15-minute doctor's visit for a common illness, Ingenix determined it was $77. Therefore, United would pay $62 when it should have paid $160, leaving the consumer with a $138 bill. [Emphasis added.] Actually, the United would probably not pay a dime. The patient would have to pay the entire $200 bill -- at least until the deductible was satisfied. That got us thinking abo... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1279412 Wed, 05 Mar 2008 01:11:20 +0100 1279412 http://www.medworm.com/index.php?rid=1220524&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2008%2F02%2Fwisconsin-wishe.html Wisconsin has withdrawn its RFP for a statewide health information exchange, issued in December. Apparently, some of the major partners thought that the Request for Proposals hadn't nailed down just exactly how the HIE would be implemented and paid for. Well, those folks in Wisconsin know a lot about cows, but you won't find many cowboys. It takes a real buckaroo to haul off and whip up a RHIO. This here is uncleared land, partner. (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1220524 Sat, 09 Feb 2008 23:21:43 +0100 1220524 http://www.medworm.com/index.php?rid=1187107&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2008%2F01%2Fbury-the-hillar.html Well, I came upon a Child of God He was walking along the road And I asked him, where are you going And this he told me I'm going on down to Yasgur's farm I was in a fine snit this morning. Michael and Allie noticed right away. "What's the matter, honey?" Allie asked. "I was listing to my Pandora station. You know, 'It's a Beautiful Day?'" I had tuned my personal music channel to play the old psychedelic stuff that was always on my siblings' turntables during that boisterous era. Years after any incipient fog had long since lifted, I continue to find the melodies and optimism uplifting. "I was doing fine until it played 'Woodstock,' then I got really mad." "But you love that song!" she protested. "I know. But it made me mad. Mad at Hillary." I said. I wasn't finished. Not nearly. (Sou... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1187107 Wed, 30 Jan 2008 01:42:46 +0100 1187107 http://www.medworm.com/index.php?rid=1155807&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2008%2F01%2Fworst-in-the-wo.html It hurts me deeply every time the American healthcare profession is knocked around by researchers. And here it comes again: Among 19 developed countries, the U.S. ranks worst in deaths that could have been prevented by healthcare says new research published in the Jan/Feb issue of Health Affairs. How bad is it? If we had performed as well as France, Japan and Australia, 101,000 fewer Americans would have died unnecessarily in 2003. Researchers Ellen Nolte and Martin McKee state in their report "Measuring the Health of Nations: Updating an Earlier Analysis" that while other nations made strides and saw these types of deaths decline by an average of 16% between 1997 and 2003, the U.S. experienced only a 4% decline. All other countries had improved substantially except the U.S. They add that ... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1155807 Wed, 16 Jan 2008 17:15:55 +0100 1155807 http://www.medworm.com/index.php?rid=1130942&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2008%2F01%2Fmartys-hit-list.html Here's my official list of prognostications for 2008.  In 2006 and 2007, I didn't call them predictions, so I probably don't deserve any credit if anything I said came true.  If you agree -- or not -- you can give me your own scorecard by clicking here.  Give your feedback by January 23 and I'll post the results (and any interesting comments) in a blog at the end of the month. As far as we know, we're the only industry analysts that give you, our valued reader, this critical "You're Full of..." HIT response tool. (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1130942 Fri, 04 Jan 2008 21:58:06 +0100 1130942 http://www.medworm.com/index.php?rid=1117575&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F12%2Fwhy-quality-doe.html Oops. I meant that headline to read, "Why Quality Scoring Doesn't Matter." Oops. My bad. I've maintained a skepticism about the value of so-called "quality transparency" scores when it comes to comparing one hospital/clinic/lab/doctor to another. My queasiness is mostly related to the problems of measurement and sample selection: Won't the toughest cases get routed to the best doctors and facilities? And if so, won't that be reflected in higher mortality rates relative to those who take the more mainstream cases? Yeah, I know about acuity adjustments, etc., but when it comes to life and death situations, I'd rather rely on the professional opinion of someone I trust -- say, the family doctor I've had for the last ten years -- than rely on my own reading of a spreadsheet with unknown risk a... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1117575 Wed, 26 Dec 2007 20:05:11 +0100 1117575 http://www.medworm.com/index.php?rid=1111785&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F12%2Frhio-riposte.html My response to the flurry of premature RHIO obituaries has been included in today's Health 2.0 blog. I was grateful they accepted my request to guest author, even though there are probably a lot of Health 2.0 types who would prefer the industry pursue a commercial model for health information exchange. Maybe even their commercial model. (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1111785 Fri, 21 Dec 2007 18:14:56 +0100 1111785 http://www.medworm.com/index.php?rid=1108565&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F12%2Fhow-much-would.html Earlier this morning I made a point that has been clear to me for a long time: Universal coverage will cost less. This opinion has evolved over a long period of time, starting with my college studies in economics, which were focused on another domain impacted by the interactions of individual, societal and natural forces: the environment. My career in healthcare, particularly in its focus on business operations and financial interactions, made it clear that the cost-shifting shell game we play in America is what is causing the system to spiral out of control both in terms of economics and quality: Letting people get sick costs more than helping them stay well. (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1108565 Thu, 20 Dec 2007 17:14:56 +0100 1108565 http://www.medworm.com/index.php?rid=1106961&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F12%2Funinsurance-is.html In what should be a no-brainer for anyone who has thought deeply about US healthcare, Matthew Holt over at the Healthcare Blog cites some fresh statistics that prove that not having insurance can kill you. Quoting this new study by the American Cancer Society, he offers a dark truth: "For all cancer sites combined, patients who were uninsured were 1.6 times as likely to die in five years as those with private insurance." (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1106961 Thu, 20 Dec 2007 10:10:10 +0100 1106961 http://www.medworm.com/index.php?rid=1106168&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F12%2Fseeking-sustain.html Health Affairs just published a study by a team of Harvard researchers that has cast a pall on the sustainability of Regional Health Information Organizations (also referred to as Health Information Exchanges). The report, The State Of Regional Health Information Organizations: Current Activities And Financing, by Julia Adler-Milstein, Andrew P. McAfee, David W. Bates, and Ashish K. Jha, seems to imply that the maladies suffered by RHIO efforts around the country might be fatal, at least if you read the many news stories and blogs that are talking about it. I say "seems to" because our analysis suggests that the industry echosphere is still missing quite a bit of the big picture. Let's take this step by step, starting with the Harvard study and moving into the invisible economy and the nat... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1106168 Wed, 19 Dec 2007 22:41:11 +0100 1106168 http://www.medworm.com/index.php?rid=1074907&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F12%2Fis-5010-a-year.html You thought I was just being clever last week when I quipped, "These umbrage-and-edit timelines rachet out to make the electronic claim standards developed three years ago available for widespread adoption sometime after the the turn of the decade, even with optimistic dependency scheduling." Oh, no. I had inside information. And that information became public this week. The North Carolina Healthcare Information and Communications Alliance and The Workgroup for Electronic Data Interchange have been working on a real live MS-Project-based timeline to show regulators and industry analysts just how much time is consumed in developing, adopting and implementing HIT standards. The equation for the 5010 version of the electronic claim and other ASC X12 administrative transaction adds up to 2014... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1074907 Thu, 06 Dec 2007 21:55:47 +0100 1074907 http://www.medworm.com/index.php?rid=1074908&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F12%2Fahic-is-behind.html In yesterday's post, I critique HHS Secretary Mike Leavitt's directive to congress to tie any restoration of the Medicare Physician fee schedule to EHR adoption. In it, I question where such a mind-bending solution originated: The idea that you can create a positive incentive for HIT out of an essentially punitive approach. Diana Manos at Healthcare IT News points the finger: Leavitt's call for incorporating healthcare IT adoption into a physician payment fix bill follows pressure last month from members of the HHS healthcare IT advisory panel, the American Health Information Community, to force adoption. Craig Barrett, chairman of Intel Corporation said after 17 meetings of AHIC, doctors are no closer to adoption. No kidding? A score of CEOs and bureaucrats meet in Washington for a... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1074908 Thu, 06 Dec 2007 19:37:03 +0100 1074908 http://www.medworm.com/index.php?rid=1072328&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F12%2Fleavitt-ties-me.html I tend to be a market-oriented sort of guy. Not just the so-called "free" market, which exists largely in pundits' brains, on commodity trading floors, and on e-bay Hummel figurine auctions, but real markets, public and private, where people and organizations act and interact collectively in a world of imperfect (and often withheld) information, unknown risks, and externalized cost transfers, both accidental and manufactured. As such, I recognize that when the actions of one party (say the gathering and organizating of information by a physician practice) creates benefits largely for another party (say a private or governmental payer), then market forces will tend to bring about a way for the party of the second part to provide an incentive to the party of the first part to do more of said... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1072328 Wed, 05 Dec 2007 21:01:26 +0100 1072328 http://www.medworm.com/index.php?rid=1062763&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F11%2Fhealthcare-need.html I don't usually like to put off all of my conservative friends at once, but here goes. There's a complex and very important economic dynamic in the relationship between the estate tax and the financial wellness of the healthcare industry. As fiscally conservative as one might want to be, this one comes down undeniably on the side of beneficial taxation. That is, if it is important to you that money stays in healthcare. First, let's note that the so-called "inheritance tax" is nothing of the sort. The estate tax is a duty assessed on residual value at death; it does not tax heirs on what they receive. Second, it is a tax paid by very few, indeed. In the past twenty years, between 1% and 2% of estates have been subject to the tax. As pointed out in a recent Economist story, it is responsible... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1062763 Fri, 30 Nov 2007 17:52:44 +0100 1062763 http://www.medworm.com/index.php?rid=1040033&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F11%2Fintegrated-dise.html The following is the text of an email I just sent to the esteemed Dr. Blackford Middleton, in response to a presentation he gave to the Agency for Healthcare Research and Quality: "Evaluating the Value of Healthcare Information Technology: New Studies on Return on Investment from HIT Adoption from the CITL." As we've come to expect from Dr. Middleton, the research was brilliant, innovative, and persuasive. But the conclusions were devastating: According to the analysis, the most comprehensive kind of diabetic disease management programs don't save any money. I invite you to download the presentation and read my response below. (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1040033 Tue, 20 Nov 2007 23:35:48 +0100 1040033 http://www.medworm.com/index.php?rid=1032904&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F11%2Fmedicare-e-pres.html Healthcare IT News reports on HHS Secretary Mike Leavitt's announcement that Medicare Part D will adopt voluntary standards for e-prescribing. Members of the AHIC board are pushing for a mandatory adoption. The standards do more than just encode the authorization from the physician's office to the pharmacy. They enable a formulary listing to help the doctor choose from a list of payer-approved meds and provide a medication history to help warn the doctor of possible drug interactions. An article in Health Data Management gives additional details about the NCPDP Script 8.1 standard.eRx is one of those "why didn't we do this already" no-brainers for all involved. It would be helpful if the despised malpractice insurance industry took note of the patient safety benefits of HIT and put a bit o... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1032904 Fri, 16 Nov 2007 20:37:23 +0100 1032904 http://www.medworm.com/index.php?rid=1032905&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F11%2Fcentralization.html Back in 2005, when Rep. Steve Buyer (R-Ind.) pushed a reorg of the HIT operations at the Department of Veteran's Affairs, we stood up for the good work the agency had done. Looks like centralization has done worse than impaired development, it may actually threaten the VistA EHR's open-source model. A recent decision to farm out the lab system to Cerner is just the tip of the iceberg, according to Fred Trotter's cogent and well-sourced analysis. Buyer's supposed to be a friend to the vet, being a Gulf War soldier himself. Maybe he should read Trotter's account before he goes back and offers any more "improvements." (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1032905 Fri, 16 Nov 2007 17:31:19 +0100 1032905 http://www.medworm.com/index.php?rid=1007218&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F11%2Ffair-share-of-c.html In the form of proposed legislation, Sen. Charles Grassley is expressing his concern about how much nonprofit hospitals spend on charitable care. The ranking Republican on the Senate Finance Committee suggests that more is due in exchange for the billions of dollars in tax breaks received by hospitals. Finance Committee staff has developed a controversial wish list of reforms, including one that would require nonprofit hospitals to dedicate a minimum of 5% of revenues to free care. The alternative would be to forfeit their tax-exempt status. As we have noted in our publications, hospitals are the rare bird in the huge nonprofit sector. There are about 3,100 nonprofit hospitals, out of a universe of a million and a half U.S. nonprofit organizations. Looking at it more conservatively, there ... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=1007218 Tue, 06 Nov 2007 05:26:24 +0100 1007218 http://www.medworm.com/index.php?rid=976316&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F10%2Fcms-discloses-n.html NPPES posted its second release of NPI data for download. Not quite 30-day cycle, but it beats the hang time for Round 1 by about 29 months. Medicare posted a note to its clearinghouse listserv calling for a moratorium on new provider connections for eligibility inquiries through the HIPAA Eligibility Transaction System (HETS), plus a full accounting of provider connections, to be submitted by November 15. Previously, they had placed a moratorium on new clearinghouse connections. Something about protecting privacy, like maybe people were pinging Medicare for beneficiary information who really didn't have legitimate need. Or maybe weren't even providers. Or maybe that's just a rumor. There were four or five possible causes discussed on a recent call, and I don't like to share such prattle. ... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=976316 Wed, 24 Oct 2007 21:38:54 +0100 976316 http://www.medworm.com/index.php?rid=968244&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F10%2Fhit-roi-and-inc.html I was digging around on some RHIO research (there's a new report out from an organization that is trying to corral the RHIOs into something that might begin to look like a National Health Information Network -- or at least look more like each other). I forgot to take my ADD meds today, so I was clicking away, deeper and deeper into hyperspace when I struck upon Mark Frisse's Policy blog. Now, Dr. Frisse is a heavy hitter in the RHIO universe. He sits on blue ribbon panels and he speaks to hifalutin conferences and he coauthors important papers, meanwhile holding a leadership position in one of the country's more forward Regional Health Information Organizations. So, I expected what I usually get when I see such a luminary has a blog: Two or three cursory posts that read like press releases... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=968244 Mon, 22 Oct 2007 01:15:45 +0100 968244 http://www.medworm.com/index.php?rid=961615&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F10%2Fhit-the-campaig.html The EMR Medical Software Information and Resources blog summarizes each of the candidates' positions on healthcare information technology.  But one burning question remains: Will they inhale? (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=961615 Thu, 18 Oct 2007 14:56:48 +0100 961615 http://www.medworm.com/index.php?rid=931068&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F10%2Fgates-way-to-he.html In what must be one of the all time editorial coinky-dinky's in recent memory, an editorial from Bill Gates appears in today's Wall Street Journal -- just one day after Microsoft released its Health Vault Personal Health Record portal! But we must admit it's timely. As Bill points out, "a groundbreaking 1999 report on health-care quality" pointed out that our healthcare system kills nearly a hundred thousand Americans a year, and a 2001 followup "urged swifter adoption of information technology." And George Bush Jr. even mentioned HIT in his 2006 State of the Union. Stop the presses! I'm from Bellevue and I'm Here to Help You Not to worry, Microsoft is on the case. "We envision a comprehensive, Internet-based system that enables health-care providers to automatically deliver personal healt... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=931068 Fri, 05 Oct 2007 18:38:49 +0100 931068 http://www.medworm.com/index.php?rid=931069&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F10%2Ffeds-say-ewww-t.html I'm just minding my own business, scrolling through Medicare's FAQs when I come upon this one: Are Erectile Dysfunction (ED) drugs covered under Part D? Now, I know just mentioning this on my blog (plus using the dreaded S-word in the subject) will add to our negatives on the spam nazi sites. But still.... The answer to the question, of course, is "No." Or, more specifically, "Not anymore." For Contract Year 2006, they were covered, but your friendly representatives explicitly withdrew funding via the QI, TMA, and Abstinence Programs Extension and Hurricane Katrina Unemployment Relief Act of 2005. (I swear I did not make that legislative title up). This comes hard on (oops! There I go again!) the heels of a survey that reported that a lot of seniors actually enjoy s--, um, you know. And I'... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=931069 Fri, 05 Oct 2007 17:13:27 +0100 931069 http://www.medworm.com/index.php?rid=915315&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F09%2Facute-and-obtus.html There’s money out there for health IT. The entire U.S. nonprofit sector – an annual $1.4 trillion chunk of the economy – collects only about $70 billion from government, and over $460 billion from private sources. (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=915315 Sun, 30 Sep 2007 16:28:10 +0100 915315 http://www.medworm.com/index.php?rid=883645&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F09%2Fkaiser-family-f.html Republicans and Independents rank healthcare right behind Iraq as the most significant issue in the 2008 presidential election; Democrats rank the two equally. You can track the issue between now and next November on a site the Henry J. Kaiser Family Foundation has set up: health08.org (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=883645 Wed, 19 Sep 2007 12:34:11 +0100 883645 http://www.medworm.com/index.php?rid=882540&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F09%2Fproviders-fight.html Back when I ran that series warning providers about the new, sophisticated claims analytics tools I dubbed Denial Engines, I turned up some scary evidence about Medicare's demonstration Recovery Audit Contractor (RAC) program (see Medicare No Longer Money in the Bank among other posts listed in the Denial Engines category to the right). I spent a lot of my free time (in both senses of the word) digging up the dirt on this payer technology (not that it's necessarily dirty -- which is part of the danger) and the RAC approach, by which Medicare hires auditors to pore over previous years' settlements looking for "overpayments" -- then rewards them with a bounty for every dollar they retroactively deduct from providers current year remittances. So, did the provider vendors come rushing to me to... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=882540 Tue, 18 Sep 2007 18:19:56 +0100 882540 http://www.medworm.com/index.php?rid=869465&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F09%2Fwedi-nchica-to-.html Those of us who work in healthcare IT have this mental cascade of imperatives: regulations, new versions of standards, Medicare mandates and more. It stretches back in time and on forward into seeming infinity, a dizzying ladder of challenges with strings of letters and numbers indicating the rungs: IPPS, HIPAA, TCS, 4010A1, NPI, ICD-10, 5010, AHIC, ad infinitum. The trouble is, we are supposed to be familiar with all of them; what's more, we frequently get assigned to implementing multiple initiatives at the same time. Worse, we are often called upon to implement one intiative (say, the National Provider Identifier Final Rule) when the feds have left out a necessary pre-requisite (like NPI Data Dissemination). When it happens, we say, "What were they thinking?" But a more important respon... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=869465 Thu, 13 Sep 2007 15:55:09 +0100 869465 http://www.medworm.com/index.php?rid=863685&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F09%2Fdam-the-rhios.html In a provocative editorial, Fierce Healthcare's Anne Zieger puts forward the arguments for Why RHIOs shouldn't exist. She cites legal issues, cost issues and the challenge of getting competitors to share data. She also references a Fierce Healthcare story on our recently-released 2007 survey of RHIO Finance, asking, "how long can this model last if most efforts are paid for by grants?" She posits one potential RHIO alternative: "[Some] form of medical data banking--by a trusted intermediary rather than providers--seems to solve many problems that straight-ahead data exchanges can." She also suggests that Patient Health Records, "[once] they become more robust," might be an answer to the data sharing challenge. She admits to being a bit contrarian. "All I'm trying to say here is that before... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=863685 Tue, 11 Sep 2007 22:29:12 +0100 863685 http://www.medworm.com/index.php?rid=799194&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F08%2Flink-to-all-cms.html Many moons ago, I wanted to share a query string that would bring up all CMS FAQs that include the term NPI. That was preferable to linking to specific items, because new items were being constantly being added. I did the search query on the CMS site, which created a URL that was a mile long. I systematically eliminated components of the string until I came up with something that produced the desired results, but was only a furlong or two in length. I've given this out before, but I didn't have a direct, isolated link on my blog, so here it is. You can click on the big ugly string, but that often gets broken in pieces when you copy/paste/send via email, so if that's an issue, you can link people to this blog post by copy/pasting the second string. (I don't use tinyurl because I'm not sure ... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=799194 Tue, 14 Aug 2007 15:06:14 +0100 799194 http://www.medworm.com/index.php?rid=782901&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F08%2Fnpi-disseminati.html Today's announcement of the newest dissemination target date puts an end to your submissions to our Dissemination Roulette contest. Of course, we won't be able to announce a winner until (or if) the NPI Registry actually goes online. Remember, just like in real life, you don't win awards for getting close to the estimate, you win for getting close to the truth. That allows us to complete the de-identified (initiated last Friday) list of the entries received before today's announcement.... (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=782901 Mon, 06 Aug 2007 21:27:25 +0100 782901 http://www.medworm.com/index.php?rid=782902&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F08%2Flucy-tees-it-up.html Today's inbox greets us with this missive from CMS:Dissemination of Data from the National Plan and Provider Enumeration System (NPPES) to Begin September 4, 2007In case you were still wondering whether the previously-announced August 7 release date for the downloadable data had somehow avoided the scrutiny that held up the online NPI Registry site, the answer is no. They sayData will be available in two forms: A query-only database, known as the NPI Registry. A downloadable file. Since these both appear under the heading, Dissemination of Data...to Begin September 4, one might assume that both would be available September 4. I would discreetly point out that the simultaneity of these two releases is not necessarily explicitly indicated by the text. (And a closer reading confirms this: The... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=782902 Mon, 06 Aug 2007 20:16:46 +0100 782902 http://www.medworm.com/index.php?rid=777571&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F08%2Ffirst-round-ent.html We've collected a number of responses to our NPI Disseminator Roulette contest. We asked for an estimated date for the NPI Registry to go online, and, more importantly, the reasoning behind the estimate. As you might guess, the answers were, well, unpredictable. Here's a selection. As promised, the identities of our contestents have been disguised....... (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=777571 Fri, 03 Aug 2007 20:27:11 +0100 777571 http://www.medworm.com/index.php?rid=773294&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F08%2Fstate-cios-invi.html The organization that represents the CIOs of state governments says its members should take a more active role in their states' Regional Health Information Organizations. This would definitely rate a Duh Of The Month here at the HIT Transition Weblog, except that I'd like to take a step backward and say that I'm not entirely sure that it's such a good idea until state governments show more willingness to pay for RHIO development. According to a Government Health IT article, the National Association of State CIOs (NASCIO) is calling for its members to have a bigger say in how RHIOs develop. “Integrating these regional efforts will become a critical aspect of state CIO responsibility,” states a NASCIO brief. State government CIOs could serve as advisors to represent state health programs... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=773294 Wed, 01 Aug 2007 16:47:49 +0100 773294 http://www.medworm.com/index.php?rid=717969&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F07%2Fcms-disseminate.html Any port in a storm, the sailors say. CMS has posted the transcript of it's June 14 Data Dissemination Roundtable. We'll still wait until the August 1 for Real Soon Now to arrive. At least until August 1, that is.... (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=717969 Fri, 06 Jul 2007 13:50:26 +0100 717969 http://www.medworm.com/index.php?rid=705656&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F06%2Fminnesota-schoo.html Once again, the state of Minnesota is showing us all how it is supposed to work. They're not satisfied with the federal mandate for a single standard -- they want a single interpretation of the standard. In fact, they insist upon it:MINNESOTA LEGISLATION Section 4: Uniform Electronic Transaction Standards (62J.536) The Administrative Uniformity Committee (AUC), under the direction of the Department of Health, will adopt uniform transaction standards for claims transactions, eligibility transactions and remittance transactions. Eligibility transaction standards will be adopted by January 15, 2008 and implemented among plans and providers no later than one year later; eligibility transaction standards will be adopted by July 15, 2008 and implemented among plans and providers no later than on... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=705656 Fri, 29 Jun 2007 16:55:21 +0100 705656 http://www.medworm.com/index.php?rid=644663&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F05%2Fwhat_does_the_d.html After the rush of discovering that the Long Awaited NPI Data Dissemination Policy (LANDDP) was far more liberal in granting data access than I and other industry observers had dreamed, I'm feeling a bit of a post-holiday hangover. It's probably got something to do with the fact that I've been asked the same question three or four times today, Is it all that?... (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=644663 Tue, 29 May 2007 22:55:39 +0100 644663 http://www.medworm.com/index.php?rid=637724&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F05%2Fcms_keeps_upins.html Okay, so May 23 came and went without an NPI train wreck -- as anticipated. Instead we got the surprise gift -- the announcement that the Long Awaited NPI Data Dissemination Policy (LANDDP) had been released. But wait, wasn't something else supposed to happen on May 23? Oh, yeah. That's when Medicare had said it would quit issuing UPINs. That caused a lot of distress in the industry -- partly because folks who weren't ready for NPI were reliant on UPINs and partly because those who are ready for NPI had devised logic that relied on UPINs for NPI crosswalk logic.... (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=637724 Fri, 25 May 2007 21:18:17 +0100 637724 http://www.medworm.com/index.php?rid=637726&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F05%2Fanalysis_npi_da.html I just finished my first read-through of the long-awaited NPI Data Dissemination Policy (we ought to just abbreviate that as LANDDP at this point). I have to say, as an instrument for deploying a universal provider ID to replace all the idiotic payer/location/context-specific IDs providers have been burdened with until now, I can't think of a sharper, more useful tool. Here at HITTG, we've tracked this issue for years (literally) and extended our efforts well beyond newsgathering and sharing information. We dug, we warned, we challenged. We joined with others in shared voice. The people working on this issue were well aware of the difficulty of coming out with a system that passed muster in terms of both regulatory scrutiny and industry utility. Meanwhile, some providers expressed privacy ... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=637726 Thu, 24 May 2007 19:08:15 +0100 637726 http://www.medworm.com/index.php?rid=637727&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F05%2Fcms_posts_npi_d.html You can tally out all those office pools: Real Soon Now is 5/24/2007. CMS just posted the long-awaited NPI Data Dissemination Notice. Gail Kocher gets the prize from HITTG (no we didn't announce it in advance, but it only seems right). Gail is one of those people that people like me treasure -- she always knows what's really going on, and she usually knows it before anybody else. (We're not forgetting Walter, here. He broke the news yesterday, but the text was locked up in an office somewhere in DC). Here's the link: http://www.cms.hhs.gov/NationalProvIdentStand/06a_DataDissemination.asp NOTE: This is the approved CMS copy, but not the final official document. Some edits may be introduced by the Office of the Federal Register. I'll put out the official official link when it arrives. I'll b... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=637727 Thu, 24 May 2007 16:01:39 +0100 637727 http://www.medworm.com/index.php?rid=637728&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F05%2Fdata_disseminat.html WEDI NPI maven Walter Suarez just posted the news that the long-awaited Data Dissemination Policy was posted at the Federal Register today for public viewing. The publication date is listed as May 30, but Walter anticipates a PDF version will hit CMS websites and listservs sometime tomorrow. If not, I expect he will hop aboard the Metro sometime around 0600 and be there when they open the doors. UPDATE: See our analysis of the NPI Data Dissemination Policy at http://blog.hittransition.com/2007/05/analysis_npi_da.html... (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=637728 Wed, 23 May 2007 23:15:12 +0100 637728 http://www.medworm.com/index.php?rid=637729&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F05%2Fnpi_contingency.html Just when I thought I had honed my provider NPI Contingency spiel: You don't get a twelve-month postponement, you get 12 months to send NPI, Legacy and Dual Use claims, comes news that makes my point pretty clear. If you don't get ready to start sending NPIs now, it's going to cost you. How much? Well, how does 99 cents a claim grab you?... (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=637729 Wed, 23 May 2007 22:56:27 +0100 637729 http://www.medworm.com/index.php?rid=586752&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F05%2Fnachimson_depar.html We received news last week that Stanley Nachimson, for years the regulatory voice for HIPAA implementation, has retired from his long career of public service to enter the private sector. Foresight issued a press release announcing he had joined its board of directors and had recently formed Nachimson Advisors, LLC., a consultancy under which he will provide health IT advisory services to various clients including WEDI and Cornichon. After more than 30 years of service to CMS and its predecessors, Stanley has earned all the praise and recognition he must already be receiving from various industry stalwarts. I would say that he will be missed at CMS were it not for the fact that he has already been missed: The regulatory body's tight-lipped, even secretive approach to NPI implementation sta... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=586752 Wed, 02 May 2007 21:42:56 +0100 586752 http://www.medworm.com/index.php?rid=533826&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F04%2Fanalysis_of_the.html I did make good on my promise to take a look at the NPI Contingency Guidance document. It's just that all the writing I've had time to do about it went into client support and modifying the presentation for the webinar I'll be doing this week. The topic is NPI Business Continuity Planning: Devising Your Own NPI Contingency Plan for May 23. I've had this event scheduled for weeks, and now it's taking place a week after CMS finally announce that a contingency plan is okay. Am I psychic, or what? What.Actually, no. One of the main points I make in my webinar is that providers, health plans and vendors needed a contingency plan whether or not CMS had their own day of reckoning with reality. And, more to the point, a contingency plan has to be about a lot more than whether an organization is wi... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=533826 Tue, 10 Apr 2007 00:54:51 +0100 533826 http://www.medworm.com/index.php?rid=518399&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F04%2Fguidance_docume.html CMS has posted the Guidance Document that was to accompany yesterday's NPI Contingency announcement: http://www.cms.hhs.gov/NationalProvIdentStand/Downloads/NPI_Contingency.pdf I''ll take a look later this morning.... (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=518399 Tue, 03 Apr 2007 13:31:21 +0100 518399 http://www.medworm.com/index.php?rid=517546&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F04%2Ffirst_look_cms_.html From a first look at the just-released CMS Guidance on NPI Contingency, there are some expected and some different-from-expected provisions. Not a lot of detail, though it promises more to come. The WEDI and NCVHS recommendations to CMS' parent Department of Health and Human Services, recommended 12-month and 6-month transition periods to allow continued use of legacy provider identifiers. But they also set a condition on when that clock should start ticking -- the later of the overall compliance date of May 23, 2007 or the date that NPI data was first made available to the industry under a Data Dissemination Policy. Today's guidance splits the difference by adopting the longer timeframe without the conditional starting point: Contingency plans may not extend beyond May 23, 2008, but entit... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=517546 Tue, 03 Apr 2007 00:43:21 +0100 517546 http://www.medworm.com/index.php?rid=517547&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F04%2Fnpi_contingency.html This just released: CMS has posted its contingency policy online.... (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=517547 Mon, 02 Apr 2007 23:27:12 +0100 517547 http://www.medworm.com/index.php?rid=511950&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F03%2Freport_trudel_o.html Just read a reliable second-hand account that CMS's Karen Trudel made statements at this week's HIT/HIPAA Summit about both the release of a statement about NPI Contingency and the Data Dissemination notice. Ordinarily, I would go ahead and double-check, try to find direct sources, etc., but in this case there is no real news except that CMS is actually saying anything about NPI.... (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=511950 Fri, 30 Mar 2007 19:23:13 +0100 511950 http://www.medworm.com/index.php?rid=510616&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F03%2Fpaper_cuts.html I keep telling people not to mess with paper. So, while those of us who focus on electronic transactions are trying to work our way through the National Provider Identifier transition, there come a couple of minor news items regarding the new good old paper forms. CMS-15oops!First, the CMS-1500 professional claim form (still commontly referred to as the HCFA-1500, a decade after the Health Care Finance Agency became the Centers for Medicare and Medicaid Services) was found to have a major glitch. The format approved by the National Uniform Claims Committee got some sort of minor tweek by accident, which left the federal to issue its own -- incorrect -- version of the same thing. Looks like millions of copies were printed according to the bad specs, leaving CMS to issue a warning a couple w... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=510616 Thu, 29 Mar 2007 22:37:25 +0100 510616 http://www.medworm.com/index.php?rid=463429&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F03%2Fhdm_boosts_npi_.html Health Data Management came out with a good long article on the current state of the industry prospects of a contengency period for NPI implementation. It's so good, I don't want to miss a word, but it's so long, I haven't been able to read it all yet. Now it's 6:30 on a Friday night and I have to go home now if I ever want to go home again. I'm posting this blog so that I'll remember to go back and read all of it when I get the chance. Meanwhile, you can read it too. Don't be put off by the hyperbolically (hyperballistically?) understated subtitle: Payers and providers might not be ready to comply with the NPI rule by the May deadline.... (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=463429 Sat, 03 Mar 2007 00:29:23 +0100 463429 http://www.medworm.com/index.php?rid=463430&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F02%2Fnpi_data_dissem.html CMS finally sent its National Provider Identifier Data Dissemination Policy to the Office of Management and Budget for regulatory review on Monday. As might be expected by now, they did so in silence. While it is probably worth noting that DDP seems to have cleared its final flaming hoop at CMS, there are additional reasons why the collective industry response might be a stifled yawn or sustained moan rather than a rousing cheer....... (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=463430 Thu, 01 Mar 2007 00:45:21 +0100 463430 http://www.medworm.com/index.php?rid=463431&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F02%2Fvery_hot_off_th.html Two days after the WSJ covered the New Arms Race of denial management, the NY Times went even further: tracing the logical path from the struggle over denial to the absurdity of US financing healthcare overall. I found the column re-printed in the Dallas Morning News.... (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=463431 Tue, 27 Feb 2007 02:37:57 +0100 463431 http://www.medworm.com/index.php?rid=463432&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F02%2Firs_may_allow_n.html The IRS threw some cold water on non-profit hospitals last year when they advised that new Stark exceptions might still compromise a facility's non-profit status. The new Stark safe harbors were designed to allow hospitals to assist non-employed physicians with certain healthcare IT investments and technology support. We didn't think the revisions went far enough, but it did seem to be a move in the right direction.... (Source: The HIT Transition Weblog) The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=463432 Tue, 27 Feb 2007 02:07:32 +0100 463432 http://www.medworm.com/index.php?rid=463434&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F02%2Fconsumer_direct.html Just got done with the first day of the X12/WEDI Real Time Adjudication Conference. Some are now abbreviating this as RTCA (for Real Time Claims Adjudication), What's RTCA, you say? Well, that's one of the questions we're debating. Basically, the concept means the patient walks in, gets treatment and the provider can submit the claim, get the health plan's payment amount (but not necessarily the payment) and the patient responsibility amount -- all before the patient leaves the office. The provider gives the patient the bill and receives payment or at least an accurately quantified promise. The WEDI/X12 conference was just announced a few weeks ago, but there are a couple hundred movers and shakers here in Reston, Virginia. Why the sudden interest? In an acronym, CDHC: Consumer Directed He... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=463434 Wed, 14 Feb 2007 03:27:44 +0100 463434 http://www.medworm.com/index.php?rid=463435&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F02%2Fmgma_acla_call_.html Both the Medical Group Management Association and the American Clinical Lab Association have called upon the Federal Government to allow for a contingency period extending beyond the May 23 deadline for implementation of the National Provider Identifier. Larrie Dawkins, chief compliance officer of Winston-Salem, N.C.-based Wake Forest University Health Sciences testified before the National Committee on Vital and Health Statistics on January 24. According to an article in Health Data Management, Dawkins said MGMA members have obtained NPIs for their individual practitioners, but many lag in determining how to enumerate their organizational subparts. Also, they see their vendors and trading partners as unready:“As of December 2006, no member reported that testing with clearinghouses or he... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=463435 Fri, 02 Feb 2007 23:06:24 +0100 463435 http://www.medworm.com/index.php?rid=463436&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F02%2Fncvhs_to_advise.html Just received a notice from a colleague attending the X12 meeting that a CMS official reported to the group that NCVHS (advisory body to HHS) is considering a contingency plan for NPI. According to this account, they don't want to encourage laxity in the deadline, but do want to ensure that end-to-end testing takes place before the final cutover to NPI-only transactions. To this end, the current thought is to tie a 6-month timeframe to the availabiltiy of NPPES data via the still-to-be-announced Data Dissemination Policy (DDP). What do we know about that? Not much, but there are some issues still flying around. Absent any official communications from CMS, which governs the implementation of the HIPAA regulations, and, for what it's worth, their enforcement, we need to share some background... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=463436 Thu, 01 Feb 2007 18:07:44 +0100 463436 http://www.medworm.com/index.php?rid=463437&cid=t_99948_113_f&fid=34635&url=http%3A%2F%2Fblog.hittransition.com%2F2007%2F01%2Fdissemination_u.html My readers are so smart and well-connected, they really help me stay on track. Which is to say, when I go off the track, they put me back on the rails. In the case of yesterday's Preview of the NPI Data Dissemination Policy (DDP), there are at least two things I may have been wrong about. One I would be happy to be wrong about, but if I am wrong about the second, I am not so thrilled. First, somebody more familiar with the various instruments avaible to regulators says that CMS could issue a notice with comment that doesn't actually go through a second draft. In other words, you can comment about what they say they're going to do, but they can ignore it -- in fact, they can institute the policy immediately. If so, that's good news -- sorta. At least in terms of time-to-data, it eliminates ... The HIT Transition Weblog blogs http://www.medworm.com/rss/comments.php?id=463437 Thu, 11 Jan 2007 17:16:48 +0100 463437