Health IT Law Blog : Health IT Law Blog : Post & Schell: Law Firm : HIT & Electronic Health Records

Government Health IT published a column by Steve Fox and yours truly on the critical role Regional Extension Centers (RECs) can and should play in distributing best practices regarding contracting for health IT systems, including EHRs.  Via Government Health IT:

RECs have the potential to serve as a valuable resource, especially for remote and underserved paper-based primary practices. However, RECs could be doing a disservice to physicians by failing to advise or provide them with essential EMR contract negotiation skills.

With HITECH Act incentives expiring in just a few years, healthcare providers will likely get only one chance to qualify for the full amount of the incentive payments. Thus, successful implementation and operation of an EMR system by the selected health IT vendor becomes critical to each healthcare organization trying to achieve “meaningful use” and take advantage of the incentive program.

In this environment, strong and effective contracts between healthcare providers and health IT vendors is especially significant, because such agreements can provide adequate protections, safeguards and other rights for the provider-customer, in the event a vendor defaults or otherwise fails to perform to the provider’s satisfaction.

You can read the full column by clicking here.

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The HITECH Act added over $27 billion to an industry whose publicly trading companies' market cap is below that, around $25 billion.  Such dramatic expansion of the industry will likely lead to significant consolidation among HIT vendors. We have already seen a merger between Eclypsis and Allscripts this summer (which became final last month); and now Cerner, another leading HIT vendor, entered into a partnership with MedAssets, Inc., a company that has specialized Internet-based financial improvement systems.  Via the Journal:

As that funding makes its way to health-care IT companies, it's likely to necessitate a lot more consolidation in an industry that's currently very fragmented. For instance, hospitals are not only looking to reduce the
number of different IT systems they use in-house, they also want more seamless ways of connecting to doctors' offices and insurers.

"We're at the beginning of the single fastest transformation of any industry in U.S. history," said Glen Tullman, chief executive of the health-care IT company Allscripts Healthcare Solutions Inc. (MDRX). <...> Tullman said he expects a lot more deals to come in the industry. He said that some of that consolidation will likely take place among the companies that provide IT systems to hospitals, a list that
includes Allscripts, privately held Epic Systems Corp., General Electric Co. (GE), Cerner, Germany-based Siemens AG (SI), McKesson Corp. (MCK) and privately held Medical Information Technology Inc., commonly known as Meditech. Tullman declined to comment on what companies he expects to make deals.

You can read more at the Wall Street Journal web site here. 

"Health-Care IT Sector Shaking Up As Medical World Goes Digital," Wall Street Journal (October 15, 2010).

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According to a new study by the Center for Studying Health System Change, less than 7% of U.S. physicians communicate with their patients via e-mail. According to the Wall Street Journal, most physicians did not have access to electronic health records or other health information technology allowing secure communication with patients online. Yet even among those physicians with access to such technology, only 19.5% reported communicating with patients via email regularly.

Via the Journal:

This survey didn’t ask non-emailing physicians why they weren’t trading LOLs and emoticons with their patients, but the CSHSC brief has a host of previously cited reasons: “lack of reimbursement, the potential for increased workload, maintaining data privacy and security, avoiding increased medical liability and the uncertain impact on care quality.” (Given that list, it’s hard to figure out why any physician would choose to email patients.)

Doctors working in practices the have already converted to electronic medical records were more likely to communicate with patients via email. So were physicians in HMOs or academic centers, compared to those in solo or two-doctor practices.

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The Chesapeake Regional Information System for our Patients (CRISP) went live this month connecting three hospitals, three radiology centers and two private companies in Montgomery County, Maryland during the initial stage of this health data exchange.  According to The Washington Post, all 48 hospitals in Maryland plan to join CRISP by 2012. The exchange will allow hospitals, physician practices, hospitals, clinics, labs, radiology centers, and other health care institutions to share information electronically.

Via the Post:

The Maryland Health Care Commission designated CRISP to oversee the state's effort to create a secure exchange for electronic health information within the state. More than 300 such exchanges are in development throughout the United States as part of a larger effort to develop national exchange standards and best practices. More than 20 organizations were involved in CRISP's development, including doctors, insurance companies, hospitals and consumer advocates, who helped structure the network in a way that will protect patient privacy in accordance with applicable law.

The funding for the network came from a patchwork of state and federal grants. In 2009, Maryland allocated $10 million from a fund that insurance companies pay into to reimburse hospitals for the network's start-up costs. The state health-care commission received an additional $9.3 million in federal stimulus money that covered the cost of the exchange's rollout. In April, a division of the U.S. Department of Health and Human Services that promotes the adoption of information technology gave CRISP $5.5 million to help 1,000 primary care physicians use electronic health records more effectively.

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Post & Schell, in collaboration with Kroll Fraud Solutions, presented a free webinar examining the crucial changes and updates to the HIPAA Privacy and Security Rules included in the Notice of Proposed Rulemaking (NPRM) issued by the Office of Civil Rights of the U.S. Department of Health and Human Services on July 8, 2010. Post & Schell's Steve Fox and Vadim Schick highlighted the key provisions in the NPRM, including:

• New restrictions on use and disclosure of protected health information (PHI) for marketing, fundraising, and other commercial purposes
• Providing patients with e-copies of their PHI
• Extension of HIPAA Privacy and Security Rules to business associates
• Effect of new rules on business associate agreements

In addition, our guest presenter for this webinar, Alex Ricardo, CIPP of Kroll Fraud Solutions, discussed the practical implications of this new set of regulations on covered entities and business associates, including:

• Assessing an organization's policies, procedures and practices for compliance with the HIPAA Rules and these updates
• Reviewing current contractual agreements and relationships with business associates and their subcontractors
• Training staff of the organization
• Breach preparedness and breach response

You can view or download the slides from this presentation by clicking here.

For more information, contact Vadim Schick at vschick@postschell.com or 202-661-6945.

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On October 1, 2010, CCHIT announced certifications of 19 "complete" EHR products, including, for example, Epic products for both hospitals and eligible professionals, and Allscripts and GE Centricity products for eligible professionals.  

CCHIT also certified 14 "module" EHR products, from vendors which applied for certification of their products as complete EHRs "but testing could not be completed on a small number of criteria (such as electronic prescribing) because planned updates to the test procedures by NIST were not available at the time of testing." Such "EHR Module" certified products may seek certification as a complete EHRs in the near future.  Via Healthcare IT News:

The Certification Commission for Health Information Technology announced Oct. 1 that it has tested and certified 33 Electronic Health Record products under the ONC-ATCB program.

CCHIT is one of three Approved Testing and Certification Bodies, designated by the Office of the National Coordinator (ONC). The other two are the Drummond Group and InfoGard Laboratories, Inc.

The ATCBs certify that the EHRs are capable of meeting the 2011/2012 criteria supporting Stage 1 meaningful use. Certification is required to qualify eligible providers and hospitals for funding under the American Recovery and Reinvestment Act (ARRA).

The CCHIT certifications include 19 Complete EHRs, which meet all of the 2011/2012 criteria for either eligible provider or hospital technology, and 14 EHR Modules, which meet one or more – but not all – of the criteria.

"CCHIT announces 33 certifications," Healthcare IT News (October 1, 2010).

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