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Dr. David Blumenthal, the National Coordinator for Health Information Technology addressed the healthcare community again, this time on the ascending curve of Electronic Health Records! There has been an increased level of adoption of Electronic Health Records and health information technology that has been taken place in the marketplace, recently, as healthcare community is showing higher level of interest in adoption of electronic health records for their medical practice units, for the meaning use, and to avail incentives from Medicare and Medicare programs!

This review was done by the National Center for Health Statistics (NCHS), the group of Health and Human Services, working on Disease Control and Prevention!

Dr. David Blumenthal wrote, physicians over the globe are vigorously putting secure/private electronic structure to attain long-term improvements in healthcare costs, quality of care and efficiency of healthcare providers, and added further that just the presence of an Electronic Health Record does not imply that a physician/doctor is a significant or a meaningful user!

He said, the electronic health record, described in the review can be just basic/essential electronic health record, which the healthcare providers utilize for to stock up patient demographics, patient/healthcare problem lists, imaging/laboratory results and reports, clinical notes, and medical orders for e-prescriptions, and continued saying that these basic Electronic Health Records are not able enough to provide meaning use to healthcare organizations!

Luckily, the data set by the Office of the National Coordinator for Health Information Technology (ONC), executed out in route of yearly observation by the American Hospital Association (AHA), and NCHS provide enough support that electronic health record adoptions is all about gaining enough speed in working up with daily healthcare organizational routines, than just with basic communication!

The survey conducted by NCHS showed up that around 41% of physicians (medical office) are at present planning to adopt EHRs, and to submit for inducement payments! Out of this slot, around 32.4% physicians are planning to adopt EHRs, only this year!

The American Hospital Association review showed that around 81% of non-federal (acute care) hospitals/healthcare organizations are planning to adopt EHRs, for the meaningful use, to submit for incentive payments only! Around 65% of healthcare organizations/hospitals are preparing to enlist during stage-1 of the inducement program, in year 2011-2012!

Dr. David Blumenthal added further that he is gratified, knowing the fact that many healthcare organizations/physicians are coming forward to adopt EHRs for the meaningful usage, and that too, without delaying further, as deciding to adopt EHRs early, with the stage-1 signify getting maximum funding through the Medicare/Medicaid EHR Incentive Programs, as entitled healthcare professionals/physicians can qualify for incentive payments, amounting around $44,000, from Medicare, and about $63,750 from Medicaid! These healthcare organizations/hospitals can entitle for millions of dollars of incentive payments for adopting EHRs, for deciding to meaningfully utilize the EHR technology, and he said further that the registrations are on for healthcare providers to acquire vital incentive payments for meaningful usage/adoption of certified EHRs!

Dr. Blumenthal even recognized the fact that adoption of Electronic Health Records, and meaning usage of it require hard work and huge investment, specially for primary care practice units, where huge majority of doctors/physicians work, where the patient care is documented/coordinated, as many of these healthcare providers have to learn about this opportunity of EHR adoption, for the meaning use, and applying for incentives that they have, currently!

He stressed that this is the right time to gain from EHR incentive, and various supported technical assistance programs, under Health Information Technology for Economic and Clinical Health (HITECH) Act that are available currently for healthcare providers! He pointed out to 62 Regional Extension Centers (RECs) over the nation that are equipped to provide tailor-made, full time support to these healthcare providers for adoption of EHRs! When the Health IT workforce development agenda is training talented healthcare professionals in managing and implementing their health IT system, medical and other professional healthcare organizations are nowhere behind in leading the path!

Mr. Blumenthal assured the healthcare community about the security of information that is stored up in an Electronic Health Record, as depicted out of applicable regulations to safeguard healthcare data, and continued saying that Health Insurance Portability and Accountability Act (HIPAA) privacy/security protection rules will be applicable to these EHRs, and urged the community to think quickly on adoption of EHRs, saying that they will never get to gain from this level of talent and resources, for to smartly switching on to health IT setting, for to go fully digital, avoiding on paper documentation!

Finally, he said this shows good promise in the community for the healthcare providers that are planning to go for swift EHR adoption, deciding to transform from paper-base-documentation to digital records, and assured full cooperation of ONC to support all these healthcare organizations that want to adopt EHRs, by all means!

Patient data confidentiality and Institutional security will continue to be at risk if proper care is not taken while, transferring data from paper to digital Ericka Chickowski from darkreading writes on Apr-30th.

Surveys recently conducted revealed that,

1. The adoption rate of EMRs within U.S. medical offices grew higher.
2. Low budgeted healthcare organizations have increased their EMR use,
3. Fraud based on exposure to health data ALSO rose.

Deke George, CEO of NetSPI, (a security consultancy with healthcare client base) are of the opinion that, Even the resourceful healthcare organizations, with established databases, are yet to catch up with their counterparts in other industries, in terms of security of data. “There are many healthcare environments that still haven’t even put in DMZs,” he says. “From just a logical separation within the larger environments, these organizations are not necessarily segmenting off their databases.” Scores of significant data is scattered around, across numerous databases to collaborate, observe and research for healthcare informatics. Unsaved or loosely kept important patient data can also be found under test environments.

George says, “It’s more than a leak- what ends up happening is there’s a lot of data warehousing and there’s a lot of information that is in one database, but it gets spread around because it needs to be used for healthcare informatics in other uses. So you have all of these databases that just multiply, whether it’s because the applications themselves grow or the use of the database information grows from the native database to the data warehouse to other types of systems that now need this information.Everyone says up front that they don’t have real information in their test environments, but I would say probably 50 percent of the time we find that test environments contain live information,” Thus, understanding the value and location of the data and allowing authorised access to them, are meant to improve data confidentiality management according to him.

However, Josh Shaul, vice president of product management for database and application security vendor Application Security Inc adds, “…In the end we’re all securing data in databases and Oracle, SQL Server, and Sybase. They work the same whether you have your secret recipe in them or you have your healthcare information in them or you have credit card data in them.”

Centers for Medicare and Medicaid Services ( CMS ), a division of the U.S. Department of Health and Human Services, announced on Apr-26th, 2010 that, Washington’s Medicaid program will receive federal matching funds for state planning activities required to utilize the electronic health record (EHR) incentive program formed by the American Recovery and Reinvestment Act of 2009 (Recovery Act). Washington is entitled to approximately $967,000 in federal matching funds.

EHRs are expected to serve the purpose of improving general health care for the people of Washington. These records are meant to fit in conveniently with various providers treating a Medicaid patient subject to care. Decision making comes in handy with EHRs. The Recovery Act provides a 90 percent federal match for state planning activities to administer the incentive payments to Medicaid assistants, to make sure of their payments through audits and statewide participation to promote “meaningful use” and work-structure within the block of EHR technology across Washington.

Washington intends to make full use of its federal matching funds for planning activities that include organising a detailed analysis to understand the recent situation of Health IT activities in the state. Data on issues such as existing barriers to its use of EHRs, provider eligibility for EHR incentive payments, and the creation of a State Medicaid HIT Plan, which will define the state’s vision for its long-term HIT use will taken into account.

We congratulate Washington for qualifying for these federal matching funds to assist its plan for implementing the Recovery Act’s EHR incentive program, Meaningful and interoperable use of EHRs in Medicaid will increase health care efficiency, reduce medical errors and improve quality-outcomes and patient satisfaction within and across the states.” said Cindy Mann, director of the Center for Medicaid and State Operations at CMS.

Other States who recieved similar funding include:

• New Mexico will be assigned about $405,000 for the EHR planning work.
• Missouri will receive approximately $1.53 million in federal matching funds.
• Puerto Rico will receive approximately $1.80 million in federal matching funds.
• Oregon will receive approximately $3.53 million in federal matching funds.

An earlier Kalorama report EMR 2010 (Market Analysis, ARRA Incentives, Key Players, and Important Trends), officially posted on April 7th-2010, states how HHS is being constantly urged by health practitioners’ organisations and Congress Members to unlax the ‘meaningful use’ criteria for active growth in the EMR industry. A $13.8 billion market is predicted in the report which can be successfully increased to almost its double earning by systematic use of incentives and urging of health systems. Kalorama identifies the standards of obtaining EMR status for a physician is the most important obstacle they are facing at the moment.

Certain criterias for medical practitioners by HSS, such as, submitting a percentage of claims electronically, implementing established diagnostic list such as ICD-9, common medications listed for every patient etc are required to be met in order to be elligible to earn the EMR incentives by 2011. Kalorama however, also believes that requiring 80% of orders via CPOE by 2011, or that half of patients get auto-reminders through an EMR system, may affect EMR systems sales.

It is also mentioned in the report, about the letter prepared by the Senate Finance Committee Chairman Max Baucus and his batch of thirty-seven U.S. Senators along with D-Montana, and American Senate Health, Education, Labor and Pensions Committee Chairman Tom Harkin, D-Iowa. It was about mprovements in an earlier proposal for distributing substantial amounts for health Information and Technology. The letter was published by the Centers for Medicare & Medicaid Services.The idea was to motivate provider participation.A total of 235 members of the United States House of Representatives insisted CMS to axpand its proposed definition and criteria for hospitals to be elligible for the ‘meaningful use’ of health IT incentives.

Kalorama quoted Mr.Bruce Carlson, the publisher of Kalorama Information saying, “Requiring physicians to undergo 25 mandates by next year may not be effective given the kind of real-world usage among physicians we see today.Getting physicians used to these systems is the challenge to a totally paperless healthcare system in the United States and we think gradual, achievable goals would be preferable.

The report can be purchased from Kalorama Information at: http://www.kaloramainformation.com/redirect.asp?progid=78541&productid=2503320.

Amidst the debates and campaigns by the Obama administration to gain support to move forward advancing the healthcare reform bill, Secretary of Health and Human Services Kathleen Sebelius has announced an additional amount of 162 million dollars in the American Recovery and Reinvestment Act (ARRA) for advancement of health information technology (HIT).

The additional funding is to award the states for meaningful use of of HIT and adoption of electronic health records and health information exchange (HIE) . It  will be given to the following 16 states and state designated entities for adoption of HIE according to the national standards:

• Agency of Health Care Administration (FL)
• The Maryland Department of Health and Mental Hygiene
• New Jersey Health Care Facilities Financing Authority
• South Carolina Department of Health & Human Services
• Iowa Department of Public Health
• Idaho Health Data Exchange
• State of North Dakota, Information Technology Department
• State of Alaska
• Nebraska Department of Administrative Services
• South Dakota Department of Health
• Department of Public Health, State of CT
• State of Mississippi
• Indiana Health Information Technology, Inc.
• HealthShare Montana
• Texas Health and Human Services Commission
• Louisiana Health Care Quality Forum

Dr. David Blumenthal, national coordinator for health information technology stated that the grant has now empowered the state to develop innovative ways to overcome the barriers preventing health information exchange.

“States play a critical leadership role in advancing the development of the exchange capacity of healthcare providers and hospitals within their states and across the nation. Health information exchange will enable eligible healthcare providers to be deemed meaningful users of health IT and receive incentive payments under the Medicare and Medicaid electronic health record (EHR) incentive program,”he added.

The funding is part of the 2 billlion effort by the government to achieve meaningful use of HIT and make available the use of electronic health record by each person by 2014.

The latest market research report by Global Industry Analysts (GIA) on Electronic Medical Records (EMR) states that there is an excellent potential for EMR systems in the healthcare industry worldwide. This is due to widespread adoption of electonic systems for effective management of data, less costs, minimum staff and improving the quality of care.

The report titled ‘Electronic Medical Record Systems: A North American and European Market Report,’ provides a comprehensive analysis of European and North American markets for EMRs, including company profiles, product reviews/introductions/innovations, key players and present industry analysis.  According to the report, the European and North American markets are exceed US$5.4 billion and US$1.4 billion, respectively by 2015.

The GIA profiles companies like Agfa-Gevaert Ltd, Ascribe plc, Cambio Healthcare Systems, Cerner Corporation, CompuGROUP HOLDING AG, Computer Programs and Systems, Inc, EBIT AET S.p.A., Eclipsys Corporation, Egton Medical Information Systems Limited, Epic Systems Corporation, GE Healthcare, Hewlett Packard Company, IBA Health (Europe) Ltd, IMS MAXIMS plc, Indra Sistemas SA, iSoft Group plc, McKesson Corporation, MDS Medical Software, MedPlus, Inc, Medical Information Technology, Inc, Medasys SA, Nexus AG, Noemalife SpA, Profdoc AB, QuadraMed Corporation, SAP (UK) Limited, Siemens Medical Solutions GSD GmbH, System C Healthcare plc etc as key players in the electronic medical records industry.