Pricing confidentiality clause and its cost to us.

Many of the hospitals,Insurers and suppliers connected with healthcare delivery have Pricing confidentiality clauses in their sales agreements. These clauses are simply ways to have unfair pricing in the market place.Many times large insurers feel that they have advantage in the marketplace as they get better pricing from the large companies for the size and scope benefits.In reality many times winners and loosers are picked up in devices on the cost and connection basis.

In the public interest while sixty percent of health care dollars are being spent by tax dollars .It is important in order to protect the week and to keep the costs in control all charges be made public and scrutinsed.

Many Doctors and other health care providers are very dedicated people and serve the community well.To reduce the cost of health care In america we will have to do the following
1.Use technology only when it improves the outcome of the healthcare.
2. Use IT and its processes for communication, data sharing and prescription and compliances help.
3.Combine ER and primary care to reduce costs for ER by providing primary care at the ER.This as pre thought not after thought.
4.Giving each patient a usb stick with healthcare data .to save time and costs in ER.
5.

Patient specific Education and diversity

Most of the EMR's are starting to recognise Diversity in creating patient Demographics.

One of the fastest growing demographic groups in our society are bi/multi racial category.Traditionally language defines us more than the ethnicity.It is true even in America for the new immigrants.As the immigrants become more English language proficient. Ethnicity start taking priority over language, suddenly Colombians who themselves identify as the people of that nation start seeing themselves as black ,white or native people.In a strange way we find that as Moroccans and french speaking Quebec people loose their french they are lumped away from each other with Germans and may be with blacks.

The main reason for this strange mix of data is US Census which has been taken every ten years from the inception of our nation.This flawed census ethnic data is least useful for Meaningful use in creation of EMR and its mandate.We recognise that Irish whites from Boston may have least in common with Hasidic Jew from southern Spain. This need to collect a detailed ancestry record is an effort to find our unique health traits and help the patient(us).

I was told by a very reputed heart Surgeon of Indian descent that natives of India in US should lower their Cholesterol below 160 as we have narrower arteries .This type of information while not currently available could be norm if we collected ethnicity specific data for the patients.

An anomaly has been found the Hispanics Live five years longer than Whites in America even while the health care availability and Obesity is worse in their population.It is also an opportunity for us to study what factors make it possible for them to live longer and could we duplicate those conditions.It has been speculated that diet though high in meat and fat content may play some role as well as involvement in the society.

For Diversity organizations it is a challenge as well as opportunity to be part of the Discussion of EMR software for better outcome.

LET US NOT MISS THIS OPPORTUNITY.

Can Polio Be Eradicated? A Skeptic Now Thinks So.NYT,

Donald Mcneil writes in NYT article that now Octogenarian Donald Henderson who is believed to be the strongest force in elimination of Small Pox. He at times is very skeptical that Polio can be eradicated in a short time.

Polio has a strange history now it is eliminated from 99 percent of the population. Yet polio Occurs in India ,Pakistan and Nigeria.Other reason is it is very difficult and arduous process to identify patients with it.To immune patients you have to use oral drops three times.

Dr. de Quadros, a former director of the Pan American Health Organization, has his own mantle: “The Man Who Found the Last Case of Smallpox in Ethiopia and Chased Polio and Measles Out of the Western Hemisphere.” It was the conversation with Dr Quadros which changed the mind of Dr Donald Henderson. With commitment of Bill Gates and his foundation ,WHO and help of group of eminent scholars and scientist it is time and Dr Henderson believes that stars have lined up for elimination of Polio.

FROM BILL GATES TALKING ON CHARLIE ROSE ONE FEELS THAT THERE IS NO FEATHER HE RATHER HAVE THAN ELIMINATION OF POLIO, SECOND DISEASE TO BE ELIMINATED .
for HUMANITY SAKE I HOPE HE GETS IT.

First in Asia. Transexuals along with others to be flight attendants,The Tribune , Chandigarh.

I thought i would like to share this news in Tribune a daily English language News paper from Chandigarh.

Transsexuals flight attendants
KUALA LUMPUR: A newly formed Thai airline is employing transsexuals as flight attendants, in a bid to provide them equal opportunity. "Ketoeys" or ladyboys, who are highly visible in mainstream jobs in Thailand, will work as flight attendants on the Asian routes of a charter airline "PC Air", starting April this year. PC Air earlier decided to hire males and females for the job but later changed its plan after it received more than 100 applications of transgenders, media reports said. — PTI

My niece and her blog about homosexuality

I am very impressed by writings of my 16 year old niece in India.She is a new blogger Kudratduttachaudhary.blogspot.com.

In India gays and lesbians are not integrated in society like they are being done in USA.Even basic understanding of sexuality is many times very limited.

Hijra's or Khusra are normally Hermaphrodite,that means people having male and female sexual organs or not developed sex organs.They have had there own colonies and make a living by dancing and entertaining others.Some of them work as male prostitutes.
and though accepted have a very low status in society.Traditionally as no hormonal and surgical solutions were available to this group of people they supported each other and created Strong community.members of this group are some times called as the third sex.In that sense they are much different than Homosexuals in America.

Homosexuals are people who like people of the same sex as there partners. Physiologically they are clearly male or female.It is a choice may be based on some psychological or hormonal variation we do not yet understand.

Kudrat might be thinking of the third sex as she has used those words.She is encouraged by the Acceptance of Homosexual soldiers in American Military as a major change.
Talking about Taboo subjects by a young person is always commendable.
here is her blog


HOMOSEXUALITY ....start accepting !
Everything around us offers variety, that’s why all of us are DIFFERENT , because our likes and dislikes are varied ,there is difference in our opinions and also there is a HUGE distinction in how we PERCIEVE life . But no matter how assorted all of us are, we all are binded together under a common term called HUMANITY .
We all are humans , irrespective of the fact that somebody is a girl or boy ,black or white ,hindu or muslim, gothic or preppy, straight or bisexual or maybe something else ,our ways of life or even our thinking cannot segregate one section of the society from the other . From a lot many years we have been hearing or rather experiencing cases of discrimination on the basis of caste ,colour and creed .If you were a BLACK or BROWN you were not considered fit to access the privileges of the fairer community .If you were a girl ,you were not considered INTELLEGENT enough to compete with the stronger sex. We all brag about living in the TODAY’S time and proudly being a part of the 21st century , which I presume would have opened our thinking capsule and brought a sense of equality towards ‘everybody’ in our minds.
Sadly , all of my presumptions are proved false by the ongoing conditions around me .Thankfully we have feminists and other social activists to fight against discrimination against women and the coloureds ,but what concerns me is that do we have ENOUGH support and a felling of acceptance for people who are generally graded as “THE THIRD SEX” ?
The answer to this is that, many of us calling ourselves advanced are scared of GAYS AND LESBIANS ,for reasons best known to individuals themselves .Many a times we would maintain distance from them just because they are not the ones belonging from the COMMON genders. I mean if we deeply look into the case, and analyse the differences between them and us all I can point out is the BASIC VARIENT that they are attracted to their own gender .The the weirdness of our reaction makes them fear to come out with the truth and live openly with their INDIVIDUAL IDENTITY. Many of us would frown at the thought of someone known to us being a gay but the question is that was this their own CHOICE ?
Tomorrow your son can be a gay to, does that mean you would behave the same way like you would do NOW after meeting someone belonging to the third sex ? The good news is that now it has been legalised in our extremely cultured nation ,which found HOMOSEXUALITY as something corrupting the minds of the population .As a fact many kings of the historical legacy were gays, but were married to women to save the name of the family thus, spoiling an innocent girl’s life and therefore forcing her to enter into an extra marital relation .
I am grateful to people who made consensual sex between homosexuals LEGAL .I mean how can we CRIMINALIZE one’s physical demands and acts of satisfying them with someone who feels the same.
It’s supposed to be a free world and in that, NARROW thoughts which classify homosexuality as vulgar and cheap have no place and room for survival .
THIS IS FOR ALL OF YOU, START EMPATHISING ,START ACCEPTING .......................
TOMORROW YOUR PRODUCE CAN BE A HOMOSEXUAL TOO AND IT ISN’T SOMETHING TO FROWN ABOUT BUT SOMETHING TO BE REFLECTED UPON ...
HOMOSEXUALS ARE A VITAL PART OF THE HUMANITY ........
Posted by Kudrat Dutta Chaudhary at 1:42 AM

Here is a great post about the Stimulus payments By JOHN HALAMKA

HERE IS A GREAT SIMPLIFIED ARTICLE BY DOCTOR JOHN HALAMKA ABOUT STIMULUS PAYMENTS.


MONDAY, JANUARY 24, 2011

Obtaining Meaningful Use Stimulus Payments
Many clinicians and hospitals have asked me about the exact steps to obtain stimulus payments.

On January 3, 2011, CMS began registering clinicians for participation in meaningful use programs. Every region of the United States has Regional Extension Centers which can help answer any questions. Here's an overview of the steps you need to take.

1. Choose between Medicare and Medicaid programs. If you qualify, Medicaid offers greater incentives and does not require you to achieve meaningful use before stimulus payments begin.
a. To qualify for Medicaid, 30% of your patient encounters must be Medicaid patients. (20% for pediatricians)
b. To qualify for Medicare, keep in mind that meaningful use payments are made at 75% of Medicare allowable charges for covered professional services in the calendar year of payment, per the payment maximums below:

Year 1 $18,000
Year 2 $12,000
Year 3 $8000
Year 4 $4000
Year 5 $2000

Thus, a total of $44,000 is available at maximum, but could be less if your allowable Medicare charges are less than

Year 1 $24,000
Year 2 $16,000
Year 3 $10,667
Year 4 $5333
Year 5 $2667

Also, if 90% of your Medicare charges take place in inpatient or emergency department locations, you cannot qualify for the meaningful use program. This means that emergency physicians, anesthesiologists, radiologists, and pathologists generally cannot participate. Some professionals may also find that they do not have enough Medicaid or Medicare charges to benefit from either program.

2. Once you've chosen Medicare or Medicaid, you must register to participate
a. You need a National Provider Identifier and password. If you do not have one, go to the NPPES website.
b. One you have a password, go to the CMS EHR Incentives Website and register as an eligible professional
c. Two valuable resources include the Registration User's Guide and the CMS overview of the EHR incentive programs.

3. The Meaningful Use demonstration period is 90 days beginning January 1, 2011 so the first date that you can attest to meaningful use of Certified EHR technology is April 1, 2011. Note that the EHR technology you use must be certified by the time you attest. You can begin your meaningful use reporting period using uncertified EHR technology as long as it is certified by the end of your reporting period.

Medicare payments will begin in May. Medicaid payments are administered by states and will begin when state governments are ready to administer the program. Some states are ready now and others will not be ready until August. Remember that Medicaid payments start before meaningful use is achieved so there is no need to wait for meaningful use measurement and attestation for the Medicaid program.

Hospital requirements are similar
a. First, you must locate the following, which your Revenue Cycle staff are likely to have:
CMS Identity and Access Management (I&A) User ID and Password.
CMS Certification Number (CCN).
National Provider Identifier (NPI).
Hospital Tax Identification Number.
b. Go to the CMS EHR Incentives Website and register as an eligible hospital
c. The Hospital Registration User's Guide is a valuable resource

Here's a summary of the key dates for the program:

January 1, 2011 – Reporting year begins for eligible professionals.
January 3, 2011 – Registration for the Medicare EHR Incentive Program begins.
January 3, 2011 – For Medicaid providers, states may launch their programs if they so choose.
April 2011 – Attestation for the Medicare EHR Incentive Program begins.
May 2011 – EHR Incentive Payments expected to begin.
July 3, 2011 – Last day for eligible hospitals to begin their 90-day reporting period to demonstrate meaningful use for the Medicare EHR Incentive Program.
September 30, 2011 – Last day of the federal fiscal year. Reporting year ends for eligible hospitals and CAHs.
October 1, 2011 – Last day for eligible professionals to begin their 90-day reporting period for calendar year 2011 for the Medicare EHR Incentive Program.
November 30, 2011 – Last day for eligible hospitals and critical access hospitals to register and attest to receive an Incentive Payment for Federal fiscal year (FY) 2011.
December 31, 2011 – Reporting year ends for eligible professionals.
February 29, 2012 – Last day for eligible professionals to register and attest to receive an Incentive Payment for calendar year (CY) 2011.

I hope this clarifies your next steps. May your stimulus funds flow quickly in 2011!
POSTED BY JOHN HALAMKA AT 3:00 AM

Stage 2 and 3 meaningful use recommendations,dr Halamka

Tuesday, January 18, 2011
The Proposed Stage 2 and 3 Meaningful Use Recommendations

On January 12, the Health Information Technology Policy Committee published its proposed Stage 2 and 3 Meaningful Use recommendations for public comment.

Robin Raiford from Allscripts created a Quick Guide to the recommendations, making it easy to compare Stage 1, 2 and 3 in a single PDF.

Here's my analysis of the proposed Stage 2 and 3 criteria.

1. CPOE - Stage 1 requires more than 30% of unique patients with at least one medication in their medication list have at least one medication order entered using CPOE Stage 2 expands this to 60% of patients for at least one medication, lab or radiology order. Stage 3 expands this further to 80%. CPOE orders do not need to be transmitted electronically to pharmacies/labs/radiology departments. This is a very reasonable rate of CPOE adoption. The hardest part of implementing CPOE is getting started, which happens in Stage 1. Adding different types of transactions (without requiring electronic transmission to back end service providers) is more about workflow and behavioral change than technology change.

2. Drug-drug/drug-allergy interaction checks - Stage 1 requires that interaction technology be enabled. Stage 2 adds that it will be used for high yield alerts, with metrics for use to be defined. The idea is that many drug databases contain too many false positive interaction rules, so adoption is slowed by alert fatigue. If only high yield alerts are required (here's what we've done at BIDMC ), clinicians are more likely to trust drug interaction decision support. Stage 3 adds drug/age checking (such as geriatric and pediatric decision support), drug dose checking, chemotherapy dosing, drug/lab checking, and drug/condition checking. These are all reasonable goals, but automating chemotherapy protocols is quite challenging. BIDMC built an Oncology Management System and added a full time research nurse to ensure all chemotherapy protocols are updated and accurate. It may be asking too much to require chemotherapy dosing decision support nationwide by 2015.

3. e-Prescribing - Stage 1 requires e-prescribing of 40% of non-controlled substances. Stage 2 expands this to 50%. Stage 3 expands it further to 80%. Electronic faxing is permitted if pharmacies cannot accept e-prescriptions. These are very reasonable goals and easily achievable if e-prescribing systems are in place, which is required for Stage 1. E-prescribing of controlled substances, which requires more effort including two-factor authentication, is not specifically mentioned.

4. Demographics - Stage 1 requires capture race/ethnicity, primary language, and other demographics for 50% of patients. Stage 2 expands this to 80%. Stage 3 expands this further to 90%. Most institutions are already near 100% since they capture this information as part of existing registration and billing processes.

5. Report quality measures electronically - Stage 2 and 3 will be specified by the Quality Measures Workgroup and CMS. No further detail is offered at this time. The hardest part of quality measure reporting is computing the numerators and denominators as is required for Stage 1. Generating the PQRI XML to send the data to CMS is quite easy.

6. Maintain problem lists - Stage 1 requires documentation of at least one problem for 80% of patients. Stage 2 is unchanged. Stage 3 requires that problem lists be up to date. This is reasonable. Clinicians will be motivated to update them because the problem list will be included in clinical summaries sent to the patient after every visit. I hope that EHR vendors improve the usability of problem list management functions by creating natural language translation into the required SNOMED-CT or ICD9/ICD10 vocabularies.

7. Maintain active medication lists - Stage 1 requires documentation of at least one medication for 80% of patients. Stage 2 is unchanged. Stage 3 requires that medication lists be up to date as part of medication reconciliation, which per requirement 31 below will be a core requirement with 80% compliance in Stage 2 and 90% in stage 3. In my view, the greatest strength of EHRs should be medication management.

8. Maintain active medication allergy lists - Stage 1 requires documentation of at least one allergy for 80% of patients. Stage 2 is unchanged. Stage 3 requires that allergy lists be up to date. Clinicians will be motivated to update them because the allergy list will be included in clinical summaries sent to the patient after every visit.

9. Vital signs - Stage 1 requires vital sign recording for 50% of patients. Stage 2 expands this to 80%. Stage 3 is the same as Stage 2. This is reasonable.

10. Smoking status - Stage 1 requires smoking status documentation for 50% of patients. Stage 2 expands this to 80%. Stage 3 expands it to 90%. This is reasonable.

11. Use Clinical Decision Support to improve performance on high-priority health conditions - Implemented properly, decision support can save time while enhancing safety. Maintaining rules can be challenging and I hope companies evolve to provide cloud-based approaches to decision support.

12. Formulary checks - In Stage 1, formulary checks are in the menu set with the requirement that clinicians and hospitals have access to at least one internal or external drug formulary for the entire EHR reporting period. Stage 2 moves this to core. Stage 3 requires the functionality to be applied to 80% of medication orders. Formulary checking is generally a part of e-prescribing, so this is reasonable. The only unknown is how formularies vary in different regions. Since Massachusetts has only 3 major payers, all regional, formularies have been relatively easy to manage.

13. Advanced directives - In Stage 1, Advanced Directives are in the menu set with the requirement that 50% of patients 65 and older have advance directive documentation. Stage 2 moves this to core. Stage 3 requires 90%. I believe this is a laudable but a challenging goal to achieve. My experience is that most hospitals have advanced directives recorded for less than 25% of their patients.

14. Incorporate lab results as structured data - The Stage 1 menu set requirement is that lab results are incorporated into EHRs as structured data for more than 40% of all clinical lab tests ordered. Stage 2 moves this to core. Stage 3 expands the functionality for 90% of tests ordered and requires they be reconciled with structured orders. Lab workflow improvement is one of the best ways to save clinicians time and ensure followup of abnormal results. My only reservation with this requirement is that the standards for content and vocabulary (lab compendiums) are still a work in process, so reconciliation with electronic orders may be premature.

15. Generate patient lists - The Stage 1 menu set requirement is to generate at least one report listing patients with a specific condition. Stage 2 moves this to core. Stage 3 requires such lists are used to manage patients for high priority health conditions. EHRs must include business intelligence capabilities as part of Stage 1 certification, so these recommendations should be easily achievable.

16. Send patient reminders - The Stage 1 menu set requirement is to send reminders to more than 20% of all unique patients 65 years/older or 5 years old/younger. Stage 2 makes this core. Stage 3 requires 20% of all active patients who prefer to receive reminders electronically receive them. I'm supportive of this requirement if I can fulfill it by offering all our patients secure web-based reminders via our PHR. Offering multiple electronic notification options (phone, fax, secure email, PHR, Facebook, Twitter, SMS texting) would be hard to manage.

17. Electronic outpatient notes - Stage 2 adds a new requirement for eligible professionals that 30% of visits have an electronic note. Stage 3 requires 90%. This note can be scanned, free text, structured etc. Offering the option of scanning, dictating, structured and unstructured makes this requirement very reasonable.

18. Electronic inpatient notes - Stage 2 adds a new requirement that 30% of hospital days have at least one electronic note by a physician, NP or PA. As with outpatient notes, this can be scanned, free text, structured etc. Very few hospitals have electronic inpatient documentation. Offering the option of scanning paper notes makes this requirement very reasonable.

19. Electronic Medication Administration Records - Stage 2 adds a new requirement that 30% of medication orders are tracked via an EMAR. Stage 3 makes this 80%. The definition of EMAR will be key. I think of an electronic medication administration record as positive patient identification of every patient, every drug and every staff member with mobile devices to record all medication events in real time. Requiring this for the entire country by 2015 is aggressive.

20. Provide an electronic copy of health information - Stage 1 requires this for 50% of patients who request it. Stage 2 is unchanged. Stage 3 requires 90%. The challenge is implementing the workflow to support this requirement, which has to be done for Stage 1. Thus Stage 2 and 3 are reasonable.

21. Provide a copy of discharge instructions - Stage 1 requires this for 50% of patients who request it. Stage 2 expands this to 80%. Stage 3 expands it to 90%. Since printed discharge instructions meet the criteria, this is reasonable.

22. Patient specific educational resources - Stage 1 requires this for 10% of patients. Stage 2 is unchanged. Stage 3 expands this to 20% in common specific languages. This key question is what is a common language? BIDMC supports 37 different languages. Offering educational resources in all these languages would be challenging.

23. Web-based download of inpatient records - Stage 2 adds the ability to view and download inpatient summaries for 80% of patients. Stage 3 is the same. Since BIDMC already has a PHR offered to all its patients, this requirement is actually an easier workflow than providing inpatient record summaries upon demand via a manual process. This requirement will be challenging for organizations which have not yet widely implemented personal health records.

24. Provide clinical summaries for each office visit - Stage 1 requires this for 50% of all patients (not just those who ask). Stage 2 expands this to "view and download" within 24 hours. Stage 3 is the same. The challenge is that records may not be completed and signed within 24 hours, especially if dictation or scanning processes are used to generate the electronic record.

25. Timely electronic access - The Stage 1 menu set requirement is that more than 10% of all unique patients seen by the clinician are provided timely electronic access to their health information subject to the clinician's discretion to withhold certain information. Stage 2 and 3 make this core and include the requirement that patients should be able to filter or organize information by date, encounter, etc. More detail is need about the requirement to organize the data to determine just how difficult this will be. This requirement will be challenging for practices which have not widely implemented personal health records.

26. Measures for clinical summaries and timely electronic access - Stage 2 requires that 20% of patients use a web-based portal and Stage 3 expands this to 30%. It seems a bit odd to measure clinician performance based on patient behavior. BIDMC has offered comprehensive secure email, timely access to all inpatient/outpatient data, and even full text notes. After 10 years, no more than 20% of our patients use these functions. I think a better approach is to require such functions be offered to all patients criteria is that all patients. Adoption is something beyond clinician control.

27. Online Secure messaging - Stage 2 and 3 adds a new requirement that online secure messaging be in use. Our experience with online secure messaging is that it reduces clinician time returning phone calls and enhances both clinician and patient satisfaction. This is a reasonable requirement.

28. Patient preference for communication medium - Stage 2 adds a new requirement that patient preference for communication be recorded for 20% of patients. Stage 3 expands this to 80%. Per my comment in Timely Electronic Access, I would prefer offering all patients web-based communications rather than trying to manage multiple communication approaches.

29. Patient Engagement - Stage 3 includes multiple new patient engagement requirements - electronic self management tools, EHR interfaces to PHRs, patient reporting of care experiences online, and patient generated data incorporation into EHRs. These need to be defined in much greater detail before their implications can be assessed.

30. Perform test of HIE - Stage 1 required one test. Stage 2 expands this to at least three external providers in primary referral networks (but outside the delivery system that uses the same EHR) or a bidirectional connection to at least one health information exchange. Stage 3 expands this to 30% of external providers or a connection to a health information exchange. Stage 2 and 3 require the HIE to connect to an entity-level provider directory. Although some regions with well developed HIE capabilities will find this easy to achieve, many will await the functionality promised by the Direct Project in order to exchange data.

31. Perform Medication reconciliation - The Stage 1 menu set requirement is medication reconciliation in 50% of care transitions. Stage 2 moves this to core and expands it to 80%. Stage 3 expands this to 90%. Since the Joint Commission required this over 3 years ago, it is very reasonable. Hard to operationalize, but the right thing to do.

32. Provide summary of care record - The Stage 1 menu set requirement is a summary of care record for more than 50% of transitions of care and referrals. Stage 2 makes this core. Stage 3 expands this to 80%. The challenge will be defining how this content is transmitted from provider to provider.

33. List Care members - Stage 2 adds a requirement to provide a list of care team members (including PCP) for 10% of patients. Stage 3 moves this to 50% via electronic exchange. Once more details about the electronic exchange are provided, I can better assess this requirement.

34. Longitudinal care plan - Stage 2 adds a requirement to record a longitudinal care plan for 20% of patients with high-priority health conditions. Stage 3 expands this to 50%. Although I'm familiar with pilots in which clinicians and patients jointly develop care plans, I have not seen it widely implemented. This may be a bit aggressive.

35. Submit immunization data - The Stage 1 menu set requirement was a single transaction. Stage 2 moves this to core and requires ongoing submission. Stage 3 requires query and review of immunization registry data. The challenge is that many state and local public health departments do not offer the ability to receive and query immunization data.

36. Submit reportable lab data - The Stage 1 menu set requirement was a single transaction. Stage 2 moves this to core. Stage 3 includes the requirement for hospitals to include complete patient contact information in 30% of reports. As with immunizations, state and local public health departments may find this challenging to support.

37. Submit syndromic surveillance data - The Stage 1 menu set requirement was a single transaction. Stage 2 moves this to core. Stage 3 includes patient self report and something called the Public Health button, which is not defined. Public Health Departments may find this challenging to support.

38. Ensure privacy - Nothing new was specified but additional privacy and security objectives are under consideration by the HIT Policy Committee’s Privacy and Security Tiger Team.

Thus my areas of concern are chemotherapy automation, recording patient communication preferences, judging clinician performance based on patient adoption of PHRs, EMAR implementation, maturity of HIE capabilities, widespread rollout of longitudinal care planning, and public health readiness.

The comment period ends Feb. 25 and the Health IT Policy Committee will consider all of the comments in making its final recommendations this Summer to the Office of the National Coordinator for Health Information Technology at HHS. Here's the work plan as I understand it

Jan, 12, 2011: release draft Meaningful Use criteria and request for comment
Feb-March, 2011: analyze comment submissions and revise Meaningful Use draft criteria
March, 2011: present revised draft Meaningful Use criteria to the HIT Policy Committee
2Q11: CMS report on initial Stage 1 Meaningful Use submissions
3Q11: Final HIT Policy Committee recommendations on Stage 2 Meaningful Use
4Q11: CMS Meaningful Use NPRM

It's great to have a roadmap so we know where we're going between now and 2015. At present BIDMC is completing its certification inspection tests and is working hard to achieve meaningful use by the end of March so we can attest in April. Given the challenges of achieving certification and meaningful use for Stage 1, we welcome a two year window to prepare for Stage 2.
Posted by John Halamka at 3:00 AM 0 comments