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An amendment to the
inpatient prospective payment system proposed rule
to delay the implementation of Medicare
severity-adjusted DRGs for one year for fiscal year
2008 overwhelmingly passed the House 412-12 during
consideration of HR 3043, appropriations legislation
for the Departments of Labor, Health and Human
Services, Education and related agencies. The
amendment, offered by Representatives John Lewis
(D-GA), Jerry Weller (R-IL), and Peter Welch (D-VT),
would also stop the implementation of the 2.4
percent behavioral offset. For the provisions of
this amendment to take effect, they will have to be
included in the final package sent to President
Bush. The full Senate has not yet considered its
Labor, HHS, and Education (S. 1710) legislation and
is not expected to do so until after the August
recess. S. 1710 currently does not contain language
consistent with the Lewis/Weller/Welch amendment.
The House passed HR 3043 on July 19, 276-140.
To learn more about the bill, go to
http://thomas.loc.gov/.
The Healthcare
Information Technology Standards Panel (HITSP), a
multi stakeholder group facilitating the development
of interoperable healthcare data standards for the
United States, is seeking public comment on
documents that will form the basis of the panel's
next set of recommendations to the American Health
Information Community. The four documents now
undergoing review address consumer access to
clinical information, emergency responder electronic
health records, as well as overarching issues such
as quality, security, and privacy. Comments received
will be used to inform the HITSP technical
committees' ongoing process of standards selection.
The input will also assist in the development of
detailed guidance documents that will facilitate the
implementation of standards to support the secure
exchange of patient data across a nationwide health
information network.
Stakeholders are encouraged to review the four
public review documents, which can be found on the
HITSP Web site at
http://www.hitsp.org, and to submit comments
using the automated tracking system through
August 17. Industry experts interested in
participating in the work of the HITSP and one or
more of its technical committees may contact Jessica
Kant, standards harmonization coordinator,
Healthcare Information and Management Systems
Society, at:
jkant@himss.org
The National
Provider Identifier (NPI) Registry, a query-only
database, will be operational on August 1. The NPI
Registry will operate in a real-time environment.
This means that Freedom of Information Act (FOIA)-disclosable
data for newly enumerated providers, as well as
updates and changes to enumerated providers'
FOIA-disclosable data, will be available in the
registry as that information is applied to the
National Plan and Provider Enumeration System (NPPES).
The registry will enable a user to query by NPI or
provider name and will return a list of all NPPES
records that meet the query specifications. The user
selects from that list the NPPES records he or she
wants to see. It will then display the
FOIA-disclosable data for those records. About a
week later, the Centers for Medicare and Medicaid
Services will make available a file for download
that will contain the FOIA-disclosable NPPES data of
enumerated healthcare providers. Technical expertise
will be required to download that file and to import
that data into a relational database or to otherwise
manipulate the data. CMS will be furnishing more
information about data dissemination, including a
“Read Me” file, Header File, and Code Value document
for the downloadable file, and will make that
information available on the CMS NPI Website.
Last week, the
Certification Commission for Healthcare Information
Technology (CCHIT) announced that it will accept
applications from vendors seeking CCHIT
certification for their inpatient electronic health
record products starting August 1. The application
period will remain open until August 14.
CCHIT recommends that vendors prepare for
certification testing by reviewing materials on its
Web site at:
www.cchit.org
HR 3043, the
House-passed appropriations bill for the Departments
of Labor, Health and Human Services, Education and
Related Agencies, provides $61,302,000 for the
Office of the National Coordinator for Health
Information Technology (ONC). This is the same
amount that was made available in 2007. According to
the House report on HR 3043, this is $56,570,000
below the President's request. S. 1710, the Senate's
appropriations legislation, currently provides
$71,000,000 for ONC. The Senate will not consider S.
1710 until after the August recess. The House has
not yet provided full ONC funding because the House
Appropriations Committee has “concerns that this
office (ONC) has yet to develop a detailed and
integrated implementation plan for achieving the
health information technology program's strategic
goals, as recommended by the General Accounting
Office,” according to the appropriations bill.
A recent survey
conducted by Aetna revealed that 64 percent of
respondents did not know or were not sure what a
personal health record (PHR) is. Of the 36 percent
of consumers who indicated that they were familiar
with PHRs, only 11 percent said they use one to
track their medical and health history. Less than 10
percent of those familiar with PHRs said they would
use a PHR to access health data during a natural
disaster. When asked why they did not use a PHR:
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35 percent of
survey respondents said they had their own
system for maintaining health records
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26 percent said
they were concerned about security
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18 percent said
they did not know how to use or manage a PHR
To read more on this
study, go to:
www.aetna.com/news/2007/0717.htm
According to a
recent report in the July issue of the Journal
of the American College of Surgeons, electronic
health record (EHR) systems can create enough cost
reduction to pay for the cost of the system in less
than two years. The article, “A Pilot Study to
Document the Return on Investment for Implementing
an Ambulatory Electronic Health Record at an
Academic Center,” analyzes the return on investment
of EHRs at five ambulatory offices within the
University of Rochester Medical Center. The study
found that total annual savings were $393,662
($14,055 per provider). The total capital cost was
$484,577. The first year operating expenses were
$24,539. Total expenses for the first year were
$509,539 ($18,182 per provider). “Initial costs were
recaptured within 15 months, with ongoing annual
savings of $9,983 per provider,” according to the
study.
A recent survey from
the American Academy of Family Physicians (AAFP)
finds that the number of family physicians using
electronic health records (EHRs) has risen
consistently since AAFP began measuring members' EHR
use in 2003. Of the 459 respondents surveyed, half
said they had either fully implemented or were in
the process of implementing an EHR system in their
practice. By comparison, in 2005, about 30 percent
of survey respondents reported that they were using
EHRs in the practices, and only about 10 to 15
percent of AAFP members had adopted the technology
when AAFP initially conducted its survey in 2003.
According to the 2007 EHR survey, the physicians who
were most likely to have a fully implemented EHR
practiced in an urban area, had practiced for seven
or fewer years, did not own their practice, and
worked in a practice with at least two other
physicians. The survey also found that about a
quarter of those surveyed said they planned to
purchase an EHR in the future. However, 25 percent
indicated no plans to implement an EHR in their
practice.
According to a
report from PricewaterhouseCoopers' Health Research
Institute, there are more doctors and nurses today
than ever before, but they are not being trained,
distributed, or deployed efficiently. The report,
“What Works: Healing the Healthcare Staffing
Shortage,” finds that a majority of doctors and
nurses is nearing retirement just as the American
public will need them most, and healthcare
organizations are left with a diminishing pipeline
of primary care physicians, new competitions for
nurses, and a generation of young clinicians who
have different expectations about work-life balance
than their predecessors. It also finds that
technology is shifting what is done and by whom.
Radiologists are now doing work that cardiologists
used to do, and cardiologists are now replacing
surgeons in some procedures as more people choose
less invasive treatments such as stents instead of
coronary bypasses.
To read more, go to:
www.primenewswire.com/newsroom/news.html?d=122491
There are currently
two resolutions being considered by the AHIMA House
of Delegates. These resolutions are the “Proposed
Resolution on Diversity” and the “Proposed
Resolution on HIM Adoption of the Personal Health
Record.” The diversity resolution is intended to
advance AHIMA's commitment to a culture that
respects diversity throughout its organization, the
federation, and the HIM profession at large. To
achieve this end, this resolution calls upon AHIMA
and its affiliates to:
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Adopt
meaningful, actionable, and durable diversity
practices to expand the real opportunities
available to all HIM professionals, including
opportunities to fully participate in AHIMA
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Engage the AHIMA
community in advancing the goals of enhanced
professional opportunities for all and improved
value of the membership experience
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Respect the
individual sensibilities, personal beliefs,
differences, and privacy and other rights of all
HIM professionals and AHIMA members
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Monitor the
impact of these practices to improve and
strengthen them over time
The PHR resolution
charges HIM professionals with the responsibility of
creating and maintaining their own personal health
record. HIM professionals are ideally suited through
their education and professional capabilities to
inform consumers and healthcare providers about the
benefits of the PHR.
The complete text of
the resolutions can be found in the AHIMA Community
of Practice at
www.ahima.org under the Resources
section. Members can review the proposals and
provide their comments to their CSA delegate. For a
listing of your delegates, see the State Leaders and
HOD CoP.
11. Upcoming
e-HIM Workflow Analysis Workshop
Workflow is cited as
a critical need for implementing EHRs and other
information systems in healthcare for which adequate
resources are often not available. “Workflow
Analysis: Foundation for Transitioning to e-HIM®”
provides a day and a half of in-depth
analysis and practice of the techniques and tools
that will equip attendees from any healthcare
setting to improve workflow in their organizations
as they transition toward an electronic health
record. Process framing, present and future state
analysis, data modeling, and developing use cases
will be explored as useful techniques to respond to
the changes occurring in healthcare organizations
today. Upcoming workshops will be held:
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August 2–3,
Chicago, IL (in conjunction with AOE)
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October 5–6,
Philadelphia, PA (in conjunction with the AHIMA
Convention and Exhibit)
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November 7–8,
Chicago, IL
For information and
registration, visit
www.ahima.org/meetings
Please refer to source code MX503
when registering.
The Northwest
Medical Informatics Conference will be held
September 13–14 at the Davenport Hotel in Spokane,
WA. Hear from national experts on healthcare IT
about other RHIOs, what works and what doesn't for
EMRs, certification, and improving outcomes. Keep
updated about security issues, legislative
activities, and making value-based purchasing
decisions. National speakers include Newt Gingrich,
former speaker of the US House of Representatives;
Mark Leavitt, MD, PhD, chairman of the Certification
Commission for Healthcare Information Technology;
Mark Frisse, MD, director of Regional Informatics
Program, Vanderbilt Center for Better Health; J.
Marc Overhage, MD, PhD, Regenstrief Institute, Inc.,
and Linda Kloss, chief executive officer of AHIMA.
For more information, visit:
www.nmis.info
Have a question
about studying for the CCS exam? Join the Studying
for the CCS Community of Practice and its monthly
Chat with Peers, held the third Sunday of each month
at 3 p.m. ET, for lively discussion and help. The
next chat will be held August 19. You don't need to
reserve space or register, and you don't need
anything other than your computer with access to the
Communities of Practice. Just sign on to the
Studying for the CCS community a few minutes before
the start time. Other communities also have chats
scheduled periodically. Check the community's
calendar or watch for e-blasts for the next one.
To be sure that you
can join us, you should test the “Chat with Peers”
function before the actual start time. If you have
Windows XP, the Java client needed to run chat no
longer comes with the Microsoft Windows XP client.
If you encounter any problems accessing the chat and
have recently started using Windows XP, please visit
Sun Microsystems' Web site to download the necessary
software. The URL is available when you click on
Chat with Peers. Some AHIMA members may experience
problems connecting to a chat (a blank gray square
appears where the chat is supposed to be). This may
be related to the network in a work facility. Please
ask your IS department to open port 7777 and port
7877 so you will have access to the Chat with Peers.
If you are new to
Chat with Peers or the CoP, click on the help link
in the upper right corner of the Chat with Peers on
the Studying for the CCS community page or any
community page.
To access the CoP,
go to
www.ahima.org. Go to myAHIMA on the right
side and enter your AHIMA ID number
(seven-digit number on your membership card) and
your password. Once in myAHIMA,
you can click on the CoP logo to enter.
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