New certification and meaningful use release

Discussion in 'General Discussion' started by Graham, Jul 16, 2009.

  1. Graham

    Graham Developer Staff Member

    Seehttp://healthit.hhs.gov/portal/server.pt?open=512&objID=1269&parentname=CommunityPage&parentid=2&mode=2&in_hi_userid=10741&cached=true

    Certification will be based on the ability of components to meet meaningful use criteria.

    ONC will set the criteria, and a number of agencies will certify. In the meantime, products currently certified by CCHIT will be considered certified. But new software will have to meet the new criteria.

    It appears from reading the documentation, Synapse will meet most of the new meaningful use criterial.
  2. Jason

    Jason Developer / Handyman Staff Member

    That link points to a generic page.

    Seems you are logged in and a non-logged in user can't view that page?

  3. Jerry

    Jerry Administrator Staff Member

    Looks to me like Synapse can do most of the items in the 10 page "Meaningful Use Matrix" for 2011 already. The matrix is certainly not anywhere as IT specific as CCHIT, but looks very reasonable. The charge has been that CCHIT favors only the very large vendors that comprise it's leadership. I hope the fed is moving in a direction that looks more fair to all vendors and leaves room for some IT innovation.
  4. Graham

    Graham Developer Staff Member

  5. Jason

    Jason Developer / Handyman Staff Member

    Where did you get that notion from ?

    /Curious.

    Graham: Your link leads to a page called: Health IT Policy Committee (a Federal Advisory Committee)
  6. Graham

    Graham Developer Staff Member

  7. Graham

    Graham Developer Staff Member

    I'm going to go thru all the 2011 objectives and state where Synapse meets the criteria
    • Use CPOE for all orders ( meds, labs, procedures, diagnostic imaging, immunizations, referrals ). Receiving interfaces not needed for 2011
      • Yes, does this already, and receiving interfaces already built ( HL7 )
    • Implement drug-drug, allergy formulary checks
      • No, but can use free Allscripts tool for this until Synapse's version is completed
    • Maintain updated list of problems using ICD9 or Snomed
      • Yes
    • Generate and transmit permissible prescriptions electronically
      • Not yet, coming soon. But can use free Allscripts tool pro tem
    • Maintain active medication list
      • Yes
    • Maintain active medication allergy list
      • Yes
    • Record demographics
      • Need to add preferrred language and racial group
      • Already have insurance type, gender and ethnicity
    • Record Advance Directives
      • Not specifically - can add in social
    • Records vitals including wt ht bp and BMI
      • Yes
    • Record smoking status
      • Yes
    • Incorporate lab test results as structured data
      • Yes
    • Generate lists of patients by conditions
      • Yes - see reports
    • Report ambulatory quality measures to CMS
      • Yes - see reports
    • Send reminders to patients for preventitive and follow up care
      • Yes, thru ticklers and HMGs
    • Implement one clinical decision rule relevant to specialty or high clincal priority
      • Yes, see embedded clinical pathways function
    • Document a progress note for each encounter
      • Yes
    • Check insurance eligibility electronically from private and public payers where possible
      • PMS function
    • Submit claims electronically
      • PMS function
    • Provide patients with electronic copies of their health information upon request ( real time not required until 2013 )
      • Portal can do this now and no need to wait till 2013
    • Provide access to patient specific education resources
      • Yes, and store them on deki wiki interface
    • Provide clinical summaries for each encounter
      • Yes ( see docs button )
  8. Jason

    Jason Developer / Handyman Staff Member

    [quote user="Graham"]

    I'm going to go thru all the 2011 objectives and state where Synapse meets the criteria
    • Use CPOE for all orders ( meds, labs, procedures, diagnostic imaging, immunizations, referrals ). Receiving interfaces not needed for 2011
      • Yes, does this already, and receiving interfaces already built ( HL7 )
        • <span class="Apple-style-span" style="border-collapse: separate; color: #000000; font-family: 'Times New Roman'; font-size: 16px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px">Is ordering a DEXA Scan recorded anywhere ? Is ordering labs recorded anywhere ?
    • Implement drug-drug, allergy formulary checks
      • No, but can use free Allscripts tool for this until Synapse's version is completed
        • Would be nice to get this.
        • Wonder if they want drugs codified ?
    • Maintain updated list of problems using ICD9 or Snomed
      • Yes
        • I wonder if they want "Versioning" of this list (ie. History of how the list was created).
    • Generate and transmit permissible prescriptions electronically
      • Not yet, coming soon. But can use free Allscripts tool pro tem
    • Maintain active medication list
      • Yes
    • Maintain active medication allergy list
      • Yes
    • Record demographics
      • Need to add preferred language and racial group
        • Easy.
      • Already have insurance type, gender and ethnicity
    • Record Advance Directives
      • Not specifically - can add in social
        • or a template in the Consults Section
        • or a Link to a Word File .pdf
    • Records vitals including wt ht BP and BMI
      • Yes
    • Record smoking status
      • Yes
    • Incorporate lab test results as structured data
      • Yes
    • Generate lists of patients by conditions
      • Yes - see reports
    • Report ambulatory quality measures to CMS
      • Yes - see reports
    • Send reminders to patients for preventative and follow up care
      • Yes, thru ticklers and HMGs
    • Implement one clinical decision rule relevant to specialty or high clinical priority
      • Yes, see embedded clinical pathways function
    • Document a progress note for each encounter
      • Yes
    • Check insurance eligibility electronically from private and public payers where possible
      • PMS function
    • Submit claims electronically
      • PMS function
    • Provide patients with electronic copies of their health information upon request ( real time not required until 2013 )
      • Portal can do this now and no need to wait till 2013
    • Provide access to patient specific education resources
      • Yes, and store them on deki wiki interface
    • Provide clinical summaries for each encounter
      • Yes ( see docs button )
    [/quote]<div style="padding
  9. Graham

    Graham Developer Staff Member

    Yes if you order labs or radiology using the templates, it is recorded.

  10. Graham

    Graham Developer Staff Member

    Continued ....
    • capability to exchange key clinical information ( to be decided hy HIE work group of the HIT policy committee ) electronically
      • unclear if this means CCR or something similar. Synapse can already read the CCR and writing it is not difficult
    • perform medication reconciliation at relevant encounters
      • not sure what this means - go over the medications and confirm them??
    • capability to submit immunization data etc where required
      • need more information on how this is supposed to be done
    • capability to provide electronic syndromic surveillance data to public health agencies
      • again need more information
    • compliance with HIPAA privacy and security rules
      • currently compliant
    • compliance with nationwide privacy and security framework
      • need more information on this
  11. Jason

    Jason Developer / Handyman Staff Member

    Would it be possible to have access to templates outside of the Consult Tab ?
  12. Graham

    Graham Developer Staff Member

    All the templates are designed to insert text into a consult ...
  13. Jason

    Jason Developer / Handyman Staff Member

    [quote user="Graham"]

    Continued ....
    • capability to exchange key clinical information ( to be decided by HIE work group of the HIT policy committee ) electronically
      • unclear if this means CCR or something similar. Synapse can already read the CCR and writing it is not difficult.
        • likely A1cs, Ethnicity, Race, Smoking Status, last lipid test, etc via HL7 ?
    • perform medication reconciliation at relevant encounters
      • not sure what this means - go over the medications and confirm them??
        • YES. Like after hospital Discharge, etc. This is all the rage for inhospital care. I really like the idea of patient's "confirming" their medications via a portal. A variable that stores the date of last medication reconciliation and a history of past reconciliations would be a good idea.
    • capability to submit immunization data etc where required
      • need more information on how this is supposed to be done
    • capability to provide electronic syndromic surveillance data to public health agencies
      • again need more information
        • Sounds like send info on H1N1 like symptoms. Other Public Health stuff : Infectious Disease outbreaks, E.Coli outbreaks.
    • compliance with HIPAA privacy and security rules
      • currently compliant
    • compliance with nationwide privacy and security framework
      • need more information on this

    [/quote]
  14. Jason

    Jason Developer / Handyman Staff Member

    Simple quote from the internets:


    Meaningful use has four main functional requirements: computerized order entry, drug interaction checking, maintaining an updated problem list, and generation of transmissible prescriptions. A certified EMR system must provide these functions, and physicians must use them daily for all their patients. In addition, a certified EMR must be capable of sharing information and working with other systems.

    The HIT Committee wisely chose existing data standards for their recommendations. Health Level 7 (HL7) is data standard based on the Extensible Markup Language (XML). HL7 was developed for earlier government programs, such as the Doctors Office Quality Information Technology (DOQIT) and Physicians Quality Reporting Initiative (PQRI).
  15. Jason

    Jason Developer / Handyman Staff Member

    November 4, 2008


    Barack Obama elected President of the United States.


    February 13, 2009
    House of Representatives and Senate approved the
    conference report for the American Recovery and
    Reinvestment Act of 2009.


    February 17, 2009
    Health Information Technology for Economic and
    Clinical Health (HITECH) Act signed into law by
    President Obama (as part of the American Recovery
    and Reinvestment Act of 2009).


    May 18, 2009
    HHS Secretary must review proposed HIT
    standards, implementation specifications, or
    certification criteria, and determine whether or
    not to propose adoption of such standards,
    specifications and criteria.


    August 16, 2009
    Federal Trade Commission promulgates interim
    final regulations on privacy requirements for vendors
    of personal health records and other non-HIPAA
    covered entities.


    November 1, 2009
    ONC submits FY 2010 annual operating plan.


    December 31, 2009
    Deadline for specifics of the HITECH Act, including
    &ldquo;meaningful use&rdquo; and &ldquo;certification&rdquo; criteria, to be
    released by the U.S. Department of Health and
    Human Services.


    January 1, 2010
    HHS Secretary may begin making competitive grants
    to states and Indian Tribes for the development of
    loan programs to facilitate the widespread adoption
    of certified EHR technology.


    February 17, 2010
    HHS Secretary shall submit to Congress a
    report that describes the specific demonstration
    projects to integrate information technology
    into Clinical Education; and contains
    recommendations for Congress.


    February 17, 2010
    HHS Secretary to submit healthcare IT privacy report
    to Congress.


    June 30, 2010
    HHS must conduct study on payment incentives to
    healthcare providers for HIT adoption.


    September 30, 2010
    $50 million for IT systems remains available for
    Veterans Benefits Administration until this date.


    October 1, 2010
    Earliest date of implementation for hospitals to
    receive payment incentives for HIT adoption.


    January 1, 2011
    Earliest date for payment incentives for physicians
    adopting HIT ($18,000 if the first payment year
    is 2011 or 2012).


    2015
    Medicare Disincentive/Penalty for failure to adopt EHR.
    Medicare Market Basket Payment Reduced by 1%.


    2016
    Medicare Disincentive/Penalty for failure to adopt EHR.
    Medicare Market Basket Payment Reduced by 2%.


    2017
    Medicare Disincentive/Penalty for failure to adopt EHR.
    Medicare Market Basket Payment Reduced by 3%.


    All Subsequent Years
    Medicare Disincentive/Penalty for failure to adopt EHR.
    Medicare Market Basket Payment Reduced by 3%

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