Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap Draft Version – Office of the National Coordinator for Health Information Technology (ONC) – January 2015

Posted on February 2, 2015. Filed under: Health Informatics | Tags: , |

Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap Draft Version – Office of the National Coordinator for Health Information Technology (ONC) – January 2015

“…describes ONC’s broad vision and framework for interoperability. The concept paper is an invitation to all health IT stakeholders to join ONC in developing a defined, shared roadmap that will allow the nation to collectively achieve health IT interoperability as a core foundational element of better care, at a lower and better health for all.”

2015 Interoperability Standards Advisory – Office of the National Coordinator for Health Information Technology (ONC) – January 2015

Infographic – Shared Nationwide Interoperability Roadmap: The Journey to Better Health and Care – Office of the National Coordinator for Health Information Technology (ONC) – January 2015

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Federal health IT strategic plan sets stage for better sharing through interoperability – The Office of the National Coordinator for Health Information Technology (ONC) [US] – 8 December 2014

Posted on December 10, 2014. Filed under: Health Informatics | Tags: , |

Federal health IT strategic plan sets stage for better sharing through interoperability – The Office of the National Coordinator for Health Information Technology (ONC) [US] – 8 December 2014

“ONC is accepting public comments on a draft version of the Federal Health IT Strategic Plan 2015-2020. The due date for public comments is 5 p.m. on February 6, 2015. This Plan represents a coordinated and focused effort among 35+ federal departments and agencies to advance the collection, sharing, and use of electronic health information to improve health care, individual and community health, and research.”

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Health IT Enabled Quality Improvement: A Vision to Achieve Better Health and Health Care – Office of the National Coordinator for Health Information Technology [US] – 13 November 2014

Posted on November 17, 2014. Filed under: Clin Governance / Risk Mgmt / Quality, Health Informatics | Tags: , |

Health IT Enabled Quality Improvement: A Vision to Achieve Better Health and Health Care – Office of the National Coordinator for Health Information Technology [US] – 13 November 2014

Media release: Health IT Enabled Quality Improvement: A Vision to Achieve Better Health and Health Care – 13 November 2014

“This paper describes ONC’s vision for advancing the use of health IT to support transformational improvement in health care quality and value. It invites health IT stakeholders – clinicians, consumers, hospitals, public health, technology developers, payers, researchers, policymakers and many others – to join ONC in shaping the future with a renewed focus on health and care quality as the “why” that aligns with the “what” of interoperable health information systems.”

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Connecting Health and Care for the Nation: A 10-Year Vision to Achieve an Interoperable Health IT Infrastructure – Office of the National Coordinator for Health Information Technology – 5 June 2014

Posted on June 6, 2014. Filed under: Health Informatics | Tags: , |

Connecting Health and Care for the Nation: A 10-Year Vision to Achieve an Interoperable Health IT Infrastructure – Office of the National Coordinator for Health Information Technology – 5 June 2014

Media release: A Call To Action for a Nationwide Interoperable Health IT Infrastructure

 

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FDASIA Health IT Report: Proposed Strategy and Recommendations for a Risk-Based Framework – April 2014

Posted on April 7, 2014. Filed under: Health Informatics | Tags: , |

 

FDASIA Health IT Report: Proposed Strategy and Recommendations for a Risk-Based Framework – April 2014

 

Proposed Strategy and Recommendations for a Risk-Based Framework

 

“Health information technology (HIT) presents tremendous benefits to the American public, including greater prevention of medical errors, improved efficiency and health care quality, reduced costs, and increased consumer engagement However, if HIT is not designed, developed, implemented, maintained, or used properly, it can pose risks to patients.

 

Federal law passed by U.S. Congress in 2012 requires that the Food and Drug Administration (FDA), in consultation with the Office of the National Coordinator for Health Information Technology (ONC) and the Federal Communications Commission (FCC) develop and post on their respective web sites “a report that contains a proposed strategy and recommendations on an appropriate, risk-based regulatory framework pertaining to health information technology, including mobile medical applications, that promotes innovation, protects patient safety, and avoids regulatory duplication.”  This report fulfills that requirement.

 

The FDA, ONC, and FCC seek public comment on whether the focus areas identified in the report are the appropriate ones, and whether the proposed next steps will lead to an environment where patient safety is protected, innovation is promoted, and regulatory duplication is avoided.

 

The three agencies sought and collected public comment in a collaborative and transparent manner, which is reflected in the draft framework. Much of the draft framework is based on recommendations from the public, industry, a 2011 Institute of Medicine report on HIT and Patient Safety, and input from the FDASIA Working Group.

 

There are some areas of health IT oversight that will benefit from continued engagement, including clinical decision support IT and electronic health records. For that reason, the FDA is opening a docket to accept comments on the report. A link will be provided as soon as it is available. In the coming weeks the FDA will announce dates for a 3-day public meeting to discuss the report.”

 

Media release: Proposed health IT strategy aims to promote innovation, protect patients, and avoid regulatory duplication

 

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Health Information Technology: An Updated Systematic Review with a Focus on Meaningful Use Functionalities – Office of the National Coordinator for Health Information Technology [US] – March 2014

Posted on March 5, 2014. Filed under: Health Informatics | Tags: , |

Health Information Technology: An Updated Systematic Review with a Focus on Meaningful Use Functionalities – Office of the National Coordinator for Health Information Technology [US] – March 2014

Structured Abstract

Objectives
The purpose of the project described in this report was to update previous systematic reviews focusing on the effects of health information technology (health IT) on key aspects of care, including health care quality, safety, and efficiency. This report provides our current understanding of the effects of health IT across a number of dimensions of care. Unlike reviews conducted prior to the introduction of the federal Meaningful Use Incentive Programs, this review focused specifically on identifying and summarizing the evidence relating to the use of health IT as outlined in the Meaningful Use regulations.

Data Sources
We performed a systematic search of the English-language literature indexed in MEDLINE from January 2010 to August 2013. We also searched the Cochrane Central Register of Controlled Trials, the Cochrane Database of Abstracts of Reviews of Effects, and the Periodical Abstracts

Database; and hand-searched personal libraries kept by content experts and project staff. We also asked content experts to identify evidence outside the peer-reviewed literature. Finally, a technical expert panel identified additional published articles and non-peer reviewed resources.

Review Methods
The systematic review was carried out in three stages by two health IT subject matter experts, with input from a panel of five nationally-known health IT experts. The reviewers used a webbased system to conduct the screening process. The first stage involved independent, dual-rater screening of articles based on their titles against a set of defined on the inclusion/exclusion criteria. The next stage involved screening each article at the abstract level using a standardized abstraction form. The final stage of the screening process involved a full text review and classification using a standardized abstraction form. Inclusion/exclusion or classification discrepancies between the two reviewers were resolved by consensus. We conducted multiple update searches using the same search terms through October 2013 using a computer-aided screening system that extends a previously described approach for facilitating systematic review updating.

Results
The systematic review identified 12,678 titles, and through the screening process, we identified 236 studies meeting the eligibility criteria: assessing the effect of health IT on healthcare quality, safety, and efficiency in ambulatory and non-ambulatory care settings. Approximately 77 percent of studies reported positive or mixed-positive findings. The effects of health IT are thought to be sensitive to the particulars of the IT system itself, the implementation process, and the context in which it is implemented, and therefore generalizations across systems and contexts must be made cautiously. Nevertheless, analyses found that neither study setting (ambulatory vs. nonambulatory), nor recognition as a health IT leader, nor commercial status were significantly associated with outcome results. However, studies of efficiency were significantly less likely to report positive results than studies of safety or quality, and studies that evaluated e-prescribing and multifaceted health IT interventions were significantly less likely to report positive results than studies of more targeted clinical decision support or computerized physician order entry interventions. Studies of multifaceted health IT interventions and studies of efficiency have structural challenges that make conclusive results more difficult to obtain than more studies of more narrowly targeted health IT interventions assessing quality or safety outcomes

Conclusions
Overall, a majority of studies that evaluated the effects of health IT on healthcare quality, safety, and efficiency reported findings that were at least partially positive. These studies evaluated several forms of health IT: metrics of satisfaction, care process, and cost and health outcomes across many different care settings. Our findings agree with previous health IT literature reviews suggesting that health IT, particularly those functionalities included in the Meaningful Use regulation, can improve healthcare quality and safety. The relationship between health IT and efficiency is complex and remains poorly documented or understood, particularly in terms of healthcare costs, which are highly dependent upon the care delivery and financial context in which the technology is implemented.

We identified two broad themes in this review. First, the published literature on health IT is expanding rapidly, driven primarily by studies of commercial health IT systems. Second, much of the health IT literature still suffers from methodological and reporting problems that limit our ability to draw firm conclusions about why the intervention and/or its implementation succeeded or failed to meet expectations, and their generalizability to other contexts. Studies of health IT must be designed, conducted, and reported in ways that allow stakeholders to understand study results and how they can replicate or improve on those results.

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Standards and Certification Regulations – Office of the National Coordinator for Health IT (ONC) – 21 February 2014

Posted on February 25, 2014. Filed under: Health Informatics | Tags: , |

Standards and Certification Regulations – Office of the National Coordinator for Health IT (ONC) – 21 February 2014

“The 2015 Edition Proposed Rule begins ONC’s shift to a more incremental and frequent approach to publishing proposed and final rules that respond to stakeholder feedback more effectively, make “bug fixes” and regulatory improvements, and enhance interoperability.

The proposed rule will be published in the Federal Register on February 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.”

ONC Fact Sheet: Voluntary 2015 Edition EHR Certification Criteria (“2015 Edition”) Proposed Rule

News release: Next edition of electronic health record technology certification criteria issued – 21 February 2014

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SAFER Guides – Safety Assurance Factors for EHR Resilience – Office of the National Coordinator for Health Information Technology – 15 January 2014

Posted on January 16, 2014. Filed under: Health Informatics, Patient Safety | Tags: , , |

SAFER Guides – Safety Assurance Factors for EHR Resilience – Office of the National Coordinator for Health Information Technology – 15 January 2014

“The SAFER guides consist of nine guides organized into three broad groups. These guides enable healthcare organizations to address EHR safety in a variety of areas. Most organizations will want to start with the Foundational Guides, and proceed from there to address their areas of greatest interest or concern. The guides identify recommended practices to optimize the safety and safe use of EHRs. The content of the guides can be explored here, at the links below, or interactive PDF versions of the guides can be downloaded and completed locally for self-assessment of an organization’s degree of conformance to the Recommended Practices. The downloaded guides can be filled out, saved, and transmitted between team members.”

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Patient Consent for Electronic Health Information Exchange – Office of the National Coordinator for Health Information Technology

Posted on September 19, 2013. Filed under: Health Informatics, Medical Records, Patient Participation | Tags: , , |

Patient Consent for Electronic Health Information Exchange – Office of the National Coordinator for Health Information Technology

“Electronic health information exchange (eHIE) — the way that health care providers share and access health information using their computers — is changing rapidly. One way some providers share and access information is through a third-party organization called a health information exchange organization (HIE).

HIEs help route information among various participating providers. In some HIEs, a provider can send out an electronic broadcast query that asks all provider participants whether they have information on a specific patient.

As eHIE increases, patient trust in HIEs must be ensured and patients may more often be asked to make a “consent decision.” This consent decision concerns the sharing and accessing of the patient’s health information through an HIE for treatment, payment, and health care operations purposes. When patients are asked to make consent decisions, we encourage providers, HIEs, and other health IT implementers to help patients make the consent decision meaningful.

Implementers can enable meaningful consent by ensuring they consider the key parts displayed in the image to the right.”

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Building a Foundation of Electronic Data to Measure and Drive Improvement – ONC – August 2013

Posted on August 22, 2013. Filed under: Health Informatics | Tags: , |

Building a Foundation of Electronic Data to Measure and Drive Improvement – ONC – August 2013

Using Electronic Health Records and Other Health IT Tools to Measure and Improve Quality of Care: Lessons Learned from the Beacon Communities – News – 19 August 2013

“Using electronic health records and other health IT tools to improve quality measurement for better patient care is essential to support ongoing quality improvement efforts.

Today ONC released a new issue brief by AcademyHealth entitled “Building a Foundation of Electronic Data to Measure and Drive Improvement.” It highlights the importance of data in measuring and improving care.”

… continues

 

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EHR contracts: key contract terms for users to understand – Prepared by Westat for The Office of the National Coordinator for Health Information Technology – 25 June 2013

Posted on August 6, 2013. Filed under: Health Informatics | Tags: , , |

EHR contracts: key contract terms for users to understand – Prepared by Westat for The Office of the National Coordinator for Health Information Technology – 25 June 2013

“This document explains a few key EHR contract terms and what you need to know about them. Understanding these terms may help you select an appropriate EHR system and protect your practice or organization from business and patient safety risks that may arise when you rely upon EHRs for critical aspects of your operations. It should help you make sure that your EHR system does what you expect and that you have ways to manage issues as they arise. If you misunderstand these terms you may not be able to rely on your contract to help prevent disruptions to your practice.”

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Health Information Technology: Patient Safety Action & Surveillance Plan – [US] Office of the National Coordinator for Health Information Technology (ONC) – 1 July 2013

Posted on July 3, 2013. Filed under: Health Informatics, Patient Safety | Tags: , |

Health Information Technology: Patient Safety Action & Surveillance Plan – [US] Office of the National Coordinator for Health Information Technology (ONC) – 1 July 2013

“This Health IT Patient Safety Action and Surveillance Plan (the “Health IT Safety Plan” or “Plan”) addresses the role of health IT within HHS’s commitment to patient safety. Building on the IOM committee’s recommendations, the Plan leverages existing authorities to strengthen patient safety efforts across government programs and the private sector—including patients, health care providers, technology companies, and health care safety oversight bodies. Importantly, the Plan outlines specific and tangible actions through which all stakeholders can fulfill their shared obligation to increase knowledge of the impact of health IT on patient safety, and maximize the safety of health IT and health IT-assisted care.”

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Strengthening Health Information Exchange: Final Report HIE Unintended Consequences Work Group – 18 September 2012

Posted on May 13, 2013. Filed under: Health Informatics | Tags: , |

Strengthening Health Information Exchange: Final Report HIE Unintended Consequences Work Group – 18 September 2012

Prepared for: The Office of the National Coordinator for Health Information Technology, Prepared by: Westat, Rockville, Maryland

Authors: Julie J. McGowan, Ph.D., FACMI, FMLA Gilad J. Kuperman, MD, Ph.D., FACMI Lois Olinger, MA Cynthia Russell, MSN, RN

Extract from the Executive Summary:

“This report describes the deliberations of Health Information Exchange Unintended Consequences Work Group (HIE UC WG), a subgroup of Unintended Consequences Technical Expert Panel (TEP), which was chartered by ONC. The HIE UC WG consisted of the authors of this report and 5 other experts selected for their knowledge and experience with HIE.

The charge to the HIE UC WG was to (i) develop a framework to categorize the kinds of UCs that can occur from the use of HIE, and (ii) develop a list of approaches that could be used to mitigate the risks of UCs from HIE. The HIE UC WG prioritized UCs that relate directly or indirectly to clinical care or that impact organizations or providers engaged in HIE. Because of other work that was being done by ONC, the HIE UC WG did not directly address unintended consequences related to privacy and security risks as they impact patients outside the care setting.”

“The results of the HIE UC WG are presented in this report and are summarized in Table 1 which lists mitigating interventions by project implementation phase. There are seven categories of unintended consequences:
(i) Incomplete, inaccurate or untimely data provided by HIE,
(ii) Problems related to data presentation, including data overload,
(iii) Heterogeneity of use of HIE,
(iv) Patient perceptions or concerns about HIE,
(v) Reputational and financial risks to organizations and providers engaged in HIE,
(vi) Vulnerability to technically related unintended consequences, and
(vii) Unintended consequences of administration of HIE.”

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White House Summit on Achieving eHealth Equity – Office of the National Coordinator for Health Information Technology (ONC) [US] – April 2013

Posted on May 6, 2013. Filed under: Health Informatics | Tags: , , |

White House Summit on Achieving eHealth Equity – Office of the National Coordinator for Health Information Technology (ONC) [US] – April 2013

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Governance Framework for Trusted Electronic Health Information Exchange – Office of the National Coordinator for Health Information Technology (ONC) [US] – April 2013

Posted on May 6, 2013. Filed under: Health Informatics | Tags: , |

Governance Framework for Trusted Electronic Health Information Exchange – Office of the National Coordinator for Health Information Technology (ONC) [US] – April 2013

“Enabling electronic health information exchange (HIE) requires consensus among multiple stakeholders. Often, complex technical and policy choices are required and, ultimately, governance is established to provide oversight and to hold accountable the parties responsible for exchanging electronic health information. The Governance Framework for Trusted Electronic Health Information Exchange (the Governance Framework) is intended to serve as the Office of the National Coordinator for Health Information Technology’s (ONC’s) guiding principles on HIE governance. It is meant to provide a common conceptual foundation applicable to all types of governance models and expresses the principles ONC believes are most important for HIE governance. The Governance Framework does not prescribe specific solutions but lays out milestones and outcomes that ONC expects for and from HIE governance entities as they enable electronic HIE.”

… continues

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Improving Transitions of Care in LTPAC: An Update from the Theme 2 Challenge Grant Awardees – Office of the National Coordinator for Health Information Technology – 21 March 2013

Posted on April 2, 2013. Filed under: Chronic Disease Mgmt, Health Informatics | Tags: , |

Improving Transitions of Care in LTPAC: An Update from the Theme 2 Challenge Grant Awardees – Office of the National Coordinator for Health Information Technology – 21 March 2013

LTPAC = long-term and post-acute care

“the grantees have identified strategies and approaches that can be widely adopted by communities seeking to improve transitions of care to and from LTPAC providers:
• Common processes and appropriate connection points for clinical information transfer between hospitals and LTPAC providers
• Recommendations for hospital and LTPAC provider data needs
• Strategies to promote the use of standards based technology to create, transmit and view clinical documents of relevance to LTPAC
• Approaches to engage LTPAC providers where they are today across the health IT adoption spectrum (from high adoption to no adoption)

In addition, the grantees have encountered challenges that will need to be addressed by any community seeking to address this issue:
• Uneven adoption of non-certified electronic health records makes connections between acute and post acute care providers challenging and labor intensive
• High staff turnover rates create implementation and ongoing operational challenges”

… continues

 

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Health IT in long-term and post-acute care – The Office of the National Coordinator for Health Information Technology [US] – 15 March 2013

Posted on March 19, 2013. Filed under: Chronic Disease Mgmt, Health Informatics | Tags: , |

Health IT in long-term and post-acute care – The Office of the National Coordinator for Health Information Technology [US] – 15 March 2013

“This issue brief provides an overview of the opportunities for long-term and post-acute care (LTPAC) providers to use health information technology (IT) to improve care delivery and health outcomes while reducing total cost of care. The first section defines the issue. The second section provides background information on the current landscape of health IT in LTPAC and an overview of the challenges and opportunities to improve care coordination and patient outcomes through the use of health IT in LTPAC settings. The third section highlights promising examples of how health IT tools and standards-based health information exchange (HIE) are enabling patient-centered care. The fourth section summarizes many health care transformation programs that represent opportunities for LTPAC providers to be integrated into health IT-enabled health care delivery and payment programs. The fifth section summarizes the key considerations for the LTPAC community today in deciding how to use health IT to transform care and the sixth and final section provides suggestions for additional resources to aid the LTPAC community as providers implement tools and standards-based HIE.”

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Consumer Innovation Challenge: Final Report – Office of the National Coordinator for Health Information Technology – February 2013

Posted on March 11, 2013. Filed under: Health Informatics, Patient Participation | Tags: , |

Consumer Innovation Challenge: Final Report – Office of the National Coordinator for Health Information Technology – February 2013

Prepared for: Office of the National Coordinator for Health Information Technology, U.S. Department of Health and Human Services
Prepared by: RTI International

“The Consumer Innovation Challenge (CIC) project convened representatives from the Health Information Exchange (HIE) cooperative agreement programs in Georgia, Indiana, Montana, and Nebraska to collaborate on ground-breaking approaches to consumer engagement via health IT. Specifically, the challenge asked each state to execute innovative approaches to sharing electronic health information with consumers and enable consumer-mediated exchange through which patients can aggregate, use, and share their own electronic health information.”

… continues

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Health IT and Patient Safety – Office of the National Coordinator for Health Information Technology (ONC) [US] – 21 December 2012

Posted on January 2, 2013. Filed under: Health Informatics, Patient Safety | Tags: , |

Health IT and Patient Safety – Office of the National Coordinator for Health Information Technology (ONC) [US] – 21 December 2012

“On December 21, 2012, the Office of the National Coordinator for Health Information Technology (ONC) issued the Health IT Patient Safety Action and Surveillance Plan for public comment.”

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Patient Safety and Health Information Technology – Institute of Medicine new area of activity – 29 September 2010

Posted on October 4, 2010. Filed under: Health Informatics, Patient Safety | Tags: , |

Patient Safety and Health Information Technology – Institute of Medicine new area of activity – 29 September 2010

“The IOM will review the available evidence and the experience from the field on how the use of health information technology (HIT) affects the safety of patient care and make recommendations on how public and private actors can maximize the safety of HIT-assisted health care services. The IOM’s final report will be both comprehensive and specific in terms of recommended options and opportunities for public and private interventions that may improve the safety of care that incorporates the use EHRs and other forms of HIT.”

Extract fom the ONC press release:

“The Institute of Medicine (IOM) will conduct a 1-year study aimed at ensuring that health information technology (HIT) will achieve its full potential for improving patient safety in health care.  The study will be carried out under a $989,000 contract announced today by the Office of the National Coordinator for Health Information Technology (ONC), which is charged with coordinating federal efforts regarding HIT adoption and meaningful use.

            “Since 1999, when the IOM published its ground-breaking study To Err Is Human, the Institute has been a leader in the movement to improve patient safety,” said David Blumenthal, M.D., national coordinator for health information technology.  “This study will draw on IOM’s depth of knowledge in this area to help all of us ensure that HIT reaches the goals we are seeking for patient safety improvement.” “

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