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Critical Access and Small Hospitals |
| Critical Access and rural hospitals in Minnesota and North Dakota can now receive subsidized assistance to work on adoption and meaningful use of health information technology (HIT). |
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In mid-September, the Regional Extension Assistance Center for HIT (REACH)
received approval for supplemental funding from the Office of National
Coordinator for HIT (ONC) to expand services to support Critical Access and
rural hospitals. The grant allows REACH to earn up to $1.49 million to provide
technical assistance to these hospitals. The amount of federal funding that
REACH receives depends on the number of clients who sign up for help and on
whether those clients achieve meaningful use of HIT.
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| The subsidies are greatest if hospitals sign up before December and agree to begin attestation of meaningful use by October 2011. Doing so would qualify hospitals for Medicare and Medicaid incentive dollars within the first year of the program. |
| Twenty-nine Minnesota and 15 North Dakota hospitals already have registered for assistance. Other eligible hospitals can register online. |
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Meaningful Use Assessment |
For as low as $1,000 through November 30
An assessment is available for clinics who already have an EHR to determine how ready they are to meet meaningful use with their current EHR system. Developed by REACH, the assessment consists of a survey, an interview, and dashboard to track their progress. An assessment will be available for hospitals (CAH and PPS <50 beds) in the near future. |
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The assessment notes strengths and uncovers areas of risk |
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Based on the assessment, REACH proposes a work plan to mitigate their risks |
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Verify you are on track with a meaningful use assessment from REACH. Your cost
could be as low as $1,000 per organization, regardless of how many providers or
how many clinics/sites are part of your organization.
This low rate ends November 30. |
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REACH's goal is to see that provider's reach their attestation period by
September 30, 2011. That way, they'll be able to receive the greatest subsidy
for REACH services and receive the maximum amount of Medicare/ Medicaid
incentives for meaningful use in the first year. |
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Be sure that your organization is ready—contact REACH at
info@khareach.org or 877-331-8783 ext. 222 for a meaningful use assessment.
Participate in the informational call on Wednesday, October 13 to learn more.
See details under Events on the left. |
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Practice Insights - Midgarden Family Clinic |
Slowing the process of EHR adoption to ensure success
Midgarden Family Clinic—a standalone, independent family practice in Park River,
North Dakota—was on the verge of selecting a new electronic health record system
when its office manager contacted REACH. Through conversations with REACH staff,
she realized that the clinic was moving too fast and had missed some of the many
details that would help ensure successful implementation of a new EHR.
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Midgarden Family Clinic staff: Mary Hurtt, Cynthia Udby, Paula Pengilly FNP, Dr.
Kristi Midgarden, MD, Karen Restad, and Joyce Iverson.
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The clinic has four full time and four part time employees. Working with REACH,
the Midgarden Family Clinic stepped back and spent more time defining its goals
and completing planning steps. The clinic developed a better understanding of
its clinical and operational needs as well as its organizational readiness.
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"We're a small family practice. We're not able to use all of the professional
components of an EHR on our own," said Cynthia Udby, office manager and the EHR
project manager. "REACH has been assisting our clinic with that and planning how
to meet our milestones."
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The details can seem limitless when evaluating clinic needs and the available
EHR options. REACH staff helped Midgarden Family Clinic understand the different
choices and the implications of these choices for their clinic. Details ranged
from understanding the various models for acquiring an EHR, such as C/S, ASP,
SaaS, and buying it all; the pros and cons of tablets versus desktop computers;
and understanding redundancy for data backups. |
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"REACH brought that experience to the table. They helped us think through the
whole plan, rather than just skimming the top," said Udby. "Without REACH
assistance we would not be able to meet meaningful use by 2015." |
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Read full story > |
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Meaningful Use Supports Quality of Life |
Julie Jacobs, MS, RN, REACH HIT Field Consultant
While much of the discussion of meaningful use criteria is around safety,
efficiency and effectiveness of health care delivery—the real issue is quality.
Describing what quality in health care actually looks like may best be
accomplished through the lens of patient experience. |
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A number of factors contribute to a diagnosis or medical condition— lifestyle
choices, heredity and environmental factors to name a few. Key to understanding
health outcomes is the matter of control. What factors can we, as patients,
readily control to impact the outcome of treatment decisions made when seeking
medical intervention for a condition that will affect our quality of life? |
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Lifestyle choices—what I eat, how I interpret my circumstances, what I do with
my time—are the only health factors that most of us can have any measurable
control over. Meaningful use criteria are written specifically around the notion
of leveraging what we can control to improve health outcomes. |
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Can a person with diabetes have better outcomes and live a better quality of life and have fewer complications from their disease, if they know and understand the impact of their lifestyle choices on their A1C results? |
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Can knowing the results of their A1C in a timely fashion impact their future behaviors? |
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According to the clinical quality measures contained in the meaningful use
criteria, the ONC and many health care professionals believe they can. |
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Meaningful use clinical quality measures are designed specifically to support
the goal of improved health outcomes by providing timely, accurate information
to those most likely to affect treatment decisions, especially patients
themselves. History, diagnoses, lab and treatment information is entered into a
database (the EHR) in a discreet format, a format that is able to be aggregated
and reported, and placed in the hands of people who need it most—those at the
point of care. By doing this in a consistent, efficient and effective manner,
the ONC is hoping to begin to move Americans along a continuum of better health. |
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The science shows that there is a direct relationship between controllable
lifestyle factors and improved health outcomes. Meaningful use quality criteria
are designed to capture these relationships in a way that can be communicated to
the entire health care team, starting with the patient. When we as patients
begin to connect the dots between our behaviors and the condition of our health,
we will all have an improved quality of life. After all, isn't that what we
really want?
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Preparing for Meaningful Use—
Requires More than the Technology
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Dr. Paul Kleeberg, REACH Clinical Director
Meaningful use is not just about the technology.
A vendor can provide you with meaningful technology, but just having a certified
EHR in place does not mean that you'll automatically achieve meaningful use nor
does it mean you'll get the most out of your EHR investment.
You also need to have your people on board and the proper processes/workflow in
place to achieve meaningful use. |
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Many of the criteria and quality measures will require a change in workflow in
order to achieve them. The more efficiently you are able to meet these measures,
the more value you will get out of your EHR. You don't need to wait until you
have an EHR in place to prepare for meaningful use. Here are some steps you can
take to prepare your staff and your workflow: |
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Demographic Requirement
The meaningful use criteria require that you collect information on race,
ethnicity, language and other data on all of the patients who walk through your
door during the measurement attestation period. Currently, many clinics and
hospitals do not ask patients for their race, ethnicity and language. Begin to
develop a process with your staff now so they will be comfortable asking
demographic questions when the EHR is installed.
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Quality Measures
Undoubtedly, you have begun collecting quality measures for other reporting
purposes. REACH recommends you look at the meaningful use quality measures and
identify which of them you would like to report on (clinics must have 3 core and
3 optional, hospitals must have all 15), and then begin the process of
establishing who can collect this information from the patient in order to make
sure that it appears in the chart.
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Populating the Face Sheet
The face sheets contain the patient's medications, the problem list, past
medical history, allergies, important contact information, surgeries and other
information. Having these sheets complete and on the paper chart will ease the
transition to the electronic chart. |
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Currently, there is a large gap between meaningful technology and meaningful
use. It takes planning and work to get the most out of your investment. REACH
can guide you to meaningful use of the technology. |
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At Your Service |
 Tina Kessel, REACH Regional Coordinator/HIT Consultant
Tina Kessel, RN, is a REACH Regional Coordinator/HIT Consultant. She provides support to ensure EHR technology is implemented effectively for REACH clients.Tina believes that implementing an electronic health record is about more than technology, it's about improving health care quality. |
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She says, "Providing quality patient care is important in health care. An EHR
supports physicians and mid-levels in providing high quality care by making all
of the patient's information and clinical decision support accessible to them at
the point of care. The role for REACH is to provide the tools that are needed to
optimize the use of the EHR to further enhance the quality and value of care
they give their patients." |
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With almost 20 years in health care delivery and technology adaptation, Tina
offers proven knowledge of and ability to implement EHR in a way that health
care providers can understand and use to their best advantage. As nurse
manager/EHR coordinator for Great Plains Clinic in Dickinson, ND, she trained
physicians and nursing staff to use EHR efficiently and effectively.
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REACH clients benefit from her ability to lead staff through EHR implementation
as well as develop and modify EHR templates and documents to improve clinic
efficiency. She also has established a method to effectively allow interface
among departments such as radiology, mammography, ultrasound and laboratory to
ensure interoperability. Strong communication and project management skills
allow Tina to lead health care providers through coordination and implementation
of EHR technology.
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Health Information Exchange |
Minnesota
The Minnesota Department of Health (MDH), Office of Health Information Technology is responsible for planning and implementing Minnesota e-Health Connect, to facilitate the development of the health information exchange (HIE) strategic and operational plan for Minnesota. The Minnesota plans are available on the MDH Web site. |
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On July 1, a law went into effect for new HIE certification requirements and
state agency oversight for businesses conducting HIE in Minnesota. The
legislation was based on the work of a Minnesota e-Health Advisory Committee
public workgroup and input from public comment. The law establishes the process
for granting Health Information Organization and Health Data Intermediary
certificates of authority, and an oversight mechanism to be established by the
Minnesota Commissioner of Health.
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For more information about MN HIE, contact
Jennifer Fritz, MDH Office of
Health Information Technology, 651-201-3662.
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North Dakota
The North Dakota Health Information Technology Advisory Committee (HITAC) with
assistance from a consultant, Hielix/MEDNET, developed the HIE strategic and
operational plan for North Dakota over the past six months and submitted it to
ONC on September 27. The
North Dakota plan is available on the HITAC Web site. |
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North Dakota HIE architecture broken down by phase (plan page 146).
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For more information about ND HIE, contact
Sheldon Wolf, ND health information technology director, 701-328-1991. |
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Medicaid Incentives |
Minnesota Medicaid HIT Update
Minnesota has appointed Bob Paulsen as Medicaid HIT Coordinator. He is
responsible for coordinating the state's efforts to complete the CMS required
State Medicaid HIT Plan (SMHP) and associated Implementation Advanced Planning
Document (IAPD). These documents will address the state's design and
implementation strategy for the administration of the Medicaid EHR incentive
program in Minnesota. Minnesota is moving forward with planning activities and
will be issuing updates in the near future. For more information, contact
Bob Paulsen, 651-431-5827.
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North Dakota Medicaid HIT Update
The North Dakota SMHP and IAPD drafts are almost complete and on schedule to be
submitted to CMS for comment. The state has completed preliminary estimates of
eligible providers and hospitals and has submitted dollar amounts for the state
budget to be prepared if and when eligible professionals and hospitals apply for
incentive payments. If you are a hospital or provider and think you may be
eligible for the incentive payment program, go to the
ND Medicaid HIT Website and
provide the information requested. |
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Vendor / Product News |
EHR Product Certification Has Started
Having a certified EHR and demonstrating its meaningful use are required for
health care providers to be eligible for federal incentive payments. To date, 34
EHR products have been certified by two of the the three organizations selected
as ONC-Authorized Testing and Certification Bodies. |
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Certification Commission for Health Information Technology (CCHIT), Drummond
Group, and InfoGard Laboratories are testing and certifying EHR technology for
compliance with the standards issued by the U.S. Department of Health and Human
Services. |
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CCHIT announced Friday that it has certified
33 products to date, including 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 for
meaningful use. The Drummond Group has certified one product. |
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Standards and Certification Criteria for Electronic Health Records > |
REACH Preferred Vendor Program
REACH is developing a cohort of "preferred" vendors from the 34 EHR vendors that responded to the initial request for information. Preferred vendors will comply with technical and regulatory standards and offer discounts to REACH clients. REACH intends to maintain healthy competition between participating vendors, while establishing ground rules and standards that will make the vendor selection process more efficient and effective for providers. The aims of the preferred vendor program are to: |
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Reduce provider resources devoted to RFP development |
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Reduce vendor time devoted to RFP processing |
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Generally, have more-accurate information which REACH clients can use to make
appropriate vendor selection decisions |
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Increase provider confidence in the accuracy and relevancy of RFP responses. |
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More >
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REACH is a project federally funded through the Office of the National
Coordinator, Department of Health and Human Services (grant number
EP-HIT-09-003). |