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March 26, 2010
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At a Glance |
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CHIME Notes |
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The College of Healthcare Information Management Executives (CHIME) would like to welcome you to our healthcare IT executive newsletter! For those of you who are unfamiliar with our organization, we have started this bi-monthly publication to help readers stay up-to-date on what is happening in the industry. With more than 1,400 members, CHIME is the professional organization for chief information officers and other senior healthcare IT leaders. CHIME enables its members and business partners to collaborate; exchange ideas; develop professionally; and advocate the effective use of information management to improve the health and healthcare in the communities they serve.
Read on to find out what 1,400 healthcare CIOs already know, CHIME is the CIO’s voice in the industry.
The CHIME/HIMSS CIO Forum in Atlanta on February 28 attracted record numbers this year, which was held the weekend before the HIMSS2010 Conference and Exposition. More than 500 attendees were registered for the event, including more than 330 CIOs. Keynote speakers included Dan Roam, Marilyn Moats Kennedy and Alison Levine, along with a town hall discussion on “The National HIT Agenda,” with guests Elizabeth Johnson, Deborah Peel, MD and Paul Tang, MD.
CHIME released its comments on the proposed meaningful use regulations to the Centers for Medicare & Medicaid Services in late February and in March issued its comments regarding the initial set of standards, implementation specifications and certification criteria for electronic health record technology with the Office of the National Coordinator for Health Information Technology. These comments are featured later on in this newsletter.
Last month, CHIME launched a new website, CIO State Net, to support state-level communication for CIOs and IT executives. The new online network www.ciostatenet.org enables all CIOs, whether CHIME members or not, public access to information, communication and coordination among IT executives at the state level. The site has at least one CIO volunteer for all 50 states, including the District of Columbia. With the purpose to ensure CIOs are kept informed of events in their states, StateNet helps hospitals and health systems take full advantage of state-level activities under the HITECH Act and enables CIOs in states to share important information on their states, while helping CIOs to share intelligence between states as well.
CHIME also released a survey which found that upgrading and/or implementing certified EHRs will be the largest hurdle for CIOs when meeting Meaningful Use requirements. While CIOs continue to express trepidation over the pressures to meet the criteria for HITECH stimulus funding, the need to install new or upgraded systems to meet meaningful use requirements was ranked as the top issue by 30 percent of respondents, with 41 percent listing it among their top three concerns. Other leading concerns for CIOs regarding EHR implementation include insufficient capital for purchasing systems, doubts about vendor readiness and staffing capabilities. A full summary report of the survey may be accessed at here.
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CHIME CIO Feature Profile |
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Major Eric McClung
Chief Information Officer
Eisenhower Army Medical Center
Fort Gordon, GA
CHIME member since November 2008
Although Major Eric McClung is a relatively new member of CHIME, he’s a strong advocate of the organization to his peers in the U.S. Army Medical Department.
“I feel very strongly about developing CIOs within the Army Medical Department,” says Maj. McClung, who is CIO at Eisenhower Army Medical Center in Fort Gordon, Ga. “My hope is for CHIME to crosswalk its educational experiences and member network to the Army, helping to make it the professional organization of choice for our military and Army civilian healthcare IT leaders.”
Maj. McClung was introduced to CHIME after meeting Russ Branzell, CIO at Poudre Valley Health System (PVHS), when Russ gave a presentation on “CIO 2.0” to the Army Medical Department’s IT Leadership. Maj. McClung made the decision to join CHIME after he attended an education seminar on PVHS’s Malcomb Baldrige Quality Award journey and spoke at length with Russ, a former Air Force Medical Service Corps officer, about the impact of CHIME in Russ’s professional development.
“While I was a member of the American College of Healthcare Executives and HIMSS, CHIME’s focus on CIO/CMIO leadership supported by high-profile members like Russ and John Glaser made it worth checking out,” Maj. McClung said.
Two of Maj. McClung’s superiors – Colonel Jose L. Lopez, CIO of the U.S. Army Medical Department, and Colonel DaCosta Barrow, Deputy CIO of the U.S. Army Medical Command – also are CHIME members and are supportive of Maj. McClung’s membership as well.
Maj. McClung recently had the opportunity to participate in several Foundation Focus Group sessions in Atlanta. “It was unique experience to be in a room with my CIO peers, and even though the focus groups are intended to answer vendors’ questions, being able to interact with and hear my peers’ responses was very educational and extremely enlightening to me.”
Maj. McClung is looking forward to an extensive learning opportunity this month, when he will attend the CHIME’s CIO Boot Camp in Chicago. “I’m looking forward to the collaborative experiences and networking I found in the Focus Groups, as well as experiencing a curriculum based on CHIMEs CIO success factors” he said.
“The U.S. Army Healthcare system isn’t a simple delivery environment,” Maj McClung explained. “The Army Medical Department is part of the Military Health System, an enormous integrated delivery network comprised of the Army, Navy, and Air Force medical departments, which have treatment facilities located around the globe. The highly mobile beneficiary population places a premium on the ability to exchange health care information from the battlefield to the stateside hospital, between the three military services, the Department of Veteran Affairs, and the civilian health network. Healthcare delivery is already complex. The military unique environment significantly adds to that complexity.”
Because many of the challenges that face civilian organizations are shared in the Military Health System, Maj. McClung is hopeful that more of its IT leaders will participate in CHIME educational opportunities in coming years. “Col Lopez and Col Barrow are working to develop a human capital strategy that encourages continuous professional development through membership in professional organizations like CHIME,” he said. With CIO focused education, networking, and certifications like the CHCIO, CHIME has the potential to become a key component of that Human Capital Strategy.”
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CHIME10 Fall CIO Forum |
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Phoenix, AZ
Sheraton Wild Horse Pass Resort and Spa
October 5-8, 2010
Registration is now open for the CHIME10 Fall CIO Forum!
The Fall CIO Forum always offers an incredible educational value for healthcare CIOs, including national thought-leaders, peer-reviewed track sessions, CIO focus groups, peer-to-peer networking, and more.
The CHIME10 Fall CIO Forum will be held October 5-8, 2010 in Phoenix, Arizona at the Sheraton Wild Horse Pass Resort and Spa. Click here for more information including registration and hotel accommodations.
It’s not too late to join CHIME and take part in this valuable educational networking event.
Blumenthal to Present Opening Keynote Remarks at CHIME10
CHIME is pleased to announce National Coordinator for Health
Information Technology, Dr. David Blumenthal, will once again serve as
Opening Keynote Speaker at the Fall CIO Forum.
Blumenthal’s appearance at the Forum in October will follow the expected
release of final rules on the meaningful use of electronic health records,
standards and certification of EHR products.
At last year’s CHIME09 Fall CIO Forum, Dr. Blumenthal interacted with CIOs and vendors about the prognosis for implementing EHR systems, and it appears possible that he will again seek input from attendees at this year’s Forum to get their assessment of expected progress toward implementing clinical systems and receiving stimulus fund payments.
"CHIME is honored to have Dr. Blumenthal provide the opening keynote at our Fall CIO Forum,” said CHIME President and CEO Rich Correll. “His insights and expertise will be of great value to our members as they begin the ambitious process of implementing the provisions of the HITECH Act."
Dr. Blumenthal, who was appointed to his position by the Department of Health and Human Services in March 2009, leads the effort to integrate a nationwide interoperable, privacy-protected health information technology infrastructure into a national reform of the American healthcare system and support the widespread, meaningful use of HIT.
Blumenthal has been busy working with other governmental agencies to help implement provisions as called for in the American Recovery and Reinvestment Act of 2009 that deal with defining and funding the adoption of electronic health records. In late December, ONC and HHS proposed regulations for determining the meaningful use of electronic health records and the use of standards. Currently, these agencies are reviewing letters commenting on the proposed regulations. Most recently, Blumenthal’s office released the long-awaited Notice for Proposed Rulemaking containing proposed regulations for the EHR certification process.
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CHIME College Live |
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CHIME would like to invite you to listen in on a free College Live
session and learn how social media is affecting the healthcare IT
industry. College LIVE is a convenient alternative to traditional, classroom-style education and represents a new standard for delivering live presentations over the Internet.
Session Title:Do You Tweet? Social Media & its Impact on Healthcare IT & Clinical Care
Session Speaker(s): Steve Bennett; David Holland / Kirby Partners, Inc.; Southern Illinois Healthcare
Original Date: 12/3/2009 at 12:00 PM ET
Electronic media vehicles such as LinkedIn, Twitter, FaceBook, and dozens of others have drastically changed the way we communicate. Hospital IT departments are assigning staff members to be their “social media experts” and assist staff members with their needs. Physicians are using Twitter during surgeries to keep family members updated. HR departments are finding LinkedIn a valuable resource for IT recruitment. Hospitals are establishing FaceBook pages to as a method of enhancing their identity and visibility online, and working with community networks via a variety of social media communications. And CIOs are branding themselves internally and externally through blogs. This session will examine how low/no cost social media is affecting hospitals and in particular, IT departments.
Listen now at https://cio-chime.webex.com/cio-chime/lsr.php?AT=pb&SP=EC&rID=36744497&rKey=978d4cf61f0feaab
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CHIME Issues Comments on Interim Final Rule on Standards, Certification |
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CHIME released the comments it filed March 15, 2010 with the Office of the National Coordinator for Health Information Technology (ONC) regarding the initial set of standards, implementation specifications and certification criteria for electronic health record technology.
CHIME emphasized the importance of certification for supporting providers’ efforts to achieve meaningful use, saying it gives “healthcare providers a degree of assurance that the products they purchase will perform as promised…certification is meant to support providers, not pose an additional burden.”
CHIME’s comments place the lion’s share of responsibility on vendors that develop IT products, which it says builds on past experience in the healthcare IT space. The organization also urges ONC to provide more lead time as it creates future certification criteria, so as to provide more time for providers to implement new and upgraded systems in the future. Previously, in its comments to CMS on meaningful use regulations, CHIME had requested that a “grandfathering provision” be implemented to grant certification to products that have already been certified by the Certification Commission for Health Information Technology.
CHIME noted that further clarification is needed in ONC’s interim final rule, particularly in describing how certification will apply to organizations that use multiple clinical systems as components to an overall electronic health record system. CHIME supports wording in the rule that requires only certification of individual EHR modules.
CHIME’s comments ask the ONC to support a single standard for patient summary records; the current interim rule allows use of either the Health Level Seven (HL7) Clinical Document Architecture (CDA) Release 2 (R2) Level 2 Continuity of Care Document (CCD) or the ASTM Continuity of Care Record (CCR) to electronically exchange a patient summary record.
“CHIME disagrees with this approach and believes that the sharing of health information across providers is best facilitated with adoption of a single standard for patient summary records,” the comment letter stated. “CHIME believes that the healthcare field is ready to transition to a single standard for patient summary records, and such a move will facilitate interoperability in a more timely fashion.” The organization believes the HL7 CDA CCD is more robust and easier to read.
Medication reconciliation requirements in the interim rule need to be adjusted so that providers can meet the requirement if clinical systems can “display simultaneously two or more medication lists and provide tools for the clinician to perform medication reconciliation and create a single medication list.”
For reporting quality data, CHIME advised against using the CMS Physician Quality Reporting Initiative (PQRI) 2008 Registry XML Specification, and the related implementation specifications, the PQRI Measure Specifications Manual for Claims and Registry. Instead, it suggests the continued development of quality data reporting standards, which are in process by HL7.
CHIME also requested a standards-based approach for submitting data to public health agencies. Current proposals for submitting data provide wide latitude to agencies for determining the format in which they want to receive data.
In addition, CHIME comments on privacy and security standards included in the interim rule, particularly in areas of encryption and decryption of data, verification of data to ensure it hasn’t been altered in transit, and cross-enterprise authentication.
CHIME advised against placing too many requirements on data transmission within an organization. “Encryption of data in EHR databases and transactional systems would slow operation of the software, thus hindering adoption of EHRs by staff and physicians,” its comments state. “We ask that ONC and CMS carefully consider the risk vs. cost and performance issues during deliberations on this requirement.”
The letter to ONC from CHIME also included its previous comments on the proposed meaningful use regulations as an attachment. To view CHIME’s comments on the IFR, please click here.
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CHIME Issues Comments on EHR Incentive Program |
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CHIME released the comments it filed February 25, 2010 with the Centers for Medicare & Medicaid Services (CMS) regarding the EHR Incentive Program.
CHIME coordinated efforts with other industry organizations, such as the American Hospital Association, to thoroughly research key concerns and reach a consensus on responses that provide guidance on how to successfully roll out the incentive program.
CHIME comments addressed what it calls “critical concerns” regarding the proposed regulations governing the meaningful use of EHRs, as well as parts of the regulation document for which the industry needs clarification.
One of the more critical concerns was that the regulations outline an “all-or-nothing” approach to defining and achieving meaningful use is too ambitious and doesn’t take into account the need for flexibility by providers and does not reward incremental progress.
In its recommendations, CHIME wants the CMS to give providers until 2017 to adequately achieve all components for EHR implementation; develop an expanded suite of 34 core objectives, some of which can scale over time; use an incremental approach that would deem a provider a meaningful user if it can achieve 25 percent of objectives by 2011, 50 percent by 2013, 75 percent by 2015, and substantially all by 2017.
Contending that the “HIT marketplace does not have the capacity to support the timeframe imposed by the proposed regulations,” CHIME noted that the lack of a certification approach is resulting in industry uncertainty regarding product certification and heightens time pressures that both providers and vendors are facing. CHIME proposed that the final regulations extend the time frame during which Stage 1 meaningful use objectives will be used, and it asks CMS to adopt a “grandfathering provision” under which existing EHR systems that meet meaningful use objectives be accepted as certified for two years.
CHIME’s comments contended that quality reporting requirements in the proposed regulation are unrealistic at the early stages of the incentive program, and it asks for a delay in implementing quality reporting until 2012. “While automated quality reporting is critically important to the meaningful use of electronic health records, no EHR system in use today is able to automatically report the full set of (35) proposed measures.”
CHIME also commented on specific objectives and HIT functionality measures included in the proposed regulations. The organization seeks the elimination of administrative measures, such as EHRs producing metrics on automated claims submissions and insurance eligibility. CHIME also is making recommendations regarding computerized provider order entry, medication reconciliation, data submission to public health agencies and HIT functionality data submissions.
An executive summary of CHIME’s comments on the regulations can be found here.
To access CHIME’s letter to the CMS in its entirety click here.
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Four CHIME Members Testify about Progress and Challenges in Implementing EHRs |
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Four members of CHIME provided testimony before a federal panel on March 8 regarding the challenges foreseen in implementing electronic health records.
Mitzi Cardenas, Charles Christian, David Muntz and Michael Sauk shared their observations before the Implementation Workgroup, which was chartered by the HIT Standards Committee, a federal advisory panel that reports to David Blumenthal, MD, national coordinator for health information technology.
The Implementation Workgroup heard reports on the topic, “Implementation Starter Kit: Lessons and Resources to Accelerate Adoption.” The workgroup is charged with developing real-world implementation experiences that can be included into recommendations of the HIT Standards Committee. Its suggestions will be aimed at accelerating the adoption of proposed standards or mitigating barriers to adoption.
The four CIOs participated in an “implementation experiences panel,” which sought to share different perspectives on their experiences in installing electronic health records systems and provided testimony with their vendor partners on the challenges they are facing, and how that could manifest itself nationwide as healthcare organizations make plans to implement records systems to get stimulus fund payments under the Electronic Health Record Incentive Programs.
For more on the testimony visit: http://cio-chime.org/chime/pressreleases/pr3_8_2010_12_33_09.asp.
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Sign up for CHIME’s CIO SmartBrief Newsletter |
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CHIME's Healthcare CIO SmartBrief is a FREE, bi-weekly e-mail newsletter tailored to healthcare CIOs and IT executives. Our SmartBrief newsletter handpicks key articles from hundreds of publications, providing brief summaries of only the most relevant industry news, with links back to the original sources.
To sign up visit: http://www.smartbrief.com/chime/index.jsp?campaign=webIndustries
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