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Health Management Technology News
  February 24, 2014
In this issue:
 

► 'Meaningful Use' Stage 3 may increase patient interaction

► Next edition of electronic health record technology certification criteria issued

► ONC proposed 2015 Edition EHR Certification criterion links UDI

► Annual Health Information Management Systems Society conference (HIMSS14), Orange County Convention Center, February 24-27, 2014, Orlando, FL


'Meaningful Use' Stage 3 may increase patient interaction

Stage 3 of "meaningful use" incentives for electronic health  records (EHRs) could require providers to work more closely with patients if recommendations from an advisory committee hold firm.

The Meaningful Use Working Group placed more emphasis on care coordination, the use of decision support tools, patient engagement, and population management in its draft recommendations this month to the Health IT Policy Committee.

"There's a minimal amount of population management and patient engagement required in Stage 2, and they're ratcheting that up in Stage 3," Robin Raiford, senior research director with the Advisory Board Company's Health Care  IT Suite, told MedPage Today.

The Health IT Policy Committee will vote on approving the recommendations next month. The recommendations are just the thinking of the committee and could be changed by the Centers for Medicare  and Medicaid Services (CMS) before the Stage 3 meaningful use rules are finalized. That likely will come next year.

"Meaningful use" refers to provisions in the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act, which authorized incentive payments throughMedicare  and Medicaid to clinicians and hospitals that use electronic health records in a meaningful way that significantly improves clinical care.

Stage 1 involved mostly checking to ensure providers had certain functionality in their EHRs, and Stage 2 turned the notch up on that concept. But Raiford said Stage 3 makes providers focus more on working with their patients.

For example, the recommendations propose that providers make patient information available 24 hours after a visit rather than the typical 3 or 4 days.

"What that means is you have to chart in real time," Raiford said. "You can't see somebody on Monday and clear your charts off on Friday afternoon."

The Meaningful Use Work Group also recommended a number of changes to what would constitute a certified EHR product. While most of these changes would impact EHR vendors more directly, clinicians may be forced to fill in or deal with additional information that comes with a certified EHR.

For example, certified EHRs -- which must be used by providers to receive meaningful use bonuses -- must capture occupation, sexual orientation, and disability status under the recommendations, said Thom Kuhn of the American College of Physicians.

They must also provide the history of patients' medication refills -- as obtained from pharmacy benefit managers -- and access to Prescription Drug Monitoring Program data, which states use to track narcotic prescriptions  to deter abuse and drug trafficking.

CMS late last year announced it would delay the start of Stage 3 by 1 year -- until 2017. Of course, the recommendations could be all for naught as Congress is looking to overhaul the EHR incentive program in its efforts to reform the way Medicare  pays physicians.

Visit MedPageToday for the article ► 

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Next edition of electronic health record technology certification criteria issued

The HHS Office of the National Coordinator for Health Information Technology (ONC) issued proposals for the next edition (the “2015 Edition”) of electronic health record (EHR) technology certification criteria.

This proposed rule marks the first time ONC has proposed an edition of certification criteria separate from the Centers for Medicare & Medicaid Services’ “meaningful use” regulations. The proposals represent ONC’s new regulatory approach that includes more incremental and frequent rulemaking. This approach allows ONC to update certification criteria more often to reference improved standards, continually improve regulatory clarity, and solicit comments on potential proposals as a way to signal ONC’s interest in a particular topic area.

“The proposed 2015 Edition EHR certification criteria reflect ONC’s commitment to incrementally improving interoperability and efficiently responding to stakeholder feedback,” said Karen DeSalvo, M.D., M.P.H., national coordinator for health IT. “We will continue to focus on setting policy and adopting standards that make it possible for health care providers to safely and securely exchange electronic health information and for patients to become an integral part of their care team.”

Compliance with the 2015 Edition would be voluntary – EHR developers that have certified EHR technology to the 2014 Edition would not need to recertify to the 2015 Edition for customers to participate in the Medicare and Medicaid EHR Incentive Programs. Similarly, health care providers eligible to participate in the Medicare and Medicaid EHR Incentive Programs would not need to “upgrade” to EHR technology certified to 2015 Edition to have EHR technology that meets the Certified EHR Technology definition. “This provides the opportunity for developers and health care providers to move to the 2015 Edition on their own terms and at their own pace,” said Dr. DeSalvo.

The proposed rule will be published in the Federal Register on Feb. 26, 2014. ONC will accept comments on the proposed rule through April 28, 2014. The final rule is expected to be issued in summer 2014.

Visit HHS for the report ► 

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ONC proposed 2015 Edition EHR Certification criterion links UDI

The Office of the National Coordinator for Health Information Technology (ONC), Department of Health and Human Services, is proposing to adopt a new 2015 Edition certification(170.315(a)(20)  criterion that would require EHR technology to be able to record and display a unique device identifier (UDI) and other information about a patient’s implantable devices.

This proposed certification criterion represents a first step towards enabling EHR technology to facilitate the widespread capture and use of UDI data to prevent device-related medical errors, improve the ability of hospitals and clinicians to respond to device recalls and device-related patient safety information, and achieve other important patient safety and public health benefits consistent with the fundamental aims of the HITECH Act32 and the July 2, 2013 HHS Health Information Technology Patient Safety Action and Surveillance Plan.

It is believed that EHR technology will play a key role in the widespread adoption and utilization of UDIs and that its use of UDIs can help reduce device-related medical errors and provide other significant patient safety, healthcare quality, and public health benefits.

Specifically, EHR technology could be leveraged in conjunction with automated identification and data capture (AIDC) technology or other technologies to streamline the capture and exchange of UDIs and associated device data in clinical and administrative workflows. Moreover, patients’ UDI data in EHR technology could pave the way for new CDS and help healthcare providers more rapidly and accurately identify a patient’s devices and key information about the safe and effective use of such devices.

Further, EHR technology could facilitate better and more accurate reporting of adverse events and other information to reporting systems and registries and enable more effective corrective and preventative action in response to device recalls and alerts and other device-related information related to patient safety.

ONC recognizes that additional standards and technical specifications will be required to support the full range of capabilities contemplated above. Indeed, efforts to identify or develop these standards are already underway. Nevertheless, they believe that it is both feasible and important for EHR technology developers to begin implementing at least the baseline functionality necessary to capture, store, and retrieve UDIs and other contextually relevant information associated with a patient’s medical devices, specifically implantable devices.

By their nature, these devices cannot be inspected with the naked eye and are more susceptible to misidentification, which can result in patient harm. Moreover, once a device is implanted, it is separated from its UDI, which is attached only to the device’s labeling and not directly marked on the device itself. Under the FDA’s accelerated implementation timeline, UDIs will be available for all implantable devices no later than September 2015.

ONC proposes to adopt a 2015 Edition certification criterion focused on EHR technology’s ability to record UDI information about implantable devices. More specifically, EHR technology would have to enable a user to electronically record the UDI of an implantable device and other relevant information (such as a procedure note or additional information about the device) as part of a patient’s “implantable device list.”

EHR technology would also be required to allow a user to electronically access and view a patient’s list of UDIs and other relevant information associated with a patient’s implantable devices. In addition, the EHR technology would need to be able to parse the UDI in order to extract and allow a user to view the “device identifier” and “production identifier” portions of the UDI.

As previously indicated, ONC believes EHR technology should also facilitate the UDI’s exchange in order to increase the overall availability and reliability of information about patients’ implants and other devices. Thus, they propose to reference “the UDI(s) for a patient’s implantable device(s)” in the following proposed 2015 Edition EHR certification criteria which also propose the adoption of the newest version of the Consolidated CDA40.

Based on stakeholder input, ONC believes that the following EHR technology capabilities could help achieve their stated objectives:

• Record a minimum set of data elements for each UDI in a patient’s implantable device list, including: Labeler Name (Manufacturer); Brand Name; Version or Model; Global Medical Device Nomenclature Name; Single Use indicator; Labeled as containing natural rubber latex or dry natural rubber; and MRI Safety Status.

• Accept electronic UDI data via automatic identification and data capture (AIDC) or other assistive technologies used in healthcare systems (e.g., bar code scanners and radio frequency identification).

• Use the device identifier portion of the UDI to obtain and incorporate GUDID device identification attributes in the patient’s implantable device list.

• Use the device identifier or production identifier portions of the UDI to generate lists of patients with a particular implantable device.

• Make a UDI and its associated identification attributes accessible to the EHR technology for reporting purposes (e.g., adverse event reporting, registry population, recalls). Exchange a UDI and UDI data with procedure reporting systems (including adverse event incident reporting systems and medical specialty reporting systems) and other systems that associate a patient with a device.

• Expand these and other capabilities to additional types of devices used by patients.

Visit here for the Federal register preview (UDI specific pages 55-60) ► 

Visit FDA for information on the UDI regulation ► 

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Annual Health Information Management Systems Society conference (HIMSS14), Orange County Convention Center, February 24-27, 2014, Orlando, FL

Teletracking highlights “real-time” upgrades at HIMSS14

TeleTracking Technologies’ ability to operate hospitals in real time will be highlighted at HIMSS14 with several software/hardware upgrades, including the industry’s first low-cost, waterproof, miniature, single-use Real-Time Location System (RTLS) patient tag, powered by CenTrak.

The 2013 KLAS patient flow category leader will feature its RTLS enabled Orchestrate application for procedural areas, along with new releases of its Capacity Management Suite system and TransferCenter application.

The benefits of using patient and staff RTLS tags include the automation of The Joint Commission recommended patient flow standards, the improvement of patient safety and satisfaction, and the removal of lag times that occur when workflow reporting must rely on human input, such as phone calls to confirm patient discharge, a completed bed turnover or patient room occupancy. The new single-use patient tag powered by CenTrak.

RTLS integration with the new Orchestrate release will allow real-time patient movement through procedural areas to be factored into the overall process of automated capacity management, as well as improve operating room utilization and patient status communication to family members. The Orchestrate upgrade also adds 24 standard reports for acute-care procedural settings and 16 reports for ambulatory care settings. These will help measure patient wait time, turnaround time, actual vs. scheduled start time, staff utilization vs. scheduled procedure time, clinical discharge time vs. PACU departure time, and case delays by cause.

The release of Capacity Management Suite offers users an interface with the PatientTracking Portal view, as well as customizable patient attribute and Care Progression Indicators that can be used to track physical therapy responsiveness or readiness to move to a step-down unit.

The upgrade of the TransferCenter application offers additional business-trending intelligence that can help hospital executives determine the benefits of adding service lines or facility expansion. Tracking business lost through outbound transfers and analyzing market trends based on the type of case being transferred to other facilities is all part of this release. This helps hospital leaders determine courses of action that might better meet the needs of their service area. In addition to outbound transfers, the application captures more clinical case data, offers new user interface enhancements, additional notifications and other reporting capabilities.

To see a demonstration visit Teletracking at HIMSS14 booth #713. TeleTracking will conduct a session highlighting the integration of RTLS technology along with the single-use patient tag powered by CenTrak, on Monday, February 24, 2014 at 3:00 PM in CenTrak booth #5645.

Read more at, visit www.teletracking.com► 

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Versus unveils business intelligence software automated by RTLS, featured in Live Experience Center at HIMSS14

Versus Technology, Inc. is celebrating 25 years of successful workflow automation in healthcare and the debut of several advancements in its Real-time Locating System (RTLS). While providing real-time efficiency in the moment, Versus automatically collects accurate, unbiased data to drive meaningful process improvement. Version 5.0 of the company’s advanced reporting software, Reports Plus Analytics, will be unveiled at HIMSS14.

The upgrade features several new reports specifically focused on daily healthcare problems — workflow efficiency, capacity management, safety, and resource allocation. These reports, developed hand-in-hand with healthcare administrators and clinicians, offer unprecedented insight into facility workflows, trends and benchmark achievement.

The new reporting package can be seen at the Versus booth, #3673, where new options for non-invasive RTLS installation will also be on display, including a new, soon to be released Wi-Fi option. Versus’ multiple mix-and-match platforms allow facilities to quickly and easily add locations to their existing RTLS, or plan for future expansions.

The platforms all work with the same Versus badges and tags, including a new mini asset tag and soon to be released patient wrist badge. Each platform can drive workflow automation with same IR accuracy Versus is known for. That accuracy and automation will be on display at Versus’ new RTLS Experience Center, a live environment with active technology driving real-time demonstrations. Participants will learn how automated patient flow, hand hygiene monitoring, integrations and reporting analytics can improve healthcare efficiency and quality, ultimately increasing profitability.

Versus is also hosting several education sessions and a cocktail reception at their booth:

• Education Sessions — Versus clients and clinicians will present several 20-minute education sessions on Hand Hygiene, Patient Flow, Staff Safety & more. RSVP atversustech.com/himss14.

• Cocktail Reception — Hosted by Versus and Georgia-Pacific Professional, attendees can learn more about the SafeHaven Automated Hand Hygiene Monitoring System and enter to win one of five tablet computers. The SafeHaven system, combining Georgia-Pacific Professional smart dispensers and skin care products with Versus RTLS technology and Advantages Hand Hygiene Safety software, helps hospitals monitor, measure and manage hand hygiene participation.

For more information on the events above, and to RSVP for education sessions, visit versustech.com/himss14 ► 

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Anton/Bauer launches battery system for Point-of-Care devices at HiMSS14

Anton/Bauer, a Vitec Group brand and provider of mobile power systems for the healthcare industry, will debut its new Elora Battery System at HiMSS14. The system is designed to dramatically transform battery management for any point-of-care technology, regardless of AC or DC power requirements, including mobile workstations, vital signs monitors, and EKG monitors.

The Elora Battery System features five modular components that can be configured into 36 unique combinations to power any device used in any workflow. The System provides a flexible, scalable solution that can be customized to meet an end-user’s unique needs, budgetary requirements and performance expectations by utilizing its key modular components. The system’s features include:

High-capacity, 240 watt-hour (WH) Lithium-Ion battery. Weighing less than 4 pounds, this lightweight, impact resistant, ergonomic, and stylishly designed battery charges in approximately three hours, requires virtually no maintenance, and most importantly, provides 100 percent uptime.

The Elora Interface can be installed on any mobile workstation, patient monitoring system, or other point-of-care technology. The new battery system is completely scalable, and features a small form factor for easy battery installation and removal.  Ergonomically designed and easy to clean, the Elora interface provides a secure fit to ensure the battery stays connected.

The Elora Battery System features an LCD screen that displays remaining runtime using Anton/Bauer’s Battery Pain Scale.  As the battery is depleted, the icon will change from an easily identifiable “happy face” to a “sad face” when the battery system requires a charge. It also has an optional power supply, and a disinfecting charger cabinet. The innovative, disinfecting Elora charger is a wall mounted cabinet that can charge three Elora Batteries simultaneously, in approximately three hours. The Elora Battery System will be available to the marketplace in the Summer of 2014. Anton/Bauer will showcase the system at their exhibit Booth #641 or for more information, visit www.antonbauer.com

Patrick Ney, vice president, Medical Power Systems division, Anton/Bauer. will be delivering a presentation. “Understanding the Importance of Battery Systems, in the HiMSS14 Intelligent Hospital. Thepresentation will discuss the importance of choosing, using, and managing the right battery system to power point-of-care technology. The session is onTuesday, February 25, 2014, at 11:30 AM to 12:00 PM

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FDB MedsTracker medication reconciliation solution certifies on newest Surescript e-prescribing standard

First Databank (FDB), a leading provider of integrated drug knowledge, announced the company’s proprietary solution for effective medication reconciliation, FDB MedsTracker, has received certification from Surescripts for prescription routing in adherence with the NCPDP SCRIPT 10.6 standard required for Meaningful Use Stage 2 certification. FDB MedsTracker was previously certified on the Surescripts 4.2 routing standard and has been used for electronic prescribing in hospitals since 2010.

Certification testing was performed on FDB MedsTracker, version 6, which is the most advanced version designed to support the required elements specified in Meaningful Use, Stage 2 certification. Surescripts' Prescription Routing service allows prescribers to securely send a prescription electronically to the patient's preferred retail or mail-order pharmacy. In turn, pharmacies can use this service to send prescription renewal authorization requests directly to the prescriber.

FDB MedsTracker has demonstrated immediate and measurable improvements in the medication reconciliation process. Notable advances reported by customers include increased accuracy of home medication lists; efficiency of discharge medication orders and electronic prescribing; reductions in missed medications, duplicate therapies, and incorrect dosing; and workflow efficiencies with measurable time savings for clinicians.

Visit the FDB booth #1965

Read more here ► 

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From the battlefield to the medical field: Lockheed Martin adapts missile defense analytics for early sepsis detection

Using analytical technology developed to detect launched missiles, Lockheed Martin has discovered a way to identify sepsis, a potentially fatal blood condition, between 14 to 16 hours earlier than physicians currently do.

Lockheed Martin's analytic framework, called Sia, monitors changing signals from the body and provides alerts for anomaly detection. The same data analytic techniques used to diagnose sepsis may also be able to predict heart attacks, the onset of diabetes and blood clots. In addition to the health field, Sia can be applied to other disciplines in which continuously changing signals need to be processed quickly and accurately.

What separates Sia from current automated sepsis detection methods is its high rate of detection and low rate of false diagnosis. In an initial trial, 4,500 patients were tested for sepsis using Lockheed Martin's solution. It correctly alerted sepsis detection 90 percent of the time, while incorrectly labeling less than one percent of patients as potentially septic. This is a significant improvement from the Systemic Inflammatory Response Syndrome (SIRS) method for detecting sepsis. SIRS only detects sepsis in patients 69 percent of the time and will incorrectly flag 65 percent of uninfected patients, burdening hospital staff and resources.

Vist Lockheed in booth 702

Read more here ► 

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At HIMSS14, Siemens promotes population health, care coordination

Siemens is launching its population health and care management solution, CareXcell, which bridges clinical systems and venues to deliver automated, evidence-based care plans that help improve care coordination and allow providers to more proactively manage the health of patients and populations across an entire community.

The company is also demonstrating how its breadth of healthcare IT solutions, including Soarian Clinicals, Soarian Enterprise Revenue Cycle Management, MobileMD HIE, Healthcare Intelligence, Strategic Consulting, and Soarian Ambulatory can help organizations succeed in the changing healthcare landscape.

Designed to enable healthcare organizations to address the risks and challenges of value-based care, CareXcell helps providers manage the health needs of all patients in a community using real-time data and embedded clinical evidence to help improve outcomes and patient satisfaction by delivering high-quality care at reduced costs. CareXcell provides a collaborative framework to promote greater transparency and efficiencies in coordinating care across venues and between providers, patients, and patients’ families or support systems.

HIMSS 2014 attendees can also explore the MobileMD Health Information Exchange (HIE), Patient Portal, and HISP. These solutions help connect providers and patients to coordinate care within and beyond communities. The MobileMD platform offers an extensive array of existing third-party EMR and EHR interfaces, and is quickly deployed as a cloud-based solution.

The Siemens Healthcare Intelligence solution aggregates and standardizes data across an enterprise to monitor performance at all levels of an organization. Healthcare Intelligence gives organizational leaders rapid access to detailed analytics so they can better achieve the outcomes associated with value-based purchasing, bundled payments and accountable care.

Soarian Ambulatory extends Soarian Clinicals into the ambulatory care environment and manages the patient encounter workflow and facilitates between-visit care, health maintenance reminders, and patient-provider engagement. Also in the Soarian family, Soarian Enterprise Revenue Cycle Management is a HFMA MAP Keys-compliant solution that uses a proactive, rules-driven approach to help providers navigate complex regulatory and reimbursement requirements.

In addition, Strategic Consulting by Siemens helps healthcare organizations address important business issues. Siemens industry experts look across entire organizations to help providers maximize outcomes, improve processes, reduce costs, and meet the objectives of accountable care through a combination of IT tools, advisory, optimization and performance improvement services.

Visit Siemens in booth #3165

Read more here ► 

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Orion Health announces collaborative care solution to support  ACO's

Orion Health, a leading global, privately-held eHealth software organization, announced the launch of the Orion Health Collaborative Care for ACOs, a comprehensive care coordination solution aimed at supporting the efforts of provider and payer organizations in achieving their accountable care goals. The solution includes interoperability, longitudinal medical records, analytics and care coordination technologies.

Together, these technologies were built to allow organizations to better serve patient populations in an ACO environment, while also supporting their Meaningful Use goals. Orion Health Collaborative Care is currently being implemented in several major healthcare organizations, including: Saint Francis Care, Scottsdale Healthcare Partners, and Mary Washington Healthcare.

The main components of Collaborative Care include: interoperability for the organization to share and store data from the wide range of internal and external source systems, semantic normalization, EMPI, clinical portal, patient portal, healthcare pathways providing actionable shared care plans, and analytics technologies. Designed as an all-inclusive solution suite, it forms the information technology foundation of an ACO, by helping to acquire and aggregate normalized, patient-centric data, and allow access to that data by both clinicians and patients.

Collaborative Care also allows for easy user adoption with change management services that address the psychology side of the implementation and provides analytics; by producing actionable results which can be used by clinicians to guide patients to appropriate healthcare pathways.

Visit Orion in Booth #965

Read more here ► 

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Meet with Merge at HIMSS And Discover Advanced Interoperability

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   February  2014  HMT digital book

 
 
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