Hawaii Electronic Health Records

Social Security Administration Seeks Electronic Health Record (EHR) System

By admin on 28 September, 2009 in EMR, Medical Record Management

The Social Security Administration Seeks Services for the Development of an Electronic Health Record (EHR)

The Social Security Administration requires a contractor to provide the application software, associated licenses, training, hosting of data, technical support and consultation services for the development of an Electronic Health Record (EHR) in accordance with the attached solicitation. This requirement is 100% set-aside for small business. The applicable NAICS code is 541512 and the size standard is $25 million.

Contract Performance shall begin October 1, 2009. The Solicitation Number: SSA-RFQ-09-2171 can be found here.

There are currently a total of thirty Employee Health Centers (EHCs) nationwide; twenty-seven of these are staffed through an interagency agreement with Federal Occupational Health (FOH). Currently, all medical records, logs and statistics are kept on paper.

The new automated system will be released as a pilot version among the six EHU’s at SSA Headquarters. If the pilot version is successful the system may be implemented by SSA EHC’s nationwide. National implementation shall not begin until at least one year after contract award.

There are six Employee Health Units (EHUs) at Headquarters (Main Complex, Security West, Meadows East, Metro West, National Computer Center (NCC), and Woodlawn Office Complex). Each health unit provides preventative health care guidance/counseling to employees and medical care of ill or injured employees, contractors and visitors.

Some of the more interesting requirements include (please send a reply or comment if you know what “lactation support” is):

System shall have the ability to attach any SSA form requested by the OMD, as a pop-up that automatically populates applicable fields, and can be completed and printed or e-mailed.

System shall have the ability to create custom templates that meet our exact criteria, ability to modify templates at any time, free text boxes available on all fields as desired by SSA OMD.

No two users shall be able to access the same chart concurrently.

Electronic signature pads shall be provided, functional, and installed for each workstation by the contractor.

System shall have the ability to share information electronically, in bidirectional mode, with private physician offices in a secure, HIPPA (sic) compliant manner.
The posting is dated September 14. The closing time and date for receipt of offers is 4:00 P.M. EST on September 18, 2009. Contract Performance shall begin October 1, 2009.

Data Requirements – The EHR shall capture the following data elements for each employee. This list may be expanded or changed by the OMD at any time and the contractor shall accommodate these changes within a predetermined and reasonable amount of time. Each element shall be marked as:

P – Pre-filled; M – Mandatory; O – Optional; G – Systems generated; or S – Sensitive

(a) Employee Data Elements

Last Name M
First Name M
Middle Initial O
Full SSN (only the last 4 will be displayed) M
Date of Birth M
Building M
Work Location M
Employee Status M
- Employee
- Contractor
- Visitor

(b) Nurse Data Elements

First Name M
Last Name M
Middle Initial O
Health Unit M

Date of Visit M S P (System Generated)
Time-In M S
Time-Out M
Health Unit (drop down menu) M
Reason for Visit (more than 1 can be selected) M
- Allergy Program
- Assessment and Treatment of injury/illness
- Blood Pressure Check
- Flu-Program
- Follow-up
- Health Counseling
- International Travel
- Lactation Support
- Self-Care program
- Vaccinations
- Other (free text box)

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Twitter Weekly Updates for 2009-09-27

By admin on 27 September, 2009 in Uncategorized

Physician EHR Software Systems Implementation – http://bit.ly/aH20w #
Just added myself to the http://wefollow.com twitter directory under: #honolulu #healthcare #informationtechnology #healthit #ehr #govern #
Just added myself to the http://wefollow.com twitter directory under: EHR #
Furloughs Dates for Hawaii’s Public Schools http://bit.ly/CAhT5 via @AddToAny
Here's the new School Calendar #

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Hawaii Federal Stimulus Funding for Waimalu Project

By admin on 23 September, 2009 in EHR

CITY BEGINS WAIMALU SEWER OVERHAUL

(Monday, September 21, 2009) — Mayor Mufi Hannemann today announced the commencement of a $45-million project to rehabilitate and reconstruct the sewer system in Waimalu.

Mayor Hannemann said, “We’re fulfilling our promise to repair our sewer system and waste water treatment plants with these major capital investments. Projects like these are constructed with the money collected in sewer fees, and this one in particular is benefiting from federal stimulus funding. This is another example of the commitment we’re making to improve our infrastructure, while also generating jobs for the construction industry.”

Most of the sewer lines were constructed in the mid- to late- 1950s. They are in poor condition because of ground settlement.

The project will involve the replacement of 5,820 linear feet of defective sewer lines by conventional open-cut trench methods. It also includes the installation of 630 linear feet of new sewer lines, including a line crossing underneath Kamehameha Highway using a trenchless micro-tunneling method.

The construction will take place in the area mauka of the Waimalu Shopping Center. The streets affected include Hekaha Street, from Kamehameha Highway to Pahemo Street; Lokowai; Olepe Loop; Lii Ipo Street; and portions of Kanunu Street.

A sum of $7,438,075 was provided from the American Recovery and Reinvestment Act, through the U.S. Environmental Protection Agency and locally from the Hawaii Department of Health.

Preliminary work has begun. The project will take 27 months to complete.

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Physician EHR Software Systems Implementation

By admin on 15 September, 2009 in ARRA, EMR, HITECH

HITECH EHR Implementation for Physicians

In order to qualify for the HITECH software funds, you must implement an EHR system according to the ARRA funding schedule listed in the HITECH Act of 2009. Payments begin in 2011 and follow a schedule of payments based on

1. Year implemented

2. Usage (meaningful use) of an EHR

3. Selection of a qualified system

4. Furnishing Medicare Part B services

Table 1 (modified from their original). Medicare HIT Physician Incentives (by year)

	Amount (in thousands)	Amount (in thousands)	Amount (in thousands)	Amount (in thousands)	Amount (in thousands)	Amount (in thousands)	*Total*
2011	18k	12k	8k	4k	2k		44k
2012		18k	12k	8k	4k	2k	44k
2013			15k	12k	8k	4k	39k
2014				15k	12k	8k	35k

How do I collect the stimulus payment incentives?

By following the items above, with the following considerations.

1. You want to implement before 2013 in order to received the highest amount. As you can see by the table, the initial payment drops to $15,000 in that year.

2. “Meaningful Use” is still being discussed and undoubtedly continue to be discussed indefinitely. The National Committee on Vital and Health Statistics (NCVHS) held a public meeting on April 28-29, 2009 to help define and clarify the term “meaningful use” with respect to the American Recovery and Reinvestment Act (ARRA) of 2009 directives for “Medicare incentives for adoption and meaningful use of certified EHR technology.” The report can be found here. Testifiers described the need to set realistic goals to capture, retrieve, and report data for quality measurement and informed clinical decision making. They recommended starting with a small number of key measures (numbers cited by testifiers ranged from 2 or 3 to 20).

As part of the “Path to Meaningful Use,” testifiers observed that vendor development cycle times are typically about 18 months; and that pushing to add functionality faster to meet HITECH deadlines could introduce usability and safety risks.

3. Critical EHR functionality identified by testifiers included:
(1)
Registry functionality, i.e., the ability to track patients, is needed but lacking from many EHR products. As a result, support for case management and care coordination is not widely available in EHR technology. Note: “self-populating registry,” seemingly as a standalone system, and “registry functionality” were both referenced in testimony to describe such capability, often in reference to a phased approach to use of EHR technology.
(2)
Data mining is a critical function for quality reporting and improvement. However, testifiers observed that (a) quality measures are often established without defining source data requirements, and (b) while the technology exists, warehousing infrastructure does not exist to support such data mining. Testifiers also noted that it is very difficult to get data out of many systems; as a result, for example, hospitals have to abstract core measures data from electronic systems.
(3)
Decision support should provide information that leads to better care. It was observed that this will require a transition from basic to more advanced; such as initially providing best practices reminders (especially in medication management and for chronic care), then building to evidence-based decision support. Even basic functionality can overwhelm small practices. It was also observed that most clinical decision support requires professional judgment, and only a small minority of clinical decisions can be specified through firm guidelines. As a result, it is critical to focus on meaningful clinical decision support. Vendors have made products flexible as a result of customer demand. But as a result of such flexibility, decision support is sometimes turned off. As described in the vision of health and healthcare transformed, product functionality does not necessarily translate into direct implementation.

4. Payments are limited to “an amount equal to 75 percent of the Secretary’s estimate (based on claims submitted not later than 2 months after the 20 end of the payment year) of the allowed charges under this part for all such covered professional services furnished by the eligible professional during such year.”

Translation: Physicians would receive the incentives as part of their regular Medicare payments. See Table 1 for eligible amounts. These amounts would be capped at 75 percent of allowed Medicare charges. The Medicare payments will be calculated by multiplying the submitted allowable charges to Medicare by 75%, up to the capped amount for the year. So a physician aiming to collect the full incentive payment of $18,000 in 2011 will need to submit allowable charges of at least $24,000.

Beginning in 2015, physicians not demonstrating meaningful use will have their Medicare fee schedule reduced. Reductions will be:
• For 2015, down to 99 percent of the regular fee schedule
• For 2016, down to 98 percent
• For 2017 and each subsequent year, down to 97 percent

If the Secretary finds that less than 75% of eligible healthcare professionals are utilizing EHR beginning in 2018, the Secretary can further reduce the fee schedule to 96% and then 95% in subsequent years but not further.

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Twitter Weekly Updates for 2009-09-13

By admin on 13 September, 2009 in Uncategorized

Electronic Health Record Acronyms – http://bit.ly/3FaVA3 #

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Electronic Health Record Acronyms

By admin on 9 September, 2009 in ARRA, EHR, HITECH

What is an EHR? Electronic Health Records and Other Acronyms and Abbreviations

AHIC	American Health Information Community (AHIC)
AHIMA	American Health Information Management Association
AHLTA	Armed Forces Health Longitudinal Technology Application
AHRQ	Agency for Healthcare Research and Quality
ANSI	American National Standards Institute
ARRA	American Recovery and Reinvestment Act of 2009 or ARRA
ATI	Advanced Technology Institute
CalRHIO	The California Regional Health Information Organization
CCHIT	Certification Commission for Healthcare Information Technology
CDA	Clinical Document Architecture
CHC	Community Health Center
CHCs	Community Health Centers
CPOE	computerized provider order entry
CPT®	Current Procedural Terminology
DoD	Department of Defense
DVA	Department of Veterans Affairs
EHR	Electronic Health Record
EHRs	Electronic Health Record System
EMR	Electronic Medical Record
FERPA	Family Educational Rights and Privacy Act of 1974
HHS	United States Department of Health and Human Services
HIE	health information exchange
HIMSS	Health Information Management and Systems Society
HIPAA	Health Insurance Portability and Accountability Act of 1996
HISPC	Health Information Security and Privacy Collaboration
HIT	health information technology
HITECH	Health Information Technology for Economic and Clinical Health Act
HITSP	Health Information Technology Standards Panel
HL7	Health Level Seven
HRSA	Health Resources and Services Administration
IHE	Integrating the Healthcare Enterprise
IOM	Institute of Medicine
ITI-TF	IT Infrastructure Technical Framework
JPEHR	Joint Patient Electronic Health Record
LOINC®	Logical Observation Identifiers Names and Codes
MCMRA	Maryland Confidentiality of Medical Records Act
MEDCIN®	MEDCIN language
MeDHIX	Metro DC Health Information eXchange
MHCC	Maryland Health Care Commission
MMA	Medicare Prescription Drug Coverage Improvement and Modernization
MSDE	Maryland State Department of Education (MSDE)
NIH	National Institutes of Health
NHIN	Nationwide Health Information Network
ONC	Office of the National Coordinator for Health Information Technology
PHIN	Public Health Information Network
PHR	personal health records
PID	patient identification segment in HL7 message
RHIO	regional health information organization
SNOMED CT®	Systematized Nomenclature of Medicine–Clinical Terms
Task Force	Task Force to Study Electronic Health Records
UMLS	Unified Medical Language System
VHA	Department of Veterans Affairs
VistA	Veterans Health Information Systems and Technology Architecture
XHTML	Extensible HyperText Markup Language
XML	Extensible Markup Language

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State-By-State Distributions For Recovery Act Funds

By admin on 9 September, 2009 in ARRA, Health Information Technology

Recovery Funds Data and Investments by State

Do you want to know what Recovery Act funds are now at work in your state? Federal agencies are beginning to report their weekly state-by-state distributions of the money. By using the accompanying map, you’ll be able to track the funds coming into your state. The mouse roll-over displays three dollar amounts: what the federal agencies announced they were giving to your state; what the agencies currently have made available for projects; and the amount the agencies have paid out to your state.

The letters to State Medicaid Directors is at

http://www.cms.hhs.gov/SMDL/SMD/ItemDetail.asp?ItemID=CMS1228276

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