Risk Management Concerns Arising Out of HITECH and the Hospital Re-admission Penalties Program

Guest post by James Hofert, Roy Bossen, Linnea Schramm and Michael Dowell, all partners with Hinshaw & Culbertson.

James Hofert
James Hofert

New federal healthcare legislation and implementing regulations, seek to exert control over multiple aspects of patient care. The Health Information Technology for Economic and Clinical Health Act (“HITECH”)[i] with staged implementation through 2016, seeks to not only promote implementation of electronic health record systems (“EHR”), but also regulate electronic communications of health information by and between the patient, physician, hospitals and other healthcare institutions so as to enhance care quality, care coordination and reduce costs.

HITECH further envisions implementation of clinical decision support algorithms for the diagnosis and treatment of disease both during admission and after discharge. The Hospital Readmission Reduction Program[ii], effective October 1, 2012, consistent with the objectives of HITECH seeks to financially penalize hospitals for higher than standardized readmission rates for heart failure, acute MI and pneumonia. The Center of Medicine and Medicaid Service (“CMS”) intends to expand application of the program to readmission for COPD, elective total hip arthroplasty and elective total knee arthroplasty in 2015[iii].  Consistent with preventative care goals so as to mitigate further health care problems as found in HITECH, CMS has refused to adjust the re-admission penalty program to account for readmissions unrelated to the patient’s initial hospitalization even though the readmission could be considered to be outside the hospital’s or physician’s control[iv].

Continue Reading

Are EHRs Dead?: Jim Gerrity, Ciena Responds

Jim Gerrity

Are EHRs dead? Well, Healthcare IT News’ Eric Wicklund recently reported that EHR vendors “will have to find a way to modify their products to focus on data that the patient and his or her care team want, or they’ll become obsolete.” Will EHRs become so obsolete so soon after the height of their heyday? When further explained, some of the reasoning makes sense.

According to panelists at the Partners HealthCare’s 10th Annual Connected Health Symposium, we’re in the time of “para-EHR,” defined as all of the phone calls, texts, e-mails and other doctor-doctor and doctor-patient communications that are not entered into the EHR. They could include everything from Skype chats between doctors to Post-It notes to data residing on mobile devices and sensors.

As such, complete records are not being entered into the EHR, and most patient communication takes place outside the EHR setting. But, are EHR’s dead and flat line or do they have some life left in them? I posted the question to Jim Gerrity, director at Ciena.

Are EHRs dead? “The short answer is ‘no,’ however, what is contained in today’s EHR will most likely evolve.  Let me expand on this a bit: Paper-based records are still the most widely used method in the healthcare industry, but that’s changing rapidly. EHRs are proving to significantly improve clinical efficiency and coordination and being adopted increasingly by healthcare institutions around the world. A relatively recent example in the U.S. was their great usefulness to provide continued care during and immediately after Superstorm Sandy … e-records backed up and accessible at disaster recovery sites. As one writer put it, EHRs are ‘ushering in a new era in how medical data is stored and shared.’ But is this transition to EHRs required?

Continue Reading

Crowdsourcing Medical Decisions: Putting Big Data to Work in Healthcare

Crowdsourcing Medical Decisions: Putting Big Data to Work in Healthcare
Cramer

Health Information Technology for Economic and Clinical Health Act

Guest post by Richard Cramer is Informatica‘s Chief Healthcare Strategist. 

The widespread adoption of electronic health records has been a key objective of the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009. With the pervasive use of these electronic health records, an enormous volume of clinical data is now becoming readily accessible that has previously been locked away in paper charts.

The potential value of this data to yield insights into what works in healthcare, and what doesn’t work, dwarfs the benefits of simply replacing a paper chart with an electronic system. There’s appropriate enthusiasm that this data is going to be a veritable goldmine for enterprise data warehousing, business intelligence, and comparative effectiveness research. However, there are other, equally valuable, uses for this data to enhance clinical decision-making and improve the value of healthcare spending. Simply having instant access to large volumes of data that span thousands or tens-of-thousands of physicians, hundreds-of-thousands of patients and millions of encounters, offers an unparalleled opportunity to increase the quality and lower the cost of healthcare.

Continue Reading