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In Case You Thought The US Was Slackening The Pace in E-Health Here Is What Is Going On!

The following appeared recently.
Monday, July 16, 2012

Federal Gov't Continues With Health IT Activity in Q2 2012

The federal government continued to implement the Health Information Technology for Economic and Clinical Health Act, enacted as part of the American Recovery and Reinvestment Act, during the second quarter of 2012. Below is a summary of key developments and milestones achieved between April 1and June 30. 
Highlights
The second quarter of 2012 saw a number of important developments:
  • ONC Seeks Public Comment on NwHIN Governance RFI. On May 15, the Office of the National Coordinator for Health IT released a request for information soliciting feedback from the public on options for governance of the Nationwide Health Information Network. ONC defines NwHIN as a set of standards, services and policies that enable secure health information exchange over the Internet. ONC included in the RFI a number of proposed "rules of the road" to govern NwHIN; the centerpiece of the proposal is a voluntary program under which entities that enable electronic health information exchange could be validated (i.e., formally recognized) for meeting ONC-established "conditions for trusted exchange." Comments on the RFI were originally due June 14, but the deadline was extended to June 29. 
  • ONC Creates Two New Offices. On May 16, ONC announced the creation of the Office of the Chief Medical Officer and the Office of Consumer eHealth. The Office of the Chief Medical Officer will address health IT issues relating to safety, usability, clinical decision support, meaningful use policy development and quality. The Office of Consumer eHealth will continue ONC's work to engage patients and families in their health, including overseeing ONC's pledge program, a nationwide campaign to encourage health care providers to make it easier for individuals and their caregivers to have electronic access to their health information.
  • ONC Releases Health IT Dashboard. On May 9, ONC launched a website highlighting national progress toward the nation's health IT adoption goals. ONC strategy, information on health IT grant programs and data from regional extension centers are examples of the information available to the public through the new website.
Health IT Policy & Standards Committees
Health IT Policy and Standards Committees Submit Comments on Medicare and Medicaid EHR Incentive Program Proposed Rules and NwHIN Governance RFI
During the second quarter of 2012, the Health IT Policy Committee and Health IT Standards Committee were largely focused on developing comments on the Stage 2 meaningful use and electronic health record standards and certification criteria proposed rules and on the NwHIN Governance RFI. The Policy Committee's various work groups also began work on Stage 3 meaningful use criteria during the month of June.
EHR Certification
ONC Releases Updated Certified Health IT Product List
On June 26, ONC released version 2.1 of the Certified Health IT Product List, which lists all the EHRs and EHR modules that have been certified by ONC's Temporary Certification Program. Version 2.1 lists 1,700 EHRs and EHR modules approved for meaningful use.
If you are not already tired there is lots more here:
And here is an earlier quarterly report.
Thursday, April 19, 2012

Federal Health IT Activity Continues in First Quarter of 2012

During the first quarter of 2012, the federal government continued to implement the HITECH Act, enacted as part of the American Recovery and Reinvestment Act.
Highlights
The first quarter of 2012 saw the following high-level developments:
  • HHS Released Proposed Rules on Stage 2 Meaningful Use and EHR Certification Criteria -- On Feb. 23, CMS released a proposed rule setting forth the requirements that health care providers must meet to achieve meaningful use of certified electronic health records under Stage 2 of the Medicare and Medicaid EHR Incentive Programs. On Feb. 24, the Office of the National Coordinator for Health IT released a companion proposed rule related to the associated standards and certification criteria for EHRs.
  • White House Selected Todd Park as New Chief Technology Officer -- On March 9, the White House announced that President Obama had selected Todd Park as the new U.S. Chief Technology Officer. Park previously served as CTO of HHS.
Medicare and Medicaid EHR Incentive Programs
CMS Released Incentive Program Provider Participation Data
In March, CMS released February data highlighting health care provider participation and incentive payment totals since the EHR Incentive Program launched in January 2011. According to CMS, over 211,500 total eligible professionals (EPs), eligible hospitals (EHs) and critical access hospitals (CAHs) had registered for the Medicare and/or Medicaid EHR Incentive Programs. Over 62,000 EPs, EHs and CAHs had been paid a total of more than $3.8 billion for successfully participating in the programs.
EHR Usability
NIST Released EHR Usability Evaluation Protocol
On March 20, the National Institute of Standards and Technology released guidance for evaluating, testing and validating the usability of EHRs. According to NIST, the proposed usability protocol "encourages a user-centered approach to the development of EHR systems" and "provides methods to measure and address critical errors in user performance before those systems are deployed in a medical setting." On Feb. 14, NIST also published a notice in the Federal Register seeking vendors to supply EHR systems for NIST to use to develop a framework for assessing the usability of health IT systems and performance-oriented user interface design guidelines for EHRs. Interested vendors were required to submit a request and Letter of Understanding by March 15.
Health Information Exchange
ONC Published Article on HIE Strategy
On March 28, ONC leaders published a Health Affairs article outlining the federal government's strategy for advancing health information exchange. The article discusses the federal government's progress to date in establishing the "essential building blocks" for health data exchange. It also describes ONC's plans to "develop additional policies and standards that will make information exchange easier and cheaper and facilitate its use on a broader scale."
ONC Released CONNECT 3.3
On March 16, ONC released version 3.3 of CONNECT, which is open-source software that supports health information exchange and relies on Nationwide Health Information Network standards. The new CONNECT version includes additional features, performance improvements, maintenance fixes and software updates. Of note, CONNECT 3.3 complies with NwHIN specifications approved in July 2011 and creates backwards compatibility between the January 2010 and July 2011 specifications and among CONNECT versions. 
Vastly more details and links are here:
Reading this I have to say I just feel tired. The pressure is really on to make this all work and it can only benefit us all in the long run.
David.

There Is A Real Point Here That Needs To Be Thought About. Not Sure I Have The Answer!

The following appeared a little while ago.

A Call for Intuitive EMRs

Scott Mace, for HealthLeaders Media , July 24, 2012

I've previously remarked that software can't do it all—resolve all antiquated workflows or figure out stumbling blocks in people and politics. Unfortunately, that's just what EMR software is about to be asked to do.

Software is a funny thing. Done well, it anticipates the needs of human beings, or other software, and responds in flexible, flowing harmony.

Done poorly, software epitomizes everything wrong with modern society: impersonal, inflexible, regimented, mundane, boring, even maddening.

Where does your electronic medical record software wind up on that spectrum? Chances are, it doesn't look so good in comparison to your searching experience on Google or your shopping experience on Amazon.

"We need the EMR that's going to intuitively know the way our physicians practice and know the difference—and not every time a physician wants a change, we get a call, and we say we'll take that to the team, and the team will analyze it, and then the team will take it to the programming team, and in about a month, we should have your change put in our system," says Pamela G. McNutt, senior vice president and CIO of Methodist Health System in Dallas, Tex.
"'EMR 2.0,' as I call it has to be intuitive. It has to adapt to the physician workflow without an army of 200 people in IT behind it trying to change the code," McNutt says. "That is not a sustainable model for us to have that many people behind the scenes creating all these boxes and screens. It has to be intuitive but we're all busy dotting I's and crossing T's.

"Even the 'Cadillac' systems for physicians and hospitals are nowhere near EMR 2.0 that I envision for the future," she adds.

McNutt hopes for some "dark-horse" software from an as-yet unseen vendor, maybe from Europe or sitting in some incubator deep inside MIT, to leapfrog the capabilities of current systems. "I could make a fortune if I could figure out who this is that's going to do that," McNutt says with a laugh.

Unfortunately, software innovators—the Amazons and Googles—only come along once in a great while. Healthcare CIOs appear to be stuck living with our current generation of imperfect software.

Another option kicked around, even more unrealistically, is to hope that clinicians adopt some kind of standardized workflow. That would help software immensely, because today's software has been constructed with layer upon layer of options to accommodate different workflows. This complexity in turn adds to the complexity of the software, of training for the software, and of trying to keep the training for the software inside one human head once training is completed.
Lots more here:
I am quite sure I don’t know how to fix this problem - but I certainly know it needs to be fixed. Just consider the NEHRS if you want an example of the worst sort of “impersonal, inflexible, regimented, mundane, boring, even maddening” software.
One thing is certain - the Health IT Industry needs help from all sorts of experts from other domains to do better than what is typically delivered!
David.