The Health IT Policy Committee (HITPC) held six public hearings in 2010 related to the future definition of “meaningful use” of electronic health records (EHRs). The hearings included testimony from several dozen stakeholders. The HITPC also received dozens of public comments via this blog. All of this input helped to inform its many hours of public deliberations regarding the future vision of MU (e.g., stage 3) as well as the interim stepping stone of stage 2 MU that will set expectations for 2013 and 2014.
The HITPC has developed a preliminary set of recommendations [PDF - 187 KB] specifically designed to solicit additional public feedback. This request for comment [PDF - 13 KB] (RFC) solely represents the preliminary thinking of the HITPC. The goal of sending out this RFC early is threefold:
- Provide some signal to the industry of potential new EHR functionalities that the HITPC may recommend to help the industry get a head start on developing new functionalities.
- Extend the public discussion of future stage MU definitions through a more formal public comment process well in advance of its formal final stage 2 recommendations to be issued in the summer of 2011.
- Request input on specific questions.
Following analysis of the comments received through the 45-day public comment period, the HITPC intends to revisit these recommendations in its public meetings in the Spring of 2011. At that time, the HITPC will be able to review public comments in the context of the early feedback from providers on experience with stage 1 MU. In addition, the HITPC will consider additional input from its other workgroups working on quality measures, information exchange, and privacy and security.
The HITPC approached its task of developing proposed stage 2 objectives by first developing a longer-term vision for MU and then determining what an appropriate stage 2 stepping stone would be to reach that vision. For this reason, the matrix also includes possible stage 3 objectives; however, they are only included to provide context for the Stage 2 recommendations. Therefore, for the purpose of this RFC, the HITPC is primarily interested in comments on the proposed Stage 2 objectives at this time.
Tags: FACA, HIT Policy Committee
http://www.scribd.com/doc/36635575/The-Healthcare-Heart-Beaon The Health Care Heart Beacon http://sawconcepts.com/id9.html
Medical surges involve mass casualty alerting and triage techniques. Beacon transponder broadcast protocols such as Sea Gull from U.C. Berkeley University, Boston University’s Project Beacon, CodeBlue MoteTrak: Harvard University / Boston Medical CodeBlue system includes MoteTrack, a system for tracking the location of individual patient devices indoors and outdoors, using radio signal information. FLUX: A Forensic Time Machine for Wireless Networks: enables a typical monitoring infrastructure for forensic data collection, storage and analysis support the recording and retrieval of traffic signatures and environmental observations, considered to be a source of network evidence. Medical triage, alert, evacuation, alternate routing of assets will be adjusted by filters using business logic / mission threads to show multicast radius defined zones. Organizations, entities, platforms, mobile smart phone & sensor equipped devices via router/switch network data heartbeat messages updates will spontaneously integrate connecting adhoc medical task forces among disparate entities maneuvering the network supporting unified operations.
Bio surveillance would improve by improving the consistency of reporting of sensors that may report the same event at different time intervals creating the dilemma of which report from which sensor system is ground truth and which is “memorex”. Depicted alerts by intensity / duration / radius by multicast IP zones according to threshold levels coinciding with the DHS color scheme would improve communicating threat level to impacted areas and communities. As events and alerts are filtered by need to know basis on the battlefield, triage instructions and egress out of the area of non essential personnel while dispatching into the area appropriate first responders will be achieved. Medical surges involve mass casualty alerting and triage techniques and sometimes searching for needles in haystacks. Unique organizational identifiers / universal resource naming would ease this task
Health Information Exchange of Montana (HIEM): HIEM will demonstrate best of breed healthcare practice and lead standardization efforts in the area of data aggregation and data distributed by workflow enhancements and disease management functionality by reuse of their pilot targeted at filling present gaps in data, enhancement of clinical communications, alerts (reminders) to adhoc, distributed clinical teams propagating in a standard manner patient data updates. HEIM will lead standardization of workflow (Fig 2) enhancements to improve clinical workflow (the template system is essentially workflow over multicast) and fill gaps for
non-automated participants (secure messaging, forms and notes, alerts and reminders). HIEM will focus on standardizing Community-specific disease management tools for improving the quality of community health care delivery (dashboards and flow sheets) (Fig 1, 2 center) enhanced by using Universal Resource Naming URN and Organizational Identification ID. Data exchange with the State’s health exchange, HealthShare Montana will be the standardization hub community for the health care information technology community.
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I have been working with EMR’s in physician practices for over 10 years. The problem with meaningful use in phase 1 even is that the quality measures relate primarily to the PCP or internal medicine specialty. My experience is that most of the EMR implementation is in the specialty environment. The meaningful use criteria do not apply to surgical specialties.
As far as phase 2 is concerned the criteria are focused on the primary care environment yet the specialist will be penalized if he/she does not comply. Also without addressing tort reform patient management tools can lead to exposure to the EP for something that may beyond his/her ability to monitor.
The interfaces necessary to exchange clinical data are very costly and I don’t believe that there is enough time to develop and implement all that is necessary to implement phase 2.
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Simply writing as a health care consumer who is 80 years old, our seriously fragmented system could be improved, in my view, by common, congruent, electronic record-keeping IN WHICH PATIENTS ARE INCLUDED.
Telephone menues are obsolete for nearly all patient interactions with everyone in the health care system. Electronic connections would save everyone (doctors, offices, pharmacies, labs, etc., etc.) time and money.
DDB, dbit@nyc.rr.com
NY NY 10016
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Updated with a Grammatical correction and an additional comment:
Company: HL7 Medical Systems
Based upon my exploratories and other market research, I have found (as have other EMR and HIE sales organizations) that MDs having small practices recognize a multi-fold impediment to buying an EMR system.
1- financing
2- nebulous definition of “Meaningful Use” (unsure if ONC will rewrite the definition of “Meaningful Use”)
3- potential ONC actions that may make a certified EMR system unable to demonstrate “meaningful use” without appropriate costly program modifications. (Many MDs do not know that software can be tailored to their requirements and to accommodate any software changes needed to accommodate any revised definition of “Meaningful Use”.
The unsure climate in the attitudes of MDs makes EMR system implementation commitment highly questionable.
The MDs seem to believe that ONC can change “its mind” on the definition of “Meaningful Use” at any time and if such changes are EMR software dependant, the MD’s EMR investment would be lost as far as “Meaningful Use” rebates are concerned leaving them with substantial debt and later with penalties from Medicare if they didn’t make a 2nd purchase of a certified EMR software system that met meaningful use.
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