The KHIT Blog: "What happens when an eligible provider or eligible hospital doesn't pass the [Meaningful Use] audit?"

Thursday, April 25, 2013

"What happens when an eligible provider or eligible hospital doesn't pass the [Meaningful Use] audit?"

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Elizabeth Holland, director of the Health Information Technology Initiatives Group for the Office of E-Health Standards & Services.

"They have to return the money."
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ONC revokes firm's EHR certifications
By Joe Carlson, Modern HealthCare
Posted: April 25, 2013 - 3:15 pm ET

For the first time, the Office of the National Coordinator for Health Information Technology at HHS has revoked certifications for two electronic health-record systems, raising troubling questions about how physicians and hospitals should react if the government nixes a system they're already using.

Federal officials require that doctors and hospitals use certified EHR systems in order to receive federal money to defray the cost of converting to EHRs. But on Thursday, the ONC said it decided to revoke certifications for two products on the market after anonymous complaints were lodged about the systems.

EHRMagic, of Santa Fe Springs, Calif., had two of its records systems shot down by the government: EHRMagic-Ambulatory and EHRMagic-Inpatient. Two people familiar with the company interviewed for this story said they were not surprised by the development, since the firm didn't seem able to live up to its promises on the sales side of the operation several years ago.

Calls and e-mails to EHRMagic on Thursday were not returned. Records with the California secretary of state list the 4-year-old company's corporate status as “suspended.”

ONC spokesman Peter Ashkenaz said no healthcare provider has “attested” to using the system, which means that no one had tried to receive federal funding to pay for installation of an EHRMagic system. Since 2011, more than 234,000 organizations and individuals have received a total of $12.7 billion in EHR incentives to install one of the 1,700 systems eligible for payments.

But a blog post Thursday from Carol Bean, director of the certification office at the ONC, makes clear that the office will continue aggressive monitoring for other EHR systems that don't meet the federal requirements. That includes proactive investigations and surveillance by the office, as well as inquiries that stem from tips from the public about shoddy systems.

“We want to be clear,” the blog post says, “the office of certification's role doesn't stop after EHR certification. We are also going to monitor certified EHRs to determine whether they continue to meet our requirements. The doctors, hospitals and other providers that are adopting—and have already adopted—EHRs deserve this and should feel confident that the tools they are using are up to the job of helping their patients get the best care possible.”

Ashkenaz declined to say what a healthcare provider should do if the system it is using ends up retroactively decertified for payments, as EHRMagic's systems were.

Richard Gant, CEO of physician-supply seller Innovative Healthcare Systems in Royal Palm Beach, Fla., said the EHRMagic situation pointed to another major concern about decertification. EHRMagic sells what is known as a “cloud-based” system, meaning that patient information is stored off-site and not physically in a provider's office.

“The biggest issue is, all of your information is on their servers,” he said. “And if they disappear, that information could go away.”...

I'd like to see more of this type of action.

A quick look under the EHRmagic.com hood:

Lordy. "Untitled page" as your home page banner title? Groan... And, no metatags in your html header section? Even my blog has a breadth of metatags.

content='Robert Gladd, Robert E. Gladd, Bobby Gladd, BobbyG, bgladd.com, @BobbyGvegas, REC, LEC, HHS, ONC, ONC-ATCB, CMS, Medicare, Medicaid, AHRQ, NIST, Regional Extension Center, Meaningful Use, CEHRT, Virtual Extension Center, HITRC, ARRA, HITECH, HealthInsight, PQRI, PQRS, MCMP, CalHIPSO, EMR, EHR, PHR, HIE, NHIN, UHIN, HIPAA, CER, EBM, CDS, CPOE, CCR, CCD, CDA, HL7, SNOMED, LOINC, CPT, ICD-9, FFS, Fee For Service, capitation, bundled payments, P4P, Pay For Performance, Beacon Community, Beacon Communities, Electronic Health Records, Electronic Medical Records, Personal Health Records, Health Information Exchange, ASQ, Global Voice of Quality, HCD, ACO, Accountable Care Organization, PCMH, Patient Centered Medical Home, Clinical Quality Measures, workflow, Lean, Gemba, swimlanes diagram, Agile, ThedaCare, John Toussaint, Deming, TQM, Six Sigma, QC, QA, QI, CQI, PDSA, medical, healthcare, health care, David Blumenthal, Donald Berwick, David Kibbe, Brent James, Joe Flower, Jan Gurley, PPACA, ObamaCare, PCORI, CMMI, PCAST, Atul Gawande, Single Payer, Individual Mandate, eClinicalWorks, e-MDs, AthenaHealth, Greenway Medical, Amazing Charts, Allscripts, Alteer, GE Centricity, NextGen, SOAPware, VA, VistA, Medicity, Axolotl, informatics, Health 2.0, THCB, Matthew Holt, #healthit, #ONC, #healthcare, #medicine, #VDTnow, #health2con, #health20 name='keywords'/>

That's just SEO 101.
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More to come...

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Brave New Health

Commonwell Health Alliance

Another important read (pdf)

I love this kind of stuff. It sustains and humbles me. "As politicians, advertisers, salesmen, and propagandists for various political, economic, moral, religious, psychic, environmental, dietary, and artistic doctrinaire positions know only too well, fallible human minds are easily tricked, by clever verbiage... Common language—or at least, the English language—has an almost universal tendency to disguise epistemological statements by putting them into a grammatical form which suggests to the unwary an ontological statement. A major source of error in current probability theory arises from an unthinking failure to perceive this."

Quotes

"An economist is a person who sees something that works in practice and tries to figure out whether it will work in theory."

- J.D. Kleinke, medical economist
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"The only person who enjoys change is a baby with a wet diaper."

"Every misspent dollar in our health care system is part of somebody's paycheck.

- Brent James, M.D., M.Stat

“We could do healthcare, at markedly higher quality, for everyone in this country, without rationing or denying anybody the care that they need, without having the government dictate how doctors practice or whether hospitals could expand, at half the cost we do it now.”

- Health Care Futurist Joe Flower

Most of the sciences, unlike parts of medical science, are not concerned with the impossible. There is not complementary and alternative physics, or chemistry, or biochemistry, or engineering. These disciplines compare their ideas against reality, and, if the ideas are found wanting, abandoned."

- Mark A. Crislip, MD

"Q: How much alcohol is too much?
A: More than your doctor drinks."

- a physician I once heard speak during a CME presentation

“Just because science doesn’t know everything, doesn’t mean you get to fill in the gaps with whatever fairy tale most appeals to you.”

- Dara O’Briain

'[I]t is one small step from using the computer for "helping" doctors to monitoring them, judging them, dictating to them what to do, and withdrawing payment for computer non-compliance. The use of computer data is a multi-edged sword. It can be used for the "good," facilitating diagnosis and treatment and making it more accurate and up-to-date, and for “evil,” invading privacy, inviting security breechs, and making decisions based on the opinions of remote authorities rather than those present at the patient-doctor encounter.'

- Richard Reece, MD

“[T]here ARE statistics which are non-political. Just because The Washington Post/Fox News reports the temperature is 75 degrees doesn’t mean it’s really snowing and sunscreen is a liberal/conservative plot. Even if you earn a living being ideological.”

- Michael L. Millenson

"It is a generally a fairly convincing argument that people shouldn’t have to be subsidized to undertake a change which is in their best interest.

The reconciliation seems to be that EHR is not supposed to make a doctor’s practice more efficient and higher quality. It is supposed to make the system of care more efficient and higher quality, which is not the same thing. Those of you who took calc recall that maximizing the total of variables is not achieved by maximizing any one variable and this is a perfect example of that.

Those of you have served in combat certainly noticed that too — if everyone works as a team the unit takes fewer casualties. If you try to save your own hide, you might, but at the expense of more casualties overall."

- Al Lewis

"There are two ideas to keep in mind about Bayesian reasoning and how we tend to mess it up. The first is that base rates matter, even in the presence of evidence about the case at hand. This is often not intuitively obvious. The second is that intuitive impressions of the diagnosticity of evidence are often exaggerated."

- Daniel Kahneman, "Thinking, Fast and Slow"

"Physicians apply advanced scientific knowledge, but they must do so without the favorable conditions that experimental scientists create for themselves. Multitasking is forced on physicians, often in chaotic environments and under severe time and resource constraints."

- Lawrence and Lincoln Weed, "Medicine in Denial"

"It’s time to stop the whining about Obama care and acknowledge we already have universal health care. We just pay for it in the stupidest way possible that ensures problems are that much more disastrous and complicated when they’re finally treated."

- Mark Hoofnagle, MD, PhD

"Every act of conscious learning requires the willingness to suffer an injury to one's self-esteem. That is why young children, before they are aware of their own self-importance, learn so easily."

- Thomas Szasz, MD
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"Of course, one reason that process metrics* are so popular is that processes are much easier to define and measure than outcomes."

- The Skeptical Scalpel
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"There is an “illusion of validity” for any random data point, a seductive sense that is colored by what we hope will be true. Mountains of pharmaceutical claims are often made from mere molehills of data."

- Danielle Ofri, MD
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"Joy empowers people. It is a source of energy that enables people to hope and plan and change their lives for the better. Spend some time around someone who is relentlessly negative and how do you feel–drained, right? More and more research shows that joy is not something that just happens to you, like a bolt of lightening out of the blue. Joy is, instead, a habit to cultivate. Negative thinking and despair are the crabgrass of our souls–weeds that take root and spread, sometimes to all areas of life. Joy, in contrast, is a soul’s rose–hardy when cared for, able to put down roots over time and withstand disease and extremes. Like a rose, however, your joy can become blighted from neglect or harsh conditions. We all need to tend to our joy–to prune away the badness, and to know that, even though it may look like a prickly bare root, if you invest time in a joyous outlook, gorgeous things will bloom, even in the harshest conditions."

- Dr. Jan Gurley
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"'Solutions' exist only in mathematics."

- Karen Martin
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"The issue of how to regulate clinical software is, in the long run, indistinguishable from the issue of how to regulate medicine. The only difference is that medicine is practiced in the open, without secrecy, subject to peer review, and under a merit-based state license."

- Adrian Gropper, MD
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"Economist, rope, tree: some assembly required."

- Source unknown

DISCLAIMER:

I write this blog wholly on my own time and my own dime. The views proffered are expressly my own as a concerned and active citizen/taxpayer (in addition to being the result of my substantive experience in the various IT fields), and in no way reflect any policy views of my former employer, notwithstanding that some of the thinking has indeed obviously been spurred by the implications of the work with which I have been doing for them.

FAIR USE POLICY
I cite a ton of news and web sources spanning the breadth of relevant technical and policy domains, sometimes at substantial length. I believe I remain well within the bounds of "Fair Use," as [1] I am not doing any of this for profit, [2] I always provide attribution and links -- which, [3] far from negatively impacting any copyright holders' commercial interests, might actually increase traffic to and interest in their offerings.

Nonetheless, should I post anything of yours regarding which you have any objection, just let me know and I will remove it forthwith.

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Thursday, April 25, 2013

"What happens when an eligible provider or eligible hospital doesn't pass the [Meaningful Use] audit?"

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