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

The Office of National Coordinator for Health IT (ONC) published on its web site a white paper analyzing the policies behind obtaining consent for the purposes of electronic health information exchange.  The paper examined the concept of patient control of their health information, focusing on "the issues, nuanced considerations, and possible tradeoffs associated with the various consent options to help facilitate informed decision making."  While the paper was written by researchers at the George Washington University, under contract with ONC, ONC clearly stated in the preamble that this white paper does not actually represent the views of the ONC or HHS.

You can find the full paper (and the attachments) by clicking here.  You can view the executive summary by clicking here.

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The Office of National Coordinator for Health IT named 17 members of the newly formed privacy and security workgroup of the HIT Policy Committee.  According to Government Health IT:

The work group will be co-chaired by Deven McGraw, director of the Health Privacy Project at the Center for Democracy and Technology, and Rachel Block, executive director of the New York eHealth Collaborative and deputy commissioner for health IT transformation at the New York State Department of Health.

Their team will advise the Policy Committee on such matters as how safeguards for the exchange of health information should fit into the “meaningful use” test for health IT incentives that ONC has been working on.

The ONC has previously announced the establishment of a separate workgroup devoted to creation of a national health information network, which, of course, will have to deal with its own set of privacy and security concerns.  There is also a privacy and security workgroup under the HIT Standards Committee.

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Via Healthcare-Informatics:

By 2011, at least 10 percent of all orders processed in a hospital must be entered through CPOE to qualify that institution for CMS incentives under the HITECH Act, according to a proposed matrix of meaningful use released today by ONC’s HIT Policy Committee.

Other 2011 hospital requirement are:

• implementation of drug-drug, drug-allergy, and drug-formulary checks
• maintenance of up-to-date problem lists of current and active diagnoses based on ICD-9 or SNOMED
• incorporation of lab-test results into EHR as structured data
• reporting of hospital quality measures to CMS
• implementation of one clinical decision rule related to a high-priority hospital condition
• providing of patients with an e-copy of their health information
• capability to exchange key clinical information (eg. discharge summary, procedures, problem lists, medication lists, allergies, test results) among providers of care

In another major development, the committee recommended that incentives be paid according to an ‘adoption year’ timeframe rather than a calendar year timeframe. “Under this scenario, qualifying for the first-year incentive payment would be assessed using the 2011 Measures. The payment rate and phaseout of payments would follow the calendar dates in the statute, but qualifying for incentives would use the ‘adoption-year’ approach,” the committee stated.

Here is the link to the matrix.

Stay tuned for more on meaningful use definition.

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On June 16, 2009, the Workgroup on Meaningful Use presented its findings to the HIT Policy Committee.  The findings include two parts:  the preamble and the matrix.   The matrix consists of goals to be achieved by 2011, 2013, and 2015, and the metrics for such goals to evaluate hospital and clinician progress in meeting them.

We will have much more analysis on this preliminary definition later, so stay tuned for our updates.  Meanwhile, our favorite "geek doctor" John Halamka stated the following on his blog:

Now that the initial definition of meaningful use is available, the HIT Standards Committee workgroups and HITSP will work through the month of July to ensure the matrix is populated with the most up to date standards and implementation guide detail.

Hospitals and Clinician offices now know what is expected for 2011, so the time is now to begin your software implementations.

"Meaningful Use has Arrived", Life as a Healthcare CIO (June 16, 2009).

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Dr. David Blumenthal was named as National Coordinator for Health Information Technology at the Department of Health and Human Services (HHS).  Dr. Blumenthal will "lead the effort for implementation of a nationwide interoperable, privacy-protected health information technology infrastructure" authorized by ARRA and the HITECH Act. 

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