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March 11, 2011
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At a Glance |
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CHIME Notes |
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Welcome to the March edition of the CHIME healthcare IT executive newsletter.
This publication helps readers stay up-to-date on what is happening in the industry.
CHIME is the professional association 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. Learn more.
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CHIME News |
Insight, Inspiration Make for a Memorable CIO Forum
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CHIME Board member Gretchen Tegethoff, CIO at George Washington University Hospital, led the Town Hall discussion on HIEs, with panelists Neal Ganguly, CHCIO, Vice President and CIO for CentraState Healthcare System (right), and John Mattison, MD, CMIO for Kaiser Permanente (left).
The 2011 CHIME/HIMSS CIO Forum played to a pack hall on Sunday, February 20, in Orlando, Fla., with more than 500 in attendance.
Inspired by the recurring theme of “change,” attendees experienced a full day of information and motivation, beginning with updates by CHIME Board Chair Lynn Vogel, Ph.D., FCHIME, CHCIO, as well as taped presentations by several board members. The messages conveyed the changes occurring in various areas of the organization and brought attendees up to speed on several CHIME initiatives, including advocacy, collaboration, education, and certification.
The pain of the current healthcare system, and the promise that
could be fulfilled by information technology, provided the basis for
the presentation by keynote speaker Nate Kaufman, managing
director and founder, Kaufman Strategic Advisors, LLC.
"Organizations that will win will be those that operate as a team,"
Kaufman told the audience. The push toward implementation of
the medical home model, acute care bundling of payments, post
acute care bundling and accountable care organizations all will
force the industry to cooperate in coordinating care. The
electronic health record will be the disruptive technology that will
push the change forward, he said. "If you don't have a fully functioning IT system by 2016-2018, there will be penalties," he said.
 Attendees also were addressed by Dr. Farzad Mostashari, Deputy National Coordinator for Programs and Policy for the Office of the National Coordinator for Health IT, who petitioned members of CHIME to become a part of his meaningful use legion.
“We have to think about how can we work together to not only implement change in your own institutions but how can we be the ‘meaningful use vanguard’ that demonstrates how you’re accomplishing meaningful use – what are the ways you have succeeded, and what can we do to help?” he said.
The challenges of health information
exchange in the U.S. were the topic of the town hall meeting
Sunday afternoon. Gretchen Tegethoff, CHIME board member
and CIO at George Washington University Hospital, led the
discussion, with panelists Indranil Ganguly, CHCIO, Vice
President and CIO for CentraState Healthcare System, and John
Mattison, MD, CMIO for Kaiser Permanente.
An animated Dr. Iris Firstenberg,
Adjunct Associate Professor of
Psychology, UCLA and Adjunct
Professor of Management at UCLA
Anderson, led CHIME members into
an interactive group project called L.A. Freeway, using the example of a California earthquake to identify how great leaders inspire innovation and lead change.
Shot down during a combat mission over North Vietnam, closing keynote Captain Charlie Plumb survived nearly six years as a Prisoner of War and shared with members a tale of remarkable self-reliance. Walking members through his inspiring journey, Plumb illustrated how perseverance, teamwork, and empowerment can help conquer adversity and change in one’s professional and personal life. His moving and thought-provoking lecture was met with a standing ovation to end the event on an uplifting note.
Relevant and targeted educational programming designed specifically for CIOs
and other healthcare IT leaders is just one of the many benefits of being a
CHIME member. Don’t miss out on another CIO Forum. Join CHIME today!
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CHIME Calls for Delay in Stage 2 Meaningful Use Timeline
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Late last month, CHIME submitted its comments on the
impending meaningful use Stage 2 objectives, requesting
that more time be allocated to enable assessment of Stage
1 progress and improved preparation for moving to Stage 2.
According to CHIME, meaningful use measures and
objectives for Stage 2 should reflect the capabilities and
experiences of hospitals and physicians to handle the scope
of Stage 1 before any measures for the second stage are
codified.
“CHIME believes that it would not be prudent to move to
Stage 2 until about 30 percent of (eligible hospitals and eligible providers) have been able to demonstrate EHR MU under Stage 1,” the comment letter read. “We believe this approach would strike a reasonable balance between the desire to push EHR adoption and MU as quickly as possible, and the recognition that unreasonable expectations could end up discouraging EHR adoption if providers conclude that it will be essentially impossible for them to qualify for incentives.”
Providers may seek to qualify incentives by achieving meaningful use objectives for Stage 1 by September 30, 2012, but legislation establishing the EHR Incentive Program does not lay out hard-and-fast deadlines for initiating the second stage of the program, with its subsequent set of objectives.
CHIME also proposed that Stage 2 have a core and menu set structure similar to that used in Stage 1; core measures are required meaningful use objectives, while providers must select at least five objectives from the menu set. Under the CHIME proposal, core measures would be those already incorporated in Stage 1, with some measures increasing in compliance levels, while the menu set would be new measures introduced in Stage 2.
“Hospitals and physicians are going to continue to need flexibility as we enter Stage 2,” said Pamela McNutt, senior vice president and CIO of Dallas-based Methodist Health System and chair of CHIME’s Policy Steering Committee. “Measures being introduced for the first time should be part of a menu set to allow providers to focus on those that best match their operational goals.”
The comments from CHIME were submitted to the Health IT Policy Committee, which is collecting public remarks in forming Stage 2 meaningful use recommendations that it will present to the Dept. of Health and Human Services later this summer.
Delaying the move to Stage 2 also would give federal agencies more time to develop clear policies that are defined in advance, which would give time-pressed providers and vendors clear guidance that they need for the industry to implement clinical systems, meet meaningful use objectives, and qualify for stimulus funding.
“Although most CIOs take the lead in deploying and encouraging optimization of information systems, our primary goal is to help introduce and manage change in our organizations,” said David Muntz, chair of CHIME’s Advocacy Leadership Team. “The change management implications of our current environment have never been greater, hence, our interest in finding certainty and practicality whenever possible. Even well-intended efforts must recognize that the staff and physicians need a clear vision of the future and time to absorb and adjust to the changes.”
CHIME said it was difficult to comment on “unknown standards or other policies” that the Health IT Standards Committee might recommend for several proposed Stage 2 measures. “CHIME believes it will be important for any such standards or policies to pass a ‘practicality test,’” the comment letter read. “They should be based on realistic expectations of what motivated providers will be able to accomplish, especially with respect to entering information in a coded or structured format.”
In response to specific proposed objectives for Stage 2, CHIME’s comments included the following:
- In using clinical decision support, CHIME calls for a limited set of rules that eligible hospitals (EHs) and eligible providers (EPs) would have the flexibility to choose. “The goal at this point should not be use of a large number of CDS rules but effective use of a smaller number,” CHIME said. “EHR technology should be capable of implementing CDS rules identified as appropriate by EHs and EPs, and MU criteria should not become a ‘back door’ means for the federal government to interfere with the practice of medicine.”
- CHIME stated concerns about several Stage 2 objectives outlining percentages of visits or patient days for which patient notes must be recorded. “We believe it is premature to focus on electronic notes, largely due to a lack of physician readiness,” the comments said. “For the foreseeable future, we believe it is much more important to focus attention on (computerized provider order entry), especially with CDS, than on electronic notes.”
- In response to a proposed objective for health information exchange requiring a provider connect to at least three external providers in a primary referral network, CHIME said it was “extremely concerned…Whether there is a functioning HIE in an area is totally beyond the control of EHs and EPs. We believe that an EH or EP should be able to opt out of the HIE requirement if reasonable access to an HIE is not possible.”
For the full text of CHIME’s comments on the proposed Stage 2 objectives, click here.
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CHIME StateNet Workgroups Develop Guiding Principles for HIEs and RECs
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CHIME StateNet has released guiding principles that it has
developed as foundational operating guidelines for regional
extension centers (RECs) and health information exchanges
(HIEs).
The federal government is funding RECs and HIEs as part of
the push to help providers implement electronic health
records and then more easily share electronic data. Separate workgroups within CHIME StateNet developed the guiding principles for each because of the overriding belief that collaboration among all parties gives RECs and HIEs the best opportunity for success.
The Department of Health and Human Services has established 62 regional extension centers around the country, while funding has been provided for dozens for health information exchanges, which are seeking to enable providers to more easily exchange clinical information. Additionally, the Office of the National Coordinator for Health Information Technology (ONC) has approved 27 state health IT plans that detail statewide initiatives; plans for the remaining states are in various stages of approval.
Both sets of principles have been presented to the Office of the National Coordinator for Health IT, which has been receptive to the recommendations, said CHIME’s Sr. Director of Advocacy Sharon Canner. “ONC continues to seek out CIOs for their expertise in these areas,” she said.
In terms of HIEs, CHIME StateNet is offering guidance because the organization believes that consistency across states and regions is essential for effective exchange of health information. Healthcare CIOs play pivotal roles in enabling the collection and exchange of health information.
“Health information exchange has the potential to bring great benefits, but strong coordination will be required to ensure that limited funds are used optimally to create an environment that supports secure and efficient exchange of vital health information,” said Neal Ganguly, Vice President and CIO at CentraState Healthcare System, and chair of the workgroup that produced the HIE principles.
Some of CHIME StateNet’s recommendations for HIEs include:
- Adoption of best practice models with common themes across states--patient identification, provider directories, consent management, privacy provisions, data standards and other common services--with standardization where possible to minimize redundant activities and optimize use of public funds;
- Where possible, recognizing defined and exclusive geographic regions for health information exchange at the State level, and in the case of regions that cross State lines, by agreement between States.
- Coordinating Regional Extension Center activities with the approved State HIE plan to ensure that resources are used effectively, guarding against any conflicts as part of the evaluation of and sustainability of the plan.
- Establishing public/private awareness campaign to raise awareness of HIEs’ benefits for patients.
- Enabling an efficient workflow based on semantic interoperability to allow exchanged data to be normalized by the caregiver’s preferred application, easing adoption and effective use.
- Adopting a standard methodology for the patient identification process that would apply across all HIEs.
- Adopting a standard procedure for correcting errors with a suitable audit trail to address the challenges of both federated and centralized HIE models.
- Creating a statewide inventory of HIE environments to identify all potential stakeholders and to assure that sustainable funding is applied equitably and tax dollars efficiently utilized to encourage a well defined State HIE infrastructure.
- Ensuring that governance model(s) include representation for all participants.
In regards to RECs, the CHIME StateNet principles highlight the role that the extension centers can play in helping small providers and critical access hospitals implement electronic health records and participate in the exchange of health information.
As guiding principles for RECs, CHIME StateNet recommendations include:
- Working with established healthcare delivery organizations;
- Maximizing federal funding through collaboration among all parties;
- Harmonizing state law requirements to assure consistency across state boundaries;
- Leveraging local healthcare community expertise on EHR adoption;
- Working with organizations that have established patient identification methods to leverage lessons learned;
- Ensuring small physician practices and other target provider populations receive the necessary assistance for sustainable longer term business models;
- Providing guidance on best practice governance models to ensure all participants have representation.
“Many CHIME members have extensive EHR implementation experience, and regional extension centers can collaborate with these CIOs as they assist providers, critical access hospitals and rural hospitals with EHR implementation and utilization,” said Randy McCleese, Vice President of Information Systems and CIO at St. Claire Regional Medical Center, and head of the workgroup that developed the REC guidelines.
To view both sets of guiding principles, access the links below:
CHIME StateNet HIE Principles
CHIME StateNet REC Principles
About StateNet
To ensure CIOs can leverage State-level HITECH
implementation, CHIME established a state-by-state
network of coordinators for
purposes of gathering and
communicating relevant in-state health
IT developments. State CIO Coordinators, representing all 50
states and the District of Columbia, are engaged in identifying
key developments for input into this website and sharing best
practices within and across states in preparation for demonstrating
meaningful use of EHRs to improve health and healthcare. CIOs are
encouraged to join at http://www.ciostatenet.org/join.asp (CHIME membership not required).
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CHIME Education Programs |
Set Yourself Apart in Today’s Competitive Industry - Become a Certified Healthcare CIO
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Join the ranks of those CHIME members who have become Certified Healthcare CIOs (CHCIOs).
CHCIO status represents achievement of the highest standard of professional development for
healthcare CIOs and is the only credentialing program that distinguishes healthcare IT executives
from others in the industry.
“We believe CHCIO status is now the standard that organizations must use when determining who leads
healthcare IT projects and initiatives,” said Tim Stettheimer, PhD, chair of CHIME’s certification
committee and senior vice president and regional CIO at St. Vincent's Health System.
“The CHCIO designation is significant, because it’s the first and only industry credential for CIOs
that focuses on healthcare IT leadership,” said CHCIO Donna Roach, VP IT/CIO at Bronson Healthcare Group.
“Becoming a CHCIO enhances your occupational credibility, validates your expertise, and illustrates your
dedication to the healthcare CIO profession and your commitment to staying up to date in your own professional
development.”
CHIME members who have been in a CIO or equivalent position for at least three years, pass the 125-question
CHCIO examination, and collect 25 Continuing Education Units (CEUs) are eligible to become certified.
To better understand what is tested for on the CHCIO Examination, potential candidates are encouraged to
review the CHCIO Examination blueprint. Additional study materials include a description of the examination
content areas mapped to a specific set of knowledge and skills statements. CHIME members may purchase a study
guide with sample questions as well as recommended reading materials to help prepare for the exam.
Mark your calendar* for upcoming CHCIO Examination dates:
Tuesday, April 19, 2011
2:30 - 5:00 PM
University of Chicago Gleacher Center
Chicago, IL
Tuesday, October 25, 2011
2:30 - 5:00 PM
JW Marriott San Antonio Hill Country
San Antonio, TX
*Only CHIME members and CHIME Affiliate Program participants may register.
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Healthcare CIO Boot Camp: Time to Get Serious
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CHIME’s Healthcare CIO Boot Camp is not just an
educational workshop; it’s a life-long experience for those
serious about achieving excellence at the highest level
professionally.
The Spring offering of this intensive 2½ day education
program taught by a faculty of healthcare
CIO thought leaders, will be held April 16-19, 2011 at the
University of Chicago Gleacher Center in Chicago, Ill.
Combining presentations, small group discussions, case
studies, and interactive problem solving, participants learn the real-world skills necessary to become a successful healthcare CIO.
Only CHIME members and direct reports who are invited by their CHIME member CIO are eligible to attend. Click here to learn more about the Healthcare CIO Boot Camp.
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CHIME Members Join AHA for Special ICD-10 Broadcast
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Find out why ICD-10 implementation needs to be part of an organization’s overall EHR strategy during the American Hospital Association’s live conference, Wait at your Own Risk: Why ICD-10 Needs to Be Your Organization’s Top Priority.
Hear from CHIME members Adrienne Edens, System Vice President & CIO at St. Luke’s Health System and Albert Oriol, CIO at Rady Children's Hospital San Diego, who taking a lead role in their organization's transition to ICD-10. Joined by national ICD-10 expert Nelly Leon-Chisen, Director of Coding and Classification at the American Hospital Association, Edens and Oriol will share specific steps and strategies to help organizations prepare for a successful ICD-10 transition.
The AHA will host a live conference on the transition to ICD-10 on March 14, 2011 at 2 PM EST.
For more information, including registration, click here.
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AHIMA Annual ICD-10 Summit is April 11-12
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Join the American Health Information Management Association (AHIMA) for the annual ICD-10 Summit: Strategies and Tactics for Industry Success, which further explores the challenges and opportunities represented in the transition to the 5010 HIPAA transaction and ICD-10-CM/PCS coding systems.
Held in Baltimore, Md., April 11–12, the 2011 ICD-10 Summit will feature information, resources, and networking opportunities needed to effectively plan and manage the transition process and gain a strategic advantage.
Through the open discussion and participation of thought leaders from all segments of the healthcare industry, the AHIMA summit will provide direction related to the challenges and obstacles that exist in the provider community, the payer community, and the vendor community to strengthen the industry as a whole. Healthcare leaders can exchange information in an open atmosphere, and attendees will discover how a well-planned process helps them go beyond compliance, and on to strategic advantage.
CHIME is proud to support the AHIMA Annual ICD-10 Summit. Current CHIME members are eligible to receive a discount on registration – just one of the many benefits of being a CHIME member.
For details, including registration, click here or call (800) 335-5535.
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CHIME Member Exclusive Benefits – College LIVE |
Listen to archived session on Navigating EHR Certification
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Topic: Navigating the Challenges Related to Complete EHR Certification: Don’t let the
Gotchas Getcha!
Speakers: Russ Branzell, FCHIME, CHCIO / Poudre Valley Health System; Pam McNutt, FCHIME / Methodist Health System
As some providers are coming down the home stretch to seek Medicare stimulus funds in 2011, some interesting challenges have arisen. Many providers have found that Certification issues are complicating their plans. The Office of the National Coordinator (ONC) recently issued some further definition and affirmation of their previous position. CHIME’s Policy Steering Committee has been vocal in working with ONC and has many important insights to share.
Did You Know? - An eligible hospital or provider must possess a Certified EHR through:
- A Certified Complete EHR or
- A combination of Certified Modules or
- Self-certification of home grown or non-certified modules
- You must possess all the modules, even if not currently using them for “meaningful use”
- There are serious complications with mixing and matching systems since most major vendors have certified as a Complete EHR (note: modules do not inherit the certification of a Complete EHR)
Click here to listen to an archive of this special session.
About College LIVE
College LIVE is a compelling alternative to traditional,
classroom-style
education and provides a unique
forum for CHIME members to collaborate,
interact
and learn. The opportunity to join and participate in College LIVE
is one of the many benefits of becoming a CHIME member. Members are even
encouraged to submit proposals to host their own College LIVE sessions.
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October 8-11, 2013
CHIME13 Fall CIO Forum
Westin Kierland Resort
Scottsdale, Arizona |
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